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Sample records for adults receiving combination

  1. Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults

    MedlinePlus

    ... 08, 2015* Combinations of types of mental health services received in the past year among young adults Combinations of types of mental health services received in the past year among young adults ...

  2. Persistently Elevated Serum Interleukin-6 Predicts Mortality Among Adults Receiving Combination Antiretroviral Therapy in Botswana: Results from a Clinical Trial

    PubMed Central

    McDonald, Bethan; Moyo, Sikhulile; Gabaitiri, Lesego; Gaseitsiwe, Simani; Bussmann, Hermann; Koethe, John R.; Musonda, Rosemary; Makhema, Joseph; Novitsky, Vladimir; Marlink, Richard G.; Wester, C. William

    2013-01-01

    Abstract Elevated serum levels of inflammatory biomarkers have been associated with increased mortality and morbidity among HIV-infected individuals receiving combination antiretroviral therapy (cART) in European and U.S. cohorts. Few similar data are available from sub-Saharan Africa, where most cART-treated adults reside and the prevalence of advanced immunosuppression and opportunistic infections (OIs) at cART initiation is higher. This was a retrospective nested case-control analysis of clinical trial data from the completed Adult Antiretroviral Treatment and Drug Resistance (“Tshepo”) study, 2002–2007, Gaborone, Botswana. We measured pretreatment serum levels of interleukin-6 (IL-6), high sensitivity C-reactive protein, and D-dimer in stored plasma samples from 32 deceased participants (cases) and 64 survivors (controls), matched for age, sex, baseline CD4+ cell count, and plasma HIV-1 RNA. Multivariate conditional logistic regression analyses were used to compare inflammatory biomarker levels, adjusting for pretreatment body mass index (BMI) and the presence of OIs. A total of 37 (5.7%) of 650 patients died on study, for a crude mortality rate of 20.6/1,000 person-years. Of 37 (86%) study participants who died on study 32 were included in this analysis. Causes of death (n=32) included non-AIDS-defining events (31.3%), HIV-related OIs (28.1%), cART/toxicity-related (21.9%), other infectious etiologies (15.6%), and unknown (3.1%). Median time to death was 31 weeks [interquartile range (IQR) 14–64]. Median baseline levels of all three biomarkers were higher in cases compared to matched controls. After adjusting for BMI and the presence of OIs, only baseline and most recent (near time of event) levels of IL-6 remained as significant predictors of all-cause mortality [adjusted OR (aOR)=1.25, 95% CI (1.05–1.48); p=0.012; and aOR=1.48 (1.05–2.09); p=0.027, respectively]. Serum IL-6 levels are important predictors of all-cause mortality in this adult

  3. Health-related quality of life of HIV-infected adults receiving combination antiretroviral therapy in Addis Ababa.

    PubMed

    Mekuria, Legese A; Sprangers, Mirjam A G; Prins, Jan M; Yalew, Alemayehu W; Nieuwkerk, Pythia T

    2015-01-01

    Health-related quality of life (HRQoL) is an important outcome measure among HIV-infected patients receiving combination antiretroviral therapy (cART), but has not been studied extensively in resource-limited settings. Insight in the predictors or correlates of poor HRQoL may be helpful to identify patients most in need of additional support and to design appropriate interventions. A cross-sectional study was conducted between September 2012 and April 2013 in 10 healthcare facilities in Addis Ababa, Ethiopia. Patients who were at least 6 months on cART were randomly selected and individual patient data were retrieved from medical records. HRQoL was measured by the WHOQoL-HIVBREF, depressive-symptoms by the Kessler-6 scale, and stigma by the Kalichman internalized AIDS-related stigma scale. Multivariate linear regression analysis was carried-out to examine associations between HRQoL and the other variables. A total of 664 patients (response-rate 95%) participated in the study. A higher level of depressive-symptoms was most strongly and consistently associated with a lower HRQoL, both in terms of the magnitude of the relationship and in the number of HRQoL domains associated with it. Also, a higher level of HIV-stigma was associated with a lower HRQoL except for the physical domain, while obtaining sufficient nutritious food and job opportunity were associated with a better HRQoL except for the spiritual and social domains, respectively. Demographics, clinical, and treatment characteristics yielded few significant associations with HRQoL. Our study findings suggest that interventions to improve HRQoL should focus on reducing depressive-symptoms and HIV-stigma, and on enhancing food security and job opportunity. PMID:25782603

  4. Non-AIDS-defining events among HIV-1-infected adults receiving combination antiretroviral therapy in resource-replete versus resource-limited urban setting

    PubMed Central

    Wester, C. William; Koethe, John R.; Shepherd, Bryan E.; Stinnette, Samuel E.; Rebeiro, Peter F.; Kipp, Aaron M.; Hong, Hwanhee; Bussmann, Hermann; Gaolathe, Tendani; McGowan, Catherine C.; Sterling, Timothy R.; Marlink, Richard G.

    2011-01-01

    Objective To compare incidence and distribution of non-AIDS-defining events (NADEs) among HIV-1-infected adults receiving combination antiretroviral therapy (cART) in urban sub-Saharan African versus United States settings. Design Retrospective cohort analysis of clinical trial and observational data. Methods Compared crude and standardized (to US cohort by age and sex) NADE rates from two urban adult HIV-infected cART-initiating populations: a clinical trial cohort in Gaborone, Botswana (Botswana) and an observational cohort in Nashville, Tennessee (USA). Results Crude NADE incidence rates were similar: 10.0 [95% confidence interval 6.3–15.9] per 1000 person-years in Botswana versus 12.4 [8.4–18.4] per 1000 person-years in the United States. However, after standardizing to an older, predominantly male US population, the overall NADE incidence rates were higher in Botswana [18.7 (8.3–33.1) per 1000 person-years]. Standardized rates differed most for cardiovascular events (8.4 versus 5.0 per 1000 person-years) and non-AIDS-defining malignancies (8.0 versus 0.5 per 1000 person-years) – both higher in Botswana. Conversely, hepatic NADE rates were higher in the United States (4.0 versus 0.0 per 1000 person-years), whereas renal NADE rates [3.0 per 1000 person-years (United States) versus 2.4 per 1000 person-years (Botswana)] were comparable. Conclusion Crude NADE incidence rates were similar between cART-treated patients in a US observational cohort and a sub-Saharan African clinical trial. However, when standardized to the US cohort, overall NADE rates were higher in Botswana. NADEs appear to be a significant problem in our sub-Saharan African setting, and the monitoring, prevention, and treatment of NADEs should be a critical component of care in resource-limited settings. PMID:21572309

  5. Percentage of Adults Who Receive Colorectal Cancer Screening as Appropriate

    MedlinePlus

    ... Appropriate Percentage of Adults Who Receive Colorectal Cancer Screening as Appropriate Colorectal cancer is the second leading ... Percentage of Adults Who Receive Recommended Colorectal Cancer Screening by Age Group 78pm-ubty Download these data » ...

  6. Combination pharmacotherapy for adult ADHD.

    PubMed

    Adler, Lenard A; Reingold, Lisa S; Morrill, Melinda S; Wilens, Timothy E

    2006-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of adulthood. Although clinical guidelines recommend monotherapy with stimulants or atomoxetine, combination pharmacotherapy is a common practice among clinicians. There are four main situations in which combination medications may be necessary: partial response, dose-limiting side effects, associated disorders, and comorbid diagnoses. We present data from two chart reviews that support existing research on combination pharmacotherapy. Adjunct treatment of d-methylphenidate to stimulant medications extended the duration of therapeutic effect. Adjunct treatment of mirtazapine to stimulant medications reduced associated insomnia. These data support previous research that validates the use of combination pharmacotherapy for adults with ADHD. PMID:16968624

  7. Receiver Diversity Combining Using Evolutionary Algorithms in Rayleigh Fading Channel

    PubMed Central

    Akbari, Mohsen; Manesh, Mohsen Riahi

    2014-01-01

    In diversity combining at the receiver, the output signal-to-noise ratio (SNR) is often maximized by using the maximal ratio combining (MRC) provided that the channel is perfectly estimated at the receiver. However, channel estimation is rarely perfect in practice, which results in deteriorating the system performance. In this paper, an imperialistic competitive algorithm (ICA) is proposed and compared with two other evolutionary based algorithms, namely, particle swarm optimization (PSO) and genetic algorithm (GA), for diversity combining of signals travelling across the imperfect channels. The proposed algorithm adjusts the combiner weights of the received signal components in such a way that maximizes the SNR and minimizes the bit error rate (BER). The results indicate that the proposed method eliminates the need of channel estimation and can outperform the conventional diversity combining methods. PMID:25045725

  8. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if...

  9. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if...

  10. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if...

  11. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if...

  12. Hybrid solar central receiver for combined cycle power plant

    DOEpatents

    Bharathan, D.; Bohn, M.S.; Williams, T.A.

    1995-05-23

    A hybrid combined cycle power plant is described including a solar central receiver for receiving solar radiation and converting it to thermal energy. The power plant includes a molten salt heat transfer medium for transferring the thermal energy to an air heater. The air heater uses the thermal energy to preheat the air from the compressor of the gas cycle. The exhaust gases from the gas cycle are directed to a steam turbine for additional energy production. 1 figure.

  13. Hybrid solar central receiver for combined cycle power plant

    DOEpatents

    Bharathan, Desikan; Bohn, Mark S.; Williams, Thomas A.

    1995-01-01

    A hybrid combined cycle power plant including a solar central receiver for receiving solar radiation and converting it to thermal energy. The power plant includes a molten salt heat transfer medium for transferring the thermal energy to an air heater. The air heater uses the thermal energy to preheat the air from the compressor of the gas cycle. The exhaust gases from the gas cycle are directed to a steam turbine for additional energy production.

  14. Assisting the Adult Receiving Inhalation and Intravenous Therapy. Care of the Adult.

    ERIC Educational Resources Information Center

    Anoka-Hennepin Area Vocational Technical Inst., MN.

    These two units for students in a practical nursing program provide supplemental instruction in caring for adult patients receiving inhalation and intravenous therapy. Unit titles are The Administration of Intermittent Positive Pressure Breathing (IPPB RX) and Intravenous Therapy of Fluids and Blood. Each unit contains the following: objectives,…

  15. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20.332 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive...

  16. Receivers

    NASA Astrophysics Data System (ADS)

    Donnelly, H.

    1983-07-01

    Before discussing Deep Space Network receivers, a brief description of the functions of receivers and how they interface with other elements of the Network is presented. Different types of receivers are used in the Network for various purposes. The principal receiver type is used for telemetry and tracking. This receiver provides the capability, with other elements of the Network, to track the space probe utilizing Doppler and range measurements, and to receive telemetry, including both scientific data from the onboard experiments and engineering data pertaining to the health of the probe. Another type of receiver is used for radio science applications. This receiver measures phase perturbations on the carrier signal to obtain information on the composition of solar and planetary atmospheres and interplanetary space. A third type of receiver utilizes very long baseline interferometry (VLBI) techniques for both radio science and spacecraft navigation data. Only the telemetry receiver is described in detail in this document. The integration of the Receiver-Exciter subsystem with other portions of the Deep Space Network is described.

  17. Receivers

    NASA Technical Reports Server (NTRS)

    Donnelly, H.

    1983-01-01

    Before discussing Deep Space Network receivers, a brief description of the functions of receivers and how they interface with other elements of the Network is presented. Different types of receivers are used in the Network for various purposes. The principal receiver type is used for telemetry and tracking. This receiver provides the capability, with other elements of the Network, to track the space probe utilizing Doppler and range measurements, and to receive telemetry, including both scientific data from the onboard experiments and engineering data pertaining to the health of the probe. Another type of receiver is used for radio science applications. This receiver measures phase perturbations on the carrier signal to obtain information on the composition of solar and planetary atmospheres and interplanetary space. A third type of receiver utilizes very long baseline interferometry (VLBI) techniques for both radio science and spacecraft navigation data. Only the telemetry receiver is described in detail in this document. The integration of the Receiver-Exciter subsystem with other portions of the Deep Space Network is described.

  18. Determinants of Adult Functional Outcome in Adolescents Receiving Special Educational Assistance

    ERIC Educational Resources Information Center

    McGeown, H. R.; Johnstone, E. C.; McKirdy, J.; Owens, D. C.; Stanfield, A. C.

    2013-01-01

    Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance. Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood…

  19. 20 CFR 663.820 - What are the eligibility requirements for adults to receive needs-related payments?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... adults to receive needs-related payments? 663.820 Section 663.820 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE... requirements for adults to receive needs-related payments? Adults must: (a) Be unemployed, (b) Not qualify...

  20. 20 CFR 663.820 - What are the eligibility requirements for adults to receive needs-related payments?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... adults to receive needs-related payments? 663.820 Section 663.820 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE... requirements for adults to receive needs-related payments? Adults must: (a) Be unemployed, (b) Not qualify...

  1. 20 CFR 663.820 - What are the eligibility requirements for adults to receive needs-related payments?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... adults to receive needs-related payments? 663.820 Section 663.820 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE... requirements for adults to receive needs-related payments? Adults must: (a) Be unemployed, (b) Not qualify...

  2. Nearly Half Of US Adults Living With HIV Received Federal Disability Benefits In 2009.

    PubMed

    Huang, Ya-Lin A; Frazier, Emma L; Sansom, Stephanie L; Farnham, Paul G; Shrestha, Ram K; Hutchinson, Angela B; Fagan, Jennifer L; Viall, Abigail H; Skarbinski, Jacek

    2015-10-01

    The effects of HIV infection on national labor-force participation have not been rigorously evaluated. Using data from the Medical Monitoring Project and the National Health Interview Survey, we present nationally representative estimates of the receipt of disability benefits by adults living with HIV receiving care compared with the general US adult population. We found that in 2009, adults living with HIV were nine times more likely than adults in the general population to receive disability benefits. The risk of being on disability is also greater for younger and more educated adults living with HIV compared to the general population, which suggests that productivity losses can result from HIV infection. To prevent disability, early diagnosis and treatment of HIV are essential. This study offers a baseline against which to measure the impacts of recently proposed or enacted changes to Medicaid and private insurance markets, including the Affordable Care Act and proposed revisions to the Social Security Administration's HIV Infection Listings. PMID:26438741

  3. Food Insecurity and Food Choices in Rural Older Adults with Diabetes Receiving Nutrition Education via Telemedicine

    ERIC Educational Resources Information Center

    Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.

    2010-01-01

    Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…

  4. Barriers to Successful Transition for Young Adults Who Receive SSI and Their Families.

    ERIC Educational Resources Information Center

    Schuster, Jennifer L.; Timmons, Jaime Ciulla; Moloney, Mairead

    2003-01-01

    A study examined barriers to transition faced by 12 young adults with disabilities receiving Supplemental Security Income (SSI) and their families. Obstacles to transition planning that were associated with SSI included difficulties managing the receipt of SSI and unawareness of the supports available through the SSI system. (Contains references.)…

  5. Changes in Quality of Life in 7 Older Adult Patients Receiving Activator Methods Chiropractic Technique

    PubMed Central

    Russell, David G.; Kimura, Melissa N.; Cowie, Harriet R.; de Groot, Caroline M.M.; McMinn, Elise A.P.; Sherson, Matthew W.

    2016-01-01

    Objective The purpose of this case series is to report on symptomatic and quality of life (QoL) changes in 7 older adult chiropractic patients who were receiving care using Activator Methods Chiropractic Technique (AMCT). Clinical Features Seven patients were selected from 2 chiropractic offices in Auckland, New Zealand. Patients were included if they were older adults receiving AMCT care and for whom at least 2 QoL assessments had been performed. The patients, aged 69-80 years, primarily received care for a variety of musculoskeletal complaints. Intervention and Outcomes The patients reported improvements in their presenting complaints as well as a number of nonmusculoskeletal symptoms. Each patient demonstrated clinical improvements in their RAND 36-Item Short Form Health Survey (SF-36) results. The average improvement in QoL measured using a SF-36 questionnaire was 8.0 points in the physical component and 4.1 points in the mental component. Four cases had a second progress evaluation using the SF-36 and showed an overall improvement of 5.2 in the physical and 9.8 in the mental components from baseline. Conclusion This case series describes an improvement in QoL, as measured by the SF-36 instrument, as well as subjectively reported improvements in both musculoskeletal and nonmusculoskeletal symptoms in 7 older adults receiving chiropractic care. PMID:27069434

  6. Sex differences in the risk of receiving potentially inappropriate prescriptions among older adults

    PubMed Central

    Morgan, Steven G.; Weymann, Deirdre; Pratt, Brandy; Smolina, Kate; Gladstone, Emilie J.; Raymond, Colette; Mintzes, Barbara

    2016-01-01

    Objectives: to measure sex differences in the risk of receiving potentially inappropriate prescription drugs and to examine what are the factors that contribute to these differences. Design: a retrospective cohort study. Setting: community setting of British Columbia, Canada. Participants: residents of British Columbia aged 65 and older (n = 660,679). Measurements: we measured 2013 period prevalence of prescription dispensations satisfying the American Geriatrics Society's 2012 version of the Beers Criteria for potentially inappropriate medication use in older adults. We used logistic regressions to test for associations between this outcome and a number of clinical and socioeconomic factors. Results: a larger share of women (31%) than of men (26%) filled one or more potentially inappropriate prescription in the community. The odds of receiving potentially inappropriate prescriptions are associated with several clinical and socioeconomic factors. After controlling for those factors, community-dwelling women were at 16% higher odds of receiving a potentially inappropriate prescription than men (adjusted odds ratio = 1.16, 95% confidence interval = 1.12–1.21). Much of this sex difference stemmed from women's increased odds of receiving potentially inappropriate prescriptions for benzodiazepines and other hypnotics, for tertiary tricyclic antidepressants and for non-selective NSAIDs. Conclusion: there are significant sex differences in older adults' risk of receiving a potentially inappropriate prescription as a result of complex intersections between gender and other social constructs. Appropriate responses will therefore require changes in the information, norms and expectations of both prescribers and patients. PMID:27151390

  7. Combined Cognitive Training vs. Memory Strategy Training in Healthy Older Adults

    PubMed Central

    Li, Bing; Zhu, Xinyi; Hou, Jianhua; Chen, Tingji; Wang, Pengyun; Li, Juan

    2016-01-01

    As mnemonic utilization deficit in older adults associates with age-related decline in executive function, we hypothesized that memory strategy training combined with executive function training might induce larger training effect in memory and broader training effects in non-memory outcomes than pure memory training. The present study compared the effects of combined cognitive training (executive function training plus memory strategy training) to pure memory strategy training. Forty healthy older adults were randomly assigned to a combined cognitive training group or a memory strategy training group. A control group receiving no training was also included. Combined cognitive training group received 16 sessions of training (eight sessions of executive function training followed by eight sessions of memory strategy training). Memory training group received 16 sessions of memory strategy training. The results partly supported our hypothesis in that indeed improved performance on executive function was only found in combined training group, whereas memory performance increased less in combined training compared to memory strategy group. Results suggest that combined cognitive training may be less efficient than pure memory training in memory outcomes, though the influences from insufficient training time and less closeness between trained executive function and working memory could not be excluded; however it has broader training effects in non-memory outcomes. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR-OON-16007793. PMID:27375521

  8. 24 CFR 1000.150 - How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or tenants? 1000.150 Section 1000.150 Housing... receive criminal conviction information on adult applicants or tenants? (a) As required by section 208...

  9. 24 CFR 1000.150 - How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or tenants? 1000.150 Section 1000.150 Housing... receive criminal conviction information on adult applicants or tenants? (a) As required by section 208...

  10. Patterns of symptom distress in adults receiving treatment for lung cancer.

    PubMed

    Cooley, Mary E; Short, Thomas H; Moriarty, Helene J

    2002-01-01

    Knowledge of the patterns of symptom distress in adults receiving treatment for lung cancer is an important first step in developing interventions that can potentially lessen symptom distress. The purposes of this secondary analysis were to describe the changes in patterns of symptom distress over time in adults receiving treatment for lung cancer, and to examine the relationship of selected demographic and clinical characteristics to symptom distress. Complete data were available for 117 patients. The patterns of symptom distress in adults receiving treatment for lung cancer varied between treatment groups and over time. Symptom distress scores were moderate to high on entry into the study, indicating that symptom management in newly diagnosed lung cancer patients is essential and should begin early in the course of illness. Moreover, clinical interventions should be tailored to the type of treatment. Various demographic and clinical variables were weak and inconsistent predictors of symptom distress, underscoring the importance of examining the role of psychosocial factors in mediating symptom distress. PMID:12418365

  11. 20 CFR 663.820 - What are the eligibility requirements for adults to receive needs-related payments?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... adults to receive needs-related payments? 663.820 Section 663.820 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.820 What are the eligibility requirements for adults...

  12. Power and Efficiency Analysis of a Solar Central Receiver Combined Cycle Plant with a Small Particle Heat Exchanger Receiver

    NASA Astrophysics Data System (ADS)

    Virgen, Matthew Miguel

    Two significant goals in solar plant operation are lower cost and higher efficiencies. To achieve those goals, a combined cycle gas turbine (CCGT) system, which uses the hot gas turbine exhaust to produce superheated steam for a bottoming Rankine cycle by way of a heat recovery steam generator (HRSG), is investigated in this work. Building off of a previous gas turbine model created at the Combustion and Solar Energy Laboratory at SDSU, here are added the HRSG and steam turbine model, which had to handle significant change in the mass flow and temperature of air exiting the gas turbine due to varying solar input. A wide range of cases were run to explore options for maximizing both power and efficiency from the proposed CSP CCGT plant. Variable guide vanes (VGVs) were found in the earlier model to be an effective tool in providing operational flexibility to address the variable nature of solar input. Combined cycle efficiencies in the range of 50% were found to result from this plant configuration. However, a combustor inlet temperature (CIT) limit leads to two distinct Modes of operation, with a sharp drop in both plant efficiency and power occurring when the air flow through the receiver exceeded the CIT limit. This drawback can be partially addressed through strategic use of the VGVs. Since system response is fully established for the relevant range of solar input and variable guide vane angles, the System Advisor Model (SAM) from NREL can be used to find what the actual expected solar input would be over the course of the day, and plan accordingly. While the SAM software is not yet equipped to model a Brayton cycle cavity receiver, appropriate approximations were made in order to produce a suitable heliostat field to fit this system. Since the SPHER uses carbon nano-particles as the solar absorbers, questions of particle longevity and how the particles might affect the flame behavior in the combustor were addressed using the chemical kinetics software Chemkin

  13. GPS/GLONASS Combined Precise Point Positioning with Receiver Clock Modeling

    PubMed Central

    Wang, Fuhong; Chen, Xinghan; Guo, Fei

    2015-01-01

    Research has demonstrated that receiver clock modeling can reduce the correlation coefficients among the parameters of receiver clock bias, station height and zenith tropospheric delay. This paper introduces the receiver clock modeling to GPS/GLONASS combined precise point positioning (PPP), aiming to better separate the receiver clock bias and station coordinates and therefore improve positioning accuracy. Firstly, the basic mathematic models including the GPS/GLONASS observation equations, stochastic model, and receiver clock model are briefly introduced. Then datasets from several IGS stations equipped with high-stability atomic clocks are used for kinematic PPP tests. To investigate the performance of PPP, including the positioning accuracy and convergence time, a week of (1–7 January 2014) GPS/GLONASS data retrieved from these IGS stations are processed with different schemes. The results indicate that the positioning accuracy as well as convergence time can benefit from the receiver clock modeling. This is particularly pronounced for the vertical component. Statistic RMSs show that the average improvement of three-dimensional positioning accuracy reaches up to 30%–40%. Sometimes, it even reaches over 60% for specific stations. Compared to the GPS-only PPP, solutions of the GPS/GLONASS combined PPP are much better no matter if the receiver clock offsets are modeled or not, indicating that the positioning accuracy and reliability are significantly improved with the additional GLONASS satellites in the case of insufficient number of GPS satellites or poor geometry conditions. In addition to the receiver clock modeling, the impacts of different inter-system timing bias (ISB) models are investigated. For the case of a sufficient number of satellites with fairly good geometry, the PPP performances are not seriously affected by the ISB model due to the low correlation between the ISB and the other parameters. However, the refinement of ISB model weakens the

  14. GPS/GLONASS Combined Precise Point Positioning with Receiver Clock Modeling.

    PubMed

    Wang, Fuhong; Chen, Xinghan; Guo, Fei

    2015-01-01

    Research has demonstrated that receiver clock modeling can reduce the correlation coefficients among the parameters of receiver clock bias, station height and zenith tropospheric delay. This paper introduces the receiver clock modeling to GPS/GLONASS combined precise point positioning (PPP), aiming to better separate the receiver clock bias and station coordinates and therefore improve positioning accuracy. Firstly, the basic mathematic models including the GPS/GLONASS observation equations, stochastic model, and receiver clock model are briefly introduced. Then datasets from several IGS stations equipped with high-stability atomic clocks are used for kinematic PPP tests. To investigate the performance of PPP, including the positioning accuracy and convergence time, a week of (1-7 January 2014) GPS/GLONASS data retrieved from these IGS stations are processed with different schemes. The results indicate that the positioning accuracy as well as convergence time can benefit from the receiver clock modeling. This is particularly pronounced for the vertical component. Statistic RMSs show that the average improvement of three-dimensional positioning accuracy reaches up to 30%-40%. Sometimes, it even reaches over 60% for specific stations. Compared to the GPS-only PPP, solutions of the GPS/GLONASS combined PPP are much better no matter if the receiver clock offsets are modeled or not, indicating that the positioning accuracy and reliability are significantly improved with the additional GLONASS satellites in the case of insufficient number of GPS satellites or poor geometry conditions. In addition to the receiver clock modeling, the impacts of different inter-system timing bias (ISB) models are investigated. For the case of a sufficient number of satellites with fairly good geometry, the PPP performances are not seriously affected by the ISB model due to the low correlation between the ISB and the other parameters. However, the refinement of ISB model weakens the

  15. Multi-aperture digital coherent combining for free-space optical communication receivers.

    PubMed

    Geisler, David J; Yarnall, Timothy M; Stevens, Mark L; Schieler, Curt M; Robinson, Bryan S; Hamilton, Scott A

    2016-06-13

    Space-to-ground optical communication systems can benefit from reducing the size, weight, and power profiles of space terminals. One way of reducing the required power-aperture product on a space platform is to implement effective, but costly, single-aperture ground terminals with large collection areas. In contrast, we present a ground terminal receiver architecture in which many small less-expensive apertures are efficiently combined to create a large effective aperture while maintaining excellent receiver sensitivity. This is accomplished via coherent detection behind each aperture followed by digitization. The digitized signals are then combined in a digital signal processing chain. Experimental results demonstrate lossless coherent combining of four lasercom signals, at power levels below 0.1 photons/bit/aperture. PMID:27410287

  16. Solar power satellite rectenna design study: Directional receiving elements and parallel-series combining analysis

    NASA Technical Reports Server (NTRS)

    Gutmann, R. J.; Borrego, J. M.

    1978-01-01

    Rectenna conversion efficiencies (RF to dc) approximating 85 percent were demonstrated on a small scale, clearly indicating the feasibility and potential of efficiency of microwave power to dc. The overall cost estimates of the solar power satellite indicate that the baseline rectenna subsystem will be between 25 to 40 percent of the system cost. The directional receiving elements and element extensions were studied, along with power combining evaluation and evaluation extensions.

  17. 20 CFR 663.820 - What are the eligibility requirements for adults to receive needs-related payments?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the eligibility requirements for adults to receive needs-related payments? 663.820 Section 663.820 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services...

  18. Reclaiming Joy: Pilot Evaluation of a Mental Health Peer Support Program for Older Adults Who Receive Medicaid

    ERIC Educational Resources Information Center

    Chapin, Rosemary K.; Sergeant, Julie F.; Landry, Sarah; Leedahl, Skye N.; Rachlin, Roxanne; Koenig, Terry; Graham, Annette

    2013-01-01

    Purpose: Stigma and lack of access to providers create barriers to mental health treatment for older adults living in the community. In order to address these barriers, we developed and evaluated a peer support intervention for older adults receiving Medicaid services. Design and Methods: Reclaiming Joy is a mental health intervention that pairs…

  19. A Randomized, Single-Blind, Substitution Study of OROS Methylphenidate (Concerta) in ADHD Adults Receiving Immediate Release Methylphenidate

    ERIC Educational Resources Information Center

    Spencer, Thomas J.; Mick, Eric; Surman, Craig B. H.; Hammerness, Paul; Doyle, Robert; Aleardi, Megan; Kotarski, Meghan; Williams, Courtney G.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the efficacy, tolerability, and compliance of an extended-release formulation of methylphenidate (OROS-MPH) in adults with ADHD receiving immediate-release methylphenidate (IR-MPH). Method: Participants were outpatient adults with ADHD who were stable on IR-MPH-administered TID. Participants…

  20. Nutritional status changes in HIV-infected children receiving combined antiretroviral therapy including protease inhibitors.

    PubMed

    Fiore, P; Donelli, E; Boni, S; Pontali, E; Tramalloni, R; Bassetti, D

    2000-11-01

    Maintaining linear growth and weight gain in HIV-infected children is often difficult. Nutritional evaluation and support are recognised as important factors to improve their quality of life. Combination antiretroviral therapy including protease inhibitors (HAART) reduces HIV-viral load and improves survival, quality of life and nutritional status. Our study aimed to determine changes in nutrional status based on body weight, height and nutritional habits, of HIV-infected children receiving HAART. Possible side effects of lipid metabolism were also studied. Twenty five children, 13 treated with HAART (group B) were followed up for 12 months. We did not observe statistically significant differences in nutritional status over that time or between groups A and B. Inadequate energy intake was more common in patients with advanced HIV-disease. Hyperlipidemia was found in 70% of children receiving ritonavir and in approximately 50% of children receiving nelfinavir. We observed an important although not statistically significative modification in the height of those in group B. PMID:11091066

  1. An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network.

    PubMed

    Saotome, Rie; Hai, Tran Minh; Matsuda, Yasuto; Suzuki, Taisaku; Wada, Tomohisa

    2015-01-01

    In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles), AUV (autonomous underwater vehicle), divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20-28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3) and 93.750 Hz (MODE2) OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20-30%. PMID:26351656

  2. An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network

    PubMed Central

    Saotome, Rie; Hai, Tran Minh; Matsuda, Yasuto; Suzuki, Taisaku; Wada, Tomohisa

    2015-01-01

    In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles), AUV (autonomous underwater vehicle), divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20–28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3) and 93.750 Hz (MODE2) OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20–30%. PMID:26351656

  3. Comparison of Direct Sequence Spread Spectrum Rake Receiver with a Maximum Ratio Combining Multicarrier Spread Spectrum Receiver

    SciTech Connect

    Daryl Leon Wasden; Hussein Moradi; Behrouz Farhang-Broujeny

    2014-06-01

    This paper presents a theoretical analysis of the performance of a filter bank-based multicarrier spread spectrum (FB-MC-SS) system. We consider an FB-MC-SS setup where each data symbol is spread across multiple subcarriers, but there is no spreading in time. The results are then compared with those of the well-known direct sequence spread spectrum (DS-SS) system with a rake receiver for its best performance. We compare the two systems when the channel noise is white. We prove that as the processing gains of the two systems tend to infinity both approach the same performance. However, numerical simulations show that, in practice, where processing gain is limited, FB-MC-SS outperforms DS-SS.

  4. Efficacy of Olanzapine Combined Therapy for Patients Receiving Highly Emetogenic Chemotherapy Resistant to Standard Antiemetic Therapy

    PubMed Central

    Abe, Masakazu; Kasamatsu, Yuka; Kado, Nobuhiro; Kuji, Shiho; Tanaka, Aki; Takahashi, Nobutaka; Takekuma, Munetaka; Hirashima, Yasuyuki

    2015-01-01

    Objective. Olanzapine is proved to be effective for chemotherapy induced nausea and vomiting (CINV). But its efficacy in combination with standard antiemetic therapy is unknown. The purpose of this study is to prove the preventive effect of olanzapine for the prevention of CINV caused by highly emetogenic chemotherapy when used with standard antiemetic therapy. Method. Gynecologic cancer patients receiving cisplatin-based chemotherapy who had grade 2 or 3 nausea in overall phase (0–120 h after chemotherapy) despite standard therapy were assigned to this study. From the next cycles to cycles in which patients developed grade 2 or 3 nausea, they received olanzapine with standard therapy. 5 mg oral olanzapine was administered for 7 days from the day before chemotherapy. The effectiveness of preventive administration of olanzapine was evaluated retrospectively. The primary endpoint was nausea control rate (grade 0 or 1) with olanzapine. Results. Fifty patients were evaluable. The nausea control rate with olanzapine was improved from 58% to 98% in acute phase (0–24 h after chemotherapy) and 2% to 94% in delayed phase (24–120 h after chemotherapy). In overall phase, the nausea control rate improved from 0% to 92%, and it was statistically significant (P < 0.001). Conclusion. Preventive use of olanzapine combined with standard antiemetic therapy showed improvement in control of refractory nausea. PMID:26425564

  5. Driver-receiver combined optical transceiver modules for bidirectional optical interconnection

    NASA Astrophysics Data System (ADS)

    Park, Hyo-Hoon; Kang, Sae-Kyoung; Kim, Do-Won; Nga, Nguyen T. H.; Hwang, Sung-Hwan; Lee, Tae-Woo

    2008-02-01

    We review a bidirectional optical link scheme for memory-interface applications. A driver-receiver combined optical transceiver (TRx) modules was demonstrated on an optical printed-circuit board (OPCB) platform. To select the bidirectional electric input/output signals, a driver-receiver combined TRx IC with a switching function was designed in 0.18-μm CMOS technology. The TRx IC was integrated with VCSEL/PD chips for optical link in the TRx module. The optical TRx module was assembled on a fiber-embedded OPCB, employing a 90°-bent fiber connector for 90° deflection of light beams between the TRx module and the OPCB. The TRx module and the 90° connector were passively assembled on the OPCB, using ferrule-type guide pins/ holes. Employing these constituent components, the bidirectional optical link between a pair of TRx modules has been successfully demonstrated up to 1.25 Gb/s on the OPCB.

  6. Response to Booster Doses of Hepatitis B Vaccine among Young Adults Who Had Received Neonatal Vaccination

    PubMed Central

    Chan, Paul K. S.; Ngai, Karry L. K.; Lao, Terence T.; Wong, Martin C. S.; Cheung, Theresa; Yeung, Apple C. M.; Chan, Martin C. W.; Luk, Scotty W. C.

    2014-01-01

    Background Newborns who have received hepatitis B immunization in 1980s are now young adults joining healthcare disciplines. The need for booster, pre- and post-booster checks becomes a practical question. Aims The aim of this study is to refine the HBV vaccination policy for newly admitted students in the future. Methods A prospective study on medical and nursing school entrants to evaluate hepatitis B serostatus and the response to booster doses among young adults. Findings Among 212 students, 17–23-year-old, born after adoption of neonatal immunization, 2 (0.9%) were HBsAg positive, 40 (18.9%) were anti-HBs positive. At 1 month after a single-dose booster for anti-HBs-negative students, 14.5% had anti-HBs <10 mIU/mL, 29.0% and 56.5% were 10–100 and >100 mIU/mL, respectively. The anti-HBs levels were significantly higher for females than males (mean [SD]: 431 [418] vs. 246 [339] mIU/mL, P = 0.047). At 2–4 month after the third booster dose, 97.1% had anti-HBs >100 mIU/mL and 2.9% had 10–100 mIU/mL. Conclusions Pre-booster check is still worthwhile to identify carriers among newly recruited healthcare workers born after adoption of neonatal immunization. A 3-dose booster, rather than a single dose, is required for the majority to achieve an anti-HBs level >100 mIU/mL, as memory immunity has declined in a substantial proportion of individuals. Cost-effectiveness of post-booster check for anti-HBs is low and should be further evaluated based on contextual specific utilization of results. PMID:25198289

  7. Time Preferences Predict Mortality among HIV-Infected Adults Receiving Antiretroviral Therapy in Kenya

    PubMed Central

    Thirumurthy, Harsha; Hayashi, Kami; Linnemayr, Sebastian; Vreeman, Rachel C.; Levin, Irwin P.; Bangsberg, David R.; Brewer, Noel T.

    2015-01-01

    Background Identifying characteristics of HIV-infected adults likely to have poor treatment outcomes can be useful for targeting interventions efficiently. Research in economics and psychology suggests that individuals’ intertemporal time preferences, which indicate the extent to which they trade-off immediate vs. future cost and benefits, can influence various health behaviors. While there is empirical support for the association between time preferences and various non-HIV health behaviors and outcomes, the extent to which time preferences predict outcomes of those receiving antiretroviral therapy (ART) has not been examined previously. Methods HIV-infected adults initiating ART were enrolled at a health facility in Kenya. Participants’ time preferences were measured at enrollment and used to classify them as having either a low or high discount rate for future benefits. At 48 weeks, we assessed mortality and ART adherence, as measured by Medication Event Monitoring System (MEMS). Logistic regression models adjusting for socio-economic characteristics and risk factors were used to determine the association between time preferences and mortality as well as MEMS adherence ≥90%. Results Overall, 44% (96/220) of participants were classified as having high discount rates. Participants with high discount rates had significantly higher 48-week mortality than participants with low discount rates (9.3% vs. 3.1%; adjusted odds ratio 3.84; 95% CI 1.03, 14.50). MEMS adherence ≥90% was similar for participants with high vs. low discount rates (42.3% vs. 49.6%, AOR 0.70; 95% CI 0.40, 1.25). Conclusion High discount rates were associated with significantly higher risk of mortality among HIV-infected patients initiating ART. Greater use of time preference measures may improve identification of patients at risk of poor clinical outcomes. More research is needed to further identify mechanisms of action and also to build upon and test the generalizability of this finding

  8. 24 CFR 1000.150 - How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false How may Indian tribes and TDHEs receive criminal conviction information on adult applicants or tenants? 1000.150 Section 1000.150 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN...

  9. Experiences of Receiving a Diagnosis of Autism Spectrum Disorder: A Survey of Adults in the United Kingdom

    ERIC Educational Resources Information Center

    Jones, Lydia; Goddard, Lorna; Hill, Elisabeth L.; Henry, Lucy A.; Crane, Laura

    2014-01-01

    A total of 128 adults with high-functioning autism spectrum disorders were surveyed concerning the process they went through to obtain their diagnosis and the subsequent support they received. Results suggested that routes to diagnosis were quite heterogeneous and overall levels of satisfaction with the diagnostic process were mixed; 40% of…

  10. The Impact of Support Received and Support Provision on Changes in Perceived Social Support among Older Adults

    ERIC Educational Resources Information Center

    Tyler, Kimberly A.

    2006-01-01

    The current study uses longitudinal data from the 1993 U.S. Midwest floods to examine the influence of support received and support provision on changes in perceived social support among older adults exposed to an acute stressor. Results indicated that flood exposure and higher levels of social support at Time 1 were positively associated with…

  11. Nonparametric estimation receiver operating characteristic analysis for performance evaluation on combined detection and estimation tasks

    PubMed Central

    Wunderlich, Adam; Goossens, Bart

    2014-01-01

    Abstract. In an effort to generalize task-based assessment beyond traditional signal detection, there is a growing interest in performance evaluation for combined detection and estimation tasks, in which signal parameters, such as size, orientation, and contrast are unknown and must be estimated. One motivation for studying such tasks is their rich complexity, which offers potential advantages for imaging system optimization. To evaluate observer performance on combined detection and estimation tasks, Clarkson introduced the estimation receiver operating characteristic (EROC) curve and the area under the EROC curve as a summary figure of merit. This work provides practical tools for EROC analysis of experimental data. In particular, we propose nonparametric estimators for the EROC curve, the area under the EROC curve, and for the variance/covariance matrix of a vector of correlated EROC area estimates. In addition, we show that reliable confidence intervals can be obtained for EROC area, and we validate these intervals with Monte Carlo simulation. Application of our methodology is illustrated with an example comparing magnetic resonance imaging k-space sampling trajectories. MATLAB® software implementing the EROC analysis estimators described in this work is publicly available at http://code.google.com/p/iqmodelo/. PMID:26158044

  12. Nonparametric estimation receiver operating characteristic analysis for performance evaluation on combined detection and estimation tasks.

    PubMed

    Wunderlich, Adam; Goossens, Bart

    2014-10-01

    In an effort to generalize task-based assessment beyond traditional signal detection, there is a growing interest in performance evaluation for combined detection and estimation tasks, in which signal parameters, such as size, orientation, and contrast are unknown and must be estimated. One motivation for studying such tasks is their rich complexity, which offers potential advantages for imaging system optimization. To evaluate observer performance on combined detection and estimation tasks, Clarkson introduced the estimation receiver operating characteristic (EROC) curve and the area under the EROC curve as a summary figure of merit. This work provides practical tools for EROC analysis of experimental data. In particular, we propose nonparametric estimators for the EROC curve, the area under the EROC curve, and for the variance/covariance matrix of a vector of correlated EROC area estimates. In addition, we show that reliable confidence intervals can be obtained for EROC area, and we validate these intervals with Monte Carlo simulation. Application of our methodology is illustrated with an example comparing magnetic resonance imaging [Formula: see text]-space sampling trajectories. MATLAB® software implementing the EROC analysis estimators described in this work is publicly available at http://code.google.com/p/iqmodelo/. PMID:26158044

  13. Well-Being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support

    PubMed Central

    Kroemeke, Aleksandra; Gruszczynska, Ewa

    2016-01-01

    Background The aim of the study was to examine the cross-sectional and longitudinal effects of provided and received support on older adults’ subjective well-being (positive affect and depression) and to examine whether being a recipient of institutional care moderates these effects. Methods Social support (provided and received), positive affect, and depressive symptoms were assessed twice (at baseline and 1 month later) for 277 older adults (age 77.39 ± 9.20 years, 67.50% women, 65% residents of an institutional care facility). Findings Two structural equation models were analyzed: cross-sectional (at baseline) and longitudinal (after 1 month). The first model revealed a significant positive relationship between providing and receiving support and positive affect, and a negative relationship between receiving support and depression. However, being a recipient of institutional care appeared to be a significant moderator in the longitudinal model. Specifically, the findings indicated effects of both providing and receiving support on positive affect but only for noninstitutionalized older adults. Discussion Although both types of support may be beneficial for older adults, their effects depend on the nature of social exchange and the dimensions of well-being. This suggests that such factors should be systematically investigated in future research. PMID:27548721

  14. Are Older Adults Receiving Evidence-Based Advice to Prevent Falls Post-Discharge from Hospital?

    ERIC Educational Resources Information Center

    Lee, Den-Ching A.; Brown, Ted; Stolwyk, Rene; O'Connor, Daniel W.; Haines, Terry P.

    2016-01-01

    Background: Older adults experience a high rate of falls when they transition to community-living following discharge from hospital. Objectives: To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe…

  15. The impact of support received and support provision on changes in perceived social support among older adults.

    PubMed

    Tyler, Kimberly A

    2006-01-01

    The current study uses longitudinal data from the 1993 U.S. Midwest floods to examine the influence of support received and support provision on changes in perceived social support among older adults exposed to an acute stressor. Results indicated that flood exposure and higher levels of social support at Time 1 were positively associated with both receiving social support and providing social support specific to the food. Individuals with higher levels of support provision and received support in turn reported higher levels of perceived support post disaster. Women were more likely to have received flood specific support and to have perceived higher social support post flood. This study provides support and elaboration of earlier findings that link disaster exposure to post-disaster changes in perceived social support. PMID:16454481

  16. Combined teleseismic surface wave and receiver function analysis of the crust and upper mantle of Madagascar

    NASA Astrophysics Data System (ADS)

    Pratt, M. J.; Aleqabi, G. I.; Wysession, M. E.; Wiens, D. A.; Nyblade, A.; Shore, P.; Rambolamanana, G.; Tsiriandrimanana, R.; Andriampenomanana Ny Ony, F. S. T.

    2014-12-01

    The continental crust and upper mantle velocity structure beneath Madagascar remained poorly constrained until recent deployments of broadband seismic instrumentation across the island. The MACOMO (MAdagascar, COmoros and MOzambique), RHUM-RUM (Réunion Hotspot and Upper Mantle - Réunions Unterer Mantel) and the Madagascar Seismic Profile experiments have opened up this region to be studied in detail for the first time. The island is an amalgamation of an Archean craton, associated with the Western Dhawar craton of southern India, and a series of Proterozoic terranes that comprise the backbone of the island (Tucker et al., 2010). A receiver-function analysis has provided both the first Moho depth measurements and spatially discrete 1-D shear velocity results that matched well with known tectonic regions. To provide a more continuous 2-D and 3-D velocity structure map, teleseismic surface wave analysis is employed. Using Helmholtz tomography as implemented by the ASWMS package (Ge, Gaherty and Hutko; 2014), we are able to map phase velocities from the cross-correlation of station pairs at periods 20-100 s. At periods 20-40 s our results compare well with ambient noise analysis results (see poster by Wysession et al. (this meeting)). The prominent features of these results are a distinct low phase-velocity sector beneath the central Itasy region, with a secondary low phase-velocity region to the north of the island. Both the central part of the island and the northern region have experienced geothermal activity in recent times as well as volcanic activity within the last 10,000 years. This may suggest that the crust and underlying mantle in these regions remains at relatively higher temperatures than the surrounding rock. Combining this information with receiver-function analysis, we jointly invert our data for the shear velocity structure. These analyses will constrain the upper mantle seismic velocities in the region, allowing further analysis from body waves to

  17. Different tonotopic regions of the lateral superior olive receive a similar combination of afferent inputs.

    PubMed

    Gómez-Álvarez, Marcelo; Saldaña, Enrique

    2016-08-01

    The mammalian lateral superior olive (LSO) codes disparities in the intensity of the sound that reaches the two ears by integrating ipsilateral excitation and contralateral inhibition, but it remains unclear what particular neuron types convey acoustic information to the nucleus. It is also uncertain whether the known conspicuous morphofunctional differences and gradients along the tonotopic axis of the LSO relate to qualitative and/or quantitative regional differences in its afferents. To clarify these issues, we made small, single injections of the neuroanatomical tracer biotinylated dextran amine (BDA) into different tonotopic regions of the LSO of albino rats and analyzed the neurons labeled retrogradely in brainstem auditory nuclei. We demonstrate that the LSO is innervated tonotopically by four brainstem neuron types: spherical bushy cells and planar multipolar neurons of the ipsilateral ventral cochlear nucleus, principal neurons of the ipsilateral medial nucleus of the trapezoid body, and small multipolar neurons of the contralateral ventral nucleus of the trapezoid body. Unexpectedly, the proportion of labeled neurons of each type was virtually identical in all cases, thus indicating that all tonotopic regions of the LSO receive a similar combination of inputs. Even more surprisingly, our data also suggest that the representation of frequencies in the LSO differs from that of the nuclei that innervate it: compared to the latter nuclei, the LSO seems to possess a relatively larger portion of its volume devoted to processing frequencies in the lower-middle part of the spectrum, and a relative smaller portion devoted to higher frequencies. J. Comp. Neurol. 524:2230-2250, 2016. © 2015 Wiley Periodicals, Inc. PMID:26659473

  18. Characteristics and Outcomes of Young Adult Opiate Users Receiving Residential Substance Abuse Treatment.

    PubMed

    Morse, Siobhan; MacMaster, Samuel

    2015-01-01

    Opiate use patterns, user characteristics, and treatment response among young adults are of interest due to current high use prevalence and historical low levels of treatment engagement relative to older populations. Prior research in this population suggests that overall, young adults present at treatment with different issues. In this study the authors investigated potential differences between young adult (18-25 years of age) and older adult (26 and older) opiate users and the impact of differences relative to treatment motivation, length and outcomes. Data for this study was drawn from 760 individuals who entered voluntary, private, residential treatment. Study measures included the Addiction Severity Index (ASI), the Treatment Service Review (TSR), and University of Rhode Island Change Assessment (URICA). Interviews were conducted at program intake and 6-month post-discharge. Results indicate that older adults with a history of opiate use present at treatment with higher levels of severity for alcohol, medical, and psychological problems and young adults present at treatment with greater drug use and more legal issues. Significant improvement for both groups was noted at 6 months post treatment; there were also fewer differences between the two age groups of opiate users. Results suggest different strategies within treatment programs may provide benefit in targeting the disparate needs of younger opiate users. Overall, however, results suggest that individualized treatment within a standard, abstinence-based, residential treatment model can be effective across opiate users at different ages and with different issues, levels of severity, and impairment at intake. PMID:25879396

  19. Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults

    PubMed Central

    Taddio, Anna; McMurtry, C. Meghan; Halperin, Scott A.; Noel, Melanie; Pillai Riddell, Rebecca; Chambers, Christine T.

    2015-01-01

    Background: This systematic review assessed the effectiveness and safety of pharmacotherapy and combined interventions for reducing vaccine injection pain in individuals across the lifespan. Design/Methods: Electronic databases were searched for relevant randomized and quasi-randomized controlled trials. Self-reported pain and fear as well as observer-rated distress were critically important outcomes. Data were combined using standardized mean difference (SMD) or relative risk with 95% confidence intervals (CI). Results: Fifty-five studies that examined breastfeeding (which combines sweet-tasting solution, holding, and sucking), topical anesthetics, sweet-tasting solutions (sucrose, glucose), vapocoolants, oral analgesics, and combination of 2 versus 1 intervention were included. The following results report findings of analyses of critical outcomes with the largest number of participants. Compared with control, acute distress was lower for infants breastfed: (1) during vaccination (n=792): SMD −1.78 (CI, −2.35, −1.22) and (2) before vaccination (n=100): SMD −1.43 (CI, −2.14, −0.72). Compared with control/placebo, topical anesthetics showed benefit on acute distress in children (n=1424): SMD −0.91 (CI, −1.36, −0.47) and self-reported pain in adults (n=60): SMD −0.85 (CI, −1.38, −0.32). Acute and recovery distress was lower for children who received sucrose (n=2071): SMD −0.76 (CI, −1.19, −0.34) or glucose (n=818): SMD −0.69 (CI, −1.03, −0.35) compared with placebo/no treatment. Vapocoolants reduced acute pain in adults [(n=185), SMD −0.78 (CI, −1.08, −0.48)] but not children. Evidence from other needle procedures showed no benefit of acetaminophen or ibuprofen. The administration of topical anesthetics before and breastfeeding during vaccine injections showed mixed results when compared with topical anesthetics alone. There were no additive benefits of combining glucose and non-nutritive sucking (pacifier) compared with

  20. Simulated Driving Changes in Young Adults with ADHD Receiving Mixed Amphetamine Salts Extended Release and Atomoxetine

    ERIC Educational Resources Information Center

    Kay, Gary G.; Michaels, M. Alex; Pakull, Barton

    2009-01-01

    Background: Psychostimulant treatment may improve simulated driving performance in young adults with attention-deficit/hyperactivity disorder (ADHD). Method: This was a randomized, double-blind, placebo-controlled, crossover study of simulated driving performance with mixed amphetamine salts--extended release (MAS XR) 50 mg/day (Cohort 1) and…

  1. Persisting high prevalence of pneumococcal carriage among HIV-infected adults receiving antiretroviral therapy in Malawi: a cohort study

    PubMed Central

    Heinsbroek, Ellen; Tafatatha, Terence; Phiri, Amos; Ngwira, Bagrey; Crampin, Amelia C.; Read, Jonathan M.; French, Neil

    2015-01-01

    Objective: HIV-infected adults have high rates of pneumococcal carriage and invasive disease. We investigated the effect of antiretroviral therapy (ART) on pneumococcal carriage in HIV-infected adults prior to infant pneumococcal conjugate vaccine (PCV) rollout. Design: Observational cohort study. Methods: We recruited HIV-infected adults newly attending a rural HIV clinic in northern Malawi between 2008 and 2010. Nasopharyngeal samples were taken at baseline and after 6, 12, 18 and 24 months. We compared pneumococcal carriage by ART status using generalized estimated equation models adjusted for CD4+ cell count, sex, seasonality, and other potential confounders. Results: In total, 336 individuals were included, of which 223 individuals started ART during follow-up. Individuals receiving ART had higher pneumococcal carriage than individuals not receiving ART (25.9 vs. 19.8%, P = 0.03) particularly for serotypes not included in PCV13 (16.1 vs. 9.6% P = 0.003). Following adjustment, increased carriage of non-PCV13 serotypes was still observed for individuals on ART, but results for all serotypes were nonsignificant [all serotypes: adjusted risk ratio (aRR) 1.22 (0.95–1.56); non-PCV13 serotypes: aRR 1.72, 95% CI 1.13–2.62]. Conclusion: Pneumococcal carriage in HIV-infected adults in Malawi remained high despite use of ART, consistent with failure of mucosal immune reconstitution in the upper respiratory tract. There was evidence of increased carriage of non-PCV13 serotypes. HIV-infected adults on ART could remain an important reservoir for pneumococcal diversity post infant pneumococcal vaccine introduction. Control of pneumococcal disease in African HIV remains a priority. PMID:26218599

  2. Digital timing recovery combined with adaptive equalization for optical coherent receivers

    NASA Astrophysics Data System (ADS)

    Zhou, Xian; Chen, Xue; Zhou, Weiqing; Fan, Yangyang; Zhu, Hai; Li, Zhiyu

    2009-11-01

    We propose a novel equalization and timing recovery scheme, which adds an adaptive butterfly-structured equalizer in an all-digital timing recovery loop, for polarization multiplexing (POLMUX) coherent receivers. It resolves an incompatible problem that digital equalizer requires the timing recovered (synchronous) signal and Gardner timing-error detection algorithm requires the equalized signal because of its small tolerance on dispersion. This joint module can complete synchronization, equalization and polarization de-multiplexing simultaneously without any extra computational cost. Finally, we demonstrate the good performance of the new scheme in a 112-Gbit/s POLMUX-NRZ-DQPSK digital optical coherent receiver.

  3. Relationships among Young Adults' Marital Messages Received, Marital Attitudes, and Relationship Self-Efficacy

    ERIC Educational Resources Information Center

    Shurts, W. Matthew; Myers, Jane E.

    2012-01-01

    The authors examined relationships among university students' marital messages received (MMR), marital attitudes, and romantic relationship self-efficacy (RSE). Results indicated that students' marital attitudes and romantic relationship status predicted their level of RSE. The authors found differences in MMR, marital attitudes, and RSE on the…

  4. Sexual risk behaviour and viral suppression among HIV-infected adults receiving medical care in the United States

    PubMed Central

    Mattson, Christine L.; Freedman, Mark; Fagan, Jennifer L.; Frazier, Emma L.; Beer, Linda; Huang, Ping; Valverde, Eduardo E.; Johnson, Christopher; Sanders, Catherine; McNaghten, A.D.; Sullivan, Patrick; Lansky, Amy; Mermin, Jonathan; Heffelfinger, James; Skarbinski, Jacek

    2014-01-01

    Objective: To describe the prevalence and association of sexual risk behaviours and viral suppression among HIV-infected adults in the United States. Design: Cross-sectional analysis of weighted data from a probability sample of HIV-infected adults receiving outpatient medical care. The facility and patient response rates were 76 and 51%, respectively. Methods: We analysed 2009 interview and medical record data. Sexual behaviours were self-reported in the past 12 months. Viral suppression was defined as all viral load measurements in the medical record during the past 12 months less than 200 copies/ml. Results: An estimated 98 022 (24%) HIV-infected adults engaged in unprotected vaginal or anal sex; 50 953 (12%) engaged in unprotected vaginal or anal sex with at least one partner of negative or unknown HIV status; 23 933 (6%) did so while not virally suppressed. Persons who were virally suppressed were less likely than persons who were not suppressed to engage in vaginal or anal sex [prevalence ratio, 0.88; 95% confidence interval (CI), 0.82–0.93]; unprotected vaginal or anal sex (prevalence ratio, 0.85; 95% CI, 0.73–0.98); and unprotected vaginal or anal sex with a partner of negative or unknown HIV status (prevalence ratio, 0.79; 95% CI, 0.64–0.99). Conclusion: The majority of HIV-infected adults receiving medical care in the U.S. did not engage in sexual risk behaviours that have the potential to transmit HIV, and of the 12% who did, approximately half were not virally suppressed. Persons who were virally suppressed were less likely than persons who were not suppressed to engage in sexual risk behaviours. PMID:25000558

  5. Screening and risk factors of exocrine pancreatic insufficiency in critically ill adult patients receiving enteral nutrition

    PubMed Central

    2013-01-01

    Introduction Malnutrition is a frequent problem associated with detrimental clinical outcomes in critically ill patients. To avoid malnutrition, most studies focus on the prevention of inadequate nutrition delivery, whereas little attention is paid to the potential role of exocrine pancreatic insufficiency (EPI). In this trial, we aim to evaluate the prevalence of EPI and identify its potential risk factors in critically ill adult patients without preexisting pancreatic diseases. Methods In this prospective cross-sectional study, we recruited 563 adult patients with critical illnesses. All details of the patients were documented, stool samples were collected three to five days following the initiation of enteral nutrition, and faecal elastase 1 (FE-1) concentrations were assayed using an enzyme-linked immunosorbent assay kit. Blood samples were also taken to determine serum amylase and lipase activity. Results The percentages of recruited patients with EPI (FE-1 concentration <200 μg/g) and severe EPI (FE-1 concentration <100 μg/g) were 52.2% and 18.3%, respectively. The incidences of steatorrhea were significantly different (P < 0.05) among the patients without EPI, with moderate EPI (FE-1 concentration = 100 to 200 μg/g) and severe EPI (FE-1 concentration < 100 μg/g). Both multivariate logistic regression analysis and z-tests indicated that the occurrence of EPI was closely associated with shock, sepsis, diabetes, cardiac arrest, hyperlactacidemia, invasive mechanical ventilation and haemodialysis. Conclusions More than 50% of critically ill adult patients without primary pancreatic diseases had EPI, and nearly one-fifth of them had severe EPI. The risk factors for EPI included shock, sepsis, diabetes, cardiac arrest, hyperlactacidemia, invasive mechanical ventilation and haemodialysis. Trial registration NCT01753024 PMID:23924602

  6. Extensive molluscum contagiosum virus infection in a young adult receiving fingolimod.

    PubMed

    Behle, Valeria; Wobser, Marion; Goebeler, Matthias; Stoevesandt, Johanna

    2016-06-01

    Fingolimod-related viral infections have been described on several occasions since its introduction in 2010. We hereby add a report on an otherwise immunocompetent, 18-year old Caucasian man with relapsing-remitting multiple sclerosis who developed a protracted and extensive molluscum contagiosum (MC) virus infection shortly after being started on fingolimod. Wide-spread cutaneous MC infections in adult patients are considered indicative of underlying immunosuppression. Neurologists prescribing fingolimod ought to be aware of a possibly increased risk of MC, but also need to know about its relative benignity, lack of extra-cutaneous complications, and adequate treatment options. PMID:26860987

  7. Performance improvement of OFDM-FSO multi-user communication system with combined transmit frequency diversity and receive space diversity

    NASA Astrophysics Data System (ADS)

    Kumar, Pravindra; Srivastava, Anand

    2016-05-01

    Orthogonal frequency division multiplexed (OFDM) based free space optical (FSO) communication link gives improved performance because of narrow-band interference, improved robustness against fading and high bandwidth efficiency. It is further improved using transmit frequency diversity and space diversity at the receiver. In this paper, we propose to use OFDM architecture combined with spreading code in electrical domain, referred as code division multiplexed-orthogonal frequency division multiplexing (CDM-OFDM) which provides frequency diversity at the transmitter and using more than one receiver to get receive diversity. Analytical model of CDM-OFDM-FSO communication system with photo-detector space diversity using maximal ratio combining (MRC) is analyzed in the presence of turbulent atmosphere, multi-user-interference (MUI) and timing jitter. The error performance is computed in terms of receiver sensitivity and bit-error-rate (BER). In the analysis, Gamma-Gamma distribution is considered for atmospheric turbulence. The performance of OFDM-FSO link and CDM-OFDM-FSO link is compared. It is seen that for multiple users, CDM-OFDM-FSO link with transmit and receive diversity gives improved performance as compared to OFDM-FSO link.

  8. Combining ray tracing and CFD in the thermal analysis of a parabolic dish tubular cavity receiver

    NASA Astrophysics Data System (ADS)

    Craig, Ken J.; Marsberg, Justin; Meyer, Josua P.

    2016-05-01

    This paper describes the numerical evaluation of a tubular receiver used in a dish Brayton cycle. In previous work considering the use of Computational Fluid Dynamics (CFD) to perform the calculation of the absorbed radiation from the parabolic dish into the cavity as well as the resulting conjugate heat transfer, it was shown that an axi-symmetric model of the dish and receiver absorbing surfaces was useful in reducing the computational cost required for a full 3-D discrete ordinates solution, but concerns remained about its accuracy. To increase the accuracy, the Monte Carlo ray tracer SolTrace is used to perform the calculation of the absorbed radiation profile to be used in the conjugate heat transfer CFD simulation. The paper describes an approach for incorporating a complex geometry like a tubular receiver generated using CFD software into SolTrace. The results illustrate the variation of CFD mesh density that translates into the number of elements in SolTrace as well as the number of rays used in the Monte Carlo approach and their effect on obtaining a resolution-independent solution. The conjugate heat transfer CFD simulation illustrates the effect of applying the SolTrace surface heat flux profile solution as a volumetric heat source to heat up the air inside the tube. Heat losses due to convection and thermal re-radiation are also determined as a function of different tube absorptivities.

  9. Coil combination for receive array spectroscopy: Are data‐driven methods superior to methods using computed field maps?

    PubMed Central

    Robson, Matthew D.

    2015-01-01

    Purpose Combining spectra from receive arrays, particularly X‐nuclear spectra with low signal‐to‐noise ratios (SNRs), is challenging. We test whether data‐driven combination methods are better than using computed coil sensitivities. Theory Several combination algorithms are recast into the notation of Roemer's classic formula, showing that they differ primarily in their estimation of coil receive sensitivities. This viewpoint reveals two extensions of the whitened singular‐value decomposition (WSVD) algorithm, using temporal or temporal + spatial apodization to improve the coil sensitivities, and thus the combined spectral SNR. Methods Radiofrequency fields from an array were simulated and used to make synthetic spectra. These were combined with 10 algorithms. The combined spectra were then assessed in terms of their SNR. Validation used phantoms and cardiac 31P spectra from five subjects at 3T. Results Combined spectral SNRs from simulations, phantoms, and humans showed the same trends. In phantoms, the combined SNR using computed coil sensitivities was lower than with WSVD combination whenever the WSVD SNR was >14 (or >11 with temporal apodization, or >9 with temporal + spatial apodization). These new apodized WSVD methods gave higher SNRs than other data‐driven methods. Conclusion In the human torso, at frequencies ≥49 MHz, data‐driven combination is preferable to using computed coil sensitivities. Magn Reson, 2015. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Magn Reson Med 75:473–487, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic

  10. Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study

    PubMed Central

    Spoorenberg, Sophie L. W.; Wynia, Klaske; Fokkens, Andrea S.; Slotman, Karin; Kremer, Hubertus P. H.; Reijneveld, Sijmen A.

    2015-01-01

    Background Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Methods Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through “Embrace,” an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Results Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”. The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants’ ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. Conclusion The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging. PMID:26489096

  11. Perceived Discrimination in Clinical Care in a Nationally Representative Sample of HIV-Infected Adults Receiving Health Care

    PubMed Central

    Schuster, Mark A; Collins, Rebecca; Cunningham, William E; Morton, Sally C; Zierler, Sally; Wong, Myra; Tu, Wenli; Kanouse, David E

    2005-01-01

    Background Perceived discrimination in clinical settings could discourage HIV-infected people from seeking health care, adhering to treatment regimens, or returning for follow-up. Objectives This study aims to determine whether HIV-infected people perceive that physicians and other health care providers have discriminated against them. Design, Participants Cross-sectional data (1996 to 1997) from the HIV Cost and Services Utilization Study (HCSUS), which conducted in-person interviews with a nationally representative probability sample of 2,466 HIV-infected adults receiving health care within the contiguous U.S. Measurements Reports of whether health care providers have been uncomfortable with the respondent, treated the respondent as an inferior, preferred to avoid the respondent, or refused the respondent service. Questions also covered the types of providers who engaged in these behaviors. Results Twenty-six percent of HIV-infected adults receiving health care reported experiencing at least 1 of 4 types of perceived discrimination by a health care provider since becoming infected with HIV, including 8% who had been refused service. White respondents (32%) were more likely than others (27%) and Latinos (21%) and nearly twice as likely as African Americans (17%) to report perceived discrimination (P<.001). Respondents whose first positive HIV test was longer ago were also more likely to report discrimination (P<.001). Respondents who reported discrimination attributed it to physicians (54%), nurses and other clinical staff (39%), dentists (32%), hospital staff (31%), and case managers or social workers (8%). Conclusions Many HIV-infected adults believe that their clinicians have discriminated against them. Clinicians should make efforts to address circumstances that lead patients to perceive discrimination, whether real or imagined. PMID:16117747

  12. Values important to terminally ill African American older adults in receiving hospice care.

    PubMed

    Noh, Hyunjin

    2014-01-01

    While racial disparity in the use of hospice care by older African Americans is widely acknowledged, little is known about the values that they consider as important in receiving health care services along with direct experiences with having these values respected by hospice care providers. Using individual, face-to-face interviews, data were collected directly from 28 African American hospice patients about their experiences in hospice care. Content analysis was used to identify and categorize themes from multiple readings of the qualitative data. Resulting themes included: dying at home, open communications, independent decision-making, autonomy in daily life, unwillingness to be a burden, and relationships. Through the initial assessment, value preferences can be explored and then shared with hospice team members to ensure that services are provided in such a way that their values and preferences are respected. PMID:25494930

  13. Pyrosequencing Analysis Reveals Changes in Intestinal Microbiota of Healthy Adults Who Received a Daily Dose of Immunomodulatory Probiotic Strains

    PubMed Central

    Plaza-Díaz, Julio; Fernández-Caballero, Jose Ángel; Chueca, Natalia; García, Federico; Gómez-Llorente, Carolina; Sáez-Lara, María José; Fontana, Luis; Gil, Ángel

    2015-01-01

    The colon microbiota plays a crucial role in human gastrointestinal health. Current attempts to manipulate the colon microbiota composition are aimed at finding remedies for various diseases. We have recently described the immunomodulatory effects of three probiotic strains (Lactobacillus rhamnosus CNCM I-4036, Lactobacillus paracasei CNCM I-4034, and Bifidobacterium breve CNCM I-4035). The goal of the present study was to analyze the compositions of the fecal microbiota of healthy adults who received one of these strains using high-throughput 16S ribosomal RNA gene sequencing. Bacteroides was the most abundant genus in the groups that received L. rhamnosus CNCM I-4036 or L. paracasei CNCM I-4034. The Shannon indices were significantly increased in these two groups. Our results also revealed a significant increase in the Lactobacillus genus after the intervention with L. rhamnosus CNCM I-4036. The initially different colon microbiota became homogeneous in the subjects who received L. rhamnosus CNCM I-4036. While some orders that were initially present disappeared after the administration of L. rhamnosus CNCM I-4036, other orders, such as Sphingobacteriales, Nitrospirales, Desulfobacterales, Thiotrichales, and Synergistetes, were detected after the intervention. In summary, our results show that the intake of these three bacterial strains induced changes in the colon microbiota. PMID:26016655

  14. Risk Factors for Thrombocytopenia in Adult Chinese Patients Receiving Linezolid Therapy

    PubMed Central

    Chen, Chao; Guo, Dai-Hong; Cao, Xiutang; Cai, Yun; Xu, Yuanjie; Zhu, Man; Ma, Liang

    2012-01-01

    Background Linezolid (LZD), an oxazolidinone antibiotic agent, has excellent activity and bioavailability against most methicillin-sensitive and methicillin-resistant gram-positive bacteria. Although LZD is generally well tolerated, several studies have found adverse hematologic effects, of which thrombocytopenia is of most concern. Objective To investigate the risk factors for thrombocytopenia in patients who received oral or parenteral LZD therapy between February 1 and November 30, 2010. Methods Data were extracted retrospectively from the electronic medical records in our hospital information system. Thrombocytopenia was defined as either a final platelet count of <100 × 109/L (criterion 1) or a 25% reduction from the baseline platelet count (criterion 2). Risk factors were determined using logistic regression analysis, and clinical features were predicted using receiver operating characteristic curves. Results The study included 254 patients, with mean (SD) age of 59 (17.66) years. The duration of LZD therapy was 9.43 (5.63) days. Thrombocytopenia developed in 69 patients (27.2%), as defined by criterion 1, and in 127 patients (50%), as defined by criterion 2. At univariate analysis, age, weight, creatinine clearance, serum albumin concentration, baseline platelet count, daily dosage, and concomitant use of caspofungin, levofloxacin, and meropenem were significant risk factors for thrombocytopenia. At multivariate analysis and using ROC curves, daily dose ≥18.75 mg/kg, baseline platelet count ≤181 × 109/L, duration of LZD therapy ≥10 days, and concomitant use of caspofungin and levofloxacin were independent risk factors for thrombocytopenia as defined by criterion 1, whereas creatinine clearance ≤88.39 mL/min/1.73 m2, serum albumin concentration ≤33.5 g/L, daily dose ≥18.46 mg/kg, and caspofungin were independent risk factors for thrombocytopenia as defined by criterion 2. Conclusions The incidence of LZD-related thrombocytopenia in the Chinese

  15. Unpacking Sleep and Suicide in Older Adults in a Combined Online Sample

    PubMed Central

    Golding, Shea; Nadorff, Michael R.; Winer, E. Samuel; Ward, Kathryn Claire

    2015-01-01

    Objective: Duration of insomnia symptoms and nightmares are related to suicidal risk in young adults independent of current symptoms of insomnia, nightmares, anxiety, depression, and PTSD. However, this relation has yet to be examined among older adults, despite older adults being at higher risk of suicidal behavior. Further, the current study aims to replicate previous research among younger adults showing that insomnia symptoms and nightmares are associated with suicide risk independent of the interpersonal psychological theory of suicide (IPTS). Methods: The present study utilized 167 participants age 55 and older obtained by combining two independent mTurk data collections of adults in the United States. Results: In the current sample, duration of nightmares was associated with suicide risk in older adults independent of symptoms of current insomnia and nightmares, duration of insomnia, and symptoms of PTSD, anhedonia, and the IPTS. Conclusions: Our findings suggest that the duration of nightmares (i.e., how long someone has been experiencing nightmares) predict substantial variance in suicide risk among older adults in addition to the risk factors typically examined. Thus, assessment of sleep dysfunction is important when assessing suicide risk among older adults. Citation: Golding S, Nadorff MR, Winer ES, Ward KC. Unpacking sleep and suicide in older adults in a combined online sample. J Clin Sleep Med 2015;11(12):1385–1392. PMID:26194726

  16. Markerless attenuation correction for carotid MRI surface receiver coils in combined PET/MR imaging.

    PubMed

    Eldib, Mootaz; Bini, Jason; Robson, Philip M; Calcagno, Claudia; Faul, David D; Tsoumpas, Charalampos; Fayad, Zahi A

    2015-06-21

    The purpose of the study was to evaluate the effect of attenuation of MR coils on quantitative carotid PET/MR exams. Additionally, an automated attenuation correction method for flexible carotid MR coils was developed and evaluated. The attenuation of the carotid coil was measured by imaging a uniform water phantom injected with 37 MBq of 18F-FDG in a combined PET/MR scanner for 24 min with and without the coil. In the same session, an ultra-short echo time (UTE) image of the coil on top of the phantom was acquired. Using a combination of rigid and non-rigid registration, a CT-based attenuation map was registered to the UTE image of the coil for attenuation and scatter correction. After phantom validation, the effect of the carotid coil attenuation and the attenuation correction method were evaluated in five subjects. Phantom studies indicated that the overall loss of PET counts due to the coil was 6.3% with local region-of-interest (ROI) errors reaching up to 18.8%. Our registration method to correct for attenuation from the coil decreased the global error and local error (ROI) to 0.8% and 3.8%, respectively. The proposed registration method accurately captured the location and shape of the coil with a maximum spatial error of 2.6 mm. Quantitative analysis in human studies correlated with the phantom findings, but was dependent on the size of the ROI used in the analysis. MR coils result in significant error in PET quantification and thus attenuation correction is needed. The proposed strategy provides an operator-free method for attenuation and scatter correction for a flexible MRI carotid surface coil for routine clinical use. PMID:26020273

  17. Markerless attenuation correction for carotid MRI surface receiver coils in combined PET/MR imaging

    NASA Astrophysics Data System (ADS)

    Eldib, Mootaz; Bini, Jason; Robson, Philip M.; Calcagno, Claudia; Faul, David D.; Tsoumpas, Charalampos; Fayad, Zahi A.

