The Role of Higher Education Institutions in Rural Development

ERIC Educational Resources Information Center

Bryden, John

2007-01-01

The topic of this paper has emerged from the work of Shelton (2000, 2003), Bernhardt, Kawagley and Hill (2000), Boylan and McSwan (1998), Bryden and Boylan (2004) and others on "place-based" and "consequential" education in rural areas, prompting the question: if place-based and consequential education is "good" for…

Validation diagnostics for defective thermocouple circuits

NASA Astrophysics Data System (ADS)

Reed, R. P.

Thermocouples, properly used under favorable conditions, can measure temperature with an accepted tolerance. However, when improperly applied or exposed to hostile mechanical, chemical, thermal, or radiation environments, they often fail without the error being evident in the temperature record. Conversely, features that appear to be unreasonable in temperature records can be authentic. When hidden failure occurs during measurement, deliberate recording of supplementary information is necessary to distinguish valid from faulty data. Loop resistance change, circuit isolation, isolated noise potential, and other measures can reveal symptoms of developing defects. Monitored continually along with temperature, they can reveal the occurrence, location, and natures of damage incurred during measurement. Special multiterminal branched thermocouple circuits and combinatorial multiplex switching allow detection of dc measurement noise and decalibration. Symptoms of insidious failure, often consequential, are illustrated by examples from field experience in measuring temperature of a propagating retorting front in underground coal gasification.

An Examination of Two Procedures for Identifying Consequential Item Parameter Drift

ERIC Educational Resources Information Center

Wells, Craig S.; Hambleton, Ronald K.; Kirkpatrick, Robert; Meng, Yu

2014-01-01

The purpose of the present study was to develop and evaluate two procedures flagging consequential item parameter drift (IPD) in an operational testing program. The first procedure was based on flagging items that exhibit a meaningful magnitude of IPD using a critical value that was defined to represent barely tolerable IPD. The second procedure…

Consequential Validity Impact of Choosing Different Aptitude-Achievement Discrepancy Models in Identifying Students with Learning Disabilities.

ERIC Educational Resources Information Center

Glasnapp, Douglas R.; Poggio, John P.

This study used computer simulation to provide information on the percentage of students with learning disabilities expected to be identified under different aptitude-achievement discrepancy eligibility models and criteria and to demonstrate the consequential effects in terms of the extent to which the different models identify students of…

Late Consequential Surgical Bed Soft Tissue Necrosis in Advanced Oropharyngeal Squamous Cell Carcinomas Treated With Transoral Robotic Surgery and Postoperative Radiation Therapy

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

Lukens, J. Nicholas; Lin, Alexander, E-mail: alexander.lin@uphs.upenn.edu; Gamerman, Victoria

Purpose: A subset of patients with oropharyngeal squamous cell carcinoma (OP-SCC) managed with transoral robotic surgery (TORS) and postoperative radiation therapy (PORT) developed soft tissue necrosis (STN) in the surgical bed months after completion of PORT. We investigated the frequency and risk factors. Materials and Methods: This retrospective analysis included 170 consecutive OP-SCC patients treated with TORS and PORT between 2006 and 2012, with >6 months' of follow-up. STN was defined as ulceration of the surgical bed >6 weeks after completion of PORT, requiring opioids, biopsy, or hyperbaric oxygen therapy. Results: A total of 47 of 170 patients (28%) hadmore » a diagnosis of STN. Tonsillar patients were more susceptible than base-of-tongue (BOT) patients, 39% (41 of 104) versus 9% (6 of 66), respectively. For patients with STN, median tumor size was 3.0 cm (range 1.0-5.6 cm), and depth of resection was 2.2 cm (range 1.0-5.1 cm). Median radiation dose and dose of fraction to the surgical bed were 6600 cGy and 220 cGy, respectively. Thirty-one patients (66%) received concurrent chemotherapy. Median time to STN was 2.5 months after PORT. All patients had resolution of STN after a median of 3.7 months. Multivariate analysis identified tonsillar primary (odds ratio [OR] 4.73, P=.01), depth of resection (OR 3.12, P=.001), total radiation dose to the resection bed (OR 1.51 per Gy, P<.01), and grade 3 acute mucositis (OR 3.47, P=.02) as risk factors for STN. Beginning May 2011, after implementing aggressive avoidance of delivering >2 Gy/day to the resection bed mucosa, only 8% (2 of 26 patients) experienced STN (all grade 2). Conclusions: A subset of OP-SCC patients treated with TORS and PORT are at risk for developing late consequential surgical bed STN. Risk factors include tonsillar location, depth of resection, radiation dose to the surgical bed, and severe mucositis. STN risk is significantly decreased with carefully avoiding a radiation dosage of >2 Gy/day to the surgical bed.« less

Life cycle costing of food waste: A review of methodological approaches.

PubMed

De Menna, Fabio; Dietershagen, Jana; Loubiere, Marion; Vittuari, Matteo

2018-03-01

Food waste (FW) is a global problem that is receiving increasing attention due to its environmental and economic impacts. Appropriate FW prevention, valorization, and management routes could mitigate or avoid these effects. Life cycle thinking and approaches, such as life cycle costing (LCC), may represent suitable tools to assess the sustainability of these routes. This study analyzes different LCC methodological aspects and approaches to evaluate FW management and valorization routes. A systematic literature review was carried out with a focus on different LCC approaches, their application to food, FW, and waste systems, as well as on specific methodological aspects. The review consisted of three phases: a collection phase, an iterative phase with experts' consultation, and a final literature classification. Journal papers and reports were retrieved from selected databases and search engines. The standardization of LCC methodologies is still in its infancy due to a lack of consensus over definitions and approaches. Research on the life cycle cost of FW is limited and generally focused on FW management, rather than prevention or valorization of specific flows. FW prevention, valorization, and management require a consistent integration of LCC and Life Cycle Assessment (LCA) to avoid tradeoffs between environmental and economic impacts. This entails a proper investigation of methodological differences between attributional and consequential modelling in LCC, especially with regard to functional unit, system boundaries, multi-functionality, included cost, and assessed impacts. Further efforts could also aim at finding the most effective and transparent categorization of costs, in particular when dealing with multiple stakeholders sustaining costs of FW. Interpretation of results from LCC of FW should take into account the effect on larger economic systems. Additional key performance indicators and analytical tools could be included in consequential approaches. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Consequential Validity and the Transformation of Tests from Measurement Tools to Policy Tools

ERIC Educational Resources Information Center

Welner, Kevin G.

2013-01-01

Background/Context: Recent U.S. policy has brought a shift in assessment use, from measurement tools to policy levers. In particular, testing has become a core part of teacher evaluation policies in many states, with test results becoming akin to a job evaluation. Purpose: To explore the notion of consequential validity in assessment use and…

Designing a Consequentially Based Study into the Online Support of Pre-Service Teachers in the UK

ERIC Educational Resources Information Center

Kontopoulou, Konstantina; Fox, Alison

2015-01-01

This paper reports on the design of a pilot doctoral study into the online support of pre-service teachers. It highlights the significance of a consequential, rather than deontological, perspective in guiding the development of a study's design. The study initially aimed to explore pre-service teachers' perceptions and use of social media on their…

FARC’s Influence in Brazil

DTIC Science & Technology

2013-05-23

to improving the ongoing Brazilian government policy, and consequentially the operational role of the Brazilian Army and its contribution to achieving...threats may be conducive to improving the ongoing Brazilian government policy, and consequentially the operational role of the Brazilian Army and its...approximately 10,000 miles) of the coastline borders its neighbors.1 It shares a border with all South American countries except Chile, Ecuador

42 CFR 482.56 - Condition of participation: Rehabilitation services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services... to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech..., physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language...

Ethics in the Military: A Review of Junior Officer Education and Training Programs

DTIC Science & Technology

2004-12-01

based ethics are founded upon the principles of consequentialism, utilitarianism, and egoism . Consequentialism is the balancing of good and bad results...and pain. It should also consider the good and bad consequences of the action. Egoism lies between utilitarianism and virtue-based ethics . It is...already possesses a moral pre- disposition , but aims to teach virtues that support navy/officer/academy core values. The genesis for the ethics course

New insights into the pathophysiology of achalasia and implications for future treatment.

PubMed

Furuzawa-Carballeda, Janette; Torres-Landa, Samuel; Valdovinos, Miguel Ángel; Coss-Adame, Enrique; Martín Del Campo, Luis A; Torres-Villalobos, Gonzalo

2016-09-21

Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn. Even though idiopathic achalasia was first described more than 300 years ago, researchers are only now beginning to unravel its complex etiology and molecular pathology. The most recent findings indicate an autoimmune component, as suggested by the presence of circulating anti-myenteric plexus autoantibodies, and a genetic predisposition, as suggested by observed correlations with other well-defined genetic syndromes such as Allgrove syndrome and multiple endocrine neoplasia type 2 B syndrome. Viral agents (herpes, varicella zoster) have also been proposed as causative and promoting factors. Unfortunately, the therapeutic approaches available today do not resolve the causes of the disease, and only target the consequential changes to the involved tissues, such as destruction of the LES, rather than restoring or modifying the underlying pathology. New therapies should aim to stop the disease at early stages, thereby preventing the consequential changes from developing and inhibiting permanent damage. This review focuses on the known characteristics of idiopathic achalasia that will help promote understanding its pathogenesis and improve therapeutic management to positively impact the patient's quality of life.

New insights into the pathophysiology of achalasia and implications for future treatment

PubMed Central

Furuzawa-Carballeda, Janette; Torres-Landa, Samuel; Valdovinos, Miguel Ángel; Coss-Adame, Enrique; Martín del Campo, Luis A; Torres-Villalobos, Gonzalo

2016-01-01

Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn. Even though idiopathic achalasia was first described more than 300 years ago, researchers are only now beginning to unravel its complex etiology and molecular pathology. The most recent findings indicate an autoimmune component, as suggested by the presence of circulating anti-myenteric plexus autoantibodies, and a genetic predisposition, as suggested by observed correlations with other well-defined genetic syndromes such as Allgrove syndrome and multiple endocrine neoplasia type 2 B syndrome. Viral agents (herpes, varicella zoster) have also been proposed as causative and promoting factors. Unfortunately, the therapeutic approaches available today do not resolve the causes of the disease, and only target the consequential changes to the involved tissues, such as destruction of the LES, rather than restoring or modifying the underlying pathology. New therapies should aim to stop the disease at early stages, thereby preventing the consequential changes from developing and inhibiting permanent damage. This review focuses on the known characteristics of idiopathic achalasia that will help promote understanding its pathogenesis and improve therapeutic management to positively impact the patient’s quality of life. PMID:27672286

Antiretroviral therapy related adverse effects: Can sub-Saharan Africa cope with the new "test and treat" policy of the World Health Organization?

PubMed

Nansseu, Jobert Richie N; Bigna, Jean Joel R

2017-02-15

Recent studies have shown that early antiretroviral therapy (ART) initiation results in significant HIV transmission reduction. This is the rationale behind the "test and treat" policy of the World Health Organization (WHO). Implementation of this policy will lead to an increased incidence of ART-related adverse effects, especially in sub-Saharan Africa (SSA). Is the region yet ready to cope with such a challenging issue? The introduction and widespread use of ART have drastically changed the natural history of HIV/AIDS, but exposure to ART leads to serious medication-related adverse effects mainly explained by mitochondrial toxicities, and the situation will get worse in the near future. Indeed, ART is associated with an increased risk of developing cardiovascular disease, lipodystrophy, prediabetes and overt diabetes, insulin resistance and hyperlactatemia/lactic acidosis. The prevalence of these disorders is already high in SSA, and the situation will be exacerbated by the implementation of the new WHO recommendations. Most SSA countries are characterized by (extreme) poverty, very weak health systems, inadequate and low quality of health services, inaccessibility to existing health facilities, lack of (qualified) health personnel, lack of adequate equipment, inaccessibility and unaffordability of medicines, and heavy workload in a context of a double burden of disease. Additionally, there is dearth of data on the incidence and predictive factors of ART-related adverse effects in SSA, to anticipate on strategies that should be put in place to prevent the occurrence of these conditions or properly estimate the upcoming burden and prepare an adequate response plan. These are required if we are to anticipate and effectively prevent this upcoming burden. While SSA would be the first region to experience the huge benefits of implementing the "test and treat" policy of the WHO, the region is not yet prepared to manage the consequential increased burden of ART-related toxic and metabolic complications. Urgent measures should be taken to fill the lacunae if SSA is not to become over-burdened by the consequences of the "test and treat" policy.

Comparative lifecycle assessment of alternatives for waste management in Rio de Janeiro - Investigating the influence of an attributional or consequential approach.

PubMed

Bernstad Saraiva, A; Souza, R G; Valle, R A B

2017-10-01

The environmental impacts from three management alternatives for organic fraction of municipal solid waste were compared using lifecycle assessment methodology. The alternatives (sanitary landfill, selective collection of organic waste for anaerobic digestion and anaerobic digestion after post-separation of organic waste) were modelled applying an attributional as well as consequential approach, in parallel with the aim of identifying if and how these approaches can affect results and conclusions. The marginal processes identified in the consequential modelling were in general associated with higher environmental impacts than average processes modelled with an attributional approach. As all investigated waste management alternatives result in net-substitution of energy and in some cases also materials, the consequential modelling resulted in lower absolute environmental impacts in five of the seven environmental impact categories assessed in the study. In three of these, the chosen modelling approach can alter the hierarchy between compared waste management alternatives. This indicates a risk of underestimating potential benefits from efficient energy recovery from waste when applying attributional modelling in contexts in which electricity provision historically has been dominated by technologies presenting rather low environmental impacts, but where projections point at increasing impacts from electricity provision in coming years. Thus, in the present case study, the chosen approach affects both absolute and relative results from the comparison. However, results were largely related to the processes identified as affected by investigated changes, and not merely the chosen modelling approach. The processes actually affected by future choices between different waste management alternatives are intrinsically uncertain. The study demonstrates the benefits of applying different assumptions regarding the processes affected by investigated choices - both for provision of energy and materials substituted by waste management processes in consequential LCA modelling, in order to present outcomes that are relevant as decision support within the waste management sector. Copyright © 2017 Elsevier Ltd. All rights reserved.

Selecting Students for Pre-Algebra: Examination of the Relative Utility of the Anchorage Pre-Algebra Screening Tests and the State of Alaska Standards Based Benchmark 2 Mathematics Study. An Examination of Consequential Validity and Recommendation.

ERIC Educational Resources Information Center

Fenton, Ray

This study examined the relative efficacy of the Anchorage (Alaska) Pre-Algebra Test and the State of Alaska Benchmark in 2 Math examination as tools used in the process of recommending grade 6 students for grade 7 Pre-Algebra placement. The consequential validity of the tests is explored in the context of class placements and grades earned. The…

Examining the Role of Religiosity in Moral Cognition, Specifically in the Formation of Sacred Values, and Researching Computational Models for Analyzing Sacred Rhetoric and its Consequential Emotions

DTIC Science & Technology

2015-08-13

AFRL-AFOSR-VA-TR-2015-0270 Examining the Role of Religiosity in Moral Cognition, Specifically in the Formation of Sacred Values, and Researching...Computational Models for Analyzing Sacred Rhetoric and its Consequential Emotions Morteza Dehghani UNIVERSITY OF SOUTHERN CALIFORNIA LOS ANGELES Final...SUBTITLE (YIP-12) Examining the Role of Religiosity in Moral Cognition, Specifically in the Formation of Sacred Values, and Researching Computational

42 CFR 482.56 - Condition of participation: Rehabilitation services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... offered. (1) The director of the services must have the necessary knowledge, experience, and capabilities to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services...

The role of MACF1 in nervous system development and maintenance.

PubMed

Moffat, Jeffrey J; Ka, Minhan; Jung, Eui-Man; Smith, Amanda L; Kim, Woo-Yang

2017-09-01

Microtubule-actin crosslinking factor 1 (MACF1), also known as actin crosslinking factor 7 (ACF7), is essential for proper modulation of actin and microtubule cytoskeletal networks. Most MACF1 isoforms are expressed broadly in the body, but some are exclusively found in the nervous system. Consequentially, MACF1 is integrally involved in multiple neural processes during development and in adulthood, including neurite outgrowth and neuronal migration. Furthermore, MACF1 participates in several signaling pathways, including the Wnt/β-catenin and GSK-3 signaling pathways, which regulate key cellular processes, such as proliferation and cell migration. Genetic mutation or dysregulation of the MACF1 gene has been associated with neurodevelopmental and neurodegenerative diseases, specifically schizophrenia and Parkinson's disease. MACF1 may also play a part in neuromuscular disorders and have a neuroprotective role in the optic nerve. In this review, the authors seek to synthesize recent findings relating to the roles of MACF1 within the nervous system and explore potential novel functions of MACF1 not yet examined. Copyright © 2017 Elsevier Ltd. All rights reserved.

Current management of atopic dermatitis and interruption of the atopic march.

PubMed

Boguniewicz, Mark; Eichenfield, Lawrence F; Hultsch, Thomas

2003-12-01

Treatment of atopic dermatitis requires a comprehensive approach that includes evaluation of potential triggers and education of the patient and family regarding proper avoidance measures. Hydration of the skin and maintenance of an intact skin barrier remain integral to proper management. Although topical corticosteroids have been a mainstay of anti-inflammatory therapy, the newer topical calcineurin inhibitors offer advantages for treatment of this chronic, relapsing disease. Studies aimed at defining optimal combination therapy and early intervention might change the treatment paradigm for atopic dermatitis.

Addressing trend-related changes within cumulative effects studies in water resources planning

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

Canter, L.W., E-mail: envimptr@aol.com; Chawla, M.K.; Swor, C.T.

2014-01-15

Summarized herein are 28 case studies wherein trend-related causative physical, social, or institutional changes were connected to consequential changes in runoff, water quality, and riparian and aquatic ecological features. The reviewed cases were systematically evaluated relative to their identified environmental effects; usage of analytical frameworks, and appropriate models, methods, and technologies; and the attention given to mitigation and/or management of the resultant causative and consequential changes. These changes also represent important considerations in project design and operation, and in cumulative effects studies associated therewith. The cases were grouped into five categories: institutional changes associated with legislation and policies (seven cases);more » physical changes from land use changes in urbanizing watersheds (eight cases); physical changes from land use changes and development projects in watersheds (four cases); physical, institutional, and social changes from land use and related policy changes in river basins (three cases); and multiple changes within a comprehensive study of land use and policy changes in the Willamette River Basin in Oregon (six cases). A tabulation of 110 models, methods and technologies used in the studies is also presented. General observations from this review were that the features were unique for each case; the consequential changes were logically based on the causative changes; the analytical frameworks provided relevant structures for the studies, and the identified methods and technologies were pertinent for addressing both the causative and consequential changes. One key lesson was that the cases provide useful, “real-world” illustrations of the importance of addressing trend-related changes in cumulative effects studies within water resources planning. Accordingly, they could be used as an “initial tool kit” for addressing trend-related changes.« less

Inhalation devices: from basic science to practical use, innovative vs generic products.