    2015-06-01

    The purpose of the study was to evaluate the effect of attenuation of MR coils on quantitative carotid PET/MR exams. Additionally, an automated attenuation correction method for flexible carotid MR coils was developed and evaluated. The attenuation of the carotid coil was measured by imaging a uniform water phantom injected with 37 MBq of 18F-FDG in a combined PET/MR scanner for 24 min with and without the coil. In the same session, an ultra-short echo time (UTE) image of the coil on top of the phantom was acquired. Using a combination of rigid and non-rigid registration, a CT-based attenuation map was registered to the UTE image of the coil for attenuation and scatter correction. After phantom validation, the effect of the carotid coil attenuation and the attenuation correction method were evaluated in five subjects. Phantom studies indicated that the overall loss of PET counts due to the coil was 6.3% with local region-of-interest (ROI) errors reaching up to 18.8%. Our registration method to correct for attenuation from the coil decreased the global error and local error (ROI) to 0.8% and 3.8%, respectively. The proposed registration method accurately captured the location and shape of the coil with a maximum spatial error of 2.6 mm. Quantitative analysis in human studies correlated with the phantom findings, but was dependent on the size of the ROI used in the analysis. MR coils result in significant error in PET quantification and thus attenuation correction is needed. The proposed strategy provides an operator-free method for attenuation and scatter correction for a flexible MRI carotid surface coil for routine clinical use.

  18. Predictive Value of National Football League Scouting Combine on Future Performance of Running Backs and Wide Receivers.

    PubMed

    Teramoto, Masaru; Cross, Chad L; Willick, Stuart E

    2016-05-01

    The National Football League (NFL) Scouting Combine is held each year before the NFL Draft to measure athletic abilities and football skills of college football players. Although the NFL Scouting Combine can provide the NFL teams with an opportunity to evaluate college players for the upcoming NFL Draft, its value for predicting future success of players has been questioned. This study examined whether the NFL Combine measures can predict future performance of running backs (RBs) and wide receivers (WRs) in the NFL. We analyzed the 2000-09 Combine data of RBs (N = 276) and WRs (N = 447) and their on-field performance for the first 3 years after the draft and over their entire careers in the NFL, using correlation and regression analyses, along with a principal component analysis (PCA). The results of the analyses showed that, after accounting for the number of games played, draft position, height (HT), and weight (WT), the time on 10-yard dash was the most important predictor of rushing yards per attempt of the first 3 years (p = 0.002) and of the careers (p < 0.001) in RBs. For WRs, vertical jump was found to be significantly associated with receiving yards per reception of the first 3 years (p = 0.001) and of the careers (p = 0.004) in the NFL, after adjusting for the covariates above. Furthermore, HT was most important in predicting future performance of WRs. The analyses also revealed that the 8 athletic drills in the Combine seemed to have construct validity. It seems that the NFL Scouting Combine has some value for predicting future performance of RBs and WRs in the NFL. PMID:27100168

  19. The association of recent incarceration and health outcomes among HIV-infected adults receiving care in the United States.

    PubMed

    Nasrullah, Muazzam; Frazier, Emma; Fagan, Jennifer; Hardnett, Felicia; Skarbinski, Jacek

    2016-09-12

    Purpose The purpose of this paper is to describe factors associated with incarceration as well as the association between recent incarceration and HIV-related sexual risk behaviors, access to insurance, healthcare utilization (emergency department (ED) and hospital use), antiretroviral therapy (ART) prescription, and viral suppression. Design/methodology/approach Using 2009-2010 data from a cross-sectional, nationally representative three-stage sample of HIV-infected adults receiving care in the USA, the authors assessed the demographic characteristics, healthcare utilization, and clinical outcomes of HIV-infected persons who had been recently incarcerated (detention for>24 hours in the past year) using bivariate analyses. The authors used multivariable logistic regression to examine associations of recent incarceration with insurance status as well as clinical and behavioral outcomes. Findings An estimated 22,949 (95 percent confidence interval (CI) 19,062-26,836) or 5.4 percent (CI: 4.7-6.1) of all HIV-infected persons receiving care were recently incarcerated. Factors associated with recent incarceration were age <50 years, being a smoker, having high school diploma or less, being homeless, income at or below the poverty guidelines, having a geometric mean of CD4 count <500 cells/ μL, and using drugs in the past 12 months. Results from multivariable modeling indicated that incarcerated persons were more likely to use ED services, and to have been hospitalized, and less likely to have achieved viral suppression. Originality/value Recent incarceration independently predicted worse health outcomes and greater use of emergency services among HIV-infected adults currently in HIV care. Options to improve the HIV continuum of care, including pre-enrollment for healthcare coverage and discharge planning, may lead to better health outcomes for HIV-infected inmates post-release. PMID:27548016

  20. Time to treatment benefit for adult patients with Fabry disease receiving agalsidase β: data from the Fabry Registry

    PubMed Central

    Ortiz, Alberto; Abiose, Ademola; Bichet, Daniel G; Cabrera, Gustavo; Charrow, Joel; Germain, Dominique P; Hopkin, Robert J; Jovanovic, Ana; Linhart, Aleš; Maruti, Sonia S; Mauer, Michael; Oliveira, João P; Patel, Manesh R; Politei, Juan; Waldek, Stephen; Wanner, Christoph; Yoo, Han-Wook; Warnock, David G

    2016-01-01

    Background Agalsidase β is a form of enzyme replacement therapy for Fabry disease, a genetic disorder characterised by low α-galactosidase A activity, accumulation of glycosphingolipids and life-threatening cardiovascular, renal and cerebrovascular events. In clinical trials, agalsidase β cleared glycolipid deposits from endothelial cells within 6 months; clearance from other cell types required sustained treatment. We hypothesised that there might be a ‘lag time’ to clinical benefit after initiating agalsidase β treatment, and analysed the incidence of severe clinical events over time in patients receiving agalsidase β. Methods The incidence of severe clinical events (renal failure, cardiac events, stroke, death) was studied in 1044 adult patients (641 men, 403 women) enrolled in the Fabry Registry who received agalsidase β (average dose 1 mg/kg every 2 weeks) for up to 5 years. Results The incidence of all severe clinical events was 111 per 1000 person-years (95% CI 84 to 145) during the first 6 months. After 6 months, the incidence decreased and remained stable within the range of 40–58 events per 1000 patient-years. The largest decrease in incidence rates was among male patients and those aged ≥40 years when agalsidase β was initiated. Conclusions Contrary to the expected increased incidence of severe clinical events with time, adult patients with Fabry disease had decreased incidence of severe clinical events after 6 months treatment with agalsidase β 1 mg/kg every 2 weeks. Trial registration number NCT00196742. PMID:26993266

  1. Metabolic syndrome in adults who received hematopoietic stem cell transplantation for acute childhood leukemia: an LEA study.

    PubMed

    Oudin, C; Auquier, P; Bertrand, Y; Contet, A; Kanold, J; Sirvent, N; Thouvenin, S; Tabone, M-D; Lutz, P; Ducassou, S; Plantaz, D; Dalle, J-H; Gandemer, V; Beliard, S; Berbis, J; Vercasson, C; Barlogis, V; Baruchel, A; Leverger, G; Michel, G

    2015-11-01

    We evaluated prospectively the incidence and risk factors of the metabolic syndrome (MS) and its components in 170 adult patients (mean age at evaluation: 24.8±5.4 years) who received an hematopoietic stem cell transplantation for childhood ALL, n=119, or AML, n=51. TBI was carried out in 124 cases; a busulfan-based conditioning was done in 30 patients. Twenty-nine patients developed a MS (17.1%, 95% confidence intervals: 11.7-23.6). The cumulative incidence was 13.4% at 25 years of age and 35.5% at 35 years of age. A higher body mass index (BMI) before transplantation and a growth hormone deficiency were associated with increased MS risk (P=0.002 and 0.01, respectively). MS risk was similar for patients who received TBI or busulfan-based conditioning. The TBI use increased the hyperglycemia risk (odds ratio (OR): 4.7, P=0.02). Women were at the risk of developing increased waist circumference (OR: 7.18, P=0.003) and low levels of high-density lipoprotein cholesterol (OR: 2.72, P=0.007). The steroid dose was not a risk factor. The MS occurs frequently among transplanted survivors of childhood leukemia. Its incidence increases with age. Both intrinsic (BMI, gender) and extrinsic factors (TBI, alkylating agents) contribute to its etiopathogenesis. PMID:26191949

  2. Combining controlled-source seismology and receiver function information to derive 3-D Moho topography for Italy

    NASA Astrophysics Data System (ADS)

    Spada, M.; Bianchi, I.; Kissling, E.; Agostinetti, N. Piana; Wiemer, S.

    2013-08-01

    The accurate definition of 3-D crustal structures and, in primis, the Moho depth, are the most important requirement for seismological, geophysical and geodynamic modelling in complex tectonic regions. In such areas, like the Mediterranean region, various active and passive seismic experiments are performed, locally reveal information on Moho depth, average and gradient crustal Vp velocity and average Vp/Vs velocity ratios. Until now, the most reliable information on crustal structures stems from controlled-source seismology experiments. In most parts of the Alpine region, a relatively large number of controlled-source seismology information are available though the overall coverage in the central Mediterranean area is still sparse due to high costs of such experiments. Thus, results from other seismic methodologies, such as local earthquake tomography, receiver functions and ambient noise tomography can be used to complement the controlled-source seismology information to increase coverage and thus the quality of 3-D crustal models. In this paper, we introduce a methodology to directly combine controlled-source seismology and receiver functions information relying on the strengths of each method and in relation to quantitative uncertainty estimates for all data to derive a well resolved Moho map for Italy. To obtain a homogeneous elaboration of controlled-source seismology and receiver functions results, we introduce a new classification/weighting scheme based on uncertainty assessment for receiver functions data. In order to tune the receiver functions information quality, we compare local receiver functions Moho depths and uncertainties with a recently derived well-resolved local earthquake tomography-derived Moho map and with controlled-source seismology information. We find an excellent correlation in the Moho information obtained by these three methodologies in Italy. In the final step, we interpolate the controlled-source seismology and receiver functions

  3. Changes in bone marrow morphology in adults receiving romiplostim for the treatment of thrombocytopenia associated with primary immune thrombocytopenia.

    PubMed

    Janssens, Ann; Rodeghiero, Francesco; Anderson, David; Chong, Beng H; Boda, Zoltán; Pabinger, Ingrid; Červinek, Libor; Terrell, Deirdra R; Wang, Xuena; Franklin, Janet

    2016-06-01

    The effects of romiplostim on bone marrow morphology were evaluated in adults with immune thrombocytopenia (ITP). Patients with platelet counts <50 × 10(9)/L, ≥1 prior ITP therapies, and no collagen at baseline received weekly subcutaneous romiplostim starting at 1 μg/kg, adjusted to maintain platelet counts between 50 and 200 × 10(9)/L. Biopsies were scheduled after 1, 2, or 3 years of romiplostim (cohorts 1, 2, and 3, respectively). Irrespective of scheduled time, biopsies were performed earlier if patients discontinued or failed to achieve/maintain a response to romiplostim. Reticulin (silver stain) and collagen (trichrome stain) were graded by two hematopathologists using the modified Bauermeister scale (0-4). Of 169 patients, 131 had evaluable biopsies; 9/131 (6.9 %) had increases of ≥2 grades on the modified Bauermeister scale (cohort 1: 0/34; cohort 2: 2/39; cohort 3: 7/58), including two with collagen. Three of the nine patients had follow-up biopsies, including one patient with collagen; changes were reversible after romiplostim discontinuation. Of the nine patients, one had neutropenia detected by laboratory test and two had adverse events of anemia, both non-serious and not treatment-related. By actual exposure (as some biopsies did not occur as scheduled), the number of patients with grade increases ≥2 were year 1: 3/41, year 2: 1/38, year 3: 5/52. Twenty-four patients sustained platelet counts ≥50 × 10(9)/L for ≥6 months with no ITP medications after discontinuing romiplostim, i.e., they entered clinical remission of their ITP. In conclusion, in patients with ITP receiving romiplostim, bone marrow changes were observed in a small proportion of patients.ClinicalTrials.gov identifier: NCT#00907478. PMID:27130310

  4. Stereotactic Radiosurgery for Melanoma Brain Metastases in Patients Receiving Ipilimumab: Safety Profile and Efficacy of Combined Treatment

    SciTech Connect

    Kiess, Ana P.; Wolchok, Jedd D.; Barker, Christopher A.; Postow, Michael A.; Tabar, Viviane; Huse, Jason T.; Chan, Timothy A.; Yamada, Yoshiya; Beal, Kathryn

    2015-06-01

    Purpose: Ipilimumab (Ipi), a monoclonal antibody against cytotoxic T-lymphocyte antigen-4, has been shown to improve survival in patients with metastatic melanoma. In this single-institution study, we investigated the safety and efficacy of stereotactic radiosurgery (SRS) for patients with melanoma brain metastases (BMs) who also received Ipi. Methods and Materials: From 2005 to 2011, 46 patients with melanoma received Ipi and underwent single-fraction SRS for BMs. A total of 113 BMs (91% intact, 9% postoperative) were treated with a median dose of 21 Gy (range, 15-24 Gy). Ipi was given at 3 mg/kg (54%) or 10 mg/kg (46%) for a median of 4 doses (range, 1-21). Adverse events were recorded with the use of the Common Terminology Criteria for Adverse Events 3.0. Kaplan-Meier methods were used to estimate survival, and Cox regression was used to investigate associations. Results: Fifteen patients received SRS during Ipi, 19 received SRS before Ipi, and 12 received SRS after Ipi. Overall survival (OS) was significantly associated with the timing of SRS/Ipi (P=.035) and melanoma-specific graded prognostic assessment (P=.013). Patients treated with SRS during or before Ipi had better OS and less regional recurrence than did those treated with SRS after Ipi (1-year OS 65% vs 56% vs 40%, P=.008; 1-year regional recurrence 69% vs 64% vs 92%, P=.003). SRS during Ipi also yielded a trend toward less local recurrence than did SRS before or after Ipi (1-year local recurrence 0% vs 13% vs 11%, P=.21). On magnetic resonance imaging, an increase in BM diameter to >150% was seen in 50% of patients treated during or before Ipi but in only 13% of patients treated after Ipi. Grade 3 to 4 toxicities were seen in 20% of patients. Conclusion: Overall, the combination of Ipi and SRS appears to be well tolerated. Concurrent delivery of Ipi and SRS is associated with favorable locoregional control and possibly longer survival. It may also cause a temporary increase in tumor size, possibly

  5. Prevalence of 'being at risk of malnutrition' and associated factors in adult patients receiving nursing care at home in Belgium.

    PubMed

    Geurden, Bart; Franck MPsych, Erik; Lopez Hartmann, Maja; Weyler, Joost; Ysebaert, Dirk

    2015-10-01

    Malnutrition is a known problem in hospitals and nursing homes. This study aims to evaluate the prevalence of being at risk of malnutrition in community living adults receiving homecare nursing and to determine factors independently associated with this risk of malnutrition. Furthermore, it also aimed to describe aspects of current nutritional nursing care. Patients (n = 100) are screened with the Malnutrition Universal Screening Tool to evaluate their risk of malnutrition. A patient survey was used to analyse associated factors. In this population, 29% are at risk for malnutrition. Following a multivariate logistic regression analysis, 'loss of appetite' proved the most important factor. A survey for nurses (n = 61) revealed low awareness, poor knowledge, poor communication between stakeholders and a moderate approach of malnutrition. These findings should encourage homecare nurses to use a recommended screening tool for malnutrition and to actively observe and report loss of appetite to initiate the prescription of individual tailored interventions. Belgian homecare nurses' management does not yet fully comply with international recommendations. Additional training in nutritional nursing care and screening methods for malnutrition is needed. Systematic screening should be further developed and evaluated in this at-risk population. PMID:24810494

  6. Cancer-related pain in older adults receiving palliative care: Patient and family caregiver perspectives on the experience of pain

    PubMed Central

    McPherson, Christine J; Hadjistavropoulos, Thomas; Lobchuk, Michelle M; Kilgour, Kelly N

    2013-01-01

    BACKGROUND: Despite an emphasis on pain management in palliative care, pain continues to be a common problem for individuals with advanced cancer. Many of those affected are older due to the disproportionate incidence of cancer in this age group. There remains little understanding of how older patients and their family caregivers perceive patients’ cancer-related pain, despite its significance for pain management in the home setting. OBJECTIVES: To explore and describe the cancer pain perceptions and experiences of older adults with advanced cancer and their family caregivers. METHODS: A qualitative descriptive approach was used to describe and interpret data collected from semistructured interviews with 18 patients (≥65 years of age) with advanced cancer receiving palliative care at home and their family caregivers. RESULTS: The main category ‘Experiencing cancer pain’ incorporated three themes. The theme ‘Feeling cancer pain’ included the sensory aspects of the pain, its origin and meanings attributed to the pain. A second theme, ‘Reacting to cancer pain’, included patients’ and family caregivers’ behavioural, cognitive (ie, attitudes, beliefs and control) and emotional responses to the pain. A third theme, ‘Living with cancer pain’ incorporated individual and social-relational changes that resulted from living with cancer pain. CONCLUSIONS: The findings provide an awareness of cancer pain experienced by older patients and their family caregivers within the wider context of ongoing relationships, increased patient morbidity and other losses common in the aged. PMID:23957019

  7. Prognostic factors for health-related quality of life in adults and children with primary antibody deficiencies receiving SCIG home therapy.

    PubMed

    Gardulf, A; Borte, M; Ochs, H D; Nicolay, U

    2008-01-01

    The aims of the present study were to evaluate the health-related quality of life (HRQL) and treatment satisfaction (TS) of adults and children with primary antibody deficiencies (PAD) before and after the introduction of subcutaneous immunoglobulin G (SCIG) self-infusions at home and to identify prognostic factors (demographic/social, medical, patient/parent reported) for HRQL. 85 adults and 21 parents of children with PAD answered the SF-36 (adults), CHQ-PF50 (parents), and the LQI (adults and parents) at baseline and following 10 months of weekly self-administered SCIG infusions at home. The SCIG home therapy was associated with significant improvements in HRQL and TS, particularly in patients who had previously received IVIG therapy in hospital settings. Background factors that were found to be associated with HRQL changes in adults were age, serum IgG levels at month 10, concomitant joint/muscle/skeletal disorders, clinical study location and smoking status. PMID:17964220

  8. Second order statistics of selection combining receiver over κ-μ fading channels subject to co-channel interferences

    NASA Astrophysics Data System (ADS)

    Stefanović, Mihajlo; Panić, Stefan R.; Stefanović, DušAn; Nikolić, Bojana; Cvetković, Aleksandra

    2012-12-01

    Radio propagation performances in interference-limited faded environment are studied in this paper. Selection combining (SC) based on signal-to-interference ratio (SIR) overκ-μfading channels is performed. Probability density function (PDF) and cumulative distribution function (CDF) of the received SIR are determined. Based on the results obtained for PDF and CDF, infinite-series expressions are derived for the output level crossing rate (LCR) and average fade duration (AFD). These second order statistical measures are regarded as necessary for supporting technical documentation in every radio communication link design. Influences of various system parameters such as fading severity and the number of co-channel interferences affecting these measures are graphically presented and discussed.

  9. Work productivity among treatment-naïve patients with genotype 1 chronic hepatitis C infection receiving telaprevir combination treatment.

    PubMed

    Aggarwal, J; Vera-Llonch, M; Donepudi, M; Suthoff, E; Younossi, Z; Goss, T F

    2015-01-01

    Work productivity is impacted in hepatitis C virus (HCV)-infected patients and has been linked to treatment. In two Phase 3 trials, ADVANCE and ILLUMINATE, treatment-naïve genotype 1 chronic HCV-infected patients received 12-week telaprevir (T) with 24 (T12PR24)- or 48 (T12PR48)-week peginterferon alfa-2a/ribavirin. The objective of this analysis was to examine the impact of chronic HCV infection and its treatment with combination therapy on work productivity. The 5-item, self-reported work productivity questionnaire (WPQ) was administered in Phase 3 trials to assess unemployment status, days unable to work due to HCV/treatment, reduced hours worked and impact on productivity in prior 4 weeks. Descriptive statistics and multivariate regression analyses were employed in analyses of pooled trial data. About 1147 patients were included; 22% (n = 255) were unemployed at baseline, with 8% being unemployed due to health reasons. At week 12, there were no differences by treatment regimen in the number of days unable to work. At week 48, improvements were observed earlier among patients receiving the shorter duration of T combination treatment. Mean (95% CI) change from baseline in days unable to work was -0.48 (-0.85, -0.11) days for T12PR24, 1.43 (0.63, 2.24) days for T12PR48 and 1.24 (0.18, 2.30) days for PR48 with placebo. Predictors of days unable to work were identified and include demographic characteristics, pretreatment and on-treatment levels of fatigue, as well regional variation. In post hoc analyses of the ADVANCE and ILLUMINATE trials, work productivity decreased during the initial 12 weeks regardless of treatment group. PMID:24528927

  10. Combined aortic and mitral valve replacement in an adult with Scheie's disease.

    PubMed

    Butman, S M; Karl, L; Copeland, J G

    1989-07-01

    Mitral, aortic, and coronary arterial disease have been described in the various mucopolysaccharidoses. We report the first successful combined aortic and mitral valve replacement in an adult female patient with severe aortic and mitral stenosis due to Scheie's syndrome, a mucopolysaccharide storage disease. Both annulae were of sufficient integrity for good prosthetic placement, and the patient had an uneventful postoperative recovery. PMID:2500310

  11. Biomechanically Preferred Consonant-Vowel Combinations Fail to Appear in Adult Spoken Corpora

    ERIC Educational Resources Information Center

    Whalen, D. H.; Giulivi, Sara; Nam, Hosung; Levitt, Andrea G.; Halle, Pierre; Goldstein, Louis M.

    2012-01-01

    Certain consonant/vowel (CV) combinations are more frequent than would be expected from the individual C and V frequencies alone, both in babbling and, to a lesser extent, in adult language, based on dictionary counts: Labial consonants co-occur with central vowels more often than chance would dictate; coronals co-occur with front vowels, and…

  12. Are Alliterative Word Combinations Comparatively Easy to Remember for Adult Learners?

    ERIC Educational Resources Information Center

    Boers, Frank; Lindstromberg, Seth; Eyckmans, June

    2012-01-01

    Lindstromberg and Boers (2008a, 2008b) have reported experiments with adult learners of English which revealed a comparative mnemonic advantage afforded by word combinations that display sound patterns such as alliteration ("green grass") and assonance ("home phone"). These findings are relevant for TESOL, given the fact that English phraseology…

  13. HOTAIR is a predictive and prognostic biomarker for patients with advanced gastric adenocarcinoma receiving fluorouracil and platinum combination chemotherapy

    PubMed Central

    Zhao, Wei; Dong, Shuang; Duan, Bensong; Chen, Ping; Shi, Lei; Gao, Hengjun; Qi, Haizhi

    2015-01-01

    Accumulating evidence suggests that long non-coding RNA (lncRNA) HOTAIR participates in many types of cancer such as gastric cancer and may confer malignant phenotype to tumor cells. Fluorouracil and platinum combination chemotherapy is the first line therapy for gastric cancer. However, it is still unknown whether HOTAIR influences the outcome of cancer patients treated with chemotherapy. This study aimed to evaluate the association of HOTAIR expression with the prognosis of patients with advanced gastric adenocarcinoma (GA) receiving fluorouracil and platinum based chemotherapy. We examined the levels of HOTAIR in 168 GA samples using quantitative real-time PCR and analyzed its relationship with clinical features and prognosis of patients with advanced GA treated with fluorouracil and platinum based chemotherapy. Compared with paracancerous tissues, HOTAIR was significantly upregulated in GA tissues, especially in more advanced cases. High HOTAIR expression was an independent poor prognostic factor for patients with advanced GA. Further stratification analyses revealed that the association between HOTAIR expression and survival in patients with advanced GA remained significant in the subgroup of patients with TNM stages IIIA and IIIB, poorly differentiated, and smaller tumors. In conclusion, our results provide first evidence that HOTAIR may be served as a biomarker that predicts which patient with advanced GA will benefit from fluorouracil and platinum combination chemotherapy. PMID:26328013

  14. Early Systemic Cellular Immune Response in Children and Young Adults Receiving Decellularized Fresh Allografts for Pulmonary Valve Replacement

    PubMed Central

    Neumann, Anneke; Breymann, Thomas; Cebotari, Serghei; Boethig, Dietmar; Horke, Alexander; Beerbaum, Philipp; Westhoff-Bleck, Mechthild; Bertram, Harald; Ono, Masamichi; Tudorache, Igor; Haverich, Axel; Beutel, Gernot

    2014-01-01

    Objectives: The longevity of homografts is determined by the activation of the recipients' immune system resulting from allogenic antigen exposition. Fresh decellularized pulmonary homografts (DPH) have shown promising early results in pulmonary valve replacement in children and young adults and could potentially avoid significant activation of the immune system, as more than 99% of the donor DNA is removed during the decellularization process. While the humoral immune response to decellularized allografts has been studied, detailed information on the more significant cellular immune response is currently lacking. Methods and Results: Peripheral blood samples were obtained from patients undergoing pulmonary valve replacement with DPH before, after, and for approximately 3 years after implantation. Absolute counts and percentages of mature T- (CD3+), B- (CD19+), and natural killer- (CD16+/CD56+) cells, as well as T helper- (CD4+) and cytotoxic T-cell- (CD8+) subsets, were determined by fluorescence-activated cell sorting (FACS). Between May 2009 and September 2013, 199 blood samples taken from 47 patients with a mean age at DPH implantation of 16.6±10.8 years were analyzed. The hemodynamic performance of DPH was excellent in all but one patient, and no valve-related deaths or conduit explantations were observed. The short-term follow up revealed a significant postoperative decrease in cell counts of most subtypes with reconstitution after 3 months. Continued assessment did not show any significant deviations in cell counts from their baseline values. Conclusion: The absence of cellular immune response in patients receiving DPH supports the concept that decellularization can provide a basis for autologous regeneration. PMID:24138470

  15. Biomechanically Preferred Consonant-Vowel Combinations Fail to Appear in Adult Spoken Corpora

    PubMed Central

    Whalen, D. H.; Giulivi, Sara; Nam, Hosung; Levitt, Andrea G.; Hallé, Pierre; Goldstein, Louis M.

    2012-01-01

    Certain consonant/vowel (CV) combinations are more frequent than would be expected from the individual C and V frequencies alone, both in babbling and, to a lesser extent, in adult language, based on dictionary counts: Labial consonants co-occur with central vowels more often than chance would dictate; coronals co-occur with front vowels, and velars with back vowels (Davis & MacNeilage, 1994). Plausible biomechanical explanations have been proposed, but it is also possible that infants are mirroring the frequency of the CVs that they hear. As noted, previous assessments of adult language were based on dictionaries; these “type” counts are incommensurate with the babbling measures, which are necessarily “token” counts. We analyzed the tokens in two spoken corpora for English, two for French and one for Mandarin. We found that the adult spoken CV preferences correlated with the type counts for Mandarin and French, not for English. Correlations between the adult spoken corpora and the babbling results had all three possible outcomes: significantly positive (French), uncorrelated (Mandarin), and significantly negative (English). There were no correlations of the dictionary data with the babbling results when we consider all nine combinations of consonants and vowels. The results indicate that spoken frequencies of CV combinations can differ from dictionary (type) counts and that the CV preferences apparent in babbling are biomechanically driven and can ignore the frequencies of CVs in the ambient spoken language. PMID:23420980

  16. Quantitative and qualitative assessment of the impact of climate change on a combined sewer overflow and its receiving water body.

    PubMed

    Bi, Eustache Gooré; Monette, Frédéric; Gachon, Philippe; Gaspéri, Johnny; Perrodin, Yves

    2015-08-01

    Projections from the Canadian Regional Climate Model (CRCM) for the southern part of the province of Québec, Canada, suggest an increase in extreme precipitation events for the 2050 horizon (2041-2070). The main goal of this study consisted in a quantitative and qualitative assessment of the impact of the 20 % increase in rainfall intensity that led, in the summer of 2013, to overflows in the "Rolland-Therrien" combined sewer system in the city of Longueuil, Canada. The PCSWMM 2013 model was used to assess the sensitivity of this overflow under current (2013) and future (2050) climate conditions. The simulated quantitative variables (peak flow, Q(CSO), and volume discharged, VD) served as the basis for deriving ecotoxicological risk indices and event fluxes (EFs) transported to the St. Lawrence (SL) River. Results highlighted 15 to 500% increases in VD and 13 to 148% increases in Q(CSO) by 2050 (compared to 2013), based on eight rainfall events measured from May to October. These results show that (i) the relationships between precipitation and combined sewer overflow variables are not linear and (ii) the design criteria for current hydraulic infrastructure must be revised to account for the impact of climate change (CC) arising from changes in precipitation regimes. EFs discharged into the SL River will be 2.24 times larger in the future than they are now (2013) due to large VDs resulting from CC. This will, in turn, lead to excessive inputs of total suspended solids (TSSs) and tracers for numerous urban pollutants (organic matter and nutrients, metals) into the receiving water body. Ecotoxicological risk indices will increase by more than 100% by 2050 compared to 2013. Given that substantial VDs are at play, and although CC scenarios have many sources of uncertainty, strategies to adapt this drainage network to the effects of CC will have to be developed. PMID:25869430

  17. Combined Cognitive-Psychological-Physical Intervention Induces Reorganization of Intrinsic Functional Brain Architecture in Older Adults

    PubMed Central

    Zheng, Zhiwei; Zhu, Xinyi; Yin, Shufei; Wang, Baoxi; Niu, Yanan; Huang, Xin; Li, Rui; Li, Juan

    2015-01-01

    Mounting evidence suggests that enriched mental, physical, and socially stimulating activities are beneficial for counteracting age-related decreases in brain function and cognition in older adults. Here, we used functional magnetic resonance imaging (fMRI) to demonstrate the functional plasticity of brain activity in response to a combined cognitive-psychological-physical intervention and investigated the contribution of the intervention-related brain changes to individual performance in healthy older adults. The intervention was composed of a 6-week program of combined activities including cognitive training, Tai Chi exercise, and group counseling. The results showed improved cognitive performance and reorganized regional homogeneity of spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signals in the superior and middle temporal gyri, and the posterior lobe of the cerebellum, in the participants who attended the intervention. Intriguingly, the intervention-induced changes in the coherence of local spontaneous activity correlated with the improvements in individual cognitive performance. Taken together with our previous findings of enhanced resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe regions following a combined intervention program in older adults, we conclude that the functional plasticity of the aging brain is a rather complex process, and an effective cognitive-psychological-physical intervention is helpful for maintaining a healthy brain and comprehensive cognition during old age. PMID:25810927

  18. Monocular perceptual learning of contrast detection facilitates binocular combination in adults with anisometropic amblyopia

    PubMed Central

    Chen, Zidong; Li, Jinrong; Liu, Jing; Cai, Xiaoxiao; Yuan, Junpeng; Deng, Daming; Yu, Minbin

    2016-01-01

    Perceptual learning in contrast detection improves monocular visual function in adults with anisometropic amblyopia; however, its effect on binocular combination remains unknown. Given that the amblyopic visual system suffers from pronounced binocular functional loss, it is important to address how the amblyopic visual system responds to such training strategies under binocular viewing conditions. Anisometropic amblyopes (n = 13) were asked to complete two psychophysical supra-threshold binocular summation tasks: (1) binocular phase combination and (2) dichoptic global motion coherence before and after monocular training to investigate this question. We showed that these participants benefited from monocular training in terms of binocular combination. More importantly, the improvements observed with the area under log CSF (AULCSF) were found to be correlated with the improvements in binocular phase combination. PMID:26829898

  19. Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study.

    PubMed

    Dash, Amitabh; Ravat, Sangeeta; Srinivasan, Avathvadi Venkatesan; Shetty, Ashutosh; Kumar, Vivek; Achtani, Renu; Mathur, Vivek Narain; Maramattom, Boby Varkey; Bajpai, Veeresh; Manjunath, Nanjappa C; Narayana, Randhi Venkata; Mehta, Suyog

    2016-01-01

    A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24 weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20.92% of patients received zonisamide as monotherapy or alternative monotherapy and 59.85% patients received zonisamide as first adjunctive therapy. Compared with baseline, 41.22% of patients achieved seizure freedom and 78.6% as responder rate at the end of 24 week study. Most commonly reported adverse events were loss of appetite, weight loss, sedation, and dizziness, but discontinuation due to adverse events of drug was seen in 0.92% of patients. This open label real-world study suggests that zonisamide is an effective and well-tolerated antiepileptic drug in Indian adults for treatment of partial, generalized as well as combined seizures type. No new safety signals were observed. PMID:27013882

  20. Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

    PubMed Central

    Dash, Amitabh; Ravat, Sangeeta; Srinivasan, Avathvadi Venkatesan; Shetty, Ashutosh; Kumar, Vivek; Achtani, Renu; Mathur, Vivek Narain; Maramattom, Boby Varkey; Bajpai, Veeresh; Manjunath, Nanjappa C; Narayana, Randhi Venkata; Mehta, Suyog

    2016-01-01

    A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24 weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20.92% of patients received zonisamide as monotherapy or alternative monotherapy and 59.85% patients received zonisamide as first adjunctive therapy. Compared with baseline, 41.22% of patients achieved seizure freedom and 78.6% as responder rate at the end of 24 week study. Most commonly reported adverse events were loss of appetite, weight loss, sedation, and dizziness, but discontinuation due to adverse events of drug was seen in 0.92% of patients. This open label real-world study suggests that zonisamide is an effective and well-tolerated antiepileptic drug in Indian adults for treatment of partial, generalized as well as combined seizures type. No new safety signals were observed. PMID:27013882

  1. Trends in Adults Receiving a Recommendation for Exercise or Other Physical Activity from a Physician or Other Health ...

    MedlinePlus

    ... a physician's advice to exercise vary by body mass index (BMI)? Adults who were obese were about ... and varies substantially across population subgroups. Definitions Body mass index : Based on respondent-reported height and weight ...

  2. Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

    ERIC Educational Resources Information Center

    Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

    2013-01-01

    For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

  3. Regional hyperthermia combined with chemotherapy in paediatric, adolescent and young adult patients: current and future perspectives.

    PubMed

    Seifert, Georg; Budach, Volker; Keilholz, Ulrich; Wust, Peter; Eggert, Angelika; Ghadjar, Pirus

    2016-01-01

    Here we evaluate the current status of clinical research on regional hyperthermia (RHT) in combination with chemotherapy or radiation therapy in paediatric oncology.Data were identified in searches of MEDLINE, Current Contents, PubMed, and references from relevant articles using medical subject headings including hyperthermia, cancer, paediatric oncology, children, radiation therapy and chemotherapy. Currently, only two RHT centres exist in Europe which treat children. Clinical RHT research in paediatric oncology has as yet been limited to children with sarcomas and germ cell tumours that respond poorly to or recur after chemotherapy. RHT is a safe and effective treatment delivering local thermic effects, which may also stimulate immunological processes via heat-shock protein reactions. RHT is used chiefly in children and adolescents with sarcomas or germ cell tumours located in the abdomino-pelvic region, chest wall or extremities to improve operability or render the tumour operable. It could potentially be combined with radiation therapy in a post-operative R1 setting where more radical surgery is not possible or combined with chemotherapy instead of radiation therapy in cases where the necessary radiation dose is impossible to achieve or would have mutilating consequences. RHT might also be an option for chemotherapy intensification in the neoadjuvant first-line treatment setting for children and adolescents, as was recently reflected in the promising long-term outcome data in adults with high-risk soft tissue sarcomas (EORTC 62961/ESHO trial).The limited data available indicate that combining RHT with chemotherapy is a promising option to treat germ cell tumours and, potentially, sarcomas. RHT may also be beneficial in first-line therapy in children, adolescents and young adults. The research should focus on optimising necessary technical demands and then initiate several clinical trials incorporating RHT into interdisciplinary treatment of children

  4. Combined treatment with sitagliptin and vitamin D in a patient with latent autoimmune diabetes in adults

    PubMed Central

    Rapti, E; Karras, S; Grammatiki, M; Mousiolis, A; Tsekmekidou, X; Potolidis, E; Zebekakis, P; Daniilidis, M

    2016-01-01

    Summary Latent autoimmune diabetes in adults (LADA) is a relatively new type of diabetes with a clinical phenotype of type 2 diabetes (T2D) and an immunological milieu characterized by high titers of islet autoantibodies, resembling the immunological profile of type 1 diabetes (T1D). Herein, we report a case of a young male, diagnosed with LADA based on both clinical presentation and positive anti-glutamic acid decarboxylase antibodies (GAD-abs), which were normalized after combined treatment with a dipeptidyl peptidase-4 inhibitor (DPP-4) (sitagliptin) and cholecalciferol. Learning points Anti-glutamic acid decarboxylase antibodies (GAD-abs) titers in young patients being previously diagnosed as type 2 diabetes (T2D) may help establish the diagnosis of latent autoimmune diabetes in adults (LADA). Sitagliptin administration in patients with LADA might prolong the insulin-free period. Vitamin D administration in patients with LADA might have a protective effect on the progression of the disease. PMID:27252860

  5. Under-nutrition at baseline and health services utilization and mortality over a one-year period in older adults receiving Medicare home health services

    PubMed Central

    Yang, Yongbin; Brown, Cynthia J.; Burgio, Kathryn L.; Kilgore, Meredith L.; Ritchie, Christine S.; Roth, David L.; West, Delia Smith; Locher, Julie L.

    2010-01-01

    Objective Older adults receiving Medicare home health services who experience under-nutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a one-year period in older adults receiving Medicare home health services. Design This was a longitudinal study using questionnaires and anthropometric measures designed to assess nutritional status (Mini-Nutritional Assessment [MNA]) at baseline and health services utilization and mortality status at six-month and one-year follow-ups. Setting Participants were evaluated in their homes. Participants 198 older adults who were receiving Medicare home health services. Results Based upon MNA, 12.0% of patients were Malnourished, 51.0% were At Risk for Malnourishment, and 36.9% had Normal Nutrition Status. Based upon body mass index (BMI), 8.1% of participants were underweight, 37.9% were normal weight, 25.3% were overweight, and 28.8% were obese. Using multivariate binary logistic regression analyses, participants who were Malnourished or At Risk for Malnourishment were more likely to experience subsequent hospitalization, emergency room visit, home health aide use, and mortality for the entire sample and hospitalization and nursing home stay for overweight and obese participants. Conclusions Experiencing under-nutrition at the time of receipt of Medicare home health services was associated with increased health services utilization and mortality for the entire sample, and with increased health services utilization only for the overweight and obese subsample. Opportunities exist to address risk of under-nutrition in patients receiving home health services, including those who are overweight or obese, to prevent subsequent adverse health outcomes. PMID:21527170

  6. Brief Report: The Effects of Typed and Spoken Modality Combinations on the Language Performance of Adults with Autism.

    ERIC Educational Resources Information Center

    Forsey, Janice; And Others

    1996-01-01

    A study of five adult males with autism investigated which combination of input/output modalities (typed or spoken) enhanced the syntactic, semantic, and/or pragmatic performance of individuals with autism when engaging in conversations with a normal language adult. Results found that typed communications facilitated the use of longer utterances.…

  7. A Combined Treatment Approach for Adults with ADHD--Results of an Open Study of 43 Patients

    ERIC Educational Resources Information Center

    Rostain, Anthony L.; Ramsay, J. Russell

    2006-01-01

    Objective: Increasing numbers of adults are seeking treatment for ADHD. Pharmacotherapy is well established as the first line treatment for adult ADHD, although medications alone may be insufficient treatment for the myriad problems experienced by these patients. Few studies have examined the clinical outcomes of a combination of pharmacotherapy…

  8. Reducing HIV-Risk Behavior Among Adults Receiving Outpatient Psychiatric Treatment: Results From a Randomized Controlled Trial

    PubMed Central

    Carey, Michael P.; Carey, Kate B.; Maisto, Stephen A.; Gordon, Christopher M.; Schroder, Kerstin E. E.; Vanable, Peter A.

    2005-01-01

    This study investigated the efficacy of a 10-session, HIV-risk-reduction intervention with 221 women and 187 men receiving outpatient psychiatric care for a mental illness. Patients were randomly assigned to the HIV intervention, a structurally equivalent substance use reduction (SUR) intervention, or standard care; they were assessed pre- and postintervention and at 3- and 6-month follow-ups. Patients receiving the HIV-risk-reduction intervention reported less unprotected sex, fewer casual sex partners, fewer new sexually transmitted infections, more safer sex communications, improved HIV knowledge, more positive condom attitudes, stronger condom use intentions, and improved behavioral skills relative to patients in the SUR and control conditions. Patients receiving the SUR intervention reported fewer total and casual sex partners compared with control patients. Exploratory analyses suggested that female patients and patients diagnosed with a major depressive disorder were more likely to benefit from the HIV-risk-reduction intervention. PMID:15065959

  9. Reducing HIV-Risk Behavior Among Adults Receiving Outpatient Psychiatric Treatment: Results From a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Carey, Michael P.; Carey, Kate B.; Maisto, Stephen A.; Gordon, Christopher M.; Schroder, Kerstin E. E.; Vanable, Peter A.

    2004-01-01

    This study investigated the efficacy of a 10-session, HIV-risk-reduction intervention with 221 women and 187 men receiving outpatient psychiatric care for a mental illness. Patients were randomly assigned to the HIV intervention, a structurally equivalent substance use reduction (SUR) intervention, or standard care; they were assessed pre- and…

  10. Implementation of Joint Pre-FFT Adaptive Array Antenna and Post-FFT Space Diversity Combining for Mobile ISDB-T Receiver

    NASA Astrophysics Data System (ADS)

    Pham, Dang Hai; Gao, Jing; Tabata, Takanobu; Asato, Hirokazu; Hori, Satoshi; Wada, Tomohisha

    In our application targeted here, four on-glass antenna elements are set in an automobile to improve the reception quality of mobile ISDB-T receiver. With regard to the directional characteristics of each antenna, we propose and implement a joint Pre-FFT adaptive array antenna and Post-FFT space diversity combining (AAA-SDC) scheme for mobile ISDB-T receiver. By applying a joint hardware and software approach, a flexible platform is realized in which several system configuration schemes can be supported; the receiver can be reconfigured on the fly. Simulation results show that the AAA-SDC scheme drastically improves the performance of mobile ISDB-T receiver, especially in the region of large Doppler shift. The experimental results from a field test also confirm that the proposed AAA-SDC scheme successfully achieves an outstanding reception rate up to 100% while moving at the speed of 80km/h.

  11. Multicenter study of combination DEP regimen as a salvage therapy for adult refractory hemophagocytic lymphohistiocytosis

    PubMed Central

    Wang, Yini; Huang, Wenqiu; Hu, Liangding; Cen, Xinan; Li, Lihong; Wang, Jijun; Shen, Jianliang; Wei, Na

    2015-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a refractory immune disorder with a significant risk of death. Although standard therapy has dramatically improved survival in HLH patients, approximately 30%, especially adults, show no response to current treatment strategies. This prospective study aimed to investigate the efficacy of liposomal doxorubicin treatment combined with etoposide and methylprednisolone (doxorubicin-etoposide-methylprednisolone; DEP) as a salvage therapy for adult refractory HLH. Adult patients who did not achieve at least partial response 2 weeks after initial standard HLH therapy were enrolled in this study between June 2013 and June 2014. Response to salvage therapy was assessed at 2 and 4 weeks after initiation of DEP therapy and patients were followed until death or until November 2014. Sixty-three refractory HLH patients were enrolled, including 29 cases of lymphoma-associated HLH, 22 cases of Epstein-Barr virus–associated HLH, and 4 cases of familial HLH. There were 8 cases with unknown underlying diseases. Seventeen cases (27.0%) achieved complete response and 31 cases (49.2%) achieved partial response. The overall response was 76.2% (48/63). Patients who showed no response to DEP died within 4 weeks after salvage therapy. Twenty-nine of the 48 patients who achieved partial or complete response survived to subsequent chemotherapy, allogenic hematopoietic stem cell transplantation, or splenectomy. Our study suggests that DEP regimen is an effective salvage regimen for adult refractory HLH, which can prolong patient survival as we continue to understand the responsible mechanisms and bridge the gap between HLH and its underlying diseases. This study was registered in the Chinese Clinical Trials Registry Platform (http://www.chictr.org.cn/) as ChiCTR-IPC-14005514. PMID:26289641

  12. SweepSAR: Beam-forming on Receive Using a Reflector-Phased Array Feed Combination for Spaceborne SAR

    NASA Technical Reports Server (NTRS)

    Freeman, A.; Krieger, G.; Rosen, P.; Younis, M.; Johnson, W. T. K.; Huber, S.; Jordan, R.; Moreira, A.

    2012-01-01

    In this paper, an alternative approach is described that is suited for longer wavelength SARs in particular, employing a large, deployable reflector antenna and a much simpler phased array feed. To illuminate a wide swath, a substantial fraction of the phased array feed is excited on transmit to sub-illuminate the reflector. Shorter transmit pulses are required than for conventional SAR. On receive, a much smaller portion of the phased array feed is used to collect the return echo, so that a greater portion of the reflector antenna area is used. The locus of the portion of the phased array used on receive is adjusted using an analog beam steering network, to 'sweep' the receive beam(s) across the illuminated swath, tracking the return echo. This is similar in some respects to the whiskbroom approach to optical sensors, hence the name: SweepSAR.SweepSAR has advantages over conventional SAR in that it requires less transmit power, and if the receive beam is narrow enough, it is relatively immune to range ambiguities. Compared to direct radiating arrays with digital beam- forming, it is much simpler to implement, uses currently available technologies, is better suited for longer wavelength systems, and does not require extremely high data rates or onboard processing.

  13. Effects of a Combined Exercise Program Using an iPad for Older Adults

    PubMed Central

    Lee, Juhee; Byun, Jinyee; Lee, Minkyung

    2016-01-01

    Objectives The purpose of this study was to examine the function, health status, and efficacy effects of a combined exercise program using an iPad among older women in Korea, a tech-savvy country. Methods The study employed a pretest and posttest experimental design with a control group. The experimental group of subjects comprised 16 female older adults and the control group comprised 10 who were aged 65 years or older. The experimental group participated in a supervised group-based exercise program and an individualized home-based exercise program that involved the use of an iPad. The combined group and home-based exercise program consisted of group exercise, which took place in a senior center for 30 minutes weekly, and a home-based iPad exercise program, which the subjects followed at least 3 times a week. The collected data were analyzed using the Statistical Analysis System (SAS ver. 9.3 TS Level 1M0) program, which utilized a chi-square test, a Fisher exact test, a t-test, and a repeated-measures ANOVA. Results The results showed that cognitive status changed significantly over time, and there was an interaction between group and time. Further, self-efficacy for exercise and outcome expectations for exercise changed significantly over time. Conclusions Exercise programs using iPad interventions may be useful for the management of cognitive functioning and the integration of functional physical abilities in older adults. PMID:27200215

  14. Epstein-Barr virus DNA loads in adult human immunodeficiency virus type 1-infected patients receiving highly active antiretroviral therapy

    NASA Technical Reports Server (NTRS)

    Ling, Paul D.; Vilchez, Regis A.; Keitel, Wendy A.; Poston, David G.; Peng, Rong Sheng; White, Zoe S.; Visnegarwala, Fehmida; Lewis, Dorothy E.; Butel, Janet S.

    2003-01-01

    Patients with human immunodeficiency virus type 1 (HIV-1) infection are at high risk of developing Epstein-Barr virus (EBV)-associated lymphoma. However, little is known of the EBV DNA loads in patients receiving highly active antiretroviral therapy (HAART). Using a real-time quantitative polymerase chain reaction assay, we demonstrated that significantly more HIV-1-infected patients receiving HAART than HIV-1-uninfected volunteers had detectable EBV DNA in blood (57 [81%] of 70 vs. 11 [16%] of 68 patients; P=.001) and saliva (55 [79%] of 68 vs. 37 [54%] of 68 patients; P=.002). The mean EBV loads in blood and saliva samples were also higher in HIV-1-infected patients than in HIV-1-uninfected volunteers (P=.001). The frequency of EBV detection in blood was associated with lower CD4+ cell counts (P=.03) among HIV-1-infected individuals, although no differences were observed in the EBV DNA loads in blood or saliva samples in the HIV-1-infected group. Additional studies are needed to determine whether EBV-specific CD4+ and CD8+ cells play a role in the pathogenesis of EBV in HIV-1-infected patients receiving HAART.

  15. The influence of calcium supplement on body composition, weight loss and insulin resistance in obese adults receiving low calorie diet

    PubMed Central

    Shalileh, Maryam; Shidfar, Farzad; Haghani, Hamid; Eghtesadi, Shahriar; Heydari, Iraj

    2010-01-01

    BACKGROUND: Obesity and diabetes are the most important problems of public health. Evidence from molecular animal research and epidemiologic investigations indicate that calcium intake may have an influence on body composition, weight and insulin resistance. The objective of this study was to determine the effects of calcium supplementation on body composition, weight, insulin resistance and blood pressure in the face of calorie restriction in obese adults. METHODS: A double blind randomized placebo-controlled trial on 40 adults with Body Mass Index > 25kg/m2 was conducted. Subjects were maintained for 24 weeks on a balanced deficit diet (-500 kcal/d deficit) and randomly assigned into two groups with 1000 mg ca/d as calcium carbonate or placebo. RESULTS: There were no significant differences in variables at the 12th and 24th week between the two groups. The lean mass showed no significant increase in the calcium group at the 12th week compared to baseline and in placebo group at the 24th week compared to the 12th week. The insulin concentration showed a significant decrease in the calcium group at the 12th week compared to the baseline (p < 0.05). The diastolic blood pressure had a significant decrease at the 24th week compared to the 12th week in both groups (p = 0.013-0.009). CONCLUSIONS: Results from this study suggest that 24 weeks of supplementation with 1000 mg ca/d did not have any effect on weight, body composition, insulin resistance and blood pressure beyond what can be achieved in an energy restricted diet in obese adults. PMID:21526081

  16. A Pilot Study of Brief Heart Rate Variability Biofeedback to Reduce Craving in Young Adult Men Receiving Inpatient Treatment for Substance Use Disorders

    PubMed Central

    Eddie, D.; Kim, C.; Lehrer, P.; Deneke, E.; Bates, M.E.

    2014-01-01

    The present pilot study investigated the implementation feasibility, and efficacy for reducing alcohol and drug craving, of a brief, 3-session heart rate variability biofeedback (HRV BFB) intervention added to a traditional 28-day substance abuse disorder (SUD) inpatient treatment program. Forty-eight young adult men received either treatment as usual (TAU) plus three sessions of HRV BFB training over three weeks, or TAU only. Participants receiving HRV BFB training were instructed to practice daily using a handheld HRV BFB device. HRV BFB training was well tolerated by participants and supported by treatment staff. Men receiving TAU + HRV BFB demonstrated a greater, medium effect size reduction in alcohol and drug craving compared to those receiving TAU only, although this difference did not reach statistical significance. In addition, an interaction effect was observed in analyses that accounted for baseline craving levels, wherein heart rate variability (HRV) levels at treatment entry were predictive of changes in craving in the TAU group only. Low baseline levels of HRV were associated with increases in craving, whereas higher baseline HRV levels were associated with greater decreases in craving from start to end of treatment. In the TAU + HRV BFB group, however, there was no such association. That is, HRV BFB appeared to dissociate individual differences in baseline HRV levels from changes in craving. Given that alcohol and drug craving often precipitates relapse, HRV BFB merits further study as an adjunct treatment to ameliorate craving experienced by persons with substance use disorders. PMID:25179673

  17. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

    PubMed

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-05-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV. PMID:25844941

  18. Talk or text to tell? How young adults in Canada and South Africa prefer to receive STI results, counseling, and treatment updates in a wireless world.

    PubMed

    Labacher, Lukas; Mitchell, Claudia

    2013-01-01

    Young adults often lack access to confidential, long-lasting, and nonjudgmental interactions with sexual health professionals at brick-and-mortar clinics. To ensure that patients return for their STI test results, post-result counseling, and STI-related information, computer-mediated health intervention programming allows them to receive sexual health information through onsite computers, the Internet, and mobile phone calls and text messages. To determine whether young adults (age: M = 21 years) prefer to communicate with health professionals about the status of their sexual health through computer-mediated communication devices, 303 second-year university students (183 from an urban North American university and 120 from a periurban university in South Africa) completed a paper-based survey indicating how they prefer to communicate with doctors and nurses: talking face to face, mobile phone call, text message, Internet chat programs, Facebook, Twitter, or e-mail. Nearly all students, and female students in South Africa in particular, prefer to receive their STI test results, post-results counseling, and STI-related information by talking face to face with doctors and nurses rather than communicating through computers or mobile phones. Results are clarified in relation to gender, availability of various technologies, and prevalence of HIV in Canada and in South Africa. PMID:24015829

  19. A case of hepatoblastoma misdiagnosed as combined hepatocellular carcinoma and cholangiocarcinoma in an adult

    PubMed Central

    Park, Keun Woo; Seo, Chang Jin; Yun, Dae Young; Kim, Min Keun; Kim, Byung Seok; Han, Young Seok; Oh, Hoon Kyu

    2015-01-01

    Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B. She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin. Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset. PMID:26523273

  20. [WPW syndrome combined with AV block 2 in an adult with glycogenosis (Type II)].

    PubMed

    Francesconi, M; Auff, E; Ursin, C; Sluga, E

    1982-08-01

    A 31 year-old female with a five year history of muscle weakness, cardiac palpitations and elevation of activity of some serum enzymes of muscular origin, showed signs of the WPW syndrome on ECG, often in combination with grade 2 A-V block. Type II glycogenosis (Pompe's disease) was diagnosed on the basis of the results of physical examination, laboratory findings--especially subtotal deficiency of acid maltase (a-1,4 glucosidase) activity-and morphological aspects of light and electron microscopy of a quadriceps muscle biopsy specimen. To our knowledge the coincidence of such a rarely encountered arrhythmia with glycogenosis type II in an adult has never been reported so far. PMID:6959422

  1. Effect of nutritional counseling on low-density lipoprotein cholesterol among Thai HIV-infected adults receiving antiretroviral therapy.

    PubMed

    Chotivichien, Saipin; Arab, Lenore; Prasithsirikul, Wisit; Manosuthi, Weerawat; Sinawat, Sangsom; Detels, Roger

    2016-01-01

    HIV-infected patients receiving antiretroviral therapy have increased risk of metabolic syndrome, including dyslipidemia. In this study, we determined whether individual nutritional counseling reduced dyslipidemia, particularly low-density lipoprotein (LDL) cholesterol, among HIV-infected patients with dyslipidemia not currently taking lipid-lowering medication. We conducted a randomized 24-week trial among HIV-infected patients with dyslipidemia who were on antiretroviral therapy and were eligible to initiate therapeutic lifestyle changes according to the Thai National Cholesterol Education Program. Participants were randomly assigned to an intervention group that received individual counseling with a nutritionist for seven sessions (baseline, weeks 2, 4, 8, 12, 18, and 24) and a control group that received standard verbal diet information at baseline and nutritional counseling only at week 24. A 24-h recall technique was used to assess dietary intake for both groups at baseline and week 24. Lipid profile (total cholesterol, LDL, high-density lipoprotein (HDL), and triglyceride) was measured at baseline and after 12 and 24 weeks of therapy. An intention-to-treat and linear mixed model were used. Seventy-two patients were randomly assigned, and 62 (86%) participants completed their lipid profile test. After 12 weeks of follow-up, there were significant reductions in the intervention group for total cholesterol (-14.4 ± 4.6 mg/dL, P = .002), LDL cholesterol (-13.7 ± 4.1 mg/dL, P = .001), and triglyceride (-30.4 ± 13.8 mg/dL, P = .03). A significant reduction in LDL cholesterol was also observed in the control group (-7.7 ± 3.8 mg/dL, P = .04), but there were no significant differences in change of mean lipid levels between the groups at 12 weeks of follow-up. After 24 weeks, participants assigned to the intervention group demonstrated significantly greater decreases in serum total cholesterol (-19.0 ± 4.6 vs. 0.2

  2. Independent and combined effect of diet and exercise in adults with prediabetes

    PubMed Central

    Sénéchal, Martin; Slaght, Jana; Bharti, Neha; Bouchard, Danielle R

    2014-01-01

    Prediabetes is defined as impaired fasting glucose and/or impaired glucose tolerance. Impaired fasting glucose is usually defined as fasting blood glucose between 5.6 mmol/L and 6.9 mmol/L (100.8–124.2 mg/dL), and impaired glucose tolerance is the 2-hour oral glucose tolerance test of 7.8–11.0 mmol/L (140.4–198.0 mg/dL). Most individuals with prediabetes are overweight or obese and are at greater risk of type 2 diabetes (T2D). The first line of treatment for individuals with prediabetes is lifestyle modification, including diet and exercise. The aim of this review, through the revision of primarily randomized control trials, is to discuss the independent and combined effect of diet and exercise on the incidence of T2D, glycemic control, and weight loss in adults with prediabetes. Based on the available literature, lifestyle modification combining both diet and exercise is effective at reducing the incidence of T2D and improving glycemic control, even without a significant reduction in body weight. Thus, it is unclear whether weight loss, through lifestyle modification, is a cornerstone for improving glycemic control in individuals with prediabetes. The independent effect of diet or exercise alone on the improvement in glycemic control and/or reduction in body weight in individuals with prediabetes still requires more studies to draw a clear conclusion, considering the quality and quantity of available studies. As of now, the best diet and/or exercise program to improve glycemic control and body weight in adults with prediabetes is unknown. PMID:25382981

  3. Independent and combined effect of diet and exercise in adults with prediabetes.

    PubMed

    Sénéchal, Martin; Slaght, Jana; Bharti, Neha; Bouchard, Danielle R

    2014-01-01

    Prediabetes is defined as impaired fasting glucose and/or impaired glucose tolerance. Impaired fasting glucose is usually defined as fasting blood glucose between 5.6 mmol/L and 6.9 mmol/L (100.8-124.2 mg/dL), and impaired glucose tolerance is the 2-hour oral glucose tolerance test of 7.8-11.0 mmol/L (140.4-198.0 mg/dL). Most individuals with prediabetes are overweight or obese and are at greater risk of type 2 diabetes (T2D). The first line of treatment for individuals with prediabetes is lifestyle modification, including diet and exercise. The aim of this review, through the revision of primarily randomized control trials, is to discuss the independent and combined effect of diet and exercise on the incidence of T2D, glycemic control, and weight loss in adults with prediabetes. Based on the available literature, lifestyle modification combining both diet and exercise is effective at reducing the incidence of T2D and improving glycemic control, even without a significant reduction in body weight. Thus, it is unclear whether weight loss, through lifestyle modification, is a cornerstone for improving glycemic control in individuals with prediabetes. The independent effect of diet or exercise alone on the improvement in glycemic control and/or reduction in body weight in individuals with prediabetes still requires more studies to draw a clear conclusion, considering the quality and quantity of available studies. As of now, the best diet and/or exercise program to improve glycemic control and body weight in adults with prediabetes is unknown. PMID:25382981

  4. Prospective Surveillance for Cardiac Adverse Events in Healthy Adults Receiving Modified Vaccinia Ankara Vaccines: A Systematic Review

    PubMed Central

    Elizaga, Marnie L.; Vasan, Sandhya; Marovich, Mary A.; Sato, Alicia H.; Lawrence, Dale N.; Chaitman, Bernard R.; Frey, Sharon E.; Keefer, Michael C.

    2013-01-01

    Background Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax) campaign initiated in 2002. A highly-attenuated vaccinia strain, modified vaccinia Ankara (MVA) has been evaluated in clinical trials as a safer alternative to DryVax and as a vector for recombinant vaccines. Due to the lack of prospectively collected cardiac safety data, the US Food and Drug Administration required cardiac screening and surveillance in all clinical trials of MVA since 2004. Here, we report cardiac safety surveillance from 6 phase I trials of MVA vaccines. Methods Four clinical research organizations contributed cardiac safety data using common surveillance methods in trials administering MVA or recombinant MVA vaccines to healthy participants. ‘Routine cardiac investigations’ (ECGs and cardiac enzymes obtained 2 weeks after injections of MVA or MVA-HIV recombinants, or placebo-controls), and ‘Symptom-driven cardiac investigations’ are reported. The outcome measure is the number of participants who met the CDC-case definition for vaccinia-related myo/pericarditis or who experienced cardiac adverse events from an MVA vaccine. Results Four hundred twenty-five study participants had post-vaccination safety data analyzed, 382 received at least one MVA-containing vaccine and 43 received placebo; 717 routine ECGs and 930 cardiac troponin assays were performed. Forty-five MVA recipients (12%) had additional cardiac testing performed; 22 for cardiac symptoms, 19 for ECG/laboratory changes, and 4 for cardiac symptoms with an ECG/laboratory change. No participant had evidence of symptomatic or asymptomatic myo/pericarditis meeting the CDC-case definition and judged to be related to an MVA vaccine. Conclusions Prospective surveillance of MVA recipients for myo/pericarditis did not detect cardiac adverse reactions in 382 study participants. Trial Registration ClinicalTrials.gov NCT00082446 NCT003766090 NCT00252148 NCT00083603 NCT00301184

  5. Evaluation of multiple ancillary therapies used in combination with an antimicrobial in newly received high-risk calves treated for bovine respiratory disease.

    PubMed

    Wilson, B K; Step, D L; Maxwell, C L; Wagner, J J; Richards, C J; Krehbiel, C R

    2015-07-01

    Ancillary therapy (ANC) is commonly provided in conjunction with an antimicrobial when treating calves for suspected bovine respiratory disease (BRD) in an attempt to improve the response to a suspected BRD challenge. The first experiment evaluated the effects of 3 ANC in combination with an antimicrobial in high-risk calves treated for BRD during a 56-d receiving period. Newly received crossbred steers (n = 516; initial BW = 217 ± 20 kg) were monitored by trained personnel for clinical signs of BRD. Calves that met antimicrobial treatment criteria (n = 320) were then randomly assigned to experimental ANC treatment (80 steers/experimental ANC treatment): intravenous flunixin meglumine injection (NSAID), intranasal viral vaccination (VACC), intramuscular vitamin C injection (VITC), or no ANC (NOAC). Animal served as the experimental unit for all variables except DMI and G:F (pen served as the experimental unit for DMI and G:F). Within calves treated 3 times for BRD, those receiving NOAC had lower (P < 0.01) clinical severity scores (severity scores ranged from 0 to 4 on the basis of observed clinical signs and severity) and heavier (P = 0.01) BW than those receiving NSAID, VACC, or VITC at the time of third treatment. Between the second and third BRD treatments, calves receiving NOAC had decreased (P < 0.01) daily BW loss (−0.13 kg ADG) compared with those receiving NSAID, VACC, or VITC (−1.30, −1.90, and −1.41 kg ADG, respectively). There were no differences in rectal temperature, combined mortalities and removals, or overall performance among the experimental ANC treatments. Overall, morbidity and mortality attributed to BRD across treatments were 66.5% and 13.2%, respectively. After the receiving period, a subset of calves (n = 126) were allocated to finishing pens to evaluate the effects ANC administration on finishing performance, carcass characteristics, and lung scores at harvest. Ultrasound estimates, BW, and visual appraisal were used to target a

  6. Identifying religious and/or spiritual perspectives of adolescents and young adults receiving blood and marrow transplants: a prospective qualitative study.

    PubMed

    Ragsdale, Judith R; Hegner, Mary Ann; Mueller, Mark; Davies, Stella

    2014-08-01

    The potential benefits (or detriments) of religious beliefs in adolescent and young adults (AYA) are poorly understood. Moreover, the literature gives little guidance to health care teams or to chaplains about assessing and addressing the spiritual needs of AYA receiving hematopoietic stem cell transplants (HSCT). We used an institutional review board-approved, prospective, longitudinal study to explore the use of religion and/or spirituality (R/S) in AYA HSCT recipients and to assess changes in belief during the transplantation experience. We used the qualitative methodology, grounded theory, to gather and analyze data. Twelve AYA recipients were interviewed within 100 days of receiving HSCT and 6 participants were interviewed 1 year after HSCT; the other 6 participants died. Results from the first set of interviews identified 5 major themes: using R/S to address questions of "why me?" and "what will happen to me;" believing God has a reason; using faith practices; and benefitting from spiritual support people. The second set of interviews resulted in 4 major themes: believing God chose me; affirming that my life has a purpose; receiving spiritual encouragement; and experiencing strengthened faith. We learned that AYA patients were utilizing R/S far more than we suspected and that rather than losing faith in the process of HSCT, they reported using R/S to cope with illness and HSCT and to understand their lives as having special purpose. Our data, supported by findings of adult R/S studies, suggest that professionally prepared chaplains should be proactive in asking AYA patients about their understanding and use of faith, and the data can actively help members of the treatment team understand how AYA are using R/S to make meaning, address fear, and inform medical decisions. PMID:24769327

  7. A multimedia adult literacy program: Combining NASA technology, instructional design theory, and authentic literacy concepts

    NASA Technical Reports Server (NTRS)

    Willis, Jerry W.

    1993-01-01

    For a number of years, the Software Technology Branch of the Information Systems Directorate has been involved in the application of cutting edge hardware and software technologies to instructional tasks related to NASA projects. The branch has developed intelligent computer aided training shells, instructional applications of virtual reality and multimedia, and computer-based instructional packages that use fuzzy logic for both instructional and diagnostic decision making. One outcome of the work on space-related technology-supported instruction has been the creation of a significant pool of human talent in the branch with current expertise on the cutting edges of instructional technologies. When the human talent is combined with advanced technologies for graphics, sound, video, CD-ROM, and high speed computing, the result is a powerful research and development group that both contributes to the applied foundations of instructional technology and creates effective instructional packages that take advantage of a range of advanced technologies. Several branch projects are currently underway that combine NASA-developed expertise to significant instructional problems in public education. The branch, for example, has developed intelligent computer aided software to help high school students learn physics and staff are currently working on a project to produce educational software for young children with language deficits. This report deals with another project, the adult literacy tutor. Unfortunately, while there are a number of computer-based instructional packages available for adult literacy instruction, most of them are based on the same instructional models that failed these students when they were in school. The teacher-centered, discrete skill and drill-oriented, instructional strategies, even when they are supported by color computer graphics and animation, that form the foundation for most of the computer-based literacy packages currently on the market may not

  8. Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy

    PubMed Central

    2016-01-01

    Recently, several prognostic scoring systems for patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) have been published. The aim of this study was to validate the established scoring systems for outcome prediction in Korean patients. We retrospectively reviewed the data of 50 patients on ECMO therapy in our center from 2012 to 2014. A calculation of outcome prediction scoring tools was performed and the comparison across various models was conducted. In our study, the overall hospital survival was 46% and successful weaning rate was 58%. The Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) score showed good discrimination of mortality prediction for patients on ECMO with AUC of 0.80 (95% CI 0.66-0.90). The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and simplified acute physiology score (SAPS) II score also showed fair prediction ability with AUC of 0.79 (95% CI 0.65-0.89) and AUC of 0.78 (95% CI 0.64-0.88), respectively. However, the ECMOnet score failed to predict mortality with AUC of 0.51 (95% CI 0.37-0.66). When evaluating the predictive accuracy according to optimal cut-off point of each scoring system, RESP score had a best specificity of 91.3% and 66.7% of sensitivity, respectively. This study supports the clinical usefulness of the prognostic scoring tools for severe ARDS with ECMO therapy when applying to the Korean patients receiving ECMO. PMID:27247503

  9. Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy.

    PubMed

    Lee, Seunghyun; Yeo, Hye Ju; Yoon, Seong Hoon; Lee, Seung Eun; Cho, Woo Hyun; Jeon, Doo Soo; Kim, Yun Seong; Son, Bong Soo; Kim, Do Hyung

    2016-06-01

    Recently, several prognostic scoring systems for patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) have been published. The aim of this study was to validate the established scoring systems for outcome prediction in Korean patients. We retrospectively reviewed the data of 50 patients on ECMO therapy in our center from 2012 to 2014. A calculation of outcome prediction scoring tools was performed and the comparison across various models was conducted. In our study, the overall hospital survival was 46% and successful weaning rate was 58%. The Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) score showed good discrimination of mortality prediction for patients on ECMO with AUC of 0.80 (95% CI 0.66-0.90). The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and simplified acute physiology score (SAPS) II score also showed fair prediction ability with AUC of 0.79 (95% CI 0.65-0.89) and AUC of 0.78 (95% CI 0.64-0.88), respectively. However, the ECMOnet score failed to predict mortality with AUC of 0.51 (95% CI 0.37-0.66). When evaluating the predictive accuracy according to optimal cut-off point of each scoring system, RESP score had a best specificity of 91.3% and 66.7% of sensitivity, respectively. This study supports the clinical usefulness of the prognostic scoring tools for severe ARDS with ECMO therapy when applying to the Korean patients receiving ECMO. PMID:27247503

  10. Characterizing Adults Receiving Primary Medical Care in New York City: Implications for Using Electronic Health Records for Chronic Disease Surveillance

    PubMed Central

    Romo, Matthew L.; Lurie-Moroni, Elizabeth; Perlman, Sharon E.; Newton-Dame, Remle; Thorpe, Lorna E.; McVeigh, Katharine H.