PubMed

Pirozynski, Michal; Sosnowski, Tomasz R

2016-11-01

Inhalation therapy is a convenient method of treating respiratory diseases. The key factors required for inhalation are the preparation of drug carriers (aerosol particles) allowing reproducible dosing during administration. These technical challenges are accomplished with a variety of inhalation devices (inhalers) and medicinal formulations, which are optimized to be easily converted into inhalable aerosols. Areas covered: This review is focused on the most important, but often overlooked, effects, which are required for the reliable and reproducible inhalable drug administration. The effects of patient-related issues that influence inhalation therapy, such as proper selection of inhalers for specific cases is discussed. We also discuss factors that are the most essential if generic inhalation product should be considered equivalent to the drugs with the clinically confirmed efficacy. Expert opinion: Proper device selection is crucial in clinical results of inhalation therapy. The patients' ability to coordinate inhalation with actuation, generation of optimal flow through the device, use of optimal inspiratory volume, all produces crucial effects on disease control. Also the severity of the disease process effects proper use of inhalers. Interchanging of inhalers can produce potentially conflicting problem regarding efficacy and safety of inhalation therapy.

Remarkable rates of lightning strike mortality in Malawi.

PubMed

Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

2012-01-01

Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

Difficulties with diagnosis and consequential poor outcome due to stigma of acquired immunodeficiency syndrome - a case report.

PubMed

Vuletic, Vladimira; Nevajda, Branimir; Spero, Martina; Chudy, Darko

2013-09-01

Low incidence of human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) has been detected in Croatia so far. Toxoplasmic encephalitis (TE) is the most common opportunistic cerebral infection in AIDS patients and is highly responsive to antiparasitic chemotherapy, if treated at an early stage. We present the case of the brain biopsy confirmed as TE on a 36-year-old female patient who at admission presented with unconsciousness and a right hemiplegia. A MSCT was performed and two hypodense lesions were diagnosed. The patient's family initially denied the presence or history of any medical problem or infection. An MRI showed multiple ring-enhanced mass lesions. An infectologist required a brain biopsy to exclude cerebral lymphoma and multiple metastases. Pathohistological analysis suggested TE. Meanwhile, patient's blood samples were found to be HIV positive. The patient was transferred to University Hospital for Infectious Diseases in Zagreb, where she died 2 days following admission. The patient's family terminally confessed that the patient had been HIV positive for 10 years and had refused any treatment. Family's denial of infection as well as 'hiding information' concerning patient's health from physicians involved in her treatment caused a delay in proper on-time patient treatment. We would like to emphasize that TE must be considered as a differential diagnosis in patients presenting with multiple cerebral lesions, including patients without acknowledged past history of HIV infection. A stigma towards HIV infection and ignorance of the disease still exist and therefore hinders proper treatment.

Difficulties with diagnosis and consequential poor outcome due to stigma of acquired immunodeficiency syndrome – a case report

PubMed Central

Vuletic, Vladimira; Nevajda, Branimir; Spero, Martina; Chudy, Darko

2013-01-01

Low incidence of human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) has been detected in Croatia so far. Toxoplasmic encephalitis (TE) is the most common opportunistic cerebral infection in AIDS patients and is highly responsive to antiparasitic chemotherapy, if treated at an early stage. We present the case of the brain biopsy confirmed as TE on a 36-year-old female patient who at admission presented with unconsciousness and a right hemiplegia. A MSCT was performed and two hypodense lesions were diagnosed. The patient’s family initially denied the presence or history of any medical problem or infection. An MRI showed multiple ring-enhanced mass lesions. An infectologist required a brain biopsy to exclude cerebral lymphoma and multiple metastases. Pathohistological analysis suggested TE. Meanwhile, patient’s blood samples were found to be HIV positive. The patient was transferred to University Hospital for Infectious Diseases in Zagreb, where she died 2 days following admission. The patient’s family terminally confessed that the patient had been HIV positive for 10 years and had refused any treatment. Family’s denial of infection as well as ‘hiding information’ concerning patient’s health from physicians involved in her treatment caused a delay in proper on-time patient treatment. We would like to emphasize that TE must be considered as a differential diagnosis in patients presenting with multiple cerebral lesions, including patients without acknowledged past history of HIV infection. A stigma towards HIV infection and ignorance of the disease still exist and therefore hinders proper treatment. PMID:24091082

Disparate effects of single endothelin A and B receptor blocker therapy on the progression of renal injury in advanced renovascular disease

PubMed Central

Chade, Alejandro R.; Stewart, Nicholas J.; Peavy, Patrick R.

2013-01-01

We hypothesized that chronic specific endothelin (ET)-A receptor blockade therapy would reverse renal dysfunction and injury in advanced experimental renovascular disease. To test this, unilateral renovascular disease was induced in 19 pigs and after 6 weeks, single-kidney hemodynamics and function was quantified in vivo using computed-tomography. All pigs with renovascular disease were divided such that 7 were untreated, 7 were treated with ET-A blockers, and 5 were treated with ET-B blockers. Four weeks later, all pigs were re-studied in vivo, then euthanized and ex vivo studies performed on the stenotic kidney to quantify microvascular density, remodeling, renal oxidative stress, inflammation, and fibrosis. RBF, GFR, and redox status were significantly improved in the stenotic kidney after ET-A but not ET-B blockade. Furthermore, only ET-A blockade therapy reversed renal microvascular rarefaction and diminished remodeling, which was accompanied by a marked decreased in renal inflammatory and fibrogenic activity. Thus, ET-A but not ET-B blockade ameliorated renal injury in pigs with advanced renovascular disease by stimulating microvascular proliferation and decreasing the progression of microvascular remodeling, renal inflammation and fibrosis in the stenotic kidney. These effects were functionally consequential since ET-A blockade improved single kidney microvascular endothelial function, RBF, and GFR, and decreased albuminuria. PMID:24352153

[Sleep disturbances in Parkinson's disease: characteristics, evaluation and therapeutic approaches].

PubMed

Faludi, Béla; Janszky, József; Komoly, Sámuel; Kovács, Norbert

2015-07-05

Parkinson's disease is a well known representent of the movement disorder group of neurological disorders. The diagnosis of Parkinson's disease is based on specific symptoms and signs of movement abnormalities. In addition to classic motor symptoms, Parkinson's disease has characteristic non-motor features, and some of these emerges the classic signs. The authors discuss characteristics and therapeutic interventions in Parkinson's disease related sleep disturbances. The authors reviewed and summarised literature data on sleep disorders in Parkinson's disease published in the PubMed database up to January 2015. Sleep problems are important non-motor complains (insomnia, hypersomnia, REM behaviour disorder, sleep apnea and restless legs syndrome). The neurodegenerative process of the brain-stem, the effect of symptoms of Parkinson's disease on sleep and concomitant sleep disorders constitute the background of the patient's complains. Appropriate diagnosis and therapy of the consequential or concomitant sleep disorders in Parkinson's disease will help to improve the patient's quality of life.

Application of bifurcation theory and siRNA-based control signal to restore the proper response of cancer cells to DNA damage.

PubMed

Kozłowska, Emilia; Puszynski, Krzysztof

2016-11-07

Many diseases with a genetic background such as some types of cancer are caused by damage in the p53 signaling pathway. The damage changes the system dynamics providing cancer cells with resistance to therapy such as radiation therapy. The change can be observed as the difference in bifurcation diagrams and equilibria type and location between normal and damaged cells, and summarized as the changes of the mathematical model parameters and following changes of the eigenvalues of Jacobian matrix. Therefore a change in other model parameters, such as mRNA degradation rates, may restore the proper eigenvalues and by that proper system dynamics. From the biological point of view, the change of mRNA degradation rate can be achieved by application of the small interfering RNA (siRNA). Here, we propose a general mathematical framework based on the bifurcation theory and siRNA-based control signal in order to study how to restore the proper response of cells with damaged p53 signaling pathway to therapy by using ionizing radiation (IR) therapy as an example. We show the difference between the cells with normal p53 signaling pathway and cells with abnormalities in the negative (as observed in SJSA-1 cell line) or positive (as observed in MCF-7 or PNT1a cell lines) feedback loop. Then we show how the dynamics of these cells can be restored to normal cell dynamics by using selected siRNA. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Reducing the risk of burns during electroconvulsive therapy.

PubMed

2011-10-01

Poor contact between electroconvulsive therapy (ECT) electrodes and the skin can result in patient burns during ECT treatment. Proper site preparation and electrode application are essential to ensure adequate contact and to reduce the risk of burns.

Remarkable Rates of Lightning Strike Mortality in Malawi

PubMed Central

Borgerhoff Mulder, Monique; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

2012-01-01

Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area. PMID:22253708

Consequentialism and the Synthetic Biology Problem.

PubMed

Heavey, Patrick

2017-04-01

This article analyzes the ethics of synthetic biology (synbio) from a consequentialist perspective, examining potential effects on food and agriculture, and on medicine, fuel, and the advancement of science. The issues of biosafety and biosecurity are also examined. A consequentialist analysis offers an essential road map to policymakers and regulators as to how to deal with synbio. Additionally, the article discusses the limitations of consequentialism as a tool for analysing synbioethics. Is it possible to predict, with any degree of plausibility, what the consequences of synthetic biology will be in 50 years, or in 100, or in 500? Synbio may take humanity to a place of radical departure from what is known or knowable.

Catalytic Oxidation of Lignins into the Aromatic Aldehydes: General Process Trends and Development Prospects

PubMed Central

Tarabanko, Valery E.; Tarabanko, Nikolay

2017-01-01

This review discusses principal patterns that govern the processes of lignins’ catalytic oxidation into vanillin (3-methoxy-4-hydroxybenzaldehyde) and syringaldehyde (3,5-dimethoxy-4-hydroxybenzaldehyde). It examines the influence of lignin and oxidant nature, temperature, mass transfer, and of other factors on the yield of the aldehydes and the process selectivity. The review reveals that properly organized processes of catalytic oxidation of various lignins are only insignificantly (10–15%) inferior to oxidation by nitrobenzene in terms of yield and selectivity in vanillin and syringaldehyde. Very high consumption of oxygen (and consequentially, of alkali) in the process—over 10 mol per mol of obtained vanillin—is highlighted as an unresolved and unexplored problem: scientific literature reveals almost no studies devoted to the possibilities of decreasing the consumption of oxygen and alkali. Different hypotheses about the mechanism of lignin oxidation into the aromatic aldehydes are discussed, and the mechanism comprising the steps of single-electron oxidation of phenolate anions, and ending with retroaldol reaction of a substituted coniferyl aldehyde was pointed out as the most convincing one. The possibility and development prospects of single-stage oxidative processing of wood into the aromatic aldehydes and cellulose are analyzed. PMID:29140301

Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate.

PubMed

Christie, Timothy; Groarke, Louis; Sweet, William

2008-02-01

There is strong evidence that harm reduction interventions such as Supervised Injection Sites and Needle Exchange Programs prevent many of the negative consequences of problematic substance use. Yet many governments, including the United States and Canada, still do not endorse these interventions, claiming that they do not get people off of drugs and send a mixed message. This paper will analyze objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle. The most important ethical issue in the abstinence vs. harm reduction debate is whether harm reduction - because it does not require individuals to either reduce their consumption of illicit substances or to abstain from illicit substance use - can be ethically justified. Harm reduction interventions are clearly justified on Utilitarian grounds because, based on the evidence, such policies would produce the greatest good for the greatest number. However, Kant would not think that the values guiding harm reduction are ethical because the justification of harm reduction interventions focuses exclusively on examining consequences. Virtue Ethics seeks to find the proper balance between harm reduction and abstinence. We claim that the virtue of compassion would provide a defense of harm reduction.

Catalytic Oxidation of Lignins into the Aromatic Aldehydes: General Process Trends and Development Prospects.

PubMed

Tarabanko, Valery E; Tarabanko, Nikolay

2017-11-15

This review discusses principal patterns that govern the processes of lignins' catalytic oxidation into vanillin (3-methoxy-4-hydroxybenzaldehyde) and syringaldehyde (3,5-dimethoxy-4-hydroxybenzaldehyde). It examines the influence of lignin and oxidant nature, temperature, mass transfer, and of other factors on the yield of the aldehydes and the process selectivity. The review reveals that properly organized processes of catalytic oxidation of various lignins are only insignificantly (10-15%) inferior to oxidation by nitrobenzene in terms of yield and selectivity in vanillin and syringaldehyde. Very high consumption of oxygen (and consequentially, of alkali) in the process-over 10 mol per mol of obtained vanillin-is highlighted as an unresolved and unexplored problem: scientific literature reveals almost no studies devoted to the possibilities of decreasing the consumption of oxygen and alkali. Different hypotheses about the mechanism of lignin oxidation into the aromatic aldehydes are discussed, and the mechanism comprising the steps of single-electron oxidation of phenolate anions, and ending with retroaldol reaction of a substituted coniferyl aldehyde was pointed out as the most convincing one. The possibility and development prospects of single-stage oxidative processing of wood into the aromatic aldehydes and cellulose are analyzed.

Subjective and objective assessment of patients' compression therapy skills as a predicator of ulcer recurrence.

PubMed

Mościcka, Paulina; Szewczyk, Maria T; Jawień, Arkadiusz; Cierzniakowska, Katarzyna; Cwajda-Białasik, Justyna

2016-07-01

To verify whether the subjectively and objectively assessed patient's skills in applying compression therapy constitute a predicting factor of venous ulcer recurrence. Systematic implementation of compression therapy by the patient is a core of prophylaxis for recurrent ulcers. Therefore, patient education constitutes a significant element of care. However, controversies remain if all individuals benefit equally from education. A retrospective analysis. The study included medical records of patients with venous ulcers (n = 351) treated between 2001 and 2011 at the Clinic for Chronic Wounds at Bydgoszcz Clinical Hospital. We compared two groups of patients, (1) with at least one episode of recurrent ulcer during the five-year observation period, and (2) without recurrences throughout the analysed period in terms of their theoretical skills and knowledge on compression therapy recorded at baseline and after one month. Very good self-assessment of a patient's compression therapy skills and weak assessment of these skills by a nurse proved significant risk factors for recurrence of the ulcers on univariate analysis. The significance of these variables as independent risk factors for recurrent ulcers has been also confirmed on multivariate analysis, which also took into account other clinical parameters. Building up proper compression therapy skills among the patients should be the key element of a properly construed nurse-based prophylactic program, as it is the most significant modifiable risk factor for recurrent ulcers. Although the development of compression skills is undeniably important, also other factors should be considered, e.g. surgical correction of superficial reflux. Instruction on compression therapy should be conducted by properly trained nursing personnel - the nurses should have received both content and psychological training. The compression therapy training should contain practical instruction with guided exercises and in-depth objective assessment of the effects of the training. © 2016 John Wiley & Sons Ltd.

Mental Health Service Career Ladder

DTIC Science & Technology

1994-01-01

suicide risk patients 54 H315 Adjust or inspect refrigerators for proper temperatures 54 1372 Participate in rehashes of therapy sessions 53 H320...included biofeedback (paragraph 13c), electroconvulsive therapy (ECT) (paragraph 13h), and combat/disaster casualty management (paragraph 13m). Two other...focused on identifying marital and family counseling factors and determining the purpose and procedures for administering electroconvulsive therapy (ECT

Phytoagents for Cancer Management: Regulation of Nucleic Acid Oxidation, ROS, and Related Mechanisms

PubMed Central

Shyur, Lie-Fen

2013-01-01

Accumulation of oxidized nucleic acids causes genomic instability leading to senescence, apoptosis, and tumorigenesis. Phytoagents are known to reduce the risk of cancer development; whether such effects are through regulating the extent of nucleic acid oxidation remains unclear. Here, we outlined the role of reactive oxygen species in nucleic acid oxidation as a driving force in cancer progression. The consequential relationship between genome instability and cancer progression highlights the importance of modulation of cellular redox level in cancer management. Current epidemiological and experimental evidence demonstrate the effects and modes of action of phytoagents in nucleic acid oxidation and provide rationales for the use of phytoagents as chemopreventive or therapeutic agents. Vitamins and various phytoagents antagonize carcinogen-triggered oxidative stress by scavenging free radicals and/or activating endogenous defence systems such as Nrf2-regulated antioxidant genes or pathways. Moreover, metal ion chelation by phytoagents helps to attenuate oxidative DNA damage caused by transition metal ions. Besides, the prooxidant effects of some phytoagents pose selective cytotoxicity on cancer cells and shed light on a new strategy of cancer therapy. The “double-edged sword” role of phytoagents as redox regulators in nucleic acid oxidation and their possible roles in cancer prevention or therapy are discussed in this review. PMID:24454991

Parasite-altered feeding behavior in insects: integrating functional and mechanistic research frontiers.

PubMed

Bernardo, Melissa A; Singer, Michael S

2017-08-15

Research on parasite-altered feeding behavior in insects is contributing to an emerging literature that considers possible adaptive consequences of altered feeding behavior for the host or the parasite. Several recent ecoimmunological studies show that insects can adaptively alter their foraging behavior in response to parasitism. Another body of recent work shows that infection by parasites can change the behavior of insect hosts to benefit the parasite; manipulations of host feeding behavior may be part of this phenomenon. Here, we address both the functional and the underlying physiological frontiers of parasite-altered feeding behavior in order to spur research that better integrates the two. Functional categories of parasite-altered behavior that are adaptive for the host include prophylaxis, therapy and compensation, while host manipulation is adaptive for the parasite. To better understand and distinguish prophylaxis, therapy and compensation, further study of physiological feedbacks affecting host sensory systems is especially needed. For host manipulation in particular, research on mechanisms by which parasites control host feedbacks will be important to integrate with functional approaches. We see this integration as critical to advancing the field of parasite-altered feeding behavior, which may be common in insects and consequential for human and environmental health. © 2017. Published by The Company of Biologists Ltd.

Photodynamic therapy (PDT) utilizing PhotofrinR for treatment of early esophageal cancer

NASA Astrophysics Data System (ADS)

Overholt, Bergein F.; Panjehpour, Masoud; Teffeteller, Elmeria; Rose, S. Mark

1993-06-01

Four lesions of early carcinoma of the esophagus found during endoscopic biopsies in three patients were treated with photodynamic therapy. Follow-up biopsies over 9 - 24 months remain negative for carcinoma. Endoscopic ultrasonography is essential for proper staging and treatment planning for these patients. Photodynamic therapy may provide an alternative to surgical resection for early esophageal carcinoma or severe dysplasia in Barrett's esophagus.

77 FR 76164 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... atmospheric pollution --Development of international measures for minimizing the transfer of invasive aquatic... pollution hazards of chemicals and preparation of consequential amendments --Additional guidelines for...

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... potential for, or the occurrence of, an allergic reaction as a result of drug therapy. (7) Clinical abuse..., including their avoidance, and the action required if they occur; (v) Techniques for self-monitoring drug therapy; (vi) Proper storage; (vii) Prescription refill information; and (viii) Action to be taken in the...