    2016-01-01

    Introduction Electronic health records (EHRs) from primary care providers can be used for chronic disease surveillance; however, EHR-based prevalence estimates may be biased toward people who seek care. This study sought to describe the characteristics of an in-care population and compare them with those of a not-in-care population to inform interpretation of EHR data. Methods We used data from the 2013–2014 New York City Health and Nutrition Examination Survey (NYC HANES), considered the gold standard for estimating disease prevalence, and the 2013 Community Health Survey, and classified participants as in care or not in care, on the basis of their report of seeing a health care provider in the previous year. We used χ2 tests to compare the distribution of demographic characteristics, health care coverage and access, and chronic conditions between the 2 populations. Results According to the Community Health Survey, approximately 4.1 million (71.7%) adults aged 20 or older had seen a health care provider in the previous year; according to NYC HANES, approximately 4.7 million (75.1%) had. In both surveys, the in-care population was more likely to be older, female, non-Hispanic, and insured compared with the not-in-care population. The in-care population from the NYC HANES also had a higher prevalence of diabetes (16.7% vs 6.9%; P < .001), hypercholesterolemia (35.7% vs 22.3%; P < .001), and hypertension (35.5% vs 26.4%; P < .001) than the not-in-care population. Conclusion Systematic differences between in-care and not-in-care populations warrant caution in using primary care data to generalize to the population at large. Future efforts to use primary care data for chronic disease surveillance need to consider the intended purpose of data collected in these systems as well as the characteristics of the population using primary care. PMID:27126554

  11. Protective effect of combined pumpkin seed and ginger extracts on sperm characteristics, biochemical parameters and epididymal histology in adult male rats treated with cyclophosphamide.

    PubMed

    Aghaie, Somaieh; Nikzad, Hossein; Mahabadi, Javad Amini; Taghizadeh, Mohsen; Azami-Tameh, Abolfazl; Taherian, Aliakbar; Sajjadian, Seyyed Mohammad Sajjad; Kamani, Mehran

    2016-09-01

    Reproductive toxicity is one of the side effects of cyclophosphamide (CP) in cancer treatment. Pumpkin seeds and Zingiber officinale are natural sources of antioxidants. We investigated the possible protective effect of combined pumpkin seed and Zingiber officinale extracts on sperm characteristics, epididymal histology and biochemical parameters of CP-treated rats. Male adult Wistar rats were divided randomly into six groups. Group 1, as a control, received an isotonic saline solution injection intraperitoneally (IP). Group 2 were injected IP with a single dose of CP (100 mg/kg) once. Groups 3 and 4 received CP plus 300 and 600 mg/kg combined pumpkin seed and Zingiber officinale extract (50:50). Groups 5 and 6 received only 300 and 600 mg/kg combined pumpkin seed and Zingiber officinale extract. Six weeks after treatment, sperm characteristics, histopathological changes and biochemical parameters were assessed. In CP-treated rats, motile spermatozoa were decreased, and abnormal or dead spermatozoa increased significantly (P < 0.001) but administration of the mixed extract improved sperm parameters. Epididymal epithelium and fibromascular thickness were also improved in extract-treated rats compared to control or CP groups. Biochemical analysis showed that the administration of combined extracts could increase the total antioxidant capacity (TAC) level significantly in groups 3, 4, 5 and 6. Interestingly, the mixed extract could decrease most of the side effects of CP such as vacuolization and separation of epididymal tissue. Our findings indicated that the combined extracts might be used as a protective agent against CP-induced reproductive toxicity. PMID:26714700

  12. Combinations of differentiation markers distinguish subpopulations of alveolar epithelial cells in adult lung.

    PubMed

    Liebler, Janice M; Marconett, Crystal N; Juul, Nicholas; Wang, Hongjun; Liu, Yixin; Flodby, Per; Laird-Offringa, Ite A; Minoo, Parviz; Zhou, Beiyun

    2016-01-15

    Distal lung epithelium is maintained by proliferation of alveolar type II (AT2) cells and, for some daughter AT2 cells, transdifferentiation into alveolar type I (AT1) cells. We investigated if subpopulations of alveolar epithelial cells (AEC) exist that represent various stages in transdifferentiation from AT2 to AT1 cell phenotypes in normal adult lung and if they can be identified using combinations of cell-specific markers. Immunofluorescence microscopy showed that, in distal rat and mouse lungs, ∼ 20-30% of NKX2.1(+) (or thyroid transcription factor 1(+)) cells did not colocalize with pro-surfactant protein C (pro-SP-C), a highly specific AT2 cell marker. In distal rat lung, NKX2.1(+) cells coexpressed either pro-SP-C or the AT1 cell marker homeodomain only protein x (HOPX). Not all HOPX(+) cells colocalize with the AT1 cell marker aquaporin 5 (AQP5), and some AQP5(+) cells were NKX2.1(+). HOPX was expressed earlier than AQP5 during transdifferentiation in rat AEC primary culture, with robust expression of both by day 7. We speculate that NKX2.1 and pro-SP-C colocalize in AT2 cells, NKX2.1 and HOPX or AQP5 colocalize in intermediate or transitional cells, and HOPX and AQP5 are expressed without NKX2.1 in AT1 cells. These findings suggest marked heterogeneity among cells previously identified as exclusively AT1 or AT2 cells, implying the presence of subpopulations of intermediate or transitional AEC in normal adult lung. PMID:26545903

  13. Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration.

    PubMed

    Rousseau, L; Dupont, A; Labrie, F; Couture, M

    1988-02-01

    The results of a written questionnaire with 44 patients (pilot study) indicated that before the beginning of treatment for advanced prostatic cancer, most subjects had an active sexual life, as illustrated by a normal erotic imagery, an adequate sexual desire and a normal frequency of intercourse. More than three-quarters (80%) of subjects had at least one coitus a week. Slightly more than 50% were able to easily achieve an erection by erotic imagery or by a preferred sexual fantasy; 50% never experienced erectile problems. When compared with their previous sexual functioning, 70% of subjects noticed during the antiandrogenic treatment a major reduction in their interest for sexual intercourse which was maintained in only 18% of patients. It became impossible for 57% to induce an erection by erotic imagery. However, 19% claimed an ability to maintain an erection during sexual activity, as compared to 56% before treatment, but erections usually lacked full rigidity. Twenty-two percent of patients mentioned having nocturnal or morning erections. Despite this dramatic decrease in sexual activity in most patients, complete antiandrogen blockade left sexual activity in approximately 20% of patients. Due to the treatment's excellent tolerance, the findings suggest that such combined androgen blockade could be beneficial for the treatment of sex offenders. PMID:3358677

  14. A comparison of psychiatric diagnoses among HIV-infected prisoners receiving combination antiretroviral therapy and transitioning to the community

    PubMed Central

    Di Paola, Angela; Altice, Frederick L; Powell, Mary Lindsay; Trestman, Robert L; Springer, Sandra A

    2014-01-01

    Background The criminal justice system (CJS), specifically prisons and jails, is ideally suited for uniform screening of psychiatric (PD) and substance use disorders (SUDs) among people living with HIV/AIDS (PLWHA), who are concentrated in these settings. By accurately diagnosing PDs and SUDs in these controlled settings, treatment can be initiated and contribute to improved continuity of care upon release. In the context of PLWHA, it may also improve combination antiretroviral treatment (cART) adherence, and reduce HIV transmission risk behaviors. Methods A retrospective data analysis was conducted by creating a cohort of PLWHA transitioning to the community from prison or jail enrolled who were enrolled in a controlled trial of directly administered antiretroviral (DAART). Participants were systematically assessed for PDs and SUDs using the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric assessment tool, and compared to diagnoses documented within the correctional medical record. Results Findings confirm a high prevalence of Axis I PDs (47.4%) and SUDs (67.1%) in PLWHA even after prolonged abstinence from alcohol and drugs. Although prevalence of PDs and SUDs were high in the medical record, there was fair to poor agreement among PDs using the MINI, making evident the potential benefit of more objective and concurrent PD assessments to guide treatment. Conclusions Additional PD diagnoses may be detected in PLWHA in CJS using supplementary and objective screening tools. By identifying and treating PDs and SUDs in the CJS, care may be improved and may ultimately contribute to healthier outcomes after community release if patients are effectively transitioned. PMID:25606368

  15. Embedding global barrier and collective in torus network with each node combining input from receivers according to class map for output to senders

    DOEpatents

    Chen, Dong; Coteus, Paul W; Eisley, Noel A; Gara, Alan; Heidelberger, Philip; Senger, Robert M; Salapura, Valentina; Steinmacher-Burow, Burkhard; Sugawara, Yutaka; Takken, Todd E

    2013-08-27

    Embodiments of the invention provide a method, system and computer program product for embedding a global barrier and global interrupt network in a parallel computer system organized as a torus network. The computer system includes a multitude of nodes. In one embodiment, the method comprises taking inputs from a set of receivers of the nodes, dividing the inputs from the receivers into a plurality of classes, combining the inputs of each of the classes to obtain a result, and sending said result to a set of senders of the nodes. Embodiments of the invention provide a method, system and computer program product for embedding a collective network in a parallel computer system organized as a torus network. In one embodiment, the method comprises adding to a torus network a central collective logic to route messages among at least a group of nodes in a tree structure.

  16. Markedly additive antitumor activity with the combination of a selective survivin suppressant YM155 and alemtuzumab in adult T-cell leukemia.

    PubMed

    Chen, Jing; Pise-Masison, Cynthia A; Shih, Joanna H; Morris, John C; Janik, John E; Conlon, Kevin C; Keating, Anne; Waldmann, Thomas A

    2013-03-14

    Adult T-cell leukemia (ATL) is an aggressive malignancy of CD4(+)CD25(+) lymphocytes caused by human T-cell lymphotropic virus type 1. Currently, there is no accepted curative therapy for ATL. In gene expression profiling, the antiapoptotic protein survivin (BIRC5) demonstrated a striking increase in ATL, and its expression was increased in patient ATL cells resistant to the anti-CD52 monoclonal antibody alemtuzumab (Campath-1H). In this study, we investigated the antitumor activity of a small-molecule survivin suppressant YM155 alone and in combination with alemtuzumab in a murine model of human ATL (MET-1). Both YM155 alone and its combination with alemtuzumab demonstrated therapeutic efficacy by lowering serum soluble IL-2Rα (sIL-2Rα) levels (P < .001) and prolonged the survival of tumor-bearing mice (P < .0001). Moreover, the combination of YM155 with alemtuzumab demonstrated markedly additive antitumor activity by significantly lowering serum sIL-2Rα levels and improving the survival of leukemia-bearing mice compared with monotherapy with either YM155 (P < .001) or alemtuzumab (P < .05). More significantly, all mice that received the combination therapy survived and were tumor free >6 months after treatment. Our data support a clinical trial of the combination of YM155 with alemtuzumab in ATL. This trial was registered at www.clinicaltrials.gov as #NCT00061048. PMID:23321252

  17. Markedly additive antitumor activity with the combination of a selective survivin suppressant YM155 and alemtuzumab in adult T-cell leukemia

    PubMed Central

    Chen, Jing; Pise-Masison, Cynthia A.; Shih, Joanna H.; Morris, John C.; Janik, John E.; Conlon, Kevin C.; Keating, Anne

    2013-01-01

    Adult T-cell leukemia (ATL) is an aggressive malignancy of CD4+CD25+ lymphocytes caused by human T-cell lymphotropic virus type 1. Currently, there is no accepted curative therapy for ATL. In gene expression profiling, the antiapoptotic protein survivin (BIRC5) demonstrated a striking increase in ATL, and its expression was increased in patient ATL cells resistant to the anti-CD52 monoclonal antibody alemtuzumab (Campath-1H). In this study, we investigated the antitumor activity of a small-molecule survivin suppressant YM155 alone and in combination with alemtuzumab in a murine model of human ATL (MET-1). Both YM155 alone and its combination with alemtuzumab demonstrated therapeutic efficacy by lowering serum soluble IL-2Rα (sIL-2Rα) levels (P < .001) and prolonged the survival of tumor-bearing mice (P < .0001). Moreover, the combination of YM155 with alemtuzumab demonstrated markedly additive antitumor activity by significantly lowering serum sIL-2Rα levels and improving the survival of leukemia-bearing mice compared with monotherapy with either YM155 (P < .001) or alemtuzumab (P < .05). More significantly, all mice that received the combination therapy survived and were tumor free >6 months after treatment. Our data support a clinical trial of the combination of YM155 with alemtuzumab in ATL. This trial was registered at www.clinicaltrials.gov as #NCT00061048. PMID:23321252

  18. Effect of whey and soy protein supplementation combined with resistance training in young adults.

    PubMed

    Candow, Darren G; Burke, Natalie C; Smith-Palmer, T; Burke, Darren G

    2006-06-01

    The purpose was to compare changes in lean tissue mass, strength, and myofibrillar protein catabolism resulting from combining whey protein or soy protein with resistance training. Twenty-seven untrained healthy subjects (18 female, 9 male) age 18 to 35 y were randomly assigned (double blind) to supplement with whey protein (W; 1.2 g/kg body mass whey protein + 0.3 g/kg body mass sucrose power, N = 9: 6 female, 3 male), soy protein (S; 1.2 g/kg body mass soy protein + 0.3 g/kg body mass sucrose powder, N= 9: 6 female, 3 male) or placebo (P; 1.2 g/kg body mass maltodextrine + 0.3 g/kg body mass sucrose powder, N = 9: 6 female, 3 male) for 6 wk. Before and after training, measurements were taken for lean tissue mass (dual energy X-ray absorptiometry), strength (1-RM for bench press and hack squat), and an indicator of myofibrillar protein catabolism (urinary 3-methylhistidine). Results showed that protein supplementation during resistance training, independent of source, increased lean tissue mass and strength over isocaloric placebo and resistance training (P < 0.05). We conclude that young adults who supplement with protein during a structured resistance training program experience minimal beneficial effects in lean tissue mass and strength. PMID:16948480

  19. Project DyAdd: Fatty acids in adult dyslexia, ADHD, and their comorbid combination.

    PubMed

    Laasonen, Marja; Hokkanen, Laura; Leppämäki, Sami; Tani, Pekka; Erkkilä, Arja T

    2009-07-01

    In project DyAdd, we compared the fatty acid (FA) profiles of serum phospholipids in adults with attention deficit hyperactivity disorder (ADHD) (n=26), dyslexia (n=36), their comorbid combination (n=9), and healthy controls (n=36). FA proportions were analyzed in a 2x2 design with Bonferroni corrected post hoc comparisons. A questionnaire was used to assess dietary fat quality and use of supplements. Results showed that ADHD and dyslexia were not associated with total saturated FAs, monounsaturated FAs, or n-3 polyunsaturated FAs (PUFAs). However, those with ADHD had elevated proportions of total n-6 PUFAs (including gamma-linolenic and adrenic acids) as compared to those without ADHD. Dyslexia was related to a higher proportion of monounsaturated nervonic acid and a higher ratio of n-6/n-3 PUFAs. Among females none of the associations were significant. However in males, all the original associations observed in all subjects remained and ADHD was associated with elevated nervonic acid and n-6/n-3 PUFA ratio like dyslexia. Controlling for poorly diagnosed reading difficulties, education, dietary fat quality, or use of FA supplements did not generally remove the originally observed associations. PMID:19523794

  20. Estimated mortality of adult HIV-infected patients starting treatment with combination antiretroviral therapy

    PubMed Central

    Yiannoutsos, Constantin Theodore; Johnson, Leigh Francis; Boulle, Andrew; Musick, Beverly Sue; Gsponer, Thomas; Balestre, Eric; Law, Matthew; Shepherd, Bryan E; Egger, Matthias

    2012-01-01

    Objective To provide estimates of mortality among HIV-infected patients starting combination antiretroviral therapy. Methods We report on the death rates from 122 925 adult HIV-infected patients aged 15 years or older from East, Southern and West Africa, Asia Pacific and Latin America. We use two methods to adjust for biases in mortality estimation resulting from loss from follow-up, based on double-sampling methods applied to patient outreach (Kenya) and linkage with vital registries (South Africa), and apply these to mortality estimates in the other three regions. Age, gender and CD4 count at the initiation of therapy were the factors considered as predictors of mortality at 6, 12, 24 and >24 months after the start of treatment. Results Patient mortality was high during the first 6 months after therapy for all patient subgroups and exceeded 40 per 100 patient years among patients who started treatment at low CD4 count. This trend was seen regardless of region, demographic or disease-related risk factor. Mortality was under-reported by up to or exceeding 100% when comparing estimates obtained from passive monitoring of patient vital status. Conclusions Despite advances in antiretroviral treatment coverage many patients start treatment at very low CD4 counts and experience significant mortality during the first 6 months after treatment initiation. Active patient tracing and linkage with vital registries are critical in adjusting estimates of mortality, particularly in low- and middle-income settings. PMID:23172344

  1. Adult combined GH, prolactin, and TSH deficiency associated with circulating PIT-1 antibody in humans

    PubMed Central

    Yamamoto, Masaaki; Iguchi, Genzo; Takeno, Ryoko; Okimura, Yasuhiko; Sano, Toshiaki; Takahashi, Michiko; Nishizawa, Hitoshi; Handayaningshi, Anastasia Evi; Fukuoka, Hidenori; Tobita, Maya; Saitoh, Takatoshi; Tojo, Katsuyoshi; Mokubo, Atsuko; Morinobu, Akio; Iida, Keiji; Kaji, Hidesuke; Seino, Susumu; Chihara, Kazuo; Takahashi, Yutaka

    2010-01-01

    The pituitary-specific transcriptional factor-1 (PIT-1, also known as POU1F1), is an essential factor for multiple hormone-secreting cell types. A genetic defect in the PIT-1 gene results in congenital growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) deficiency. Here, we investigated 3 cases of adult-onset combined GH, PRL, and TSH deficiencies and found that the endocrinological phenotype in each was linked to autoimmunity directed against the PIT-1 protein. We detected anti–PIT-1 antibody along with various autoantibodies in the patients’ sera. An ELISA-based screening revealed that this antibody was highly specific to the disease and absent in control subjects. Immunohistochemical analysis revealed that PIT-1–, GH-, PRL-, and TSH-positive cells were absent in the pituitary of patient 2, who also had a range of autoimmune endocrinopathies. These clinical manifestations were compatible with the definition of autoimmune polyendocrine syndrome (APS). However, the main manifestations of APS-I — hypoparathyroidism and Candida infection — were not observed and the pituitary abnormalities were obviously different from the hypophysitis associated with APS. These data suggest that these patients define a unique “anti–PIT-1 antibody syndrome,” related to APS. PMID:21123951

  2. Re-epithelialization of cutaneous wounds in adult zebrafish combines mechanisms of wound closure in embryonic and adult mammals.

    PubMed

    Richardson, Rebecca; Metzger, Manuel; Knyphausen, Philipp; Ramezani, Thomas; Slanchev, Krasimir; Kraus, Christopher; Schmelzer, Elmon; Hammerschmidt, Matthias

    2016-06-15

    Re-epithelialization of cutaneous wounds in adult mammals takes days to complete and relies on numerous signalling cues and multiple overlapping cellular processes that take place both within the epidermis and in other participating tissues. Re-epithelialization of partial- or full-thickness skin wounds of adult zebrafish, however, is extremely rapid and largely independent of the other processes of wound healing. Live imaging after treatment with transgene-encoded or chemical inhibitors reveals that re-epithelializing keratinocytes repopulate wounds by TGF-β- and integrin-dependent lamellipodial crawling at the leading edges of the epidermal tongue. In addition, re-epithelialization requires long-range epithelial rearrangements, involving radial intercalations, flattening and directed elongation of cells - processes that are dependent on Rho kinase, JNK and, to some extent, planar cell polarity within the epidermis. These rearrangements lead to a massive recruitment of keratinocytes from the adjacent epidermis and make re-epithelialization independent of keratinocyte proliferation and the mitogenic effect of FGF signalling, which are only required after wound closure, allowing the epidermis outside the wound to re-establish its normal thickness. Together, these results demonstrate that the adult zebrafish is a valuable in vivo model for studying and visualizing the processes involved in cutaneous wound closure, facilitating the dissection of direct from indirect and motogenic from mitogenic effects of genes and molecules affecting wound re-epithelialization. PMID:27122176

  3. Combined effects of aerobic exercise and diet on lipids and lipoproteins in overweight and obese adults: a meta-analysis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study used the aggregate data meta-analytic approach to determine the combined effects of aerobic exercise and diet on lipids and lipoproteins in overweight and obese adults. Twelve studies representing 859 men and women (443 intervention, 416 control) were included. Using random-effects models...

  4. The Safety and Efficacy of an Enzyme Combination in Managing Knee Osteoarthritis Pain in Adults: A Randomized, Double-Blind, Placebo-Controlled Trial

    PubMed Central

    Bolten, Wolfgang W.; Glade, Michael J.; Raum, Sonja; Ritz, Barry W.

    2015-01-01

    This randomized, double-blind, placebo-controlled, and comparator-controlled trial evaluated the safety and efficacy of an enzyme combination, as Wobenzym, in adults with moderate-to-severe osteoarthritis (OA) of the knee. Adults (n = 150) received Wobenzym, diclofenac (a nonsteroidal anti-inflammatory drug, NSAID), or placebo for 12 weeks. Improvement in pain scores (Lequesne Functional Index) did not differ between subjects treated with Wobenzym or diclofenac, and both treatment groups improved compared to placebo (P < 0.05). Reduction in total WOMAC scores (secondary outcome measure) did not differ between Wobenzym and diclofenac, although only diclofenac emerged as different from placebo (P < 0.05). The median number of rescue medication (paracetamol) tablets consumed was less in the Wobenzym group compared to placebo (P < 0.05), while there was no difference between diclofenac and placebo. Adverse events were similar in frequency in Wobenzym and placebo groups (7.2% and 9.1% of subjects, resp.) and higher in diclofenac group (15.6%). Wobenzym is comparable to the NSAID diclofenac in relieving pain and increasing function in adults with moderate-to-severe painful knee OA and reduces reliance on analgesic medication. Wobenzym is associated with fewer adverse events and, therefore, may be appropriate for long-term use. PMID:25802756

  5. Combined Healthy Lifestyle Is Inversely Associated with Psychological Disorders among Adults

    PubMed Central

    Saneei, Parvane; Esmaillzadeh, Ahmad; Hassanzadeh Keshteli, Ammar; Reza Roohafza, Hamid; Afshar, Hamid; Feizi, Awat; Adibi, Peyman

    2016-01-01

    Background and Aims Joint association of lifestyle-related factors and mental health has been less studied in earlier studies, especially in Middle Eastern countries. This study aimed to examine how combinations of several lifestyle-related factors related to depression and anxiety in a large group of middle-age Iranian population. Methods In a cross-sectional study on 3363 Iranian adults, a healthy lifestyle score was constructed by the use of data from dietary intakes, physical activity, smoking status, psychological distress and obesity. A dish-based 106-item semi-quantitative validated food frequency questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ) and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. The Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. Results After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle were 95% less likely to be anxious (OR: 0.05; 95% CI: 0.01–0.27) and 96% less likely to be depressed (OR: 0.04; 95% CI: 0.01–0.15), compared with those with the lowest score. In addition, non-smokers had lower odds of anxiety (OR: 0.64; 95% CI: 0.47–0.88) and depression (OR: 0.62; 95% CI: 0.48–0.81) compared with smokers. Individuals with low levels of psychological distress had expectedly lower odds of anxiety (OR: 0.13; 95% CI: 0.10–0.16) and depression (OR: 0.10; 95% CI: 0.08–0.12) than those with high levels. Individuals with a healthy diet had 29% lower odds of depression (OR: 0.71; 95% CI: 0.59–0.87) than those with a non-healthy diet. Conclusion We found evidence indicating that healthy lifestyle score was associated with lower odds of anxiety and depression in this group of Iranian adults. Healthy diet, psychological distress, and smoking status were independent predictors of mental disorders. PMID:26771311

  6. TSH and thyroid hormones concentrations in patients with hypothyroidism receiving replacement therapy with L-thyroxine alone or in combination with L-triiodothyronine.

    PubMed

    Fadeyev, Valentin V; Morgunova, Tatiana B; Sytch, Julia P; Melnichenko, Galina A

    2005-01-01

    The aim of this study was to evaluate parameters of thyroid function in patients with primary hypothyroidism receiving either monotherapy with L-T4 or combination L-T4+L-T3. Fifty-eight women with primary hypothyroidism receiving L-T4 were enrolled in the study. The patients were randomised into two groups: Group 1 (n=42) patients continued monotherapy with L-T4, and Group 2 (n=16) patients were switched to combined therapy with L-T4+L-T3 (25 microg L-T4 was replaced with 12.5 microg L-T3). The final examination was carried out 6 months thereafter. There was also a third group of 20 healthy women (control group). Under monotherapy with L-T4, serum FT4 levels were higher (p < 0.05) and FT3 lower (p < 0.05) than in the control group, while the monotherapy subgroup of patients with low-normal TSH had serum FT4 levels higher than in the control group (p < 0.05). Serum FT4 under combined therapy was significantly lower than in both control and monotherapy groups. FT3 levels did not differ between the two groups of combined and monotherapy subjects; the highest FT3 levels were in the control group. L-T4 replacement therapy is associated with non-physiologically high FT4 and low FT3 levels. Therapy with L-T3 once a day does not simulate the normal production of T3 by the thyroid. PMID:16613812

  7. Combined MI + CBT for Depressive Symptoms and Binge Drinking Among Young Adults: Two Case Studies.

    PubMed

    Pedrelli, Paola; Borsari, Brian; Palm, Kathleen M; Dalton, Elizabeth; Fava, Maurizio

    2013-08-01

    There are high rates of comorbidity between heavy drinking and depressive symptoms among college students, often resulting in severe alcohol-related consequences. No empirically supported treatment exists that concurrently addresses both of these problems in this population. Research with college students has demonstrated that brief motivational interventions (BMIs) reduce heavy drinking and alcohol-related consequences, and that cognitive behavioral therapy for depression (CBT-D) is effective in reducing depressive symptoms. Thus, a program combining BMI and CBT-D appears ideal for college students with co-occurring binge drinking and depressive symptoms. This manuscript presents the rationale and format of a BMI + CBT-D treatment protocol for this population, and provides a case example of a female college student who received the protocol and experienced improvement in depressive symptoms, a reduction in alcohol use and alcohol-related negative consequences, and an increase in readiness to change alcohol consumption. We discuss theoretical and clinical implications of these findings, and suggest directions for future research. PMID:25170188

  8. Combined MI + CBT for Depressive Symptoms and Binge Drinking Among Young Adults: Two Case Studies

    PubMed Central

    Pedrelli, Paola; Borsari, Brian; Palm, Kathleen M.; Dalton, Elizabeth; Fava, Maurizio

    2014-01-01

    There are high rates of comorbidity between heavy drinking and depressive symptoms among college students, often resulting in severe alcohol-related consequences. No empirically supported treatment exists that concurrently addresses both of these problems in this population. Research with college students has demonstrated that brief motivational interventions (BMIs) reduce heavy drinking and alcohol-related consequences, and that cognitive behavioral therapy for depression (CBT-D) is effective in reducing depressive symptoms. Thus, a program combining BMI and CBT-D appears ideal for college students with co-occurring binge drinking and depressive symptoms. This manuscript presents the rationale and format of a BMI + CBT-D treatment protocol for this population, and provides a case example of a female college student who received the protocol and experienced improvement in depressive symptoms, a reduction in alcohol use and alcohol-related negative consequences, and an increase in readiness to change alcohol consumption. We discuss theoretical and clinical implications of these findings, and suggest directions for future research. PMID:25170188

  9. Second Cancer Risk and Late Mortality in Adult Australians Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A Population-Based Cohort Study.

    PubMed

    Vajdic, Claire M; Mayson, Eleni; Dodds, Anthony J; O'Brien, Tracey; Wilcox, Leonie; Nivison-Smith, Ian; Le Marsney, Renate; Daniels, Benjamin; Ashton, Lesley J

    2016-05-01

    We quantified the risk of second cancer and late mortality in a population-based Australian cohort of 3273 adult (≥15 years) allogeneic hematopoietic stem cell transplant recipients (1992 to 2007). Most recipients received nonradiation-based conditioning and a peripheral blood graft from a matched related donor. Using record linkage with death and cancer registries, 79 second cancers were identified a median of 3.5 years after transplantation. The competing-risk adjusted cumulative incidence of second cancers was 3.35% (95% CI, 2.59 to 4.24) at 10 years, and the cancer risk relative to the matched general population was 2.10 (95% CI, 1.65 to 2.56). We observed an excess risk of melanoma and lip, tongue, esophagus, and soft tissue cancers. Cancer risk relative to the general population was elevated for those transplanted for lymphoma, some leukemia subtypes, and severe aplastic anemia, recipients who developed chronic graft-versus-host disease (cGVHD) and irrespective of radiation-based conditioning or stem cell source. In those alive 2 years after transplantation (n = 1463), the cumulative incidence of late mortality was 22.2% (95% CI, 19.7 to 24.9) at 10 years, and the risk of death relative to the matched general population was 13.8 (95% CI, 12.2 to 15.6). In multivariable modeling, risk of late death was reduced for females compared with males and those transplanted for chronic myeloid leukemia compared with acute myeloid leukemia; risk was increased for recipients with discordant sex donors, cGVHD, those undergoing second transplants, and disease relapse. Adults undergoing allogeneic transplantation have unique cancer and mortality risk profiles that continue to warrant prevention and surveillance activities targeted at high-risk subgroups. PMID:26860637

  10. Artemisinin-naphthoquine combination (ARCO™) therapy for uncomplicated falciparum malaria in adults of Papua New Guinea: A preliminary report on safety and efficacy

    PubMed Central

    Hombhanje, Francis W; Linge, David; Saweri, Adolf; Kuanch, Cynthia; Jones, Robert; Toraso, Stephen; Geita, Jacobed; Masta, Andrew; Kevau, Isi; Hiawalyer, Gilbert; Sapuri, Mathias

    2009-01-01

    Background The use of anti-malarial drug combinations with artemisinin or with one of its derivatives is now widely recommended to overcome drug resistance in falciparum as well as vivax malaria. The fixed oral dose artemisinin-naphthoquine combination (ANQ, ARCO™) is a newer artemisinin-based combination (ACT) therapy undergoing clinical assessment. A study was undertaken to assess the safety, efficacy and tolerability of ANQ combination in areas of multi-drug resistance to generate preliminary baseline data in adult population of Papua New Guinea. Methods The clinical assessment was an open-labeled, two-arm, randomized study comparing ANQ combination as a single dose regimen and three days regimen (10 mg/kg/day) of chloroquine plus single dose sulphadoxine-pyrimethamine (CQ+SP) for the treatment of uncomplicated falciparum malaria with 28 days follow-up in an adult population. The primary outcome measures for efficacy were day 1, 2, 3 7, 14 and 28-day cure rates. Secondary outcomes included parasite clearance time, fever clearance time, and gametocyte carriage. The main outcome measures for safety were incidences of post-treatment clinical and laboratory adverse events. Results Between June 2005 and July 2006, 130 patients with confirmed uncomplicated P. falciparum were randomly assigned to receive ANQ and CQ+SP, only 100 patients (51 in ANQ group and 49 in CQ+SP group) were evaluated for clinical and parasitological outcomes. All the patients treated with ANQ and CQ+SP showed adequate clinical and parasitological response with 28 days follow-up. The cure rate for ANQ on day 1, 2, 3, 7, 14, and 28 was 47%, 86%, 92%, 94%, 94% and 94%, respectively. Recrudescence account for 6%; all were cleared on day 21. For CQ+SP treated group the cure rates were 24%, 67%, 82%, 82%, 84% and 88%, respectively. Recrudescence accounted for 10%; all were cleared on day 28 except for one patient. Both regimens were well tolerated with no serious adverse events. The proportion of

  11. Efficacy and safety of different doses of tirofiban combined with ticagrelor on diabetic patients with AMI receiving in emergency percutaneous coronary intervention (PCI)

    PubMed Central

    Liu, Yang; Liu, Hengliang; Hao, Zhenxuan; Geng, Guoying; Chen, Qi; Han, Wenjie; Jia, Kailong; Zhou, Yuxin

    2015-01-01

    Objective: The aim of this study was to investigate the efficacy and safety of dual antiplatelet drugs combined with different doses of tirofiban on diabetic patients with acute myocardial infarction (AMI) receiving emergency percutaneous coronary intervention (PCI). Methods: 158 diabetic patients with AMI undergone emergency PCI were randomly divided into three groups: Group A (53 cases) as the control group-dual anti-platelet agents (aspirin + ticagrelor); Group B (52 cases)-dual anti-platelet agents + conventional dose of tirofiban [10 μg/kg by PCI and 0.15 μg/(kg·min) by continue venous pump for 24 h]; Group C (53 cases)-dual antiplatelet agents + half-dose tirofiban [10 μg/kg by PCI and 0.075 μg/(kg·min) by continue venous pump for 24 h]. Results: Compared with group A, thrombolysis in myocardial infarction 3 (TIMI3) blood flow and TIMI myocardial perfusion grade 3 (TMPG3) myocardial perfusion of patients in group B and group C after PCI was significantly higher (P < 0.05), the average day of hospitalization was significantly shorter (P < 0.05), reinfarction during hospitalization, post-infarction angina, severe arrhythmia, the incidence of cardiac function above KillipIII level was significantly lower (P < 0.05). And the differences between group B and C was not statistically significant (P > 0.05). Severe bleeding and moderate incidence of bleeding in group B was significantly higher than that in group A and group C (P < 0.05). Conclusions: Based on combination of dual the anti-platelet agents and ticagrelor for diabetic patients with AMI receiving PCI, the combination of half-dose tirofiban can effectively improve TIMI flow and TMPG myocardial tissue perfusion, and reduce the incidence of major adverse cardiac events (MACE) and severe bleeding. PMID:26379951

  12. Addressing the Vaccine Hesitancy Continuum: An Audience Segmentation Analysis of American Adults Who Did Not Receive the 2009 H1N1 Vaccine.

    PubMed

    Ramanadhan, Shoba; Galarce, Ezequiel; Xuan, Ziming; Alexander-Molloy, Jaclyn; Viswanath, Kasisomayajula

    2015-01-01

    Understanding the heterogeneity of groups along the vaccine hesitancy continuum presents an opportunity to tailor and increase the impact of public engagement efforts with these groups. Audience segmentation can support these goals, as demonstrated here in the context of the 2009 H1N1 vaccine. In March 2010, we surveyed 1569 respondents, drawn from a nationally representative sample of American adults, with oversampling of racial/ethnic minorities and persons living below the United States Federal Poverty Level. Guided by the Structural Influence Model, we assessed knowledge, attitudes, and behaviors related to H1N1; communication outcomes; and social determinants. Among those who did not receive the vaccine (n = 1166), cluster analysis identified three vaccine-hesitant subgroups. Disengaged Skeptics (67%) were furthest from vaccine acceptance, with low levels of concern and engagement. The Informed Unconvinced (19%) were sophisticated consumers of media and health information who may not have been reached with information to motivate vaccination. The Open to Persuasion cluster (14%) had the highest levels of concern and motivation and may have required engagement about vaccination broadly. There were significant sociodemographic differences between groups. This analysis highlights the potential to use segmentation techniques to identify subgroups on the vaccine hesitancy continuum and tailor public engagement efforts accordingly. PMID:26350595

  13. Longitudinal changes of endocrine and bone disease in adults with β-thalassemia major receiving different iron chelators over 5 years.

    PubMed

    Poggi, Maurizio; Sorrentino, Francesco; Pugliese, Pellegrina; Smacchia, Maria Paola; Daniele, Carmine; Equitani, Francesco; Terlizzi, Filomena; Guitarrini, Maria Rita; Monti, Salvatore; Maffei, Laura; Losardo, Anna; Pasin, Methap; Toscano, Vincenzo

    2016-04-01

    In this study, we compared the long-term effects of different iron chelation regimens (deferoxamine, deferiprone, deferoxamine + deferiprone, and deferasirox) in preventing or reversing endocrinopathy (diabetes mellitus, hypothyroidism, or hypogonadism) and bone disease (measured through DEXA) in 165 adults with β-thalassemia major (TM) (mean age 39.9 ± 8.3 years, 43 % males). After five consecutive years of therapy, patients on deferasirox had the highest decrease in the prevalence of any endocrinopathy compared to other chelators which either had no change (deferiprone and deferoxamine) or had an increase (deferoxamine + deferiprone), p = 0.015. This was attributed to a lower proportion of patients on deferasirox developing new-onset endocrinopathy and higher proportion showing reversal of disease, compared to other chelators. A serum ferritin level of >1300 ng/mL predicted the development of new endocrinopathy (p = 0.025) while a level of <200 ng/mL predicted reversal of existing endocrinopathy (p = 0.147). A significant increase in mean BMD T-score (p < 0.001) and a considerable decrease in osteoporosis prevalence were observed in patients receiving deferasirox but not other chelators. Iron chelation therapy with deferasirox has a role in the prevention of endocrinopathy and reversal of existing disease. PMID:26957357

  14. Addressing the Vaccine Hesitancy Continuum: An Audience Segmentation Analysis of American Adults Who Did Not Receive the 2009 H1N1 Vaccine

    PubMed Central

    Ramanadhan, Shoba; Galarce, Ezequiel; Xuan, Ziming; Alexander-Molloy, Jaclyn; Viswanath, Kasisomayajula

    2015-01-01

    Understanding the heterogeneity of groups along the vaccine hesitancy continuum presents an opportunity to tailor and increase the impact of public engagement efforts with these groups. Audience segmentation can support these goals, as demonstrated here in the context of the 2009 H1N1 vaccine. In March 2010, we surveyed 1569 respondents, drawn from a nationally representative sample of American adults, with oversampling of racial/ethnic minorities and persons living below the United States Federal Poverty Level. Guided by the Structural Influence Model, we assessed knowledge, attitudes, and behaviors related to H1N1; communication outcomes; and social determinants. Among those who did not receive the vaccine (n = 1166), cluster analysis identified three vaccine-hesitant subgroups. Disengaged Skeptics (67%) were furthest from vaccine acceptance, with low levels of concern and engagement. The Informed Unconvinced (19%) were sophisticated consumers of media and health information who may not have been reached with information to motivate vaccination. The Open to Persuasion cluster (14%) had the highest levels of concern and motivation and may have required engagement about vaccination broadly. There were significant sociodemographic differences between groups. This analysis highlights the potential to use segmentation techniques to identify subgroups on the vaccine hesitancy continuum and tailor public engagement efforts accordingly. PMID:26350595

  15. Phase IIa study of the immunogenicity and safety of the novel Staphylococcus aureus vaccine V710 in adults with end-stage renal disease receiving hemodialysis.

    PubMed

    Moustafa, Moustafa; Aronoff, George R; Chandran, Chandra; Hartzel, Jonathan S; Smugar, Steven S; Galphin, Claude M; Mailloux, Lionel U; Brown, Elizabeth; Dinubile, Mark J; Kartsonis, Nicholas A; Guris, Dalya

    2012-09-01

    Bacteremia is the second leading cause of death in patients with end-stage renal disease who are on hemodialysis. A vaccine eliciting long-term immune responses against Staphylococcus aureus in patients on chronic hemodialysis may reduce the incidence of bacteremia and its complications in these patients. V710 is a vaccine containing iron surface determinant B (IsdB), a highly conserved S. aureus surface protein, which has been shown to be immunogenic in healthy subjects. In this blinded phase II immunogenicity study, 206 chronic hemodialysis patients between the ages of 18 and 80 years old were randomized to receive 60 μg V710 (with or without adjuvant), 90 μg V710 (with adjuvant), or a placebo in various combinations on days 1, 28, and 180. All 201 vaccinated patients were to be followed through day 360. The primary hypothesis was that at least 1 of the 3 groups receiving 2 V710 doses on days 1 and 28 would have a ≥2.5 geometric mean fold rise (GMFR) in anti-IsdB IgG titers over the baseline 28 days after the second vaccination (day 56). At day 56, all three groups receiving 2 doses of V710 achieved a ≥2.5 GMFR in anti-IsdB antibodies compared to the baseline (P values of <0.001 for all 3 groups), satisfying the primary immunogenicity hypothesis. None of the 33 reported serious adverse experiences were considered vaccine related by the investigators. V710 induced sustained antibody responses for at least 1 year postvaccination in patients on chronic hemodialysis. PMID:22837094

  16. Differential effects of arsenite and arsenate to Drosophila melanogaster in a combined adult/developmental toxicity assay

    SciTech Connect

    Goldstein, S.H.; Babich, H.

    1989-02-01

    Current concern of the environmental consequences of chemical wastes in soils has led to the development of microbial, plant, and, to a lesser extent, animal bioassays for terrestrial ecosystems. This paper evaluated a Drosophila assay that yields data both on acute toxicity to adults and on developmental toxicity to offspring and which is applicable for screening extracts from soils contaminated with chemical wastes. Acute toxicity assays with Drosophila have been used to evaluate the relative potencies of chemicals. The acute toxicity to adults and the developmental exposure bioassays were designed to be performed as separate tests. This paper combined these two tests into a single bioassay, using arsenic compounds as the test agents. Arsenite and arsenate were selected to evaluate the sensitivity of this combined assay in distinguishing between the toxicities of closely related chemicals.

  17. Urine Liver-Type Fatty Acid-Binding Protein and Kidney Injury Molecule-1 in HIV-Infected Patients Receiving Combined Antiretroviral Treatment Based on Tenofovir

    PubMed Central

    Wójcik, Kamila; Piekarska, Anna

    2014-01-01

    Abstract The aim of this study was to determine the presence of kidney tubular damage in the absence of overt evidence of glomerular dysfunction (GFR>60 ml/min without proteinuria) in HIV-infected patients receiving antiretroviral therapy. Urine kidney injury molecule-1 (KIM-1) and liver-type fatty acid-binding protein (L-FABP) levels were measured by ELISA and expressed as a ratio to creatinine. Sixty-six patients (median age 38 years) and 10 healthy controls (median age 35.5 years) were included in the study. Patients with chronic diseases such as diabetes, hypertension, heart disease, or kidney disease were excluded from the study. All patients received tenofovir/emtricitabine combined with one of three other components, namely efavirenz, atazanavir/norvir, or lopinavir/norvir. A lower concentration of L-FABP/creatinine was observed in HIV-infected as compared to healthy individuals (p=0.0353); KIM-1/creatinine was also lower in comparison with healthy controls but not statistically significantly. Patients receiving efavirenz had higher levels of L-FABP/creatinine in comparison to healthy controls (p=0.0039). Patients with anti-HCV had higher concentrations of L-FABP/creatinine as compared to the HIV-monoinfected individuals (not statistically significant) and to healthy subjects (p=0.0356). All four patients with L-FABP>17.5 μg/g creatinine were HIV/HCV coinfected. On multivariate logistic regression urine L-FABP above 5.5 μg/g creatinine was independently associated with body weight (OR=0.93 p=0.039). This study suggests that HIV/HCV-coinfected patients with lower body weight treated with tenofovir may be at an increased risk of tubular dysfunction and should be monitored more closely. The use of protease inhibitors was not associated with an increased risk of tubular disorders. PMID:24164392

  18. Folic acid in combination with adult neural stem cells for the treatment of spinal cord injury in rats

    PubMed Central

    Zhang, Chen; Shen, Lin

    2015-01-01

    Purpose: To observe the therapeutic effect of folic acid in combination with adult neural stem cells on spinal cord injury and to investigate the possible mechanism. Methods: A total of 120 Wistar rats were randomly assigned to six groups: normal, model, sham-surgery, folic acid injection, adult neural stem cell transplantation, and combination (folic acid injection + adult neural stem cells transplantation) groups. Morphology of neural stem cells was observed by inverted microscopy. Expression of CD105, CD45, CD44, and CD29 were detected by flow cytometry; expression of neuron-specific enolase and glial fibrillary acidic protein were determined by immunofluorescence. Motor coordination and integration capabilities were assessed using BBB scores; Morphology of spinal cord tissues was observed by hematoxylin-eosin staining and 5-bromodeoxyuridine immunohistochemistry. GDNF, BDNF and NT-3 expression in spinal cord tissues were determined by ELISA; while expression of the apoptosis-related proteins BCL-2, Bax and caspase-3 was detected using western blotting. Results: Flow cytometry showed that the isolated cells were positive for CD44 and CD29 and negative for CD105 and CD45. Combination treatment significantly improved the behavior of model rats with spinal cord injury, attenuated inflammatory reaction of spinal cord tissues, restored injured nerve cells, and increased expression of GDNF, BDNF and NT-3 in spinal cord tissues, up regulated BCL-2 expression, and down regulated Bax and caspase-3 expression. Conclusions: Folic acid in combination with adult neural stem cells significantly improved nerve function and plays a key role in maintaining microenvironment homeostasis in the neurons of rats with spinal cord injury. PMID:26379837

  19. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-06-16

    An improved receiver and receiver mount for calutrons are described. The receiver can be manipulated from outside the tank by a single control to position it with respect to the beam. A door can be operated exteriorly also to prevent undesired portions of the beam from entering the receiver. The receiver has an improved pocket which is more selective in the ions collected. (T.R.H.)

  20. Effects of roflumilast in COPD patients receiving inhaled corticosteroid/long-acting β2-agonist fixed-dose combination: RE2SPOND rationale and study design

    PubMed Central

    Rennard, Stephen I; Martinez, Fernando J; Rabe, Klaus F; Sethi, Sanjay; Pizzichini, Emilio; McIvor, Andrew; Siddiqui, Shahid; Anzueto, Antonio; Zhu, Haiyuan

    2016-01-01

    Background Roflumilast, a once-daily, selective phosphodiesterase-4 inhibitor, reduces the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. The RE2SPOND study is examining whether roflumilast, when added to an inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fixed-dose combination (FDC), further reduces exacerbations. The methodology is described herein. Methods In this Phase IV, multicenter, double-blind, placebo-controlled, parallel-group trial, participants were randomized 1:1 (stratified by long-acting muscarinic antagonist use) to receive roflumilast or placebo, plus ICS/LABA FDC, for 52 weeks. Eligible participants had severe COPD associated with chronic bronchitis, had two or more moderate–severe exacerbations within 12 months, and were receiving ICS/LABA FDC for ≥3 months. The primary efficacy measure is the rate of moderate or severe COPD exacerbations per participant per year. The secondary efficacy outcomes include mean change in prebronchodilator forced expiratory volume in 1 second (FEV1) over 52 weeks, rate of severe exacerbations, and rate of moderate, severe, or antibiotic-treated exacerbations. Additional assessments include spirometry, rescue medication use, the COPD assessment test, daily symptoms using the EXACT-Respiratory symptoms (E-RS) questionnaire, all-cause and COPD-related hospitalizations, and safety and pharmacokinetic measures. Results Across 17 countries, 2,354 participants were randomized from September 2011 to October 2014. Enrollment goal was met in October 2014, and study completion occurred in June 2016. Conclusion This study will further characterize the effects of roflumilast added to ICS/LABA on exacerbation rates, lung function, and health of severe–very severe COPD participants at risk of further exacerbations. The results will determine the clinical benefits of roflumilast combined with standard-of-care inhaled COPD treatment. PMID

  1. The effect of combination treatment using palonosetron and dexamethasone for the prevention of postoperative nausea and vomiting versus dexamethasone alone in women receiving intravenous patient-controlled analgesia

    PubMed Central

    Ryoo, Seung-hwa; Yoo, Jae Hwa; Kim, Mun Gyu; Lee, Ki Hoon

    2015-01-01

    Background The purpose of this study was to evaluate the effect of palonosetron combined with dexamethasone for the prevention of PONV compared to dexamethasone alone in women who received intravenous patient-controlled analgesia (IV-PCA) using fentanyl. Methods In this randomized, double-blinded, placebo-controlled study, 204 healthy female patients who were scheduled to undergo elective surgery under general anesthesia followed by IV-PCA for postoperative pain control were enrolled. Patients were divided into two groups: the PD group (palonosetron 0.075 mg and dexamethasone 5 mg IV; n = 102) and the D group (dexamethasone 5 mg IV; n = 102). The treatments were given after the induction of anesthesia. The incidence of nausea, vomiting, severity of nausea, and the use of rescue anti-emetics during the first 48 hours after surgery were evaluated. Results The incidence of PONV was significantly lower in the PD group compared with the D group during the 0-24 hours (43 vs. 59%) and 0-48 hours after surgery (45 vs. 63%) (P < 0.05). The severity of nausea during the 6-24 hours after surgery was significantly less in the PD group compared with the D group (P < 0.05). The incidence of rescue antiemetic used was significantly lower in the PD group than in the D group during the 0-6 hours after surgery (13.1 vs. 24.5%) (P < 0.05). Conclusions Palonosetron combined with dexamethasone was more effective in preventing PONV compared to dexamethasone alone in women receiving IV-PCA using fentanyl. PMID:26045930

  2. Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis.

    PubMed

    Montesinos, P; Rodríguez-Veiga, R; Boluda, B; Martínez-Cuadrón, D; Cano, I; Lancharro, A; Sanz, J; Arilla, M J; López-Chuliá, F; Navarro, I; Lorenzo, I; Salavert, M; Pemán, J; Calvillo, P; Martínez, J; Carpio, N; Jarque, I; Sanz, G F; Sanz, M A

    2015-11-01

    Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to construct a post-engraftment IFD risk score. The 1-year CI of IFD was 11%. The non-relapse mortality was 40% in those developing IFD and 16% in those who did not. The intent-to-treat analysis showed that 17% of patients abandoned the assigned prophylaxis. Age >40 years, ⩾1 previous SCT, pre-engraftment neutropenia >15 days, extensive chronic GVHD and CMV reactivation were independent risk factors. The post-engraftment IFD score stratified patients into low risk (0-1 factor, CI 0.7%), intermediate risk (2 factors, CI 9.9%) and high risk (3-5 factors, CI 24.7%) (P<0.0001). The antifungal prophylaxis strategy failed to prevent post-engraftment IFD in 11% of alloSCT. Our risk score could be useful to implement risk-adapted strategies using antifungal prophylaxis after engraftment. PMID:26281032

  3. Magnitude and correlates of moderate to severe anemia among adult HIV patients receiving first line HAART in Northwestern Tanzania: a cross sectional clinic based study

    PubMed Central

    Gunda, Daniel Wilfred; Kilonzo, Semvua Bukheti; Mpondo, Bonaventura Cornel

    2016-01-01

    Introduction Moderate to severe anemia is an important clinical problem in HIV patients on Highly Active Antiretroviral Therapy. The rate of progression and mortality in this sub group of patients is high compared to non anemic patients. In sub Saharan Africa with scale up of Anti retroviral therapy, the magnitude of this problem is not known especially in Tanzania. This study aimed at determining the magnitude and correlates of moderate to severe anemia in HIV patients receiving first line ART in northwestern Tanzania. Methods This was a cross sectional clinic based study, involving adult HIV patients on first line Highly Active Antiretroviral Therapy at Bugando Medical Centre Care and Treatment Center. The patients’ data were analyzed using STATA version 11 to determine the prevalence of moderate to severe anemia and risk factors that could predict occurrence of anemia. Results In this study 346 patients on Highly Active Anti-Retroviral Therapy were enrolled, of whom 100(40.46%) had moderate to severe anemia. The odds of being anemic were strongly predicted by Zidovudine based regime, low baseline CD4 count (< 200 cells/μl) and HIV stage 3&4 at enrollment. Most of the anemic patients had mean corpuscular volume of >100fl. Conclusion The prevalence of moderate to severe anemia is significantly high in this cohort of HIV-infected patients on first line Anti Retroviral Therapy and it is strongly predicted by Zidovudine based regime, low baseline CD4 and HIV stage 3 and 4. On clinical grounds this suggests that patients who are initiated on Zidovudine based regimen and those in advanced HIV at enrollment should have regular haemoglobin follow up to identify anemia at its earliest stage to improve the clinical outcome of these patients. PMID:27200131

  4. Delayed entry into HIV medical care in a nationally representative sample of HIV-infected adults receiving medical care in the USA.

    PubMed

    Robertson, McKaylee; Wei, Stanley C; Beer, Linda; Adedinsewo, Demilade; Stockwell, Sandra; Dombrowski, Julia C; Johnson, Christopher; Skarbinski, Jacek

    2016-01-01

    Before widespread antiretroviral therapy (ART), an estimated 17% of people delayed HIV care. We report national estimates of the prevalence and factors associated with delayed care entry in the contemporary ART era. We used Medical Monitoring Project data collected from June 2009 through May 2011 for 1425 persons diagnosed with HIV from May 2004 to April 2009 who initiated care within 12 months. We defined delayed care as entry >three months from diagnosis. Adjusted prevalence ratios (aPRs) were calculated to identify risk factors associated with delayed care. In this nationally representative sample of HIV-infected adults receiving medical care, 7.0% (95% confidence interval [CI]: 5.3-8.8) delayed care after diagnosis. Black race was associated with a lower likelihood of delay than white race (aPR 0.38). Men who have sex with women versus women who have sex with men (aPR 1.86) and persons required to take an HIV test versus recommended by a provider (aPR 2.52) were more likely to delay. Among those who delayed 48% reported a personal factor as the primary reason. Among persons initially diagnosed with HIV (non-AIDS), those who delayed care were twice as likely (aPR 2.08) to develop AIDS as of May 2011. Compared to the pre-ART era, there was a nearly 60% reduction in delayed care entry. Although relatively few HIV patients delayed care entry, certain groups may have an increased risk. Focus on linkage to care among persons who are required to take an HIV test may further reduce delayed care entry. PMID:26493721

  5. CALUTRON RECEIVER

    DOEpatents

    Brunk, W.O.

    1959-09-29

    A description is given for an improved calutron receiver having a face plate lying at an angle to the direction of the entering ion beams but having an opening, the plane of which is substantially perpendicular to that of the entering ion beams. By so positioning the opening in the receiver, the effective area through which the desired material may enter the receiver is increased, and at the same time the effective area through which containattng material may enter the receiver is reduced.

  6. Treating the Whole Person: A Combination of Medical and Psychiatric Treatment for Older Adults.

    ERIC Educational Resources Information Center

    Orr, Penny P.

    1997-01-01

    Presents the experience of, and case studies resulting from, working with older adults whose changing physical health has directly affected their emotional health. Claims that adjustments to a new body concept can be aided by a team-oriented approach, which includes medical doctors, physical therapists, occupational therapists, dieticians, and…

  7. Literacity: A multimedia adult literacy package combining NASA technology, recursive ID theory, and authentic instruction theory

    NASA Technical Reports Server (NTRS)

    Willis, Jerry; Willis, Dee Anna; Walsh, Clare; Stephens, Elizabeth; Murphy, Timothy; Price, Jerry; Stevens, William; Jackson, Kevin; Villareal, James A.; Way, Bob

    1994-01-01

    An important part of NASA's mission involves the secondary application of its technologies in the public and private sectors. One current application under development is LiteraCity, a simulation-based instructional package for adults who do not have functional reading skills. Using fuzzy logic routines and other technologies developed by NASA's Information Systems Directorate and hypermedia sound, graphics, and animation technologies the project attempts to overcome the limited impact of adult literacy assessment and instruction by involving the adult in an interactive simulation of real-life literacy activities. The project uses a recursive instructional development model and authentic instruction theory. This paper describes one component of a project to design, develop, and produce a series of computer-based, multimedia instructional packages. The packages are being developed for use in adult literacy programs, particularly in correctional education centers. They use the concepts of authentic instruction and authentic assessment to guide development. All the packages to be developed are instructional simulations. The first is a simulation of 'finding a friend a job.'

  8. Combining Drug Court with Adolescent Residential Treatment: Lessons from Juvenile and Adult Programs

    ERIC Educational Resources Information Center

    MacMaster, Samuel A.; Ellis, Rodney A.; Holmes, Tammy

    2005-01-01

    Drug courts have been recognized and empirically supported as an effective means of reducing recidivism and use of substances for both juveniles and adults. The paper reports the results of an outcome evaluation of a juvenile drug court in the Upper Cumberland area of Middle Tennessee. As with previous studies, the program showed impressive…

  9. Combined Sensory Impairment (Deaf-Blindness) in Five Percent of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Meuwese-Jongejeugd, Anneke; van Splunder, Jacques; Vink, Marianne; Stilma, Jan Sietse; van Zanten, Bert; Verschuure, Hans; Bernsen, Roos; Evenhuis, Heleen

    2008-01-01

    Our purpose in this cross-sectional study with 1,598 adult clients who had intellectual disabilities was to obtain valid prevalences of sensory impairments and to identify associations. The diagnoses were made through ophthalmologic and audiometric assessments, applying WHO/IASSID definitions. Re-weighted prevalences were 5.0% (95% CI 3.9-6.2%)…

  10. Temporal Envelope Changes of Compression and Speech Rate: Combined Effects on Recognition for Older Adults

    ERIC Educational Resources Information Center

    Jenstad, Lorienne M.; Souza, Pamela E.

    2007-01-01

    Purpose: When understanding speech in complex listening situations, older adults with hearing loss face the double challenge of cochlear hearing loss and deficits of the aging auditory system. Wide-dynamic range compression (WDRC) is used in hearing aids as remediation for the loss of audibility associated with hearing loss. WDRC processing has…

  11. The combined effect of sleep and time of day on emotion decoding from dynamic visual cues in older adults.

    PubMed

    Tsokanaki, Paraskevi; Moraitou, Despina; Papantoniou, Georgia

    2016-01-01

    It is well known that night sleep is a decisive factor for the effective functioning of the human body and mind. In addition to the role of sleep, older adults report that they are "morning types" and that their cognitive and emotional abilities seem to be at a higher level in the morning hours. In this vein, this study is aimed at examining the effect of sleep combined with the "time of day" condition on a specific ability that is crucial for interpersonal communication, namely, emotion recognition, in older adults. Specifically, the study compared older adults' performance in decoding emotions from ecologically valid, dynamic visual cues, in two conditions: "early in the morning and after night sleep", and "in the afternoon and after many hours since night sleep". An emotion recognition task was administered twice to 37 community-dwelling older adults. The results showed a statistically significant higher performance in the morning in decoding all emotions presented, compared to the afternoon condition. Pleasant surprise, sadness, and anxiety were revealed as the most difficult emotions to be recognized in the afternoon condition. PMID:27621639

  12. Prenatal ethanol exposure affects temperature responses of adult rats to pentobarbital and diazepam alone and in combination with ethanol.

    PubMed

    Taylor, A N; Branch, B J; Randolph, D; Hill, M A; Kokka, N

    1987-06-01

    Long-term effects of prenatal alcohol exposure on body temperature responses to pentobarbital and diazepam and to either drug in combination with ethanol were studied in adult rats who were the offspring of dams fed a 5.0% w/v ethanol-containing liquid diet during the last 2 weeks of gestation. Adult offspring of pair-fed and chow-fed dams served as nutritional and normal controls, respectively. Pentobarbital (6.25-25.0 mg/kg) and diazepam (2.5-10.0 mg/kg) produced significantly greater dose-related hypothermic responses in females than males. Following either pentobarbital or diazepam administration female prenatally ethanol-exposed (E) rats responded with a greater fall in body temperature than the controls. Significantly greater hypothermia occurred in both male and female E rats than in controls when ethanol (1.5 g/kg) was administered together with pentobarbital or diazepam. However, the drug combinations did not produce additive effects on body temperature in any prenatal treatment group. Pentobarbital produced acute cross-tolerance to ethanol while diazepam potentiated ethanol's effect. These studies confirm and extend our previous findings of enhanced hypothermic responses to ethanol in adult rats exposed to ethanol in utero and indicate that maternal alcohol consumption produces long-term effects on the central thermoregulatory systems of offspring. PMID:3307489

  13. Bioinsecticide and leaf litter combination increases oviposition and reduces adult recruitment to create an effective ovitrap for Culex mosquitoes.

    PubMed

    Bellile, Katie G; Vonesh, James R

    2016-06-01

    Mosquito egg traps, aquatic habitats baited with oviposition attractant and insecticide, are important tools for surveillance and control efforts in integrated vector management programs. The bioinsecticide Bacillus thuringiensis subsp. israelensis (Bti) is increasingly used as an environmentally friendly alternative to chemical insecticides and the combination of Bti with a simple oviposition attractant like leaf litter to create an effective egg trap seems appealing. However, previous research suggests that Bti may itself alter oviposition, and that leaf litter may dramatically reduce Bti toxicity. Here we present results from field experiment designed to link the effects of litter and Bti on mosquito oviposition habitat selection and post-colonization survival to production of adult mosquitoes. Tripling litter increased Culex spp. oviposition nearly nine-fold, while Bti had no effect on oviposition. Neither factor altered egg survival, thus larval abundance reflected the effects of litter on oviposition. Both Bti and litter reduced larval survival by ∼60%. We found no evidence that increased litter reduced Bti toxicity. Adult production was dependent upon both litter and Bti. In the absence of Bti, effects of litter on oviposition translated into three-fold more adults. However, in the presence of Bti, initial increases in oviposition were erased by the combined negative effects of Bti and litter on post-colonization survival. Thus, our study provides field evidence that combined litter and Bti application creates an effective ovitrap. This combined treatment had the highest oviposition and the lowest survival, and thus removed the greatest number of mosquitoes from the landscape. PMID:27232134

  14. Combining glycosylated hemoglobin A1c and fasting plasma glucose for diagnosis of type 2 diabetes in Chinese adults

    PubMed Central

    2013-01-01

    Background Glycosylated hemoglobin A1c (HbA1c) has been applied to identify type 2 diabetes (T2DM) in the U.S. and European countries. It has not been used in China mainly due to lack of a standardized approach to measure HbA1c, short of knowledge about racial-specific standard and deficiency of an optimal cut-off point. Methods To evaluate combination of HbA1c and fasting plasma glucose (FPG) in diagnosing T2DM in Chinese adults, a multistage sampling cross-sectional study was conducted in Shanghai, China, in 2009. The FPG measurement, HbA1c assay, and oral glucose tolerance test (OGTT) were performed in 6,661 Chinese adults (3057 men, 3604 women) who had no prior history of diabetes to identify the unrecognized T2DM. Results A total of 454 participants were identified as T2DM based on the 1999 World Health Organization (WHO) diagnostic criteria. Of these patients, 239 were detected using an FPG ≥ 7.0 mmol/l and 141 were further identified using an HbA1c ≥ 43 mmol/mol (6.1%), achieving a sensitivity of 83.7% and a specificity of 89.3% for combining use of FPG and HbA1c. In subjects at high risk of diabetes, the combining use of FPG and HbA1c produced a higher sensitivity and an improved positive predictive value (PPV), and had a satisfactory specificity and negative predictive value (NPV). Conclusions The combining use of FPG and HbA1c is a potential screening and diagnosis approach for T2DM in Chinese adults, especially among those at high risk of the disease. PMID:24099651

  15. CALUTRON RECEIVER

    DOEpatents

    York, H.F.

    1959-07-01

    A receiver construction is presented for calutrons having two or more ion sources and an individual receiver unit for each source. Design requirements dictate that the face plate defining the receiver entrance slots be placed at an angle to the approaching beam, which means that ions striking the face plate are likely to be scattcred into the entrance slots of other receivers. According to the present invention, the face plate has a surface provided with parallel ridges so disposed that one side only of each ridge's exposed directly to the ion beam. The scattered ions are directed away from adjacent receivers by the ridges on the lace plate.

  16. Removal of micropollutants, facultative pathogenic and antibiotic resistant bacteria in a full-scale retention soil filter receiving combined sewer overflow.

    PubMed

    Scheurer, Marco; Heß, Stefanie; Lüddeke, Frauke; Sacher, Frank; Güde, Hans; Löffler, Herbert; Gallert, Claudia

    2015-01-01

    Combined sewer systems collect surface runoff as well as wastewater of industrial and domestic origin. During periods of heavy rainfall the capacity of the sewer system is exceeded and the overflow is discharged into receiving waters without any treatment. Consequently, combined sewer overflow (CSO) is considered as a major source of water pollution. This study investigates the effectiveness of a retention soil filter (RSF) for the removal of micropollutants as well as facultative pathogenic and antibiotic resistant bacteria from CSO. The removal of organic group parameters like total organic carbon was excellent and the removal efficiency for micropollutants of the RSF and the wastewater treatment plant (WWTP), which treats wastewater of the same origin during dry and normal weather conditions, was comparable. Compounds of high environmental concern like estrogens or certain pharmaceuticals, e.g. diclofenac, were completely eliminated or removed to a high degree during RSF passage. RSF treatment also reduced the number of E. coli, enterococci and staphylococci by 2.7, 2.2 and 2.4 log-units (median values), respectively. Obviously, some Staphylococcus species can better adapt to the conditions of the RSF than others as a shift of the abundance of the different species was observed when comparing the diversity of staphylococci obtained from the RSF influent and effluent. RSF treatment also decreased the absolute number of antibiotic resistant bacteria. The percentage of antibiotic resistant E. coli and staphylococci isolates also decreased during passage of the RSF, whereas the percentage of resistant enterococci did not change. For E. coli ampicillin and for enterococci and staphylococci erythromycin determined the antibiotic resistance level. The results demonstrate that RSFs can be considered as an adequate treatment option for CSO. The performance for the removal of micropollutants is comparable with a medium sized WWTP with conventional activated sludge

  17. Is More Better? Combining Actuarial Risk Scales to Predict Recidivism among Adult Sex Offenders

    ERIC Educational Resources Information Center

    Seto, Michael C.

    2005-01-01

    The present study was conducted to determine whether combining the results of multiple actuarial risk scales increases accuracy in predicting sex offender recidivism. Multiple methods of combining 4 validated actuarial risk scales--the Violence Risk Appraisal Guide, the Sex Offender Risk Appraisal Guide, the Rapid Risk Assessment for Sexual…

  18. Influence of Strength, Sprint Running, and Combined Strength and Sprint Running Training on Short Sprint Performance in Young Adults.

    PubMed

    Marques, M C; Gabbett, T J; Marinho, D A; Blazevich, A J; Sousa, A; van den Tillaar, R; Izquierdo, M

    2015-10-01

    The purpose of this study was to assess the degree of transference of 6 weeks of full squat vs. full squat plus sprint running training to short (ranged from 0-10 to 0-30 m) sprint running performance in non-athletes. We hypothesized that a speed-full-squat training regimen could enhance squat strength and power with simultaneous improvements in short sprint performance. 122 physically active adults (age: 20.5±2.5 years; body mass: 65.8±6.1 kg; height: 1.71±0.08 m) were randomly divided into 4 groups: full squat training (n=36), combined full squat and sprint training (n=32), speed training only (n=34) and non-training control group (n=20). Each training group completed 2 sessions per week over 6 weeks, while the control group performed only their normal physical activity. Sprint performance was improved after sprint running or full squat training alone (1.7% and 1.8% P<0.05, respectively), however larger enhancements (2.3%; P<0.01) were observed after the combined full squat plus sprint training intervention. These results suggest that in recreationally active adults, combined full squat and sprint training provides a greater stimulus for improving sprint performance than either modality alone. PMID:25958946

  19. Radio receivers

    NASA Astrophysics Data System (ADS)

    Bankov, V. N.; Barulin, L. G.; Zhodzishskii, M. I.; Malyshev, I. V.; Petrusinskii, V. V.

    The book is concerned with the design of microelectronic radio receivers and their components based on semiconductor and hybrid integrated circuits. Topics discussed include the hierarchical structure of radio receivers, the synthesis of structural schemes, the design of the principal functional units, and the design of radio receiver systems with digital signal processing. The discussion also covers the integrated circuits of multifunctional amplifiers, analog multipliers, charge-transfer devices, frequency filters, piezoelectronic devices, and microwave amplifiers, filters, and mixers.

  20. Combined Detection of Serum IL-10, IL-17, and CXCL10 Predicts Acute Rejection Following Adult Liver Transplantation

    PubMed Central

    Kim, Nayoung; Yoon, Young-In; Yoo, Hyun Ju; Tak, Eunyoung; Ahn, Chul-Soo; Song, Gi-Won; Lee, Sung-Gyu; Hwang, Shin

    2016-01-01

    Discovery of non-invasive diagnostic and predictive biomarkers for acute rejection in liver transplant patients would help to ensure the preservation of liver function in the graft, eventually contributing to improved graft and patient survival. We evaluated selected cytokines and chemokines in the sera from liver transplant patients as potential biomarkers for acute rejection, and found that the combined detection of IL-10, IL-17, and CXCL10 at 1-2 weeks post-operation could predict acute rejection following adult liver transplantation with 97% specificity and 94% sensitivity. PMID:27498551

  1. Partial lung resection of supernumerary tracheal bronchus combined with pulmonary artery sling in an adult: report of a case.

    PubMed

    Miyazaki, Takuro; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Hayashi, Hideyuki; Izumikawa, Koichi; Izumikawa, Kinichi; Nagayasu, Takeshi

    2015-03-01

    An adult case of pulmonary resection for repeated infections in a supernumerary tracheal bronchus combined with a pulmonary artery sling is reported. A 33-year-old woman with a pulmonary artery sling was referred for recurrent lung infections. Chest computed tomography showed the left pulmonary artery arising from the right pulmonary artery and coursing posterior to the trachea. The lung parenchyma connected to the tracheal bronchus showed dense opacity and traction bronchiectasis. Partial pulmonary resection was performed with an ultrasonically activated scalpel after the tracheal bronchus was auto-sutured. The patient's postoperative course was uneventful, and she is now in good condition. PMID:23852428

  2. CALUTRON RECEIVERS

    DOEpatents

    Lofgren, E.J.

    1958-09-01

    Improvements are described in isotope separation devices of the calutron type and, in particular, deals with a novel caiutron receiver which passes the optimum portions of the ion beam to a collecting chamber. In broad aspects the receiver provides means for pass delimited pontion of the beam and an elongated collecting pocket disposed to receive ions passed by the beam delimiting means. The collecting pocket is transversely partitioned into a plurality of ion receiving compartments respectively defined by a corresponding plurality of separately removable liner elements.

  3. CALUTRON RECEIVERS

    DOEpatents

    Schmidt, F.H.; Stone, K.F.

    1958-09-01

    S>This patent relates to improvements in calutron devices and, more specifically, describes a receiver fer collecting the ion curreot after it is formed into a beam of non-homogeneous isotropic cross-section. The invention embodies a calutron receiver having an ion receiving pocket for separately collecting and retaining ions traveling in a selected portion of the ion beam and anelectrode for intercepting ions traveling in another selected pontion of the ion beam. The electrode is disposed so as to fix the limit of one side of the pontion of the ion beam admitted iato the ion receiving pocket.

  4. Etoposide in combination with cyclophosphamide and total body irradiation or busulfan as conditioning for marrow transplantation in adults and children

    SciTech Connect

    Spitzer, T.R.; Ortlieb, M.; Tefft, M.C.; Torrisi, J.; Cahill, R.; Deeg, H.J. ); Peters, C.; Gadner, H. ); Urban, C. )

    1994-04-30

    In an attempt to intensify conditioning therapy for bone marrow transplantation of hematologic malignancies, a retrospective three center evaluation of escalating doses of etoposide added to cyclophosphamide and either total body irradiation or busulfan was undertaken. Seventy-six patients who received etoposide (25-65 mg/kg) added to cyclophosphamide (60-120 mg/kg) and either total body irradiation (12.0-13.2 Gy) or busulfan (12-16 mg/kg) were evaluable for toxicity. Fifty-one of the evaluable patients received allogeneic transplants, while twenty-six received autologous transplants. A comparative analysis of toxicities according to conditioning regimen, donor source and etoposide dose was made. Similar toxicities were observed among the treatment groups with the exception of more frequent skin (p = 0.03) and life threatening hepatic toxicities (p = 0.01) in the busulfan treated patients. Life threatening or fatal toxicities were not influenced by donor source, either when analyzed by treatment group or etoposide dose. Etoposide at a dose of 60-65 mg/kg in combination with TBI and cyclophosphamide was associated with a significantly increased incidence of life threatening or fatal toxicities compared with a combination using a dose of 25-50 mg/kg (15 of 24 vs. 5 of 20; p = 0.013). The maximally tolerated dose of etoposide in combination with busulfan and cyclophosphamide cannot be definitively established in this analysis in part due to the heterogeneity of the patient population and treatment schemes. Although toxicities with bone marrow transplant preparative regimens containing etoposide in combination with cyclophosphamide and total body irradiation or busulfan were frequently severe, treatment related mortality risk was believed to be acceptably low. 27 refs., 3 tabs.

  5. Development of a case-mix funding system for adults with combined vision and hearing loss

    PubMed Central

    2013-01-01

    Background Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. Methods A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. Results The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). Conclusions The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support. PMID:23587314

  6. Herpes Zoster Meningitis Complicating Combined Tocilizumab and Cyclosporine Therapy for Adult-Onset Still's Disease

    PubMed Central

    Tsurukawa, Shinichiro; Iwanaga, Nozomi; Izumi, Yasumori; Shirakawa, Atsunori; Kawahara, Chieko; Shukuwa, Tetsuo; Inamoto, Miwako; Kawakami, Atsushi; Migita, Kiyoshi

    2016-01-01

    A 56-year-old female with refractory adult-onset Still's disease presented with ocular herpes zoster infection during TCZ treatment. After three days of acyclovir treatment (5 mg/kg), she developed a severe headache and high fever. Viral DNA isolation and cerebral spinal fluid abnormalities led to a herpes zoster meningitis diagnosis. Her meningitis was cured by high doses of intravenous acyclovir (10 mg/kg for 14 days). To our knowledge, this is the first report of meningeal herpes zoster infection in rheumatic diseases under TCZ treatment. PMID:27092286

  7. Herpes Zoster Meningitis Complicating Combined Tocilizumab and Cyclosporine Therapy for Adult-Onset Still's Disease.

    PubMed

    Tsurukawa, Shinichiro; Iwanaga, Nozomi; Izumi, Yasumori; Shirakawa, Atsunori; Kawahara, Chieko; Shukuwa, Tetsuo; Inamoto, Miwako; Kawakami, Atsushi; Migita, Kiyoshi

    2016-01-01

    A 56-year-old female with refractory adult-onset Still's disease presented with ocular herpes zoster infection during TCZ treatment. After three days of acyclovir treatment (5 mg/kg), she developed a severe headache and high fever. Viral DNA isolation and cerebral spinal fluid abnormalities led to a herpes zoster meningitis diagnosis. Her meningitis was cured by high doses of intravenous acyclovir (10 mg/kg for 14 days). To our knowledge, this is the first report of meningeal herpes zoster infection in rheumatic diseases under TCZ treatment. PMID:27092286

  8. The combined effect of sleep and time of day on emotion decoding from dynamic visual cues in older adults

    PubMed Central

    Tsokanaki, Paraskevi; Moraitou, Despina; Papantoniou, Georgia

    2016-01-01

    It is well known that night sleep is a decisive factor for the effective functioning of the human body and mind. In addition to the role of sleep, older adults report that they are “morning types” and that their cognitive and emotional abilities seem to be at a higher level in the morning hours. In this vein, this study is aimed at examining the effect of sleep combined with the “time of day” condition on a specific ability that is crucial for interpersonal communication, namely, emotion recognition, in older adults. Specifically, the study compared older adults’ performance in decoding emotions from ecologically valid, dynamic visual cues, in two conditions: “early in the morning and after night sleep”, and “in the afternoon and after many hours since night sleep”. An emotion recognition task was administered twice to 37 community-dwelling older adults. The results showed a statistically significant higher performance in the morning in decoding all emotions presented, compared to the afternoon condition. Pleasant surprise, sadness, and anxiety were revealed as the most difficult emotions to be recognized in the afternoon condition. PMID:27621639

  9. Combination of erythritol and fructose increases gastrointestinal symptoms in healthy adults.

    PubMed

    Kim, Yeonsoo; Park, Sonhee C; Wolf, Bryan W; Hertzler, Steven R

    2011-11-01

    Consumption of a large amount of dietary fructose induces gastrointestinal intolerance, and glucose has been known as an enhancer of fructose absorption. Erythritol is a nonglycemic sugar alcohol, and it has been suggested that erythritol is absorbed paracellularly. It was hypothesized that paracellular absorption of erythritol could also enhance paracellular absorption of fructose in healthy adults. This is one of the proposed pathways for how additional glucose enhances the absorption of fructose. Thirty-seven nondiabetic, healthy adults participated in a randomized, double-masked, controlled crossover study. After an overnight fast, participants consumed beverages containing either 50 g fructose and 50 g glucose, 50 g fructose and 33.3 g erythritol (an equimolar concentration of fructose), or 50 g fructose alone. Breath hydrogen response was determined for 8 hours postprandially. Gastrointestinal intolerance symptoms and the number and consistency of bowel movements were recorded for 24 hours postprandially. The breath hydrogen area under the curve (AUC) of the fructose and erythritol beverage was 2 times the AUC of the fructose beverage and 8.75 times the AUC of the fructose and glucose beverage (P < .001, respectively). Compared with fructose and glucose beverage and fructose alone, frequency of watery stools increased (P < .05) and gastrointestinal tolerance worsened (P < .05) when participants consumed fructose and erythritol. These data suggest that coingestion of equimolar concentrations of fructose and erythritol increased carbohydrate malabsorption. PMID:22118754

  10. Effects of combined nicotine and fluoxetine treatment on adult hippocampal neurogenesis and conditioned place preference.

    PubMed

    Faillace, M P; Zwiller, J; Bernabeu, R O

    2015-08-01

    Adult neurogenesis occurs in mammals within the dentate gyrus, a hippocampal subarea. It is known to be induced by antidepressant treatment and reduced in response to nicotine administration. We checked here whether the antidepressant fluoxetine would inverse the decrease in hippocampal neurogenesis caused by nicotine. It is shown that repeated, but not a single injection of rats with fluoxetine was able to abolish the decrease in adult dentate cell proliferation produced by nicotine treatment. We measured the expression of several biochemical parameters known to be associated with neurogenesis in the dentate gyrus. Both drugs increased the expression of p75 neurotrophin receptor, which promotes proliferation and early maturation of dentate gyrus cells. Using the conditioned place preference (CPP) paradigm, we also gave both drugs in a context in which their rewarding properties could be measured. Fluoxetine produced a significant but less robust CPP than nicotine. A single injection of fluoxetine was found to reduce nicotine-induced CPP. Moreover, the rewarding properties of nicotine were completely abolished in response to repeated fluoxetine injections. Expression of nicotine-induced CPP was accompanied by an increase of phospho-CREB (cyclic AMP-responsive element-binding protein) and HDAC2 (histone deacetylase 2) expression in the nucleus accumbens. The data suggest that fluoxetine reward, as opposed to nicotine reward, depends on dentate gyrus neurogenesis. Since fluoxetine was able to disrupt the association between nicotine and the environment, this antidepressant may be tested as a treatment for nicotine addiction using cue exposure therapy. PMID:25981209

  11. Repeated dose liver micronucleus assay using adult mice with multiple genotoxicity assays concurrently performed as a combination test.

    PubMed

    Hagio, Soichiro; Furukawa, Satoshi; Abe, Masayoshi; Kuroda, Yusuke; Hayashi, Seigo; Ogawa, Izumi

    2014-06-01

    Recently, the liver micronucleus (MN) assay using young adult rats with repeated administrations has been investigated by employing a new method without partial hepatectomy or in situcollagenase perfusion as the repeated dose liver MN (RDLMN) assay by Narumi et al. (2012). In our study, in order to investigate the possibility of the RDLMN assay using young adult mice instead of rats and the feasibility of employing some genotoxicity assays along with the RDLMN assay as a combination test, two genotoxic carcinogens (N,N-diethylnitrosoamine (DEN) and cisplatin (CIS)) and a nongenotoxic carcinogen (phenobarbital sodium (PHE)) were administered to mice for 15 or 29 days. Then, the liver MN assay, peripheral blood (PB) MN assay and comet assay using the liver and kidney were concurrently performed as a combination test. DEN showed positive responses to all endpoints except MN induction in PB after 15 days of repeat administration. A cross-linking agent, CIS, showed MN induction in liver after 29 days of repeat administration, and in PB after 15 and 29 days of repeat administration, although the comet assay yielded negative responses for both organs at both sampling times. PHE yielded negative responses for all endpoints. In conclusion, it is suggested that the RDLMN assay using mice is a feasible method to be integrated into the general repeated toxicity test along with the combination assays, i.e., comet assay or PB MN assay, which would help in risk assessment for carcinogenicity by comparing the results of combination assays with each other. PMID:24849678

  12. Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia.

    PubMed

    Chalandon, Yves; Thomas, Xavier; Hayette, Sandrine; Cayuela, Jean-Michel; Abbal, Claire; Huguet, Françoise; Raffoux, Emmanuel; Leguay, Thibaut; Rousselot, Philippe; Lepretre, Stéphane; Escoffre-Barbe, Martine; Maury, Sébastien; Berthon, Céline; Tavernier, Emmanuelle; Lambert, Jean-François; Lafage-Pochitaloff, Marina; Lhéritier, Véronique; Chevret, Sylvie; Ifrah, Norbert; Dombret, Hervé

    2015-06-11

    In this study, we randomly compared high doses of the tyrosine kinase inhibitor imatinib combined with reduced-intensity chemotherapy (arm A) to standard imatinib/hyperCVAD (cyclophosphamide/vincristine/doxorubicin/dexamethasone) therapy (arm B) in 268 adults (median age, 47 years) with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). The primary objective was the major molecular response (MMolR) rate after cycle 2, patients being then eligible for allogeneic stem cell transplantation (SCT) if they had a donor, or autologous SCT if in MMolR and no donor. With fewer induction deaths, the complete remission (CR) rate was higher in arm A than in arm B (98% vs 91%; P = .006), whereas the MMolR rate was similar in both arms (66% vs 64%). With a median follow-up of 4.8 years, 5-year event-free survival and overall survival (OS) rates were estimated at 37.1% and 45.6%, respectively, without difference between the arms. Allogeneic transplantation was associated with a significant benefit in relapse-free survival (hazard ratio [HR], 0.69; P = .036) and OS (HR, 0.64; P = .02), with initial white blood cell count being the only factor significantly interacting with this SCT effect. In patients achieving MMolR, outcome was similar after autologous and allogeneic transplantation. This study validates an induction regimen combining reduced-intensity chemotherapy and imatinib in Ph+ ALL adult patients and suggests that SCT in first CR is still a good option for Ph+ ALL adult patients. This trial was registered at www.clinicaltrials.gov as #NCT00327678. PMID:25878120

  13. Adult acclimation to combined temperature and pH stressors significantly enhances reproductive outcomes compared to short-term exposures.

    PubMed

    Suckling, Coleen C; Clark, Melody S; Richard, Joelle; Morley, Simon A; Thorne, Michael A S; Harper, Elizabeth M; Peck, Lloyd S

    2015-05-01

    This study examined the effects of long-term culture under altered conditions on the Antarctic sea urchin, Sterechinus neumayeri. Sterechinus neumayeri was cultured under the combined environmental stressors of lowered pH (-0.3 and -0.5 pH units) and increased temperature (+2 °C) for 2 years. This time-scale covered two full reproductive cycles in this species and analyses included studies on both adult metabolism and larval development. Adults took at least 6-8 months to acclimate to the altered conditions, but beyond this, there was no detectable effect of temperature or pH. Animals were spawned after 6 and 17 months exposure to altered conditions, with markedly different outcomes. At 6 months, the percentage hatching and larval survival rates were greatest in the animals kept at 0 °C under current pH conditions, whilst those under lowered pH and +2 °C performed significantly less well. After 17 months, performance was not significantly different across treatments, including controls. However, under the altered conditions urchins produced larger eggs compared with control animals. These data show that under long-term culture adult S. neumayeri appear to acclimate their metabolic and reproductive physiology to the combined stressors of altered pH and increased temperature, with relatively little measureable effect. They also emphasize the importance of long-term studies in evaluating effects of altered pH, particularly in slow developing marine species with long gonad maturation times, as the effects of altered conditions cannot be accurately evaluated unless gonads have fully matured under the new conditions. PMID:25491898

  14. Prognostic Value of Lymph Node Ratio in Patients Receiving Combined Surgical Resection for Gastric Cancer Liver Metastasis: Results from Two National Centers in China.

    PubMed

    Li, Mu-Xing; Jin, Zheng-Xiong; Zhou, Jian-Guo; Ying, Jian-Ming; Liang, Zhi-Yong; Mao, Xin-Xin; Bi, Xin-Yu; Zhao, Jian-Jun; Li, Zhi-Yu; Huang, Zhen; Zhang, Ye-Fan; Li, Yuan; Chen, Xiao; Hu, Xu-Hui; Hu, Han-Jie; Zhao, Dong-Bing; Wang, Ying-Yi; Cai, Jian-Qiang; Zhao, Hong

    2016-04-01

    The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer liver metastasis (GCLM) who received combined surgical resection.A retrospective analysis of 46 patients from two hospitals was conducted. Patients were dichotomized into two groups (high LNR and low LNR) by the median value of LNR. The overall survival (OS) and recurrence-free survival (RFS) were analyzed by the Kaplan-Meier method with the log-rank test. The Cox proportional hazard model was used to carry out the subsequent multivariate analyses. And the relationship between LNR and clinicopathological characteristics was assessed.The cut-off value defining elevated LNR was 0.347. With a median follow-up of 67.5 months, the median OS and RFS of the patients were 17 and 9.5 months, respectively. Six patients survived for >5 years after surgery. Patients with higher LNR had significantly shorter OS and RFS than those with lower LNR. In the multivariate analyses, higher LNR and multiple liver metastatic tumors were identified as the independent prognostic factors for both OS and RFS. Elevated LNR was significantly associated with advanced pN stage (P <0.001), larger primary tumor size (P = 0.046), the presence of microvascular invasion (P = 0.008), and neoadjuvant chemotherapy (P = 0.004).LNR may be prognostic indicator for patients with GCLM treated by synchronous surgical resection. Patients with lower LNR and single liver metastasis may gain more survival benefits from the surgical resection. Further prospective studies with reasonable study design are warranted. PMID:27100426

  15. Prognostic Value of Lymph Node Ratio in Patients Receiving Combined Surgical Resection for Gastric Cancer Liver Metastasis: Results from Two National Centers in China

    PubMed Central

    Li, Mu-Xing; Jin, Zheng-Xiong; Zhou, Jian-Guo; Ying, Jian-Ming; Liang, Zhi-Yong; Mao, Xin-Xin; Bi, Xin-Yu; Zhao, Jian-Jun; Li, Zhi-Yu; Huang, Zhen; Zhang, Ye-Fan; Li, Yuan; Chen, Xiao; Hu, Xu-Hui; Hu, Han-Jie; Zhao, Dong-Bing; Wang, Ying-Yi; Cai, Jian-Qiang; Zhao, Hong

    2016-01-01

    Abstract The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer liver metastasis (GCLM) who received combined surgical resection. A retrospective analysis of 46 patients from two hospitals was conducted. Patients were dichotomized into two groups (high LNR and low LNR) by the median value of LNR. The overall survival (OS) and recurrence-free survival (RFS) were analyzed by the Kaplan–Meier method with the log-rank test. The Cox proportional hazard model was used to carry out the subsequent multivariate analyses. And the relationship between LNR and clinicopathological characteristics was assessed. The cut-off value defining elevated LNR was 0.347. With a median follow-up of 67.5 months, the median OS and RFS of the patients were 17 and 9.5 months, respectively. Six patients survived for >5 years after surgery. Patients with higher LNR had significantly shorter OS and RFS than those with lower LNR. In the multivariate analyses, higher LNR and multiple liver metastatic tumors were identified as the independent prognostic factors for both OS and RFS. Elevated LNR was significantly associated with advanced pN stage (P <0.001), larger primary tumor size (P = 0.046), the presence of microvascular invasion (P = 0.008), and neoadjuvant chemotherapy (P = 0.004). LNR may be prognostic indicator for patients with GCLM treated by synchronous surgical resection. Patients with lower LNR and single liver metastasis may gain more survival benefits from the surgical resection. Further prospective studies with reasonable study design are warranted. PMID:27100426

  16. Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study.

    PubMed

    Elzi, Luigia; Conen, Anna; Patzen, Annalea; Fehr, Jan; Cavassini, Matthias; Calmy, Alexandra; Schmid, Patrick; Bernasconi, Enos; Furrer, Hansjakob; Battegay, Manuel

    2016-01-01

    Background.  Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods.  Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results.  Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions.  Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV. PMID:26955645

  17. Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study

    PubMed Central

    Elzi, Luigia; Conen, Anna; Patzen, Annalea; Fehr, Jan; Cavassini, Matthias; Calmy, Alexandra; Schmid, Patrick; Bernasconi, Enos; Furrer, Hansjakob; Battegay, Manuel

    2016-01-01

    Background. Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods. Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results. Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20–3.54), higher education (OR, 4.03; 95% CI, 2.47–7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20–2.80). Older age (OR, 0.55; 95% CI, .42–.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13–.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998–2001 to 41.2% in 2009–2012, but the employment rates did not increase. Conclusions. Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV. PMID:26955645

  18. Mycobacterium avium lung disease combined with a bronchogenic cyst in an immunocompetent young adult.

    PubMed

    Kwon, Yong Soo; Han, Joungho; Jung, Ki Hwan; Kim, Je Hyeong; Koh, Won-Jung

    2013-01-01

    We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin. PMID:23346002

  19. CALUTRON RECEIVERS

    DOEpatents

    MacKenzie, K.R.

    1958-09-16

    A novel calutron receiver is described for collecting the constituent material of two closely adjacent selected portions of an ion beam in separate compartments. The receiver is so conntructed that ion scatter and intermixing of the closely adjacent beam portions do nnt occur when the ions strike the receiver structure, and the beam is sharply separated Into the two compartments. In essence, these desirable results are achieved by inclining the adjoining wall of one compartment with respect to the approaching ions to reduce possible rebounding of ions from the compartment into the adjacent compartment.

  20. Reading and Writing; Adult Education in Comprehensive Combined Addiction Treatment: Needs, Problems, and Benefits.

    ERIC Educational Resources Information Center

    Schneider, Karl A.; And Others

    This paper describes the results of the first year of the Eagleville Reading Academy and Satellite Program, a demonstration project funded by the U.S. Office of Education, Right to Read. Eagleville Hospital and Rehabilitation Center treats addicts and alcoholics in a combined abstinent therapeutic community program setting. The goals of the…

  1. Effects of Combined Repeated Reading and Question Generation Intervention on Young Adults with Cognitive Disabilities

    ERIC Educational Resources Information Center

    Hua, Youjia; Therrien, William J.; Hendrickson, Jo M.; Woods-Groves, Suzanne; Ries, Pamela S.; Shaw, Julia W.

    2012-01-01

    The combined repeated reading and question generation procedure is a reading intervention designed to target both fluency and comprehension for students with disabilities. Previous research has demonstrated the effectiveness of the intervention for school age children with learning disabilities. This study extended the research by utilizing the…

  2. Atazanavir/ritonavir-based combination antiretroviral therapy for treatment of HIV-1 infection in adults.

    PubMed

    Achenbach, Chad J; Darin, Kristin M; Murphy, Robert L; Katlama, Christine

    2011-02-01

    In the past 15 years, improvements in the management of HIV infection have dramatically reduced morbidity and mortality. Similarly, rapid advances in antiretroviral medications have resulted in the possibility of life-long therapy with simple and tolerable regimens. Protease inhibitors have been important medications in regimens of combination antiretroviral therapy for the treatment of HIV. One of the recommended and commonly used therapies in this class is once-daily-administered atazanavir, pharmacologically boosted with ritonavir (atazanavir/r). Clinical studies and practice have shown these drugs, in combination with other antiretroviral agents, to be potent, safe and easy to use in a variety of settings. Atazanavir/r has minimal short-term toxicity, including benign bilirubin elevation, and has less potential for long-term complications of hyperlipidemia and insulin resistance compared with other protease inhibitors. A high genetic barrier to resistance and a favorable resistance profile make it an excellent option for initial HIV treatment or as the first drug utilized in the protease inhibitors class. Atazanavir/r is also currently being studied in novel treatment strategies, including combinations with new classes of antiretrovirals to assess nucleoside reverse transcriptase inhibitor-sparing regimens. In this article we review atazanavir/r as a treatment for HIV infection and discuss the latest information on its pharmacology, efficacy and toxicity. PMID:21731578

  3. Atazanavir/ritonavir-based combination antiretroviral therapy for treatment of HIV-1 infection in adults

    PubMed Central

    Achenbach, Chad J; Darin, Kristin M; Murphy, Robert L; Katlama, Christine

    2011-01-01

    In the past 15 years, improvements in the management of HIV infection have dramatically reduced morbidity and mortality. Similarly, rapid advances in antiretroviral medications have resulted in the possibility of life-long therapy with simple and tolerable regimens. Protease inhibitors have been important medications in regimens of combination antiretroviral therapy for the treatment of HIV. One of the recommended and commonly used therapies in this class is once-daily-administered atazanavir, pharmacologically boosted with ritonavir (atazanavir/r). Clinical studies and practice have shown these drugs, in combination with other antiretroviral agents, to be potent, safe and easy to use in a variety of settings. Atazanavir/r has minimal short-term toxicity, including benign bilirubin elevation, and has less potential for long-term complications of hyperlipidemia and insulin resistance compared with other protease inhibitors. A high genetic barrier to resistance and a favorable resistance profile make it an excellent option for initial HIV treatment or as the first drug utilized in the protease inhibitors class. Atazanavir/r is also currently being studied in novel treatment strategies, including combinations with new classes of antiretrovirals to assess nucleoside reverse transcriptase inhibitor-sparing regimens. In this article we review atazanavir/r as a treatment for HIV infection and discuss the latest information on its pharmacology, efficacy and toxicity. PMID:21731578

  4. A New Anaesthetic Protocol for Adult Zebrafish (Danio rerio): Propofol Combined with Lidocaine

    PubMed Central

    Valentim, Ana M.; Félix, Luís M.; Carvalho, Leonor; Diniz, Enoque; Antunes, Luís M.

    2016-01-01

    Background The increasing use of zebrafish model has not been accompanied by the evolution of proper anaesthesia for this species in research. The most used anaesthetic in fishes, MS222, may induce aversion, reduction of heart rate, and consequently high mortality, especially during long exposures. Therefore, we aim to explore new anaesthetic protocols to be used in zebrafish by studying the quality of anaesthesia and recovery induced by different concentrations of propofol alone and in combination with different concentrations of lidocaine. Material and Methods In experiment A, eighty-three AB zebrafish were randomly assigned to 7 different groups: control, 2.5 (2.5P), 5 (5P) or 7.5 μg/ml (7.5P) of propofol; and 2.5 μg/ml of propofol combined with 50, (P/50L), 100 (P/100L) or 150 μg/ml (P/150L) of lidocaine. Zebrafish were placed in an anaesthetic water bath and time to lose the equilibrium, reflex to touch, reflex to a tail pinch, and respiratory rate were measured. Time to gain equilibrium was also assessed in a clean tank. Five and 24 hours after anaesthesia recovery, zebrafish were evaluated concerning activity and reactivity. Afterwards, in a second phase of experiments (experiment B), the best protocol of the experiment A was compared with a new group of 8 fishes treated with 100 mg/L of MS222 (100M). Results In experiment A, only different concentrations of propofol/lidocaine combination induced full anaesthesia in all animals. Thus only these groups were compared with a standard dose of MS222 in experiment B. Propofol/lidocaine induced a quicker loss of equilibrium, and loss of response to light and painful stimuli compared with MS222. However zebrafish treated with MS222 recovered quickly than the ones treated with propofol/lidocaine. Conclusion In conclusion, propofol/lidocaine combination and MS222 have advantages in different situations. MS222 is ideal for minor procedures when a quick recovery is important, while propofol/lidocaine is best to

  5. [Forensic age estimation in juveniles and young adults: Reducing the range of scatter in age diagnosis by combining different methods].

    PubMed

    Schmidt, Sven; Schramm, Danilo; Ribbecke, Sebastian; Schulz, Ronald; Wittschieber, Daniel; Olze, Andreas; Vieth, Volker; Ramsthaler, H Frank; Pfischel, Klaus; Pfeiffer, Heidi; Geserick, Gunther; Schmeling, Andreas

    2016-01-01

    The dramatic rise in the number of refugees entering Germany means that age estimation for juveniles and young adults whose age is unclear but relevant to legal and official procedures has become more important than ever. Until now, whether and to what extent the combination of methods recommended by the Study Group on Forensic Age Diagnostics has resulted in a reduction of the range of scatter of the summarized age diagnosis has been unclear. Hand skeletal age, third molar mineralization stage and ossification stage of the medial clavicular epiphyses were determined for 307 individuals aged between 10 and 29 at time of death on whom autopsies were performed at the Institutes of Legal Medicine in Berlin, Frankfurt am Main and Hamburg between 2001 and 2011. To measure the range of scatter, linear regression analysis was used to calculate the standard error of estimate for each of the above methods individually and in combination. It was found that combining the above methods led to a reduction in the range of scatter. Due to various limitations of the study, the statistical parameters determined cannot, however, be used for age estimation practice. PMID:26934764

  6. Advances in Functional Neuroanatomy: A Review of Combined DTI and fMRI Studies in Healthy Younger and Older Adults

    PubMed Central

    Bennett, Ilana J.; Rypma, Bart

    2013-01-01

    Structural connections between brain regions are thought to influence neural processing within those regions. It follows that alterations to the quality of structural connections should influence the magnitude of neural activity. The quality of structural connections may also be expected to differentially influence activity in directly versus indirectly connected brain regions. To test these predictions, we reviewed studies that combined diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) in younger and older adults. By surveying studies that examined relationships between DTI measures of white matter integrity and fMRI measures of neural activity, we identified variables that accounted for variability in these relationships. Results revealed that relationships between white matter integrity and neural activity varied with (1) aging (i.e., positive and negative DTI-fMRI relationships in younger and older adults, respectively) and (2) spatial proximity of the neural measures (i.e., positive and negative DTI-fMRI relationships when neural measures were extracted from adjacent and non-adjacent brain regions, respectively). Together, the studies reviewed here provided support for both of our predictions. PMID:23628742

  7. AAVshRNA-Mediated Suppression of PTEN in Adult Rats in Combination with Salmon Fibrin Administration Enables Regenerative Growth of Corticospinal Axons and Enhances Recovery of Voluntary Motor Function after Cervical Spinal Cord Injury

    PubMed Central

    2014-01-01

    Conditional genetic deletion of phosphatase and tensin homolog (PTEN) in the sensorimotor cortex of neonatal mice enables regeneration of corticospinal tract (CST) axons after spinal cord injury (SCI). The present study addresses three questions: (1) whether PTEN knockdown in adult rats by nongenetic techniques enables CST regeneration, (2) whether interventions to enable CST regeneration enhance recovery of voluntary motor function, and (3) whether delivery of salmon fibrin into the injury site further enhances CST regeneration and motor recovery. Adult rats were trained in a staircase-reaching task and then received either intracortical injections of AAVshPTEN to delete PTEN or a control vector expressing shRNA for luciferase (AAVshLuc). Rats then received cervical dorsal hemisection injuries and salmon fibrin was injected into the injury site in half the rats, yielding four groups (AAVshPTEN, AAVshLuc, AAVshPTEN + fibrin, and AAVshLuc + fibrin). Forepaw function was assessed for 10 weeks after injury and CST axons were traced by injecting biotin-conjugated dextran amine into the sensorimotor cortex. Rats that received AAVshPTEN alone did not exhibit improved motor function, whereas rats that received AAVshPTEN and salmon fibrin had significantly higher forelimb-reaching scores. Tract tracing revealed that CST axons extended farther caudally in the group that received AAVshPTEN and salmon fibrin versus other groups. There were no significant differences in lesion size between the groups. Together, these data suggest that the combination of PTEN deletion and salmon fibrin injection into the lesion can significantly improve voluntary motor function after SCI by enabling regenerative growth of CST axons. PMID:25057197

  8. Maternal and paternal parenting styles: unique and combined links to adolescent and early adult delinquency.

    PubMed

    Hoeve, Machteld; Dubas, Judith Semon; Gerris, Jan R M; van der Laan, Peter H; Smeenk, Wilma

    2011-10-01

    The present study examines the cross-sectional and longitudinal associations between fathers' and mothers' parenting styles and male and female delinquency using a sample of 330 Dutch families with a mid or late adolescent son or daughter (ages 14-22), followed across two measurement waves with a 5-year interval. Parenting styles of fathers and mothers were linked to delinquency. A significant parenting style by sex interaction was found: neglectful parenting was related to higher levels of delinquency in males and permissive parenting was linked to delinquency in females. A long term relationship was found between fathers' neglectful parenting style and delinquency in males. Furthermore, results revealed that levels of delinquency were the lowest in families with at least one authoritative parent and highest in families with two neglectful parents, indicating that the level of delinquency was dependent on the combination of mother's and father's parenting styles. PMID:21397317

  9. Risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen negative/hepatitis B core antibody positive patients receiving rituximab-containing combination chemotherapy without routine antiviral prophylaxis.

    PubMed

    Koo, Yu Xuan; Tay, Matthew; Teh, Yii Ean; Teng, David; Tan, Daniel S W; Tan, Iain B H; Tai, David W M; Quek, Richard; Tao, Miriam; Lim, Soon Thye

    2011-10-01

    The use of rituximab has been associated with increased risk of hepatitis B virus (HBV) reactivation in patients who are hepatitis B surface antigen (HBsAg) negative and antihepatitis B core antibody (anti-HBc) positive. We aim to determine the rate of HBV reactivation in this group of patients who received rituximab-containing combination chemotherapy without concomitant antiviral prophylaxis and to identify potential risk factors for reactivation. Sixty-two HBsAg negative/anti-HBc positive patients with B-cell lymphoma treated with rituximab-based immunochemotherapy from 2006 to 2009 were included. None of the patients received concomitant antiviral prophylaxis. In this cohort, 48 (77%) patients received rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), eight (13%) received rituximab with cyclophosphamide, vincristine and prednisolone, and six (10%) received other chemotherapy regimens. Two patients suffered HBV reactivation; both were above 70 years of age, received R-CHOP chemotherapy and were negative for antihepatitis B surface antibody (anti-HBs) at baseline. One of the two patients reactivated shortly after completion of R-CHOP chemotherapy while the other reactivated during rituximab maintenance treatment. Thus, the overall reactivation rate in this cohort of patients is 3% (2/62), 4% (2/48), and 25% (1/4) in patients who received R-CHOP chemotherapy and who received rituximab maintenance, respectively. The rate of HBV reactivation is low in patients who are HBsAg negative/anti-HBc positive receiving rituximab-based combination chemotherapy without concomitant antiviral prophylaxis. However, elderly patients, particularly those without anti-HBs, seemed particularly at risk. PMID:21520001

  10. Design and Application of Combined 8-Channel Transmit and 10-Channel Receive Arrays and Radiofrequency Shimming for 7-T Shoulder Magnetic Resonance Imaging

    PubMed Central

    Brown, Ryan; Deniz, Cem Murat; Zhang, Bei; Chang, Gregory; Sodickson, Daniel K.; Wiggins, Graham C.

    2014-01-01

    Objective The objective of the study was to investigate the feasibility of 7-T shoulder magnetic resonance imaging by developing transmit and receive radiofrequency (RF) coil arrays and exploring RF shim methods. Materials and Methods A mechanically flexible 8-channel transmit array and an anatomically conformable 10-channel receive array were designed and implemented. The transmit performance of various RF shim methods was assessed through local flip angle measurements in the right and left shoulders of 6 subjects. The receive performance was assessed through signal-to-noise ratio measurements using the developed 7-T coil and a baseline commercial 3-T coil. Results The 7-T transmit array driven with phase-coherent RF shim weights provided adequate B1+ efficiency and uniformity for turbo spin echo shoulder imaging. B1+ twisting that is characteristic of high-field loop coils necessitates distinct RF shim weights in the right and left shoulders. The 7-T receive array provided a 2-fold signal-to-noise ratio improvement over the 3-T array in the deep articular shoulder cartilage. Conclusions Shoulder imaging at 7-T is feasible with a custom transmit/receive array either in a single-channel transmit mode with a fixed RF shim or in a parallel transmit mode with a subject-specific RF shim. PMID:24056112

  11. Combination formoterol and budesonide as maintenance and reliever therapy versus inhaled steroid maintenance for chronic asthma in adults and children

    PubMed Central

    Cates, Christopher J; Lasserson, Toby J

    2014-01-01

    Background Traditionally inhaled treatment for asthma has been considered as preventer and reliever therapy. The combination of formoterol and budesonide in a single inhaler introduces the possibility of using a single inhaler for both prevention and relief of symptoms (single inhaler therapy). Objectives The aim of this review is to compare formoterol and corticosteroid in single inhaler for maintenance and relief of symptoms with inhaled corticosteroids for maintenance and a separate reliever inhaler. Search methods We last searched the Cochrane Airways Group trials register in September 2008. Selection criteria Randomised controlled trials in adults and children with chronic asthma. Data collection and analysis Two review authors independently assessed studies for inclusion and extracted the characteristics and results of each study. Authors or manufacturers were asked to supply unpublished data in relation to primary outcomes. Main results Five studies on 5,378 adults compared single inhaler therapy with current best practice, and did not show a significant reduction in participants with exacerbations causing hospitalisation (Peto OR 0.59; 95% CI 0.24 to 1.45) or treated with oral steroids (OR 0.83; 95% CI 0.66 to 1.03). Three of these studies on 4281 adults did not show a significant reduction in time to first severe exacerbation needing medical intervention (HR 0.96; 95% CI 0.85 to 1.07). These trials demonstrated a reduction in the mean total daily dose of inhaled corticosteroids with single inhaler therapy (mean reduction ranged from 107 to 267 micrograms/day, but the trial results were not combined due to heterogeneity). The full results from four further studies on 4,600 adults comparing single inhaler therapy with current best practice are awaited. Three studies including 4,209 adults compared single inhaler therapy with higher dose budesonide maintenance and terbutaline for symptom relief. No significant reduction was found with single inhaler therapy

  12. Combination of Cytokine Responses Indicative of Latent TB and Active TB in Malawian Adults

    PubMed Central

    Hur, Yun-Gyoung; Gorak-Stolinska, Patricia; Ben-Smith, Anne; Lalor, Maeve K.; Chaguluka, Steven; Dacombe, Russell; Doherty, T. Mark; Ottenhoff, Tom H.; Dockrell, Hazel M.; Crampin, Amelia C.

    2013-01-01

    Background An IFN-γ response to M. tuberculosis-specific antigens is an effective biomarker for M. tuberculosis infection but it cannot discriminate between latent TB infection and active TB disease. Combining a number of cytokine/chemokine responses to M. tuberculosis antigens may enable differentiation of latent TB from active disease. Methods Asymptomatic recently-exposed individuals (spouses of TB patients) were recruited and tuberculin skin tested, bled and followed-up for two years. Culture supernatants, from a six-day culture of diluted whole blood samples stimulated with M. tuberculosis-derived PPD or ESAT-6, were measured for IFN-γ, IL-10, IL-13, IL-17, TNF-α and CXCL10 using cytokine ELISAs. In addition, 15 patients with sputum smear-positive pulmonary TB were recruited and tested. Results Spouses with positive IFN-γ responses to M. tuberculosis ESAT-6 (>62.5 pg/mL) and TB patients showed high production of IL-17, CXCL10 and TNF-α. Higher production of IL-10 and IL-17 in response to ESAT-6 was observed in the spouses compared with TB patients while the ratios of IFN-γ/IL-10 and IFN-γ/IL-17 in response to M. tuberculosis-derived PPD were significantly higher in TB patients compared with the spouses. Tuberculin skin test results did not correlate with cytokine responses. Conclusions CXCL10 and TNF-α may be used as adjunct markers alongside an IFN-γ release assay to diagnose M. tuberculosis infection, and IL-17 and IL-10 production may differentiate individuals with LTBI from active TB. PMID:24260295

  13. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-08-25

    An improvement in a calutron receiver for collecting the isotopes ts described. The electromagnetic separation of the isotopes produces a mass spectrum of closely adjacent beams of ions at the foci regions, and a dividing wall between the two pockets is arranged at an angle. Substantially all of the tons of the less abundant isotope enter one of the pockets and strike one side of the wall directly, while substantially none of the tons entering the other pocket strikes the wall directly.

  14. Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults

    PubMed Central

    Shatil, Evelyn

    2013-01-01

    Cognitive training and aerobic training are known to improve cognitive functions. To examine the separate and combined effects of such training on cognitive performance, four groups of healthy older adults embarked on a 4 months cognitive and/or mild aerobic training. A first group [n = 33, mean age = 80 (66–90)] engaged in cognitive training, a second [n = 29, mean age = 81 (65–89)] in mild aerobic training, a third [n = 29, mean age = 79 (70–93)] in the combination of both, and a fourth [n = 31, mean age = 79 (71–92)] control group engaged in book-reading activity. The outcome was a well-validated multi-domain computerized cognitive evaluation for older adults. The results indicate that, when compared to older adults who did not engage in cognitive training (the mild aerobic and control groups) older adults who engaged in cognitive training (separate or combined training groups) showed significant improvement in cognitive performance on Hand-Eye Coordination, Global Visual Memory (GVM; working memory and long-term memory), Speed of Information Processing, Visual Scanning, and Naming. Indeed, individuals who did not engage in cognitive training showed no such improvements. Those results suggest that cognitive training is effective in improving cognitive performance and that it (and not mild aerobic training) is driving the improvement in the combined condition. Results are discussed in terms of the special circumstances of aerobic and cognitive training for older adults who are above 80 years of age. PMID:23531885

  15. Efficacy of a combined oral formulation of derquantel-abamectin against the adult and larval stages of nematodes in sheep, including anthelmintic-resistant strains.

    PubMed

    Little, Peter R; Hodge, Andrew; Maeder, Steven J; Wirtherle, Nicole C; Nicholas, David R; Cox, George G; Conder, George A

    2011-09-27

    and respiratory nematode parasites of sheep, as follows: ≥ 98.9% efficacy against Haemonchus contortus (adult and L4); Teladorsagia circumcincta (adult, L4 and hypobiotic L4); Teladorsagia trifurcata (L4); Trichostrongylus axei (adult and L4); Trichostrongylus colubriformis (adult and L4); Trichostrongylus falculatus (adult); Trichostrongylus rugatus (adult); Trichostrongylus vitrinus (adult and L4); Cooperia curticei (adult and L4); Cooperia oncophora (adult and L4); Nematodirus spathiger (adult); Nematodirus battus (adult); Nematodirus spp. (hypobiotic L4); Strongyloides papillosus (adult); Strongyloides spp. (L4); Chabertia ovina (adult); Oesophagostomum venulosum (adult); Dictyocaulus filaria (adult); and Protostrongylus rufescens (adult); ≥ 97.0% efficacy against Trichuris ovis (adult); and ≥ 95.9% efficacy against T. trifurcata (adult). Derquantel-abamectin is a highly effective combination anthelmintic, which will provide an important new tool for controlling helminths of sheep when used in conjunction with sustainable drenching practices. PMID:21684691

  16. The Combined Effect of Neuropsychological and Neuropathological Deficits on Instrumental Activities of Daily Living in Older Adults: a Systematic Review.

    PubMed

    Overdorp, Eduard J; Kessels, Roy P C; Claassen, Jurgen A; Oosterman, Joukje M

    2016-03-01

    To date, studies have consistently demonstrated associations between either neuropsychological deficits or neuroanatomical changes and instrumental activities of daily living (IADL) in aging. Only a limited number of studies have evaluated morphological brain changes and neuropsychological test performance concurrently in relation to IADL in this population. As a result, it remains largely unknown whether these factors independently predict functional outcome. The current systematic review intended to address this lack of information by reviewing the literature on older adults, incorporating studies that examined e.g., normal aging, but also stroke or dementia patients. A comprehensive search of databases (Pubmed, Embase, Medline, Web of Science, PsycINFO) and reference lists was performed, focusing on papers in the English language that examined the combined effect of neuropsychological and neuroanatomical factors on IADL in samples of adults with an average age above 50. In total, 58 potential articles were identified; 20 were included in the review. The results show that especially neuropsychological variables (primarily memory and executive functions) independently predict IADL. Although some unique predictive value of brain morphological changes, such as hippocampal atrophy, was found, support for the importance of white matter changes was limited. However, the results of the studies reviewed are diverse, and appear to be at least partially determined by the variables included. For example, studies were less likely to find an independent effect of cognition if they solely employed a cognitive screening instrument. This indicates that a structured examination of neuroanatomical and neuropsychological correlates of IADL in different patient populations is warranted. PMID:26732392

  17. Great Spotted Cuckoo Fledglings Often Receive Feedings from Other Magpie Adults than Their Foster Parents: Which Magpies Accept to Feed Foreign Cuckoo Fledglings?

    PubMed Central

    Soler, Manuel; Pérez-Contreras, Tomás; Ibáñez-Álamo, Juan Diego; Roncalli, Gianluca; Macías-Sánchez, Elena; de Neve, Liesbeth

    2014-01-01

    Natural selection penalizes individuals that provide costly parental care to non-relatives. However, feedings to brood-parasitic fledglings by individuals other than their foster parents, although anecdotic, have been commonly observed, also in the great spotted cuckoo (Clamator glandarius) – magpie (Pica pica) system, but this behaviour has never been studied in depth. In a first experiment, we here show that great spotted cuckoo fledglings that were translocated to a distant territory managed to survive. This implies that obtaining food from foreign magpies is a frequent and efficient strategy used by great spotted cuckoo fledglings. A second experiment, in which we presented a stuffed-cuckoo fledgling in magpie territories, showed that adult magpies caring for magpie fledglings responded aggressively in most of the trials and never tried to feed the stuffed cuckoo, whereas magpies that were caring for cuckoo fledglings reacted rarely with aggressive behavior and were sometimes disposed to feed the stuffed cuckoo. In a third experiment we observed feedings to post-fledgling cuckoos by marked adult magpies belonging to four different possibilities with respect to breeding status (i.e. composition of the brood: only cuckoos, only magpies, mixed, or failed breeding attempt). All non-parental feeding events to cuckoos were provided by magpies that were caring only for cuckoo fledglings. These results strongly support the conclusion that cuckoo fledglings that abandon their foster parents get fed by other adult magpies that are currently caring for other cuckoo fledglings. These findings are crucial to understand the co-evolutionary arms race between brood parasites and their hosts because they show that the presence of the host's own nestlings for comparison is likely a key clue to favour the evolution of fledgling discrimination and provide new insights on several relevant points such as learning mechanisms and multiparasitism. PMID:25272009

  18. Great spotted cuckoo fledglings often receive feedings from other magpie adults than their foster parents: which magpies accept to feed foreign cuckoo fledglings?

    PubMed

    Soler, Manuel; Pérez-Contreras, Tomás; Ibáñez-Álamo, Juan Diego; Roncalli, Gianluca; Macías-Sánchez, Elena; de Neve, Liesbeth

    2014-01-01

    Natural selection penalizes individuals that provide costly parental care to non-relatives. However, feedings to brood-parasitic fledglings by individuals other than their foster parents, although anecdotic, have been commonly observed, also in the great spotted cuckoo (Clamator glandarius)--magpie (Pica pica) system, but this behaviour has never been studied in depth. In a first experiment, we here show that great spotted cuckoo fledglings that were translocated to a distant territory managed to survive. This implies that obtaining food from foreign magpies is a frequent and efficient strategy used by great spotted cuckoo fledglings. A second experiment, in which we presented a stuffed-cuckoo fledgling in magpie territories, showed that adult magpies caring for magpie fledglings responded aggressively in most of the trials and never tried to feed the stuffed cuckoo, whereas magpies that were caring for cuckoo fledglings reacted rarely with aggressive behavior and were sometimes disposed to feed the stuffed cuckoo. In a third experiment we observed feedings to post-fledgling cuckoos by marked adult magpies belonging to four different possibilities with respect to breeding status (i.e. composition of the brood: only cuckoos, only magpies, mixed, or failed breeding attempt). All non-parental feeding events to cuckoos were provided by magpies that were caring only for cuckoo fledglings. These results strongly support the conclusion that cuckoo fledglings that abandon their foster parents get fed by other adult magpies that are currently caring for other cuckoo fledglings. These findings are crucial to understand the co-evolutionary arms race between brood parasites and their hosts because they show that the presence of the host's own nestlings for comparison is likely a key clue to favour the evolution of fledgling discrimination and provide new insights on several relevant points such as learning mechanisms and multiparasitism. PMID:25272009

  19. Efficacy and Safety of Subcutaneous Amifostine in Minimizing Radiation-Induced Toxicities in Patients Receiving Combined-Modality Treatment for Squamous Cell Carcinoma of the Head and Neck

    SciTech Connect

    Law, Amy; Wood, Craig

    2007-12-01

    Purpose: To report long-term data from a prospective trial of subcutaneous (s.c.) amifostine in patients who received chemoradiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Methods and Materials: Patients {>=}18 years of age with previously untreated Stage III/IV SCCHN received fractionated radiotherapy, 1.8-2.0 Gy/day, 5 days per week, to a total dose of 70-72 Gy, plus weekly paclitaxel (40 mg/m{sup 2}) and carboplatin (100 mg/m{sup 2}) administered intravenously (i.v.) for 6 weeks. All patients received 500 mg s.c. amifostine 30-60 min before radiotherapy with antihistamine and antiemetic prophylaxis. Results: Twenty patients were evaluable (median age, 55 years). The incidence of Grade 2 xerostomia was 42% and 29% at 12 and 18 months, respectively; there were no reports of Grade {>=}3 xerostomia. Grade {>=}3 mucositis occurred in 30% of patients, with median time to resolution of 12.5 weeks (range, 5-17 weeks). Survival estimates at 1 and 2 years were 95% and 71%, respectively. All patients experienced Grade 2 weight loss; 7 patients (35%) experienced Grade {<=}2 nausea/vomiting. There were no reports of Grade {>=}3 amifostine-related adverse events. Conclusions: Subcutaneous amifostine was well tolerated by patients receiving chemoradiotherapy for SCCHN, with lower rates of nausea/vomiting than reported in trials with i.v. amifostine. Xerostomia and mucositis rates were similar to those reported in trials with i.v. amifostine.

  20. Adults Need Vaccines, Too!

    MedlinePlus

    ... turn JavaScript on. Feature: Adult Vaccinations Adults Need Vaccines, Too! Past Issues / Summer 2015 Table of Contents ... of the millions of adults not receiving the vaccines you need? What vaccines do you need? All ...

  1. What do we need for airway management of adult casualties on the Primary Casualty Receiving Facility? A review of airway management on Role 3 Afloat.

    PubMed

    Mercer, S; Read, J; Sudheer, S; Risdall, J E; Connor, D

    2015-01-01

    The Primary Casualty Receiving Facility (PCRF) of the Royal Navy (RN) is currently based on Royal Fleet Auxiliary (RFA) ARGUS and provides a functioning hospital with surgical teams and a CT scanner (Role 3) within the maritime environment. The case mix could include complex trauma, critically ill patients returning to theatre several times, as well as non-battle injury procedures. This paper describes how we have used national guidelines, evidence from recent military experience, and the Clinical Guidelines for Operations (CGOs) to review and rationalise the airway equipment that is available and that would be required for the PCRF in its current configuration, whilst maintaining capability in a deployed setting. PMID:26867417

  2. Dose-intensified chemotherapy alone or in combination with mogamulizumab in newly diagnosed aggressive adult T-cell leukaemia-lymphoma: a randomized phase II study.

    PubMed

    Ishida, Takashi; Jo, Tatsuro; Takemoto, Shigeki; Suzushima, Hitoshi; Uozumi, Kimiharu; Yamamoto, Kazuhito; Uike, Naokuni; Saburi, Yoshio; Nosaka, Kisato; Utsunomiya, Atae; Tobinai, Kensei; Fujiwara, Hiroshi; Ishitsuka, Kenji; Yoshida, Shinichiro; Taira, Naoya; Moriuchi, Yukiyoshi; Imada, Kazunori; Miyamoto, Toshihiro; Akinaga, Shiro; Tomonaga, Masao; Ueda, Ryuzo

    2015-06-01

    This multicentre, randomized, phase II study was conducted to examine whether the addition of mogamulizumab, a humanized anti-CC chemokine receptor 4 antibody, to mLSG15, a dose-intensified chemotherapy, further increases efficacy without compromising safety of patients with newly diagnosed aggressive adult T-cell leukaemia-lymphoma (ATL). Patients were assigned 1:1 to receive mLSG15 plus mogamulizumab or mLSG15 alone. The primary endpoint was the complete response rate (%CR); secondary endpoints included the overall response rate (ORR) and safety. The %CR and ORR in the mLSG15-plus-mogamulizumab arm (n = 29) were 52% [95% confidence interval (CI), 33-71%] and 86%, respectively; the corresponding values in the mLSG15 arm (n = 24) were 33% (95% CI, 16-55%) and 75%, respectively. Grade ≥ 3 treatment-emergent adverse events, including anaemia, thrombocytopenia, lymphopenia, leucopenia and decreased appetite, were observed more frequently (≥10% difference) in the mLSG15-plus-mogamulizumab arm. Several adverse events, including skin disorders, cytomegalovirus infection, pyrexia, hyperglycaemia and interstitial lung disease, were observed only in the mLSG15-plus-mogamulizumab arm. Although the combination strategy showed a potentially less favourable safety profile, a higher %CR was achieved, providing the basis for further investigation of this novel treatment for newly diagnosed aggressive ATL. This study was registered at ClinicalTrials.gov, identifier: NCT01173887. PMID:25733162

  3. Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses.

    PubMed

    Nieto, Jorge E; Trela, Jan; Stanley, Scott D; Yamout, Sawsan; Snyder, Jack R

    2016-07-01

    The aim of this study was to determine the pharmacokinetics of amikacin and penicillin G sodium when administered in combination as an intravenous regional limb perfusion (IVRLP) to horses. Seven healthy adult horses underwent an IVRLP in the cephalic vein with 2 g of amikacin sulfate and 10 mill IU of penicillin G sodium diluted to 60 mL in 0.9% saline. A pneumatic tourniquet set at 450 mmHg was left in place for 30 min. Synovial fluid was collected from the metacarpophalangeal joint 35 min and 2, 6, 12, and 24 h after infusion of the antimicrobials. Concentrations of amikacin and penicillin in synovial fluid were quantitated by liquid chromatography tandem-mass spectrometry analysis. Therapeutic concentrations of amikacin and penicillin for equine-susceptible pathogens were achieved in the synovial fluid. Maximum synovial concentrations (Cmax) (mean ± SE) for amikacin and penicillin were 132 ± 33 μg/mL and 8474 ± 5710 ng/mL, respectively. Only 3 horses had detectable levels of penicillin at 6 h and 1 at the 12 h sample. The combination of amikacin with penicillin G sodium via IVDLP resulted in reported therapeutic concentrations of both antibiotics in the synovial fluid. The Cmax:MIC (minimum inhibitory concentration) ratio for amikacin was 8:1 and Time > MIC for penicillin was 6 h. At 24 h, the mean concentration of amikacin was still above 4 μg/mL. Terminal elimination rate constants (T1/2 lambdaz) were 13.6 h and 2.8 h for amikacin and penicillin, respectively. The use of IVDLP with penicillin may therefore not be practical as rapid clearance of penicillin from the synovial fluid requires frequent perfusions to maintain acceptable therapeutic concentrations. PMID:27408337

  4. High rates of malnutrition in older adults receiving different levels of health care in Lleida, Catalonia: an assessment of contributory factors.

    PubMed

    Jürschik, Pilar; Torres, Joan; Solá, Román; Nuin, Carmen; Botigué, Teresa; Lavedán, Ana

    2010-10-01

    The aim of this study was to define the factors associated with the presence or risk of malnutrition in older adults (>65 years of age) attending health care centers in Lleida, Catalonia, using a cross-sectional study approach. Nutritional parameters assessed included the Mini Nutritional Assessment Scale, sociodemographic and psychosocial factors, functional and cognitive status, swallowing and oral problems, texture and route of administration of the diet, changes in dietary intake, and presence of digestive disorders. A total of 398 individuals (184 men) with an average age of 77 years were included in the assessment. Poor nutritional status was recorded in 58% of the individuals. Factors independently associated with unsatisfactory nutritional status included weight loss, functional dependence, cognitive impairment, loneliness, living without a partner, history of heart disease, lung disease, and the presence of acute vomiting. PMID:21104512

  5. Tuberculosis Incidence and Risk Factors Among Human Immunodeficiency Virus (HIV)-Infected Adults Receiving Antiretroviral Therapy in a Large HIV Program in Nigeria.

    PubMed

    Chang, Charlotte A; Meloni, Seema Thakore; Eisen, Geoffrey; Chaplin, Beth; Akande, Patrick; Okonkwo, Prosper; Rawizza, Holly E; Tchetgen Tchetgen, Eric; Kanki, Phyllis J

    2015-12-01

    Background.  Despite the benefits of antiretroviral therapy (ART), tuberculosis (TB) is the leading cause of mortality among human immunodeficiency virus (HIV)-infected persons in Africa. Nigeria bears the highest TB burden in Africa and second highest HIV burden globally. This long-term multicenter study aimed to determine the incidence rate and predictors of TB in adults in the Harvard/AIDS Prevention Initiative in Nigeria (APIN) and President's Emergency Plan for AIDS Relief (PEPFAR) Nigeria ART program. Methods.  This retrospective evaluation used data collected from 2004 to 2012 through the Harvard/APIN PEPFAR program. Risk factors for incident TB were determined using multivariate Cox proportional hazards regression with time-dependent covariates. Results.  Of 50 320 adults enrolled from 2005 to 2010, 11 092 (22%) had laboratory-confirmed active TB disease at ART initiation, and 2021 (4%) developed active TB after commencing ART. During 78 228 total person-years (PY) of follow-up, the TB incidence rate was 25.8 cases per 1000 PY (95% confidence interval [CI], 24.7-27.0) overall, and it decreased significantly both with duration on ART and calendar year. Risk factors at ART initiation for incident TB included the following: earlier ART enrollment year, tenofovir-containing initial ART regimen, and World Health Organization clinical stage above 1. Time-updated risk factors included the following: low body mass index, low CD4(+) cell count, unsuppressed viral load, anemia, and ART adherence below 80%. Conclusions.  The rate of incident TB decreased with longer duration on ART and over the program years. The strongest TB risk factors were time-updated clinical markers, reinforcing the importance of consistent clinical and laboratory monitoring of ART patients in prompt diagnosis and treatment of TB and other coinfections. PMID:26613097

  6. Tuberculosis Incidence and Risk Factors Among Human Immunodeficiency Virus (HIV)-Infected Adults Receiving Antiretroviral Therapy in a Large HIV Program in Nigeria

    PubMed Central

    Chang, Charlotte A.; Meloni, Seema Thakore; Eisen, Geoffrey; Chaplin, Beth; Akande, Patrick; Okonkwo, Prosper; Rawizza, Holly E.; Tchetgen Tchetgen, Eric; Kanki, Phyllis J.

    2015-01-01

    Background. Despite the benefits of antiretroviral therapy (ART), tuberculosis (TB) is the leading cause of mortality among human immunodeficiency virus (HIV)-infected persons in Africa. Nigeria bears the highest TB burden in Africa and second highest HIV burden globally. This long-term multicenter study aimed to determine the incidence rate and predictors of TB in adults in the Harvard/AIDS Prevention Initiative in Nigeria (APIN) and President's Emergency Plan for AIDS Relief (PEPFAR) Nigeria ART program. Methods. This retrospective evaluation used data collected from 2004 to 2012 through the Harvard/APIN PEPFAR program. Risk factors for incident TB were determined using multivariate Cox proportional hazards regression with time-dependent covariates. Results. Of 50 320 adults enrolled from 2005 to 2010, 11 092 (22%) had laboratory-confirmed active TB disease at ART initiation, and 2021 (4%) developed active TB after commencing ART. During 78 228 total person-years (PY) of follow-up, the TB incidence rate was 25.8 cases per 1000 PY (95% confidence interval [CI], 24.7–27.0) overall, and it decreased significantly both with duration on ART and calendar year. Risk factors at ART initiation for incident TB included the following: earlier ART enrollment year, tenofovir-containing initial ART regimen, and World Health Organization clinical stage above 1. Time-updated risk factors included the following: low body mass index, low CD4+ cell count, unsuppressed viral load, anemia, and ART adherence below 80%. Conclusions. The rate of incident TB decreased with longer duration on ART and over the program years. The strongest TB risk factors were time-updated clinical markers, reinforcing the importance of consistent clinical and laboratory monitoring of ART patients in prompt diagnosis and treatment of TB and other coinfections. PMID:26613097

  7. The effects of combined vitamin D and calcium supplementation on fasting plasma glucose in non-diabetic adults age 65 and older

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Altered vitamin D and calcium homeostasis may play a role in the development of glucose intolerance. In a 3-year randomized controlled trial, we compared the effects of combined vitamin D and calcium supplementation vs. placebo on fasting plasma glucose (FPG) in healthy adults 65 years of age or old...

  8. Severe adverse immunologic reaction in a patient with glioblastoma receiving autologous dendritic cell vaccines combined with GM-CSF and dose-intensified temozolomide

    PubMed Central

    Mitchell, Duane A.; Sayour, Elias J.; Reap, Elizabeth; Schmittling, Robert; De Leon, Gabriel; Norberg, Pamela; Desjardins, Annick; Friedman, Allan H.; Friedman, Henry S.; Archer, Gary; Sampson, John H.

    2015-01-01

    Therapeutic vaccination of patients with cancer-targeting tumor-associated antigens is a promising strategy for the specific eradication of invasive malignancies with minimal toxicity to normal tissues. However, as increasingly potent modalities for stimulating immunologic responses are developed for clinical evaluation, the risk of inflammatory and autoimmune toxicities also may be exacerbated. In this report, we describe the induction of a severe (Grade 3) immunologic reaction in a patient with newly-diagnosed glioblastoma (GBM) receiving autologous RNA-pulsed dendritic cell (DC) vaccines admixed with GM-CSF and administered coordinately with cycles of dose-intensified temozolomide (diTMZ). Shortly after the eighth administration of the admixed intradermal vaccine, the patient experienced dizziness, flushing, conjunctivitis, headache, and the outbreak of a disseminated macular/papular rash and bilateral indurated injection sites. Immunologic work-up of patient reactivity revealed sensitization to the GM-CSF component of the vaccine and the production of high levels of anti-GM-CSF autoantibodies during vaccination. Removal of GM-CSF from the DC vaccine allowed continued vaccination without incident. Despite the known lymphodepletive and immunosuppressive effects of TMZ, these observations demonstrate the capacity for the generation of severe immunologic reactivity in patients with GBM receiving DC-based therapy during adjuvant diTMZ. PMID:25387895

  9. Highly directional acoustic receivers.

    PubMed

    Cray, Benjamin A; Evora, Victor M; Nuttall, Albert H

    2003-03-01

    The theoretical directivity of a single combined acoustic receiver, a device that can measure many quantities of an acoustic field at a collocated point, is presented here. The formulation is developed using a Taylor series expansion of acoustic pressure about the origin of a Cartesian coordinate system. For example, the quantities measured by a second-order combined receiver, denoted a dyadic sensor, are acoustic pressure, the three orthogonal components of acoustic particle velocity, and the nine spatial gradients of the velocity vector. The power series expansion, which can be of any order, is cast into an expression that defines the directivity of a single receiving element. It is shown that a single highly directional dyadic sensor can have a directivity index of up to 9.5 dB. However, there is a price to pay with highly directive sensors; these sensors can be significantly more sensitive to nonacoustic noise sources. PMID:12656387

  10. A phase II trial of enzastaurin (LY317615) in combination with bevacizumab in adults with recurrent malignant gliomas.

    PubMed

    Odia, Yazmin; Iwamoto, Fabio M; Moustakas, Argirios; Fraum, Tyler J; Salgado, Carlos A; Li, Aiguo; Kreisl, Teri N; Sul, Joohee; Butman, John A; Fine, Howard A

    2016-03-01

    We evaluated the efficacy of combination enzastaurin (LY317615) and bevacizumab for recurrent malignant gliomas and explored serologic correlates. We enrolled 81 patients with glioblastomas (GBM, n = 40) and anaplastic gliomas (AG, n = 41). Patients received enzastaurin as a loading dose of 1125 mg, followed by 500 or 875 mg daily for patients on non-enzyme-inducing or enzyme-inducing antiepileptics, respectively. Patients received bevacizumab 10 mg/kg intravenously biweekly. Clinical evaluations were repeated every 4 weeks. Magnetic resonance imaging was obtained at baseline and every 8 weeks from treatment onset. Phosphorylated glycogen synthase kinase (GSK)-3 levels from peripheral blood mononuclear cells (PBMCs) were checked with each MRI. Median overall survival was 7.5 and 12.4 months for glioblastomas and anaplastic glioma cohorts, with median progression-free survivals of 2.0 and 4.4 months, respectively. Of GBM patients, 3/40 (7.5 %) were not evaluable, while 8/37 (22 %) had partial or complete response and 20/37 (54 %) had stable disease for 2+ months. Of the 39 evaluable AG patients, 18 (46 %) had an objective response, and 16 (41 %) had stable disease for 2+ months. The most common grade 3+ toxicities were lymphopenia (15 %), hypophosphatemia (8.8 %) and thrombotic events (7.5 %). Two (2.5 %) GBM patients died suddenly; another death (1.3 %) occurred from intractable seizures. Phosphorylated GSK-3 levels from PBMCs did not correlate with treatment response. A minimally important improvement in health-related quality of life was self-reported in 7-9/24 (29.2-37.5 %). Early response based on Levin criteria was significantly associated with significantly longer progression free survival for glioblastomas. Enzastaurin (LY317615) in combination with bevacizumab for recurrent malignant gliomas is well-tolerated, with response and progression-free survival similar to bevacizumab monotherapy. PMID:26643807

  11. Decreasing population selection rates of resistance mutation K65R over time in HIV-1 patients receiving combination therapy including tenofovir

    PubMed Central

    Theys, K.; Snoeck, J.; Vercauteren, J.; Abecasis, A. B.; Vandamme, A.-M.; Camacho, R. J.

    2013-01-01

    Objectives The use of tenofovir is highly associated with the emergence of mutation K65R, which confers broad resistance to nucleoside/nucleotide analogue reverse transcriptase inhibitors (NRTIs), especially when tenofovir is combined with other NRTIs also selecting for K65R. Although recent HIV-1 treatment guidelines discouraging these combinations resulted in reduced K65R selection with tenofovir, updated information on the impact of currently recommended regimens on the population selection rate of K65R is presently lacking. Methods In this study, we evaluated changes over time in the selection rate of resistance mutation K65R in a large population of 2736 HIV-1-infected patients failing combination antiretroviral treatment between 2002 and 2010. Results The K65R resistance mutation was detected in 144 patients, a prevalence of 5.3%. A large majority of observed K65R cases were explained by the use of tenofovir, reflecting its wide use in clinical practice. However, changing patterns over time in NRTIs accompanying tenofovir resulted in a persistent decreasing probability of K65R selection by tenofovir-based therapy. The currently recommended NRTI combination tenofovir/emtricitabine was associated with a low probability of K65R emergence. For any given dual NRTI combination including tenofovir, higher selection rates of K65R were consistently observed with a non-nucleoside reverse transcriptase inhibitor than with a protease inhibitor as the third agent. Discussion Our finding of a stable time trend of K65R despite elevated use of tenofovir illustrates increased potency of current HIV-1 therapy including tenofovir. PMID:23027713

  12. Predictors and impact of non-adherence in adults with attention-deficit/hyperactivity disorder receiving OROS methylphenidate: results from a randomized, placebo-controlled trial

    PubMed Central

    2013-01-01

    Background Medication non-adherence has an important impact on treatment efficacy and healthcare burden across a range of conditions and therapeutic areas. The aim of this analysis was to determine predictors of non-adherence and impact of non-adherence on treatment response in adults with attention-deficit/hyperactivity disorder (ADHD). Methods Post-hoc analysis of a 13-week randomized, double-blind placebo-controlled study of OROS methylphenidate (MPH) 54 and 72 mg/day. Primary efficacy variable was the Conners’ Adult ADHD Rating Scale – Screening Version (CAARS:O-SV). Daily adherence was calculated as average daily adherence (100 × capsules taken/2), with overall adherence calculated as the average daily adherence. Predictors of adherence were assessed using mixed-effects logistic regression. Descriptive statistics were generated for change in CAARS:O-SV score for adherent (> 95% adherence) and non-adherent subjects. Predictors of change were analyzed using a mixed model. Results Subjects were allocated to OROS MPH (54 mg, n = 87; 72 mg, n = 92) or placebo (n = 97). Mean adherence was 92.6% and 93.3% (OROS MPH 54 and 72 mg/day, respectively), versus 97.5% (placebo). Adherence was higher and less variable in completers. Factors significantly associated with non-adherence included female sex, shorter time since ADHD diagnosis, higher education level (completion of university) and score on the Drug Use Screening Inventory psychiatric disorders subscale. Improvements from baseline in CAARS:O-SV score were numerically greater in subjects defined as adherent than in those who were non-adherent. Significant predictors of CAARS:O-SV change in patients who completed the study included percentage adherence up to the point of assessment (p < 0.0001), baseline score (p < 0.0001) and family history of ADHD (p = 0.0003). Conclusion The results of this analysis suggest that newly diagnosed patients, those with a high score on the DUSI-R psychiatric disorder scale, women

  13. Radiation receiver

    DOEpatents

    Hunt, A.J.

    1983-09-13

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles. 5 figs.

  14. Radiation receiver

    DOEpatents

    Hunt, Arlon J.

    1983-01-01

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles.

  15. Monopulse receiver

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A time division multiplexing and a quadraphase combining dual channel system were analyzed, designed, and tested. Analyses performed include the following: (1) boresight error as a function of the error channel bandwidth; (2) error channel interference with the sum channel functions; (3) threshold performance; and (4) error channel crosstalk, linearity, and drift as a function of signal level, Doppler, and environment. Test results indicate that the time division multiplexing system meets the design goals of the program. However, careful selection and alignment of all gain controlled amplifiers are required along with temperature compensation of the angle channel gain. The quadraphase system crosstalk performance is comparatively poor (-15 dB) with respect to the -30 dB requirements and this consequently affects gain tracking performance. Gain tracking was found to be + or - 20 percent rather than the + or - 5 percent specification. Data for the two systems is compared and recommendations are presented.

  16. Obesity Among HIV-Infected Adults Receiving Medical Care in the United States: Data From the Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey.

    PubMed

    Thompson-Paul, Angela M; Wei, Stanley C; Mattson, Christine L; Robertson, McKaylee; Hernandez-Romieu, Alfonso C; Bell, Tanvir K; Skarbinski, Jacek

    2015-07-01

    Our objective was to compare obesity prevalence among human immunodeficiency virus (HIV)-infected adults receiving care and the U.S. general population and identify obesity correlates among HIV-infected men and women.Cross-sectional data was collected in 2009 to 2010 from 2 nationally representative surveys: Medical Monitoring Project (MMP) and National Health and Nutrition Examination Survey (NHANES).Weighted prevalence estimates of obesity, defined as body mass index ≥30.0 kg/m, were compared using prevalence ratios (PR, 95% confidence interval [CI]). Correlates of obesity in HIV-infected adults were examined using multivariable logistic regression.Demographic characteristics of the 4006 HIV-infected adults in MMP differed from the 5657 adults from the general U.S. population in NHANES, including more men (73.2% in MMP versus 49.4% in NHANES, respectively), black or African Americans (41.5% versus 11.6%), persons with annual incomes <$20,000 (64.5% versus 21.9%), and homosexuals or bisexuals (50.9% versus 3.9%). HIV-infected men were less likely to be obese (PR 0.5, CI 0.5-0.6) and HIV-infected women were more likely to be obese (PR1.2, CI 1.1-1.3) compared with men and women in the general population, respectively. Among HIV-infected women, younger age was associated with obesity (<40 versus >60 years). Among HIV-infected men, correlates of obesity included black or African American race/ethnicity, annual income >$20,000 and <$50,000, heterosexual orientation, and geometric mean CD4+ T-lymphocyte cell count >200 cells/μL.Obesity is common, affecting 2 in 5 HIV-infected women and 1 in 5 HIV-infected men. Correlates of obesity differ for HIV-infected men and women; therefore, different strategies may be needed for the prevention and treatment. PMID:26166086

  17. Radiation doses received by adult Japanese populations living outside Fukushima Prefecture during March 2011, following the Fukushima 1 nuclear power plant failures.

    PubMed

    Priest, N D

    2012-12-01

    Data on the concentration of radionuclides in air for March following the reactor failures at the Fukushima NPP were available for Takasaki, Chiba and Tokyo. Gamma dose data for the same/close locations and for fixed locations in other prefectures were also obtained. Gamma dose data was used to calculate the cumulative gamma dose, during 2 weeks (15th-28th March) following the power plant failures. Corresponding doses were calculated for sites in other Japanese prefectures - except Fukushima Prefecture, for which equivalent monitoring data was not published. For Takasaki, Chiba and Tokyo air concentration data and ICRP dose coefficients were used to calculate inhalation committed effective doses (CED, E(50)) and thyroid equivalent doses (H) for adult members of the public. Average ratios of gamma dose to inhalation CED and inhalation CED from iodine isotopes to thyroid equivalent dose, determined for Takasaki, Chiba and Tokyo, were then used to predict these quantities for sites in other prefectures. Cumulative gamma dose profiles were used to identify dose increments that could be attributed to Fukushima releases within 11 prefectures (excluding Fukushima Prefecture). The most impacted of these were located in Gunma, Ibaraki, Tochigi and Saitama Prefectures - to the south of Fukushima - and in Miyagi Prefecture - to the north of Fukushima. Calculated total doses ranged from 16 μSv in Shizuoka (Shizuoka) to 400 μSv in Ibaraki (Mito). The total doses calculated for the major population centres of Tokyo and Chiba were 97 μSv and 80 μSv, respectively. For all prefecture locations the largest calculated contribution to total dose, during the period of assessment, was from inhalation (~80%). Estimated thyroid equivalent doses ranged from 5.9 mSv in Ibaraki to 200 μSv in Shizuoka. All total doses calculated were probably overestimates - since no allowances were made for shielding and shelter during the passage of radioactive clouds. Minor contributions to dose from

  18. Learning at the Center: A Proposal for Dynamic Assessment in a Combined University and Community Adult Learning Center Course

    ERIC Educational Resources Information Center

    Prins, Lisa; Pauchulo, Ana Laura; Brooke, Auralia; Corrigan, Joe

    2015-01-01

    We ask the reader to consider a proposal for cooperative renewal in the evaluation of a course (OurU) offered in partnership between a university and community-based adult learning center. This proposal's aim is to enhance adult learners' ability to evaluate their learning experiences, with the goal of adopting more learner-directed content into…

  19. "I Have Remained Strong Because of That Food": Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy.