Distribution Atlas of Proliferating Bone Marrow in Non-Small Cell Lung Cancer Patients Measured by FLT-PET/CT Imaging, With Potential Applicability in Radiation Therapy Planning

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

Campbell, Belinda A., E-mail: Belinda.Campbell@petermac.org; Callahan, Jason; Bressel, Mathias

Purpose: Proliferating bone marrow is exquisitely sensitive to ionizing radiation. Knowledge of its distribution could improve radiation therapy planning to minimize unnecessary marrow exposure and avoid consequential prolonged myelosuppression. [18F]-Fluoro-3-deoxy-3-L-fluorothymidine (FLT)–positron emission tomography (PET) is a novel imaging modality that provides detailed quantitative images of proliferating tissues, including bone marrow. We used FLT-PET imaging in cancer patients to produce an atlas of marrow distribution with potential clinical utility. Methods and Materials: The FLT-PET and fused CT scans of eligible patients with non-small cell lung cancer (no distant metastases, no prior cytotoxic exposure, no hematologic disorders) were reviewed. The proportions of skeletalmore » FLT activity in 10 predefined bony regions were determined and compared according to age, sex, and recent smoking status. Results: Fifty-one patients were studied: 67% male; median age 68 (range, 31-87) years; 8% never smokers; 70% no smoking in the preceding 3 months. Significant differences in marrow distribution occurred between sex and age groups. No effect was detected from smoking in the preceding 3 months. Using the mean percentages of FLT uptake per body region, we created an atlas of the distribution of functional bone marrow in 4 subgroups defined by sex and age. Conclusions: This atlas has potential utility for estimating the distribution of active marrow in adult cancer patients to guide radiation therapy planning. However, because of interindividual variation it should be used with caution when radiation therapy risks ablating large proportions of active marrow; in such cases, individual FLT-PET scans may be required.« less

Caring for parents: a consequentialist approach.

PubMed

Sin, William

2016-03-01

In this paper, I explain the demands of filial obligations from act and rule consequentialism. More specifically, I defend a rule-consequentialist explanation of filial obligations, and identify a few factors in relation to the determination of filial demands; they include the costs of internalization of filial obligations, and the proportions of the young and the old generations in a population pyramid. I believe that in a society with an aging population, we may accept a strong view of filial obligation. Towards the end of the paper, I explain that rule-consequentialism is compatible with certain special views of filial obligations, such as the gratitude theory and the special goods theory; these theories represent ways in which adult children and their parents may obtain special goods from engaging in the relationship.

A virtue ethics approach to moral dilemmas in medicine

PubMed Central

Gardiner, P

2003-01-01

Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine. PMID:14519840

A virtue ethics approach to moral dilemmas in medicine.

PubMed

Gardiner, P

2003-10-01

Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.

Consequentialism, complacency, and slippery slope arguments.

PubMed

Oakley, Justin; Cocking, Dean

2005-01-01

The standard problem with many slippery slope arguments is that they fail to provide us with the necessary evidence to warrant our believing that the significantly morally worse circumstances they predict will in fact come about. As such these arguments have widely been criticised as 'scare-mongering'. Consequentialists have traditionally been at the forefront of such criticisms, demanding that we get serious about guiding our prescriptions for right action by a comprehensive appreciation of the empirical facts. This is not surprising, since consequentialism has traditionally been committed to the idea that right action be driven by empirical realities, and this hard-headed approach has been an especially notable feature of Australian consequentialism. But this apparent empirical hard-headedness is very selective. While consequentialists have understood their moral outlook and commitments as guided by a partnership with empirical science - most explicitly in their replies to the arguments of their detractors - some consequentialists have been remarkably complacent about providing empirical support for their own prescriptions. Our key example here is the consequentialist claim that our current practises of partiality in fact maximise the good, impartially conceived. This claim has invariably been made without compelling support for the large empirical claims upon which it rests, and so, like the speculative empirical hand-waving of weak slippery slope arguments, it seems similarly to be undermined. While these arguments have presented us with 'wishful thinking' rather than 'scare-mongering', we argue in this paper that their complacency in meeting the relevant empirical justificatory burden remains much the same.

Effective protective surveillance for waterside-located chemical plants

NASA Astrophysics Data System (ADS)

Love, John; Van Dover, Doug

2006-05-01

Millions of citizens live and work in the dangerous proximity of chemical plants, at ports and along waterways, which are under-protected and whose security is under-regulated, according to findings of the Congressional Research Service (CRS). There is a new and intense focus on the security of the nation's critical infrastructure. Thanks to recent philosophy and policy shifts within our federal government, the alarming situations in which we find ourselves will be mitigated somewhat a) by setting priorities based on proper threat analysis that considers event likelihoods and consequential impacts, and b) by employing effective systems design and engineering that will make it possible to address the highest priority threats with affordable solutions. It is the latter concern that we address, especially as it is relates to design and engineering of solutions for maintaining vigilance night and day. We begin by reviewing the nature of the facilities we wish to protect, our assumptions, and an accepted framework for analysis. Next we outline a hypothetical design case involving a representative facility and a plausible design basis threat. We then derive requirements for surveillance and examine the interrelationships among key design variables. Finally, we describe a solution involving multiple sensor types coupled with intelligent video. The end result is a significant increase in interdiction probability with a minimum of required assets.

Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence.

PubMed

Ball, P; Baquero, F; Cars, O; File, T; Garau, J; Klugman, K; Low, D E; Rubinstein, E; Wise, R

2002-01-01

Widespread, increasing antibiotic resistance amongst the major respiratory pathogens has compromised traditional therapy of the major infective respiratory syndromes, including bacterial pneumonia and acute exacerbations of chronic bronchitis. Guidelines for antibiotic prescribing dating from the 1980s to 1990s, which attempted to address such problems, were commonly too prescriptive and difficult to apply, and took little account of end-user practice or locally prevalent resistance levels. Further confusion was caused by conflicting recommendations emanating from differing specialty groups. The evidence that such guidelines benefited either clinical outcomes or treatment costs has been disputed. They have probably had little effect on resistance emergence. We report the recommendations of an independent, multi-national, inter-disciplinary group, which met to identify principles underlying prescribing and guideline formulation in an age of increasing bacterial resistance. Unnecessary prescribing was recognized as the major factor in influencing resistance and costs. Antibiotic therapy must be limited to syndromes in which bacterial infection is the predominant cause and should attempt maximal reduction in bacterial load, with the ultimate aim of bacterial eradication. It should be appropriate in type and context of local resistance prevalence, and optimal in dosage for the pathogen(s) involved. Prescribing should be based on pharmacodynamic principles that predict efficacy, bacterial eradication and prevention of resistance emergence. Pharmacoeconomic analyses confirm that bacteriologically more effective antibiotics can reduce overall management costs, particularly with respect to consequential morbidity and hospital admission. Application of these principles should positively benefit therapeutic outcomes, resistance avoidance and management costs and will more accurately guide antibiotic choices by both individuals and formulary/guideline committees.

75 FR 82129 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... consequential amendments; -- Application of the requirements for the carriage of bio-fuels and bio-fuel blends... through bio-fouling of ships; -- Revision of the IGC Code; -- Review of relevant non-mandatory instruments...

Physical medicine and rehabilitation in the elderly arthritic patient.

PubMed

Schutt, A H

1977-02-01

The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.

The structure and function of the epidermal barrier in patients with atopic dermatitis – treatment options. Part two

PubMed Central

Czarnecka-Operacz, Magdalena; Adamski, Zygmunt

2018-01-01

Atopic dermatitis (AD) is a chronic and recurrent disease induced by underlying defects of the epidermal barrier and immunological disorders, typical of atopic diseases. The genetic and immunological mechanisms (outlined in the previous paper) affecting the dysfunction of the barrier are intensified by environmental factors, e.g. airborne and food allergens, infections and stress. For this reason, proper skin care, which prevents further damage and restores the epidermal barrier is of such importance in the field of AD therapy. Appropriate therapy is based on emollients which, coupled with anti-inflammatory and antipruritic treatment, should be used as the first-line therapy. The aim of the present paper is to outline the effects of the abovementioned factors on the dysfunction of the epidermal barrier as well as to emphasize the importance of proper atopic skin care in maintaining the integrity of the barrier and preventing exacerbation of the disease. PMID:29760610

[The quality of patient information brochures can be improved: a discussion using radium-223 therapy as an example].

PubMed

Vogel, Wouter V; Lam, Marnix G E H; Vegt, Erik; Prompers, Leonne; Roef, Mark J

2015-01-01

Patients and their peers need to be adequately informed to ensure proper treatment selection, and to facilitate optimal realisation and outcome of treatment. Written patient information can contribute, but only when brochures are of sufficient quality. An evaluation of patient brochures for radium-223 therapy in the Netherlands revealed significant differences in the information provided, as well as discrepancies between the brochures and national guidelines and product documentation. This potentially leads to confusion, false expectations, wrong treatment decisions, suboptimal realisation and outcome of treatment, and unnecessary toxicity and in radiation hygiene risks. Here we discuss the option of national patient information brochures that can be used by all centres in order to circumvent such issues. This would require collaboration between all medical professions, patient organisations and other groups involved, and responsibilities for medical information, distribution and updates must be properly defined. A national patient information brochure of this kind is currently under development for radium-223 therapy.

[Risk factors for developing tuberculosis].

PubMed

Skodrić-Trifunović, Vesna

2004-01-01

Application of modern achievements in the field of medicine such as organ transplantation, long-term immunosuppressive therapy in treatment of numerous diseases, dialysis, successful treatment of malignant diseases prolonged duration of life and consequential continuation of long-term immunodeficiency. HIV infection currently represents a major risk factor for reactivation of tuberculosis with its associated relative risk being 30-170 times higher in comparison to the control group, in regard to the number of CD4 T-lymphocytes. Malignant diseases (hematological, lung and breast carcinomas) are important immunocompromising conditions affecting reactivation of tuberculosis, whereas the relative risk is 16. Development of tuberculosis among diabetics is considerably more frequent in comparison to general population (relative risk 2-4). Prominent glycoregulation disorders point to greater liability to development of tuberculosis. Alcoholism is characterized by general reduction of resistance, resulting from alcohol intoxication, malnutrition, irregular life style, etc. In malabsorption, immunosuppression is induced by deficiency of nutritive components and thus, relative risk for reactivation of tuberculosis is 5-12 in gastrectomy and 27-63 in jejunoileal bypass. In patients with chronic renal failur the relative risk ranges from 10 (nephropathies) to 37 (transplantation). Numerous patients use long-term immunosuppressive therapy that contributes to increased risk for developing tuberculosis (relative risk 12) as early as one month after application of a dose above 15 mg/day. There are numerous of risk factors that have frequently combined effects responsible for immunologic imbalance and development of tuberculosis.

Endo-periodontal lesion--endodontic approach.

PubMed

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system.

A Behavior Analytic Interpretation of Alexithymia

PubMed Central

Darrow, Sabrina M.; Follette, William C.

2014-01-01

Alexithymia is a term used to describe individuals who seem unable to experience or at least describe emotions. This paper offers a theoretical interpretation of alexithymia from a radical behaviorist perspective. While there have been attempts to explain the etiology of alexithymia, the current analysis is unique in that it provides direct treatment implications. The pragmatic analysis described focuses on the verbal behavior of individuals rather than looking “inside” for explanations. This is supported by a review of experimental research that has failed to find consistencies among alexithymic individuals’ physiological responding. Descriptions of the various discriminative and consequential stimulus conditions involved in the complex learning histories of individuals that could result in an alexithymic presentation are provided. This analysis helps situate the alexithymia construct in a broader behavior analytic understanding of emotions. Finally this paper outlines implications for assessment and treatment, which involve influencing discriminative and consequential interpersonal stimulus conditions to shape verbal behavior about emotions. PMID:25473602

Assessment of cortical auditory evoked potentials in children with specific language impairment.

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Pilka, Adam; Skarżyński, Henryk

2018-02-28

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Acupuncture therapy related cardiac injury.

PubMed

Li, Xue-feng; Wang, Xian

2013-12-01

Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

Principles of endodontic therapy.

PubMed

Lobprise, H B

1993-08-01

Endodontics is that branch of dentistry concerned with the treatment of damaged or diseased dental pulp. Veterinarians are now being asked to preserve tooth function and structure rather than to extract injured or diseased teeth. A variety of instruments are available that facilitate endodontic treatment. Endodontic treatment involves preparation (filing), sterilization, and obturation (filling) of the pulp cavity. Properly performed, endodontic therapy can effectively preserve dental structure and function. Complications of endodontic therapy will be discussed in "Problem Solving in Veterinary Endodontics" on page 165 in this issue.

Dystonia: Physical Therapy

MedlinePlus

... straight. Soft, sunken chairs and sofas do not foster proper alignment and may affect the position of ... dystonia, one should consider modifying the task to foster posture and muscle control. A person with trouble ...

Photomedicine and Stem Cells; The Janus face of photodynamic therapy (PDT) to kill cancer stem cells, and photobiomodulation (PBM) to stimulate normal stem cells

NASA Astrophysics Data System (ADS)

Abrahamse, Heidi; Hamblin, Michael R.

2017-12-01

Janus, the ancient Roman god depicted with two faces is an appropriate metaphor for light therapy. In the right photodynamic therapy conditions, light is able to kill nearly anything that is living such as cancers, microorganisms, parasites, and more. On the opposite face, light of the correct wavelength and proper dose (photobiomodulation) can heal, regenerate, protect, revitalize and restore any kind of dead, damaged, stressed, dying, degenerating cells, tissue, or organ system. This book discusses both sides of Janus' face in regards to light therapy.

Integrated deployment architecture for predictive real-time traffic routing incorporating human factors considerations.

DOT National Transportation Integrated Search

2014-05-01

As Advanced Traveler Information Systems (ATIS) are being more widely accessed by drivers, understanding drivers behavioral responses to real-time travel information through ATIS and its consequential benefits are important to the widespread deplo...

Moisture sensitivity of hot mix asphalt (HMA) mixtures in Nebraska : phase II.

DOT National Transportation Integrated Search

2009-12-01

As a consequential effort to the previous NDOR research project (P564) on moisture damage, this report presents : outcomes from this project incorporated with the previous project. Performance changes and fundamental material : characteristics associ...

Beyond Gaussians: a study of single spot modeling for scanning proton dose calculation

PubMed Central

Li, Yupeng; Zhu, Ronald X.; Sahoo, Narayan; Anand, Aman; Zhang, Xiaodong

2013-01-01

Active spot scanning proton therapy is becoming increasingly adopted by proton therapy centers worldwide. Unlike passive-scattering proton therapy, active spot scanning proton therapy, especially intensity-modulated proton therapy, requires proper modeling of each scanning spot to ensure accurate computation of the total dose distribution contributed from a large number of spots. During commissioning of the spot scanning gantry at the Proton Therapy Center in Houston, it was observed that the long-range scattering protons in a medium may have been inadequately modeled for high-energy beams by a commercial treatment planning system, which could lead to incorrect prediction of field-size effects on dose output. In the present study, we developed a pencil-beam algorithm for scanning-proton dose calculation by focusing on properly modeling individual scanning spots. All modeling parameters required by the pencil-beam algorithm can be generated based solely on a few sets of measured data. We demonstrated that low-dose halos in single-spot profiles in the medium could be adequately modeled with the addition of a modified Cauchy-Lorentz distribution function to a double-Gaussian function. The field-size effects were accurately computed at all depths and field sizes for all energies, and good dose accuracy was also achieved for patient dose verification. The implementation of the proposed pencil beam algorithm also enabled us to study the importance of different modeling components and parameters at various beam energies. The results of this study may be helpful in improving dose calculation accuracy and simplifying beam commissioning and treatment planning processes for spot scanning proton therapy. PMID:22297324

[Pain, flare-ups and failures in root canal therapy].

PubMed

Moorer, W R

1989-10-01

In this overview the incidences and causes of pain, flare-ups and failures that occur after root canal therapy are discussed. Infection is considered the most important single, underlying determinant of the many factors that may cause pain and failures. Therefore, strict adherence to recognized therapeutic principles of shaping, disinfection and filling, in addition to proper aftercare, is of importance to diminish postoperative sequelae.

Ethical issues in growth hormone therapy.

PubMed

Lantos, J; Siegler, M; Cuttler, L

1989-02-17

Pediatricians face clinical and ethical dilemmas about therapy to augment growth in short children who do not meet classic criteria for growth hormone (GH) deficiency. Biologic norms of health are unhelpful because of the uncertain relationship between stature, GH secretion, health, and disease. Instead, we suggest that GH therapy be evaluated from the perspective of cultural norms. We compare GH therapy for short normal children with currently accepted therapies for non--life-threatening pediatric conditions such as well-child care, cosmetic therapy, treatment of psychological problems, and invasive outpatient therapy for chronic conditions. Based on this analysis, we argue that the burdens of therapy, the uncertainty about long-term risks and benefits, the unclear therapeutic end point, and the implications for child health policy place routine GH therapy for children without documented deficiency of GH secretion outside current pediatric ethical norms. Such therapy is properly administered within a comprehensive clinical research protocol.

NBIC: National Ballast Information Clearinghouse

Science.gov Websites

, incidental, direct, indirect, special, punitive, or consequential damages, loss of use, loss of data, loss of income or profit, loss of or damage to property, claims of third parties, or other losses of any kind or

LOOP marine and estuarine monitoring program, 1978-95 : volume 2 : water chemistry.

DOT National Transportation Integrated Search

1998-01-01

The proposed construction and use of facilities in an environmentally sensitive area led to questions about various consequential environmental impacts arising from the following activities: 1) oil storage caverns were created by leaching out a salt ...

The dancer's hip.

PubMed

Sammarco, G J

1983-11-01

Conditions that occur in the dancer's hip fall into the following categories: poor training; conditions that occur as the result of normal use; overuse syndromes, including tendinitis and myositis; and conditions referring pain to the hip. Dancers are highly motivated and goal oriented and often suppress symptoms for long periods, making diagnosis and treatment difficult. Observing the dancer at work and understanding his art are emphasized, and a practical guide to therapy is presented. Development of proper dance technique and a proper flexibility program can decrease the incidence of injuries.

Preablation 131-I scans with SPECT/CT contribute to thyroid cancer risk stratification and 131-I therapy planning.

PubMed

Avram, Anca M; Esfandiari, Nazanene H; Wong, Ka Kit

2015-05-01

The use of preablation diagnostic radioiodine scans for risk stratification and radioiodine therapy planning for differentiated thyroid cancer (DTC) remains controversial. The objective was to assess the contribution of preablation diagnostic 131-I scans with SPECT/CT (Dx 131-I scan) to (1) the risk stratification and (2) the postoperative management of DTC. The study was designed as a prospective sequential patient series. The study was conducted at a University hospital. Three hundred twenty patients (pts) with DTC (219F; 101M, mean age 47.3 ± 16.4 y, range 10-90) were studied. Using clinical and histopathology information an endocrinologist performed risk stratification and determined postoperative management with respect to radioiodine therapy (RAI) planning. The decision to withhold or to administer RAI, and the recommended low, medium or high therapeutic 131-I activity were recorded. Dx 131-I scans were performed and interpreted by two nuclear medicine physicians as showing thyroid remnant, cervical nodal, or distant metastases. The endocrinologist then reperformed risk stratification and reformulated management after consideration of Dx 131-I scans and stimulated thyroglobulin (Tg) information. Main outcome measures were changes in risk stratification and management after Dx 131-I scans. Detection of unsuspected nodal and distant metastases and elevated stimulated Tg levels resulted in a change in the estimated risk of recurrence in 15% of patients, and management in 31% of patients, as compared to initial risk stratification and management based on histopathology alone. Both imaging data and stimulated thyroglobulin levels acquired at the time of Dx 131-I scans are consequential for 131-I therapy planning, providing information that changes risk stratification in 15% of patients as compared to recurrence risk estimation based on histopathology alone. Dx 131-I scans contribute to risk stratification by defining residual nodal and distant metastatic disease, changing clinical management in 29.4% of patients.