    PubMed

    Young, Sera; Natamba, Barnabas; Luwedde, Flavia; Nyafwono, Dorcas; Okia, Ben; Osterbauer, Beth; Natureeba, Paul; Johnson, Lynn; Michel, Chloe; Zheng, Amy; Robine, Marion; Achan, Jane; Charlebois, Edwin; Cohan, Deb; Havlir, Diane

    2015-08-01

    We evaluated the acceptability and use of macronutrient supplementation among HIV-infected pregnant Ugandan women receiving antiretroviral therapy in a clinical study (NCT 00993031). We first conducted formative research among 56 pregnant and lactating women to select a supplement regimen. Acceptability and use of the supplementation regimen (35 sachets of lipid-based nutrient supplements (LNS) and 4 or 6 kg of instant soy porridge for the household provided monthly) were evaluated among 87 pregnant women. Organoleptic assessments of LNS were favorable. Participants reported consuming LNS a mean of 6.1 days per week, and adherence to recommended consumption behaviors (e.g. frequency, quantity, not sharing) was >80 %. Few women reported negative social consequences of supplementation. The majority of participants also consumed most of the porridge intended for the household. In sum, LNS was acceptable and used regularly. Larger studies to evaluate physical and psychosocial consequences of LNS during pregnancy among HIV-infected women are warranted. PMID:25416075

  20. Combined triaxial accelerometry and heart rate telemetry for the physiological characterization of Latin dance in non-professional adults.

    PubMed

    Domene, Pablo A; Easton, Chris

    2014-03-01

    The purpose of this study was to value calibrate, cross-validate, and determine the reliability of a combined triaxial accelerometry and heart rate telemetry technique for characterizing the physiological and physical activity parameters of Latin dance. Twenty-two non-professional adult Latin dancers attended two laboratory-based dance trials each. After familiarization and a standardized warm-up, a multi-stage (3 x 5-minute) incremental (based on song tempo) Afro-Cuban salsa choreography was performed while following a video displayed on a projection screen. Data were collected with a portable indirect calorimeter, a heart rate telemeter, and wrist-, hip-, and ankle-mounted ActiGraph GT3X+ accelerometers. Prediction equations for energy expenditure and step count were value calibrated using forced entry multiple regression and cross-validated using a delete-one jackknife approach with additional Bland-Altman analysis. The average dance intensity reached 6.09 ± 0.96 kcal/kg/h and demanded 45.9 ± 11.3% of the heart rate reserve. Predictive ability of the derived models was satisfactory, where R(2) = 0.80; SEE = 0.44 kcal/kg/h and R(2) = 0.74; SEE = 3 step/min for energy expenditure and step count, respectively. Dependent t-tests indicated no differences between predicted and measured values for both energy expenditure (t65 = -0.25, p = 0.80) and step count (t65 = -0.89, p = 0.38). The 95% limits of agreement for energy expenditure and step count were -0.98 to 0.95 kcal/kg/h and -7 to 7 step/min, respectively. Latin dance to salsa music elicits physiological responses representative of moderate to vigorous physical activity, and a wrist-worn accelerometer with simultaneous heart rate measurement constitutes a valid and reliable technique for the prediction of energy expenditure and step count during Latin dance. PMID:24568801

  1. Reduction in incidence of invasive fungal infection in patients receiving allogeneic stem cell transplantation using combined diagnostic-driven approach and itraconazole oral solution.

    PubMed

    Tzadok, Roie; Shapira, Michael Y; Moses, Allon E; Or, Reuven; Block, Colin; Strahilevitz, Jacob

    2015-12-01

    Invasive fungal infections are an important cause of morbidity and mortality after allogeneic haematopoietic stem cell transplantation. We evaluated, in our allogeneic stem cell transplant patients, the effect on the incidence of invasive fungal infection during neutropenia of a strategy combining a diagnostic-driven approach with chemoprophylaxis during higher risk periods of graft vs. host disease and prolonged neutropenia, using itraconazole oral solution with parenteral voriconazole bridging. One hundred and thirty patients admitted for allogeneic stem cell transplantation within two predefined 20 month periods were included in the study. Data for all patients were collected prospectively. Implementation of the protocol resulted in the administration of more prophylactic antifungals to more patients. Following implementation, there was a non-significant decrease in the overall number of invasive fungal infections (IFI) [11 of 65 patients (17.2%) vs. 4 of 65 patients (6.2%, P = 0.051)], as well as in the occurrence of invasive mould infections [8 of 65 patients (12.5%) vs. 2 of 65 patients (3.1%, P = 0.054)]. Survival rates at three and 6 months were not significantly affected. A combined diagnostic-driven approach and antifungal prophylaxis with oral itraconazole and an intravenous voriconazole bridging protocol, was associated with a reduced, albeit non-statistically significant, number of IFI in our medical centre. PMID:26429354

  2. Model-based evaluation of the pharmacokinetic differences between adults and children for lopinavir and ritonavir in combination with rifampicin

    PubMed Central

    Zhang, Chao; Denti, Paolo; Decloedt, Eric H; Ren, Yuan; Karlsson, Mats O; McIlleron, Helen

    2013-01-01

    Aims Rifampicin profoundly reduces lopinavir concentrations. Doubled doses of lopinavir/ritonavir compensate for the effect of rifampicin in adults, but fail to provide adequate lopinavir concentrations in young children on rifampicin-based antituberculosis therapy. The objective of this study was to develop a population pharmacokinetic model describing the pharmacokinetic differences of lopinavir and ritonavir, with and without rifampicin, between children and adults. Methods An integrated population pharmacokinetic model developed in nonmem 7 was used to describe the pharmacokinetics of lopinavir and ritonavir in 21 HIV infected adults, 39 HIV infected children and 35 HIV infected children with tuberculosis, who were established on lopinavir/ritonavir-based antiretroviral therapy with and without rifampicin-containing antituberculosis therapy. Results The bioavailability of lopinavir was reduced by 25% in adults whereas children on antituberculosis treatment experienced a 59% reduction, an effect that was moderated by the dose of ritonavir. Conversely, rifampicin increased oral clearance of both lopinavir and ritonavir to a lesser extent in children than in adults. Rifampicin therapy in administered doses increased CL of lopinavir by 58% in adults and 48% in children, and CL of ritonavir by 34% and 22% for adults and children, respectively. In children, the absorption half-life of lopinavir and the mean transit time of ritonavir were lengthened, compared with those in adults. Conclusions The model characterized important differences between adults and children in the effect of rifampicin on the pharmacokinetics of lopinavir and ritonavir. As adult studies cannot reliably predict their magnitude in children, drug–drug interactions should be evaluated in paediatric patient populations. PMID:23432610

  3. Health Care Outcomes and Advance Care Planning in Older Adults Who Receive Home-Based Palliative Care: A Pilot Cohort Study

    PubMed Central

    Thorsteinsdottir, Bjorg; Cha, Stephen S.; Hanson, Gregory J.; Peterson, Stephanie M.; Rahman, Parvez A.; Naessens, James M.; Takahashi, Paul Y.

    2015-01-01

    Abstract Background: Approximately 20% of seniors live with five or more chronic medical illnesses. Terminal stages of their lives are often characterized by repeated burdensome hospitalizations and advance care directives are insufficiently addressed. This study reports on the preliminary results of a Palliative Care Homebound Program (PCHP) at the Mayo Clinic in Rochester, Minnesota to service these vulnerable populations. Objective: The study objective was to evaluate inpatient hospital utilization and the adequacy of advance care planning in patients who receive home-based palliative care. Methods: This is a retrospective pilot cohort study of patients enrolled in the PCHP between September 2012 and March 2013. Two control patients were matched to each intervention patient by propensity scoring methods that factor in risk and prognosis. Primary outcomes were six-month hospital utilization including ER visits. Secondary outcomes evaluated advance care directive completion and overall mortality. Results: Patients enrolled in the PCHP group (n=54) were matched to 108 controls with an average age of 87 years. Ninety-two percent of controls and 33% of PCHP patients were admitted to the hospital at least once. The average number of hospital admissions was 1.36 per patient for controls versus 0.35 in the PCHP (p<0.001). Total hospital days were reduced by 5.13 days. There was no difference between rates of ER visits. Advanced care directive were completed more often in the intervention group (98%) as compared to controls (31%), with p<0.001. Goals of care discussions were held at least once for all patients in the PCHP group, compared to 41% in the controls. PMID:25375663

  4. Combining low-cost GPS receivers with upGPR to derive continuously liquid water content, snow height and snow water equivalent in Alpine snow covers

    NASA Astrophysics Data System (ADS)

    Koch, Franziska; Schmid, Lino; Prasch, Monika; Heilig, Achim; Eisen, Olaf; Schweizer, Jürg; Mauser, Wolfram

    2015-04-01

    The temporal evolution of Alpine snowpacks is important for assessing water supply, hydropower generation, flood predictions and avalanche forecasts. Especially in high mountain regions with an extremely varying topography, it is until now often difficult to derive continuous and non-destructive information on snow parameters. Since autumn 2012, we are running a new low-cost GPS (Global Positioning System) snow measurement experiment at the high alpine study site Weissfluhjoch (2450 m a.s.l.) in Switzerland. The globally and freely broadcasted GPS L1-band (1.57542 GHz) was continuously recorded with GPS antennas, which are installed at the ground surface underneath the snowpack. GPS raw data, containing carrier-to-noise power density ratio (C/N0) as well as elevation and azimuth angle information for each time step of 1 s, was stored and analyzed for all 32 GPS satellites. Since the dielectric permittivity of an overlying wet snowpack influences microwave radiation, the bulk volumetric liquid water content as well as daily melt-freeze cycles can be derived non-destructively from GPS signal strength losses and external snow height information. This liquid water content information is qualitatively in good accordance with meteorological and snow-hydrological data and quantitatively highly agrees with continuous data derived from an upward-looking ground-penetrating radar (upGPR) working in a similar frequency range. As a promising novelty, we combined the GPS signal strength data with upGPR travel-time information of active impulse radar rays to the snow surface and back from underneath the snow cover. This combination allows determining liquid water content, snow height and snow water equivalent from beneath the snow cover without using any other external information. The snow parameters derived by combining upGPR and GPS data are in good agreement with conventional sensors as e.g. laser distance gauges or snow pillows. As the GPS sensors are cheap, they can easily

  5. Risk reduction of falls and fractures, reduction of back pain and safety in elderly high risk patients receiving combined therapy with alfacalcidol and alendronate: a prospective study.

    PubMed

    Schacht, Erich; Ringe, Johann D

    2011-01-01

    Efficacy and safety of a new combination package containing 4 or 12 self-explanatory one-week blisters, each with one tablet of 70 mg alendronate (CAS 260055-05-8) and 7 capsules of 1 microg alfacalcidol (CAS 41294-56-8) (Tevabone) on muscle power, muscle function, balance and back pain was investigated in an open, multi-centered, uncontrolled, prospective study on a cohort of elderly patients with a high risk of falls and fractures. 818 practicing physicians all over Germany recruited 2579 patients for a 3-month observational trial being treated with the above combination package. 92.4% were women [89.7% of the women had postmenopausal osteoporosis (PMO)]. Their average age was 74.1 years and the mean body mass index 26.4 kg/m2. 55.4% had a history of falls. Prevalent vertebral and non-vertebral fractures were documented in 62.9% and 61.4% of the patients, respectively, and a creatinine clearance below 65 ml/min was documented in 65.5%. Main outcome parameters were the Chair Rising Test (CRT), Timed Up and Go Test (TUG), back pain and safety at onset and after 3 months. In addition an evaluation of the package design was done at the end of the study. The percentage of patients able to perform the CRT within 10 sec increased from 26.3% to 42.9% after 3 months (increase 63%, p < 0.0001), while successful performance within 10 sec of TUG increased by 54% (p < 0.0001) from 30.6% at onset to 47.1% after 3 months. The average overall improvement of CRT was 2.3 sec (p < 0.0001) and of TUG amounted to 2.4 sec (p < 0.0001). It was shown in another recently published study that a mean increase of 2.6 sec in the performance of TUG results in a 24% increased risk for non-vertebral fractures. Mean back pain measured by a 0-10 visual analogue scale decreased significantly by 41% from 5.9 to 3.5 (p < 0.0001). Throughout the study, 178 adverse events (AE) were reported in 85 of the 2579 patients (incidence: 3.3 %). Only 3 patients experienced serious AE, 2 without causal

  6. [Significance of correlation between weather factors and hemodynamic parameters in patients with arterial hypertension and coronary heart desease receiving traditional treatment and combined therapy with melatonin].

    PubMed

    2011-01-01

    The study included 2 groups of patients with arterial hypertension and coronary heart disease treated by traditional therapy or its combination with melatonin. All 31 patients aged 41-70 years underwent measurement of AP and pulse rate in morning and evening hours. Correlation analysis between hemodynamic parameters and weather factors (curtsey of Institute of Terrestrial Magnetism, Ionosphere and Radiowaves) was performed. The study revealed 64 significant correlations in patients given traditional treatment. Atmospheric pressure, air and dew point temperature proved to have the most pronounced effect on hemodynamic parameters. Morning pulse rate was especially sensitive to meteorological factors. Treatment with melaxene reduced the number of correlations to 35. Specifically, the influence of temperature on hemodynamics decreased whereas effects of dew point temperature, wind speed and direction on the cardiovascular system were totally absent. PMID:22242268

  7. Combined electron microscopy and spectroscopy characterization of as-received, acid purified, and oxidized HiPCO single-wall carbon nanotubes

    SciTech Connect

    Rosario-Castro, Belinda I.; Contes, Enid J.; Lebron-Colon, Marisabel; Meador, Michael A.; Sanchez-Pomales, Germarie; Cabrera, Carlos R.

    2009-12-15

    Single-wall carbon nanotubes (SWCNTs) are very important materials due to their combination of unique structure, dimension, strength, chemical stability, and electronic properties. Nevertheless, SWCNTs from commercial sources usually contain several impurities, which are usually removed by a purification process that includes reflux in acids and strong oxidation. This strong chemical procedure may alter the nanotube properties and it is thus important to control the extent of functionalization and oxidation during the purification procedure. In this report, we provide a comprehensive study of the structure and physical composition of SWCNTs during each step of the purification process. Techniques such as Raman spectroscopy, transmission electron microscopy, scanning electron microscopy, thermogravimetric analysis, X-ray photoelectron spectroscopy and Infrared spectroscopy were used to track the SWCNTs structure, in terms of length and diameter distribution, and surface chemical modifications during each purification stage.

  8. Are combined AOPs effective for toxicity reduction in receiving marine environment? Suitability of battery of bioassays for wastewater treatment plant (WWTP) effluent as an ecotoxicological assessment.

    PubMed

    Díaz-Garduño, B; Rueda-Márquez, J J; Manzano, M A; Garrido-Pérez, C; Martín-Díaz, M L

    2016-03-01

    Ecotoxicological assessment of three different wastewater treatment plant (WWTP) effluents D1, D2 and D3 was performed before and after tertiary treatment using combination of advanced oxidation processes (AOPs). A multibarrier treatment (MBT) consisting of microfiltration (MF), hydrogen peroxide photolysis (H2O2/UVC) and catalytic wet peroxide oxidation (CWPO) was applied for all effluents. Sparus aurata, Paracentrotus lividus, Isochrysis galbana and Vibrio fischeri, representing different trophic levels, constituted the battery of bioassays. Different acute toxicity effects were observed in each WWTP effluents tested. The percentage of sea urchin larval development and mortality fish larvae were the most sensitive endpoints. Significant reduction (p < 0.05) of effluent's toxicity was observed using a classification pT-method after MBT process. Base on obtained results, tested battery of bioassays in pT-method framework can be recommended for acute toxicity preliminary evaluation of WWTP effluents for the marine environment. PMID:26741736

  9. Albuminuria is associated with elevated acute phase reactants and proinflammatory markers in HIV-infected patients receiving suppressive combination antiretroviral therapy.

    PubMed

    O-charoen, Pichaya; Ndhlovu, Lishomwa C; Gangcuangco, Louie Mar A; Keating, Sheila M; Norris, Philip J; Ng, Roland C K; Mitchell, Brooks I; Shikuma, Cecilia M; Chow, Dominic C

    2014-12-01

    Albuminuria among HIV-infected individuals has been found to be associated with cardiovascular disease (CVD) and mortality. Inflammation has been associated with albuminuria. The pathophysiology of albuminuria in HIV-infected individuals is poorly understood. We investigated the association of albuminuria with inflammatory biomarkers among HIV-infected individuals on combination antiretroviral therapy (cART). This is a cross-sectional analysis of participants enrolled in the Hawaii Aging with HIV-Cardiovascular Cohort. Plasma inflammatory biomarkers were assessed using the Milliplex Human Cardiovascular disease multiplex assays. A random urine sample was collected for albumin measurement. Albuminuria was defined as urine albumin-to-creatinine ratio of ≥30 mg/g. Framingham risk score was calculated and divided into three classes. Simple and multivariable logistic regression analyses were utilized to assess the correlation between plasma inflammatory biomarkers and albuminuria and were adjusted for Framingham risk category. Among 111 HIV-infected patients [median (IQR) age of 52 (46-57) years, 86% male, median (IQR) CD4 count of 489 (341-638) cells/mm(3), 85% with HIV RNA <50 copies/ml], 18 subjects (16.2%) had moderately increased albuminuria (albuminuria range between 30 and 300 mg/g) and 2 subjects (1.8%) had severely increased albuminuria (albuminuria more than 300 mg/g). In multivariable logistic models, sE-selectin, sVCAM-1, CRP, SAA, and SAP remained significantly associated with albuminuria after adjustment of CVD risk factors. This study showed an association between inflammation and albuminuria independent of previously reported risk factors for albuminuria in HIV-infected subjects who were on combination antiretroviral therapy (cART). Chronic inflammation despite potent antiretroviral treatment may contribute to higher rates of albuminuria among HIV-infected patients. PMID:25205472

  10. Association of ITPA gene polymorphisms and the risk of ribavirin-induced anemia in HIV/hepatitis C virus (HCV)-coinfected patients receiving HCV combination therapy.

    PubMed

    Domingo, Pere; Guardiola, Josep M; Salazar, Juliana; Torres, Ferran; Mateo, M Gracia; Pacho, Cristina; Del Mar Gutierrez, M; Lamarca, Karuna; Fontanet, Angels; Martin, Jordi; Muñoz, Jessica; Vidal, Francesc; Baiget, Montserrat

    2012-06-01

    Polymorphisms of the ITPA gene have been associated with anemia during combination therapy in hepatitis C virus (HCV)-monoinfected patients. Our aim was to confirm this association in HIV/HCV-coinfected patients. In this prospective, observational study, 73 HIV/HCV-coinfected patients treated with pegylated interferon plus ribavirin (RBV) were enrolled. Two single nucleotide polymorphisms within or adjacent to the ITPA gene (rs1127354 and rs7270101) were genotyped. The associations between the ITPA genotype and anemia or treatment outcome were examined. Fifty-nine patients (80.8%) had CC at rs1127354, whereas 14 (19.2%) had a CA/AA ITPA genotype. Percent decreases from baseline hemoglobin level were significantly greater in patients with the CC genotype than in those with the CA/AA genotype at week 4 (P = 0.0003), week 12 (P < 0.0001), and week 36 (P = 0.0102) but not at the end of treatment. RBV dose reduction was more often needed in patients with the CC genotype than in those with the CA/AA genotype (odds ratio [OR] = 11.81; 95% confidence interval [CI] = 1.45 to 256.17; P = 0.0039), as was erythropoietin therapy (OR = 8.28; 95% CI = 1.04 to 371.12; P = 0.0057). Risk factors independently associated with percent hemoglobin nadir decrease were RBV dose reduction (OR = 11.72; 95% CI = 6.82 to 16.63; P < 0.001), baseline hemoglobin (OR = 1.69; 95% CI = 0.23 to 3.15; P = 0.024), and body mass index (OR = -0.7; 95% CI = -1.43 to 0.03; P = 0.061). ITPA polymorphism was not an independent predictor of sustained virological response. Polymorphisms at rs1127354 in the ITPA gene influence hemoglobin levels during combination HCV therapy and the need for RBV dose reduction and erythropoietin use in HIV/HCV-coinfected patients. PMID:22430973

  11. Association of ITPA Gene Polymorphisms and the Risk of Ribavirin-Induced Anemia in HIV/Hepatitis C Virus (HCV)-Coinfected Patients Receiving HCV Combination Therapy

    PubMed Central

    Guardiola, Josep M.; Salazar, Juliana; Torres, Ferran; Mateo, M. Gracia; Pacho, Cristina; del Mar Gutierrez, M.; Lamarca, Karuna; Fontanet, Angels; Martin, Jordi; Muñoz, Jessica; Vidal, Francesc; Baiget, Montserrat

    2012-01-01

    Polymorphisms of the ITPA gene have been associated with anemia during combination therapy in hepatitis C virus (HCV)-monoinfected patients. Our aim was to confirm this association in HIV/HCV-coinfected patients. In this prospective, observational study, 73 HIV/HCV-coinfected patients treated with pegylated interferon plus ribavirin (RBV) were enrolled. Two single nucleotide polymorphisms within or adjacent to the ITPA gene (rs1127354 and rs7270101) were genotyped. The associations between the ITPA genotype and anemia or treatment outcome were examined. Fifty-nine patients (80.8%) had CC at rs1127354, whereas 14 (19.2%) had a CA/AA ITPA genotype. Percent decreases from baseline hemoglobin level were significantly greater in patients with the CC genotype than in those with the CA/AA genotype at week 4 (P = 0.0003), week 12 (P < 0.0001), and week 36 (P = 0.0102) but not at the end of treatment. RBV dose reduction was more often needed in patients with the CC genotype than in those with the CA/AA genotype (odds ratio [OR] = 11.81; 95% confidence interval [CI] = 1.45 to 256.17; P = 0.0039), as was erythropoietin therapy (OR = 8.28; 95% CI = 1.04 to 371.12; P = 0.0057). Risk factors independently associated with percent hemoglobin nadir decrease were RBV dose reduction (OR = 11.72; 95% CI = 6.82 to 16.63; P < 0.001), baseline hemoglobin (OR = 1.69; 95% CI = 0.23 to 3.15; P = 0.024), and body mass index (OR = −0.7; 95% CI = −1.43 to 0.03; P = 0.061). ITPA polymorphism was not an independent predictor of sustained virological response. Polymorphisms at rs1127354 in the ITPA gene influence hemoglobin levels during combination HCV therapy and the need for RBV dose reduction and erythropoietin use in HIV/HCV-coinfected patients. PMID:22430973

  12. Low-dose and combined effects of oral exposure to bisphenol A and diethylstilbestrol on the male reproductive system in adult Sprague-Dawley rats.

    PubMed

    Jiang, Xiao; Chen, Hong-Qiang; Cui, Zhi-Hong; Yin, Li; Zhang, Wen-Long; Liu, Wen-Bin; Han, Fei; Ao, Lin; Cao, Jia; Liu, Jin-Yi

    2016-04-01

    Study of the joint action of xenobiotics is important to fully explore their toxicity and complete risk analysis. In this study, we investigated the effects of low-dose and combined exposure of bisphenol A (BPA) and diethylstilbestrol (DES) on the reproductive system in adult male rats. The results showed that the sperm motility decreased in the BPA/DES and combined groups. Sperm deformity ratios and histological lesions of the testes were significantly higher and more significant, respectively, in the combined group compared with the single treated groups. No dose-effect relationship or significant additive effect on serum hormone levels was observed after combined exposure to BPA/DES. Ultrastructural results showed lesions of the Sertoli and Leydig cells, mainly in the endoplasmic reticulum (ER), in all treated groups. ER stress molecular sensor IRE1 was phosphorylated and activated after BPA and DES treatment in this study. The protein levels of ES stress molecular marker CHOP were significantly up-regulated after exposure to BPA, DES, and BPA and DES combined. These findings indicate that ER stress is important in BPA/DES-induced damage in rat testes. Low-dose and combined exposure to BPA and DES may have toxic effects on male fertility in the adult population. PMID:26970683

  13. Long Term Clinical Outcome of Patients with Severe Combined Immunodeficiency who Received Related Donor Bone Marrow Transplants without Pre-transplant Chemotherapy or Post-transplant GVHD Prophylaxis

    PubMed Central

    Railey, Mary Dell; Lokhnygina, Yuliya; Buckley, Rebecca H.

    2009-01-01

    Objective To determine long term health benefits of non-ablative bone marrow transplantation for severe combined immunodeficiency (SCID), we investigated our cohort of 161 related donor bone marrow transplanted SCID patients. Only 16 (10%) had HLA-identical donors. Study design All 124 survivors were sent questionnaires about their current clinical statuses. Details from clinic visits were also compiled. One hundred eleven patients (90%) were reached. We compared outcomes of patients transplanted before and after 3.5 months of life and by molecular defect. Results The overall survival rate is 77%, but the rate for the 48 infants transplanted in the first 3.5 months of life is 94%, compared with 70% for the 113 transplanted after 3.5 months (p=0.002). Twenty-eight (76%) of the 37 deceased patients died from viral infections present at diagnosis. One or more clinical problems were reported to have been present in the past two years in 71 (64%) of the survivors, although 95 (86%) are considered healthy by their families. Conclusions Most patients with SCID transplanted with related donor marrow without pre-transplant chemotherapy have done well long-term, but those transplanted at <3.5 months of age had a superior survival rate, a lower rate of clinical problems, less need for booster transplants and better nutritional status. PMID:19818451

  14. Analgesic Effects of Intra-Articular Bupivacaine/Intravenous Parecoxib Combination Therapy versus Intravenous Parecoxib Monotherapy in Patients Receiving Total Knee Arthroplasty: A Randomized, Double-Blind Trial

    PubMed Central

    Shen, Shih-Jyun; Peng, Pei-Yu; Chen, Hsiu-Pin; Lin, Jr-Rung; Lee, Mel S.; Yu, Huang-Ping

    2015-01-01

    Objectives. The purpose of this double-blind, randomized study was to investigate whether the addition of intra-articular bupivacaine to intravenous parecoxib could improve pain relief in patients undergoing total knee arthroplasty. Methods. A total of 36 patients undergoing total knee arthroplasty were enrolled into our study. These patients were randomly allocated either to a placebo-controlled group or study group. Postoperative pain scores and analgesic consumption were evaluated. Results. Numeric rating scale (NRS) data of bupivacaine group in postoperative room were significantly lower than that of control group (control group versus bupivacaine group, 7.9 (6.7–9.1) (mean and 95% confidence interval) versus 4.5 (3.2–5.8) (mean and 95% confidence interval), p = 0.001). NRS data of bupivacaine group in ward were also significantly lower than that of control group. A significantly lower dose of meperidine was used in the study group postoperatively during the first 24 hours (control group versus bupivacaine group, 3.08 ± 0.80 mg/Kg versus 2.34 ± 0.42 mg/Kg, p = 0.001). Conclusion. Intra-articular bupivacaine in combination with intravenous parecoxib may improve pain relief and reduce the demand for rescue analgesics in patients undergoing total knee arthroplasty. The trial is registered with Australian New Zealand Clinical Trials Registry (ACTRN12615000463572). PMID:26171392

  15. Herpes simplex virus type 2 (HSV-2) genital shedding in HSV-2-/HIV-1-co-infected women receiving effective combination antiretroviral therapy.

    PubMed

    Péré, Héléne; Rascanu, Aida; LeGoff, Jérome; Matta, Mathieu; Bois, Frédéric; Lortholary, Olivier; Leroy, Valériane; Launay, Odile; Bélec, Laurent

    2016-03-01

    The dynamics of genital shedding of HSV-2 DNA was assessed in HIV-1-infected women taking combination antiretroviral therapy (cART). HIV-1 RNA, HIV-1 DNA and HSV DNA loads were measured during 12-18 months using frozen plasma, PBMC and cervicovaginal lavage samples from 22 HIV-1-infected women, including 17 women naive for antiretroviral therapy initiating cART and 5 women with virological failure switching to a new regimen. Nineteen (86%) women were HSV-2-seropositive. Among HSV-2-/HIV-1-co-infected women, HIV-1 RNA loads showed a rapid fall from baseline after one month of cART, in parallel in paired plasma and cervicovaginal secretions. In contrast, HIV-1 DNA loads did not show significant variations from baseline up to 18 months of treatment in both systemic and genital compartments. HSV DNA was detected at least once in 12 (63%) of 19 women during follow up: HSV-2 shedding in the genital compartment was observed in 11% of cervicovaginal samples at baseline and in 16% after initiating or switching cART. Cervicovaginal HIV-1 RNA loads were strongly associated with plasma HIV-1 RNA loads over time, but not with cervicovaginal HSV DNA loads. Reactivation of genital HSV-2 replication frequently occurred despite effective cART in HSV-2-/HIV-1-co-infected women. Genital HSV-2 replication under cART does not influence cervicovaginal HIV-1 RNA or DNA shedding. PMID:25769886

  16. AB027. Long-acting beta-agonist in combination or separate inhaler as step-up therapy for children with uncontrolled asthma receiving inhaled corticosteroids

    PubMed Central

    Turner, Steve; Richardson, Kathryn; Murray, Clare; Thomas, Mike; Hillyer, Elizabeth V.; Burden, Anne; Price, David B.

    2016-01-01

    Background Adding a long-acting β2-agonist (LABA) to inhaled corticosteroids (ICS) using a fixed-dose combination (FDC) inhaler containing ICS and LABA is the UK guideline-recommended step-up option for children aged >4 years with uncontrolled asthma on ICS monotherapy. The evidence of benefit of FDC inhalers over adding a separate LABA inhaler to ICS therapy is limited. Our aim was to compare outcomes for FDCversusseparate LABA + ICS inhalers for children by analyzing routinely-acquired clinical and prescribing data. Methods This matched cohort study used large UK primary care databases to study children prescribed their first step-up from ICS monotherapy at 5–12 years of age as add-on LABA, either via separate LABA inhaler or FDC inhaler. A baseline year was examined to characterize patients and identify potential confounders; outcomes were examined during the subsequent year. The primary outcome was overall asthma control. Results After matching, there were 1,330 children in each cohort [mean age (SD) 9 (2) years; 59% male]. All measures of asthma exacerbations and control improved during the outcome year in both cohorts. In the separate ICS + LABA cohort, the odds of failing to achieve overall asthma control were higher [adjusted odds ratio 1.30, (95% CI, 1.10–1.52) P=0.002] compared with the FDC cohort. Acute respiratory events were more frequent [adjusted rate ratio 1.21, (1.04–1.39) P=0.012] in the ICS + LABA compared to the FDC cohort. Conclusions These results support current recommendations that add-on LABA therapy for children should be administered as an FDC and not as separate inhaler.

  17. Multichannel homodyne receiver

    DOEpatents

    Landt, Jeremy A.

    1982-01-01

    A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

  18. Multichannel homodyne receiver

    DOEpatents

    Landt, J.A.

    1981-01-19

    A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals is described. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

  19. Evidence of Subclinical mtDNA Alterations in HIV-Infected Pregnant Women Receiving Combination Antiretroviral Therapy Compared to HIV-Negative Pregnant Women

    PubMed Central

    Money, Deborah M.; Wagner, Emily C.; Maan, Evelyn J.; Chaworth-Musters, Tessa; Gadawski, Izabelle; van Schalkwyk, Julie E.; Forbes, John C.; Burdge, David R.; Albert, Arianne Y. K.; Lohn, Zoe; Côté, Hélène C. F.

    2015-01-01

    Introduction Combination antiretroviral therapy (cART) can effectively prevent vertical transmission of HIV but there is potential risk of adverse maternal, foetal or infant effects. Specifically, the effect of cART use during pregnancy on mitochondrial DNA (mtDNA) content in HIV-positive (HIV+) women is unclear. We sought to characterize subclinical alterations in peripheral blood mtDNA levels in cART-treated HIV+ women during pregnancy and the postpartum period. Methods This prospective longitudinal observational cohort study enrolled both HIV+ and HIV-negative (HIV-) pregnant women. Clinical data and blood samples were collected at three time points in pregnancy (13-<23 weeks, 23-<30 weeks, 30–40 weeks), and at delivery and six weeks post-partum in HIV+ women. Peripheral blood mtDNA to nuclear DNA (nDNA) ratio was measured by qPCR. Results Over a four year period, 63 HIV+ and 42 HIV- women were enrolled. HIV+ women showed significantly lower mtDNA/nDNA ratios compared to HIV- women during pregnancy (p = 0.003), after controlling for platelet count and repeated measurements using a multivariable mixed-effects model. Ethnicity, gestational age (GA) and substance use were also significantly associated with mtDNA/nDNA ratio (p≤0.02). Among HIV+ women, higher CD4 nadir was associated with higher mtDNA/nDNA ratios (p<0.0001), and these ratio were significantly lower during pregnancy compared to the postpartum period (p<0.0001). Conclusions In the context of this study, it was not possible to distinguish between mtDNA effects related to HIV infection versus cART therapy. Nevertheless, while mtDNA levels were relatively stable over time in both groups during pregnancy, they were significantly lower in HIV+ women compared to HIV- women. Although no immediate clinical impact was observed on maternal or infant health, lower maternal mtDNA levels may exert long-term effects on women and children and remain a concern. Improved knowledge of such subclinical alterations is

  20. Comparison of the effects of bisphenol A alone and in a combination with X-irradiation on sperm count and quality in male adult and pubescent mice.

    PubMed

    Dobrzyńska, Małgorzata M; Jankowska-Steifer, Ewa A; Tyrkiel, Ewa J; Gajowik, Aneta; Radzikowska, Joanna; Pachocki, Krzysztof A

    2014-11-01

    Bisphenol A (BPA) is employed in the manufacturing of epoxy, polyester-styrene, and polycarbonate resins, which are used for the production of baby and water bottles and reusable containers, food and beverage packing, dental fillings and sealants. The study was designed to examine the effects of 8-week exposure (a full cycle of spermatogenesis) to BPA alone and in a combination with X-irradiation on the reproductive organs and germ cells of adult and pubescent male mice. Pzh:Sfis male mice were exposed to BPA (5, 10, and 20 mg/kg) or X-rays (0.05 Gy) or to a combination of both (0.05 Gy + 5 mg/kg bw BPA). The following parameters were examined: sperm count, sperm motility, sperm morphology, and DNA damage in male gametes. Both BPA and X-rays alone diminished sperm quality. BPA exposure significantly reduced sperm count in pubescent males compared to adult mice, with degenerative changes detected in seminiferous epithelium. This may suggest a higher susceptibility of germ cells of younger males to BPA action. Combined BPA with X-ray treatment enhanced the harmful effect induced by BPA alone in male germ cells of adult males, whereas low-dose irradiation showed sometimes protective or additive effects in pubescent mice. PMID:23619965

  1. Single-Dose Pharmacokinetics and Safety of Abacavir (1592U89), Zidovudine, and Lamivudine Administered Alone and in Combination in Adults with Human Immunodeficiency Virus Infection

    PubMed Central

    Wang, Laurene H.; Chittick, Gregory E.; McDowell, James A.

    1999-01-01

    Abacavir (1592U89), a nucleoside reverse transcriptase inhibitor with in vitro activity against human immunodeficiency virus type-1 (HIV-1), has been evaluated for efficacy and safety in combination regimens with other nucleoside analogs, including zidovudine (ZDV) and lamivudine (3TC). To evaluate the potential pharmacokinetic interactions between these agents, 15 HIV-1-infected adults with a median CD4+ cell count of 347 cells/mm3 (range, 238 to 570 cells/mm3) were enrolled in a randomized, seven-period crossover study. The pharmacokinetics and safety of single doses of abacavir (600 mg), ZDV (300 mg), and 3TC (150 mg) were evaluated when each drug was given alone or when any two or three drugs were given concurrently. The concentrations of all drugs in plasma and the concentrations of ZDV and its 5′-glucuronide metabolite, GZDV, in urine were measured for up to 24 h postdosing, and pharmacokinetic parameter values were calculated by noncompartmental methods. The maximum drug concentration (Cmax), the area under the concentration-time curve from time zero to infinity (AUC0–∞), time to Cmax (Tmax), and apparent elimination half-life (t1/2) of abacavir in plasma were unaffected by coadministration with ZDV and/or 3TC. Coadministration of abacavir with ZDV (with or without 3TC) decreased the mean Cmax of ZDV by approximately 20% (from 1.5 to 1.2 μg/ml), delayed the median Tmax for ZDV by 0.5 h, increased the mean AUC0–∞ for GZDV by up to 40% (from 11.8 to 16.5 μg · h/ml), and delayed the median Tmax for GZDV by approximately 0.5 h. Coadministration of abacavir with 3TC (with or without ZDV) decreased the mean AUC0–∞ for 3TC by approximately 15% (from 5.1 to 4.3 μg · h/ml), decreased the mean Cmax by approximately 35% (from 1.4 to 0.9 μg/ml), and delayed the median Tmax by approximately 1 h. While these changes were statistically significant, they are similar to the effect of food intake (for ZDV) or affect an inactive metabolite (for GZDV) or are

  2. Obesity Among HIV-Infected Adults Receiving Medical Care in the United States: Data From the Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey

    PubMed Central

    Thompson-Paul, Angela M.; Wei, Stanley C.; Mattson, Christine L.; Robertson, McKaylee; Hernandez-Romieu, Alfonso C.; Bell, Tanvir K.; Skarbinski, Jacek

    2015-01-01

    Abstract Our objective was to compare obesity prevalence among human immunodeficiency virus (HIV)-infected adults receiving care and the U.S. general population and identify obesity correlates among HIV-infected men and women. Cross-sectional data was collected in 2009 to 2010 from 2 nationally representative surveys: Medical Monitoring Project (MMP) and National Health and Nutrition Examination Survey (NHANES). Weighted prevalence estimates of obesity, defined as body mass index ≥30.0 kg/m2, were compared using prevalence ratios (PR, 95% confidence interval [CI]). Correlates of obesity in HIV-infected adults were examined using multivariable logistic regression. Demographic characteristics of the 4006 HIV-infected adults in MMP differed from the 5657 adults from the general U.S. population in NHANES, including more men (73.2% in MMP versus 49.4% in NHANES, respectively), black or African Americans (41.5% versus 11.6%), persons with annual incomes <$20,000 (64.5% versus 21.9%), and homosexuals or bisexuals (50.9% versus 3.9%). HIV-infected men were less likely to be obese (PR 0.5, CI 0.5–0.6) and HIV-infected women were more likely to be obese (PR1.2, CI 1.1–1.3) compared with men and women in the general population, respectively. Among HIV-infected women, younger age was associated with obesity (<40 versus >60 years). Among HIV-infected men, correlates of obesity included black or African American race/ethnicity, annual income >$20,000 and <$50,000, heterosexual orientation, and geometric mean CD4+ T-lymphocyte cell count >200 cells/μL. Obesity is common, affecting 2 in 5 HIV-infected women and 1 in 5 HIV-infected men. Correlates of obesity differ for HIV-infected men and women; therefore, different strategies may be needed for the prevention and treatment. PMID:26166086

  3. Combined early and adult life risk factor associations for mid-life obesity in a prospective birth cohort: assessing potential public health impact

    PubMed Central

    Pinto Pereira, Snehal M; van Veldhoven, Karin; Li, Leah; Power, Chris

    2016-01-01

    Objective The combined effect of life-course influences on obesity development and thus their potential public health impact is unclear. We evaluated combined associations and predicted probabilities for early and adult life risk factors with central and general obesity in mid-adulthood. Setting 1958 British birth cohort. Participants 4629 males and 4670 females with data on waist circumference. Outcome measures 45 year obesity measured via waist circumference, waist–hip ratio (WHR) and BMI. Results At 45 years, approximately a third of the population were centrally obese and a quarter were generally obese. Three factors (parental overweight, maternal smoking during pregnancy and adult inactivity) were consistently associated with central and general obesity. Predicted probabilities for waist obesity increased from those with none to all three risk factors (0.15–0.33 in men; 0.19–0.39 in women (ptrend<0.001)), with a similar trend for general obesity. Additional factors (adult smoking, low fibre and heavy alcohol consumption) were associated with WHR obesity, although varying by gender. Prevalence of risk factors was higher in manual than non-manual groups: for example, in men 38% versus 25%, respectively, had ≥2 risk factors for waist and general obesity. Conclusions Early-life and adult factors that are amenable to change are highly prevalent and accumulate in association with central and general obesity in mid-adulthood. The increase in probabilities for mid-adult obesity associated with cumulative levels of risk factors suggests the potential for public health impact. PMID:27072572

  4. Efficacy of a novel topical combination of fipronil, (S)-methoprene, eprinomectin and praziquantel against adult and immature stages of the cat flea (Ctenocephalides felis) on cats.

    PubMed

    Baker, Christine; Tielemans, Eric; Prullage, Joseph B; Chester, S Theodore; Knaus, Martin; Rehbein, Steffen; Fourie, Josephus J; Young, David R; Everett, William R; Rosentel, Joseph K

    2014-04-28

    The efficacy of a novel topical combination of fipronil 8.3% (w/v), (S)-methoprene 10% (w/v), eprinomectin 0.4% (w/v) and praziquantel 8.3% (w/v) (BROADLINE(®)) was tested against adult and immature stages of Ctenocephalides felis fleas in six studies. For that purpose, fleas from different colonies from North America, Germany and South Africa were used to induce infestations in cats under laboratory conditions. In each study, between 12 and 16 cats were allocated randomly to 2 groups. Cats in Group 1 were not treated and served as controls. Cats in Group 2 were treated once on Day 0 with BROADLINE(®) at the minimum recommended dosage of 0.12 mg/kg body weight. In 4 studies, all animals were infested experimentally with unfed C. felis (100 ± 5) on Days 2 (or 1), 7, 14, 21, 28 and 35. Live fleas were counted 24h post-treatment or infestation. In 2 additional studies, animals were infested at the same frequency with gravid C. felis fleas (100 ± 5) that were fed previously on an untreated host. Forty-eight hours post-infestation, flea eggs were collected, counted and incubated for the evaluation of the reduction of emergence of adults. The combined curative efficacy against adult fleas at 24h after treatment was 94.3% and the combined preventive efficacy values remained greater than 95.9% at 24h after 5 subsequent weekly infestations. In addition, the product reduced dramatically the emergence of new adult fleas for at least 5 weeks (>98.1% for one month and 93.2% at 5 weeks after infestation), demonstrating its efficiency in preventing environmental contamination by immature stages. PMID:24703078

  5. Efficacy of a Web-Based, Center-Based or Combined Physical Activity Intervention among Older Adults

    ERIC Educational Resources Information Center

    Mouton, Alexandre; Cloes, Marc

    2015-01-01

    With more social support and environment-centered interventions being recommended in web-based interventions, this study examined the efficacy of three intervention conditions aimed at promoting physical activity (PA) in older adults. The efficacy analyses included the self-reported PA level, stage of change for PA and awareness about PA among…

  6. A randomized comparative trial of a combined oral contraceptive and azelaic acid to assess their effect on sleep quality in adult female acne patients.

    PubMed

    Albuquerque, Rachel Gimenes; da Rocha, Marco Alexandre Dias; Hirotsu, Camila; Hachul, Helena; Bagatin, Edileia; Tufik, Sergio; Andersen, Monica Levy

    2015-12-01

    Several studies have reported an increase in the prevalence of adult female acne. This subtype of acne presents particular characteristics, and can be triggered by several factors such as smoking, stress, the use of oily cosmetics and even by poor sleep. Sleep quality is related to well-being and the maintenance of body homeostasis. In addition, several skin diseases present a bidirectional relationship with sleep, demonstrating an important connection between skin and the central nervous system. With this in mind, we aimed to compare the effect of two types of treatment for adult female acne (azelaic acid or a combined oral contraceptive) on sleep quality and on concentrations of stress hormones. Also, we proposed to assess the correlation of sleep and hormonal parameters with acne severity. In order to do this, 32 women underwent a clinical evaluation, completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and had their blood collected for hormone assays. These procedures were performed at baseline and after 6 months of treatment. At baseline there were no differences between the groups in terms of body mass index, age, acne severity and hormone concentrations. Results showed that both treatments demonstrated effectiveness but that women treated with azelaic acid presented a better sleep quality after the treatment compared to baseline and to the group treated with the combined oral contraceptive. The combined oral contraceptive group presented an increase in cortisol and a decrease in free testosterone concentration in relation to baseline. These data suggest that both azelaic acid and combined oral contraceptive are effective in the treatment of adult female acne but, azelaic acid seems to be a more suitable option for those women who may benefit from a better subjective sleep quality. PMID:26472098

  7. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    PubMed Central

    2012-01-01

    Background Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL). Whether this is due to their endocrine consequences (hypopituitarism), their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL) in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Methods Consecutive patients (n=101) treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years) with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL)-90, Nottingham Health Profile (NHP), and Psychological Well Being (PGWB) questionnaires. Level of physical activity was assessed using the Baecke questionnaire. Results The median accumulated dose was 1.9 Gy (1.5–2.2 Gy) to the hypothalamus and 2.4 Gy (1.8–3.3 Gy) to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2). The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. Conclusion In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls. PMID:23101561

  8. Combined Effects of Child and Adult Elevated Blood pressure on Subclinical Atherosclerosis: The International Childhood Cardiovascular Cohort Consortium

    PubMed Central

    Berenson, Gerald S.; Venn, Alison; Burns, Trudy L.; Sabin, Matthew A.; Srinivasan, Sathanur R.; Daniels, Stephen R.; Davis, Patricia H.; Chen, Wei; Kähönen, Mika; Taittonen, Leena; Urbina, Elaine; Viikari, Jorma S.A.; Dwyer, Terence; Raitakari, Olli T.; Juonala, Markus

    2013-01-01

    Background Elevated blood pressure (BP) levels in childhood have been associated with subsequent atherosclerosis. However, it is uncertain whether this risk is attenuated in individuals who acquire normal BP by adulthood. The present study examined the effect of child and adult BP levels on carotid artery intima-media thickness (cIMT) in adulthood. Methods and Results The cohort consisted of 4,210 participants from four prospective studies (mean follow-up 23 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood BP was classified as elevated for individuals with systolic BP ≥120mmHg, diastolic BP ≥80mmHg or with self-reported use of antihypertensive medications. cIMT was measured in the left common carotid artery. High IMT was defined as an IMT ≥age-, sex-, race-, and cohort-specific 90th percentile. Individuals with persistently elevated BP and individuals with normal childhood BP, but elevated adult BP had increased risk of high cIMT (RR[95%CI]) 1.82[1.47-2.38] and 1.57[1.22-2.02], respectively) when compared to individuals with normal child and adult BP. In contrast, individuals with elevated BP as children but not as adults did not have significantly increased risk (1.24[0.92-1.67]). In addition, these individuals had lower risk of increased cIMT (0.66[0.50-0.88]) when compared to those with persistently elevated BP. The results were consistent when controlling for age, sex, adiposity and when different BP definitions were applied. Conclusions Individuals with persistently elevated BP from childhood to adulthood had increased risk of carotid atherosclerosis. This risk was reduced if elevated BP during childhood resolved by adulthood. PMID:23780579

  9. Combined effect of hyperuricemia and overweight/obesity on the prevalence of hypertension among US adults: result from the National Health and Nutrition Examination Survey.

    PubMed

    Han, G-M; Gonzalez, S; DeVries, D

    2014-10-01

    Hypertension is a large and growing public health problem worldwide. Hyperuricemia and overweight/obesity are two of the most important risk factors for hypertension. However, their combined effect on the risk of hypertension is not known. Participants aged 20 years and older from the National Health and Nutrition Examination Survey from 1999-2012 were used to evaluate the separate and combined effects of hyperuricemia and overweight/obesity on the risk of prevalent hypertension among different race, gender and age groups. Participants (31,473) were used to estimate separate and combined effects on the prevalence of hypertension. The overall prevalence of hypertension among adults with a combination of hyperuricemia and overweight/obesity (50.2%, 95% confidence interval (CI) 48.3-52.1%) was significantly higher than separate hyperuricemia (41.7%, 95% CI 37.2-46.2%) and overweight/obesity (30.6%, 95% CI 29.5-31.8%). The magnitude of odds ratio (OR) from the combination of hyperuricemia and overweight/obesity (OR=4.53, 95% CI 4.05-5.07) was significantly higher than both hyperuricemia (OR=2.62, 95% CI 2.07-3.32) and overweight/obesity (OR=2.08, 95% CI 1.89-2.30). Combined effect of hyperuricemia and overweight/obesity on the risk of hypertension is much stronger than any separate one. These data can provide important information for identification of target populations for future intervention and patient management. PMID:24785975

  10. Efficacy of a single dose of milbemycin oxime/praziquantel combination tablets, Milpro(®), against adult Echinococcus multilocularis in dogs and both adult and immature E. multilocularis in young cats.

    PubMed

    Cvejic, Dejan; Schneider, Claudia; Fourie, Josephus; de Vos, Christa; Bonneau, Stephane; Bernachon, Natalia; Hellmann, Klaus

    2016-03-01

    Two single-site, laboratory, negatively controlled, masked, randomised dose confirmation studies were performed: one in dogs, the other in cats. After a period of acclimatisation, both the dogs and cats were orally infected with Echinococcus multilocularis protoscoleces. In the dog study, 10 dogs received a single dose of Milpro® tablets at a minimum dose of 0.5 mg/kg milbemycin oxime and 5 mg/kg praziquantel 18 days post-infection and 10 dogs received no treatment. In the cat study, 10 cats received a single dose of Milpro® tablets at a minimum dose of 2 mg/kg milbemycin oxime and 5 mg/kg praziquantel 7 days post-infection, 10 cats received a single dose of the treatment 18 days post-infection and 10 cats remained untreated. In both studies, intestinal worm counts were performed 23 days post-infection at necropsy. No worms were retrieved from any of the 30 treated animals. Nine of 10 control dogs had multiple worms (geometric mean 91, arithmetic mean 304) and all 10 control cats had multiple worms (geometric mean 216, arithmetic mean 481). The difference in worm counts between all three treated groups and their controls was highly significant (ANOVA p values of log transformed data <0.0001). Efficacy of 100 % was demonstrated for the elimination of adult E. multilocularis in dogs and cats as well as for elimination of immature E. multilocularis in cats as evidenced by the effectiveness of treatment 7 days post-infection. The treatments were well accepted and tolerated, and there were no adverse drug reactions observed. PMID:26660919

  11. Treatment of moderate and severe adult chronic atopic dermatitis with narrow-band UVB and the combination of narrow-band UVB/UVA phototherapy.

    PubMed

    Fernández-Guarino, Montserrat; Aboin-Gonzalez, Sonsoles; Barchino, Lucia; Velazquez, Diana; Arsuaga, Carmen; Lázaro, Pablo

    2016-01-01

    The phototherapy is a safe and effective technique for the treatment of adult patients with atopic dermatitis (AD). The treatment of chronic forms of the disease is most often done with narrow-band UVB (NB-UVB). There also exist effective phototherapy options against the AD. The aim of this study was to asses if the combination of NB-UVB with UVA was more effective than the treatment with only NB-UVB against adult chronic AD. We carried out a prospective and observational study. Adult patients with chronic AD with more than 50% of the total body surface area affected (TBSA) were included. The affected TBSA was calculated using the so-called "rule of nines." Patients with a clearance rate >75% of the initial affected TBSA or complete clearance rate were considered as complete response (CR). An analogue scale from 0 to 10 was used to measure the improvement grade of the pruritus. The treatments were repeated three times a week. The initial doses of NB-UVB and UVA were determined by patient's phototype. The treatments were performed using a phototherapy booth (UV7002, Walmann, Villingen-Schwenningen, Germany(®) ) with TL01 and UVA fluorescent lamps. Statistical analysis was performed with SPSS(®) (IBM, New York, NY) for Windows 21.0. A total of 26 patients with adult chronic AD were included in the study, 16 patients were treated with UVB-BE and 10 patients with the combined treatment option NB-UVB/UVA. The mean value of cumulative doses and the mean number of performed treatments were similar between both groups of patients (p > 0.05). The mean value of duration of response was significantly higher in the patients treated only with NB-UVB, 101 versus 6.8 months (p ≥ 0.05). No differences were observed for the patients that showed complete response (p = 0.42) and in the analogue scale of pruritus (p > 0.005). In our study, the patients treated with the combination of NB-UVB and UVA were similar to the patient that were only treated with NB-UVB e

  12. 20 CFR 663.220 - Who may receive intensive services?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.220 Who may receive intensive services? There are two categories of adults and dislocated workers who may receive intensive services: (a) Adults and dislocated workers who are unemployed,...

  13. 20 CFR 663.220 - Who may receive intensive services?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.220 Who may receive intensive services? There are two categories of adults and dislocated workers who may receive intensive services: (a) Adults and dislocated workers who are unemployed,...

  14. Long-term immune responses and comparative effectiveness of one or two doses of 7-valent pneumococcal conjugate vaccine (PCV7) in HIV-positive adults in the era of combination antiretroviral therapy

    PubMed Central

    Cheng, Aristine; Chang, Sui-Yuan; Tsai, Mao-Song; Su, Yi-Ching; Liu, Wen-Chun; Sun, Hsin-Yun; Hung, Chien-Ching

    2016-01-01

    Introduction HIV infection impairs maintenance of immunological memory, yet few studies of HIV-positive adults receiving 7-valent pneumococcal conjugate vaccine (PCV7) have followed them beyond the first year. We determined and compared the durability of serological responses and the clinical outcomes of HIV-positive adults annually for five years following vaccination with one or two doses of PCV7. Methods In this non-randomized clinical trial, 221 pneumococcal vaccine-naïve HIV-positive adults receiving one (n=109) or two doses four weeks apart (n=112) of PCV7 between 2008 and 2010 were longitudinally followed for evaluation of significant serological response and for episodes of pneumonia and invasive pneumococcal disease. Results At the time of vaccination, the two groups were well matched for age, risk factors, combination antiretroviral therapy (cART) coverage, CD4 count and plasma HIV RNA load (PVL). At the end of five years, the CD4 counts for the one- and two-dose groups had increased from 407 and 406 to 550 and 592 cells/µL, respectively, and 82.4 and 81.6% of the participants had fully suppressed PVL. Significant immune responses to ≥2 serotypes persisted for 67.9 vs 78.6%, 64.2 vs 71.4%, 66.1 vs 71.4%, 57.8 vs 69.6% in the second, third, fourth and fifth years after one and two doses of PCV7 in the intention-to-treat analysis, respectively. In multivariate analysis, immunization with two doses of PCV7 (odds ratio (OR) 1.71, 95% confidence interval (CI) 1.10 to 2.65, p=0.016), concurrent cART (OR 2.16, 95% CI 1.16 to 4.00, p=0.015) and CD4 proliferation (OR 1.12, 95% CI 1.01 to 1.27, p=0.031) were predictive of persistent serological responses in the fifth year. Only one patient in the one-dose group had documented pneumococcal pneumonia (non-bacteraemic) and none had invasive pneumococcal disease in the 6.5 years of follow-up. Conclusions One or two doses of PCV7 achieve durable seroprotective responses in HIV-treated participants; however, two

  15. A prospective investigation of neurodevelopmental risk factors for adult antisocial behavior combining official arrest records and self-reports.

    PubMed

    Paradis, Angela D; Fitzmaurice, Garrett M; Koenen, Karestan C; Buka, Stephen L

    2015-09-01

    Neurodevelopmental deficits are postulated to play an important role in the etiology of persistent antisocial behavior (ASB). Yet it remains uncertain as to which particular deficits are most closely associated with ASB. We seek to advance this understanding using prospectively collected data from a birth cohort in which multiple indices of neurodevelopmental functioning and ASB were assessed. Participants (n = 2776) were members of the Providence, Rhode Island cohort of the Collaborative Perinatal Project. Information on demographic and neurodevelopmental variables was collected from pregnancy through age 7. When all offspring had reached 33 years of age an adult criminal record check was conducted. A subset of subjects also self-reported on their engagement in serious ASB. Bivariate logistic regression was used to examine the relationship between each neurodevelopmental factor and adult ASB and test whether associations varied depending on how ASB was ascertained. After controlling for background and contextual characteristics, maternal smoking during pregnancy, lower childhood verbal and performance IQ, and age 7 aggressive/impulsive behavior all significantly increased the odds of adult ASB. Associations were not modified by sex and did not depend on how ASB was assessed. However, while both males and Black participants were more likely to engage in ASB than their respective female and White counterparts, relationships were significantly stronger for official records than for self-reports. Results point to a particular subset of early neurodevelopmental risks for antisocial outcomes in adulthood. Findings also suggest that prior contradictory results are not due to the use of official records versus self-reported outcomes. PMID:26050211

  16. Asthma control in patients receiving inhaled corticosteroid and long-acting beta2-agonist fixed combinations. A real-life study comparing dry powder inhalers and a pressurized metered dose inhaler extrafine formulation

    PubMed Central

    2011-01-01

    Background Although patients have more problems using metered dose inhalers, clinical comparisons suggest they provide similar control to dry powder inhalers. Using real-life situations this study was designed to evaluate asthma control in outpatients with moderate to severe persistent asthma and to compare efficacy of fixed combinations of inhaled corticosteroids (ICS) and long acting beta-agonists (LABA). Methods This real-life study had a cross-sectional design. Patients using fixed combinations of ICS and LABA had their asthma control and spirometry assessed during regular visits. Results 111 patients were analyzed: 53 (47.7%) received maintenance therapy of extrafine beclomethasone-formoterol (BDP/F) pressurized metered dose inhaler (pMDI), 25 (22.5%) fluticasone-salmeterol (FP/S) dry powder inhaler (DPI), and 33 (29.7%) budesonide-formoterol (BUD/F) DPI. Severity of asthma at time of diagnosis, assessed by the treating physician, was comparable among groups. Asthma control was achieved by 45.9% of patients; 38.7% were partially controlled and 15.3% were uncontrolled. In the extrafine BDF/F group, asthma control total score, daytime symptom score and rescue medication use score were significantly better than those using fixed DPI combinations (5.8 ± 6.2 vs. 8.5 ± 6.8; 1.4 ± 1.8 vs. 2.3 ± 2.1; 1.8 ± 2.2 vs. 2.6 ± 2.2; p = 0.0160; p = 0.012 and p = 0.025, respectively) and the mean daily ICS dose were significantly lower. Conclusions pMDI extrafine BDP/F combination demonstrated better asthma control compared to DPIs formulated with larger particles. This could be due to the improved lung deposition of the dose or less reliance on the optimal inhalation technique or both. PMID:21762500

  17. Histologic evolution of the reactions to hemorrhage in the premature human infant's brain. A combined ultrasound and autopsy study and a comparison with the reaction in adults.

    PubMed Central

    Darrow, V. C.; Alvord, E. C.; Mack, L. A.; Hodson, W. A.

    1988-01-01

    With the development and routine use of real-time ultrasound scanning, it has been possible to collect 20 autopsy cases of infants in whom the ultrasound scan was first normal and then showed evidence of subependymal/intraventricular hemorrhage (SEH/IVH). Analysis of these cases with known postnatal origin of the hemorrhage permitted the development for the first time of a time scale to characterize the temporal evolution of the histopathologic reactions to hemorrhage in the premature human brain. This time scale was then used to define the histologic stage of the lesions in 27 other cases of infants who had a scan demonstrating SEH/IVH prior to death but who had not a previously normal scan. Only 2 cases were found to lie off the original scale, indicating a prenatal onset of the hemorrhage in about 5% of the total cases. Thus, postnatal events immediately preceding the onset of the hemorrhage are more likely to be implicated in the pathogenesis of SEH/IVH than prenatal or obstetric events. Comparison with similar reactions in the adult indicate that the early reactions by macrophages occur at about the same rate but the routine transfer of iron from macrophages to astrocytes and the much slower rate of absorption to form a cyst in the adult combine to form a complicated pattern that requires a different set of criteria for the intermediate and late stages in the adult. Images Figure 4 Figure 3 Figure 9 Figure 2 Figure 1 Figure 5 Figure 7 PMID:3276212

  18. Some Books about Alaska Received in 1990.

    ERIC Educational Resources Information Center

    Alaska State Dept. of Education, Juneau. Div. of State Libraries.

    This annual bibliography of Alaska- and Arctic-related publications received by the Alaska Division of State Libraries is divided into three categories. There are 26 titles in the "Juvenile Fiction" section, 122 in the "Adult Non-Fiction" section, and 19 in the "Adult Fiction" section. Government publications are generally not included, although a…

  19. Some Books about Alaska Received in 1986.

    ERIC Educational Resources Information Center

    Alaska State Dept. of Education, Juneau. Div. of State Libraries.

    This publication is an annotated listing of 143 books about Alaska or the Arctic, received by the Alaska Division of State Libraries in 1986. Most of the material is current or published in recent years, with the exception of government publications. Categories are juvenile, adult non-fiction, adult fiction, and reference. A few Alaska state and…

  20. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults.

    PubMed

    Zhuang, Jie; Huang, Liang; Wu, Yanqiang; Zhang, Yanxin

    2014-01-01

    This study aimed to evaluate the effectiveness of an innovative exercise program on muscle strength, balance, and gait kinematics in elderly community-dwellers. The exercise program included strength and balance training and the 8-form Tai Chi Chuan. The measurements were carried out at baseline and 12 weeks, and consisted of four physical performance tests, joint isokinetic strength tests, and three-dimensional gait analysis. Fifty-six community-dwelling older adults aged 60-80 years old were randomly assigned to an intervention or control group. After 12 weeks, the intervention group showed a 17.6% improvement in the timed up and go test, accompanied by a 54.7% increase in the 30-second chair stand test score. Significant increases in the score of star excursion balance tests, and the strength of the extensor and flexor muscles at knee and ankle joints were also observed. In addition, the intervention group walked at a faster speed with a longer step length, shorter support phase, and a greater sagittal plane range of motion at the hip and ankle joints. No statistical improvements were seen in the control group. This study provided an effective, evidence-based falls prevention program that can be implemented in community settings to improve physical fitness and reduce fall risks among community-dwelling older adults. The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people. PMID:24453483

  1. Impacts of thyroxine combined with donepezil on hippocampal ultrastructures and expressions of synaptotagmin-1 and SNAP-25 in adult rats with hypothyroidism

    PubMed Central

    Yang, Hao; Zha, Xiaoxue; Cai, Yaojun; Wang, Fen; Wu, Zhangbi; Wu, Bo; Jia, Xuemei; Zhu, Defa

    2015-01-01

    The study aims to observe the impacts of thyroxine (T4) combined with donepezil (DON) on hippocampal ultrastructures and expressions of synaptotagmin-1 and SNAP-25 in adult rats with hypothyroidism. All rats were randomly divided into five groups: the normal control group (CON), the hypothyroidism group (Hypo), the T4 treatment group (T4), the DON treatment group (DON) and the T4+DON combined treatment group (T4+DON). Technique of Electron Microscope (TEM) was used to observe the hippocampal ultrastructures of each group, Western blot and real-time RT-PCR were performed to analyze the protein and mRNA expressions of syt-1 and SNAP-25 in the hippocampus of each group. TEM revealed that the Hypo group exhibited the significant vacuolar degeneration of mitochondria in the hippocampal neurons, the free ribosomes were sparse, the synaptic structures were damaged, and the number of synaptic vesicles was reduced, the above injuries in the T4 or DON group were improved, and the performance of the T4+DON group was the most close to the CON group. From the protein and mRNA levels, the dorsal hippocampal syt-1 expression of the Hypo group was significantly reduced, while SNAP-25 was significantly increased, the expressions were partially recovered after the T4 treatment, and the T4+DON combined treatment made the expression return to normal. The adult hypothyroid rats exhibited pathological damages in the hippocampal ultrastructures, the expression of syt-1 was downregulated, while that of SNAP-25 was upregulated, the T4+DON combined therapy could repair the above injuries, and the roles were better than the single drug treatment. PMID:26770386

  2. The combined effects of diet quality and physical activity on maintenance of muscle strength among diabetic older adults from the NuAge cohort.

    PubMed

    Rahi, Berna; Morais, José A; Dionne, Isabelle J; Gaudreau, Pierrette; Payette, Hélène; Shatenstein, Bryna

    2014-01-01

    Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabetic counterparts. Adequate protein and energy intakes and physical activity (PA) may preserve MS during aging. However, the role of diet quality (DQ) in MS maintenance is still unknown. This study aimed to determine the association between DQ - alone or combined with PA - and changes in MS over 3 years in diabetic participants aged 67 to 84 years at recruitment in a secondary analysis of the longitudinal observational NuAge study. Changes in handgrip, knee extensor and elbow flexor strengths were calculated as the difference between recruitment (T1) and after 3 years (T4) in 156 diabetic older adults. Baseline DQ was calculated from 3 non-consecutive 24-hour dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). Change in PA was calculated from Physical Activity Scale for the Elderly (PASE) as PASE T4-PASE T1. Four combinations of variables were created: C-HEI<70 with PASE change either < or > median and C-HEI ≥ 70 with PASE change either < or > median. The association between these four categories and MS maintenance was evaluated using General Linear Modeling (GLM). Analyses were stratified by sex and controlled for covariates. Baseline DQ alone was not associated with MS maintenance. Baseline DQ combined with PASE change showed associations with crude and baseline adjusted handgrip strength (p=0.031, p=0.018) and crude and baseline adjusted elbow flexor change (p=0.028, p=0.017) in males only; no significant results were found for knee extensor strength in either males or females. While findings for females were inconclusive, results demonstrate that better adherence to dietary guidelines combined with a more active lifestyle may prevent MS decline among diabetic older males. Additional research is needed on a larger sample since generalization of these results is limited by the small sample size. PMID:24269377

  3. Effects of vitamin D and quercetin, alone and in combination, on cardiorespiratory fitness and muscle function in physically active male adults

    PubMed Central

    Scholten, Shane D; Sergeev, Igor N; Song, Qingming; Birger, Chad B

    2015-01-01

    Introduction Vitamin D and the antioxidant quercetin, are promising agents for improving physical performance because of their possible beneficial effects on muscular strength and cardiorespiratory fitness. Purpose The purpose of this study was to determine the effects of increased intakes of vitamin D, quercetin, and their combination on antioxidant status, the steroid hormone regulators of muscle function, and measures of physical performance in apparently healthy male adults engaged in moderate-to-vigorous-intensity exercise training. Methods A total of 40 adult male participants were randomized to either 4,000 IU vitamin D/d, 1,000 mg/d quercetin, vitamin D plus quercetin, or placebo for 8 weeks. Measures of cardiorespiratory fitness and muscle function, blood markers for antioxidant and vitamin D status, and hormones 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and testosterone were measured pre- and postsupplementation. Results At enrollment, 88.6% of participants were vitamin D sufficient (serum 25-hydroxyvitamin D >50 nmol/L) and had normal serum testosterone levels. Supplementation with vitamin D significantly increased serum 25(OH)D concentration (by 87.3% in the vitamin D group, P<0.001) and was associated with an increasing trend of testosterone concentration. There were no changes in concentration of 1,25(OH)2D3 and markers of antioxidant status associated with vitamin D or quercetin supplementation. No improvements in physical performance measures associated with vitamin D and quercetin supplementation were found. Conclusion The findings obtained demonstrate that long-term vitamin D and quercetin supplementation, alone or in combination, does not improve physical performance in male adults with adequate vitamin D, testosterone, and antioxidant status. PMID:26244032

  4. Assessing motor imagery ability in younger and older adults by combining measures of vividness, controllability and timing of motor imagery.

    PubMed

    Saimpont, Arnaud; Malouin, Francine; Tousignant, Béatrice; Jackson, Philip L

    2015-02-01

    With the population aging, a large number of patients undergoing rehabilitation are older than 60 years. Also, since the use of motor imagery (MI) training in rehabilitation is becoming more popular, it is important to gain a better knowledge about the age-related changes in MI ability. The main goal of this study was to compare MI ability in younger and older adults as well as to propose a new procedure for testing this ability. Thirty healthy young subjects (mean age: 22.9±2.7 years) and 28 healthy elderly subjects (mean age: 72.4±5.5 years) participated in the experiment. They were administered three tests aimed at assessing three dimensions of MI: (1) the kinesthetic and visual imagery questionnaire (KVIQ) to assess MI vividness; (2) a finger-thumb opposition task to assess MI controllability; and (3) a chronometric task to assess the timing of MI. On average, the younger and older groups showed similar results on the KVIQ and the chronometric task, but the younger group was more accurate at the finger-thumb opposition task. Interestingly, there was a large variability in the performance within both groups, emphasizing the importance of considering each person individually regarding MI ability, whatever his age. Finally, we propose two indexes of MI ability to identify the potential of persons to engage in MI training programs. Future studies are needed to confirm the predictive value of these MI indexes and define inclusion/exclusion thresholds for their use as a screening tool in both younger and older adults. PMID:25481412

  5. Heart Rate Recovery and Variability Following Combined Aerobic and Resistance Exercise Training in Adults with and without Down Syndrome

    ERIC Educational Resources Information Center

    Mendonca, Goncalo V.; Pereira, Fernando D.; Fernhall, Bo

    2013-01-01

    Persons with Down syndrome (DS) are at high risk for cardiovascular morbidity and mortality, and there is compelling evidence of autonomic dysfunction in these individuals. The main purpose of this study was to determine whether a combined aerobic and resistance exercise intervention produces similar results in cardiac autonomic function between…

  6. Sensation Seeking and Impulsivity: Combined Associations with Risky Sexual Behavior in a Large Sample of Young Adults

    PubMed Central

    Charnigo, Richard; Noar, Seth M.; Garnett, Christopher; Crosby, Richard; Palmgreen, Philip; Zimmerman, Rick S.

    2015-01-01

    Although prior studies have shown that sensation seeking and impulsive decision-making are related to sexual risk-taking, it is still unclear whether these personality traits operate independently or synergistically. The purpose of this study was to elucidate the joint contribution of these personality traits to HIV and sexually transmitted disease (STD) risk behaviors using data from a large sample of sexually active young adults (N = 2,386). Regression modeling indicated that both sensation seeking and impulsive decision-making were consistently associated with sexual risk behaviors across 11 risk-related outcomes. Results further indicated that sensation seeking and impulsive decision-making operated synergistically with respect to the outcome variables of sex acts using drugs, acts with a partner using alcohol, and acts with a partner using drugs. In contrast to this, sensation seeking and impulsive decision-making operated independently with respect to the other sexual risk outcomes. Theoretical implications, as well as implications for HIV/STD prevention among high sensation seekers and impulsive decision-makers, are discussed. PMID:22456443

  7. The Effect of Combined Sensory and Semantic Components on Audio–Visual Speech Perception in Older Adults

    PubMed Central

    Maguinness, Corrina; Setti, Annalisa; Burke, Kate E.; Kenny, Rose Anne; Newell, Fiona N.

    2011-01-01

    Previous studies have found that perception in older people benefits from multisensory over unisensory information. As normal speech recognition is affected by both the auditory input and the visual lip movements of the speaker, we investigated the efficiency of audio and visual integration in an older population by manipulating the relative reliability of the auditory and visual information in speech. We also investigated the role of the semantic context of the sentence to assess whether audio–visual integration is affected by top-down semantic processing. We presented participants with audio–visual sentences in which the visual component was either blurred or not blurred. We found that there was a greater cost in recall performance for semantically meaningless speech in the audio–visual ‘blur’ compared to audio–visual ‘no blur’ condition and this effect was specific to the older group. Our findings have implications for understanding how aging affects efficient multisensory integration for the perception of speech and suggests that multisensory inputs may benefit speech perception in older adults when the semantic content of the speech is unpredictable. PMID:22207848

  8. Sensation seeking and impulsivity: combined associations with risky sexual behavior in a large sample of young adults.

    PubMed

    Charnigo, Richard; Noar, Seth M; Garnett, Christopher; Crosby, Richard; Palmgreen, Philip; Zimmerman, Rick S

    2013-01-01

    Although prior studies have shown that sensation seeking and impulsive decision-making are related to sexual risk-taking, it is still unclear whether these personality traits operate independently or synergistically. The purpose of this study was to elucidate the joint contribution of these personality traits to HIV and sexually transmitted disease (STD) risk behaviors using data from a large sample of sexually active young adults (N = 2,386). Regression modeling indicated that both sensation seeking and impulsive decision-making were consistently associated with sexual risk behaviors across 11 risk-related outcomes. Results further indicated that sensation seeking and impulsive decision-making operated synergistically with respect to the outcome variables of sex acts using drugs, acts with a partner using alcohol, and acts with a partner using drugs. In contrast to this, sensation seeking and impulsive decision-making operated independently with respect to the other sexual risk outcomes. Theoretical implications, as well as implications for HIV/STD prevention among high sensation seekers and impulsive decision-makers, are discussed. PMID:22456443

  9. The European Medicines Agency Review of Pomalidomide in Combination With Low-Dose Dexamethasone for the Treatment of Adult Patients With Multiple Myeloma: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use

    PubMed Central

    Flores, Beatriz; Hemmings, Robert; Camarero, Jorge; Sancho-Lopez, Arantxa; Salmonson, Tomas; Gisselbrecht, Christian; Laane, Edward; Pignatti, Francesco

    2015-01-01

    On August 5, 2013, a marketing authorization valid throughout the European Union (EU) was issued for pomalidomide in combination with dexamethasone for the treatment of adult patients with relapsed and refractory multiple myeloma (MM) who have received at least two prior treatment regimens, including both lenalidomide and bortezomib, and have demonstrated disease progression on the last therapy. Pomalidomide is an immunomodulating agent. The recommended starting dose of pomalidomide is 4 mg once daily taken on days 1–21 of repeated 28-day cycles. The main evidence of efficacy for pomalidomide in MM was based on a phase III multicenter, randomized, open-label study (CC-4047-MM-003) in which pomalidomide plus low-dose dexamethasone therapy (POM+LoDEX) was compared with high-dose dexamethasone alone (HiDEX) in previously treated adult patients with relapsed and refractory multiple myeloma who had received at least two prior treatment regimens, including both lenalidomide and bortezomib, and had demonstrated disease progression on the last therapy. For the intent-to-treat population, median progression-free survival based on International Myeloma Working Group criteria was 15.7 weeks (95% confidence interval [CI]: 13.0–20.1) in the POM+LoDEX group versus 8.0 weeks (95% CI: 7.0–9.0) in the HiDEX group (log-rank p value <.001). Overall survival (secondary endpoint) was also different in the two treatment groups (hazard ratio 0.53 [95% CI: 0.37–0.74]). The most commonly reported adverse reactions to pomalidomide in clinical studies were anemia (45.7%), neutropenia (45.3%) and thrombocytopenia (27%), fatigue (28.3%), pyrexia (21%), peripheral edema (13%), and infections including pneumonia (10.7%). Peripheral neuropathy adverse reactions were reported in 12.3% of patients, and venous embolic or thrombotic (VTE) adverse reactions were reported in 3.3% of patients. Pomalidomide is expected to be teratogenic. This paper summarizes the scientific review of the

  10. A randomized, placebo-controlled, phase 1/2 study of tivantinib (ARQ 197) in combination with irinotecan and cetuximab in patients with metastatic colorectal cancer with wild-type KRAS who have received first-line systemic therapy.

    PubMed

    Eng, Cathy; Bessudo, Alberto; Hart, Lowell L; Severtsev, Aleksey; Gladkov, Oleg; Müller, Lothar; Kopp, Mikhail V; Vladimirov, Vladimir; Langdon, Robert; Kotiv, Bogdan; Barni, Sandro; Hsu, Ching; Bolotin, Ellen; von Roemeling, Reinhard; Schwartz, Brian; Bendell, Johanna C

    2016-07-01

    Cetuximab in combination with an irinotecan-containing regimen is a standard treatment in patients with KRAS wild-type (KRAS WT), metastatic colorectal cancer (mCRC). We investigated the addition of the oral MET inhibitor tivantinib to cetuximab + irinotecan (CETIRI) based on preclinical evidence that activation of the MET pathway may confer resistance to anti-EGFR therapy. Previously treated patients with KRAS WT advanced or mCRC were enrolled. The phase 1, open-label 3 + 3, dose-escalation study evaluated the safety and maximally tolerated dose of tivantinib plus CETIRI. The phase 2, randomized, double-blinded, placebo-controlled study of biweekly CETIRI plus tivantinib or placebo was restricted to patients who had received only one prior line of chemotherapy. The phase 2 primary endpoint was progression-free survival (PFS). The recommended phase 2 dose was tivantinib (360 mg/m(2) twice daily) with biweekly cetuximab (500 mg/m(2)) and irinotecan (180 mg/m(2)). Among 117 patients evaluable for phase 2 analysis, no statistically significant PFS difference was observed: 8.3 months on tivantinib vs. 7.3 months on placebo (HR, 0.85; 95% confidence interval, 0.55-1.33; P = 0.38). Subgroup analyses trended in favor of tivantinib in patients with MET-High tumors by immunohistochemistry, PTEN-Low tumors, or those pretreated with oxaliplatin, but subgroups were too small to draw conclusions. Neutropenia, diarrhea, nausea and rash were the most frequent severe adverse events in tivantinib-treated patients. The combination of tivantinib and CETIRI was well tolerated but did not significantly improve PFS in previously treated KRAS WT mCRC. Tivantinib may be more active in specific subgroups. PMID:26891420

  11. An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report

    PubMed Central

    Yavuz, Ferdi; Balaban, Birol

    2016-01-01

    Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient’s walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport®) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy. PMID:27504395

  12. An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report.

    PubMed

    Kibar, Sibel; Yavuz, Ferdi; Balaban, Birol

    2016-06-01

    Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient's walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport(®)) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy. PMID:27504395

  13. Dietary intake exposure to sulphites in Italy--analytical determination of sulphite-containing foods and their combination into standard meals for adults and children.

    PubMed

    Leclercq, C; Molinaro, M G; Piccinelli, R; Baldini, M; Arcella, D; Stacchini, P

    2000-12-01

    The theoretical risk of exceeding the Acceptable Daily Intake (ADI) for sulphites has mostly been examined on the basis of a worst-case scenario. In order to examine the real situation the determination of residue sulphite levels in ready-to-consume foods is required. The aim of this paper is to assess the actual sulphite content of diets obtained from a combination of realistic meals high in sulphite-containing foods. Food products available in Italy containing added sulphites were identified. Overall, 211 samples of foods and beverages (including 85 samples of wine) were collected. The determination of sulphite residues was carried out on the foods which were prepared according to normal domestic practice. It was shown that the diets obtained from these foods would lead to an intake of 23 mg/day in children and 50 mg/day in adults (both slightly above the ADI for respectively a 30 kg child and a 60 kg adult). Among all sulphite-containing foods, the highest contributors to the intake were dried fruit and wine, both ingested without further treatment. The analysis of specific consumption data confirmed the existence of a risk of exceeding the ADI related to sulphite residue levels in wine. PMID:11271844

  14. Improving visual functions in adult amblyopia with combined perceptual training and transcranial random noise stimulation (tRNS): a pilot study

    PubMed Central

    Campana, Gianluca; Camilleri, Rebecca; Pavan, Andrea; Veronese, Antonella; Lo Giudice, Giuseppe

    2014-01-01

    Amblyopia is a visual disorder due to an abnormal pattern of functional connectivity of the visual cortex and characterized by several visual deficits of spatial vision including impairments of visual acuity (VA) and of the contrast sensitivity function (CSF). Despite being a developmental disorder caused by reduced visual stimulation during early life (critical period), several studies have shown that extensive visual perceptual training can improve VA and CSF in people with amblyopia even in adulthood. With the present study we assessed whether a much shorter perceptual training regime, in association with high-frequency transcranial electrical stimulation (hf-tRNS), was able to improve visual functions in a group of adult participants with amblyopia. Results show that, in comparison with previous studies where a large number sessions with a similar training regime were used (Polat et al., 2004), here just eight sessions of training in contrast detection under lateral masking conditions combined with hf-tRNS, were able to substantially improve VA and CSF in adults with amblyopia. PMID:25538653

  15. Phase II, open label, randomized comparative trial of ondansetron alone versus the combination of ondansetron and aprepitant for the prevention of nausea and vomiting in patients with hematologic malignancies receiving regimens containing high-dose cytarabine.

    PubMed

    Badar, Talha; Cortes, Jorge; Borthakur, Gautam; O'Brien, Susan; Wierda, William; Garcia-Manero, Guillermo; Ferrajoli, Alessandra; Kadia, Tapan; Poku, Rebeca; Kantarjian, Hagop; Mattiuzzi, Gloria

    2015-01-01

    Background. Aprepitant is a P/neurokinin-1 receptor antagonist approved for the prevention of CINV in moderate emetic risk chemotherapy. We explored its effectiveness in patients with leukemia receiving cytarabine-based chemotherapy. Methods. Patients were randomized to ondansetron (OND) 8 mg IV 30 minutes before cytarabine followed by 24 mg IV continuous infusion daily until 6-12 hours after the last dose of chemotherapy alone or with aprepitant (APREP) oral 125 mg 6-12 hrs before chemotherapy and 80 mg daily until 1 day after the last dose of chemotherapy. Results. Forty-nine patients were enrolled in each arm; 42 in OND and 41 in OND + APREP arm were evaluable for efficacy. The ORR with OND + APREP was 80% compared to 67% with OND alone (P = 0.11). On days 6 and 7, higher proportion of patients treated with OND + APREP were free from nausea (74%, 74% versus 68%, 67%; P = 0.27 and 0.18, resp.). Requirement of rescue medications on days 2 and 3 was fewer in OND + APREP arm 7% and 5% compared to 21% and 16% in the OND arm, respectively (P = 0.06 and P = 0.07). Conclusions. There was a trend for overall improvement in emesis with ondansetron plus aprepitant. The potential benefit of this approach with specific chemotherapy combinations remains to be determined. PMID:25654108

  16. Phase II, Open Label, Randomized Comparative Trial of Ondansetron Alone versus the Combination of Ondansetron and Aprepitant for the Prevention of Nausea and Vomiting in Patients with Hematologic Malignancies Receiving Regimens Containing High-Dose Cytarabine

    PubMed Central

    Badar, Talha; Cortes, Jorge; Borthakur, Gautam; O'Brien, Susan; Wierda, William; Garcia-Manero, Guillermo; Ferrajoli, Alessandra; Kadia, Tapan; Poku, Rebeca; Kantarjian, Hagop; Mattiuzzi, Gloria

    2015-01-01

    Background. Aprepitant is a P/neurokinin-1 receptor antagonist approved for the prevention of CINV in moderate emetic risk chemotherapy. We explored its effectiveness in patients with leukemia receiving cytarabine-based chemotherapy. Methods. Patients were randomized to ondansetron (OND) 8 mg IV 30 minutes before cytarabine followed by 24 mg IV continuous infusion daily until 6–12 hours after the last dose of chemotherapy alone or with aprepitant (APREP) oral 125 mg 6–12 hrs before chemotherapy and 80 mg daily until 1 day after the last dose of chemotherapy. Results. Forty-nine patients were enrolled in each arm; 42 in OND and 41 in OND + APREP arm were evaluable for efficacy. The ORR with OND + APREP was 80% compared to 67% with OND alone (P = 0.11). On days 6 and 7, higher proportion of patients treated with OND + APREP were free from nausea (74%, 74% versus 68%, 67%; P = 0.27 and 0.18, resp.). Requirement of rescue medications on days 2 and 3 was fewer in OND + APREP arm 7% and 5% compared to 21% and 16% in the OND arm, respectively (P = 0.06 and P = 0.07). Conclusions. There was a trend for overall improvement in emesis with ondansetron plus aprepitant. The potential benefit of this approach with specific chemotherapy combinations remains to be determined. PMID:25654108

  17. The effects of cognitive activity combined with active extremity exercise on balance, walking activity, memory level and quality of life of an older adult sample with dementia.

    PubMed

    Yoon, Jung Eun; Lee, Suk Min; Lim, Hee Sung; Kim, Tae Hoon; Jeon, Ji Kyeng; Mun, Mee Hyang

    2013-12-01

    [Purpose] The purpose of this study was to compare the effectiveness of cognitive activity combined with active physical exercise for a sample of older adults with dementia. [Subjects] A convenience sample of 30 patients with dementia (Mini-Mental State Examination score between 16 and 23) was used. Participants were randomly allocated to one of two groups: cognitive activity combined with physical exercise CAE, n=11), and only cognitive activity CA, n=9). [Methods] Both groups participated in a therapeutic exercise program for 30 minutes, three days a week for 12 weeks. The CAE group performed an additional exercise for 30 minutes a day, three days a week for 12 weeks. A Wii Balance Board (WBB, Nintendo, Japan) was used to evaluate postural sway as an assessment of balance. The Berg Balance Scale (BBS) and Modified Falls Efficacy Scale (MFES) were used to assess dynamic balance abilities. The Timed Up-and-Go test (TUG) was used to assess gait, and the Digit Span Test (DST) and 7 Minute Screening Test (7MST) were used to measure memory performance. The Mini-Mental Status Exam-Korean version (MMSE-K), Kenny Self-Care Evaluation (KSCE), and Short Geriatric Depression Scale (GDS) were used to assess quality of life (QOL). [Results] There were significant beneficial effects of the therapeutic program on balance (velocity in EOWB, path length in ECNB, BBS, and MMFE), QOL (MMSE-KC, GDS, KSCE), and memory performance (DSB) in the CAE group compared to CA group, and between pre-test and post-test. [Conclusion] A 12-week CAE program resulted in improvements in balance, memory and QOL. Therefore, some older adults with dementia have the ability to acquire effective skills relevant to daily living. PMID:24409029

  18. The Effects of Cognitive Activity Combined with Active Extremity Exercise on Balance, Walking Activity, Memory Level and Quality of Life of an Older Adult Sample with Dementia

    PubMed Central

    Yoon, Jung Eun; Lee, Suk Min; Lim, Hee Sung; Kim, Tae Hoon; Jeon, Ji Kyeng; Mun, Mee Hyang

    2014-01-01

    [Purpose] The purpose of this study was to compare the effectiveness of cognitive activity combined with active physical exercise for a sample of older adults with dementia. [Subjects] A convenience sample of 30 patients with dementia (Mini-Mental State Examination score between 16 and 23) was used. Participants were randomly allocated to one of two groups: cognitive activity combined with physical exercise CAE, n=11), and only cognitive activity CA, n=9). [Methods] Both groups participated in a therapeutic exercise program for 30 minutes, three days a week for 12 weeks. The CAE group performed an additional exercise for 30 minutes a day, three days a week for 12 weeks. A Wii Balance Board (WBB, Nintendo, Japan) was used to evaluate postural sway as an assessment of balance. The Berg Balance Scale (BBS) and Modified Falls Efficacy Scale (MFES) were used to assess dynamic balance abilities. The Timed Up-and-Go test (TUG) was used to assess gait, and the Digit Span Test (DST) and 7 Minute Screening Test (7MST) were used to measure memory performance. The Mini-Mental Status Exam-Korean version (MMSE-K), Kenny Self-Care Evaluation (KSCE), and Short Geriatric Depression Scale (GDS) were used to assess quality of life (QOL). [Results] There were significant beneficial effects of the therapeutic program on balance (velocity in EOWB, path length in ECNB, BBS, and MMFE), QOL (MMSE-KC, GDS, KSCE), and memory performance (DSB) in the CAE group compared to CA group, and between pre-test and post-test. [Conclusion] A 12-week CAE program resulted in improvements in balance, memory and QOL. Therefore, some older adults with dementia have the ability to acquire effective skills relevant to daily living. PMID:24409029

  19. Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort

    PubMed Central

    Walker, AS; Ford, D; Gilks, CF; Munderi, P; Ssali, F; Reid, A; Katabira, E; Grosskurth, H; Mugyenyi, P; Hakim, J; Darbyshire, JH; Gibb, DM; Babiker, AG

    2010-01-01

    Summary Background Co-trimoxazole prophylaxis can reduce mortality from untreated HIV infection in Africa; whether benefits occur alongside combination antiretroviral therapy (ART) is unclear. We estimated the effect of prophylaxis after ART initiation in adults. Methods Participants in our observational analysis were from the DART randomised trial of management strategies in HIV-infected, symptomatic, previously untreated African adults starting triple-drug ART with CD4 counts lower than 200 cells per μL. Co-trimoxazole prophylaxis was not routinely used or randomly allocated, but was variably prescribed by clinicians. We estimated effects on clinical outcomes, CD4 cell count, and body-mass index (BMI) using marginal structural models to adjust for time-dependent confounding by indication. DART was registered, number ISRCTN13968779. Findings 3179 participants contributed 14 214 years of follow-up (8128 [57%] person-years on co-trimoxazole). Time-dependent predictors of co-trimoxazole use were current CD4 cell count, haemoglobin concentration, BMI, and previous WHO stage 3 or 4 events on ART. Present prophylaxis significantly reduced mortality (odds ratio 0·65, 95% CI 0·50–0·85; p=0·001). Mortality risk reduction on ART was substantial to 12 weeks (0·41, 0·27–0·65), sustained from 12–72 weeks (0·56, 0·37–0·86), but not evident subsequently (0·96, 0·63–1·45; heterogeneity p=0·02). Variation in mortality reduction was not accounted for by time on co-trimoxazole or current CD4 cell count. Prophylaxis reduced frequency of malaria (0·74, 0·63–0·88; p=0·0005), an effect that was maintained with time, but we observed no effect on new WHO stage 4 events (0·86, 0·69–1·07; p=0·17), CD4 cell count (difference vs non-users, −3 cells per μL [−12 to 6]; p=0·50), or BMI (difference vs non-users, −0·04 kg/m2 [−0·20 to 0·13); p=0·68]. Interpretation Our results reinforce WHO guidelines and provide strong motivation for provision

  20. Combined therapeutic effects of low power laser (980nm) and CoQ10 on Neuropathic Pain in adult male rat

    PubMed Central

    Jameie, Seyed Behnamedin; Masoumipoor, Masoumeh; Janzadeh, Atousa; Nasirinezhad, Farinaz; Kerdari, Mahdieh; Soleimani, Maryam

    2014-01-01

    Background: Neuropathic pain (NP) is one of the most suffering medical conditions that often fail to respond to certain pain therapy. Although its exact etiology is still unknown the role of reactive oxygen species (ROS) and oxidative stress were explored by many researchers. Neuropathies either central or peripheral lead to painful condition as well as social and economic isolation, thus various therapies were used to treat or reduce the pain. Laser therapy and antioxidant drugs have separately considered as treatment for NP, but the combination of them have not been used yet. In order to study the combination effects of Low Level Laser Therapy (LLLT) and Coenzyme Q10 (CoQ10) the present study was designed. Methods: Sixty adult male rats (230-320g) were used in this experimental study that divided into six groups (n=10). Chronic constriction injury (CCI) was used to induce neuropathic pain. The CoQ10 or vehicle, a low level laser of 980nm was used for two consecutive weeks. Thermal and mechanical paw withdrawal thresholds were assessed before and after surgery on 7th and 14th days. Results: As we expected CCI decreased the pain threshold, whereas CoQ10 administration for two weeks increased mechanical and thermal threshold. The same results obtained for laser therapy using the CCI animals. Combination of laser 980nm with CoQ10 also showed significant differences in CCI animals. Conclusion: Based on our findings the combination of CoQ10 with LLLT showed better effects than each one alone. In this regard we believe that there might be cellular and molecular synergism in simultaneous use of CoQ10 and LLLT on pain relief. PMID:25405124

  1. Autologous dermal graft combined with a modified degloving procedure for penile augmentation in young adults: a preliminary study.

    PubMed

    Zhang, G-X; Weng, M; Wang, M-D; Bai, W-J

    2016-09-01

    In order to evaluate the effect of penile enhancement, we retrospectively reviewed the data of the patients operated with autologous dermal graft implantation combined with a modified penile degloving procedure. The patients with the complaints of small penis, asking for penile augmentation, and normal erectile function were psychologically screened and enrolled. Data of follow-up visit including patient demographics, medical history, surgical procedure, patient-reported outcomes were analysed. In all, 30 eligible persons were operated. After degloving of the penis, the suspensory ligament was incised and the tunica albuginea was fixed to the proximal tunica dartos at the penile base. Then, the dermis graft was implanted on the dorsal surface of the tunica albuginea. The file of follow-up visit was available in 17 (57%) patients. The mean age was 23.7 years (19-35 years) and the mean follow-up was 13 months (range, 4-24 months). During the follow-up period, the average gain in the penis length was 2.7 cm in flaccid and 0.8 cm in erection, respectively. And the average gain in the penis circumference was 1.5 cm in flaccid and 1.2 cm in erection, respectively. Also, psychosexual sexual self-esteem and confidence of the patients were significantly improved (p < 0.001). Overall, 13 (76%) patients reported satisfaction with the penile appearance. We believe that the surgery is both safe and effective in the enhancement of the penis, however, further clinical studies with a larger patient population are necessary. PMID:27115979

  2. A controlled Phase II trial assessing three doses of enfuvirtide (T-20) in combination with abacavir, amprenavir, ritonavir and efavirenz in non-nucleoside reverse transcriptase inhibitor-naive HIV-infected adults.

    PubMed

    Lalezari, Jacob P; DeJesus, Edwin; Northfelt, Donald W; Richmond, Gary; Wolfe, Peter; Haubrich, Richard; Henry, David; Powderly, William; Becker, Stephen; Thompson, Melanie; Valentine, Fred; Wright, David; Carlson, Margrit; Riddler, Sharon; Haas, Frances F; DeMasi, Ralph; Sista, Prokash R; Salgo, Miklos; Delehanty, John

    2003-08-01

    Enfuvirtide is a novel antiretroviral that blocks HIV-1 cell fusion and viral entry. This Phase II, controlled, open-label, randomized, multicentre dose-ranging trial explored the safety, antiviral activity and pharmacokinetics of enfuvirtide, administered by subcutaneous (s.c.) injection, in 71 HIV-1-infected, protease inhibitor-experienced, non-nucleoside reverse transcriptase inhibitor (NNRTI)-naive adults for 48 weeks. Study participants were randomized to receive enfuvirtide at a deliverable dose of 45, 67.5 or 90 mg twice daily; the 45 mg twice daily dose required 2 injections/day, while the higher doses required 4 injections/day. A background oral antiretroviral (ARV) regimen of abacavir (300 mg twice daily), amprenavir (1200 mg twice daily), ritonavir (200 mg twice daily) and efavirenz (600 mg once daily) was provided with enfuvirtide. A control group received the background ARV regimen alone. All potential participants underwent an HIV genotype at screen to ensure a homogenous population and to exclude patients with evidence of genotypic resistance to NNRTIs. Overall, the tolerability of the combination of abacavir, amprenavir, ritonavir, efavirenz and enfuvirtide was generally comparable to control through 48 weeks. No enfuvirtide dose-dependent adverse events (AEs) were observed across treatment groups. Injection site reactions (ISRs) occurred at least once in 68.5% of the enfuvirtide-treated population, and most ISRs were mild to moderate in severity, with no apparent dose relationship. Excluding ISRs, the most common treatment-emergent AEs were nausea, diarrhoea, dizziness and fatigue; with no clinically significant differences in the incidence of AEs observed between the control and enfuvirtide groups. Each treatment group benefited from ARV therapy, with a trend of increasing antiviral and immunological activity associated with increasing enfuvirtide dose. At 48 weeks, the median HIV-1 RNA change from baseline for the ITT population was -2.24 log10

  3. Combined parental obesity augments single-parent obesity effects on hypothalamus inflammation, leptin signaling (JAK/STAT), hyperphagia, and obesity in the adult mice offspring.

    PubMed

    Ornellas, Fernanda; Souza-Mello, Vanessa; Mandarim-de-Lacerda, Carlos Alberto; Aguila, Marcia Barbosa

    2016-01-01

    We aimed to evaluate the effects of maternal and/or paternal obesity on offspring body mass, leptin signaling, appetite-regulating neurotransmitters and local inflammatory markers. C57BL/6 mice received standard chow (SC, lean groups) or high-fat diet (HF, obese groups) starting from one month of age. At three months, HF mice became obese relative to SC mice. They were then mated as follows: lean mother and lean father, lean mother and obese father, obese mother and lean father, and obese mother and obese father. The offspring received the SC diet from weaning until three months of age, when they were sacrificed. In the offspring, paternal obesity did not lead to changes in the Janus kinase (JAK)/signal transducer and activation of the transcription (STAT) pathway or feeding behavior but did induce hypothalamic inflammation. On the other hand, maternal obesity resulted in increased weight gain, hyperleptinemia, decreased leptin OBRb receptor expression, JAK/STAT pathway impairment, and increased SOCS3 signaling in the offspring. In addition, maternal obesity elevated inflammatory markers and altered NPY and POMC expression in the hypothalamus. Interestingly, combined parental obesity exacerbated the deleterious outcomes compared to single-parent obesity. In conclusion, while maternal obesity is known to program metabolic changes and obesity in offspring, the current study demonstrated that obese fathers induce hypothalamus inflammation in offspring, which may contribute to the development of metabolic syndromes in adulthood. PMID:26485293

  4. [High frequency jet ventilation combined with conventional mechanical ventilation in the treatment of adult respiratory distress syndrome].

    PubMed

    Roustan, J P

    1995-01-01

    , a posteriori, explained by insufficient lung volumes, unable to maintain adequate gas exchanges. Current work is aimed at re-evaluating HFV, using higher mean airway pressure levels. Combined HFV is another advance towards the theoretical goal of restoring and maintaining optimally ventilated lung volumes. Though HFV alone can maintain lung volumes oscillating around a mean value, it cannot re-expand atelectatic areas. The small VT's used are insufficient to overcome these area's elevated opening pressures. Volume recruitment by periodic hyperinflations, or sighs, though generally considered useless in conventional MV, have been shown to be of great benefit in HFV.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7486298

  5. Spaceborne receivers: Basic principles

    NASA Technical Reports Server (NTRS)

    Stacey, J. M.

    1984-01-01

    The underlying principles of operation of microwave receivers for space observations of planetary surfaces were examined. The design philosophy of the receiver as it is applied to operate functionally as an efficient receiving system, the principle of operation of the key components of the receiver, and the important differences among receiver types are explained. The operating performance and the sensitivity expectations for both the modulated and total power receiver configurations are outlined. The expressions are derived from first principles and are developed through the important intermediate stages to form practicle and easily applied equations. The transfer of thermodynamic energy from point to point within the receiver is illustrated. The language of microwave receivers is applied statistics.

  6. Phase 1 Randomized, Double-Blind, Placebo-Controlled Study of RG7667, an Anticytomegalovirus Combination Monoclonal Antibody Therapy, in Healthy Adults

    PubMed Central

    Ishida, Julie H.; Burgess, Tracy; Derby, Michael A.; Brown, Pearline A.; Maia, Mauricio; Deng, Rong; Emu, Brinda; Feierbach, Becket; Fouts, Ashley E.; Liao, X. Charlene

    2015-01-01

    Cytomegalovirus can cause debilitating and life-threatening disease in newborns infected in utero and immunocompromised individuals, including transplant recipients. RG7667 is a unique combination of two monoclonal antibodies that binds glycoprotein complexes on the surface of cytomegalovirus and inhibits its entry into host cells. A phase 1 first-in-human, randomized, double-blind, placebo-controlled, dose-escalation study of RG7667 given intravenously was conducted in 181 healthy adults. The study involved a single ascending dose stage (1, 3, 5, and 10 mg/kg each antibody; n = 21), a multiple ascending dose stage (5 and 10 mg/kg each antibody monthly for 3 doses; n = 10), and a multiple dose expansion stage (10 mg/kg each antibody monthly for 3 doses; n = 150). Subjects were followed for 85 to 141 days to evaluate safety, tolerability, pharmacokinetics, and immunogenicity. Most adverse events were mild, and the incidence of adverse events was similar among the RG7667 and placebo groups. RG7667 had dose-proportional pharmacokinetics in all three dosing stages, a mean terminal half-life of 20 to 30 days, and an overall pharmacokinetic profile consistent with that of a human monoclonal antibody that lacks endogenous host targets. The proportion of subjects developing an antitherapeutic antibody response was not higher in the RG7667 group than in the placebo group. In summary, single and multiple doses of RG7667 were found to be safe and well-tolerated in healthy adults and had a favorable pharmacokinetic and immunogenicity profile. This study supports further development of RG7667 as a therapy for the prevention and treatment of cytomegalovirus infection in susceptible populations. (This study has been registered at ClinicalTrials.gov under registration no. NCT01496755.) PMID:26055360

  7. Solar heat receiver

    DOEpatents

    Hunt, A.J.; Hansen, L.J.; Evans, D.B.

    1982-09-29

    A receiver is described for converting solar energy to heat a gas to temperatures from 700 to 900/sup 0/C. The receiver is formed to minimize impingement of radiation on the walls and to provide maximum heating at and near the entry of the gas exit. Also, the receiver is formed to provide controlled movement of the gas to be heated to minimize wall temperatures. The receiver is designed for use with gas containing fine heat absorbing particles, such as carbon particles.

  8. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol

    PubMed Central

    2013-01-01

    Background Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. Methods/design A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. Discussion The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12608000228381. PMID:23895258

  9. Combination of fluoxetine and extinction treatments forms a unique synaptic protein profile that correlates with long-term fear reduction in adult mice.

    PubMed

    Popova, Dina; Ágústsdóttir, Arna; Lindholm, Jesse; Mazulis, Ulams; Akamine, Yumiko; Castrén, Eero; Karpova, Nina N

    2014-07-01

    The antidepressant fluoxetine induces synaptic plasticity in the visual and fear networks and promotes the structural remodeling of neuronal circuits, which is critical for experience-dependent plasticity in response to an environmental stimulus. We recently demonstrated that chronic fluoxetine administration together with extinction training in adult mice reduced fear in a context-independent manner. Fear conditioning and extinction alter excitatory and inhibitory transmissions within the fear circuitry. In this study, we investigated whether fluoxetine, extinction or their combination produced distinct long-lasting changes in the synaptic protein profile in the amygdala, hippocampus and prefrontal cortex of conditioned mice. We determined that extinction induced synaptophysin expression and down-regulated the GluA1:GluA2 ratio throughout the fear network in water- and fluoxetine-treated mice, suggesting a common fluoxetine-independent mechanism for increased synaptic transmission and re-arrangement of AMPA-receptors by extinction training. In contrast to common changes, the presynaptic vesicular neurotransmitter transporters VGAT and Vglut1 were upregulated after extinction in water- and fluoxetine-treated mice, respectively. The cortical levels of the GABA transporter Gat1 were reduced in high-freezing water-drinking mice, suggesting a maladaptive increase of GABA spillover at cortical inhibitory synapses. Fear conditioning decreased, and extinction induced the expression of GABA-receptor alpha1 and alpha2 subunits in water- and fluoxetine-treated mice, respectively. Only a combination of fluoxetine with extinction enhanced GluN2A expression in the amygdala and hippocampus, emphasizing the role of this NMDA-receptor subunit in the successful erasure of fear memories. Our finding provides novel data that may become helpful in developing beneficial pharmacological fear-reducing treatment strategies. PMID:24837571

  10. Multiple-Dose Pharmacokinetics and Pharmacodynamics of Abacavir Alone and in Combination with Zidovudine in Human Immunodeficiency Virus-Infected Adults

    PubMed Central

    McDowell, James A.; Lou, Yu; Symonds, William S.; Stein, Daniel S.

    2000-01-01

    Abacavir (1592U89) is a nucleoside reverse transcriptase inhibitor with potent activity against human immunodeficiency virus type 1 (HIV-1) when used alone or in combination with other antiretroviral agents. The present study was conducted to determine the multiple-dose pharmacokinetics and pharmacodynamics of abacavir in HIV-1-infected subjects following oral administration of daily doses that ranged from 600 to 1,800 mg, with and without zidovudine. Seventy-nine subjects received abacavir monotherapy for 4 weeks (200, 400, or 600 mg every 8 hours [TID] and 300 mg every 12 h [BID]) and thereafter received either zidovudine (200 mg TID or 300 mg BID) or matching placebo with abacavir for 8 additional weeks. Pharmacokinetic parameters were calculated for abacavir after administration of the first dose and at week 4 and for abacavir, zidovudine, and its glucuronide metabolite at week 12. The concentrations of abacavir in cerebrospinal fluid were determined in a subset of subjects. Steady-state plasma abacavir concentrations were achieved by week 4 of monotherapy and persisted to week 12. At steady state, abacavir pharmacokinetic parameters (area under the plasma concentration-time curve for a dosing interval [AUCtau] and peak concentration [Cmax]) were generally proportional to dose over the range of a 600- to 1,200-mg total daily dose. Coadministration of zidovudine with abacavir produced a small and inconsistent effect on abacavir pharmacokinetic parameters across the different doses. At the clinical abacavir dose (300 mg BID) zidovudine coadministration had no effect on the abacavir AUCtau, which is most closely associated with efficacy. Zidovudine pharmacokinetics appeared to be unaffected by abacavir. Statistically significant but weak relationships were found for the change in the log10 HIV-1 RNA load from the baseline to week 4 versus total daily AUCtau and Ctau (P < 0.05). The incidence of nausea was significantly associated with total daily AUCtau and Cmax

  11. Benefits of combined preventive therapy with co-trimoxazole and isoniazid in adults living with HIV: time to consider a fixed-dose, single tablet coformulation.

    PubMed

    Harries, Anthony D; Lawn, Stephen D; Suthar, Amitabh B; Granich, Reuben

    2015-12-01

    Antiretroviral therapy (ART) is the main intervention needed to reduce morbidity and mortality and to prevent tuberculosis in adults living with HIV. However, in most resource-limited countries, especially in sub-Saharan Africa, ART is started too late to have an effect with substantial early morbidity and mortality, and in high tuberculosis burden settings ART does not reduce the tuberculosis risk to that reported in individuals not infected with HIV. Co-trimoxazole preventive therapy started before or with ART, irrespective of CD4 cell count, reduces morbidity and mortality with benefits that continue indefinitely. Isoniazid preventive therapy as an adjunct to ART prevents tuberculosis in high-exposure settings, with long-term treatment likely to be needed to sustain this benefit. Unfortunately, both preventive therapies are underused in low-income and high-burden settings. ART development has benefited from patient-centred simplification with several effective regimens now available as a one per day pill. We argue that co-trimoxazole and isoniazid should also be combined into a single fixed-dose pill, along with pyridoxine (vitamin B6), that would be taken once per day to help with individual uptake and national scale-up of therapies. PMID:26515525

  12. Optimization of MLS receivers for multipath environments

    NASA Technical Reports Server (NTRS)

    Mcalpine, G. A.; Irwin, S. H.; NELSON; Roleyni, G.

    1977-01-01

    Optimal design studies of MLS angle-receivers and a theoretical design-study of MLS DME-receivers are reported. The angle-receiver results include an integration of the scan data processor and tracking filter components of the optimal receiver into a unified structure. An extensive simulation study comparing the performance of the optimal and threshold receivers in a wide variety of representative dynamical interference environments was made. The optimal receiver was generally superior. A simulation of the performance of the threshold and delay-and-compare receivers in various signal environments was performed. An analysis of combined errors due to lateral reflections from vertical structures with small differential path delays, specular ground reflections with neglible differential path delays, and thermal noise in the receivers is provided.

  13. Data-fusion receiver

    DOEpatents

    Gabelmann, Jeffrey M.; Kattner, J. Stephen; Houston, Robert A.

    2006-12-19

    This invention is an ultra-low frequency electromagnetic telemetry receiver which fuses multiple input receive sources to synthesize a decodable message packet from a noise corrupted telemetry message string. Each block of telemetry data to be sent to the surface receiver from a borehole tool is digitally encoded into a data packet prior to transmission. The data packet is modulated onto the ULF EM carrier wave and transmitted from the borehole to the surface and then are simultaneously detected by multiple receive sensors disbursed within the rig environment. The receive sensors include, but are not limited to, electric field and magnetic field sensors. The spacing of the surface receive elements is such that noise generators are unequally coupled to each receive element due to proximity and/or noise generator type (i.e. electric or magnetic field generators). The receiver utilizes a suite of decision metrics to reconstruct the original, non noise-corrupted data packet from the observation matrix via the estimation of individual data frames. The receiver will continue this estimation process until: 1) the message validates, or 2) a preset "confidence threshold" is reached whereby frames within the observation matrix are no longer "trusted".

  14. Hybrid receiver study

    NASA Technical Reports Server (NTRS)

    Stone, M. S.; Mcadam, P. L.; Saunders, O. W.

    1977-01-01

    The results are presented of a 4 month study to design a hybrid analog/digital receiver for outer planet mission probe communication links. The scope of this study includes functional design of the receiver; comparisons between analog and digital processing; hardware tradeoffs for key components including frequency generators, A/D converters, and digital processors; development and simulation of the processing algorithms for acquisition, tracking, and demodulation; and detailed design of the receiver in order to determine its size, weight, power, reliability, and radiation hardness. In addition, an evaluation was made of the receiver's capabilities to perform accurate measurement of signal strength and frequency for radio science missions.

  15. Optical superheterodyne receiver.

    NASA Technical Reports Server (NTRS)

    Duval, K.; Lang, K.; Lucy, R. F.; Peters, C. J.

    1967-01-01

    Optical communication experiments to compare coherent and noncoherent optical detection fading characteristics in different weather conditions, using laser transmitter and optical superheterodyne receiver

  16. Comparison of the EPIC Physical Activity Questionnaire with Combined Heart Rate and Movement Sensing in a Nationally Representative Sample of Older British Adults

    PubMed Central

    España-Romero, Vanesa; Golubic, Rajna; Martin, Kathryn R.; Hardy, Rebecca; Ekelund, Ulf; Kuh, Diana; Wareham, Nicholas J.; Cooper, Rachel; Brage, Soren

    2014-01-01

    Objectives To compare physical activity (PA) subcomponents from EPIC Physical Activity Questionnaire (EPAQ2) and combined heart rate and movement sensing in older adults. Methods Participants aged 60–64y from the MRC National Survey of Health and Development in Great Britain completed EPAQ2, which assesses self-report PA in 4 domains (leisure time, occupation, transportation and domestic life) during the past year and wore a combined sensor for 5 consecutive days. Estimates of PA energy expenditure (PAEE), sedentary behaviour, light (LPA) and moderate-to-vigorous PA (MVPA) were obtained from EPAQ2 and combined sensing and compared. Complete data were available in 1689 participants (52% women). Results EPAQ2 estimates of PAEE and MVPA were higher than objective estimates and sedentary time and LPA estimates were lower [bias (95% limits of agreement) in men and women were 32.3 (−61.5 to 122.6) and 29.0 (−39.2 to 94.6) kJ/kg/day for PAEE; −4.6 (−10.6 to 1.3) and −6.0 (−10.9 to −1.0) h/day for sedentary time; −171.8 (−454.5 to 110.8) and −60.4 (−367.5 to 246.6) min/day for LPA; 91.1 (−159.5 to 341.8) and 55.4 (−117.2 to 228.0) min/day for MVPA]. There were significant positive correlations between all self-reported and objectively assessed PA subcomponents (rho  = 0.12 to 0.36); the strongest were observed for MVPA (rho = 0.30 men; rho = 0.36 women) and PAEE (rho = 0.26 men; rho = 0.25 women). Conclusion EPAQ2 produces higher estimates of PAEE and MVPA and lower estimates of sedentary and LPA than objective assessment. However, both methodologies rank individuals similarly, suggesting that EPAQ2 may be used in etiological studies in this population. PMID:24516543

  17. Right to Receive.

    ERIC Educational Resources Information Center

    Oborn, Richard

    The concept of a United States citizen's right to receive information is acquiring increased judicial recognition. This report traces the evolution of that right from its philosophical basis in the United States Consitution, through its interpretation by the Supreme Court, up to the current concern that the public receive certain economic…

  18. Effect of increase in duration of aprepitant consumption from 3 to 6 days on the prevention of nausea and vomiting in women receiving combination of anthracycline/cyclophosphamide chemotherapy: A randomized, crossover, clinical trial

    PubMed Central

    Ahvazi, Negah Chaabi; Hemati, Simin; Mohamadianpanah, Mohamad

    2015-01-01

    Background: Aprepitant is one of the effective antiemetic drugs that usually used for a period of 3 days for prevention of anthracycline/cyclophosphamide (AC) induced nausea and vomiting. However, many patients still experience nausea and vomiting on days 3–5. The aim of this study was to evaluate the effect of an increase in duration of aprepitant consumption from 3 to 6 days on the prevention of nausea and vomiting in women receiving AC chemotherapy. Materials and Methods: It was a randomized, crossover, controlled clinical trial. Women with breast cancer and scheduled to receive AC regimens were enrolled in this study. Enrolled patients were randomized into two groups. Group I received 3 days regimen of aprepitant in the first course of AC regimen chemotherapy and 6 days regimen of aprepitant in the second course; Group II received 6 days regimen followed by 3 days regimen. For nausea and vomiting assessment, we used Eastern Cooperative Oncology Group questionnaire. Results: Forty-nine patients were enrolled in this study. Sixty-three percent achieved a complete response with 6 days aprepitant regimen compared with 39% with 3 days regimen (P < 0.001). Ten percent had at least one vomiting episode during the 6 days regimen versus 15% with 3 days regimen (P = 0.034). Nausea was significantly more severe in 3 days regimen of aprepitant than in 6 days regimen. Conclusion: Increase in the duration of aprepitant consumption through 6 days resulted in significantly better prevention of nausea and vomiting than 3 days consumption for women receiving AC chemotherapy. PMID:26682204

  19. Adult Day Services

    MedlinePlus

    A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...

  20. CALUTRON RECEIVER STRUCTURE

    DOEpatents

    Roush, J.L.

    1959-09-01

    A receiver is described for collecting isotopes in a calutron The receiver has several compartments, formed by a sertes of parallel metal plates and an open front. Each plate has flanges which space it from the other plates and a flexible extension pressing against a common supporting red to maintain the plate in assembled relation when all but the last rod is removed. The plates may be removed individualy from the front of the receiver, cleaned ard replaced without disturbing the alignment of the other plates.

  1. Melatonin combined with exercise cannot alleviate cerebral injury in a rat model of focal cerebral ischemia/reperfusion injury.

    PubMed

    Lee, Seunghoon; Shin, Jinhee; Lee, Minkyung; Hong, Yunkyung; Lee, Sang-Kil; Lee, Youngjeon; Lkhagvasuren, Tserentogtokh; Kim, Dong-Wook; Yang, Young-Ae; Chang, Kyu-Tae; Hong, Yonggeun

    2012-05-01

    Previous studies have demonstrated that melatonin combined with exercise can alleviate secondary damage after spinal cord injury in rats. Therefore, it is hypothesized that melatonin combined with exercise can also alleviate ischemic brain damage. In this study, adult rats were subjected to right middle cerebral artery occlusion after receiving 10 mg/kg melatonin or vehicle subcutaneously twice daily for 14 days. Forced exercise using an animal treadmill was performed at 20 m/min for 30 minutes per day for 6 days prior to middle cerebral artery occlusion. After middle cerebral artery occlusion, each rat received melatonin combined with exercise, melatonin or exercise alone equally for 7 days until sacrifice. Interestingly, rats receiving melatonin combined with exercise exhibited more severe neurological deficits than those receiving melatonin or exercise alone. Hypoxia-inducible factor 1α mRNA in the brain tissue was upregulated in rats receiving melatonin combined with exercise. Similarly, microtubule associated protein-2 mRNA expression was significantly upregulated in rats receiving melatonin alone. Chondroitin sulfate proteoglycan 4 (NG2) mRNA expression was significantly decreased in rats receiving melatonin combined with exercise as well as in rats receiving exercise alone. Furthermore, neural cell loss in the primary motor cortex was significantly reduced in rats receiving melatonin or exercise alone, but the change was not observed in rats receiving melatonin combined with exercise. These findings suggest that excessive intervention with melatonin, exercise or their combination may lead to negative effects on ischemia/reperfusion-induced brain damage. PMID:25722687

  2. Ceramic Solar Receiver

    NASA Technical Reports Server (NTRS)

    Robertson, C., Jr.

    1984-01-01

    Solar receiver uses ceramic honeycomb matrix to absorb heat from Sun and transfer it to working fluid at temperatures of 1,095 degrees and 1,650 degrees C. Drives gas turbine engine or provides heat for industrial processes.

  3. Ultrasonic pulser-receiver

    SciTech Connect

    Taylor, Steven C.

    2006-09-12

    Ultrasonic pulser-receiver circuitry, for use with an ultrasonic transducer, the circuitry comprising a circuit board; ultrasonic pulser circuitry supported by the circuit board and configured to be coupled to an ultrasonic transducer and to cause the ultrasonic transducer to emit an ultrasonic output pulse; receiver circuitry supported by the circuit board, coupled to the pulser circuitry, including protection circuitry configured to protect against the ultrasonic pulse and including amplifier circuitry configured to amplify an echo, received back by the transducer, of the output pulse; and a connector configured to couple the ultrasonic transducer directly to the circuit board, to the pulser circuitry and receiver circuitry, wherein impedance mismatches that would result if the transducer was coupled to the circuit board via a cable can be avoided.

  4. Solar energy receiver

    DOEpatents

    Schwartz, Jacob

    1978-01-01

    An improved long-life design for solar energy receivers provides for greatly reduced thermally induced stress and permits the utilization of less expensive heat exchanger materials while maintaining receiver efficiencies in excess of 85% without undue expenditure of energy to circulate the working fluid. In one embodiment, the flow index for the receiver is first set as close as practical to a value such that the Graetz number yields the optimal heat transfer coefficient per unit of pumping energy, in this case, 6. The convective index for the receiver is then set as closely as practical to two times the flow index so as to obtain optimal efficiency per unit mass of material.

  5. Receiver Gain Modulation Circuit

    NASA Technical Reports Server (NTRS)

    Jones, Hollis; Racette, Paul; Walker, David; Gu, Dazhen

    2011-01-01

    A receiver gain modulation circuit (RGMC) was developed that modulates the power gain of the output of a radiometer receiver with a test signal. As the radiometer receiver switches between calibration noise references, the test signal is mixed with the calibrated noise and thus produces an ensemble set of measurements from which ensemble statistical analysis can be used to extract statistical information about the test signal. The RGMC is an enabling technology of the ensemble detector. As a key component for achieving ensemble detection and analysis, the RGMC has broad aeronautical and space applications. The RGMC can be used to test and develop new calibration algorithms, for example, to detect gain anomalies, and/or correct for slow drifts that affect climate-quality measurements over an accelerated time scale. A generalized approach to analyzing radiometer system designs yields a mathematical treatment of noise reference measurements in calibration algorithms. By treating the measurements from the different noise references as ensemble samples of the receiver state, i.e. receiver gain, a quantitative description of the non-stationary properties of the underlying receiver fluctuations can be derived. Excellent agreement has been obtained between model calculations and radiometric measurements. The mathematical formulation is equivalent to modulating the gain of a stable receiver with an externally generated signal and is the basis for ensemble detection and analysis (EDA). The concept of generating ensemble data sets using an ensemble detector is similar to the ensemble data sets generated as part of ensemble empirical mode decomposition (EEMD) with exception of a key distinguishing factor. EEMD adds noise to the signal under study whereas EDA mixes the signal with calibrated noise. It is mixing with calibrated noise that permits the measurement of temporal-functional variability of uncertainty in the underlying process. The RGMC permits the evaluation of EDA by

  6. [Adult twins].

    PubMed

    Charlemaine, Christiane

    2006-12-31

    This paper explores the deep roots of closeness that twins share in their youngest age and their effect on their destiny at the adult age. Psychologists believe the bond between twins begins in utero and develops throughout the twins' lives. The four patterns of twinship described show that the twin bond is determined by the quality of parenting that twins receive in their infancy and early childhood. Common problems of adult twins bring about difficulties to adapt in a non-twin world. The nature versus nurture controversy has taken on new life focusing on inter-twin differences and the importance of parent-child interaction as fundamental to the growth and development of personality. PMID:17352324

  7. Analysis of Optimum Heterodyne Receivers for Coherent Lidar Applications

    NASA Technical Reports Server (NTRS)

    Amzajerdian, Farzin

    2002-01-01

    A full analysis of the combined effects of all the noise sources of optical heterodyne receiver and the interaction between the competing control parameters of the receiver detector and pre-amplifier will be presented. This analysis provides the mean for true optimization of the coherent lidar receiver. The significance of the optimization of heterodyne receiver is shown for 2-micron coherent lidar.

  8. Metabolism and pharmacokinetics of the combination Zidovudine plus Lamivudine in the adult Erythrocebus patas monkey determined by liquid chromatography-tandem mass spectrometric analysis

    SciTech Connect

    Divi, Rao L.; Doerge, Daniel R.; Twaddle, Nathan C.; Shockley, Marie E.; St Claire, Marisa C.; Harbaugh, Jeffrey W.; Harbaugh, Steven W.; Poirier, Miriam C.

    2008-01-15

    Because of their similarity to humans, non-human primates constitute useful preclinical models in which to examine potential human drug toxicities. Antiretroviral nucleoside reverse transcriptase inhibitor (NRTI) toxicity is currently under investigation in Erythrocebus patas monkeys, and whereas NRTI pharmacokinetics have been studied in other monkey species, pharmacokinetics for Zidovudine plus Lamivudine (AZT/3TC) dosing have not been reported in the patas. Here we present 24 h serum pharmacokinetic parameters after a single oral exposure to the combination of AZT (40 mg) and 3TC (24 mg), doses equivalent to a human daily dose of Combivir (registered) . The patas (n = 3) AZT/3TC pharmacokinetic profiles were similar to those seen in other primate species. Average maximum serum concentrations (C{sub max}) for AZT and 3TC were 2.35 and 2.65 {mu}g/ml, respectively, and were observed at 0.83 h (T{sub max}). C{sub max} was 13.34 {mu}g/ml for the AZT-glucuronide (AZT-G) and was 0.023 {mu}g/ml for the potentially toxic minor metabolite 3'-amino-3'-deoxythymidine (AMT), both occurring at about 1 h after dosing. Similar elimination half-times, 0.70 and 0.68 h{sup -1}, were found for AZT and AZT-G, respectively, while 3TC was eliminated about half as fast (0.33 h{sup -1}) resulting in AUC{sub (0-{infinity})} values of 6.97 {mu}g/ml h for 3TC, 2.99 {mu}g/ml h for AZT, 20.5 {mu}g/ml h for AZT-G and 0.002 for AMT 6.97 {mu}g/ml h. This study shows similar metabolism and pharmacokinetics for oral administration of AZT/3TC in the adult patas monkey, other primate species and humans. The data validate the use of the patas monkey for studies of NRTI toxicity.

  9. Gender Differences in Current Received during Transcranial Electrical Stimulation

    PubMed Central

    Russell, Michael; Goodman, Theodore; Wang, Qiang; Groshong, Bennett; Lyeth, Bruce G.

    2014-01-01

    Low current transcranial electrical stimulation (tCS) is an effective but somewhat inconsistent tool for augmenting neuromodulation. In this study, we used 3D MRI guided electrical transcranial stimulation modeling to estimate the range of current intensities received at cortical brain tissues. Combined T1, T2, and proton density MRIs from 24 adult subjects (12 male and 12 female) were modeled with virtual electrodes placed at F3, F4, C3, and C4. Two sizes of electrodes 20 mm round and 50 mm × 45 mm were examined at 0.5, 1, and 2 mA input currents. The intensity of current received was sampled in a 1-cm sphere placed at the cortex directly under each scalp electrode. There was a 10-fold difference in the amount of current received by individuals. A large gender difference was observed with female subjects receiving significantly less current at targeted parietal cortex than male subjects when stimulated at identical current levels (P < 0.05). Larger electrodes delivered somewhat larger amounts of current than the smaller ones (P < 0.01). Electrodes in the frontal regions delivered less current than those in the parietal region (P < 0.05). There were large individual differences in current levels that the subjects received. Analysis of the cranial bone showed that the gender difference and the frontal parietal differences are due to differences in cranial bone. Males have more cancelous parietal bone and females more dense parietal bone (P < 0.01). These differences should be considered when planning tCS studies and call into question earlier reports of gender differences due to hormonal influences. PMID:25177301

  10. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  11. Musculoskeletal Safety Outcomes of Patients Receiving Daptomycin with HMG-CoA Reductase Inhibitors

    PubMed Central

    Bookstaver, P. Brandon; Lu, Z. Kevin; Dunn, Brianne L.; Rumley, Kathey Fulton

    2014-01-01

    Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl–coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and presence of myalgias or muscle complaints, was collected. Myalgias were noted in 3/49 (6.1%) patients receiving combination therapy compared with 5/171 (2.9%) of patients receiving daptomycin alone (P = 0.38). CPK elevations of >1,000 U/liter occurred in 5/49 (10.2%) patients receiving combination therapy compared to 9/171 (5.3%) patients receiving daptomycin alone (P = 0.32). Two of five patients experiencing CPK elevations of >1,000 U/liter in the combination group had symptoms of myopathy. Three patients (6.1%) discontinued therapy due to CPK elevations with concurrent myalgias in the combination group versus 6 patients (3.5%) in the daptomycin-alone group (P = 0.42). CPK levels and myalgias reversed upon discontinuation of daptomycin therapy. Overall musculoskeletal toxicity was numerically higher in the combination group but this result was not statistically significant. Further prospective study is warranted in a larger population. PMID:25022580

  12. Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors.

    PubMed

    Bland, Christopher M; Bookstaver, P Brandon; Lu, Z Kevin; Dunn, Brianne L; Rumley, Kathey Fulton

    2014-10-01

    Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and presence of myalgias or muscle complaints, was collected. Myalgias were noted in 3/49 (6.1%) patients receiving combination therapy compared with 5/171 (2.9%) of patients receiving daptomycin alone (P = 0.38). CPK elevations of >1,000 U/liter occurred in 5/49 (10.2%) patients receiving combination therapy compared to 9/171 (5.3%) patients receiving daptomycin alone (P = 0.32). Two of five patients experiencing CPK elevations of >1,000 U/liter in the combination group had symptoms of myopathy. Three patients (6.1%) discontinued therapy due to CPK elevations with concurrent myalgias in the combination group versus 6 patients (3.5%) in the daptomycin-alone group (P = 0.42). CPK levels and myalgias reversed upon discontinuation of daptomycin therapy. Overall musculoskeletal toxicity was numerically higher in the combination group but this result was not statistically significant. Further prospective study is warranted in a larger population. PMID:25022580

  13. Simplified OMEGA receivers

    NASA Technical Reports Server (NTRS)

    Burhans, R. W.

    1974-01-01

    The details are presented of methods for providing OMEGA navigational information including the receiver problem at the antenna and informational display and housekeeping systems based on some 4 bit data processing concepts. Topics discussed include the problem of limiters, zero crossing detectors, signal envelopes, internal timing circuits, phase counters, lane position displays, signal integrators, and software mapping problems.

  14. Submillimeter wave heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Goutam (Inventor); Manohara, Harish (Inventor); Siegel, Peter H. (Inventor); Ward, John (Inventor)

    2011-01-01

    In an embodiment, a submillimeter wave heterodyne receiver includes a finline ortho-mode transducer comprising thin tapered metallic fins deposited on a thin dielectric substrate to separate a vertically polarized electromagnetic mode from a horizontally polarized electromagnetic mode. Other embodiments are described and claimed.

  15. Olympus beacon receiver

    NASA Technical Reports Server (NTRS)

    Ostergaard, Jens

    1988-01-01

    A medium-size Beacon Receiving System for reception and processing of the B1 (20 GHz) and B2 (30 GHz) beacons from Olympus has been developed. Integration of B1 and B2 receiving equipment into one system using one antenna and a common computer for control and data processing provides the advantages of a compact configuration and synchronization of the two receiver chains. Range for co-polar signal attenuation meaurement is about 30 dB for both beacons, increasing to 40 dB for B2 if the receivers are synchronized to B1. The accuracy is better than 0.5 dB. Cross-polarization discriminations of the order of 10 to 30 dB may be determined with an accuracy of 1 to 2 dB. A number of radiometers for complementary measurements of atmospheric attenuation of 13 to 30 GHz has also been constructed. A small multi-frequency system for operation around 22 GHz and 31 GHz is presently under development.

  16. The expression pattern of Adam10 in the central nervous system of adult mice: Detection by in situ hybridization combined with immunohistochemistry staining.

    PubMed

    Guo, Zhi-Bao; Su, Ying-Ying; Wang, Yi-Hui; Wang, Wei; Guo, Da-Zhi

    2016-09-01

    ADAM10 (a disintegrin and metalloprotease 10) is a member of the ADAMs family, which is key in the development of the nervous system, by regulating proliferation, migration, differentiation and survival of various cells, including axonal growth and myelination. Previous studies have investigated the embryonic or postnatal expression of ADAM10, however, detailed information regarding its cellular distribution in the adult stage, to the best of our knowledge, is not available. The present study investigated the expression pattern of the ADAM10 gene in the adult mouse central nervous system (CNS) using an ADAM10 complementary RNA probe for in situ hybridization (ISH). Immunohistochemical staining was used to identify the type of the ISH staining‑positive cells with neuron‑ or astrocyte‑specific antibodies. The results of the current study demonstrated that the ADAM10 gene was predominantly expressed in the neurons of the cerebral cortex, hippocampus, thalamus and cerebellar granular cells in adult mouse CNS. PMID:27431484

  17. The expression pattern of Adam10 in the central nervous system of adult mice: Detection by in situ hybridization combined with immunohistochemistry staining

    PubMed Central

    Guo, Zhi-Bao; Su, Ying-Ying; Wang, Yi-Hui; Wang, Wei; Guo, Da-Zhi

    2016-01-01

    ADAM10 (a disintegrin and metalloprotease 10) is a member of the ADAMs family, which is key in the development of the nervous system, by regulating proliferation, migration, differentiation and survival of various cells, including axonal growth and myelination. Previous studies have investigated the embryonic or postnatal expression of ADAM10, however, detailed information regarding its cellular distribution in the adult stage, to the best of our knowledge, is not available. The present study investigated the expression pattern of the ADAM10 gene in the adult mouse central nervous system (CNS) using an ADAM10 complementary RNA probe for in situ hybridization (ISH). Immunohistochemical staining was used to identify the type of the ISH staining-positive cells with neuron- or astrocyte-specific antibodies. The results of the current study demonstrated that the ADAM10 gene was predominantly expressed in the neurons of the cerebral cortex, hippocampus, thalamus and cerebellar granular cells in adult mouse CNS. PMID:27431484

  18. Facts about Measles for Adults

    MedlinePlus

    ... as part of a combination vaccine, called the MMR vaccine that protects against measles, mumps, and rubella. Which adults should get vaccinated against measles with MMR vaccine? Adults born in 1957 or later who do ...

  19. Moments Of Microdiversity EGC Receivers And Macrodiversity SC Receiver Output Signal Over Gamma Shadowed Nakagami-m Multipath Fading Channel

    NASA Astrophysics Data System (ADS)

    Djordjević, Nebojša; Jaksić, Branimir S.; Matović, Ana; Matović, Marija; Smilić, Marko

    2015-11-01

    A system with macrodiversity selection combining (SC) receiver and for microdiversity equal gain combining (EGC) receivers is considered. Received signal is subjected, simultaneously to multipath fading and shadowing, resulting in signal envelope and signal power variation. Closed form expressions for moments of macrodiversity SC receiver output signal envelope are calculated. Numerical expressions are plotted to present the influences of Gamma shadowing severity and Nakagami-m severity on moments of proposed system output signal.

  20. Efficacy of the fipronil 10%+(S)-methoprene 9% combination against Rhipicephalus sanguineus in naturally infested dogs: speed of kill, persistent efficacy on immature and adult stages and effect of water.

    PubMed

    Brianti, Emanuele; Pennisi, Maria Grazia; Brucato, Giuseppina; Risitano, Anna Lia; Gaglio, Gabriella; Lombardo, Gabriella; Malara, Daniela; Fogliazza, Alessandro; Giannetto, Salvatore

    2010-05-28

    This field trial was designed to test the efficacy, in terms of treatment and prevention, of the fipronil 10%+(S)-methoprene 9% combination against immature and adult stages of Rhipicephalus sanguineus in naturally infested dogs, and to assess the effect of a single plain water exposure. Twenty-four dogs of various age, sex, weight and coat length were divided into two homogeneous groups, treated (T) and control (C), and housed into twin outdoor kennels. Trial baseline was designed as day 0, when dogs from group T were treated with a commercial spot-on formulation of fipronil 10%+(S)-methoprene 9%, while subjects from group C were left untreated and served as control. After treatment, tick load for each included dog was estimated, for both adult and immature ticks, using the localization and count over the entire body surface at the following time-points: day 2, to evaluate the speed of kill and at days 7, 14, 21 and 28 to assess the persistence of efficacy. The effect of water exposure on the product efficacy was tested at day 14 of the study, when six dogs, homogenously selected from group T, were soaked through with plain water. The overall tick load in dogs from group C was high throughout the entire study period, ranging from 103.2 (day 28) to 161.3 (day 0), and confirmed the high tick pressure. Speed of kill calculated at 48 h post-treatment was slightly higher for adult ticks (96.2%) than for immature stages (91.6%). Compared to the control, dogs treated with the fipronil+(S)-methoprene maintained a significantly lower mean tick load for both adult and immature stages in the four weeks of observation. Persistence of efficacy against immature stages ranged from 97.1% the first week, 99.6% second week, 99.7 third week and 93.1% in the last week. In the same way, efficacy against adult ticks was constantly high, shifting from 94.5% to 92.5%. Overall efficacy (adults+immatures) was the strongest in the first two weeks (i.e., 96.1% and 96.6%) and lowered in the

  1. A digital beacon receiver

    NASA Technical Reports Server (NTRS)

    Ransome, Peter D.

    1988-01-01

    A digital satellite beacon receiver is described which provides measurement information down to a carrier/noise density ratio approximately 15 dB below that required by a conventional (phase locked loop) design. When the beacon signal fades, accuracy degrades gracefully, and is restored immediately (without hysteresis) on signal recovery, even if the signal has faded into the noise. Benefits of the digital processing approach used include the minimization of operator adjustments, stability of the phase measuring circuits with time, repeatability between units, and compatibility with equipment not specifically designed for propagation measuring. The receiver has been developed for the European Olympus satellite which has continuous wave (CW) beacons at 12.5 and 29.7 GHz, and a switched polarization beacon at 19.8 GHz approximately, but the system can be reconfigured for CW and polarization-switched beacons at other frequencies.

  2. Targeting Cydia pomonella (L.)(Lepidoptera: Tortricidae) Adults with Low Volume Applications of Insecticides Alone and in Combination with Sex Pheromone

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studies examined the effectiveness of adding insecticides to low volume sprays of a microencapsulated (MEC) sex pheromone to manage codling moth, Cydia pomonella (L). The activities of fifteen insecticides against the adult stage were first evaluated with a plastic cup assay. In general, moth longev...

  3. Maternal exposure to diets containing high fructose and saturated fats, low B vitamins, or their combination programs growth, adiposity, and insulin sensitivity in adult offspring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Early exposure to unfavorable nutrition programs increases risk of adult-onset diseases. In this rat study, we investigate morphological, metabolic and endocrinal phenotypes of offspring born to dams consuming isocaloric diets containing 30% fructose, 9.9% coconut fat and 0.5% cholesterol (F+SFA), m...

  4. Training in Influencing Skills from Neuro-Linguistic Programming (Modelled from Hypnosis and Family Therapy), in Combination with Innovative Maths Pedagogy, Raises Maths Attainment in Adult Numeracy Learners

    ERIC Educational Resources Information Center

    Allan, F.; Bourne, J.; Bouch, D.; Churches, R.; Dennison, J.; Evans, J.; Fowler, J.; Jeffers, A.; Prior, E.; Rhodes, L.

    2012-01-01

    Case study research suggests that NLP [neuro-linguistic programming] influencing strategies benefit teacher effectiveness. Maths pedagogy involving higher-order questioning, challenge, problem solving and collaborative working may be a way of improving attainment in adult numeracy learning, however, such strategies may be less effective if the…

  5. Galileo probe relay receiver

    NASA Technical Reports Server (NTRS)

    Prouty, D. A.; Von Der Embse, U. A.

    1982-01-01

    For the Jovian mission, the data link from the Galileo probe to the orbiter uses suppressed-carrier Manchester encoded BPSK modulation and is protected with R = 1/2, K = 7 convolutional coding. The receiver closes the link by acquiring, tracking, and demodulating the data. It has to operate in a highly stressed environment with severe frequency offset, frequency rate, wind gust, and antenna spin conditions. Salient features are described and breadboard test data presented.

  6. Assessment of the safety and immunogenicity of Rhodococcus equi-secreted proteins combined with either a liquid nanoparticle (IMS 3012) or a polymeric (PET GEL A) water-based adjuvant in adult horses and foals--identification of promising new candidate antigens.

    PubMed

    Cauchard, S; Bertrand, F; Barrier-Battut, I; Jacquet, S; Laurentie, M; Barbey, C; Laugier, C; Deville, S; Cauchard, J

    2014-02-15

    Rhodococcus equi is the most common infectious cause of mortality in foals between 1 and 6 months of age. Because of an increase in the number of antibiotic-resistant strains, the optimization of a prophylactic strategy is a key factor in the comprehensive management of R. equi pneumonia. The objectives of this study were to assess the safety and immunogenicity of R. equi-secreted proteins (ReSP) co-administered with either the nanoparticular adjuvant Montanide™ IMS 3012 VG, or a new polymeric adjuvant Montanide™ PET GEL A, and to further investigate the most immunogenic proteins for subsequent immunization/challenge experiments in the development of a vaccine against rhodoccocal pneumonia. The approach involved two phases. The first phase aimed to investigate the safety of vaccination in six adult horses. The second phase aimed to determine the safety and immunogenicity of vaccination in twelve 3-week-old foals. We set out to develop a method based on ultrasound measurements for safety assessment in adult horses in order to evaluate any in situ changes at the injection site, in the skin or the underlying muscle, with quantitative and qualitative data revealing that administration of ReSP combined with the Pet Gel A adjuvant led to an increase in local inflammation, associated with 4- to 7-fold higher levels of anti-R. equi IgGa, IgGb and IgGT, compared to administration of ReSP associated with IMS 3012 adjuvant, but without any impact on animal demeanor. Investigations were then performed in foals with serological and clinical follow-up until 6 months of age. Interestingly, we observed in foals a much lower incidence of adverse local tissue reactions at the injection site than in adult horses, with transient and moderate swelling for the group that received ReSP combined with Pet Gel A. Immunized foals with Pet Gel A adjuvant exhibited a similar response in both IgGa and IgGT levels, but a lower response in IgGb levels, compared to adult horses, with a

  7. LANL receiver system development

    SciTech Connect

    Laubscher, B.; Cooke, B.; Cafferty, M.; Olivas, N.

    1997-08-01

    The CALIOPE receiver system development at LANL is the story of two technologies. The first of these technologies consists of off-the-shelf mercury-cadmium-telluride (MCT) detectors and amplifiers. The vendor for this system is Kolmar Technologies. This system was fielded in the Tan Trailer I (TTI) in 1995 and will be referred to in this paper as GEN I. The second system consists of a MCT detector procured from Santa Barbara Research Center (SBRC) and an amplifier designed and built by LANL. This system was fielded in the Tan Trailer II (TTII) system at the NTS tests in 1996 and will be referred to as GEN II. The LANL CALIOPE experimental plan for 1996 was to improve the lidar system by progressing to a higher rep rate laser to perform many shots in a much shorter period of time. In keeping with this plan, the receiver team set a goal of developing a detector system that was background limited for the projected 100 nanosecond (ns) laser pulse. A set of detailed simulations of the DIAL lidar experiment was performed. From these runs, parameters such as optimal detector size, field of view of the receiver system, nominal laser return power, etc. were extracted. With this information, detector physics and amplifier electronic models were developed to obtain the required specifications for each of these components. These derived specs indicated that a substantial improvement over commercially available, off-the-shelf, amplifier and detector technologies would be needed to obtain the goals. To determine if the original GEN I detector was usable, the authors performed tests on a 100 micron square detector at cryogenic temperatures. The results of this test and others convinced them that an advanced detector was required. Eventually, a suitable detector was identified and a number of these single element detectors were procured from SBRC. These single element detectors were witness for the detector arrays built for another DOE project.

  8. Ultra-wideband receiver

    DOEpatents

    McEwan, Thomas E.

    1994-01-01

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

  9. Ultra-wideband receiver

    DOEpatents

    McEwan, Thomas E.

    1996-01-01

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

  10. Ultra-wideband receiver

    DOEpatents

    McEwan, T.E.

    1996-06-04

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, {+-}UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 21 figs.

  11. Ultra-wideband receiver

    DOEpatents

    McEwan, T.E.

    1994-09-06

    An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, [+-] UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 16 figs.

  12. Weather Data Receiver

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Northern Video Graphics, Inc. developed a low-cost satellite receiving system for users such as independent meteorologists, agribusiness firms, small airports or flying clubs, marine vessels and small TV stations. Called Video Fax, it is designed for use with certain satellites; the GOES (Geostationary Operational Environmental Satellite) spacecraft operated by the National Oceanic and Atmospheric Administration, the European Space Agency's Meteosat and Japan's Geostationary Meteorological Satellite. By dictum of the World Meteorological Organization, signals from satellites are available to anyone without cost so the Video Fax user can acquire signals directly from the satellite and cut out the middle man, enabling savings. Unit sells for about one-fifth the cost of the equipment used by TV stations. It consists of a two-meter antenna; a receiver; a microprocessor-controlled display computer; and a video monitor. Computer stores data from the satellites and converts it to an image which is displayed on the monitor. Weather map can be preserved as signal data on tape, or it can be stored in a video cassette as a permanent image.