BOOK REVIEW OF "ECOLOGICAL EFFECTS OF ROADS"

EPA Science Inventory

Throughout the world, roads have become a permanent part of our environment. The ecological effects of roads and traffic are as consequential as other topical issues such as losses in biological diversity and damage by exotic and invasive species. However, this issue has usuall...

Rare but evolutionarily consequential outcrossing in a highly inbred zoonotic parasite

USDA-ARS?s Scientific Manuscript database

Recurrent self-mating can result in nearly clonal propagation of biological lineages, but even occasional outcrossing can serve to redistribute variation in future generations, providing cohesion among regional populations. The zoonotic parasite Trichinella spiralis has been suspected to undergo fr...

Negotiating Diversity: Fostering Collaborative Interpretations of Case Studies

ERIC Educational Resources Information Center

Guo, Shujie; Cockburn-Wootten, Cheryl; Munshi, Debashish

2014-01-01

The intercultural divides in values, perceptions, and interpretations of concepts have been studied extensively by international business and intercultural communication scholars. Consequentially, much effort in university classrooms is spent on focusing on the differences between groups and on finding ways to "manage" cultural…

Endo-periodontal lesion – endodontic approach

PubMed Central

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system. PMID:25713618

Applying consequential LCA to support energy policy: land use change effects of bioenergy production.

PubMed

Vázquez-Rowe, Ian; Marvuglia, Antonino; Rege, Sameer; Benetto, Enrico

2014-02-15

Luxembourg aims at complying with the EU objective of attaining a 14% use of bioenergy in the national grid by 2020. The increase of biomethane production from energy crops could be a valuable option in achieving this objective. However, the overall environmental benefit of such option is yet to be proven. Consequential Life Cycle Assessment (CLCA) has shown to be a useful tool to evaluate the environmental suitability of future energy scenarios and policies. The objective of this study was, therefore, to evaluate the environmental consequences of modifying the Luxembourgish agricultural system to increase maize production for biomethane generation. A total of 10 different scenarios were modelled using a partial equilibrium (PE) model to identify changes in land cultivation based on farmers' revenue maximisation, which were then compared to the baseline scenario, i.e. the state of the agricultural sector in 2009. The results were divided into three different consequential decision contexts, presenting differing patterns in terms of land use changes (LUCs) but with minor shifts in environmental impacts. Nevertheless, energy from maize production would imply substantially higher environmental impacts when compared with the current use of natural gas, mainly due to increases in climate change and agricultural land occupation impacts. The results are discussed based on the consequences they may generate on the bioenergy policy, the management of arable land, the changes in import-export flows in Luxembourg and LUCs in the domestic agricultural system. In addition, the specific PE+LCA method presented intends to be of use for other regional studies in which a high level of site-specific data is available. Copyright © 2013 Elsevier B.V. All rights reserved.

State Variation in Increased ADHD Prevalence: Links to NCLB School Accountability and State Medication Laws.

PubMed

Fulton, Brent D; Scheffler, Richard M; Hinshaw, Stephen P

2015-10-01

The study's objective was to investigate whether attention-deficit hyperactivity disorder (ADHD) diagnoses from 2003 to 2011 were associated with either public school consequential accountability reforms initiated by the No Child Left Behind (NCLB) Act, particularly for low-income children, or with state psychotropic medication laws that prohibit public schools from recommending or requiring medication use. Logistic regression difference-in-differences models were estimated with repeated U.S. and state-representative cross-sections of responses to the 2003, 2007, and 2011 National Survey of Children's Health. Each wave included approximately 35,000 public school children between ages six and 13. From 2003 to 2007, the change in adjusted diagnostic prevalence was 2.8 percentage points higher for children ages six to 13 in households with incomes ≤185% of the federal poverty level residing in states first exposed to consequential accountability through NCLB (from 8.5% to 13.2%), compared with demographically similar children residing in other states (from 10.2% to 12.1%). From 2003 to 2011, the change in adjusted diagnostic prevalence was 2.2 percentage points lower for children ages six to 13 residing in states with a psychotropic medication law (from 8.1% to 7.8%), compared with children residing in other states (from 8.1% to 10.1%). NCLB-initiated consequential accountability reforms were associated with more ADHD diagnoses among low-income children, consistent with increased academic pressures from NCLB for this subgroup. In contrast, psychotropic medication laws were associated with fewer ADHD diagnoses, because they may indirectly reduce diagnoses via restrictions on recommending or requiring medication use. Future research should investigate whether children most affected by these policies are receiving appropriate diagnoses.

Maize YABBY Genes drooping leaf1 and drooping leaf2 Regulate Plant Architecture[OPEN

PubMed Central

Briggs, Sarah; Bradbury, Peter J.

2017-01-01

Leaf architecture directly influences canopy structure, consequentially affecting yield. We discovered a maize (Zea mays) mutant with aberrant leaf architecture, which we named drooping leaf1 (drl1). Pleiotropic mutations in drl1 affect leaf length and width, leaf angle, and internode length and diameter. These phenotypes are enhanced by natural variation at the drl2 enhancer locus, including reduced expression of the drl2-Mo17 allele in the Mo17 inbred. A second drl2 allele, produced by transposon mutagenesis, interacted synergistically with drl1 mutants and reduced drl2 transcript levels. The drl genes are required for proper leaf patterning, development and cell proliferation of leaf support tissues, and for restricting auricle expansion at the midrib. The paralogous loci encode maize CRABS CLAW co-orthologs in the YABBY family of transcriptional regulators. The drl genes are coexpressed in incipient and emergent leaf primordia at the shoot apex, but not in the vegetative meristem or stem. Genome-wide association studies using maize NAM-RIL (nested association mapping-recombinant inbred line) populations indicated that the drl loci reside within quantitative trait locus regions for leaf angle, leaf width, and internode length and identified rare single nucleotide polymorphisms with large phenotypic effects for the latter two traits. This study demonstrates that drl genes control the development of key agronomic traits in maize. PMID:28698237

The Effect of Fixed Orthodontic Appliances and Fluoride Mouthwash on the Oral Microbiome of Adolescents – A Randomized Controlled Clinical Trial

PubMed Central

Buijs, Mark J.; Elyassi, Yassaman; van der Veen, Monique H.; Crielaard, Wim; ten Cate, Jacob M.; Zaura, Egija

2015-01-01

While the aesthetic effect of orthodontic treatment is clear, the knowledge on how it influences the oral microbiota and the consequential effects on oral health are limited. In this randomized controlled clinical trial we investigated the changes introduced in the oral ecosystem, during and after orthodontic treatment with fixed appliances in combination with or without a fluoride mouthwash, of 10–16.8 year old individuals (N = 91). We followed several clinical parameters in time, in combination with microbiome changes using next-generation sequencing of the bacterial 16S rRNA gene. During the course of our study, the oral microbial community displayed remarkable resilience towards the disturbances it was presented with. The effects of the fluoride mouthwash on the microbial composition were trivial. More pronounced microbial changes were related to gingival health status, orthodontic treatment and time. Periodontal pathogens (e.g. Selenomonas and Porphyromonas) were highest in abundance during the orthodontic treatment, while the health associated Streptococcus, Rothia and Haemophilus gained abundance towards the end and after the orthodontic treatment. Only minor compositional changes remained in the oral microbiome after the end of treatment. We conclude that, provided proper oral hygiene is maintained, changes in the oral microbiome composition resulting from orthodontic treatment are minimal and do not negatively affect oral health. PMID:26332408

The Effect of Fixed Orthodontic Appliances and Fluoride Mouthwash on the Oral Microbiome of Adolescents - A Randomized Controlled Clinical Trial.

PubMed

Koopman, Jessica E; van der Kaaij, Nicoline C W; Buijs, Mark J; Elyassi, Yassaman; van der Veen, Monique H; Crielaard, Wim; Ten Cate, Jacob M; Zaura, Egija

2015-01-01

While the aesthetic effect of orthodontic treatment is clear, the knowledge on how it influences the oral microbiota and the consequential effects on oral health are limited. In this randomized controlled clinical trial we investigated the changes introduced in the oral ecosystem, during and after orthodontic treatment with fixed appliances in combination with or without a fluoride mouthwash, of 10-16.8 year old individuals (N = 91). We followed several clinical parameters in time, in combination with microbiome changes using next-generation sequencing of the bacterial 16S rRNA gene. During the course of our study, the oral microbial community displayed remarkable resilience towards the disturbances it was presented with. The effects of the fluoride mouthwash on the microbial composition were trivial. More pronounced microbial changes were related to gingival health status, orthodontic treatment and time. Periodontal pathogens (e.g. Selenomonas and Porphyromonas) were highest in abundance during the orthodontic treatment, while the health associated Streptococcus, Rothia and Haemophilus gained abundance towards the end and after the orthodontic treatment. Only minor compositional changes remained in the oral microbiome after the end of treatment. We conclude that, provided proper oral hygiene is maintained, changes in the oral microbiome composition resulting from orthodontic treatment are minimal and do not negatively affect oral health.

Utilizing Integrative Medicine in the U.S. Army Medical Department

DTIC Science & Technology

2012-05-15

This first group can be considered ―complementary‖ to traditional Western medicine (TWM6), such as diet and herbal therapy, or mind-body medicine, in...categorized as: nutritional medicine (including dietary supplements ), botanical medicine, lifestyle medicine, mind-body medicine, manual medicine, traditional...focus on the body and the psyche‘s ability to restore themselves, aided by measures such as proper diet, healing spices, herbal therapy, meditation

Electrotherapy: yesterday, today and tomorrow.

PubMed

Tiktinsky, R; Chen, L; Narayan, P

2010-07-01

The use of electrotherapy has been part of physical therapy treatment for the past few decades. There have been numerous modalities used such as TENS, interferential, diathermy, magnetic therapy, ultrasound, laser and surface electromyography to name a few. There has been an upsurge in the past decade of new and innovative modalities. There needs to be extensive research on each of these electrotherapy devices to determine the proper use of each device.

78 FR 39543 - Practices and Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... the short time within which amendments to the Act and the WPEA took effect, the Board finds that good..., suffering, inconvenience, mental anguish, and loss of enjoyment of life. * * * * * 0 10. Section 1201.202 is... costs incurred, travel expenses, and any other reasonable and foreseeable consequential damages...

INTEGRATION OF HEAT PUMPS IN PERVAPORATION SYSTEMS FOR IMPROVED ENERGY EFFICIENCY

EPA Science Inventory

The removal of organic compounds from water by pervaporation is highly energy efficient when the separation factor offered by the pervaporation process is high. In cases where the separation factor is relatively small, consequential amounts of water permeate the membrane per uni...

The Dilemmas of Childhood HIV Infection.

ERIC Educational Resources Information Center

Rudigier, Anne F.; And Others

1990-01-01

Increase in number of children infected with human immunodeficiency virus (HIV), and consequential developmental disabilities of these children are discussed. Families caring for HIV-infected children express four recurrent themes: psychological stress, grief and mourning, guilt and self-blame, and isolation and fear of discrimination. Flexible…

Justification of Paternalism in Education.

ERIC Educational Resources Information Center

Nordenbo, Sven Erik

1986-01-01

A systematic presentation is given of the theories of justification normally applied to paternalistic acts: (1) pseudo-paternalism, (2) consequentialism, and (3) consent-based theories. The validity of four common arguments for educational paternalism is discussed: education is necessary, children are ignorant, children are unable to choose, and…

Faculty: Thy Administrator's Keeper? Some Evidence

ERIC Educational Resources Information Center

Cunningham, Brendan M.

2009-01-01

Colleges and universities face a principal-agent problem. There are information asymmetries over the actions chosen by administrators. Because non-profit constraints limit the financial stake of trustees there may be insufficient monitoring of administrators and, consequentially, shirking. It is conceivable that faculty will serve as "delegated…

Describing Changes in Undergraduate Students' Preconceptions of Research Activities

ERIC Educational Resources Information Center

Cartrette, David P.; Melroe-Lehrman, Bethany M.

2012-01-01

Research has shown that students bring naive scientific conceptions to learning situations which are often incongruous with accepted scientific explanations. These preconceptions are frequently determined to be misconceptions; consequentially instructors spend time to remedy these beliefs and bring students' understanding of scientific concepts to…

The costs (or benefits) associated with attended objects do little to influence inattentional blindness.

PubMed

Stothart, Cary R; Wright, Timothy J; Simons, Daniel J; Boot, Walter R

2017-02-01

We sometimes fail to notice unexpected objects or events when our attention is directed elsewhere, a phenomenon called inattentional blindness. We explored whether unexpected objects that shared the color of consequential objects would be noticed more often. In three pre-registered experiments, participants played a custom video game in which they avoided both low- and high-cost missiles (Experiment 1 and 2) or tried to hit rewarding missiles while avoiding costly ones (Experiment 3). After participants had played the game for about 8min, an unexpected object moved across the screen. Although participants selectively avoided more costly missiles when playing, they were no more likely to notice an unexpected object when its color was associated with greater costs. Apparently, people are no more likely to notice unexpected objects that are associated with negative consequences. Future research should examine whether objects that are themselves consequential are noticed more frequently. Copyright © 2016 Elsevier B.V. All rights reserved.

Open Hearts Build Lives: Positive Emotions, Induced Through Loving-Kindness Meditation, Build Consequential Personal Resources

PubMed Central

Fredrickson, Barbara L.; Cohn, Michael A.; Coffey, Kimberly A.; Pek, Jolynn; Finkel, Sandra M.

2011-01-01

B. L. Fredrickson’s (1998, 2001) broaden-and-build theory of positive emotions asserts that people’s daily experiences of positive emotions compound over time to build a variety of consequential personal resources. The authors tested this build hypothesis in a field experiment with working adults (n = 139), half of whom were randomly-assigned to begin a practice of loving-kindness meditation. Results showed that this meditation practice produced increases over time in daily experiences of positive emotions, which, in turn, produced increases in a wide range of personal resources (e.g., increased mindfulness, purpose in life, social support, decreased illness symptoms). In turn, these increments in personal resources predicted increased life satisfaction and reduced depressive symptoms. Discussion centers on how positive emotions are the mechanism of change for the type of mind-training practice studied here and how loving-kindness meditation is an intervention strategy that produces positive emotions in a way that outpaces the hedonic treadmill effect. PMID:18954193

Changing the paradigm for engineering ethics.

PubMed

Schmidt, Jon Alan

2014-12-01

Modern philosophy recognizes two major ethical theories: deontology, which encourages adherence to rules and fulfillment of duties or obligations; and consequentialism, which evaluates morally significant actions strictly on the basis of their actual or anticipated outcomes. Both involve the systematic application of universal abstract principles, reflecting the culturally dominant paradigm of technical rationality. Professional societies promulgate codes of ethics with which engineers are expected to comply (deontology), while courts and the public generally assign liability to engineers primarily in accordance with the results of their work, whether intended or unintended (consequentialism). A third option, prominent in ancient philosophy, has reemerged recently: virtue ethics, which recognizes that sensitivity to context and practical judgment are indispensable in particular concrete situations, and therefore rightly focuses on the person who acts, rather than the action itself. Beneficial character traits--i.e., virtues--are identified within a specific social practice in light of the internal goods that are unique to it. This paper proposes a comprehensive framework for implementing virtue ethics within engineering.

Market-driven emissions from recovery of carbon dioxide gas.

PubMed

Supekar, Sarang D; Skerlos, Steven J

2014-12-16

This article uses a market-based allocation method in a consequential life cycle assessment (LCA) framework to estimate the environmental emissions created by recovering carbon dioxide (CO2). We find that 1 ton of CO2 recovered as a coproduct of chemicals manufacturing leads to additional greenhouse gas emissions of 147-210 kg CO2 eq , while consuming 160-248 kWh of electricity, 254-480 MJ of heat, and 1836-4027 kg of water. The ranges depend on the initial and final purity of the CO2, particularly because higher purity grades require additional processing steps such as distillation, as well as higher temperature and flow rate of regeneration as needed for activated carbon treatment and desiccant beds. Higher purity also reduces process efficiency due to increased yield losses from regeneration gas and distillation reflux. Mass- and revenue-based allocation methods used in attributional LCA estimate that recovering CO2 leads to 19 and 11 times the global warming impact estimated from a market-based allocation used in consequential LCA.

Abnormal Visual Motion Processing is not a Cause of Dyslexia

PubMed Central

Olulade, Olumide A.; Napoliello, Eileen M.; Eden, Guinevere F.

2013-01-01

SUMMARY Developmental dyslexia is a reading disorder, yet deficits also manifest in the magnocellular-dominated dorsal visual system. Uncertainty about whether visual deficits are causal or consequential to reading disability encumbers accurate identification and appropriate treatment of this common learning disability. Using fMRI, we demonstrate in typical readers a relationship between reading ability and activity in area V5/MT during visual motion processing and, as expected, also found lower V5/MT activity for dyslexic children compared to age-matched controls. However, when dyslexics were matched to younger controls on reading ability, no differences emerged, suggesting that weakness in V5/MT may not be causal to dyslexia. To further test for causality, dyslexics underwent a phonological-based reading intervention. Surprisingly, V5/MT activity increased along with intervention-driven reading gains, demonstrating that activity here is mobilized through reading. Our results provide strong evidence that visual magnocellular dysfunction is not causal to dyslexia, but may instead be consequential to impoverished reading. PMID:23746630

Long-term proton pump induced hypergastrinaemia does induce lineage-specific restitution but not clonal expansion in benign Barrett's oesophagus in vivo.

PubMed

Obszynska, Jolanta A; Atherfold, Paul A; Nanji, Manoj; Glancy, Deborah; Santander, Sonia; Graham, Trevor A; Otto, William R; West, Kevin; Harrison, Rebecca F; Jankowski, Janusz A Z

2010-02-01

Barrett's oesophagus is a common premalignant lesion caused partly by acid reflux. Although the requisite therapy, proton pump inhibitors (PPIs), have been implicated in the progression of Barrett's oesophagus in animal models, harmful effects of prolonged PPI therapy in Barrett's oesophagus is both inconclusive and controversial. We therefore aimed to test the role of PPI-induced hypergastrinaemia in vitro and see whether any biological parameters were useful surrogates of long-term therapy in man. We undertook detailed serological and tissue assessment of gastrin and CCK(2) receptors in 90 patients randomised to different doses of PPI therapy during a detailed 2-year follow-up. We also undertook a comprehensive study of cell models to study the consequential biological effects of gastrin on the mucosa. Gastrin and its cognate receptor CCK(2)R were expressed highest in the stomach, then less in Barrett's oesophagus and least in squamous oesophagus (SqE) (n=20 paired t-test, p<0.01). Analysis of the change in Barrett's oesophagus segment length change in 70 patients who were randomised to high or low PPI dose showed no difference over 2 years (n=70 t-test, p=0.8). Prolonged PPI use did, however, increase the serum gastrin, (36 pg/ml+/-57 pg/ml to 103 pg/ml+/-94 pg/ml (paired t test, p<0.05)). In vitro gastrin also induced changes in OE33(E)(cckr) Barrett's oesophagus cells, but not OE21(E)(cckr) squamous cells, transfected with CCK(2)R; migration was induced by 1 ng/ml of gastrin but proliferation only increased with 100 ng/ml (paired t-test, p<0.01) and both were abolished by antagonists. While the short-term effects of gastrin enhance epithelial restitution in Barrett's oesophagus (but not squamous mucosa) there is no clinical evidence that Barrett's oesophagus length expands over time. This study, which is the largest and longest term randomised controlled trial of gastrin biology in Barrett's oesophagus, is further proof of the clinical safety of PPI therapy.

Immune System

EPA Science Inventory

A properly functioning immune system is essential to good health. It defends the body against infectious agents and in some cases tumor cells. Individuals with immune deficiencies resulting from genetic defects, diseases (e.g., AIDS, leukemia), or drug therapies are more suscepti...

The Ideology of Political Science

ERIC Educational Resources Information Center

Heiden, Bruce

2013-01-01

In a recent article in "Academic Questions" political scientists Robert Maranto and Matthew C. Woessner have suggested a program to reform their discipline and enhance its social utility. They encourage researchers to engage with consequential social issues and educate the public, while admonishing political scientists to resist partisan advocacy…

Challenges in protecting the wilderness of Antarctica

Treesearch

Tina Tin; Alan Hemmings

2011-01-01

Since 1998, the wilderness values of Antarctica have been among those given legal recognition under the Protocol on Environmental Protection to the Antarctic Treaty. Despite the legal obligation, on-the-ground implementation has attracted little interest. The term "wilderness" and its consequential operational implication, including the designation of...

Collaborating in Life Science Research Groups: The Question of Authorship

ERIC Educational Resources Information Center

Muller, Ruth

2012-01-01

This qualitative study explores how life science postdocs' perceptions of contemporary academic career rationales influence how they relate to collaboration within research groups. One consequential dimension of these perceptions is the high value assigned to publications. For career progress, postdocs consider producing publications and…

Learning and Teaching through the Naturalist Intelligence.

ERIC Educational Resources Information Center

Meyer, Maggie

1998-01-01

Howard Gardner defines naturalists as persons who recognize flora and fauna and other consequential distinctions in the natural world and use this ability productively. A sixth-grade teacher discusses Gardner's theory of multiple intelligences, specifically the naturalist intelligence, and suggests ways to teach the naturalist intelligence through…

Nanotechnology and stem cell therapy for cardiovascular diseases: potential applications.

PubMed

La Francesca, Saverio

2012-01-01

The use of stem cell therapy for the treatment of cardiovascular diseases has generated significant interest in recent years. Limitations to the clinical application of this therapy center on issues of stem cell delivery, engraftment, and fate. Nanotechnology-based cell labeling and imaging techniques facilitate stem cell tracking and engraftment studies. Nanotechnology also brings exciting new opportunities to translational stem cell research as it enables the controlled engineering of nanoparticles and nanomaterials that can properly relate to the physical scale of cell-cell and cell-niche interactions. This review summarizes the most relevant potential applications of nanoscale technologies to the field of stem cell therapy for the treatment of cardiovascular diseases.

Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017

PubMed Central

Tandon, Nikhil; Kalra, Sanjay; Balhara, Yatan Pal Singh; Baruah, Manash P.; Chadha, Manoj; Chandalia, Hemraj B.; Prasanna Kumar, K. M.; Madhu, S. V.; Mithal, Ambrish; Sahay, Rakesh; Shukla, Rishi; Sundaram, Annamalai; Unnikrishnan, Ambika G.; Saboo, Banshi; Gupta, Vandita; Chowdhury, Subhankar; Kesavadev, Jothydev; Wangnoo, Subhash K.

2017-01-01

Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD. PMID:28670547

Fecal Fat: The Test

MedlinePlus

... for Targeted Cancer Therapy Glucose Tests Gonorrhea Testing Gram Stain Growth Hormone Haptoglobin hCG Pregnancy hCG Tumor Marker ... can I vary it between 50 and 150 grams? You should ... has the proper stain and equipment. The quantitative test requires specialized equipment; ...

The emergence and popularisation of autologous somatic cellular therapies in Australia: therapeutic innovation or regulatory failure?

PubMed

McLean, Alison K; Stewart, Cameron; Kerridge, Ian

2014-09-01

Private stem cell clinics throughout Australia are providing autologous stem cell therapies for a range of chronic and debilitating illnesses despite the lack of published literature to support the clinical application of these therapies. The Therapeutic Goods Administration has excluded autologous stem cell therapies from its regulatory domain leaving such therapies to be regulated by the same mechanisms that regulate research, such as the National Health and Medical Research Council Research Ethics Guidelines, and clinical practice, such as the Australian Health Practitioner Regulation Agency. However, the provision of these stem cell therapies does not follow the established pathways for legitimate medical advance--therapeutic innovation or research. The current regulatory framework is failing to achieve its aims of protecting vulnerable patients and ensuring the proper conduct of medical practitioners in the private stem cell industry.

Learning in Equity-Oriented Scale-Making Projects

ERIC Educational Resources Information Center

Jurow, A. Susan; Shea, Molly

2015-01-01

This article examines how new forms of learning and expertise are made to become consequential in changing communities of practice. We build on notions of scale making to understand how particular relations between practices, technologies, and people become meaningful across spatial and temporal trajectories of social action. A key assumption of…

Recent Developments in Information about Programme Quality in the UK

ERIC Educational Resources Information Center

Brown, Roger; Carpenter, Caroline; Collins, Roz; Winkvist-Noble, Lilian

2007-01-01

There is general recognition that increased demand for information about programme quality has accompanied the nearly universal massification of higher education, the consequential pressures on public expenditure, and the associated requirements of greater accountability. The UK government has sought to respond to this demand by establishing an…

High Stakes Testing and Reading Assessment. National Reading Conference Policy Brief

ERIC Educational Resources Information Center

Afflerbach, Peter

2005-01-01

This National Reading Conference Policy Brief provides information related to high stakes reading tests and reading assessment. High stakes reading tests are those with highly consequential outcomes for students, teachers, and schools. These outcomes may include student promotion or retention, student placement in reading groups, school funding…

Toxicological Responses of Fischer Rats to Naturally Occurring Asbestos Samples from the United States and Canada

EPA Science Inventory

To support risk assessment efforts, a comparative study was designed to provide understanding of the toxicity of different types of fibers encountered in EPA clean-up efforts. Physico-chemical properties, and consequentially toxicity, are likely to be different among various fib...

Hypothesis-Driven Story Building: Counteracting Human Cognitive Biases to Improve Medical Diagnosis Support

ERIC Educational Resources Information Center

Zhu, Shizhuo

2010-01-01

Clinical decision-making is challenging mainly because of two factors: (1) patient conditions are often complicated with partial and changing information; (2) people have cognitive biases in their decision-making and information-seeking. Consequentially, misdiagnoses and ineffective use of resources may happen. To better support clinical…

Assessing Mathematical Problem Solving Using Comparative Judgement

ERIC Educational Resources Information Center

Jones, Ian; Swan, Malcolm; Pollitt, Alastair

2015-01-01

There is an increasing demand from employers and universities for school leavers to be able to apply their mathematical knowledge to problem solving in varied and unfamiliar contexts. These aspects are however neglected in most examinations of mathematics and, consequentially, in classroom teaching. One barrier to the inclusion of mathematical…

Interest in Science: A RIASEC-Based Analysis of Students' Interests

ERIC Educational Resources Information Center

Dierks, Pay O.; Höffler, Tim N.; Blankenburg, Janet S.; Peters, Heide; Parchmann, Ilka

2016-01-01

Considering the reported lack of interest in the STEM-domain and the consequential difficulties in recruiting talented and interested young academics, the development of effective enrichment measures is indispensable. This requires a precise picture of students' interests. The paper presents an approach to characterize interest profiles in…

Conceptualizing and Assessing Higher-Order Thinking in Reading

ERIC Educational Resources Information Center

Afflerbach, Peter; Cho, Byeong-Young; Kim, Jong-Yun

2015-01-01

Students engage in higher-order thinking as they read complex texts and perform complex reading-related tasks. However, the most consequential assessments, high-stakes tests, are currently limited in providing information about students' higher-order thinking. In this article, we describe higher-order thinking in relation to reading. We provide a…

Rap and Orality in a Post-NCLB/ALEC World

ERIC Educational Resources Information Center

Paul, Dierdre Glenn

2013-01-01

Rigid foci on accountability, accreditation, and customer service pose significant challenges for literacy educators today. The most consequential identified as the snuffing out of scholastic innovation and erosion of academic freedom. This article recounts a recent experience that occurred while the author prepared a lesson for an undergraduate…

Biochar amendment of soil improves resilience to climate change

USDA-ARS?s Scientific Manuscript database

Because of climate change, insufficient soil moisture may become an increasing limitation to crop productivity in certain regions of the world. This may be particularly consequential for biofuel crops, many of which will have to be grown in drought-prone soils to avoid competition with food crops. ...

The Form and Flow of Teaching Ethnographic Knowledge: Hands-On Approaches for Learning Epistemology

ERIC Educational Resources Information Center

Corte, Ugo; Irwin, Katherine

2017-01-01

A glance across ethnographic methods terrain reveals multiple controversies and divisive critiques. When training graduate students, these debates and controversies can be consequential. We offer suggestions for teaching graduate ethnographic methods courses that, first, help students understand some of the common epistemological debates in the…

Consequentialism and harsh interrogations.

PubMed

Wynia, Matthew K

2005-01-01

With this issue, we begin a regular feature on bioethics and public health. We welcome Matthew K. Wynia, M.D., M.P.H., Director of the Institute for Ethics of the American Medical Association as our new Contributing Editor. If you have comments or suggestions regarding this feature, please email us at manuscript@ bioethics.net.

Peace Education: Exploring Some Philosophical Foundations

ERIC Educational Resources Information Center

Page, James S.

2004-01-01

Peace education has been recognized as an important aspect of social education for the past three decades. The critical literature as well as official documents, however, have given little attention to its philosophical foundations. This essay explores these foundations in the ethics of (1) virtue, (2) consequentialism, (3) aesthetics, (4)…

Looking at Learning as Preparation for Teaching

ERIC Educational Resources Information Center

Hughes-McDonnell, Fiona J.

2016-01-01

One of the more heated and consequential debates in teacher education today concerns the instructional methods used in preparation programs and the knowledge and skills that teacher candidates should acquire. In this study, I examine looking at learning as a pedagogical approach to transition teacher candidates from the technical conceptions of…

Consequential Validity of an Assistive Technology Supplement for the School Function Assessment

ERIC Educational Resources Information Center

Silverman, Michelle Kaye; Smith, Roger O.

2006-01-01

Educators and therapists implement assistive technology to maximize educational outcomes of students with disabilities. However, few measure the outcomes of interventions because of a lack of valid measurement tools. This study investigated whether an assistive technology supplement for the School Function Assessment demonstrates an important…

The Emotional Base of America’s Military-Industrial Complex

DTIC Science & Technology

2003-04-24

profoundly consequential, as a prelude to what Nietzsche calls ‘a great year of becoming’…. – James Der Derian. Virtuous War: Mapping the Military...future form nothing but a pipe dream. Der Derian’s analysis is epistemological. Relying on Nietzsche and the post-modern constructivists rather

20 CFR 30.506 - To whom and in what manner will OWCP pay compensation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Survivors... Part B of the Act, compensation for any consequential injury, illness, impairment or disease is limited...

IMPACTS OF CLIMATE-INDUCED CHANGES IN EXTREME EVENTS ON OZONE AND PARTICULATE MATTER AIR QUALITY

EPA Science Inventory

Historical data records of air pollution meteorology from multiple datasets will be compiled and analyzed to identify possible trends in extreme events. Changes in climate and air quality between 2010 and 2050 will be simulated with a suite of models. The consequential effe...

Missing: Critical and Skeptical Perspectives on Comprehensive Soldier Fitness

ERIC Educational Resources Information Center

Quick, James Campbell

2011-01-01

The author read with interest, and concern, the January 2011 issue of the "American Psychologist". The "Special Issue on Comprehensive Soldier Fitness" addressed a hugely consequential national issue and offered a vision for psychological resilience along with an elaborate set of supporting articles, concluding with some comments on "Objections"…

Emotional Fitness and the Movement of Affective Science from Lab to Field

ERIC Educational Resources Information Center

Algoe, Sara B.; Fredrickson, Barbara L.

2011-01-01

Emotions provide a ubiquitous and consequential backdrop to daily life, influencing everything from physiology to interpersonal relationships in the blink of an eye. Instances of emotional experience accumulate and compound to impact overall mental and physical health. Under optimal conditions, emotions are adaptive for the successful navigation…

Screening, prevention, detection, and treatment of cancer therapy-induced bone loss in patients with breast cancer.

PubMed

Limburg, Connie E

2007-01-01

To identify protocols to screen, detect, prevent, and treat cancer therapy-induced bone loss resulting in osteoporosis in patients with breast cancer. Published books and articles. Normal bone remodeling is affected by hormonal stimulation. Breast cancer therapies target hormones that promote cancer cell growth. Chemotherapy regimens and hormone ablation may cause ovarian failure, resulting in decreased hormone levels. A decrease in hormones, in estrogen- and progesterone-positive and -negative patients, introduces an environment for decreased bone remodeling, which may result in thinning bone and osteoporosis. The acceleration of bone loss leading to osteoporosis can result in higher fracture rates among breast cancer survivors. With proper use of screening tools, patient education, and advice about lifestyle changes, all prior to cancer treatment, healthcare professionals may decrease or prevent bone loss in patients with breast cancer. Doing so minimizes healthcare costs and decreases morbidity and mortality rates in breast cancer survivors. As more individuals diagnosed with breast cancer are surviving for extended periods of time, oncology nurses are providing long-term follow-up care. Part of the care should include proper screening and patient education for healthier recovery and prevention of further healthcare complications as a result of cancer treatment.

The application of machine learning techniques in the clinical drug therapy.

PubMed

Meng, Huan-Yu; Jin, Wan-Lin; Yan, Cheng-Kai; Yang, Huan

2018-05-25

The development of a novel drug is an extremely complicated process that includes the target identification, design and manufacture, and proper therapy of the novel drug, as well as drug dose selection, drug efficacy evaluation, and adverse drug reaction control. Due to the limited resources, high costs, long duration, and low hit-to-lead ratio in the development of pharmacogenetics and computer technology, machine learning techniques have assisted novel drug development and have gradually received more attention by researchers. According to current research, machine learning techniques are widely applied in the process of the discovery of new drugs and novel drug targets, the decision surrounding proper therapy and drug dose, and the prediction of drug efficacy and adverse drug reactions. In this article, we discussed the history, workflow, and advantages and disadvantages of machine learning techniques in the processes mentioned above. Although the advantages of machine learning techniques are fairly obvious, the application of machine learning techniques is currently limited. With further research, the application of machine techniques in drug development could be much more widespread and could potentially be one of the major methods used in drug development. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Customizing inhaled therapy to meet the needs of COPD patients.

PubMed

Fromer, Leonard; Goodwin, Elizabeth; Walsh, John

2010-03-01

Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airflow limitation resulting from emphysema and chronic bronchitis. Inhaled therapy is the major therapeutic approach for treating COPD. Multiple inhaler medications are available in the United States and are delivered by a variety of different devices: metered-dose inhalers, dry powdered inhalers, and nebulizers. Each inhaler device has unique requirements for use that must be correctly performed by the patient for successful drug delivery. Patients with COPD represent a medically diverse population, with each patient having distinct characteristics, such as lung function, comorbidities, cognitive functions, hand strength, and lifestyle. These characteristics impact the patient's ability to properly use specific inhaler devices and therefore affect adherence to therapy, therapeutic outcomes, and quality of life. It is estimated that between 28% to 68% of patients do not use metered-dose inhalers or dry powder inhalers correctly. Worsening symptoms or increased frequency of exacerbations may not always indicate disease progression but may indicate a patient's inability to use their inhaler device properly. This review discusses the patient- and device-specific factors to be considered when choosing an inhaled therapy, which will be concordant with the patient's medical needs, preferences, and lifestyle. The review also considers how the ideas underlying the patient-centered medical home model can be incorporated into the choice and use of inhaler device for a given patient with COPD to improve treatment outcomes.

Efficient preloading of the ventricles by a properly timed atrial contraction underlies stroke work improvement in the acute response to cardiac resynchronization therapy

PubMed Central

Hu, Yuxuan; Gurev, Viatcheslav; Constantino, Jason; Trayanova, Natalia

2013-01-01

Background The acute response to cardiac resynchronization therapy (CRT) has been shown to be due to three mechanisms: resynchronization of ventricular contraction, efficient preloading of the ventricles by a properly timed atrial contraction, and mitral regurgitation reduction. However, the contribution of each of the three mechanisms to the acute response of CRT, specifically stroke work improvement, has not been quantified. Objective The goal of this study was to use an MRI-based anatomically accurate 3D model of failing canine ventricular electromechanics to quantify the contribution of each of the three mechanisms to stroke work improvement and identify the predominant mechanisms. Methods An MRI-based electromechanical model of the failing canine ventricles assembled previously by our group was further developed and modified. Three different protocols were used to dissect the contribution of each of the three mechanisms to stroke work improvement. Results Resynchronization of ventricular contraction did not lead to significant stroke work improvement. Efficient preloading of the ventricles by a properly timed atrial contraction was the predominant mechanism underlying stroke work improvement. Stroke work improvement peaked at an intermediate AV delay, as it allowed ventricular filling by atrial contraction to occur at a low diastolic LV pressure but also provided adequate time for ventricular filling before ventricular contraction. Diminution of mitral regurgitation by CRT led to stroke work worsening instead of improvement. Conclusion Efficient preloading of the ventricles by a properly timed atrial contraction is responsible for significant stroke work improvement in the acute CRT response. PMID:23928177

A case of adverse drug reaction induced by dispensing error.