  13. Adult Education Regional Planning

    ERIC Educational Resources Information Center

    California Community Colleges, Chancellor's Office, 2015

    2015-01-01

    For more than one hundred and fifty years, until 2008, California was an undisputed national leader in its commitment to adult education. The state's investment in adult learners topped $750 million, a sum greater than the combined total of every other state in the nation. However, for the past several years recession and fiscal crisis have left…

  14. Digital Receiver Phase Meter

    NASA Technical Reports Server (NTRS)

    Marcin, Martin; Abramovici, Alexander

    2008-01-01

    The software of a commercially available digital radio receiver has been modified to make the receiver function as a two-channel low-noise phase meter. This phase meter is a prototype in the continuing development of a phase meter for a system in which radiofrequency (RF) signals in the two channels would be outputs of a spaceborne heterodyne laser interferometer for detecting gravitational waves. The frequencies of the signals could include a common Doppler-shift component of as much as 15 MHz. The phase meter is required to measure the relative phases of the signals in the two channels at a sampling rate of 10 Hz at a root power spectral density <5 microcycle/(Hz)1/2 and to be capable of determining the power spectral density of the phase difference over the frequency range from 1 mHz to 1 Hz. Such a phase meter could also be used on Earth to perform similar measurements in laser metrology of moving bodies. To illustrate part of the principle of operation of the phase meter, the figure includes a simplified block diagram of a basic singlechannel digital receiver. The input RF signal is first fed to the input terminal of an analog-to-digital converter (ADC). To prevent aliasing errors in the ADC, the sampling rate must be at least twice the input signal frequency. The sampling rate of the ADC is governed by a sampling clock, which also drives a digital local oscillator (DLO), which is a direct digital frequency synthesizer. The DLO produces samples of sine and cosine signals at a programmed tuning frequency. The sine and cosine samples are mixed with (that is, multiplied by) the samples from the ADC, then low-pass filtered to obtain in-phase (I) and quadrature (Q) signal components. A digital signal processor (DSP) computes the ratio between the Q and I components, computes the phase of the RF signal (relative to that of the DLO signal) as the arctangent of this ratio, and then averages successive such phase values over a time interval specified by the user.

  15. Solar thermal energy receiver

    NASA Technical Reports Server (NTRS)

    Baker, Karl W. (Inventor); Dustin, Miles O. (Inventor)

    1992-01-01

    A plurality of heat pipes in a shell receive concentrated solar energy and transfer the energy to a heat activated system. To provide for even distribution of the energy despite uneven impingement of solar energy on the heat pipes, absence of solar energy at times, or failure of one or more of the heat pipes, energy storage means are disposed on the heat pipes which extend through a heat pipe thermal coupling means into the heat activated device. To enhance energy transfer to the heat activated device, the heat pipe coupling cavity means may be provided with extensions into the device. For use with a Stirling engine having passages for working gas, heat transfer members may be positioned to contact the gas and the heat pipes. The shell may be divided into sections by transverse walls. To prevent cavity working fluid from collecting in the extensions, a porous body is positioned in the cavity.

  16. Effects of Low-Load, Elastic Band Resistance Training Combined With Blood Flow Restriction on Muscle Size and Arterial Stiffness in Older Adults.

    PubMed

    Yasuda, Tomohiro; Fukumura, Kazuya; Uchida, Yusuke; Koshi, Hitomi; Iida, Haruko; Masamune, Ken; Yamasoba, Tatsuya; Sato, Yoshiaki; Nakajima, Toshiaki

    2015-08-01

    We examined the effect of low-load, elastic band resistance training with blood flow restriction (BFR) on muscle size and arterial stiffness in older adults. Healthy older adults (aged 61-85 years) were divided into BFR training (BFR-T, n = 9) or non-BFR training (CON-T, n = 8) groups. Both groups performed low-load arm curl and triceps down exercises (four sets, total 75 repetitions for each) using an elastic band, 2 d/wk for 12 weeks. The BFR-T group wore inflated pneumatic elastic cuffs (120-270 mm Hg) on both arms during training. Magnetic resonance imaging-measured muscle cross-sectional area of the upper arm, maximum voluntary isometric contraction of the elbow flexors and extensors, cardio-ankle vascular index testing, and ankle-brachial pressure index were measured before and 3-5 days after the final training session. Muscle cross-sectional area of the elbow flexors (17.6%) and extensors (17.4%) increased, as did elbow flexion and elbow extension maximum voluntary isometric contraction (7.8% and 16.1%, respectively) improved (p < .05) in the BFR-T group, but not in the CON-T group. In cardio-ankle vascular index and ankle-brachial pressure index testing, there were no changes between pre- and post-results in either group. In conclusion, elastic band BFR-T improves muscle cross-sectional area as well as maximal muscle strength but does not negatively affect arterial stiffness in older adults. PMID:24917178

  17. Cellular transfer of experimental allergic encephalomyelitis employing suckling and adult Lewis rats.

    PubMed

    Fujinami, R S; Paterson, P Y

    1981-07-01

    Experiments designed to assess the importance of age of donors and recipients in cellular transfer of experimental allergic encephalomyelitis (EAE) in inbred Lewis rats indicate: (a) that lymph node cells (LNC) of suckling rats sensitized to neuroantigen-adjuvant are just as effective in transfer of the disease to adult recipients as LNC from similarly sensitized adult donors, (b) that EAE can be transferred to suckling rats just as well as adults using lymphoid cells from either suckling or adult donors, and (c) while relatively low numbers of sensitized splenocytes from suckling or adult donors may transfer EAE, relatively large numbers of spleen cells do not. Based on additional EAE transfer experiments, in which recipients received combinations of sensitized LNC and normal splenocytes, no evidence could be secured that the spleen exerts a suppressive influence on cellular transfer of the disease in Lewis s may transfer EAE, relatively large numbers of spleen cells do not. Based on additional EAE transfer experiments, in which recipients received combinations of sensitized LNC and normal splenocytes, no evidence could be secured that the spleen exerts a suppressive influence on cellular transfer of the disease in Lewis s may transfer EAE, relatively large numbers of spleen cells do not. Based on additional EAE transfer experiments, in which recipients received combinations of sensitized LNC and normal splenocytes, no evidence could be secured that the spleen exerts a suppressive influence on cellular transfer of the disease in Lewis rats. PMID:6973635

  18. Advanced space solar dynamic receivers

    NASA Technical Reports Server (NTRS)

    Strumpf, Hal J.; Coombs, Murray G.; Lacy, Dovie E.

    1988-01-01

    A study has been conducted to generate and evaluate advanced solar heat receiver concepts suitable for orbital application with Brayton and Stirling engine cycles in the 7-kW size range. The generated receiver designs have thermal storage capability (to enable power production during the substantial eclipse period which accompanies typical orbits) and are lighter and smaller than state-of-the-art systems, such as the Brayton solar receiver being designed and developed by AiResearch for the NASA Space Station. Two receiver concepts have been developed in detail: a packed bed receiver and a heat pipe receiver. The packed bed receiver is appropriate for a Brayton engine; the heat pipe receiver is applicable for either a Brayton or Stirling engine. The thermal storage for both concepts is provided by the melting and freezing of a salt. Both receiver concepts offer substantial improvements in size and weight compared to baseline receivers.

  19. USEPA CSO CAPSTONE REPORT: RECEIVING WATER IMPACTS

    EPA Science Inventory

    Urban storm-generated combined sewer overflows (CSOs) significantly contribute to the degradation of the nation's water quality. Although not one of the largest pollution sources by volume, their impacts on receiving waters can be locally intense and visible due to shock effect a...

  20. DHA Supplementation Alone or in Combination with Other Nutrients Does not Modulate Cerebral Hemodynamics or Cognitive Function in Healthy Older Adults

    PubMed Central

    Jackson, Philippa A.; Forster, Joanne S.; Bell, J. Gordon; Dick, James R.; Younger, Irene; Kennedy, David O.

    2016-01-01

    A number of recent trials have demonstrated positive effects of dietary supplementation with the omega-3 polyunsaturated fatty acids (n-3 PUFAs), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on measures of cognitive function in healthy young and older adults. One potential mechanism by which EPA, and DHA in particular, may exert these effects is via modulation of cerebral hemodynamics. In order to investigate the effects of DHA alone or provided as one component of a multinutrient supplement (also including Gingko biloba, phosphatidylserine and vitamins B9 and B12) on measures of cerebral hemodynamics and cognitive function, 86 healthy older adults aged 50–70 years who reported subjective memory deficits were recruited to take part in a six month daily dietary supplementation trial. Relative changes in the concentration of oxygenated hemoglobin and deoxygenated hemoglobin were assessed using Near Infrared Spectroscopy (NIRS) during the performance of cognitive tasks prior to and following the intervention period. Performance on the cognitive tasks was also assessed. No effect of either active treatment was found for any of the NIRS measures or on the cognitive performance tasks, although the study was limited by a number of factors. Further work should continue to evaluate more holistic approaches to cognitive aging. PMID:26867200

  1. Combined anatomical and functional imaging using coronary CT angiography and myocardial perfusion SPECT in symptomatic adults with abnormal origin of a coronary artery.

    PubMed

    Uebleis, C; Groebner, M; von Ziegler, F; Becker, A; Rischpler, C; Tegtmeyer, R; Becker, C; Lehner, S; Haug, A R; Cumming, P; Bartenstein, P; Franz, W M; Hacker, M

    2012-10-01

    There has been a lack of standardized workup guidelines for patients with congenital abnormal origin of a coronary artery from the opposite sinus (ACAOS). We aimed to evaluate the use of cardiac hybrid imaging using multi-detector row CT (MDCT) for coronary CT angiography (Coronary CTA) and stress-rest myocardial perfusion SPECT (MPS) for comprehensive diagnosis of symptomatic adult patients with ACAOS. Seventeen symptomatic patients (12 men; 54 ± 13 years) presenting with ACAOS underwent coronary CTA and MPS. Imaging data were analyzed by conventional means, and with additional use of 3D image fusion to allocate stress induced perfusion defects (PD) to their supplying coronary arteries. An anomalous RCA arose from the left anterior sinus in eight patients, an abnormal origin from the right sinus was detected in nine patients (5 left coronary arteries, LCA and 4 LCx). Five of the 17 patients (29%) demonstrated a reversible PD in MPS. There was no correlation between the anatomical variants of ACAOS and the presence of myocardial ischemia. Image fusion enabled the allocation of reversible PD to the anomalous vessel in three patients (two cases in the RCA and the other in the LCA territory); PD in two patients were allocated to the territory of artery giving rise to the anomalies, rather than the anomalies themselves. In a small cohort of adult symptomatic patients with ACAOS anomaly there was no relation found between the specific anatomical variant and the appearance of stress induced myocardial ischemia using cardiac hybrid imaging. PMID:22147107

  2. DHA Supplementation Alone or in Combination with Other Nutrients Does not Modulate Cerebral Hemodynamics or Cognitive Function in Healthy Older Adults.

    PubMed

    Jackson, Philippa A; Forster, Joanne S; Bell, J Gordon; Dick, James R; Younger, Irene; Kennedy, David O

    2016-02-01

    A number of recent trials have demonstrated positive effects of dietary supplementation with the omega-3 polyunsaturated fatty acids (n-3 PUFAs), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on measures of cognitive function in healthy young and older adults. One potential mechanism by which EPA, and DHA in particular, may exert these effects is via modulation of cerebral hemodynamics. In order to investigate the effects of DHA alone or provided as one component of a multinutrient supplement (also including Gingko biloba, phosphatidylserine and vitamins B₉ and B₁₂) on measures of cerebral hemodynamics and cognitive function, 86 healthy older adults aged 50-70 years who reported subjective memory deficits were recruited to take part in a six month daily dietary supplementation trial. Relative changes in the concentration of oxygenated hemoglobin and deoxygenated hemoglobin were assessed using Near Infrared Spectroscopy (NIRS) during the performance of cognitive tasks prior to and following the intervention period. Performance on the cognitive tasks was also assessed. No effect of either active treatment was found for any of the NIRS measures or on the cognitive performance tasks, although the study was limited by a number of factors. Further work should continue to evaluate more holistic approaches to cognitive aging. PMID:26867200

  3. ADMX Receiver and Analysis

    NASA Astrophysics Data System (ADS)

    Malagon, Ana; ADMX Collaboration

    2016-03-01

    ADMX looks for the excess radiation deposited into a cavity from the conversion of a dark matter axion into a microwave photon. The sensitivity of the experiment increases by reducing the background thermal noise and minimizing the electronic noise of the readout system. The axion masses that the experiment can detect are determined by the resonant frequency of the cavity mode of interest, which is tuned using a two rod configuration. One can also increase the search rate by measuring the output from two cavity modes at once, which requires two separate readout schemes. I will discuss the ADMX dual-channel receiver which has been upgraded to have near quantum-limited sensitivity on both channels, and describe how the correct modes are verified, using simulations, in the presence of dense electromagnetic structure. I conclude by describing upgrades to the ADMX analysis which allow for real-time exclusion limits. Supported by DOE Grants DE-FG02-97ER41029, DE-FG02-96ER40956, DE- AC52-07NA27344, DE-AC03-76SF00098, and the Livermore LDRD program.

  4. Anchorage Receives Record Snowfall

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The forecast called for flurries, but the snow accumulated on the ground in Anchorage, Alaska, at the rate of 2 inches per hour (5 cm per hour) for much of Saturday, March 16, 2002. By the time the winter storm passed on Sunday afternoon, Anchorage had received 28.6 inches (72.6 cm) of snow, surpassing by far the previous record of 15.6 inches (39.6 cm) set on December 29, 1955. Flights were canceled and schools were closed as a result of the storm. This true-color image of Alaska was acquired by the Sea-viewing Wide Field-of-view Sensor (SeaWiFS), flying aboard the OrbView-2 satellite, on March 18. It appears another large, low-pressure system is heading toward the Anchorage region, which could bring substantially more snowfall. The low-pressure system can be identified by the characteristic spiral pattern of clouds located off Alaska's southwestern coast in this scene.

  5. Single-Receiver GPS Phase Bias Resolution

    NASA Technical Reports Server (NTRS)

    Bertiger, William I.; Haines, Bruce J.; Weiss, Jan P.; Harvey, Nathaniel E.

    2010-01-01

    Existing software has been modified to yield the benefits of integer fixed double-differenced GPS-phased ambiguities when processing data from a single GPS receiver with no access to any other GPS receiver data. When the double-differenced combination of phase biases can be fixed reliably, a significant improvement in solution accuracy is obtained. This innovation uses a large global set of GPS receivers (40 to 80 receivers) to solve for the GPS satellite orbits and clocks (along with any other parameters). In this process, integer ambiguities are fixed and information on the ambiguity constraints is saved. For each GPS transmitter/receiver pair, the process saves the arc start and stop times, the wide-lane average value for the arc, the standard deviation of the wide lane, and the dual-frequency phase bias after bias fixing for the arc. The second step of the process uses the orbit and clock information, the bias information from the global solution, and only data from the single receiver to resolve double-differenced phase combinations. It is called "resolved" instead of "fixed" because constraints are introduced into the problem with a finite data weight to better account for possible errors. A receiver in orbit has much shorter continuous passes of data than a receiver fixed to the Earth. The method has parameters to account for this. In particular, differences in drifting wide-lane values must be handled differently. The first step of the process is automated, using two JPL software sets, Longarc and Gipsy-Oasis. The resulting orbit/clock and bias information files are posted on anonymous ftp for use by any licensed Gipsy-Oasis user. The second step is implemented in the Gipsy-Oasis executable, gd2p.pl, which automates the entire process, including fetching the information from anonymous ftp

  6. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models

    PubMed Central

    Eaton, Jeffrey W; Menzies, Nicolas A; Stover, John; Cambiano, Valentina; Chindelevitch, Leonid; Cori, Anne; Hontelez, Jan A C; Humair, Salal; Kerr, Cliff C; Klein, Daniel J; Mishra, Sharmistha; Mitchell, Kate M; Nichols, Brooke E; Vickerman, Peter; Bakker, Roel; Bärnighausen, Till; Bershteyn, Anna; Bloom, David E; Boily, Marie-Claude; Chang, Stewart T; Cohen, Ted; Dodd, Peter J; Fraser, Christophe; Gopalappa, Chaitra; Lundgren, Jens; Martin, Natasha K; Mikkelsen, Evelinn; Mountain, Elisa; Pham, Quang D; Pickles, Michael; Phillips, Andrew; Platt, Lucy; Pretorius, Carel; Prudden, Holly J; Salomon, Joshua A; van de Vijver, David A M C; de Vlas, Sake J; Wagner, Bradley G; White, Richard G; Wilson, David P; Zhang, Lei; Blandford, John; Meyer-Rath, Gesine; Remme, Michelle; Revill, Paul; Sangrujee, Nalinee; Terris-Prestholt, Fern; Doherty, Meg; Shaffer, Nathan; Easterbrook, Philippa J; Hirnschall, Gottfried; Hallett, Timothy B

    2014-01-01

    Background New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand ART eligibility accordingly. Methods We used multiple independent mathematical models in four settings—South Africa, Zambia, India, and Vietnam—to evaluate the potential health impact, costs, and cost-effectiveness of different adult ART eligibility criteria under scenarios of current and expanded treatment coverage, with results projected over 20 years. Analyses considered extending eligibility to include individuals with CD4 ≤500 cells/µL or all HIV-positive adults, compared to the previous recommendation of initiation with CD4 ≤350 cells/µL. We assessed costs from a health system perspective, and calculated the incremental cost per DALY averted ($/DALY) to compare competing strategies. Strategies were considered ‘very cost-effective’ if the $/DALY was less than the country’s per capita gross domestic product (GDP; South Africa: $8040, Zambia: $1425, India: $1489, Vietnam: $1407) and ‘cost-effective’ if $/DALY was less than three times per capita GDP. Findings In South Africa, the cost per DALY averted of extending ART eligibility to CD4 ≤500 cells/µL ranged from $237 to $1691/DALY compared to 2010 guidelines; in Zambia, expanded eligibility ranged from improving health outcomes while reducing costs (i.e. dominating current guidelines) to $749/DALY. Results were similar in scenarios with substantially expanded treatment access and for expanding eligibility to all HIV-positive adults. Expanding treatment coverage in the general population was therefore found to be cost-effective. In India, eligibility for all HIV-positive persons ranged from $131 to $241/DALY and in Vietnam eligibility for CD4 ≤500 cells/µL cost $290/DALY. In concentrated epidemics, expanded access among key populations was also cost

  7. Relation of Combined Non-High-Density Lipoprotein Cholesterol and Apolipoprotein B With Atherosclerosis in Adults With Type 1 Diabetes Mellitus.

    PubMed

    Bjornstad, Petter; Eckel, Robert H; Pyle, Laura; Rewers, Marian; Maahs, David M; Snell-Bergeon, Janet K

    2015-10-01

    Apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C) are cardiovascular disease risk markers, although data in adults with type 1 diabetes mellitus (DM) are limited. We hypothesized that elevated apoB and non-HDL-C would be associated with greater odds of coronary artery calcification progression (CACp), a measure of coronary atherosclerosis, than either category alone in adults with type 1 DM. We grouped subjects with type 1 DM (n = 652) into 4 groups: elevated apoB (≥90 mg/dl) and elevated non-HDL-C (≥130 mg/dl), elevated non-HDL-C alone, elevated apoB alone, and normal apoB and non-HDL-C. We used logistic regression to examine the associations between the groups and CACp for a period of 6 years. We performed sensitivity analyses with elevated apoB and non-HDL-C redefined as at or more than the cohort means (91.4 and 119.0 mg/dl, respectively). Subjects with elevated apoB and non-HDL-C had greater odds of CACp compared with those with normal apoB and non-HDL-C (odds ratio 1.90, 95% confidence interval 1.15 to 3.15) and compared with subjects with elevated apoB alone (odds ratio 2.86, 95% confidence interval 1.43 to 5.74) adjusting for age, gender, duration, hemoglobin A1c, and statins. Similar results were obtained with elevated apoB and non-HDL-C defined as at or more than the cohort means. In conclusion, elevated apoB and non-HDL-C carry a greater risk of atherosclerosis than elevated apoB in the absence of elevated non-HDL-C in adults with type 1 DM. These data suggest that apoB and non-HDL-C should be viewed as complementary rather than competitive indexes of cardiovascular disease risk in type 1 DM. PMID:26251001

  8. Evaluation of a combined blood glucose monitoring and gaming system (Didget®) for motivation in children, adolescents, and young adults with type 1 diabetes.

    PubMed

    Klingensmith, Georgeanna J; Aisenberg, Javier; Kaufman, Francine; Halvorson, Mary; Cruz, Eric; Riordan, Mary Ellen; Varma, Chandrasekhar; Pardo, Scott; Viggiani, Maria T; Wallace, Jane F; Schachner, Holly C; Bailey, Timothy

    2013-08-01

    The purpose of this study was to assess the performance and acceptability of a blood glucose meter coupled with a gaming system for children, adolescents, and young adults with type 1 diabetes. During an in-clinic visit, duplicate blood samples were tested by subjects (N = 147; aged 5-24 yr) and health care providers (HCPs) to evaluate the accuracy and precision of the Didget® system. Subjects' meter results were compared against Yellow Springs Instruments (YSI) reference results and HCP results using least squares regression and error grid analyses. Precision was measured by average within-subject and within-HCP coefficient of variation (CV). During the home-use component of this study, subjects (n = 58) tested their blood glucose at least two to three times daily for 3-5 d to evaluate routine use of the system. Subjects' meter results showed significant correlations with both YSI (r(2) = 0.94; p < 0.001 for regression slope) and HCP results (r(2) = 0.96; p < 0.001). Average within-subject and within-HCP CVs were 5.9 and 7.2%, respectively. Overall satisfaction was assessed by subjects, their parents or guardians, and HCP surveys. Subject satisfaction with the Didget® system was good to excellent; most subjects found the system easy to use, motivating, and helpful for building good blood glucose monitoring habits. Most HCPs agreed that the system fulfilled a need in diabetes management. In conclusion, the Didget® system was precise and clinically accurate in the hands of children, adolescents, and young adults with type 1 diabetes. PMID:21699639

  9. Intention to Receive Influenza Vaccine After an Acute Respiratory Illness

    PubMed Central

    Nowalk, Mary Patricia; Balasubramani, G. K.; Schaffer, Mallory; Lieberman, Rhett H.; Eng, Heather; Kyle, Shakala; Wisniewski, Stephen; Zimmerman, Richard K.; Middleton, Donald B.

    2015-01-01

    Objective To determine the effects of symptoms and presence of confirmed influenza on intention to receive an influenza vaccine, specifically in patients recovering from a medically-attended acute (≤ 7 days’ duration) respiratory illness (ARI). Methods During the 2013–2014 influenza season, individuals seeking outpatient care for an ARI that included cough were tested for influenza using reverse transcription polymerase chain reaction assays (PCR) and completed surveys. Children (6 months–18 years) and adults (≥ 18 years) were grouped by their combined current season’s influenza vaccination status (vaccinated/not vaccinated) and their vaccination intentions for next season (intend/do not intend). Results Forty-one percent (323/786) were unvaccinated at enrollment, of whom nearly half (151/323) intended to be vaccinated next season. When adjusting for demographic, health and other factors, unvaccinated individuals who intended to be vaccinated next season were approximately 1.5 times more likely to have PCR-confirmed influenza compared with vaccinated individuals who intended to be vaccinated next season. Conclusion The combined experience of not being vaccinated against influenza and seeking medical attention for an ARI seemed to influence approximately one-half of unvaccinated participants to consider influenza vaccination for next season. PMID:26018106

  10. The effects of combined vitamin D and calcium supplementation on glycemia, insulin resistance and systemic inflammation in non-diabetic adults age 65 and older

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Altered vitamin D and calcium homeostasis may play a role in the development of glucose intolerance and type 2 diabetes. In a 3-year randomized controlled trial, we compared the effects of combined vitamin D and calcium supplementation vs. placebo on glycemia, insulin sensitivity and systemic infla...

  11. Economic Essays on Adult Students

    ERIC Educational Resources Information Center

    Shetty, Sandeep

    2013-01-01

    Adult students are an important component of the current U.S education landscape. They account for over 40% of the degree-seeking fresh enrollees in the U.S. colleges and according to the U.S. Department of Education, their growth will soon outpace that of traditional students. Adult students have also received considerable attention in higher…

  12. Testing in Adult Basic Education.

    ERIC Educational Resources Information Center

    Ehringhaus, Carolyn

    1991-01-01

    Responses from 427 adult basic education teachers (51 percent response) indicated that (1) 84.8 percent use tests for placement; (2) the Tests of Adult Basic Education are overwhelmingly the most frequently used; and (3) 77.7 percent find their testing practices effective, although informal observation and assessment received the highest ranking.…

  13. How states are expanding Medicaid to low-income adults through Section 1115 waiver demonstrations.

    PubMed

    Rosenbaum, Sara; Hurt, Carla

    2014-12-01

    In the wake of the Supreme Court's 2012 decision making state expansion of Medicaid to more adults optional under the Affordable Care Act, several states have received approval to combine such expansion with broader Medicaid reforms. They are doing so under Section 1115 of the Social Security Act, which authorizes Medicaid demonstrations that further program objectives. State demonstrations approved so far combine expanded adult coverage with changes in that coverage and in how the states deliver and pay for health care. These states have focused especially on expanding the use of private health insurance, requiring beneficiaries to pay premiums, and incentivizing them to choose cost-effective care. By enabling states to link wider program reforms to the adult expansion, Section 1115 has allowed them to better align Medicaid with local political conditions while extending insurance to more than 1 million adults who would otherwise lack a pathway to coverage. PMID:25588234

  14. Review of hematological indices of cancer patients receiving combined chemotherapy & radiotherapy or receiving radiotherapy alone.

    PubMed

    Shahid, Saman

    2016-09-01

    We observed the outcomes of chemotherapy with radiotherapy (CR) or radiotherapy (RT) alone for cancer patients of larynx, breast, blood and brain origins through complete blood count (CBC). Following were more depressed in CR patients: mean corpuscular hemoglobin-MCH & lymphocytes-LYM, hematocrit, mean corpuscular hemoglobin concentration-MCHC, hemoglobin-HB and red blood cells-RBC. In RT patients, following were more depressed: LYM, MCH and MCHC. Overall, in all cancer patients, the lymphocytes were depressed 52%. There existed a significant difference between white blood cells and RBC in both CR and RT patients. A significant moderate negative correlation is found in HB with the dose range 30-78 (Gray) given to the CR cancer patients. More number of CBC parameters affected in patients treated with CR and RT; but in less percentage as compared to patients who treated with RT alone. The cancer patients suffered from anemia along with immune modulations from the treatments. PMID:27423975

  15. Real-time software receiver

    NASA Technical Reports Server (NTRS)

    Ledvina, Brent M. (Inventor); Psiaki, Mark L. (Inventor); Powell, Steven P. (Inventor); Kintner, Jr., Paul M. (Inventor)

    2007-01-01

    A real-time software receiver that executes on a general purpose processor. The software receiver includes data acquisition and correlator modules that perform, in place of hardware correlation, baseband mixing and PRN code correlation using bit-wise parallelism.

  16. Real-time software receiver

    NASA Technical Reports Server (NTRS)

    Ledvina, Brent M. (Inventor); Psiaki, Mark L. (Inventor); Powell, Steven P. (Inventor); Kintner, Jr., Paul M. (Inventor)

    2006-01-01

    A real-time software receiver that executes on a general purpose processor. The software receiver includes data acquisition and correlator modules that perform, in place of hardware correlation, baseband mixing and PRN code correlation using bit-wise parallelism.

  17. Opportunistic infections and immune reconstitution inflammatory syndrome in HIV-1-infected adults in the combined antiretroviral therapy era: a comprehensive review.

    PubMed

    Manzardo, Christian; Guardo, Alberto C; Letang, Emilio; Plana, Montserrat; Gatell, Jose M; Miro, Jose M

    2015-06-01

    Despite the availability of effective combined antiretroviral treatment, many patients still present with advanced HIV infection, often accompanied by an AIDS-defining disease. A subgroup of patients starting antiretroviral treatment under these clinical conditions may experience paradoxical worsening of their disease as a result of an exaggerated immune response towards an active (but also subclinical) infectious agent, despite an appropriate virological and immunological response to the treatment. This clinical condition, known as immune reconstitution inflammatory syndrome, may cause significant morbidity and even mortality if it is not promptly recognized and treated. This review updates current knowledge about the incidence, diagnostic criteria, risk factors, clinical manifestations, and management of opportunistic infections and immune reconstitution inflammatory syndrome in the combined antiretroviral treatment era. PMID:25860288

  18. The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial.

    PubMed

    AbouAssi, Hiba; Slentz, Cris A; Mikus, Catherine R; Tanner, Charles J; Bateman, Lori A; Willis, Leslie H; Shields, A Tamlyn; Piner, Lucy W; Penry, Lorrie E; Kraus, Erik A; Huffman, Kim M; Bales, Connie W; Houmard, Joseph A; Kraus, William E

    2015-06-15

    Most health organizations recommend a combination of aerobic training (AT) and resistance training (RT), yet few studies have compared their acute (within 24 h of the last exercise bout) and sustained (after 14 days of no exercise training) effects alone and in combination on glucose metabolism. The present study (Studies Targeting Risk Reduction Interventions through Defined Exercise-Aerobic Training and/or Resistance Training) compared the effects of AT, RT, and the combination (AT/RT) on insulin action at both acute and sustained phases. Subjects (N = 196) were 18-70 yr old (mean age = 50 yr), overweight (mean body mass index = 30 kg/m2), sedentary with moderate dyslipidemia, and were randomized into one of three 8-mo exercise groups: 1) RT: 3 days/wk, 8 exercises, 3 sets/exercise, 8-12 repetitions/set; 2) AT: equivalent to ∼19.2 km/wk (12 miles/wk) at 75% peak O2 consumption; 3) AT/RT: the combination of AT and RT. One hundred forty-four subjects completed the intervention. Eighty-eight subjects completed all pre- and postintervention testing visits. Insulin sensitivity, glucose effectiveness, and disposition index were measured via a frequently sampled intravenous glucose tolerance test with subsequent minimal model analyses. AT/RT resulted in greater improvements in insulin sensitivity, β-cell function (disposition index), and glucose effectiveness than either AT or RT alone (all P < 0.05). Approximately 52% of the improvement in insulin sensitivity by AT/RT was retained 14 days after the last exercise training bout. Neither AT or RT led to acute or chronic improvement in sensitivity index. In summary, only AT/RT (which required twice as much time as either alone) led to significant acute and sustained benefits in insulin sensitivity PMID:25882384

  19. Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium-ACE combined with topical corticosteroids plus antifungal agent

    PubMed Central

    Belal, Mahmoud Helmy

    2015-01-01

    Aim: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of selenium combined with Vitamins A, C & E (Selenium-ACE) in the treatment of erosive-ulcerative OLP as an adjunctive to topical corticosteroids plus antifungal agent. Subjects and Methods: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of three groups and treated as follows: (I) Topical corticosteroids, (II) topical corticosteroids plus antifungal, and (III) SE-ACE combined with topical corticosteroids plus antifungal. The patients were followed for 6 weeks. The pain and severity of the lesions were recorded at the initial and follow-up visits. All recorded data were analyzed using paired t-test and ANOVA test. A P ≤ 0.05 was considered significant. Results: The experimental groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period, but there was no significant difference between the first two Groups I and II. However, healing of lesions and improvement of pain sensation was effective in Group III since a significant difference was found favoring Group III over both Groups I and II. Conclusion: No significant difference was found in treating erosive-ulcerative lesions of OLP by topical corticosteroids alone or combined with antifungal. However, when using SE-ACE in combination with topical corticosteroids plus antifungal, this approach may be effective in managing ulcerative lesions of OLP; but more research with a larger sample size and a longer evaluation period may be recommended. PMID:26681847

  20. Fracture Risk Assessment in Older Adults Using a Combination of Selected Quantitative Computed Tomography Bone Measures: A Subanalysis of the Age, Gene/Environment Susceptibility-Reykjavik Study

    PubMed Central

    Rianon, Nahid J.; Lang, Thomas F.; Siggeirsdottir, Kristin; Sigurdsson, Gunnar; Eiriksdottir, Gudny; Sigurdsson, Sigurdur; Jonsson, Brynjolfur Y.; Garcia, Melissa; Yu, Binbing; Kapadia, Asha S.; Taylor, Wendell C.; Selwyn, Beatrice J.; Gudnason, Vilmundur; Launer, Lenore J.; Harris, Tamara B.

    2016-01-01

    Bone mineral density (BMD) and geometric bone measures are individually associated with prevalent osteoporotic fractures. Whether an aggregate of these measures would better associate with fractures has not been examined. We examined relationships between self-reported fractures and selected bone measures acquired by quantitative computerized tomography (QCT), a composite bone score, and QCT-acquired dual-energy X-ray absorptiometry–like total femur BMD in 2110 men and 2682 women in the Age, Gene/Environment Susceptibility-Reykjavik Study. The combined bone score was generated by summing gender-specific Z-scores for 4 QCT measures: vertebral trabecular BMD, femur neck cortical thickness, femur neck trabecular BMD, and femur neck minimal cross-sectional area. Except for the latter measure, lower scores for QCT measures, singly and combined, showed positive (p < 0.05) associations with fractures. Results remained the same in stratified models for participants not taking bone-promoting medication. In women on bone-promoting medication, greater femur neck cortical thickness and trabecular BMD were significantly associated with fracture status. However, the association between fracture and combined bone score was not stronger than the associations between fracture and individual measures or total femur BMD. Thus, the selected measures did not all similarly associate with fracture status and did not appear to have an additive effect on fracture status. PMID:23562129

  1. High-temperature ceramic receivers

    SciTech Connect

    Jarvinen, P. O.

    1980-01-01

    An advanced ceramic dome cavity receiver is discussed which heats pressurized gas to temperatures above 1800/sup 0/F (1000/sup 0/C) for use in solar Brayton power systems of the dispersed receiver/dish or central receiver type. Optical, heat transfer, structural, and ceramic material design aspects of the receiver are reported and the development and experimental demonstration of a high-temperature seal between the pressurized gas and the high-temperature silicon carbide dome material is described.

  2. High temperature solar thermal receiver

    NASA Technical Reports Server (NTRS)

    1979-01-01

    A design concept for a high temperature solar thermal receiver to operate at 3 atmospheres pressure and 2500 F outlet was developed. The performance and complexity of windowed matrix, tube-header, and extended surface receivers were evaluated. The windowed matrix receiver proved to offer substantial cost and performance benefits. An efficient and cost effective hardware design was evaluated for a receiver which can be readily interfaced to fuel and chemical processes or to heat engines for power generation.

  3. Receiving signals of any polarization

    NASA Technical Reports Server (NTRS)

    Ohlson, J. E.; Seidel, B. L.; Stelzried, C. H.

    1981-01-01

    Two-channel detection accomodates linear, circular, and elliptical polarization in one receiving unit. Receiver employs orthomode transducer which breaks any type signal into one left and one right circular component. These are processed in separate receiver channels with equal time-delay, and then recombined for data extraction. System eliminates losses due to polarization mismatch.

  4. Self-assembled adult adipose-derived stem cell spheroids combined with biomaterials promote wound healing in a rat skin repair model.

    PubMed

    Hsu, Shan-Hui; Hsieh, Pai-Shan

    2015-01-01

    Adult adipose-derived stem cells (ASCs) are a type of multipotent mesenchymal stem cells (MSCs) with easy availability and serve as a potential cell source for cell-based therapy. Three-dimensional MSC spheroids may be derived from the self-assembly of individual MSCs grown on certain polymer membranes. In this study, we demonstrated that the self-assembled ASC spheroids on chitosan-hyaluronan membranes expressed more cytokine genes (fibroblast growth factor 1, vascular endothelial growth factor, and chemokine [C-C motif] ligand 2) as well as migration-associated genes (chemokine [C-X-C motif] receptor type 4 and matrix metalloprotease 1) compared with ASC dispersed single cells grown on culture dish. To evaluate the in vivo effects of these spheroids, we applied ASC single cells and ASC spheroids in a designed rat skin repair model. Wounds of 15 × 15 mm were created on rat dorsal skin, where ASCs were administered and covered with hyaluronan gel/chitosan sponge to maintain a moist environment. Results showed that skin wounds treated with ASC spheroids had faster wound closure and a significantly higher ratio of angiogenesis. Tracking of fluorescently labeled ASCs showed close localization of ASC spheroids to microvessels, suggesting enhanced angiogenesis through paracrine effects. Based on the in vitro and in vivo results, the self-assembled ASC spheroids may be a promising cellular source for skin tissue engineering and wound regeneration. PMID:25421559

  5. Behenoyl cytosine arabinoside, daunorubicin, 6-mercaptopurine, and prednisolone combination therapy for acute myelogenous leukemia in adults and prognostic factors related to remission duration and survival length.

    PubMed

    Ohno, R; Kato, Y; Nagura, E; Murase, T; Okumura, M; Yamada, H; Ogura, M; Minami, S; Suzuki, H; Morishima, Y

    1986-12-01

    Fifty-one consecutive previously untreated adult patients with acute myelogenous leukemia (AML) were treated with BHAC-DMP (N4-behenoyl-I-beta-D-arabinofuranosyl-cytosine, daunorubicin, 6-mercaptopurine, and prednisolone) therapy. Forty-two patients (82.4%) achieved complete remission (CR). The Kaplan-Meier analysis revealed a probability for remaining in remission of 14% and for survival of 23% at 6 years. Pretreatment factors related to the achievement of CR, such as age, French-American-British (FAB) classification and WBC at the start of treatment, were not identified. Factors related to the CR duration and survival time of the patients who had achieved CR were first analyzed by a univariate analysis with the generalized Wilcoxon test. WBC count at the start of treatment, percent of blasts in the marrow at 1 and 2 weeks after the initiation of therapy, days required until CR, number of courses of induction therapy required until CR, and days required for the disappearance of circulating blasts were identified as statistically significant prognostic factors. When these characteristics were further analyzed by the Cox multivariate regression model, the percent of blasts in the bone marrow at 2 weeks was the most important prognostic factor with a statistical significance, and WBC count at the start of treatment and days required until CR (or number of courses required to achieve CR) were also important factors, with borderline significance. PMID:3465875

  6. Cytogenetic and molecular diagnostic characterization combined to postconsolidation minimal residual disease assessment by flow cytometry improves risk stratification in adult acute myeloid leukemia.

    PubMed

    Buccisano, Francesco; Maurillo, Luca; Spagnoli, Alessandra; Del Principe, Maria Ilaria; Fraboni, Daniela; Panetta, Paola; Ottone, Tiziana; Consalvo, Maria Irno; Lavorgna, Serena; Bulian, Pietro; Ammatuna, Emanuele; Angelini, Daniela F; Diamantini, Adamo; Campagna, Selenia; Ottaviani, Licia; Sarlo, Chiara; Gattei, Valter; Del Poeta, Giovanni; Arcese, William; Amadori, Sergio; Lo Coco, Francesco; Venditti, Adriano

    2010-09-30

    A total of 143 adult acute myeloid leukemia (AML) patients with available karyotype (K) and FLT3 gene mutational status were assessed for minimal residual disease (MRD) by flow cytometry. Twenty-two (16%) patients had favorable, 115 (80%) intermediate, and 6 (4%) poor risk K; 19 of 129 (15%) carried FLT3-ITD mutation. Considering postconsolidation MRD status, patients with good/intermediate-risk K who were MRD(-) had 4-year relapse-free survival (RFS) of 70% and 63%, and overall survival (OS) of 84% and 67%, respectively. Patients with good- and intermediate-risk K who were MRD(+) had 4-year RFS of 15% and 17%, and OS of 38% and 23%, respectively (P < .001 for all comparisons). FLT3 wild-type patients achieving an MRD(-) status, had a better outcome than those who remained MRD(+) (4-year RFS, 54% vs 17% P < .001; OS, 60% vs 23%, P = .002). Such an approach redefined cytogenetic/genetic categories in 2 groups: (1) low-risk, including good/intermediate K-MRD(-) with 4-year RFS and OS of 58% and 73%, respectively; and (2) high risk, including poor-risk K, FLT3-ITD mutated cases, good/intermediate K-MRD(+) categories, with RFS and OS of 22% and 17%, respectively (P < .001 for all comparisons). In AML, the integrated evaluation of baseline prognosticators and MRD improves risk-assessment and optimizes postremission therapy. PMID:20548095

  7. The effects of the combination of egg and fiber on appetite, glycemic response and food intake in normal weight adults - a randomized, controlled, crossover trial.

    PubMed

    Bonnema, Angela L; Altschwager, Deena K; Thomas, William; Slavin, Joanne L

    2016-09-01

    This study evaluated appetite and glycemic effects of egg-based breakfasts, containing high and moderate protein (30 g protein and 20 g protein +7 g fiber, respectively) compared to a low-protein cereal breakfast (10 g protein) examined in healthy adults (N = 48; age 24 ± 1 yr; BMI 23 ± 1 kg/m(2); mean ± SE). Meals provided 390 kcal/serving and equal fat content. Food intake was measured at an ad libitum lunch meal and blood glucose response was measured. Visual analog scales (VAS) were used to assess hunger, satisfaction, fullness, and prospective food intake. The egg-based breakfast meal with high protein produced greater overall satiety (p < 0.0001), and both high protein and moderate protein with fiber egg-based breakfasts reduced postprandial glycemic response (p < 0.005) and food intake (p < 0.05) at subsequent meal (by 135 kcal and 69 kcal; effect sizes 0.44 and 0.23, respectively) compared to a cereal-based breakfast with low protein and fiber. PMID:27306734

  8. Monitoring the aquatic toxicity of mosquito vector control spray pesticides to freshwater receiving waters.

    PubMed

    Phillips, Bryn M; Anderson, Brian S; Voorhees, Jennifer P; Siegler, Katie; Denton, Debra; TenBrook, Patti; Larsen, Karen; Isorena, Philip; Tjeerdema, Ron S

    2014-07-01

    Pesticides are applied to state and local waterways in California to control insects such as mosquitoes, which are known to serve as a vector for West Nile Virus infection of humans. The California State Water Resources Control Board adopted a National Pollutant Discharge Elimination System General Permit to address the discharge to waters of the United States of pesticides resulting from adult and larval mosquito control. Because pesticides used in spray activities have the potential to cause toxicity to nontarget organisms in receiving waters, the current study was designed to determine whether toxicity testing provides additional, useful environmental risk information beyond chemical analysis in monitoring spray pesticide applications. Monitoring included a combination of aquatic toxicity tests and chemical analyses of receiving waters from agricultural, urban, and wetland habitats. The active ingredients monitored included the organophosphate pesticides malathion and naled, the pyrethroid pesticides etofenprox, permethrin, and sumithrin, pyrethrins, and piperonyl butoxide (PBO). Approximately 15% of the postapplication water samples were significantly toxic. Toxicity of half of these samples was attributed to the naled breakdown product dichlorvos. Toxicity of 2 other water samples likely occurred when PBO synergized the effects of pyrethroid pesticides that were likely present in the receiving system. Four of 43 postapplication sediment samples were significantly more toxic than their corresponding pre-application samples, but none of the observed toxicity was attributed to the application events. These results indicate that many of the spray pesticides used for adult mosquito control do not pose significant acute toxicity risk to invertebrates in receiving systems. In the case of naled in water, analysis of only the active ingredient underestimated potential impacts to the receiving system, because toxicity was attributed to the breakdown product, dichlorvos

  9. The Submillimeter Array Antennas and Receivers

    NASA Astrophysics Data System (ADS)

    Blundell, R.

    band, typically 80 - 100 GHz, and provide for relatively low receiver noise, typically 5 - 10 hv/k for the low frequency bands, and 10 - 15 hv/k for the 650 GHz receivers. Local oscillator power to each receiver is provided by a mechanically tunable Gunn oscillator followed by the appropriate diode frequency multiplier or multiplier combination.

  10. Reflux solar receiver design considerations

    NASA Astrophysics Data System (ADS)

    Diver, R. B.

    Reflux heat-pipe and pool-boiler receivers are being developed to improve upon the performance and life of directly-illuminated tube receiver technology used in previous successful demonstrations of dish-Stirling systems. The design of a reflux receiver involves engineering tradeoffs. In this paper, on-sun performance measurements of the Sandia pool-boiler receiver are compared with results from the reflux receiver thermal analysis model, AEETES. Flux and performance implications of various design options are analyzed and discussed.

  11. Advanced solar thermal receiver technology

    NASA Technical Reports Server (NTRS)

    Kudirka, A. A.; Leibowitz, L. P.

    1980-01-01

    Development of advanced receiver technology for solar thermal receivers designed for electric power generation or for industrial applications, such as fuels and chemical production or industrial process heat, is described. The development of this technology is focused on receivers that operate from 1000 F to 3000 F and above. Development strategy is mapped in terms of application requirements, and the related system and technical requirements. Receiver performance requirements and current development efforts are covered for five classes of receiver applications: high temperature, advanced Brayton, Stirling, and Rankine cycle engines, and fuels and chemicals.

  12. Effective treatment of a murine model of adult T-cell leukemia using 211At-7G7/B6 and its combination with unmodified anti-Tac (daclizumab) directed toward CD25.

    PubMed

    Zhang, Zhuo; Zhang, Meili; Garmestani, Kayhan; Talanov, Vladimir S; Plascjak, Paul S; Beck, Barbara; Goldman, Carolyn; Brechbiel, Martin W; Waldmann, Thomas A

    2006-08-01

    Adult T-cell leukemia (ATL) consists of an overabundance of T cells, which express CD25. Therapeutic efficacy of astatine-211 ((211)At)-labeled murine monoclonal antibody 7G7/B6 alone and in combination with daclizumab was evaluated in nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice given injections of MET-1 human T-cell leukemia cells. Daclizumab and 7G7/B6 are directed toward different epitopes of CD25. Either a single dose of 12 microCi (0.444 MBq) (211)At-7G7/B6 per mouse given intravenously or receptor-saturating doses of daclizumab given at 100 microg weekly for 4 weeks intravenously inhibited tumor growth as monitored by serum levels of human beta-2 microglobulin (beta(2)mu) and by prolonged survival of leukemia-bearing mice compared with the control groups (P < .001). The combination of 2 agents enhanced the antitumor effect when compared with groups treated with 12 microCi (0.444 MBq) of (211)At-7G7/B6 (P < .05) or daclizumab alone (P < .05). The median survival duration of the PBS group was 62.6 days and 61.5 days in the radiolabeled nonspecific antibody (211)At-11F11-treated group. In contrast, 91% of mice in the combination group survived through day 94. These results that demonstrate a significantly improved therapeutic efficacy by combining (211)At-7G7/B6 with daclizumab support a clinical trial of this regimen in patients with ATL. PMID:16569769

  13. Bragg-cell receiver study

    NASA Technical Reports Server (NTRS)

    Wilson, Lonnie A.

    1987-01-01

    Bragg-cell receivers are employed in specialized Electronic Warfare (EW) applications for the measurement of frequency. Bragg-cell receiver characteristics are fully characterized for simple RF emitter signals. This receiver is early in its development cycle when compared to the IFM receiver. Functional mathematical models are derived and presented in this report for the Bragg-cell receiver. Theoretical analysis is presented and digital computer signal processing results are presented for the Bragg-cell receiver. Probability density function analysis are performed for output frequency. Probability density function distributions are observed to depart from assumed distributions for wideband and complex RF signals. This analysis is significant for high resolution and fine grain EW Bragg-cell receiver systems.

  14. RFI receiver. [deep space network

    NASA Technical Reports Server (NTRS)

    Lay, R.

    1980-01-01

    An S-band radio frequency interference (RFI) receiver to analyze and identify sources of RFI problems in the Deep Space Network DSN tracking stations is described. The RFI receiver is a constant gain, double conversion, open loop receiver with dual sine/cosine channel outputs, providing a total of 20 MHZ monitoring capability. This receiver is computer controlled using a MODCOMP II miniprocessor. The RFI receiver has been designed to operate at a 150 Kelvin system noise temperature accomplished by cascading two low noise field effect transistor (FET) amplifiers for the receiver front-end. The first stage low noise FET amplifier is mounted at the feed horn to minimize any cable losses to achieve a lower system noise temperature. The receiver is tunable over the frequency range of 2150 to 2450 MHz in both sine/cosine output channels with a resolution of 100 kHz.

  15. Performance testing of lidar receivers

    NASA Technical Reports Server (NTRS)

    Shams, M. Y.

    1986-01-01

    In addition to the considerations about the different types of noise sources, dynamic range, and linearity of a lidar receiver, one requires information about the pulse shape retaining capabilities of the receiver. For this purpose, relatively precise information about the height resolution as well as the recovery time of the receiver, due both to large transients and to fast changes in the received signal, is required. As more and more analog receivers using fast analog to digital converters and transient recorders will be used in the future lidar systems, methods to test these devices are essential. The method proposed for this purpose is shown. Tests were carried out using LCW-10, LT-20, and FTVR-2 as optical parts of the optical pulse generator circuits. A commercial optical receiver, LNOR, and a transient recorder, VK 220-4, were parts of the receiver system.

  16. Communicating While Receiving Mechanical Ventilation: Texting With a Smartphone.

    PubMed

    Shiber, Joseph; Thomas, Ayesha; Northcutt, Ashley

    2016-03-01

    Two young adults with severe facial injuries were receiving care in the trauma/surgical intensive care unit at a tertiary care, level I trauma center in the southeastern United States. Both patients were able to communicate by texting on their cellphones to family members, friends, and caregivers in the intensive care unit. Patients who are awake and already have experience texting with a smartphone or other electronic handheld device may be able to communicate well while receiving mechanical ventilation. PMID:26932926

  17. Treatment of malignant gliomas and brain metastases in adults with a combination of adriamycin, VM 26, and CCNU. Results of a phase II trail.

    PubMed

    Pouillart, P; Mathe, G; Thy, T H; Lheritier, J; Poisson, M; Huguenin, P; Gauthier, H; Morin, P; Parrot, R

    1976-11-01

    Forty-three patients with inoperable or recurring malignant gliomas, and 30 patients with multiple recurring brain metastases were treated with a combination of Adriamycin (45 mg/m2) and 4-dimethyl-epipodophyllotoxin D-thenylidene (VM 26) (60 mg/m2 for 2 days) with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) (60 mg/m2 for 2 days). These cycles of treatment were repeated as soon as the hematologic restoration was complete. The treatment was well tolerated and the clinical condition of 31 of 43 glioblastoma patients improved during the 2 months after the beginning of the treatment. Six of eight patients with breast cancer metastases, one of 13 with bronchial cancer matastases, and three of nine with other types of cancer metastases also benefitted from the treatment. Examination of the results obtained revealed the following characteristics: 1) This combination had a low degree of efficiency in the treatment of metastases to brain, except for breast cancer metastases; 2) there was no complete correlation between the clinical results observed and the cinegammagraphic developments; 3) the results obtained were similar, independent of the initial localization; and a 6-month median survival period was established, with 10 patients now in a state of apparently complete remission, 180 to 506 days after beginning of the treatment. PMID:1033028

  18. Precision Continuum Receivers for Astrophysical Applications

    NASA Technical Reports Server (NTRS)

    Wollack, Edward J.

    2011-01-01

    Cryogenically cooled HEMT (High Electron Mobility Transistor) amplifiers find widespread use in radioastronomy receivers. In recent years, these devices have also been commonly employed in broadband receivers for precision measurements of the Cosmic Microwave Background (CMB) radiation. In this setting, the combination of ultra-low-noise and low-spectral-resolution observations reinforce the importance achieving suitable control over the device environment to achieve fundamentally limited receiver performance. The influence of the intrinsic amplifier stability at low frequencies on data quality (e.g., achievable noise and residual temporal correlations), observational and calibration strategies, as well as architectural mitigation approaches in this setting will be discussed. The implications of device level 1/f fluctuations reported in the literature on system performance will be reviewed.

  19. [Consensus document of Gesida and Spanish Secretariat for the National Plan on AIDS (SPNS) regarding combined antiretroviral treatment in adults infected by the human immunodeficiency virus (January 2012)].

    PubMed

    2012-06-01

    This consensus document has been prepared by a panel consisting of members of the AIDS Study Group (Gesida) and the Spanish Secretariat for the National Plan on AIDS (SPNS) after reviewing the efficacy and safety results of clinical trials, cohort and pharmacokinetic studies published in medical journals, or presented in medical scientific meetings. Gesida has prepared an objective and structured method to prioritise combined antiretroviral treatment (cART) in naïve patients. Recommendations strength (A, B, C) and the evidence which supports them (I, II, III) are based on a modification of the Infectious Diseases Society of America criteria. The current antiretroviral treatment (ART) of choice for chronic HIV infection is the combination of three drugs. ART is recommended in patients with symptomatic HIV infection, in pregnancy, in serodiscordant couples with high transmission risk, hepatitis B fulfilling treatment criteria, and HIV nephropathy. Guidelines on ART treatment in patients with concurrent diagnosis of HIV infection and an opportunistic type C infection are included. In asymptomatic patients ART is recommended on the basis of CD4 lymphocyte counts, plasma viral load and patient co-morbidities, as follows: 1) therapy should be started in patients with CD4 counts <350 cells/μL; 2) when CD4 counts are between 350 and 500 cells/μL, therapy will be recommended and only delayed if patient is reluctant to take it, the CD4 are stabilised, and the plasma viral load is low; 3) therapy could be deferred when CD4 counts are above 500 cells/μL, but should be considered in cases of cirrhosis, chronic hepatitis C, high cardiovascular risk, plasma viral load >10(5) copies/mL, proportion of CD4 cells <14%, and in people aged >55 years. ART should include 2 reverse transcriptase inhibitors nucleoside analogues and a third drug (non-analogue reverse transcriptase inhibitor, ritonavir boosted protease inhibitor or integrase inhibitor). The panel has consensually

  20. Aging in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Burt, Diana B.; Primeaux-Hart, Sharon; Loveland, Katherine A.; Cleveland, Lynne A.; Lewis, Kay R.; Lesser, Jary; Pearson, Pamela L.

    2005-01-01

    A cross-sequential design was used to examine changes related to aging in adults with and without Down syndrome (ns = 55 and 75, respectively). Adults received yearly neuropsychological and medical evaluations. Support for precocious aging in adults with Down syndrome was evident only on a test of verbal fluency, with weaker support obtained on a…

  1. Generalised receiver functions and seismic interferometry

    NASA Astrophysics Data System (ADS)

    Galetti, Erica; Curtis, Andrew

    2012-04-01

    Classical seismological receiver functions are correlational or deconvolutional combinations of vertical and horizontal component seismometer recordings of earthquake waves that focus information on near-receiver subsurface Earth structure and properties. We show that seismic interferometry can be thought of as a generalisation of receiver functions analysis to cases where recordings at pairs of receivers are considered simultaneously, and where either the same or different component recordings are combined. Further, seismic interferometry uses any of deconvolution, convolution and cross-correlation, and energy from either impulsive or random noise sources. We show both how receiver functions can logically be extended to a new, convolutional form, and that the now little-used correlational form of receiver functions contains more intuitive information than previously realised. Seismic interferometry has provided other extraordinary extensions to seismologists' arsenal. Passive noise recordings can be converted into seismograms from virtual (imagined) earthquakes that in turn can be used to image the real Earth. Active sources (e.g., earthquakes or man-made sources) can be redatumed into new, virtual sources elsewhere, or can be converted into virtual sensors (seismometers) that record seismograms from other real earthquakes, man-made sources or noise sources that occur either in the future or in the past. And the ability to construct virtual sources and sensors at desired times and locations (rather than having to wait for earthquake sources that occur at uncontrollable locations) promises more repeatable monitoring of changes in Earth subsurface properties over time. Indeed, so-called coda wave interferometry offers unprecedented accuracy in detecting such changes. Finally, existing theoretical extensions to other regimes such as electromagnetic, electrokinetic and diffusive energy propagation may lead to future revolutions in other domains of science.

  2. Pharmacokinetics of loratadine and pseudoephedrine following single and multiple doses of once- versus twice-daily combination tablet formulations in healthy adult males.

    PubMed

    Kosoglou, T; Radwanski, E; Batra, V K; Lim, J M; Christopher, D; Affrime, M B

    1997-01-01

    The pharmacokinetic profiles of single and multiple doses of loratadine, descarboethoxyloratadine (DCL) (the major active metabolite of loratadine), and pseudoephedrine were determined in a randomized, open-label, two-way crossover study in 24 healthy men. Subjects received a single dose (day 1) and multiple doses (days 3 to 10) of a once-daily (QD) formulation of loratadine 10 mg in an immediate-release coating and pseudoephedrine sulfate 240 mg in an extended-release core (CLAR-ITIN-D 24 HOUR tablets), and a twice-daily (BID) formulation of loratadine 5 mg in an immediate-release coating and pseudoephedrine sulfate 120 mg, with 60 mg in an immediate-release coating and 60 mg in the barrier-protected core (CLARITIN-D 12 HOUR tablets) in study sessions, each separated by a 10-day washout period. Both regimens were safe and well tolerated. On day 1, plasma loratadine, DCL, and pseudoephedrine concentrations were higher following the QD formulation than following the BID formulation, as expected. On day 10, loratadine and DCL maximum plasma concentration (Cmax) values were, on average, 87% and 35% higher, respectively, for the QD formulation than for the BID formulation; however, the values of the area under the plasma concentration-time curve from 0 to 24 hours (AUC0-24) for loratadine and DCL were equivalent (90% confidence interval [CI]: 83% to 110% for loratadine; 90% to 107% for DCL). On day 10, pseudoephedrine Cmax and AUC0-24 values were equivalent (90% CI for Cmax: 94% to 109%; for AUC: 91% to 106%) for the two formulations, and lower pseudoephedrine concentrations were observed from 16 to 24 hours with the QD formulation. Both loratadine/pseudoephedrine formulations produced equivalent loratadine and DCL AUC0-24 values and equivalent pseudoephedrine Cmax and AUC0-24 values following multiple dosing. The lower pseudoephedrine concentrations in the evening with the QD formulation may minimize the potential for insomnia in patients when compared with the BID

  3. Effects of combined exposure to 17α-ethynylestradiol and dibutyl phthalate on the growth and reproduction of adult male zebrafish (Danio rerio).

    PubMed

    Xu, Nan; Chen, Pengyu; Liu, Lei; Zeng, Yaqiong; Zhou, Haixia; Li, Song

    2014-09-01

    To evaluate the combined effects of 17α-ethynylestradiol (EE2) and dibutyl phthalate (DBP) on the growth and reproduction of male zebrafish, three-month-old fish were exposed to 0.005 or 0.020µg/L EE2, 100 or 500µg/L DBP or their binary mixtures under semi-static conditions. Investigated parameters include the length, weight, condition factor, vitellogenin (VTG) induction, acyl-CoA oxidase (AOX) protein level, histopathological alteration of testis, liver and gill, and reproductive capacity. After 21d exposure, no statistical difference was found among the weights, lengths and condition factors of different treatment groups. In all binary mixture groups, decreased VTG levels were detected compared to EE2-only groups; and the AOX levels were significantly lower than DBP-only treatments while both chemicals can individually induce AOX synthesis. Therefore, EE2 and DBP may act additively on VTG and antagonistically on AOX induction in males. After 45d exposure, delayed gametogenesis was observed for the DBP-only groups, indicated by fewer spermatozoa and more spermatocytes, which was further aggravated with the addition of EE2. The developmental delay of testis partially recovered after a 30d depuration in clean water. Combined exposure also caused liver and gill lesions, which were not alleviated during the 30d depuration, suggesting a nonreversible harmful effect the same as single exposure. Mixed EE2 and DBP were observed to impair the reproductive capability (the fecundity and fertilization rate) of males, while single exposure did not. Co-exposed to 0.020µg/L EE2 and 100µg/L DBP promoted the early hatching of offspring (F1 generation) at 48h post-fertilization (hpf), but the survival rates of the F1 generation were similar in all treatments. Our findings indicate that the effects of mixed EE2 and DBP at environmentally relevant levels can be either antagonistic or additive relying on the specific toxicological endpoints and the respective doses of each

  4. Therapeutic Assessment of Chloroquine-Primaquine Combined Regimen in Adult Cohort of Plasmodium vivax Malaria from Primary Care Centres in Southwestern India

    PubMed Central

    Saravu, Kavitha; Kumar, Rishikesh; Ashok, Herikudru; Kundapura, Premananda; Kamath, Veena; Kamath, Asha; Mukhopadhyay, Chiranjay

    2016-01-01

    Background Several reports of chloroquine treatment failure and resistance in Plasmodium vivax malaria from Southeast Asian countries have been published. Present study was undertaken to assess the efficacy of chloroquine-primaquine (CQ-PQ) combined regimen for the treatment of P. vivax malaria patients who were catered by the selected primary health centres (PHCs) of Udupi taluk, Udupi district, Karnataka, India. Method Five PHCs were selected within Udupi taluk based on probability proportional to size. In-vivo therapeutic efficacy assessment of CQ (1500 mg over three days) plus PQ (210 mg over 14 days) regimen was carried out in accordance with the World Health Organization’s protocol of 28 days follow-up among microscopically diagnosed monoinfection P. vivax cohort. Results In total, 161 participants were recruited in the study of which, 155 (96.3%) participants completed till day 28 follow-up, fully complied with the treatment regimen and showed adequate clinical and parasitological response. Loss to follow up was noted with 5 (3.1%) participants and non-compliance with treatment regimen occurred with one participant (0.6%). Glucose-6-phosphate dehydrogenase deficiency (G6PDd, <30% of normal mean activity) was noted among 5 (3.1%) participants and one of them did develop PQ induced dark-brown urination which subsided after PQ discontinuation. G6PDd patients were treated with PQ 45 mg/week for eight weeks while PQ was discontinued in one case with G6PD 1.4 U/g Hb due to complaint of reddish-brown coloured urine by 48 hours of PQ initiation. Nested polymerase chain reaction test revealed 45 (28%) cases as mixed (vivax and falciparum) malaria. Conclusions The CQ-PQ combined regimen remains outstandingly effective to treat uncomplicated P. vivax malaria in Udupi taluk and thus it should continue as first line regimen. For all P. vivax cases, G6PD screening before PQ administration must be mandatory and made available in all PHCs. PMID:27315280

  5. Combined fluticasone furoate/vilanterol reduces decline in lung function following inhaled allergen 23 h after dosing in adult asthma: a randomised, controlled trial

    PubMed Central

    2012-01-01

    Background There is a need for preventative asthma maintenance therapy that provides lasting bronchoprotection against allergen provocation. Fluticasone furoate (FF) is a novel inhaled once-daily corticosteroid, being investigated as monotherapy for asthma and in combination with vilanterol (VI), a novel inhaled once-daily long-acting beta-agonist, for asthma and chronic obstructive pulmonary disease. Methods In a crossover study of 52 subjects with mild asthma, FF/VI 100/25mcg and FF 100 dosed once-daily in the evening for 28 days were compared with placebo to evaluate their capacity to provide bronchoprotection against the early asthmatic response (EAR) stimulated by an inhaled allergen challenge. Bronchoprotection was assessed by change from post-saline baseline in weighted mean (wm) forced expiratory volume in 1 s (FEV1) for the first 2 h post-allergen challenge, which was on Day 29 (22–23 h post final dose on Day 28). The EAR was also assessed using maximum percent decrease from post-saline baseline and minimum absolute FEV1; the incidence of adverse events was a secondary endpoint. Results FF/VI 100/25 and FF 100 both provided significant bronchoprotection against the EAR for all endpoints assessed. For wmFEV1 over the first 2 h post-allergen challenge, a 162 mL (95% CI, 87 to 237 mL) difference was observed between placebo and FF 100, while a 145 mL (95% CI, 69 to 222 mL) difference was observed between placebo and FF/VI 100/25 treatment. No difference between active treatments was observed (−17 mL; 95% CI, –91 to 57 mL). Both treatments were well tolerated. Conclusions FF 100 alone and in combination with VI 25 provides significant bronchoprotection against the EAR in subjects with mild asthma. That this protection is provided at the trough of dosing, i.e. 23 h post last dose, supports the utility of FF 100 and FF/VI 100/25 as viable once-daily therapies. Trial registration Clinicaltrials.gov identifier: NCT01128569, GSK Study

  6. Immigration: perspectives from receiving countries.

    PubMed

    Weiner, M

    1990-01-01

    The author examines the issue of international migration from the standpoint of receiving countries. He attempts "to understand how and why migrant-receiving countries respond as they do, and to suggest some of the new issues in international migration that arise in a world in which the supply of would-be migrants and refugees is now greater than receiving countries are willing to accept." PMID:12283227

  7. Depression in Older Adults

    PubMed Central

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2010-01-01

    Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support. PMID:19327033

  8. Performance outlook of the SCRAP receiver

    NASA Astrophysics Data System (ADS)

    Lubkoll, Matti; von Backström, Theodor W.; Harms, Thomas M.

    2016-05-01

    A combined cycle (CC) concentrating solar power (CSP) plant provides significant potential to achieve an efficiency increase and an electricity cost reduction compared to current single-cycle plants. A CC CSP system requires a receiver technology capable of effectively transferring heat from concentrated solar irradiation to a pressurized air stream of a gas turbine. The small number of pressurized air receivers demonstrated to date have practical limitations, when operating at high temperatures and pressures. As yet, a robust, scalable and efficient system has to be developed and commercialized. A novel receiver system, the Spiky Central Receiver Air Pre-heater (SCRAP) concept has been proposed to comply with these requirements. The SCRAP system is conceived as a solution for an efficient and robust pressurized air receiver that could be implemented in CC CSP concepts or standalone solar Brayton cycles without a bottoming Rankine cycle. The presented work expands on previous publications on the thermal modeling of the receiver system. Based on the analysis of a single heat transfer element (spike), predictions for its thermal performance can be made. To this end the existing thermal model was improved by heat transfer characteristics for the jet impingement region of the spike tip as well as heat transfer models simulating the interaction with ambient. While the jet impingement cooling effect was simulated employing a commercial CFD code, the ambient heat transfer model was based on simplifying assumptions in order to employ empirical and analytical equations. The thermal efficiency of a spike under design conditions (flux 1.0 MW/m2, air outlet temperature just below 800 °C) was calculated at approximately 80 %, where convective heat losses account for 16.2 % of the absorbed radiation and radiative heat losses for a lower 2.9 %. This effect is due to peak surface temperatures occurring at the root of the spikes. It can thus be concluded that the geometric

  9. Pseudoloma neurophilia Infection Combined with Gamma Irradiation Causes Increased Mortality in Adult Zebrafish (Danio rerio) Compared to Infection or Irradiation Alone: New Implications for Studies Involving Immunosuppression.

    PubMed

    Spagnoli, Sean T; Sanders, Justin L; Watral, Virginia; Kent, Michael L

    2016-07-01

    Gamma irradiation is commonly used as a bone marrow suppressant in studies of the immune system and hematopoiesis, most commonly in mammals. With the rising utility and popularity of the zebrafish (Danio rerio), gamma irradiation is being used for similar studies in this species. Pseudoloma neurophilia, a microparasite and common contaminant of zebrafish facilities, generally produces subclinical disease. However, like other microsporidia, P. neurophilia is a disease of opportunity and can produce florid infections with high morbidity and mortality, secondary to stress or immune suppression. In this study, we exposed zebrafish to combinations of P. neurophilia infection and gamma irradiation to explore the interaction between this immunosuppressive experimental modality and a normally subclinical infection. Zebrafish infected with P. neurophilia and exposed to gamma irradiation exhibited higher mortality, increased parasite loads, and increased incidences of myositis and extraneural parasite infections than fish exposed either to P. neurophilia or gamma irradiation alone. This experiment highlights the devastating effects of opportunistic diseases on immunosuppressed individuals and should caution researchers utilizing immunosuppressive modalities to carefully monitor their stocks to ensure that their experimental animals are not infected. PMID:27123755

  10. EVALUATION OF NEONATE SQUIRREL MONKEYS RECEIVING TRITIATED WATER THROUGHOUT GESTATION

    EPA Science Inventory

    The effect of receiving tritiated water (HTO) throughout gestation on the developing primate was assessed by administering HTO to adult female squirrel monkeys (Saimiri sciureus) as the only source of drinking water beginning with the day of insemination and continuing throughout...

  11. Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: Results of the JAGES.

    PubMed

    Tani, Yukako; Kondo, Naoki; Takagi, Daisuke; Saito, Masashige; Hikichi, Hiroyuki; Ojima, Toshiyuki; Kondo, Katsunori

    2015-12-01

    We examined whether eating alone is associated with dietary behaviors and body weight status, and assessed the modifying effects of cohabitation status in older Japanese people. Data from the 2010 Japan Gerontological Evaluation Study, with a self-reported questionnaire for 38,690 men and 43,674 women aged ≥65 years, were used. Eating status was classified as eating with others, sometimes eating alone, or exclusively eating alone. We calculated adjusted prevalence ratios (APRs) of unhealthy dietary behaviors, obesity, and underweight, adjusting for age, education, income, disease, and dental status using Poisson regression. Overall, 16% of men and 28% of women sometimes or exclusively ate alone. Among those who exclusively ate alone, 56% of men and 68% of women lived alone. Men who exclusively ate alone were 3.74 times more likely to skip meals than men who ate with others. Among men who exclusively ate alone, those who lived alone had a higher APR than men who lived with others. Compared with subjects who ate and lived with others, the APRs of being obese (BMI ≥ 30.0 kg/m(2)) among men who exclusively ate alone were 1.34 (1.01-1.78) in those who lived alone and 1.17 (0.84-1.64) in those who lived with others. These combined effects of eating and living alone were weaker in women, with a potential increase in the APRs among those who ate alone despite living with others. Men who exclusively ate alone were more likely to be underweight (BMI < 18.5 kg/m(2)) than men who ate with others in both cohabitation statuses. Eating alone and living alone may be jointly associated with higher prevalence of obesity, underweight and unhealthy eating behaviors in men. PMID:26116391

  12. UWB delay and multiply receiver

    DOEpatents

    Dallum, Gregory E.; Pratt, Garth C.; Haugen, Peter C.; Romero, Carlos E.

    2013-09-10

    An ultra-wideband (UWB) delay and multiply receiver is formed of a receive antenna; a variable gain attenuator connected to the receive antenna; a signal splitter connected to the variable gain attenuator; a multiplier having one input connected to an undelayed signal from the signal splitter and another input connected to a delayed signal from the signal splitter, the delay between the splitter signals being equal to the spacing between pulses from a transmitter whose pulses are being received by the receive antenna; a peak detection circuit connected to the output of the multiplier and connected to the variable gain attenuator to control the variable gain attenuator to maintain a constant amplitude output from the multiplier; and a digital output circuit connected to the output of the multiplier.

  13. Cumberland Valley School District's "High School Diploma Program for Adults." How This Program Can Be Modeled by Local School Districts and Educational Agencies.

    ERIC Educational Resources Information Center

    Gruber, Samuel C.

    Since 1976, the Cumberland Valley School District (Mechanicsburg, Pennsylvania) has offered an external high school diploma program for adults that combines academic achievement with life skill competencies. In 1995-1996, the Cumberland Valley School District received funds to recruit three educational agencies/school districts willing to…

  14. Customizable Digital Receivers for Radar

    NASA Technical Reports Server (NTRS)

    Moller, Delwyn; Heavey, Brandon; Sadowy, Gregory

    2008-01-01

    Compact, highly customizable digital receivers are being developed for the system described in 'Radar Interferometer for Topographic Mapping of Glaciers and Ice Sheets' (NPO-43962), NASA Tech Briefs, Vol. 31, No. 7 (August 2007), page 72. The receivers are required to operate in unison, sampling radar returns received by the antenna elements in a digital beam-forming (DBF) mode. The design of these receivers could also be adapted to commercial radar systems. At the time of reporting the information for this article, there were no commercially available digital receivers capable of satisfying all of the operational requirements and compact enough to be mounted directly on the antenna elements. A provided figure depicts the overall system of which the digital receivers are parts. Each digital receiver includes an analog-to-digital converter (ADC), a demultiplexer (DMUX), and a field-programmable gate array (FPGA). The ADC effects 10-bit band-pass sampling of input signals having frequencies up to 3.5 GHz. The input samples are demultiplexed at a user-selectable rate of 1:2 or 1:4, then buffered in part of the FPGA that functions as a first-in/first-out (FIFO) memory. Another part of the FPGA serves as a controller for the ADC, DMUX, and FIFO memory and as an interface between (1) the rest of the receiver and (2) a front-panel data port (FPDP) bus, which is an industry-standard parallel data bus that has a high data-rate capability and multichannel configuration suitable for DBF. Still other parts of the FPGA in each receiver perform signal-processing functions. The digital receivers can be configured to operate in a stand-alone mode, or in a multichannel mode as needed for DBF. The customizability of the receiver makes it applicable to a broad range of system architectures. The capability for operation of receivers in either a stand-alone or a DBF mode enables the use of the receivers in an unprecedentedly wide variety of radar systems.