PubMed

Gallelli, L; Staltari, O; Palleria, C; Di Mizio, G; De Sarro, G; Caroleo, B

2012-11-01

To report about a case of acute renal failure due to absence of communication between physician and patient. A 78 year old man with human immunodeficiency virus (HIV) accessed our hospital and was brought to our attention in August 2011 for severe renal failure. Clinical history revealed that he had been taking highly active antiretroviral therapy with lamivudine/abacavir and fosamprenavir since 2006. In April 2011 due to an augmentation in creatinine plasma levels, a reduction in lamivudine dosage to 100 mg/day and the prescription of abacavir 300 mg/day became necessary. Unfortunately, the patient took both lamivudine and abacavir therefore the association of the two medications (lamivudine/abacavir) lead to asthenia and acute renal failure within a few days. This case emphasizes the importance about how physicians must pay very careful attention during drug prescription, most particularly, as far as elderly patients are concerned. In fact, communication improvement between physicians and patients can prevent increase of adverse drug reactions related to drug dispensing, with consequential reduction of costs in the healthcare system. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Oncogenic MicroRNA-20a is downregulated by the HIF-1α/c-MYC pathway in IDH1 R132H-mutant glioma.

PubMed

Xu, Qingfu; Ahmed, A Karim; Zhu, Yan; Wang, Kimberly; Lv, Shengqing; Li, Yunqing; Jiang, Yugang

2018-05-23

Mutations in the isocitrate dehydrogenase 1 (IDH1) gene have been identified as one of the earliest events in gliomagenesis, occurring in over 70% of low grade gliomas and are present in the vast majority of secondary glioblastoma (GBM) that develop from these low-grade lesions. The aim of this study was to investigate whether the IDH1 R132H mutation influences the expression of oncogenic miR-20a and shed light on the underlying molecular mechanisms. The findings of the current study demonstrate presence of the IDH1 R132H mutation in primary human glioblastoma cell lines with upregulated HIF-1α expression, downregulating c-MYC activity and resulting in a consequential decrease in miR-20a, which is responsible for cell proliferation and resistance to standard temozolomide treatment. Elucidating the mechanism of oncogenic miR-20a activity introduces its role among well-established signaling pathways (i.e. HIF/c-MYC) and may be a meaningful prognostic biomarker or target for novel therapies among patients with IDH1-mutant glioma. Copyright © 2018 Elsevier Inc. All rights reserved.

Spontaneous resolution of hemorrhagic polyps of the true vocal fold.

PubMed

Klein, Adam M; Lehmann, Marcus; Hapner, Edie R; Johns, Michael M

2009-01-01

Hemorrhagic polyps are the most common benign lesions surgically removed from the vocal folds. Although this modality does offer satisfactory results in most of the cases, there is a subset of polyps that seems to resolve with conservative therapy. This study was performed to examine this subset of polyps. Thirty-four consecutive subjects diagnosed with hemorrhagic polyps of the true vocal fold were retrospectively reviewed to determine the incidence of spontaneous resolution of the lesions with nonsurgical therapy. Sixteen subjects began conservative therapy, consisting of voice therapy and proper vocal hygiene, often while awaiting an optimal personal time for surgical intervention. Of these subjects, nine (56.3%) experienced a resolution of their lesion and symptoms without undergoing surgical therapy. Surgical removal of hemorrhagic polyps is often considered the standard of treatment for these benign lesions. However, these observations support a regimen of voice therapy and observation in select cases.

Targets for therapy in sarcomeric cardiomyopathies

PubMed Central

Tardiff, Jil C.; Carrier, Lucie; Bers, Donald M.; Poggesi, Corrado; Ferrantini, Cecilia; Coppini, Raffaele; Maier, Lars S.; Ashrafian, Houman; Huke, Sabine; van der Velden, Jolanda

2015-01-01

To date, no compounds or interventions exist that treat or prevent sarcomeric cardiomyopathies. Established therapies currently improve the outcome, but novel therapies may be able to more fundamentally affect the disease process and course. Investigations of the pathomechanisms are generating molecular insights that can be useful for the design of novel specific drugs suitable for clinical use. As perturbations in the heart are stage-specific, proper timing of drug treatment is essential to prevent initiation and progression of cardiac disease in mutation carrier individuals. In this review, we emphasize potential novel therapies which may prevent, delay, or even reverse hypertrophic cardiomyopathy caused by sarcomeric gene mutations. These include corrections of genetic defects, altered sarcomere function, perturbations in intracellular ion homeostasis, and impaired myocardial energetics. PMID:25634554

The Potentials of Student Initiated Netspeak in a Middle Primary Science-Inspired Multiliteracies Project

ERIC Educational Resources Information Center

Ridgewell, Jay; Exley, Beryl

2011-01-01

There is no denying that the information technology revolution of the late twentieth century has arrived. Whilst not equitably accessible for many, others hold high expectations for the contributions online activity will make to student learning outcomes. Concurrently, and not necessarily consequentially, the number of science and technology…

Student Restraints to Reform: Conceptual Change Issues in Enhancing Students' Learning Processes.

ERIC Educational Resources Information Center

Thomas, Gregory P.

1999-01-01

Describes a teacher-researcher's investigation into barriers to student adoption of an alternative referent for learning and its consequential learning strategies in an 11th-grade chemistry class. Suggests that various contextual factors influenced students' willingness to adopt the alternative referent, and that students' beliefs, trust of the…

Observer Use of Standardized Observation Protocols in Consequential Observation Systems

ERIC Educational Resources Information Center

Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

2014-01-01

Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

A Selected Review of the Underpinnings of Ethics for Human Performance Technology Professionals--Part One: Key Ethical Theories and Research.

ERIC Educational Resources Information Center

Dean, Peter J.

1993-01-01

Provides a review of the key ethical theories and relevant empirical research relating to the practice of human performance technology. Topics addressed include ethics, morals, business ethics, ethics officers, empiricism versus normative ethical theory, consequentialism, utilitarianism, nonconsequentialism, Kohlberg model of cognitive moral…

Army Sustainment. Volume 43, Issue 2. March-April 2011

DTIC Science & Technology

2011-04-01

the night before. Barker notes, “Like the men, the animals were nearly mad with thirst,” and consequentially “a number of mules made a dash for the...5-month siege. The majority of these cap- tives died of starvation, exhaustion, disease, or cruelty by their Turkish captors. The fall of Kut

Schooling and Sex Roles: The Case of GCE 'O' Level Mathematics.

ERIC Educational Resources Information Center

Sharma, Shiam; Meighan, Roland

1980-01-01

Questions why girls, who perform at least as well as boys in mathematical reasoning until the age of 11, experience an ever-decreasing set of educational possibilities and consequential achievements during the secondary years of schooling. Relates sex stereotyping to differences in mathematics achievement among male and female students in…

Toward a Sociology of Criminological Theory

ERIC Educational Resources Information Center

Hauhart, Robert C.

2012-01-01

It is a truism to remind ourselves that scientific theory is a human product subject to many of the same social processes that govern other social acts. Science, however, whether social or natural, pretends to claim a higher mission, a more sophisticated methodology, and more consequential and reliable outcomes than human efforts arising from…

Beyond Research "on" Cultural Minorities: Challenges and Implications of Research as Situated Cultural Practice

ERIC Educational Resources Information Center

Arzubiaga, Angela E.; Artiles, Alfredo J.; King, Kathleen A.; Harris-Murri, Nancy

2008-01-01

This article examines the cultural nature of research. This is a consequential idea as research knowledge is expected to inform professional practices for our increasingly multicultural society. We highlight theoretical and methodological limits of the traditional practice of research on cultural groups and outline research as situated cultural…

Replacing Representation with Imagination: Finding Ingenuity in Everyday Practices

ERIC Educational Resources Information Center

Gutiérrez, Kris D.; Cortes, Krista; Cortez, Arturo; DiGiacomo, Daniela; Higgs, Jennifer; Johnson, Patrick; Ramón Lizárraga, José; Mendoza, Elizabeth; Tien, Joanne; Vakil, Sepehr

2017-01-01

This chapter is a call for consequential education research that has transformative potential: intellectually, educationally, and socially. It is about learning to see differently. It is an argument about seeing our work with youth and communities in ways that can help education researchers see ingenuity instead of ineptness and inability, to see…

Implications of the Articles for Interpreting Interest Inventories: Consequential Validity and Meaning Making

ERIC Educational Resources Information Center

Healy, Charles C.; Chope, Robert C.

2006-01-01

Interpretation of interest inventories deepens self-knowledge, promotes career exploration, and assists counselors in understanding a client. This article highlights findings from the studies that appear in this special issue of the journal of Measurement and Evaluation in Counseling and Development, with implications for encouraging clients'…

Early Parenthood and Coming of Age in the 1990s.

ERIC Educational Resources Information Center

Rosenheim, Margaret K., Ed.; Testa, Mark F., Ed.

This book examines how early parenthood differs historically, cross-nationally (in Korea and Sweden), and by class, race, and age in the United States. Contributors discuss how consequential is early parenthood for the future social and economic well-being of parents and children, whether postponing childbearing beyond the teenage years would…

77 FR 26686 - Transmission Planning Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... Normal (No Contingency) Conditions (Category A), TPL-002-1b--System Performance Following Loss of a... Reliability Standard should not allow an entity to plan for the loss of non-consequential firm load in the... approval of its proposal to revise and clarify footnote `b' ``in regard to load loss following a single...

Which Is More Consequential: Fields of Study or Institutional Selectivity?

ERIC Educational Resources Information Center

Ma, Yingyi; Savas, Gokhan

2014-01-01

The persisting gender pay gap favoring men among college graduates is a puzzle given women's remarkable success in postsecondary education. This article examines income disparities among recent college graduates by intersecting gender and social class and evaluating the relative importance of fields of study and institutional selectivity.…

Goal Setting and Decision Making by At-Risk Youth

ERIC Educational Resources Information Center

Galotti, Kathleen M.; Kozberg, Steven F.; Gustafon, Mary

2009-01-01

Typically, adolescence is a time when individuals begin to make consequential, life-framing decisions. However, much of the decision-making literature focuses on high-risk decisions, such as the use of drugs and alcohol, while much less is known about how adolescents make positive decisions, for example, regarding their educational or career…

Problems due to superheating of cryogenic liquids

NASA Astrophysics Data System (ADS)

Hands, B. A.

1988-12-01

Superheating can cause several problems in the storage of cryogenic liquids: stratification can cause unexpectedly high tank pressures or, in multicomponent liquids, rollover with its consequential high vaporization rate; geysering causes the rapid expulsion of static liquid from a vertical tube; chugging is a similar phenomenon observed when liquid flows through a reasonably well-insulated pipe.

Towards a Stronger Covalent Bond: Pedagogical Change for Inclusivity and Equity

ERIC Educational Resources Information Center

Koretsky, Milo; Montfort, Devlin; Nolen, Susan Bobbitt; Bothwell, Michelle; Davis, Susannah; Sweeney, James

2018-01-01

We describe progress on a comprehensive, programmatic change initiative whose goal is to create an inclusive culture that fosters diversity and a shift towards more meaningful, consequential work. While this initiative has several elements that target different aspects of unit practices and culture, we focus here on pedagogical change. Our…

Horace's Compromise. The Dilemma of the American High School.

ERIC Educational Resources Information Center

Sizer, Theodore R.

This book urges renewed public attention to the importance of teaching in high schools and to the complexity and subtlety of that craft. While our system of schools contains many consequential characteristics--for example, the subjects of the curriculum, the organization of programs for special groups--none is more important than who the teachers…

"Let Your Data Tell a Story:" Climate Change Experts and Students Navigating Disciplinary Argumentation in the Classroom

ERIC Educational Resources Information Center

Walsh, Elizabeth Mary; McGowan, Veronica Cassone

2017-01-01

Science education trends promote student engagement in authentic knowledge in practice to tackle personally consequential problems. This study explored how partnering scientists and students on a social media platform supported students' development of disciplinary practice knowledge through practice-based learning with experts during two pilot…

Peer Involvement in Campus-Based Suicide Prevention: Key Considerations

ERIC Educational Resources Information Center

Ilakkuvan, Vinu; Snyder, Melanie G.; Wiggins, Jane

2015-01-01

Students on a college campus are involved in each other's lives in ways that are pervasive and consequential, including during times of distress. A comprehensive campus based suicide prevention plan includes strategies to promote peer involvement that are both safe and effective. Careful program planning, careful training and careful messaging are…

Using a Prescreening Rubric for All-State Violin Selection: Influences of Performance and Teaching Experience

ERIC Educational Resources Information Center

Geringer, John M.; Allen, Michael L.; MacLeod, Rebecca B.; Scott, Laurie

2009-01-01

Performance assessment is an integral part of young musicians' development. Students enrolled in music programs frequently participate in adjudication festivals and many audition for select ensembles. Outcomes of such events are deemed consequential among all concerned: students, parents, teachers, and administrators. Furthermore, the number of…

Learning to Collaborate: General and Special Educators in Teacher Education

ERIC Educational Resources Information Center

Pellegrino, Anthony; Weiss, Margaret; Regan, Kelley

2015-01-01

One of the foremost challenges for K-12 teachers is to provide relevant learning experiences in an environment of increasing accountability and student diversity. This balance is particularly consequential for students with disabilities who rely on special and general education teachers to ensure access to and success within the general…

Predicting wolf (Canis lupus)-cattle (Bos Taurus) encounters and consequential effects on cattle resource selection patterns

USDA-ARS?s Scientific Manuscript database

The gray wolf population in Idaho has grown dramatically from the original 35 reintroduced individuals in 1995-1996 to 94 documented packs and a minimum population of 835 individuals in 2009. Wolf depredation on livestock has also increased dramatically with this population growth. Substantial spa...

Relationships "de Confianza" and the Organisation of Collective Social Action

ERIC Educational Resources Information Center

Teeters, Leah A.; Jurow, A. Susan

2018-01-01

This article examines the social and cultural organisation of learning and community change in a largely new immigrant and under-resourced neighbourhood in the US. Situating our investigation within a local social movement for food justice, we use an ethnographic lens to study how learning is made to become consequential across relationships…

Supervisory Control Information Management Research (SCIMR)

DTIC Science & Technology

2013-06-01

1 Figure 2: Screen Shot of a Typical VSCS Configuration. .............................................................. 2 Figure 3: Displayed...Station ( VSCS ) serves as a multi-faceted facilitator in areas ranging from research to combat missions. The result, consequentially, is an increase in the...success. Developed with this in mind, VSCS effectively integrates sophisticated advancements for the purpose of strengthening the collaborative

Tracing Lines of Meaning: A Course Redesign for Dance Pedagogy

ERIC Educational Resources Information Center

Enghauser, Rebecca Gose

2012-01-01

The 21st-century dance milieu demands that a dancer possess a highly diverse skill set, including effective teaching skills and a broader appreciation of a pedagogical orientation. It is vital that in preparing dance educators, we create opportunities for students to reflect on their dance learning histories and consequential beliefs about…

Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

ERIC Educational Resources Information Center

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2007-01-01

In this paper we describe our research using a multi-user virtual environment, "Quest Atlantis," to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment…

Why So Difficult? Exploring Negative Relationships between Educational Leaders: The Role of Trust, Climate, and Efficacy

ERIC Educational Resources Information Center

Daly, Alan J.; Moolenaar, Nienke M.; Liou, Yi-Hwa; Tuytens, Melissa; del Fresno, Miguel

2015-01-01

Recent work suggests the importance of collaboration among district-office and school leaders. Most studies examine prosocial relationships, but negative social ties, which may be more consequential, are rarely examined. We collected survey data from 78 educational leaders on perceptions of culture and negative relationships and used…

76 FR 66353 - Tireco, Inc., Grant of Petition for Decision of Inconsequential Noncompliance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... this case is that there is no effect of the noncompliances on the operational safety of vehicles on... information will not have any consequential effect on motor vehicle safety because it is extremely unlikely... tire retread, repair, and recycling industries was also to be considered. As with consumers, it is...

Oral Reading Fluency Assessment: Issues of Construct, Criterion, and Consequential Validity

ERIC Educational Resources Information Center

Valencia, Sheila W.; Smith, Antony T.; Reece, Anne M.; Li, Min; Wixson, Karen K.; Newman, Heather

2010-01-01

This study investigated multiple models for assessing oral reading fluency, including 1-minute oral reading measures that produce scores reported as words correct per minute (wcpm). We compared a measure of wcpm with measures of the individual and combined indicators of oral reading fluency (rate, accuracy, prosody, and comprehension) to examine…

Resource Management and Risk Mitigation in Online Storage Grids

ERIC Educational Resources Information Center

Du, Ye

2010-01-01

This dissertation examines the economic value of online storage resources that could be traded and shared as potential commodities and the consequential investments and deployment of such resources. The value proposition of emergent business models such as Akamai and Amazon S3 in online storage grids is capacity provision and content delivery at…

Is There a Downside to Shooting for the Stars? Unrealized Educational Expectations and Symptoms of Depression

ERIC Educational Resources Information Center

Reynolds, John R.; Baird, Chardie L.

2010-01-01

Despite decades of research on the benefits of educational expectations, researchers have failed to show that unrealized plans are consequential for mental health, as self-discrepancy and other social psychological theories would predict. This article uses two national longitudinal studies of youth to test whether unrealized educational…

Too Little and Too Much Trust: Performance Measurement in Australian Higher Education

ERIC Educational Resources Information Center

Woelert, Peter; Yates, Lyn

2015-01-01

A striking feature of contemporary Australian higher education governance is the strong emphasis on centralized, template style, metric-based, and consequential forms of performance measurement. Such emphasis is indicative of a low degree of political trust among the central authorities in Australia in the intrinsic capacity of universities and…

Well-Doing: Personal Projects and the Quality of Lives

ERIC Educational Resources Information Center

Little, Brian R.

2014-01-01

"What are you doing?" and "How is it going?" are foundational questions we can ask of agents. They elicit answers that illuminate aspects of well-doing, or felicitous action, by directing attention to an agent's personal projects. Personal projects are constitutive elements of daily existence and are consequential for a…

Focusing Our Aim: Strengthening Faculty Commitment to Community Engagement

ERIC Educational Resources Information Center

Butin, Dan W.

2007-01-01

While many speak strongly about community engagement, few are able or willing to develop sustained and consequential programs and practices that further it. Many faculty are, in fact, dubious about an educational reform that appears too a-theoretical, too co-curricular, too much like yet another under-financed fad. In this article, the author…

Comparability of Fidelity Measures for Assessing Tier 1 School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Mercer, Sterett H.; McIntosh, Kent; Hoselton, Robert

2017-01-01

Several reliable and valid fidelity surveys are commonly used to assess Tier 1 implementation in School-Wide Positive Behavioral Interventions and Supports (SWPBIS); however, differences across surveys complicate consequential decisions regarding school implementation status when multiple measures are compared. To address this concern, the current…

Does Occupational Mobility Influence Health among Working Women? Comparing Objective and Subjective Measures of Work Trajectories

ERIC Educational Resources Information Center

Wilkinson, Lindsay R.; Shippee, Tetyana P.; Ferraro, Kenneth F.

2012-01-01

Occupational mobility is highly valued in American society, but is it consequential to women's health? Previous studies have yielded inconsistent results, but most measured occupational mobility by identifying transitions across occupational categories. Drawing from cumulative inequality theory, this study (1) compares objective and subjective…

American Identity in the USA: Youth Perspectives

ERIC Educational Resources Information Center

Jahromi, Parissa

2011-01-01

National identity, how one sees oneself as a member of a given nation, is an important form of social identity. Feelings toward one's country are a matter of both individual and collective concern. In an increasingly diverse world, the issue of identifying with a nation is complex and consequential for individual identity formation as well as…

Peer effects in early childhood education: testing the assumptions of special-education inclusion.

PubMed

Justice, Laura M; Logan, Jessica A R; Lin, Tzu-Jung; Kaderavek, Joan N

2014-09-01

There has been a push in recent years for students with disabilities to be educated alongside their typically developing peers, a practice called inclusion. In this study, we sought to determine whether peer effects operate within early-childhood special-education (ECSE) classrooms in which preschoolers with disabilities are educated alongside typical peers. Peer effects specific to language growth were assessed for 670 preschoolers (mean age = 52 months) in 83 ECSE classrooms; 55% of the children had disabilities. We found that the average language skills of classmates, as assessed in the fall of the year, significantly predicted children's language skills in the spring (after controlling for their relative skill level in the fall); in addition, there was a significant interactive effect of disability status (i.e., the presence or absence of a disability) and peers' language skills. Peer effects were the least consequential for children without disabilities whose classmates had relatively strong language skills, and the most consequential for children with disabilities whose classmates had relatively poor language skills. © The Author(s) 2014.

Lysosomal storage diseases: natural history and ethical and economic aspects.

PubMed

Beutler, Ernest

2006-07-01

Potential treatment for lysosomal diseases now includes enzyme replacement therapy, substrate reduction therapy, and chaperone therapy. The first two of these have been implemented commercially, and the spectrum of diseases that are now treatable has expanded from Gaucher disease to include several other disorders. Treatment of these diseases is extremely costly. We explore some of the reasons for the high cost and discuss how, by proper selection of patients and appropriate dosing, the economic burden on society of treating these disease may be ameliorated, at least in part. However, the cost of treating rare diseases is a growing problem that society needs to address.

Management of children with prolonged diarrhea

PubMed Central

Giannattasio, Antonietta; Guarino, Alfredo; Lo Vecchio, Andrea

2016-01-01

Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded. PMID:26962439

Early urinary diversion with ileal conduit and vesicovaginostomy in the treatment of radiation cystitis due to carcinoma cervix: a study from a tertiary care hospital in South India.

PubMed

Banerji, John Samuel; Devasia, Antony; Kekre, Nitin Sudhakar; Chacko, Ninan

2015-10-01

To study the magnitude of radiation cystitis following radiation therapy for carcinoma cervix, and propose an algorithm to decide on early diversion, with or without vesicovaginostomy. Women who developed radiation cystitis following radiotherapy for carcinoma cervix from January 1998 to December 2011 were included in this retrospective study. Electronic hospital records were analysed to document the presence of radiation cystitis. All women who developed evidence of radiation-induced cystitis, according to the common toxicity and Radiation Therapy Oncology Group criteria, were included in the study. We looked at transfusion requirements, number of hospital admissions, quality of life and cost involved. Chi-square tests were done where applicable. SPSS version 16 was used for analysis. Of the 902 patients who received radiation for carcinoma cervix in the 13-year period, 62 (6.87%) developed grade 3/4 cystitis. Twenty-eight of them underwent ileal conduit diversion, with 18 undergoing concomitant vesicovaginostomy. When compared with the patients who did not have diversion, the transfusion requirements, number of hospital admissions and quality of life had a statistically significant difference. Cost analysis of early diversion too showed a marginal benefit with early diversion. The limitation of the study was that it was retrospective in nature. In radiation cystitis, multiple hospital admissions and consequential increase in cost is the norm. In severe disease, early diversion is a prudent, cost-effective approach with good quality of life and early return to normal activity. © 2014 Royal Australasian College of Surgeons.

Management of children with prolonged diarrhea.

PubMed

Giannattasio, Antonietta; Guarino, Alfredo; Lo Vecchio, Andrea

2016-01-01

Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded.

Mitochondrial Dynamics in Diabetic Cardiomyopathy

PubMed Central

Galloway, Chad A.

2015-01-01

Abstract Significance: Cardiac function is energetically demanding, reliant on efficient well-coupled mitochondria to generate adenosine triphosphate and fulfill the cardiac demand. Predictably then, mitochondrial dysfunction is associated with cardiac pathologies, often related to metabolic disease, most commonly diabetes. Diabetic cardiomyopathy (DCM), characterized by decreased left ventricular function, arises independently of coronary artery disease and atherosclerosis. Dysregulation of Ca2+ handling, metabolic changes, and oxidative stress are observed in DCM, abnormalities reflected in alterations in mitochondrial energetics. Cardiac tissue from DCM patients also presents with altered mitochondrial morphology, suggesting a possible role of mitochondrial dynamics in its pathological progression. Recent Advances: Abnormal mitochondrial morphology is associated with pathologies across diverse tissues, suggesting that this highly regulated process is essential for proper cell maintenance and physiological homeostasis. Highly structured cardiac myofibers were hypothesized to limit alterations in mitochondrial morphology; however, recent work has identified morphological changes in cardiac tissue, specifically in DCM. Critical Issues: Mitochondrial dysfunction has been reported independently from observations of altered mitochondrial morphology in DCM. The temporal relationship and causative nature between functional and morphological changes of mitochondria in the establishment/progression of DCM is unclear. Future Directions: Altered mitochondrial energetics and morphology are not only causal for but also consequential to reactive oxygen species production, hence exacerbating oxidative damage through reciprocal amplification, which is integral to the progression of DCM. Therefore, targeting mitochondria for DCM will require better mechanistic characterization of morphological distortion and bioenergetic dysfunction. Antioxid. Redox Signal. 22, 1545–1562. PMID:25738230

When to consider transfusion therapy for patients with non-transfusion-dependent thalassaemia

PubMed Central

Taher, A T; Radwan, A; Viprakasit, V

2015-01-01

Non-transfusion-dependent thalassaemia (NTDT) refers to all thalassaemia disease phenotypes that do not require regular blood transfusions for survival. Thalassaemia disorders were traditionally concentrated along the tropical belt stretching from sub-Saharan Africa through the Mediterranean region and the Middle East to South and South-East Asia, but global migration has led to increased incidence in North America and Northern Europe. Transfusionists may be familiar with β-thalassaemia major because of the lifelong transfusions needed by these patients. Although patients with NTDT do not require regular transfusions for survival, they may require transfusions in some instances such as pregnancy, infection or growth failure. The complications associated with NTDT can be severe if not properly managed, and many are directly related to chronic anaemia. Awareness of NTDT is important, and this review will outline the factors that should be taken into consideration when deciding whether to initiate and properly plan for transfusion therapy in these patients in terms of transfusion interval and duration of treatment. PMID:25286743

Untangling Consequential Futures: Discovering Self-Consistent Regional and Global Multi-Sector Change Scenarios

NASA Astrophysics Data System (ADS)

Lamontagne, J. R.; Reed, P. M.

2017-12-01

Impacts and adaptations to global change largely occur at regional scales, yet they are shaped globally through the interdependent evolution of the climate, energy, agriculture, and industrial systems. It is important for regional actors to account for the impacts of global changes on their systems in a globally consistent but regionally relevant way. This can be challenging because emerging global reference scenarios may not reflect regional challenges. Likewise, regionally specific scenarios may miss important global feedbacks. In this work, we contribute a scenario discovery framework to identify regionally-specific decision relevant scenarios from an ensemble of scenarios of global change. To this end, we generated a large ensemble of time evolving regional, multi-sector global change scenarios by a full factorial sampling of the underlying assumptions in the emerging shared socio-economic pathways (SSPs), using the Global Change Assessment Model (GCAM). Statistical and visual analytics were then used to discover which SSP assumptions are particularly consequential for various regions, considering a broad range of time-evolving metrics that encompass multiple spatial scales and sectors. In an illustrative examples, we identify the most important global change narratives to inform water resource scenarios for several geographic regions using the proposed scenario discovery framework. Our results highlight the importance of demographic and agricultural evolution compared to technical improvements in the energy sector. We show that narrowly sampling a few canonical reference scenarios provides a very narrow view of the consequence space, increasing the risk of tacitly ignoring major impacts. Even optimistic scenarios contain unintended, disproportionate regional impacts and intergenerational transfers of consequence. Formulating consequential scenarios of deeply and broadly uncertain futures requires a better exploration of which quantitative measures of consequences are important, for whom are they important, where, and when. To this end, we have contributed a large database of climate change futures that can support `backwards' scenario generation techniques, that capture a broader array of consequences than those that emerge from limited sampling of a few reference scenarios.

Psychedelics: Where we are now, why we got here, what we must do.

PubMed

Belouin, Sean J; Henningfield, Jack E

2018-02-21

The purpose of this commentary is to provide an introduction to this special issue of Neuropharmacology with a historical perspective of psychedelic drug research, their use in psychiatric disorders, research-restricting regulatory controls, and their recent emergence as potential breakthrough therapies for several brain-related disorders. It begins with the discovery of lysergic acid diethylamide (LSD) and its promising development as a treatment for several types of mental illnesses during the 1940s. This was followed by its abuse and stigmatization in the 1960s that ultimately led to the placement of LSD and other psychedelic drugs into the most restrictively regulated drug schedule of the United States Controlled Substances Act (Schedule I) in 1970 and its international counterparts. These regulatory controls severely constrained development of psychedelic substances and their potential for clinical research in psychiatric disorders. Despite the limitations, there was continued research into brain mechanisms of action for psychedelic drugs with potential clinical applications which began during the 1990s and early 2000s. Finding pathways to accelerate clinical research in psychedelic drug development is supported by the growing body of research findings that are documented throughout this special issue of Neuropharmacology. Accumulated research to date suggests psychedelic drug assisted psychotherapy may emerge as a potential breakthrough treatment for several types of mental illnesses including depression, anxiety, post-traumatic stress disorder, and addiction that are refractory to current evidenced based therapies. This research equally shows promise in advancing the understanding of the brain, brain related functioning, and the consequential effects of untreated brain related diseases that have been implicated in causing and/or exacerbating numerous physical disease state conditions. The authors conclude that more must be done to effectively address mental illnesses and brain related diseases which have become so pervasive, destructive, and whose treatments are becoming increasingly resistant to current evidenced based therapies. Published by Elsevier Ltd.

Evaluation of dosimetric effect caused by slowing with multi-leaf collimator (MLC) leaves for volumetric modulated arc therapy (VMAT)

PubMed Central

Wang, Iris Z.; Kumaraswamy, Lalith K.; Podgorsak, Matthew B.

2016-01-01

Background This study is to report 1) the sensitivity of intensity modulated radiation therapy (IMRT) QA method for clinical volumetric modulated arc therapy (VMAT) plans with multi-leaf collimator (MLC) leaf errors that will not trigger MLC interlock during beam delivery; 2) the effect of non-beam-hold MLC leaf errors on the quality of VMAT plan dose delivery. Materials and methods. Eleven VMAT plans were selected and modified using an in-house developed software. For each control point of a VMAT arc, MLC leaves with the highest speed (1.87-1.95 cm/s) were set to move at the maximal allowable speed (2.3 cm/s), which resulted in a leaf position difference of less than 2 mm. The modified plans were considered as ‘standard’ plans, and the original plans were treated as the ‘slowing MLC’ plans for simulating ‘standard’ plans with leaves moving at relatively lower speed. The measurement of each ‘slowing MLC’ plan using MapCHECK®2 was compared with calculated planar dose of the ‘standard’ plan with respect to absolute dose Van Dyk distance-to-agreement (DTA) comparisons using 3%/3 mm and 2%/2 mm criteria. Results All ‘slowing MLC’ plans passed the 90% pass rate threshold using 3%/3 mm criteria while one brain and three anal VMAT cases were below 90% with 2%/2 mm criteria. For ten out of eleven cases, DVH comparisons between ‘standard’ and ‘slowing MLC’ plans demonstrated minimal dosimetric changes in targets and organs-at-risk. Conclusions For highly modulated VMAT plans, pass rate threshold (90%) using 3%/3mm criteria is not sensitive in detecting MLC leaf errors that will not trigger the MLC leaf interlock. However, the consequential effects of non-beam hold MLC errors on target and OAR doses are negligible, which supports the reliability of current patient-specific IMRT quality assurance (QA) method for VMAT plans. PMID:27069458

Translational Application of Microfluidics and Bioprinting for Stem Cell-Based Cartilage Repair

PubMed Central

Mondadori, Carlotta; Mainardi, Valerio Luca; Talò, Giuseppe; Candrian, Christian; Święszkowski, Wojciech

2018-01-01

Cartilage defects can impair the most elementary daily activities and, if not properly treated, can lead to the complete loss of articular function. The limitations of standard treatments for cartilage repair have triggered the development of stem cell-based therapies. In this scenario, the development of efficient cell differentiation protocols and the design of proper biomaterial-based supports to deliver cells to the injury site need to be addressed through basic and applied research to fully exploit the potential of stem cells. Here, we discuss the use of microfluidics and bioprinting approaches for the translation of stem cell-based therapy for cartilage repair in clinics. In particular, we will focus on the optimization of hydrogel-based materials to mimic the articular cartilage triggered by their use as bioinks in 3D bioprinting applications, on the screening of biochemical and biophysical factors through microfluidic devices to enhance stem cell chondrogenesis, and on the use of microfluidic technology to generate implantable constructs with a complex geometry. Finally, we will describe some new bioprinting applications that pave the way to the clinical use of stem cell-based therapies, such as scaffold-free bioprinting and the development of a 3D handheld device for the in situ repair of cartilage defects. PMID:29535776

The Landing Phase of a Jump Strategies to Minimize Injuries

ERIC Educational Resources Information Center

Bressel, Eadric; Cronin, John

2005-01-01

Most people probably do not remember being coached to jump, or--more important--to land. Research on landing concentrates on the impact forces associated with landing, the consequential effect on the legs, and the subsequent injury potential. There is an abundance of literature on how to create stronger and more powerful muscles, which may be…

Assessing the Validity of an Annual Survey for Measuring the Enacted Literacy Curriculum

ERIC Educational Resources Information Center

Camburn, Eric M.; Han, Seong Won; Sebastian, James

2017-01-01

Surveys are frequently used to inform consequential decisions about teachers, policies, and programs. Consequently, it is important to understand the validity of these instruments. This study assesses the validity of measures of instruction captured by an annual survey by comparing survey data with those of a validated daily log. The two…

20 CFR 30.222 - How does a claimant establish that the employee has been diagnosed with chronic silicosis or has...

Code of Federal Regulations, 2010 CFR

2010-04-01

..., impairment or disease? 30.222 Section 30.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... has sustained a consequential injury, illness, impairment or disease? (a) A written diagnosis of the... biopsy findings consistent with silicosis. (b) An injury, illness, impairment or disease sustained as a...

20 CFR 30.222 - How does a claimant establish that the employee has been diagnosed with chronic silicosis or has...

Code of Federal Regulations, 2011 CFR

2011-04-01

..., impairment or disease? 30.222 Section 30.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... has sustained a consequential injury, illness, impairment or disease? (a) A written diagnosis of the... biopsy findings consistent with silicosis. (b) An injury, illness, impairment or disease sustained as a...

Analysis of Leadership Dynamics in Educational Settings during Times of External and Internal Change

ERIC Educational Resources Information Center

Jäppinen, Aini-Kristiina

2017-01-01

Background: The article concerns the tensions that can arise during demanding external, and consequential internal changes and considers how educational leadership is able to respond to them. Leadership is here understood as a collaborative endeavour, producing shared sense-making in situations of tension. Purpose: The main research question was:…

A Tale of Two Tests (and of Two Examinees)

ERIC Educational Resources Information Center

Clauser, Amanda L.; Wainer, Howard

2016-01-01

It is widely accepted dogma that consequential decisions are better made with multiple measures, because using but a single one is thought more likely to be laden with biases and errors that can be better controlled with a wider source of evidence for making judgments. Unfortunately, advocates of using multiple measures too rarely provide detailed…

Patterns and Trends in Grade Retention Rates in the United States, 1995-2010

ERIC Educational Resources Information Center

Warren, John Robert; Hoffman, Emily; Andrew, Megan

2014-01-01

Although grade retention may be consequential for a number of important educational and socioeconomic outcomes, we know surprisingly little about the actual rate at which students are made to repeat grades. We build on Hauser, Frederick, and Andrew's 2007 measure of grade retention using data from the 1995 through 2010 Current Population…

Creative Convergence in Practice and Its Effects on Higher Education: A Mixed-Methods, Neopragmatist Study Examining Media Arts

ERIC Educational Resources Information Center

Rosner, Terre Layng

2017-01-01

This study is a mixed-methods, neopragmatist examination of the systems currently being practiced in creative professional companies and the consequential changes in Higher Education Media Arts curricula, supporting a kind of meta-disciplinary pedagogy emerging from the pressures of content and device convergence in industry. The research…

A Little Knowledge is a Dangerous Thing...Emerging Miranda Research and Professional Roles for Psychologists

ERIC Educational Resources Information Center

Rogers, Richard

2008-01-01

In Miranda v. Arizona (1966), the 20th century's most prominent and consequential legal decision on constitutionally guaranteed rights against compelled self-incrimination, the Supreme Court of the United States mandated the delivery of specific warnings to persons facing custodial interrogation. Owing in large part to popularization of these…

20 CFR 30.222 - How does a claimant establish that the employee has been diagnosed with chronic silicosis or has...

Code of Federal Regulations, 2013 CFR

2013-04-01

..., impairment or disease? 30.222 Section 30.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... has sustained a consequential injury, illness, impairment or disease? (a) A written diagnosis of the... biopsy findings consistent with silicosis. (b) An injury, illness, impairment or disease sustained as a...

20 CFR 30.222 - How does a claimant establish that the employee has been diagnosed with chronic silicosis or has...

Code of Federal Regulations, 2012 CFR

2012-04-01

..., impairment or disease? 30.222 Section 30.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... has sustained a consequential injury, illness, impairment or disease? (a) A written diagnosis of the... biopsy findings consistent with silicosis. (b) An injury, illness, impairment or disease sustained as a...

20 CFR 30.222 - How does a claimant establish that the employee has been diagnosed with chronic silicosis or has...

Code of Federal Regulations, 2014 CFR

2014-04-01

..., impairment or disease? 30.222 Section 30.222 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... has sustained a consequential injury, illness, impairment or disease? (a) A written diagnosis of the... biopsy findings consistent with silicosis. (b) An injury, illness, impairment or disease sustained as a...