  15. Effects of Combined Calcium and Vitamin D Supplementation on Insulin Secretion, Insulin Sensitivity and β-Cell Function in Multi-Ethnic Vitamin D-Deficient Adults at Risk for Type 2 Diabetes: A Pilot Randomized, Placebo-Controlled Trial

    PubMed Central

    Gagnon, Claudia; Daly, Robin M.; Carpentier, André; Lu, Zhong X.; Shore-Lorenti, Catherine; Sikaris, Ken; Jean, Sonia; Ebeling, Peter R.

    2014-01-01

    Objectives To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, β-cell function, inflammation and metabolic markers. Design 6-month randomized, placebo-controlled trial. Participants Ninety-five adults with serum 25-hydroxyvitamin D [25(OH)D] ≤55 nmol/L at risk of type 2 diabetes (with prediabetes or an AUSDRISK score ≥15) were randomized. Analyses included participants who completed the baseline and final visits (treatment n = 35; placebo n = 45). Intervention Daily calcium carbonate (1,200 mg) and cholecalciferol [2,000–6,000 IU to target 25(OH)D >75 nmol/L] or matching placebos for 6 months. Measurements Insulin sensitivity (HOMA2%S, Matsuda index), insulin secretion (insulinogenic index, area under the curve (AUC) for C-peptide) and β-cell function (Matsuda index x AUC for C-peptide) derived from a 75 g 2-h OGTT; anthropometry; blood pressure; lipid profile; hs-CRP; TNF-α; IL-6; adiponectin; total and undercarboxylated osteocalcin. Results Participants were middle-aged adults (mean age 54 years; 69% Europid) at risk of type 2 diabetes (48% with prediabetes). Compliance was >80% for calcium and vitamin D. Mean serum 25(OH)D concentration increased from 48 to 95 nmol/L in the treatment group (91% achieved >75 nmol/L), but remained unchanged in controls. There were no significant changes in insulin sensitivity, insulin secretion and β-cell function, or in inflammatory and metabolic markers between or within the groups, before or after adjustment for potential confounders including waist circumference and season of recruitment. In a post hoc analysis restricted to participants with prediabetes, a significant beneficial effect of vitamin D and calcium supplementation on insulin sensitivity (HOMA%S and Matsuda) was observed. Conclusions Daily vitamin D and calcium supplementation for 6 months may not change OGTT-derived measures of insulin sensitivity, insulin secretion and

  16. Adult Compacts.

    ERIC Educational Resources Information Center

    Further Education Unit, London (England).

    This bulletin focuses on adult compacts, three-way agreements among employers, potential employees, and trainers to provide the right kind of quality training to meet the employers' requirements. Part 1 is an executive summary of a report of the Adult Compacts Project, which studied three adult compacts in Birmingham and Loughborough, England, and…

  17. Optical receivers with large-diameter photodiode

    NASA Astrophysics Data System (ADS)

    Swoboda, Robert; Schneider, Kerstin; Zimmermann, Horst

    2006-04-01

    This work presents two types of optical receivers with large-diameter photodiodes. Both are optoelectronic integrated circuits (OEICs) realized in 0.6μm BiCMOS Si technology integrating PIN photodiode, transimpedance amplifier (TIA) and output circuit on chip. The two circuits are an optocoupler with a photodiode diameter of 780μm and a rise- and falltime of 5ns and 4.9ns respectively at 850nm light and a plastic optical fiber (POF) receiver with a photodiode diameter of 500μm and upper -3dB cut-off frequencies of 165MHz at 660nm light and 148MHz at 850nm light. The measured rise- and falltime of the POF receiver was 1.78ns and 2.45ns at 660nm light and 1.94ns and 2.5ns at 850ns, respectively. The presented results combine the advantage of easier handling of large-diameter photodiode receivers and high performance.

  18. Adult Vaccinations | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Adult Vaccinations Adults Need Vaccines, Too! Past Issues / Summer 2015 ... high-risk medical conditions had received a pneumococcal vaccination. Only about 1 out of 4 (24 percent) ...

  19. Coe Receives 2007 Gilbert Award

    NASA Astrophysics Data System (ADS)

    Bogue, Scott W.; Coe, Robert S.

    2008-05-01

    Robert S. Coe received the 2007 William Gilbert Award at the 2007 AGU Fall Meeting in San Francisco, Calif. The award recognizes outstanding and unselfish work in magnetism of Earth materials and of the Earth and planets.

  20. Streak camera receiver definition study

    NASA Technical Reports Server (NTRS)

    Johnson, C. B.; Hunkler, L. T., Sr.; Letzring, S. A.; Jaanimagi, P.

    1990-01-01

    Detailed streak camera definition studies were made as a first step toward full flight qualification of a dual channel picosecond resolution streak camera receiver for the Geoscience Laser Altimeter and Ranging System (GLRS). The streak camera receiver requirements are discussed as they pertain specifically to the GLRS system, and estimates of the characteristics of the streak camera are given, based upon existing and near-term technological capabilities. Important problem areas are highlighted, and possible corresponding solutions are discussed.

  1. Next generation digital GPS receiver

    NASA Astrophysics Data System (ADS)

    Frank, G. B.; Yakos, Michael D.

    1990-07-01

    The architecture and technology features of the next-generation (NGR) digital GPS receiver manufactured by Collins are described. The project's objective was to develop an advanced GPS receiver chipset with high antijam capabilities. The program, initiated in 1985, has provided the technology for miniature receiver products for both unmanned and manned vehicle applications. A two-channel version of the receiver is currently in full-scale development for tactical missile applications. A five-channel version is being tested and evaluated as a drop-in replacement for RCVR-3A, the US Department of Defense standard high dynamic receiver. The NGR design started with the digital signal processing architecture developed for the Defense Advanced Research Project Agency (DARPA) hand-held GPS receiver. Enhancements were made to improve the antijam and signal acquisition performance. Producible, qualifiable and cost-effective silicon monolithic microwave integrated circuits and semicustom digital technologies were used to develop the core GPS chipset. A system design approach was established to permit reuse of mature and validated GPS software.

  2. Solar dynamic heat receiver technology

    NASA Technical Reports Server (NTRS)

    Sedgwick, Leigh M.

    1991-01-01

    A full-size, solar dynamic heat receiver was designed to meet the requirements specified for electrical power modules on the U.S. Space Station, Freedom. The heat receiver supplies thermal energy to power a heat engine in a closed Brayton cycle using a mixture of helium-xenon gas as the working fluid. The electrical power output of the engine, 25 kW, requires a 100 kW thermal input throughout a 90 minute orbit, including when the spacecraft is eclipsed for up to 36 minutes from the sun. The heat receiver employs an integral thermal energy storage system utilizing the latent heat available through the phase change of a high-temperature salt mixture. A near eutectic mixture of lithium fluoride and calcium difluoride is used as the phase change material. The salt is contained within a felt metal matrix which enhances heat transfer and controls the salt void distribution during solidification. Fabrication of the receiver is complete and it was delivered to NASA for verification testing in a simulated low-Earth-orbit environment. This document reviews the receiver design and describes its fabrication history. The major elements required to operate the receiver during testing are also described.

  3. Sense and sensitivity: How ALMA receivers work

    NASA Astrophysics Data System (ADS)

    Wilson, T. L.; Mauersberger, R.; Hales, A.

    2010-09-01

    In previous articles, we described how electromagnetic waves emitted from objects in the sky are collected by the ALMA antennas (Anatomy of ALMA), and how they are combined in order to produce images. Before these images can be processed, they are picked up by the antennas and concentrated by the large main mirror and a smaller secondary mirror in the so called focal point of each antenna. In order to process the data they must be first converted to electromagnetic waves of a lower frequency and amplified. This is the role of the ALMA receivers. In principle they work like a normal FM receiver, but at much higher frequencies. Here we describe how they work and what makes them special.

  4. Fused silica windows for solar receiver applications

    NASA Astrophysics Data System (ADS)

    Hertel, Johannes; Uhlig, Ralf; Söhn, Matthias; Schenk, Christian; Helsch, Gundula; Bornhöft, Hansjörg

    2016-05-01

    A comprehensive study of optical and mechanical properties of quartz glass (fused silica) with regard to application in high temperature solar receivers is presented. The dependence of rupture strength on different surface conditions as well as high temperature is analyzed, focussing particularly on damage by devitrification and sandblasting. The influence of typical types of contamination in combination with thermal cycling on the optical properties of fused silica is determined. Cleaning methods are compared regarding effectiveness on contamination-induced degradation for samples with and without antireflective coating. The FEM-aided design of different types of receiver windows and their support structure is presented. A large-scale production process has been developed for producing fused silica dome shaped windows (pressurized window) up to a diameter of 816 mm. Prototypes were successfully pressure-tested in a test bench and certified according to the European Pressure Vessel Directive.

  5. Life Course Status and Exchanges of Support between Young Adults and Parents

    ERIC Educational Resources Information Center

    Bucx, Freek; van Wel, Frits; Knijn, Trudie

    2012-01-01

    The authors investigated intergenerational support exchanges in relation to young adults' life course status. In a sample of 2,022 young adults (ages 18-34 years) in The Netherlands, single young adults reported receiving more advice from parents than married young adults, and those with children of their own received more practical support.…

  6. Comparison between Coherent and Noncoherent Receivers for UWB Communications

    NASA Astrophysics Data System (ADS)

    Durisi, Giuseppe; Benedetto, Sergio

    2005-12-01

    We present a comparison between coherent and noncoherent UWB receivers, under a realistic propagation environment, that takes into account also the effect of path-dependent pulse distortion. As far as coherent receivers are concerned, both maximal ratio combining (MRC) and equal gain combining (EGC) techniques are analyzed, considering a limited number of estimated paths. Furthermore, two classical noncoherent schemes, a differential detector, and a transmitted-reference receiver, together with two iterative solutions, recently proposed in the literature, are considered. Finally, we extend the multisymbol approach to the UWB case and we propose a decision-feedback receiver that reduces the complexity of the previous strategy, thus still maintaining good performance. While traditional noncoherent receivers exhibit performance loss, if compared to coherent detectors, the iterative and the decision-feedback ones are able to guarantee error probability close to the one obtained employing an ideal RAKE, without requiring channel estimation, in the presence of static indoor channel and limited multiuser interference.

  7. FAST CP: protocol of a randomised controlled trial of the efficacy of a 12-week combined Functional Anaerobic and Strength Training programme on muscle properties and mechanical gait deficiencies in adolescents and young adults with spastic-type cerebral palsy

    PubMed Central

    Gillett, Jarred G; Lichtwark, Glen A; Boyd, Roslyn N; Barber, Lee A

    2015-01-01

    Introduction Individuals with cerebral palsy (CP) have muscles that are smaller, weaker and more resistant to stretch compared to typically developing people. Progressive resistance training leads to increases in muscle size and strength. In CP, the benefits of resistance training alone may not transfer to improve other activities such as walking; however, the transfer of strength improvements to improved mobility may be enhanced by performing training that involves specific functional tasks or motor skills. This study aims to determine the efficacy of combined functional anaerobic and strength training in (1) influencing muscle strength, structure and function and (2) to determine if any changes in muscle strength and structure following training impact on walking ability and gross motor functional capacity and performance in the short (following 3 months of training) and medium terms (a further 3 months post-training). Methods and analysis 40 adolescents and young adults with CP will be recruited to undertake a 12-week training programme. The training programme will consist of 3×75 min sessions per week, made up of 5 lower limb resistance exercises and 2–3 functional anaerobic exercises per session. The calf muscles will be specifically targeted, as they are the most commonly impacted muscles in CP and are a key muscle group involved in walking. If, as we believe, muscle properties change following combined strength and functional training, there may be long-term benefits of this type of training in slowing the deterioration of muscle function in people with spastic-type CP. Ethics and dissemination Ethical approval has been obtained from the ethics committees at The University of Queensland (2014000066) and Children's Health Queensland (HREC/15/QRCH/30). The findings will be disseminated by publications in peer-reviewed journals, conferences and local research organisations’ media. Trial registration number Australian and New Zealand Clinical Trials

  8. PPM Receiver Implemented in Software

    NASA Technical Reports Server (NTRS)

    Gray, Andrew; Kang, Edward; Lay, Norman; Vilnrotter, Victor; Srinivasan, Meera; Lee, Clement

    2010-01-01

    A computer program has been written as a tool for developing optical pulse-position- modulation (PPM) receivers in which photodetector outputs are fed to analog-to-digital converters (ADCs) and all subsequent signal processing is performed digitally. The program can be used, for example, to simulate an all-digital version of the PPM receiver described in Parallel Processing of Broad-Band PPM Signals (NPO-40711), which appears elsewhere in this issue of NASA Tech Briefs. The program can also be translated into a design for digital PPM receiver hardware. The most notable innovation embodied in the software and the underlying PPM-reception concept is a digital processing subsystem that performs synchronization of PPM time slots, even though the digital processing is, itself, asynchronous in the sense that no attempt is made to synchronize it with the incoming optical signal a priori and there is no feedback to analog signal processing subsystems or ADCs. Functions performed by the software receiver include time-slot synchronization, symbol synchronization, coding preprocessing, and diagnostic functions. The program is written in the MATLAB and Simulink software system. The software receiver is highly parameterized and, hence, programmable: for example, slot- and symbol-synchronization filters have programmable bandwidths.

  9. UWB communication receiver feedback loop

    DOEpatents

    Spiridon, Alex; Benzel, Dave; Dowla, Farid U.; Nekoogar, Faranak; Rosenbury, Erwin T.

    2007-12-04

    A novel technique and structure that maximizes the extraction of information from reference pulses for UWB-TR receivers is introduced. The scheme efficiently processes an incoming signal to suppress different types of UWB as well as non-UWB interference prior to signal detection. Such a method and system adds a feedback loop mechanism to enhance the signal-to-noise ratio of reference pulses in a conventional TR receiver. Moreover, sampling the second order statistical function such as, for example, the autocorrelation function (ACF) of the received signal and matching it to the ACF samples of the original pulses for each transmitted bit provides a more robust UWB communications method and system in the presence of channel distortions.

  10. Frequency synthesizers for telemetry receivers

    NASA Astrophysics Data System (ADS)

    Stirling, Ronald C.

    1990-07-01

    The design of a frequency synthesizer is presented for telemetry receivers. The synthesizer contains two phase-locked loops, each with a programmable frequency counter, and incorporates fractional frequency synthesis but does not use a phase accumulator. The selected receiver design has a variable reference loop operating as a part of the output loop. Within the synthesizer, a single VTO generates the output frequency that is voltage-tunable from 375-656 MHz. The single-sideband phase noise is measured with an HP 8566B spectrum analyzer, and the receiver's bit error rate (BER) is measured with a carrier frequency of 250 MHz, synthesized LO at 410 MHz, and the conditions of BPSK, NRZ-L, and 2.3 kHz bit rate. The phase noise measurement limits and the BER performance data are presented in tabular form.

  11. Receiver-exciter controller design

    NASA Astrophysics Data System (ADS)

    Jansma, P. A.

    1982-06-01

    A description of the general design of both the block 3 and block 4 receiver-exciter controllers for the Deep Space Network (DSN) Mark IV-A System is presented along with the design approach. The controllers are designed to enable the receiver-exciter subsystem (RCV) to be configured, calibrated, initialized and operated from a central location via high level instructions. The RECs are designed to be operated under the control of the DMC subsystem. The instructions are in the form of standard subsystem blocks (SSBs) received via the local area network (LAN). The centralized control provided by RECs and other DSCC controllers in Mark IV-A is intended to reduce DSN operations costs from the Mark III era.

  12. Receiver-exciter controller design

    NASA Technical Reports Server (NTRS)

    Jansma, P. A.

    1982-01-01

    A description of the general design of both the block 3 and block 4 receiver-exciter controllers for the Deep Space Network (DSN) Mark IV-A System is presented along with the design approach. The controllers are designed to enable the receiver-exciter subsystem (RCV) to be configured, calibrated, initialized and operated from a central location via high level instructions. The RECs are designed to be operated under the control of the DMC subsystem. The instructions are in the form of standard subsystem blocks (SSBs) received via the local area network (LAN). The centralized control provided by RECs and other DSCC controllers in Mark IV-A is intended to reduce DSN operations costs from the Mark III era.

  13. Central solar-energy receiver

    DOEpatents

    Not Available

    1981-10-27

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan is described. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  14. The GBT 4mm Receiver

    NASA Astrophysics Data System (ADS)

    Frayer, David T.; White, S.; Watts, G.; Stennes, M.; Maddalena, R. J.; Simon, R.; Pospieszalski, M.; Bryerton, E.

    2013-01-01

    The new 4mm receiver (67--93 GHz) for the Robert C. Byrd Green Bank Telescope (GBT) was built to take advantage of the improved surface accuracy of the dish. The low frequency end of the 3mm atmospheric window is not available with ALMA (<84 GHz), and the sensitivity of the GBT is better than any other facility within this band. We discuss the design and performance of this new receiver for the GBT, and highlight the science opportunities available with the instrument. The National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc.

  15. Digital Receiver for Microwave Radiometry

    NASA Technical Reports Server (NTRS)

    Ellingson, Steven W.; Hampson, Grant A.; Johnson, Joel T.

    2005-01-01

    A receiver proposed for use in L-band microwave radiometry (for measuring soil moisture and sea salinity) would utilize digital signal processing to suppress interfering signals. Heretofore, radio frequency interference has made it necessary to limit such radiometry to a frequency band about 20 MHz wide, centered at .1,413 MHz. The suppression of interference in the proposed receiver would make it possible to expand the frequency band to a width of 100 MHz, thereby making it possible to obtain greater sensitivity and accuracy in measuring moisture and salinity

  16. Optical receivers using rough reflectors

    NASA Technical Reports Server (NTRS)

    Vilnrotter, V. A.

    1985-01-01

    This report examines the possible use of rough, or nondiffraction-limited, reflectors for collecting optical signals. It is shown that in the absence of background radiation, the reflector's surface quality has little effect on the performance of a properly designed receiver, but that the presence of even small amounts of background radiation can lead to severe performance degradation. Techniques are suggested for improving receiver performance in high-background environments, and bounds and approximations to the exact error-probability expressions are derived.

  17. Range filtering for sequential GPS receivers

    NASA Technical Reports Server (NTRS)

    Paielli, Russell

    1987-01-01

    The filtering of the satellite range and range-rate measurements from single channel sequential Global Positioning System receivers is usually done with an extended Kalman filter which has state variables defined in terms of an orthogonal navigation reference frame. An attractive suboptimal alternative is range-domain filtering, in which the individual satellite measurements are filtered separately before they are combined for the navigation solution. The main advantages of range-domain filtering are decreased processing and storage requirements and simplified tuning. Several range filter mechanization alternatives are presented, along with an innovative approach for combining the filtered range-domain quantities to determine the navigation state estimate. In addition, a method is outlined for incorporating measurements from auxiliary sensors such as altimeters into the navigation state estimation scheme similarly to the satellite measurements. A method is also described for incorporating inertial measurements into the navigation state estimator as a process driver.

  18. Long-term Use of Systemic Treatments for Moderate-to-Severe Atopic Dermatitis in Adults: A Monocentric Retrospective Study.

    PubMed

    Védie, Anne-Laure; Ezzedine, Khaled; Amazan, Emmanuelle; Boralevi, Franck; Milpied, Brigitte; Taïeb, Alain; Seneschal, Julien

    2016-08-23

    Data regarding systemic therapies in the management of atopic dermatitis are limited. The aim of this study was to provide evidence for the efficacy and tolerance of systemic immunosuppressive treatments for moderate-to-severe adult atopic dermatitis. A single-centre retrospective study was conducted. A total of 54 patients were prescribed systemic treatments between 2000 and 2014. Of these, 28 received methotrexate and 55.6% were considered as responders based on Physician's Global Assessment, 17 received azathioprine (37.5% responders), 43 received cyclosporin A (65.9% responders) and 7 received a combination therapy with methotrexate and azathioprine (57.1% responders). These treatments were well-tolerated overall and few adverse events required discontinuation of treatment. Combination therapy associating methotrexate and azathioprine appears to be a promising treatment for patients who fail to respond to conventional monotherapies. PMID:26925822

  19. Optical Communications Channel Combiner

    NASA Technical Reports Server (NTRS)

    Quirk, Kevin J.; Quirk, Kevin J.; Nguyen, Danh H.; Nguyen, Huy

    2012-01-01

    NASA has identified deep-space optical communications links as an integral part of a unified space communication network in order to provide data rates in excess of 100 Mb/s. The distances and limited power inherent in a deep-space optical downlink necessitate the use of photon-counting detectors and a power-efficient modulation such as pulse position modulation (PPM). For the output of each photodetector, whether from a separate telescope or a portion of the detection area, a communication receiver estimates a log-likelihood ratio for each PPM slot. To realize the full effective aperture of these receivers, their outputs must be combined prior to information decoding. A channel combiner was developed to synchronize the log-likelihood ratio (LLR) sequences of multiple receivers, and then combines these into a single LLR sequence for information decoding. The channel combiner synchronizes the LLR sequences of up to three receivers and then combines these into a single LLR sequence for output. The channel combiner has three channel inputs, each of which takes as input a sequence of four-bit LLRs for each PPM slot in a codeword via a XAUI 10 Gb/s quad optical fiber interface. The cross-correlation between the channels LLR time series are calculated and used to synchronize the sequences prior to combining. The output of the channel combiner is a sequence of four-bit LLRs for each PPM slot in a codeword via a XAUI 10 Gb/s quad optical fiber interface. The unit is controlled through a 1 Gb/s Ethernet UDP/IP interface. A deep-space optical communication link has not yet been demonstrated. This ground-station channel combiner was developed to demonstrate this capability and is unique in its ability to process such a signal.

  20. Microwave blackbodies for spaceborne receivers

    NASA Technical Reports Server (NTRS)

    Stacey, J. M.

    1985-01-01

    The properties of microwave blackbody targets are explained as they apply to the calibration of spaceborne receivers. Also described are several practicable, blackbody targets used to test and calibrate receivers in the laboratory and in the thermal vacuum chamber. Problems with the precision and the accuracy of blackbody targets, and blackbody target design concepts that overcome some of the accuracy limitations present in existing target designs, are presented. The principle of the Brewster angle blackbody target is described where the blackbody is applied as a fixed-temperature test target in the laboratory and as a variable-temperature target in the thermal vacuum chamber. The reflectivity of a Brewster angle target is measured in the laboratory. From this measurement, the emissivity of the target is calculated. Radiatively cooled thermal suspensions are discussed as the coolants of blackbody targets and waveguide terminations that function as calibration devices in spaceborne receivers. Examples are given for the design of radiatively cooled thermal suspensions. Corrugated-horn antennas used to observe the cosmic background and to provide a cold-calibration source for spaceborne receivers are described.

  1. RFID receiver apparatus and method

    DOEpatents

    Scott, Jeffrey Wayne

    2006-12-26

    An RFID backscatter interrogator for transmitting data to an RFID tag, generating a carrier for the tag, and receiving data from the tag modulated onto the carrier, the interrogator including a single grounded-coplanar wave-guide circuit board and at least one surface mount integrated circuit supported by the circuit board.

  2. Advances in SIS receiver technology

    NASA Technical Reports Server (NTRS)

    Frerking, M. A.

    1988-01-01

    Significant advances in SIS receiver technology since the last Asilomar meeting include: superconductor materials, integrated inductive tuning elements, and planar mounting structures. The effect of these advances is to push the upper frequency operating limit from about 600 to 1500 GHz, and to enhance the feasibility of focal plane arrays of heterodyne receivers. A fundamental high frequency operating limit of SIS mixers is set by the superconducting energy gap. A practical limitation for high frequency operation of SIS junctions is their parasitic capacitance and resistance. The performance of the mixer will be degraded by the Resistor-Capacitor rolloff. Several designs were reported for inductive elements integrated on the same substrate as the SIS junctions to tune out the bulk junction capacitance. Most millimeter SIS-based heterodyne receivers have used waveguide coupling structures. Technology has advanced to the state where programs that have a high probability of success can be defined to produce arrays of SIS receivers for frequencies as high as 1500 GHz.

  3. Clark Receives Ocean Sciences Award

    NASA Astrophysics Data System (ADS)

    Roman, Michael R.; Clark, H. Lawrence

    2008-09-01

    H. Lawrence Clark received the 2008 Ocean Sciences Award at the 2008 Ocean Sciences Meeting, held 2-7 March 2008 in Orlando, Fla. The award is given in recognition of outstanding and long-standing service to the ocean sciences.

  4. Converting accounts receivable into cash.

    PubMed

    Folk, M D; Roest, P R

    1995-09-01

    In recent years, increasing numbers of healthcare providers have converted their accounts receivable into cash through a process called securitization. This practice has gained popularity because it provides a means to raise capital necessary to healthcare organizations. Although securitization transactions can be complex, they may provide increased financial flexibility to providers as they prepare for continuing change in the healthcare industry. PMID:10145096

  5. Urinary tract infection - adults

    MedlinePlus

    Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults ... to the hospital if you: Are an older adult Have kidney stones or changes in the anatomy ...

  6. Development of a digital receiver for range imaging atmospheric radar

    NASA Astrophysics Data System (ADS)

    Yamamoto, Masayuki K.; Fujita, Toshiyuki; Abdul Aziz, Noor Hafizah Binti; Gan, Tong; Hashiguchi, Hiroyuki; Yu, Tian-You; Yamamoto, Mamoru

    2014-10-01

    In this paper, we describe a new digital receiver developed for a 1.3-GHz range imaging atmospheric radar. The digital receiver comprises a general-purpose software-defined radio receiver referred to as the Universal Software Radio Peripheral 2 (USRP2) and a commercial personal computer (PC). The receiver is designed to collect received signals at an intermediate frequency (IF) of 130 MHz with a sample rate of 10 MS s-1. The USRP2 digitizes IF received signals, produces IQ time series, and then transfers the IQ time series to the PC through Gigabit Ethernet. The PC receives the IQ time series, performs range sampling, carries out filtering in the range direction, decodes the phase-modulated received signals, integrates the received signals in time, and finally saves the processed data to the hard disk drive (HDD). Because only sequential data transfer from the USRP2 to the PC is available, the range sampling is triggered by transmitted pulses leaked to the receiver. For range imaging, the digital receiver performs real-time signal processing for each of the time series collected at different frequencies. Further, the receiver is able to decode phase-modulated oversampled signals. Because the program code for real-time signal processing is written in a popular programming language (C++) and widely used libraries, the signal processing is easy to implement, reconfigure, and reuse. From radar experiments using a 1-μs subpulse width and 1-MHz frequency span (i.e., 2-MHz frequency bandwidth), we demonstrate that range imaging in combination with oversampling, which was implemented for the first time by the digital receiver, is able to resolve the fine-scale structure of turbulence with a vertical scale as small as 100 m or finer.

  7. Long-term maintenance combination chemotherapy with OPEC/MPEC (vincristine or methotrexate, prednisolone, etoposide and cyclophosphamide) or with daily oral etoposide and prednisolone can improve survival and quality of life in adult T-cell leukemia/lymphoma.

    PubMed

    Matsushita, K; Matsumoto, T; Ohtsubo, H; Fujiwara, H; Imamura, N; Hidaka, S; Kukita, T; Tei, C; Matsumoto, M; Arima, N

    1999-12-01

    Acute leukemia and lymphoma varieties of adult T-cell leukemia/lymphoma (ATL) usually carry a poor prognosis. While etoposide is generally useful for treating ATL, especially as a daily oral maintenance regimen, etoposide has not proven effective in severe types of ATL efficient in some patients. Of 87 ATL patients whom we have treated, 51 had acute leukemia, 22 lymphoma and 14 progressive chronic leukemia. Seventy-nine patients were treated with a long term maintenance combination protocol, OPEC/MPEC (weekly doses of vincristine, 0.7 mg/m2 or methotrexate, 14 mg/m2; prednisolone, 20 mg/m2; etoposide, 70 mg/m2 and cyclophosphamide, 200 mg/m2). The other 8 patients, 3 with acute leukemia, 2 with lymphoma and 3 with progressive chronic leukemia, were treated with daily oral administration of 25 mg of etoposide and 10 mg of prednisolone (DOEP). The dose administered was modified in individual cases to maintain the granulocyte count and reduce the number of ATL cells. Considering both protocols, a complete response and a partial response were achieved in 31.0% and 58.6% patients, respectively. Median survival times (MST) of all patients and, acute leukemia, lymphoma and progressive chronic leukemia types were 7.5, 6.7, 9.6 and 12.4 months, respectively. Respective MST of patients treated with OPEC/MPEC or DOEP protocols were 7.1 and 18.0 months. Relatively normal WBC counts, lower lactate dehydrogenase concentration and normal calcium concentration, limited numbers of anatomic sites involved, good performance status and good response to chemotherapy were significantly associated with long survival time. Drug toxicity was not apparent, and about half of patients were treated in an outpatient setting. PMID:10613451

  8. SAW correlator spread spectrum receiver

    DOEpatents

    Brocato, Robert W

    2014-04-01

    A surface acoustic wave (SAW) correlator spread-spectrum (SS) receiver is disclosed which utilizes a first demodulation stage with a chip length n and a second demodulation stage with a chip length m to decode a transmitted SS signal having a code length l=n.times.m which can be very long (e.g. up to 2000 chips or more). The first demodulation stage utilizes a pair of SAW correlators which demodulate the SS signal to generate an appropriate code sequence at an intermediate frequency which can then be fed into the second demodulation stage which can be formed from another SAW correlator, or by a digital correlator. A compound SAW correlator comprising two input transducers and a single output transducer is also disclosed which can be used to form the SAW correlator SS receiver, or for use in processing long code length signals.

  9. 30 GHz Commercial Satellite Receivers

    NASA Technical Reports Server (NTRS)

    Kerczewski, Robert J.; Ponchak, George E.; Romanofsky, Robert R.

    1989-01-01

    NASA's research and development work in satellite communications for the past 10 years has included a major technology thrust aimed at opening the Ka frequency band to commercial exploitation. This has included the development and testing of advanced system network architectures, on-board switching and processing, multibeam and phased array antennas, and satellite and ground terminal RF and digital hardware. Development work in system hardware has focused on critical components including power amplifiers, satellite IF switch matrices, low noise receivers, baseband processors, and high data rate bandwidth efficient modems. This paper describes NASA's work in developing and testing 30 GHz low noise satellite receivers for commercial space communications uplink applications. Frequencies allotted for fixed service commercial satellite communications in the Ka band are 27.5 - 30.0 GHz for uplink transmission and 17.7 - 20.2 GHz for downlink transmission. The relatively large 2.5 GHz bandwidth lends itself to wideband, high data rate digital transmission applications.

  10. Femtosecond Photon-Counting Receiver

    NASA Technical Reports Server (NTRS)

    Krainak, Michael A.; Rambo, Timothy M.; Yang, Guangning; Lu, Wei; Numata, Kenji

    2016-01-01

    An optical correlation receiver is described that provides ultra-precise distance and/or time-pulse-width measurements even for weak (single photons) and short (femtosecond) optical signals. A new type of optical correlation receiver uses a fourth-order (intensity) interferometer to provide micron distance measurements even for weak (single photons) and short (femtosecond) optical signals. The optical correlator uses a low-noise-integrating detector that can resolve photon number. The correlation (range as a function of path delay) is calculated from the variance of the photon number of the difference of the optical signals on the two detectors. Our preliminary proof-of principle data (using a short-pulse diode laser transmitter) demonstrates tens of microns precision.

  11. Femtosecond Photon-Counting Receiver

    NASA Technical Reports Server (NTRS)

    Krainak, Michael A.; Rambo, Timothy M.; Yang, Guangning; Lu, Wei; Numata, Kenji

    2016-01-01

    An optical correlation receiver is described that provides ultra-precise distance and/or time/pulse-width measurements even for weak (single photons) and short (femtosecond) optical signals. A new type of optical correlation receiver uses a fourth-order (intensity) interferometer to provide micron distance measurements even for weak (single photons) and short (femtosecond) optical signals. The optical correlator uses a low-noise-integrating detector that can resolve photon number. The correlation (range as a function of path delay) is calculated from the variance of the photon number of the difference of the optical signals on the two detectors. Our preliminary proof-of principle data (using a short-pulse diode laser transmitter) demonstrates tens of microns precision.

  12. Scintillation-Hardened GPS Receiver

    NASA Technical Reports Server (NTRS)

    Stephens, Donald R.

    2015-01-01

    CommLargo, Inc., has developed a scintillation-hardened Global Positioning System (GPS) receiver that improves reliability for low-orbit missions and complies with NASA's Space Telecommunications Radio System (STRS) architecture standards. A software-defined radio (SDR) implementation allows a single hardware element to function as either a conventional radio or as a GPS receiver, providing backup and redundancy for platforms such as the International Space Station (ISS) and high-value remote sensing platforms. The innovation's flexible SDR implementation reduces cost, weight, and power requirements. Scintillation hardening improves mission reliability and variability. In Phase I, CommLargo refactored an open-source GPS software package with Kalman filter-based tracking loops to improve performance during scintillation and also demonstrated improved navigation during a geomagnetic storm. In Phase II, the company generated a new field-programmable gate array (FPGA)-based GPS waveform to demonstrate on NASA's Space Communication and Navigation (SCaN) test bed.

  13. Digital-data receiver synchronization

    DOEpatents

    Smith, Stephen F.; Turner, Gary W.

    2005-08-02

    Digital-data receiver synchronization is provided with composite phase-frequency detectors, mutually cross-connected comparison feedback or both to provide robust reception of digital data signals. A single master clock can be used to provide frequency signals. Advantages can include fast lock-up time in moderately to severely noisy conditions, greater tolerance to noise and jitter when locked, and improved tolerance to clock asymmetries.

  14. Estimating Total Electron Content Using 1,000+ GPS Receivers

    NASA Technical Reports Server (NTRS)

    Komjathy, Attila; Mannucci, Anthony

    2006-01-01

    A computer program uses data from more than 1,000 Global Positioning System (GPS) receivers in an Internet-accessible global network to generate daily estimates of the global distribution of vertical total electron content (VTEC) of the ionosphere. This program supersedes an older program capable of processing readings from only about 200 GPS receivers. This program downloads the data via the Internet, then processes the data in three stages. In the first stage, raw data from a global subnetwork of about 200 receivers are preprocessed, station by station, in a Kalman-filter-based least-squares estimation scheme that estimates satellite and receiver differential biases for these receivers and for satellites. In the second stage, an observation equation that incorporates the results from the first stage and the raw data from the remaining 800 receivers is solved to obtain the differential biases for these receivers. The only remaining error sources for which an account cannot be given are multipath and receiver noise contributions. The third stage is a postprocessing stage in which all the processed data are combined and used to generate new data products, including receiver differential biases and global and regional VTEC maps and animations.

  15. Coherently combining antennas

    NASA Technical Reports Server (NTRS)

    Dybdal, Robert B. (Inventor); Curry, Samuel J. (Inventor)

    2009-01-01

    An apparatus includes antenna elements configured to receive a signal including pseudo-random code, and electronics configured to use the pseudo-random code to determine time delays of signals incident upon the antenna elements and to compensate the signals to coherently combine the antenna elements.

  16. The advanced receiver 2: Telemetry test results in CTA 21

    NASA Technical Reports Server (NTRS)

    Hinedi, S.; Bevan, R.; Marina, M.

    1991-01-01

    Telemetry tests with the Advanced Receiver II (ARX II) in Compatibility Test Area 21 are described. The ARX II was operated in parallel with a Block-III Receiver/baseband processor assembly combination (BLK-III/BPA) and a Block III Receiver/subcarrier demodulation assembly/symbol synchronization assembly combination (BLK-III/SDA/SSA). The telemetry simulator assembly provided the test signal for all three configurations, and the symbol signal to noise ratio as well as the symbol error rates were measured and compared. Furthermore, bit error rates were also measured by the system performance test computer for all three systems. Results indicate that the ARX-II telemetry performance is comparable and sometimes superior to the BLK-III/BPA and BLK-III/SDA/SSA combinations.

  17. Efficacy of the Modifying Phonation Intervals (MPI) Stuttering Treatment Program With Adults Who Stutter

    PubMed Central

    Ingham, Janis C.; Bothe, Anne K.; Wang, Yuedong; Kilgo, Martin

    2015-01-01

    Purpose This study compared a new adult stuttering treatment program (Modifying Phonation Intervals, or MPI) with the standard of care for reducing stuttered speech in adults (prolonged speech). Method Twenty-seven adults who stutter were assigned to either MPI or prolonged speech treatment, both of which used similar infrastructures. Speech and related variables were assessed in 3 within-clinic and 3 beyond-clinic speaking situations for participants who successfully completed all treatment phases. Results At transfer, maintenance, and follow-up, the speech of 14 participants who successfully completed treatment was similar to that of normally fluent adults. Successful participants also showed increased self-identification as a “normal speaker,” decreased self-identification as a “stutterer,” reduced short intervals of phonation, and some increased use of longer duration phonation intervals. Eleven successful participants received the MPI treatment, and 3 received the prolonged speech treatment. Conclusions Outcomes for successful participants were very similar for the 2 treatments. The much larger proportion of successful participants in the MPI group, however, combined with the predictive value of specific changes in PI durations suggest that MPI treatment was relatively more effective at assisting clients to identify and change the specific speech behaviors that are associated with successful treatment of stuttered speech in adults. PMID:25633470

  18. Dividing Attention Lowers Children's but Increases Adults' False Memories

    ERIC Educational Resources Information Center

    Otgaar, Henry; Peters, Maarten; Howe, Mark L.

    2012-01-01

    The present study examined the impact of divided attention on children's and adults' neutral and negative true and false memories in a standard Deese/Roediger-McDermott paradigm. Children (7- and 11-year-olds; n = 126) and adults (n = 52) received 5 neutral and 5 negative Deese/Roediger-McDermott word lists; half of each group also received a…

  19. Vincristine-induced paralytic ileus during induction therapy of treatment protocols for acute lymphoblastic leukemia in adult patients.

    PubMed

    Yasu, Takeo; Ohno, Nobuhiro; Kawamata, Toyotaka; Kurokawa, Yosuke

    2016-06-01

    Vincristine (VCR) is an important drug used in the treatment of acute lymphoblastic leukemia (ALL). VCR-induced neurotoxicity can manifest as peripheral neuropathy, constipation, or paralytic ileus. While there are some case reports describing VCR-induced paralytic ileus (VIPI) in pediatric ALL, there are fewer publication on adult ALL patients. Therefore, we retrospectively investigated VIPI during induction therapy of treatment protocols for ALL in 19 adult patients. The incidence of VIPI was 32%. VIPI was significantly increased in patients receiving concomitant itraconazole (ITCZ) (p = 0.04). We recommend avoidance of the combination of VCR and ITCZ. PMID:27087157

  20. Testing the Grandchildren's Received Affection Scale using Affection Exchange Theory.

    PubMed

    Mansson, Daniel H

    2013-04-01

    The purpose of this study was to test the Grandchildren's Received Affection Scale (GRAS) using Affection Exchange Theory (Floyd, 2006). In accordance with Affection Exchange Theory, it was hypothesized that grandchildren's scores on the Trait Affection Received Scale (i.e., the extent to which individuals by nature receive affection) would be related significantly and positively to their reports of received affection from their grandparents (i.e., their scores on the GRAS). Additionally, a research question was asked to explore if grandchildren's received affection from their grandparents is dependent on their grandparent's biological sex or lineage (i.e., maternal vs paternal). Thus, young adult grandchildren (N = 422) completed the GRAS and the Trait Affection Received Scale. The results of zero-order Pearson correlational analyses provided support for the hypothesis, whereas the results of MANOVAs tests only partially support extant grandparent-grandchild theory and research. These findings broaden the scope of Affection Exchange Theory and also bolster the GRAS's utility in future grandparent-grandchild affectionate communication research. PMID:23833883

  1. Adult Strabismus

    MedlinePlus

    ... will likely improve the double vision and depth perception. Also, strabismus affects adults in emotional, social, and ... muscle surgery is usually not severe. Headache, pulling sensation with eye movement and foreign body sensation in ...

  2. Adult Children's Divorce and Intergenerational Relationships.

    ERIC Educational Resources Information Center

    Spitze, Glenna; And Others

    1994-01-01

    Examined effects of adult children's divorce on their relationships with parents, using local probability sample of 905 parents. In general, divorced daughters with child custody had more contact than married daughters and received more help from parents. Sons received more babysitting help when they were married than in other situations. Divorce…

  3. Prospective Memory Training in Older Adults.

    ERIC Educational Resources Information Center

    Schmidt, Iris W.; Berg, Ina J.; Deelman, Betto G.

    2001-01-01

    Twenty adults received training in prospective memory; 23 who received training in reducing worries about forgetfulness and 22 controls formed a comparison group. Results of a telephone task and a prospective categorization task revealed significant but small effects for the prospective memory group. After 3 months, the comparison group's…

  4. Stennis group receives NESC award

    NASA Technical Reports Server (NTRS)

    2009-01-01

    The NASA Engineering & Safety Center recently presented its Group Achievement Award to a Stennis team in recognition of technical excellence in evaluating the operational anomalies and reliability improvements associated with the space shuttle engine cut-off system. Stennis employees receiving the award were: (standing, l to r) Freddie Douglas (NASA), George Drouant (Jacobs Technology Inc.), Fred Abell (Jacobs), Robert Drackett (Jacobs) and Mike Smiles (NASA); (seated, l to r): Binh Nguyen (Jacobs), Stennis Director Gene Goldman and Joseph Lacker (NASA). Phillip Hebert of NASA is not pictured.

  5. Adult Brainstem Gliomas

    PubMed Central

    Reyes-Botero, German; Mokhtari, Karima; Martin-Duverneuil, Nadine; Delattre, Jean-Yves

    2012-01-01

    Brainstem gliomas are uncommon in adults and account for only 1%–2% of intracranial gliomas. They represent a heterogeneous group of tumors that differ from those found in their pediatric counterparts. In adults, a low-grade phenotype predominates, which is a feature that likely explains their better prognosis compared to that in children. Because biopsies are rarely performed, classifications based on the radiological aspect of magnetic resonance imaging results have been proposed to establish treatment strategies and to determine outcomes: (a) diffuse intrinsic low-grade, (b) enhancing malignant glioma, (c) focal tectal gliomas, and (d) exophytic gliomas. Despite significant advances in neuroradiology techniques, a purely radiological classification remains imperfect in the absence of a histological diagnosis. Whereas a biopsy may often be reasonably avoided in the diffuse nonenhancing forms, obtaining histological proof seems necessary in many contrast-enhanced brainstem lesions because of the wide variety of differential diagnoses in adults. Conventional radiotherapy is the standard treatment for diffuse intrinsic low-grade brainstem gliomas in adults (the median survival is 5 years). In malignant brainstem gliomas, radiotherapy is the standard treatment. However, the possible benefit of combined radiotherapy and chemotherapy (temozolomide or other agents) has not been thoroughly evaluated in adults. The role of anti-angiogenic therapies in brainstem gliomas remains to be defined. A better understanding of the biology of these tumors is of primary importance for identifying homogeneous subgroups and for improving therapy options and outcomes. PMID:22382458

  6. Front end for GPS receivers

    NASA Technical Reports Server (NTRS)

    Thomas, Jr., Jess Brooks (Inventor)

    1999-01-01

    The front end in GPS receivers has the functions of amplifying, down-converting, filtering and sampling the received signals. In the preferred embodiment, only two operations, A/D conversion and a sum, bring the signal from RF to filtered quadrature baseband samples. After amplification and filtering at RF, the L1 and L2 signals are each sampled at RF at a high selected subharmonic rate. The subharmonic sample rates are approximately 900 MHz for L1 and 982 MHz for L2. With the selected subharmonic sampling, the A/D conversion effectively down-converts the signal from RF to quadrature components at baseband. The resulting sample streams for L1 and L2 are each reduced to a lower rate with a digital filter, which becomes a straight sum in the simplest embodiment. The frequency subsystem can be very simple, only requiring the generation of a single reference frequency (e.g. 20.46 MHz minus a small offset) and the simple multiplication of this reference up to the subharmonic sample rates for L1 and L2. The small offset in the reference frequency serves the dual purpose of providing an advantageous offset in the down-converted carrier frequency and in the final baseband sample rate.

  7. Solar receiver with integrated optics

    NASA Astrophysics Data System (ADS)

    Jiang, Lun; Winston, Roland

    2012-10-01

    The current challenge for PV/Thermal (PV/T) systems is the reduction of radiation heat loss. Compared to solar thermal selective coating, the solar cells cannot be used as an efficient thermal absorber due to their large emissivity of the encapsulation material. Many commercial PV/T products therefore require a high concentration (more than 10x) to reach an acceptable thermal efficiency for their receivers. Such a concentration system inevitably has to track or semi-track, which induces additional cost and collects only the direct radiation from the sun. We propose a new PV/T design using a vacuum encapsulated thin film cell to solve this problem. The proposed design also collects the diffuse sun light efficiently by using an external compound parabolic concentrator (XCPC). Since the transparent electrode (TCO) of thin film cell is inherently transparent in visible light and reflective beyond infrared, this design uses this layer instead of the conventional solar cell encapsulation as the outmost heat loss surface. By integrating such a vacuum design with a tube shaped absorber, we reduce the complexity of conducting the heat energy and electricity out of the device. A low concentration standalone non-tracking solar collector is proposed in this paper. We also analyzed the thermosyphon system configuration using heat transfer and ray tracing models. The economics of such a receiver are presented.

  8. Superconductor Digital-RF Receiver Systems

    NASA Astrophysics Data System (ADS)

    Mukhanov, Oleg A.; Kirichenko, Dmitri; Vernik, Igor V.; Filippov, Timur V.; Kirichenko, Alexander; Webber, Robert; Dotsenko, Vladimir; Talalaevskii, Andrei; Tang, Jia Cao; Sahu, Anubhav; Shevchenko, Pavel; Miller, Robert; Kaplan, Steven B.; Sarwana, Saad; Gupta, Deepnarayan

    Digital superconductor electronics has been experiencing rapid maturation with the emergence of smaller-scale, lower-cost communications applications which became the major technology drivers. These applications are primarily in the area of wireless communications, radar, and surveillance as well as in imaging and sensor systems. In these areas, the fundamental advantages of superconductivity translate into system benefits through novel Digital-RF architectures with direct digitization of wide band, high frequency radio frequency (RF) signals. At the same time the availability of relatively small 4K cryocoolers has lowered the foremost market barrier for cryogenically-cooled digital electronic systems. Recently, we have achieved a major breakthrough in the development, demonstration, and successful delivery of the cryocooled superconductor digital-RF receivers directly digitizing signals in a broad range from kilohertz to gigahertz. These essentially hybrid-technology systems combine a variety of superconductor and semiconductor technologies packaged with two-stage commercial cryocoolers: cryogenic Nb mixed-signal and digital circuits based on Rapid Single Flux Quantum (RSFQ) technology, room-temperature amplifiers, FPGA processing and control circuitry. The demonstrated cryocooled digital-RF systems are the world's first and fastest directly digitizing receivers operating with live satellite signals in X-band and performing signal acquisition in HF to L-band at ˜30GHz clock frequencies.

  9. Agile multiple aperture imager receiver development

    NASA Astrophysics Data System (ADS)

    Lees, David E. B.; Dillon, Robert F.

    1990-02-01

    A variety of unconventional imaging schemes have been investigated in recent years that rely on small, unphased optical apertures (subaperture) to measure properties of an incoming optical wavefront and recover images of distant objects without using precisely figured, large aperture optical elements. Such schemes offer several attractive features. They provide the potential to create very lare effective aperture that are expandable over time and can be launched into space in small pieces. Since the subapertures are identical in construction, they may be mass producible at potentially low cost. A preliminary design for a practical low cost optical receiver is presented. The multiple aperture design has high sensitivity, wide field-of-view, and is lightweight. A combination of spectral, temporal, and spatial background suppression are used to achieve daytime operation at low signal levels. Modular packaging to make the number of receiver subapertures conveniently scalable is also presented. The design is appropriate to a ground-base proof-of-concept experiment for long range active speckle imaging.

  10. CD4 Cell Count and the Risk of AIDS or Death in HIV-Infected Adults on Combination Antiretroviral Therapy with a Suppressed Viral Load: A Longitudinal Cohort Study from COHERE

    PubMed Central

    2012-01-01

    Background Most adults infected with HIV achieve viral suppression within a year of starting combination antiretroviral therapy (cART). It is important to understand the risk of AIDS events or death for patients with a suppressed viral load. Methods and Findings Using data from the Collaboration of Observational HIV Epidemiological Research Europe (2010 merger), we assessed the risk of a new AIDS-defining event or death in successfully treated patients. We accumulated episodes of viral suppression for each patient while on cART, each episode beginning with the second of two consecutive plasma viral load measurements <50 copies/µl and ending with either a measurement >500 copies/µl, the first of two consecutive measurements between 50–500 copies/µl, cART interruption or administrative censoring. We used stratified multivariate Cox models to estimate the association between time updated CD4 cell count and a new AIDS event or death or death alone. 75,336 patients contributed 104,265 suppression episodes and were suppressed while on cART for a median 2.7 years. The mortality rate was 4.8 per 1,000 years of viral suppression. A higher CD4 cell count was always associated with a reduced risk of a new AIDS event or death; with a hazard ratio per 100 cells/µl (95% CI) of: 0.35 (0.30–0.40) for counts <200 cells/µl, 0.81 (0.71–0.92) for counts 200 to <350 cells/µl, 0.74 (0.66–0.83) for counts 350 to <500 cells/µl, and 0.96 (0.92–0.99) for counts ≥500 cells/µl. A higher CD4 cell count became even more beneficial over time for patients with CD4 cell counts <200 cells/µl. Conclusions Despite the low mortality rate, the risk of a new AIDS event or death follows a CD4 cell count gradient in patients with viral suppression. A higher CD4 cell count was associated with the greatest benefit for patients with a CD4 cell count <200 cells/µl but still some slight benefit for those with a CD4 cell count ≥500 cells/µl. Please see later in the article for the

  11. Obstructive sleep apnea - adults

    MedlinePlus

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... the upper airway for obstructive sleep apnea in adults. Sleep . 2010;33:1408-1413. PMID: 21061864 www. ...

  12. Sexual Abuse of Older Adults: Aps Cases and Outcomes

    ERIC Educational Resources Information Center

    Teaster, Pamela B.; Roberto, Karen A.

    2004-01-01

    Purpose: The purpose of this study was to develop a profile of sexual abuse cases among adults aged 60 and older receiving attention from Adult Protective Services units in Virginia over a 5-year period. Design and Methods: We used bivariate analysis to characterize older adults (n = 82) experiencing sexual abuse and the circumstances of the…

  13. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  14. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  15. Adult Children of Alcoholics: Theory and Research. Pamphlet Series.

    ERIC Educational Resources Information Center

    Johnson, Jeannette L.; Bennett, Linda A.

    The concept of adult children of alcoholics (ACoA) has received wide public recognition and acceptance. An ACoA is defined as any adult who, as a child, was reared by one or two alcoholic parents. To date research has not sufficiently addressed the many questions generated by the grass roots movement, such as whether or not adult children of…

  16. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

    ERIC Educational Resources Information Center

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  17. Promoting Adult Learning in Public Places: Two Asian Case Studies of Adult Learning about Peace through Museums and Peace Architecture

    ERIC Educational Resources Information Center

    Duffy, Gavin

    2009-01-01

    This paper explores an area of adult learning that has received little attention of late, the terrain of public education through museums and civic architecture. The goal of promoting adult learning in public places e.g. through the work of museums has become commonplace in countries seeking to encourage adult learning about peace. This invariably…

  18. A cryogenic receiver for EPR.

    PubMed

    Narkowicz, R; Ogata, H; Reijerse, E; Suter, D

    2013-12-01

    Cryogenic probes have significantly increased the sensitivity of NMR. Here, we present a compact EPR receiver design capable of cryogenic operation. Compared to room temperature operation, it reduces the noise by a factor of ≈2.5. We discuss in detail the design and analyze the resulting noise performance. At low microwave power, the input noise density closely follows the emission of a cooled 50Ω resistor over the whole measurement range from 20K up to room temperature. To minimize the influence of the microwave source noise, we use high microwave efficiency (≈1.1-1.7mTW(-1/2)) planar microresonators. Their efficient conversion of microwave power to magnetic field permits EPR measurements with very low power levels, typically ranging from a few μW down to fractions of nW. PMID:24161681

  19. Obesity Prevention in Older Adults.

    PubMed

    Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

    2016-06-01

    The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented. PMID:27107762

  20. 47 CFR 80.913 - Radiotelephone receivers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... receivers. (a) If a medium frequency radiotelephone installation is provided, the receiver must be capable... kHz, and the receiving frequency(s) of public coast stations serving the area in which the vessel is... reception of H3E and J3E emissions on 2182 kHz and J3E emission on any receiving frequency...

  1. 47 CFR 80.913 - Radiotelephone receivers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... receivers. (a) If a medium frequency radiotelephone installation is provided, the receiver must be capable... kHz, and the receiving frequency(s) of public coast stations serving the area in which the vessel is... reception of H3E and J3E emissions on 2182 kHz and J3E emission on any receiving frequency...

  2. 47 CFR 80.913 - Radiotelephone receivers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... receivers. (a) If a medium frequency radiotelephone installation is provided, the receiver must be capable... kHz, and the receiving frequency(s) of public coast stations serving the area in which the vessel is... reception of H3E and J3E emissions on 2182 kHz and J3E emission on any receiving frequency...

  3. Development of an Air Brayton solar receiver

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Various receiver configurations and operating conditions were examined. The interface requirements between the receiver/concentrator/power module were addressed. Production cost estimates were obtained to determine the cost of the receiver during the 1980 timeframe. A conceptual design of an air Brayton solar receiver is presented based on the results. The following design goals were established: (1)peak thermal input power - 85 KWt; (2)receiver outlet air temperature - 1500 F; (3)receiver inlet air temperature - 1050 F; (4)design mass flow rate - 0.533 lb/sec; and (5)design receiver inlet pressure - 36.75 psia.

  4. Lidar receivers for picosecond remote sensing

    NASA Technical Reports Server (NTRS)

    Stoyanov, D. V.; Dreischuh, T. N.

    1992-01-01

    The lidars of picosecond resolution are an attractive tool for remote probing of some highly dynamic objects like sea subsurface waters, small-scale turbulences in the atmosphere, etc. The picosecond lasers are suitable illuminating sources, but the main restrictions are due to the lack of proper receiving methods, combining the both high temporal and amplitude resolution, good sensitivity, short integration time, and wide dynamic range. The methods for short pulse measurements are not suitable for picosecond lidars, operating at low level, with highly dynamic signals. The streak-cameras are of high cost, lower sensitivity, and lower dynamic range (approximately 10(exp 3)). Because of the background, the single quantum regime in photomultipliers (PMT) is ineffective. The sampling of highly dynamic optical signals with resolution less than or equal to 1ns is a serious problem, limiting the application of the high speed PMT-MCP (microchannel plate) in the picosecond lidar systems. The goal of this work is to describe the use of a new photodetection technique which combines the picosecond resolution with the high amplitude resolution, dynamic range, and sensitivity.

  5. Predictors of Adult Education Program Satisfaction in Urban Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Yamashita, Takashi; López, Erick B.; Keene, Jennifer R.; Kinney, Jennifer M.

    2015-01-01

    Lifelong learning is receiving greater attention due to population aging in modern societies. Lifelong learning benefits individuals by supporting their physical, psychological, social, and economic well-being. However, older adults generally have lower motivation for learning than younger adults, and facilitating long-term participation in…

  6. Toward Local Collaborative Networks for Adult Learners. Final Report of the Adult Learner Project.

    ERIC Educational Resources Information Center

    Gold, Gerard G.

    The Adult Learner Project was a two-phase program in which a total of 10 community-level projects received funding to develop collaborative agendas that would meet the learning needs of adults in their respective communities. During the second phase of the project, the following community-level collaborative councils were also given $20,000 each:…

  7. Mark 4A DSN receiver-exciter and transmitter subsystems

    NASA Astrophysics Data System (ADS)

    Wick, M. R.

    1986-05-01

    The present configuration of the Mark 4A DSN Receiver-Exciter and Transmitter Subsystems is described. Functional requirements and key characteristics are given to show the differences in the capabilities required by the Networks Consolidation task for combined High Earth Orbiter and Deep Space Network tracking support.

  8. Mark 4A DSN receiver-exciter and transmitter subsystems

    NASA Technical Reports Server (NTRS)

    Wick, M. R.

    1986-01-01

    The present configuration of the Mark 4A DSN Receiver-Exciter and Transmitter Subsystems is described. Functional requirements and key characteristics are given to show the differences in the capabilities required by the Networks Consolidation task for combined High Earth Orbiter and Deep Space Network tracking support.

  9. Structural analysis of a reflux pool-boiler solar receiver

    NASA Astrophysics Data System (ADS)

    Hoffman, E. L.; Stone, C. M.

    1991-06-01

    Coupled thermal-structural finite element calculations of a reflux pool-boiler solar receiver were performed to characterize the operating stresses and to address issues affecting the service life of the receiver. Analyses performed using shell elements provided information for receiver material selection and design optimization. Calculations based on linear elastic fracture mechanics principles were performed using continuum elements to assess the vulnerability of a seam-weld to fatigue crack growth. All calculations were performed using ABAQUS, a general purpose finite element code, and elements specifically formulated for coupled thermal-structural analysis. Two materials were evaluated: 316L SS and Haynes 230 alloys. The receiver response was simulated for a combination of structural and thermal loads that represent the startup and operating conditions of the receiver. For both materials, maximum stresses in the receiver developed shortly after startup due to uneven temperature distribution across the receiver surface. The largest effective stress was near yield in the 316L SS receiver and below 39 percent of yield in the Haynes 230 receiver. The calculations demonstrated that stress reductions of over 25 percent could be obtained by reducing the aft dome thickness to one closer to the absorber. The fatigue calculations demonstrated that the stress distribution near the seam-weld notch depends primarily on the structural load created by internal pressurization of the receiver rather than the thermal, indicating that the thermal loads can be neglected when assessing the stress intensity near the seam-weld notch. The stress intensity factor, computed using the J-integral method and crack opening-displacement field equations, was significantly below the fatigue threshold for most steels. The calculations indicated that the weld notch was always loaded in compression, a condition which is not conducive to fatigue crack growth.

  10. Structural analysis of a reflux pool-boiler solar receiver

    SciTech Connect

    Hoffman, E.L.; Stone, C.M.

    1991-06-01

    Coupled thermal-structural finite element calculations of a reflux pool-boiler solar receiver were performed to characterize the operating stresses and to address issues affecting the service life of the receiver. Analyses performed using shell elements provided information for receiver material selection and design optimization. Calculations based on linear elastic fracture mechanics principles were performed using continuum elements to assess the vulnerability of a seam-weld to fatigue crack growth. All calculations were performed using ABAQUS, a general purpose finite element code, and elements specifically formulated for coupled thermal-structural analysis. Two materials were evaluated: 316L SS and Haynes 230 alloys. The receiver response was simulated for a combination of structural and thermal loads that represent the startup and operating conditions of the receiver. For both materials, maximum stresses in the receiver developed shortly after startup due to uneven temperature distribution across the receiver surface. The largest effective stress was near yield in the 316L SS receiver and below 39 percent of yield in the Haynes 230 receiver. The calculations demonstrated that stress reductions of over 25 percent could be obtained by reducing the aft dome thickness to one closer to the absorber. The fatigue calculations demonstrated that the stress distribution near the seam-weld notch depends primarily on the structural load created by internal pressurization of the receiver rather than the thermal, indicating that the thermal loads can be neglected when assessing the stress intensity near the seam-weld notch. The stress intensity factor, computed using the J-integral method and crack opening-displacement field equations, was significantly below the fatigue threshold for most steels. The calculations indicated that the weld notch was always loaded in compression, a condition which is not conducive to fatigue crack growth. 15 refs., 30 figs., 3 tabs.

  11. Comparison of Outcomes of Allogeneic Transplantation for CML with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan or TBI

    PubMed Central

    Copelan, Edward A.; Avalos, Belinda; Ahn, Kwang Woo; Zhu, Xiaochun; Gale, Robert Peter; Grunwald, Michael R.; Hamadani, Mehdi; Hamilton, Betty K.; Hale, Gregory A.; Marks, David I.; Waller, Edmund K.; Savani, Bipin N.; Costa, Luciano J.; Ramanathan, Muthalagu; Cahn, Jean-Yves; Khoury, H. Jean; Weisdorf, Daniel J.; Inamoto, Yoshihiro; Kamble, Rammurti T.; Schouten, Harry C.; Wirk, Baldeep; Litzow, Mark R.; Aljurf, Mahmoud D.; van Besien, Koen W.; Ustun, Celalettin; Bolwell, Brian J.; Bredeson, Christopher N.; Fasan, Omotayo; Ghosh, Nilanjan; Horowitz, Mary M.; Arora, Mukta; Szer, Jeffrey; Loren, Alison W.; Alyea, Edwin P.; Cortes, Jorge; Maziarz, Richard T.; Kalaycio, Matt E.; Saber, Wael

    2014-01-01

    Cyclophosphamide in combination with busulfan (Bu) or total body irradiation (TBI) are the most commonly used myeloablative conditioning regimens in patients with Chronic Myeloid Leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase following myeloablative conditioning with cyclophosphamide (Cy) in combination with TBI, oral Bu or intravenous (IV) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving IV Bu compared to TBI (RR=0.36; P=0.022) or oral Bu (RR=0.39; P=0.028), but non-relapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving IV (RR=0.53; P=0.025) or oral Bu (RR=0.64; P=0.017) compared to TBI. In CML in first chronic phase, Cy in combination with IV Bu was associated with less relapse than TBI or oral Bu. LFS was better following IV or oral Bu compared to TBI. PMID:25528388

  12. Cognitive heterogeneity in adult attention deficit/hyperactivity disorder: A systematic analysis of neuropsychological measurements.

    PubMed

    Mostert, Jeanette C; Onnink, A Marten H; Klein, Marieke; Dammers, Janneke; Harneit, Anais; Schulten, Theresa; van Hulzen, Kimm J E; Kan, Cornelis C; Slaats-Willemse, Dorine; Buitelaar, Jan K; Franke, Barbara; Hoogman, Martine

    2015-11-01

    Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA's comparing patients with persistent ADHD (N=133, 42% male, mean age 36) and healthy adults (N=132, 40% male, mean age 36). In addition, we tested which combination of variables provided the highest accuracy in predicting ADHD diagnosis. We also estimated for each individual the severity of neuropsychological dysfunctioning. Lastly, we investigated potential effects of stimulant medication and a history of comorbid major depressive disorder (MDD) on performance. Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding. However, effect sizes were small to moderate (range: 0.05-0.70) and 11% of patients did not show neuropsychological dysfunctioning. The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity). Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired. To conclude, while adults with ADHD as a group are impaired on several cognitive domains, the results confirm that adult ADHD is neuropsychologically heterogeneous. This provides a starting point to investigate individual differences in terms of impaired cognitive pathways. PMID:26336867

  13. Comparative analysis of semantic localization accuracies between adult and pediatric DICOM CT images

    NASA Astrophysics Data System (ADS)

    Robertson, Duncan; Pathak, Sayan D.; Criminisi, Antonio; White, Steve; Haynor, David; Chen, Oliver; Siddiqui, Khan

    2012-02-01

    Existing literature describes a variety of techniques for semantic annotation of DICOM CT images, i.e. the automatic detection and localization of anatomical structures. Semantic annotation facilitates enhanced image navigation, linkage of DICOM image content and non-image clinical data, content-based image retrieval, and image registration. A key challenge for semantic annotation algorithms is inter-patient variability. However, while the algorithms described in published literature have been shown to cope adequately with the variability in test sets comprising adult CT scans, the problem presented by the even greater variability in pediatric anatomy has received very little attention. Most existing semantic annotation algorithms can only be extended to work on scans of both adult and pediatric patients by adapting parameters heuristically in light of patient size. In contrast, our approach, which uses random regression forests ('RRF'), learns an implicit model of scale variation automatically using training data. In consequence, anatomical structures can be localized accurately in both adult and pediatric CT studies without the need for parameter adaptation or additional information about patient scale. We show how the RRF algorithm is able to learn scale invariance from a combined training set containing a mixture of pediatric and adult scans. Resulting localization accuracy for both adult and pediatric data remains comparable with that obtained using RRFs trained and tested using only adult data.

  14. Fluid absorption solar energy receiver

    NASA Technical Reports Server (NTRS)

    Bair, Edward J.

    1993-01-01

    A conventional solar dynamic system transmits solar energy to the flowing fluid of a thermodynamic cycle through structures which contain the gas and thermal energy storage material. Such a heat transfer mechanism dictates that the structure operate at a higher temperature than the fluid. This investigation reports on a fluid absorption receiver where only a part of the solar energy is transmitted to the structure. The other part is absorbed directly by the fluid. By proportioning these two heat transfer paths the energy to the structure can preheat the fluid, while the energy absorbed directly by the fluid raises the fluid to its final working temperature. The surface temperatures need not exceed the output temperature of the fluid. This makes the output temperature of the gas the maximum temperature in the system. The gas can have local maximum temperatures higher than the output working temperature. However local high temperatures are quickly equilibrated, and since the gas does not emit radiation, local high temperatures do not result in a radiative heat loss. Thermal radiation, thermal conductivity, and heat exchange with the gas all help equilibrate the surface temperature.

  15. Recent developments in superconducting receivers

    SciTech Connect

    Richards, P.L.

    1990-09-01

    A description is given of recent work at Berkeley on superconducting mixers and detectors for infrared and millimeter wavelengths. The first report is a review article which summarizes the status of development of superconducting components for infrared and millimeter wave receivers. The next report describes accurate measurements and also theoretical modeling of an SIS quasiparticle waveguide mixer for W-band which uses very high quality Ta junctions. The best mixer noise is only 1.3 times the quantum limit. Both the mixer gain and the noise are in quantitative agreement with the quantum theory. Next, a report is given on measurements and theoretical modeling of the absorptivity (surface resistance) of high quality epitaxial films of the high {Tc} superconductor YBCO from 750 GHz to 21 THz. Finally, there are reports on the design and experimental performance of two different types of high {Tc} bolometric detectors. One is a conventional bolometer with a gold-black absorber. The other is an antenna coupled microbolometer.

  16. Lunar Receiving Laboratory Project History

    NASA Technical Reports Server (NTRS)

    Mangus, Susan; Larsen, William

    2004-01-01

    As early as 1959, the Working Group on Lunar Exploration within NASA advocated that 'one of the prime objectives of the first lunar landing mission should be the collection of samples for return to Earth, where they could be subjected to detailed study and analysis.' Within NASA, neither this group nor any other scientists working with the Agency were concerned about back contamination issues. Outside of NASA, back contamination concerns had been raised as early as 1960. Although NASA did not seem to pay any attention to the concerns at that time, the scientific community continued to be interested in the topic. In 1962 and again in 1963, as the Apollo Program loomed large, further discussions were held. These early discussions of back contamination did not make their way into NASA's administration, however, and when Manned Spacecraft Center personnel began to articulate early concepts for the Lunar Receiving Laboratory (LRL), the back contamination issue was not considered. Once this concern became a major focus, however, the LRL's development became increasingly complex. This is the history of that development.

  17. Adult Play.

    ERIC Educational Resources Information Center

    Charles, John M.

    In its broadest context, play can be interpreted as any pleasurable use of discretionary time. Playfulness is an intrinsic feature of being human, and should be viewed in the light of a total lifestyle, not as an occurrence in an isolated time of life. Adult play appears to be an indefinable and controversial concept. A holistic approach should be…

  18. CPR: Adult

    MedlinePlus Videos and Cool Tools

    Refresher Center Home FIRST AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Adult (2:03) Refresher videos only utilize this player QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store ...

  19. Thermal resistance model for CSP central receivers

    NASA Astrophysics Data System (ADS)

    de Meyer, O. A. J.; Dinter, F.; Govender, S.

    2016-05-01

    The receiver design and heliostat field aiming strategy play a vital role in the heat transfer efficiency of the receiver. In molten salt external receivers, the common operating temperature of the heat transfer fluid or molten salt ranges between 285°C to 565°C. The optimum output temperature of 565°C is achieved by adjusting the mass flow rate of the molten salt through the receiver. The reflected solar radiation onto the receiver contributes to the temperature rise in the molten salt by means of heat transfer. By investigating published work on molten salt external receiver operating temperatures, corresponding receiver tube surface temperatures and heat losses, a model has been developed to obtain a detailed thermographic representation of the receiver. The steady state model uses a receiver flux map as input to determine: i) heat transfer fluid mass flow rate through the receiver to obtain the desired molten salt output temperature of 565°C, ii) receiver surface temperatures iii) receiver tube temperatures iv) receiver efficiency v) pressure drop across the receiver and vi) corresponding tube strain per panel.

  20. Adults with ADHD. An overview.

    PubMed

    Wender, P H; Wolf, L E; Wasserstein, J

    2001-06-01

    Attention-Deficit Hyperactivity Disorder (ADHD) is a common, genetically transmitted neurological disorder, with onset in childhood, probably mediated by decreased brain dopaminergic functioning. The first author was one of the earliest to describe the persistence of symptoms into adulthood. Prevalence and natural history data suggest that of the 3 to 10% of children diagnosed with ADHD, one- to two-thirds (somewhere between 1 and 6% of the general population) continue to manifest appreciable ADHD symptoms into adult life. This paper describes how ADHD in adults can be readily diagnosed and treated, despite resembling or coexisting with other psychiatric disorders. The Wender Utah diagnostic criteria address adult characteristics of the disorder. Informant and patient interviews and rating scales are used to determine the psychiatric status of the patient as a child, make a retroactive diagnosis of childhood ADHD, and establish the current diagnosis of the adult. Stringent diagnosis is key to determining effective treatment. Dopamine agonist stimulant medications appear to be the most effective in treating ADHD. About 60% of patients receiving stimulant medication showed moderate-to-marked improvement, as compared with 10% of those receiving placebo. The core symptoms of hyperactivity, inattention, mood lability, temper, disorganization, stress sensitivity, and impulsivity have been shown to respond to treatment with stimulant medications. Non-dopaminergic medications, such as the tricyclic antidepressants and SSRIs have generally not been useful in adults with ADHD in the absence of depression or dysthymia. Pemoline is no longer approved for use in these patients, despite early favorable reports. Appropriate management of adult patients with ADHD is multimodal. Psychoeducation, counseling, supportive problem-directed therapy, behavioral intervention, coaching, cognitive remediation, and couples and family therapy are useful adjuncts to medication management