The Need for a Principled Approach for Examining Indirect Effects of Test Use

ERIC Educational Resources Information Center

Lane, Suzanne

2013-01-01

In Shepard's (1997) discussion on the importance of test use and consequences in a validity argument for educational assessments, she reflected on Cronbach and Meehl's (1955) perspective on the role of test developers in providing consequential evidence. In the following year, a special issue in "Educational Measurement: Issues and Practice"…

Consequential Boards: Adding Value Where It Matters Most. Report of the National Commission on College and University Board Governance

ERIC Educational Resources Information Center

Association of Governing Boards of Universities and Colleges, 2014

2014-01-01

The value of American higher education faces multiple risks, and changes in governance are needed to address them. At risk are accessibility and degree attainment for current and future students, institutional fiscal sustainability, educational quality, economic development and social equity, service to communities, and knowledge creation. Higher…

Changing Workplaces to Reduce Work-Family Conflict: Schedule Control in a White-Collar Organization

ERIC Educational Resources Information Center

Kelly, Erin L.; Moen, Phyllis; Tranby, Eric

2011-01-01

Work-family conflicts are common and consequential for employees, their families, and work organizations. Can workplaces be changed to reduce work-family conflict? Previous research has not been able to assess whether workplace policies or initiatives succeed in reducing work-family conflict or increasing work-family fit. Using longitudinal data…

Examining Evidence for External and Consequential Validity of the First Term General Chemistry Exam from the ACS Examinations Institute

ERIC Educational Resources Information Center

Lewis, Scott E.

2014-01-01

Validity of educational research instruments and student assessments has appropriately become a growing interest in the chemistry education research community. Of particular concern is an attention to the consequences to students that result from the interpretation of assessment scores and whether those consequences are swayed by invalidity within…

Are Some Animals More Equal than Others? Animal Rights and Deep Ecology in Environmental Education

ERIC Educational Resources Information Center

Kopnina, Helen; Gjerris, Mickey

2015-01-01

This article focuses on the role of ethical perspectives such as deep ecology and animal rights in relation to environmental education, arguing that such perspectives are well-placed to reposition students as responsible planetary citizens. We focus on the linkage between non-consequentialism, animal rights, and deep ecology in an educational…

Keeping Students on Track to Graduate: A Synthesis of School Dropout Trends, Prevention, and Intervention Initiatives

ERIC Educational Resources Information Center

Ecker-Lyster, Meghan; Niileksela, Christopher

2016-01-01

This article reviews the literature on dropout trends, prevention, and intervention initiatives for school-aged children. Theoretical and consequential trends are highlighted to offer educators a perspective in which to view the dropout problem. This article also examines current trends in prevention and intervention initiatives aimed at reducing…

Pulling Back the Curtain: Relearning the History of the Philosophy of Education

ERIC Educational Resources Information Center

Titone, Connie

2007-01-01

Women have played an undeniable part in shaping the history of philosophy and philosophy of education for at least 1,000 years. Yet, current anthologies, encyclopedias, and textbooks in the field rarely recognize large numbers of women's works as consequential to our understanding of the development of educational topics and debates. This article,…

"Here, without English, You Are Dead": Ideologies of Language and Discourses of Neoliberalism in Adult English Language Learning

ERIC Educational Resources Information Center

Warriner, Doris S.

2016-01-01

Ideologies of language (and language learning)--in concert with discourses of individualism and meritocracy that characterize neoliberalism--shape pedagogical policies and practices in ways that are consequential for multilingual students all over the developing and developed world. To investigate how such intersections and influences work in…

Two Distinct Exploratory Behaviors in Decisions from Experience: Comment on Gonzalez and Dutt (2011)

ERIC Educational Resources Information Center

Hills, Thomas T.; Hertwig, Ralph

2012-01-01

Gonzalez and Dutt (2011) recently reported that trends during sampling, prior to a consequential risky decision, reveal a gradual movement from exploration to exploitation. That is, even when search imposes no immediate costs, people adopt the same pattern manifest in costly search: early exploration followed by later exploitation. From this…

How Nurses Decide to Ambulate Hospitalized Older Adults: Development of a Conceptual Model

ERIC Educational Resources Information Center

Doherty-King, Barbara; Bowers, Barbara

2011-01-01

Adults over the age of 65 years account for 60% of all hospital admissions and experience consequential negative outcomes directly related to hospitalization. Negative outcomes include falls, delirium, loss in ability to perform basic activities of daily living, and new walking dependence. New walking dependence, defined as the loss in ability to…

What Students Think and Do in Classroom Teams When Peer Evaluations Are Highly Consequential: A Two-Stage Study

ERIC Educational Resources Information Center

Jassawalla, Avan R.; Sashittal, Hemant C.

2017-01-01

The article presents findings from a two-stage study that examined student perceptions of peer evaluations (PEs) conducted in undergraduate business classroom teams. In stage 1, we used qualitative research to identify constructs focal in students' PE-related cognitive schemas and developed grounded measurement scales and hypotheses about their…

Changes in Transitions: The Role of Mobility, Class and Gender

ERIC Educational Resources Information Center

Smith, Douglas I.

2009-01-01

This paper provides an analysis of changing patterns of transition from before the second world to the end of the twentieth century. It examines the longer term changes in the occupational structure and the consequential transformation of the patterns of labour market entry for young people. It links labour market entry to subsequent early…

Emerging Issues with Consequential Use of the edTPA: Overall and through a Special Education Lens

ERIC Educational Resources Information Center

Bergstrand Othman, Lama; Robinson, Rowand; Molfenter, Nancy F.

2017-01-01

The purpose of teacher preparation programs is to ensure that teachers are adequately equipped with the necessary knowledge and skills to support the various educational needs of their students. Nevertheless, a call for a uniform process through which teacher candidates can demonstrate their ability to meet their students' educational needs using…

Reactive Sequences in the Evolution of Maryland's Consequential Accountability Regime

ERIC Educational Resources Information Center

Mawhinney, Hanne B.

2013-01-01

An institutional analysis is presented of the policy, political, and legislative events associated with the failure of an attempt in 2006 by the state of Maryland to take control of 11 schools in Baltimore City and turn them over to independent managers or into charter schools under No Child Left Behind. The place of the failed…

Extending Talk on a Prescribed Discussion Topic in a Learner-Native Speaker eTandem Learning Task

ERIC Educational Resources Information Center

Black, Emily

2017-01-01

Opportunities for language learners to access authentic input and engage in consequential interactions with native speakers of their target language abound in this era of computer mediated communication. Synchronous audio/video calling software represents one opportunity to access such input and address the challenges of developing pragmatic and…

Managing What We Can Measure: Quantifying the Susceptibility of Automated Scoring Systems to Gaming Behavior

ERIC Educational Resources Information Center

Higgins, Derrick; Heilman, Michael

2014-01-01

As methods for automated scoring of constructed-response items become more widely adopted in state assessments, and are used in more consequential operational configurations, it is critical that their susceptibility to gaming behavior be investigated and managed. This article provides a review of research relevant to how construct-irrelevant…

Teaching versus Living: Managerial Decision Making in the Gray

ERIC Educational Resources Information Center

Soltes, Eugene

2017-01-01

Preparing students for the consequential ethical decisions that they will face in their careers is among the most difficult tasks of management education. I describe some of these challenges based on my book "Why They Do It: Inside the Mind of the White-Collar Criminal" and recent work in behavioral ethics. I explore why some decisions…

Art School Consequential: Teaching and Learning in the First Year of Art School

ERIC Educational Resources Information Center

McKenna, Stacey Redford

2011-01-01

In order to understand better the dimensions of education in the foundation year of contemporary art school, this study explores teaching and learning through the lenses of art school freshmen and foundation studio art professors. Since scholarly study of art school education is limited, the author begins with a survey of related fields of…

Accountability with Voucher Threats, Responses, and the Test-Taking Population: Regression Discontinuity Evidence from Florida

ERIC Educational Resources Information Center

Chakrabarti, Rajashri

2013-01-01

Florida's 1999 A-plus program was a consequential accountability program that embedded vouchers in an accountability regime. Under Florida rules, scores of students in several special education (ESE) and limited English proficient (LEP) categories were not included in the computation of school grades. One might expect these rules to induce F…

The Role of Goal Structures and Peer Climate in Trajectories of Social Achievement Goals during High School

ERIC Educational Resources Information Center

Makara, Kara A.; Madjar, Nir

2015-01-01

Students' social goals--reasons for engaging in interpersonal relationships with peers-are consequential for students' interactions with their peers at school and for their well-being. Despite the salience of peer relationships during adolescence, research on social goals is generally lacking compared with academic goals, and it is unknown how…

From Poor Performance to Success under Stress: Working Memory, Strategy Selection, and Mathematical Problem Solving under Pressure

ERIC Educational Resources Information Center

Beilock, Sian L.; DeCaro, Marci S.

2007-01-01

Two experiments demonstrate how individual differences in working memory (WM) impact the strategies used to solve complex math problems and how consequential testing situations alter strategy use. In Experiment 1, individuals performed multistep math problems under low- or high-pressure conditions and reported their problem-solving strategies.…

Working without Shame in International Educational Development? From Consequentialism to Casuistry

ERIC Educational Resources Information Center

Bridges, David

2015-01-01

The central question addressed in this paper is about the ethics of engaging with educational development in countries perceived as undemocratic or as failing to respect human rights. More particularly, it examines the nature of the arguments that are brought to bear on this issue. It suggests that these are essentially consequentialist in…

Toward the Development of a Self-Management Intervention to Promote Pro-Social Behaviors for Students with Visual Impairment

ERIC Educational Resources Information Center

Ivy, Sarah E.; Lather, Amanda B.; Hatton, Deborah D.; Wehby, Joseph H.

2016-01-01

Students with visual impairment (VI) lack access to the same models and reinforcers as students with sight. Consequentially, behaviors that children with sight acquire through observation must be explicitly taught to children with VI. In addition, children with VI have difficulty maintaining such behaviors. Therefore, interventions that promote…

A Comparative Study of Coteaching in Middle School Special and General Education Classrooms and Student Mathematics Achievement

ERIC Educational Resources Information Center

Tillman-Walker, LaCricia

2017-01-01

There is a consequential amount of research in regards to coteaching and student achievement in students with disabilities. Although there is a substantial body of research, there is still uncertainty whether achievement in mathematics differs between students with and without disabilities in cotaught and non-cotaught classrooms. Therefore, the…

7 CFR 1726.252 - Prior approved contract modification related to liability for special and consequential damages.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CONSTRUCTION POLICIES AND PROCEDURES Modifications to RUS Standard Contract Forms § 1726.252 Prior approved... difficulty in obtaining responsive bids on RUS standard contract forms due to a lack of limitation with... modifications in the RUS standard contract form on which the borrower solicits bids: (a) Insert new paragraphs...

Direct Behavior Rating: An Evaluation of Time-Series Interpretations as Consequential Validity

ERIC Educational Resources Information Center

Christ, Theodore J.; Nelson, Peter M.; Van Norman, Ethan R.; Chafouleas, Sandra M.; Riley-Tillman, T. Chris

2014-01-01

Direct Behavior Rating (DBR) is a repeatable and efficient method of behavior assessment that is used to document teacher perceptions of student behavior in the classroom. Time-series data can be graphically plotted and visually analyzed to evaluate patterns of behavior or intervention effects. This study evaluated the decision accuracy of novice…

PLENATITUDE Teacher Education for Effectiveness and Well-Being with Neuro-Linguistic Programming

ERIC Educational Resources Information Center

Vieira, Cristina Rocha; Gaspar, Maria Filomena

2013-01-01

The role and functioning of schools are changing as well as what is expected of teachers (who face growing and diversified challenges); consequentially, well-being at the schools is endangered. As teachers and teachers' educators concern is: How to improve schools' and teachers' effectiveness and promote well-being. Believing that the path to…

Responsibility beyond Rationality: The Case for Rhizomatic Consequentialism

ERIC Educational Resources Information Center

Stables, Andrew

2004-01-01

A key challenge for education is to encourage children to act responsibly. If "spiritual literacy" does not involve an autonomous, rational soul capable of "reading and writing the world as God intended", it must refer to ethical (and perhaps religious) capacity in relation to contingent actions in a context free of moral absolutes. In relation to…

Validity and the Consequences of Test Interpretation and Use

ERIC Educational Resources Information Center

Hubley, Anita M.; Zumbo, Bruno D.

2011-01-01

The vast majority of measures have, at their core, a purpose of personal and social change. If test developers and users want measures to have personal and social consequences and impact, then it is critical to consider the consequences and side effects of measurement in the validation process itself. The consequential basis of test interpretation…

Consequential Creativity: Student Competency and Lateral Thinking Incorporation in Architectural Education

ERIC Educational Resources Information Center

Hamza, Tamer S.; Hassan, Doaa K.

2016-01-01

Creativity is an original cognitive ability and problem solving process which enables individuals to use their intelligence in a way that is unique and directed toward coming up with a product. Architectural education is one of the fields in which human creativity has been exhibited; because, it can be defined as a design study that correlates…

Leading the Way: 25 Women Making a Difference

ERIC Educational Resources Information Center

Diverse: Issues in Higher Education, 2012

2012-01-01

When it comes to leadership, women are now taking on long overdue roles. This article presents 25 dynamic women in the world of higher education and beyond. They lead some of the most demanding and consequential organizations and programs on the planet. No longer sitting on the decision-making sidelines, they have shattered the glass ceiling and,…

The Role of Surgery, Radiosurgery and Whole Brain Radiation Therapy in the Management of Patients with Metastatic Brain Tumors

PubMed Central

Ellis, Thomas L.; Neal, Matthew T.; Chan, Michael D.

2012-01-01

Brain tumors constitute the most common intracranial tumor. Management of brain metastases has become increasingly complex as patients with brain metastases are living longer and more treatment options develop. The goal of this paper is to review the role of stereotactic radiosurgery (SRS), whole brain radiation therapy (WBRT), and surgery, in isolation and in combination, in the contemporary treatment of brain metastases. Surgery and SRS both offer management options that may help to optimize therapy in selected patients. WBRT is another option but can lead to late toxicity and suboptimal local control in longer term survivors. Improved prognostic indices will be critical for selecting the best therapies. Further prospective trials are necessary to continue to elucidate factors that will help triage patients to the proper brain-directed therapy for their cancer. PMID:22312545

Identification of reduced-order thermal therapy models using thermal MR images: theory and validation.

PubMed

Niu, Ran; Skliar, Mikhail

2012-07-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate.

Emerging science and therapies in non-small-cell lung cancer: targeting the MET pathway.

PubMed

Kris, Mark G; Arenberg, Douglas A; Herbst, Roy S; Riely, Gregory J

2014-11-01

During this enduring, learner-driven, interactive CME webseries, lung cancer specialists will address the science and targeted therapies for the MET pathway in non-small cell lung cancer. Over the past decade, research has evolved in the science of identifying targeted biological changes in DNA and individual cancer cells. Along with the advanced understanding of lung cancer mutations, has come the development of specific targeted therapies that improve patient outcomes. The first step in treating a patient with lung cancer is proper diagnosis and staging, applying to the principles of personalize medicine. Our current understanding of lung cancer is that of a collection of diseases individualized through specific mutations. This CME activity reviews the role of the pulmonologist and pathologist in proper tissue acquisition and analysis. This new era of personalized medicine and clinical research advances has changed the way clinicians evaluate and treat patients with lung cancer. The data on lung cancer cell mutations and newer targeted therapies have improved the progression free survival and quality of life of lung cancer patients. This CME activity is designed to present a practical overview of recent evidenced based data of MET targeted therapies for patients with lung cancer. As research continues to evolve, we continue to advance our understanding in the science of lung cancers involving the MET pathway. Evidenced based data supporting newer targeted therapeutics provides insight on applying treatment for optimal outcomes. This CME activity will focus on the individualized treatment strategies using practical decision making for patients with MET expression. This activity has been designed to meet the educational needs of medical oncologists, pathologists, radiation oncologists, surgeons, pulmonologists, internists, and other healthcare clinicians responsible for the care of patients with lung cancer. Online access:http://www.elseviercme.com/516/.

Periodontal therapy.

PubMed

Niemiec, Brook A

2008-05-01

Periodontal disease is the most common disease in small animal patients. It not only creates severe localized infection, but it has been linked to numerous severe systemic maladies. Proper therapy of this disease process results in a significant increase in the overall health of the patient. The treatment of periodontal disease is currently evolving due to the acceptance of the specific plaque hypothesis of periodontal disease. These findings have led to the development of the "one-stage full-mouth disinfection" treatment as well as a vaccine against these organisms. However, the cornerstone of therapy is still meticulous plaque control. This control is achieved via a combination of regular dental prophylaxis and home care. With progressive disease, advanced periodontal surgery or extraction becomes necessary.

Irrigation in endodontic treatment.

PubMed

Basrani, Bettina

2011-01-01

The primary endodontic treatment goal is to optimize root canal disinfection and to prevent reinfection. Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal system. In this review of the literature, various irrigants and the interactions between irrigants are discussed and new delivery systems are introduced.

Implementation of an Undergraduate Nutritional Support Clerkship.

ERIC Educational Resources Information Center

Stennett, Douglass J.; And Others

1983-01-01

A 10-week, full-time elective nutritional support clerkship designed for fifth-year pharmacy students is described. The course refines the student's communication skills and develops the student's ability to properly prepare and adjust a nutritional therapy plan. A weekly student activity plan and student evaluation form are appended. (MSE)

Affect of Early Life Oxygen Exposure on Proper Lung Development and Response to Respiratory Viral Infections

PubMed Central

Domm, William; Misra, Ravi S.; O’Reilly, Michael A.

2015-01-01

Children born preterm often exhibit reduced lung function and increased severity of response to respiratory viruses, suggesting that premature birth has compromised proper development of the respiratory epithelium and innate immune defenses. Increasing evidence suggests that premature birth promotes aberrant lung development likely due to the neonatal oxygen transition occurring before pulmonary development has matured. Given that preterm infants are born at a point of time where their immune system is also still developing, early life oxygen exposure may also be disrupting proper development of innate immunity. Here, we review current literature in hopes of stimulating research that enhances understanding of how the oxygen environment at birth influences lung development and host defense. This knowledge may help identify those children at risk for disease and ideally culminate in the development of novel therapies that improve their health. PMID:26322310

Diagnosis and treatment of common metabolic spinal disorders in the geriatric population.

PubMed

Eck, J C; Humphreys, S C

1998-12-01

Bone is constantly resorbed and remodeled throughout life. After approximately age 30, there is a net loss of bone mass. This places the geriatric population at an increased risk of pathologic bone disorders that can lead to fractures and deformity. In this paper, we review bone metabolism and remodeling and introduce the proper diagnostic techniques. The most common pathologic spinal disorders are introduced, with emphasis on presentation and treatment options. To prevent excessive bone loss, patients should be educated on proper nutrition (calcium and vitamin D requirements) and lifestyle (avoiding alcohol and cigarette smoking). Sex hormone and drug therapies are available to reduce bone loss. New bisphosphonates such as alendronate sodium (Fosamax) have been effective in increasing bone mass. Early diagnosis and proper treatment of pathologic bone disorders can reduce the incidence of fracture and allow the patient a more productive and comfortable life.

Topical therapies in hyperhidrosis care.

PubMed

Pariser, David M; Ballard, Angela

2014-10-01

Primary focal hyperhidrosis affects 3% of the US population; about the same number as psoriasis. More than half of these patients have primary focal axillary hyperhidrosis: sweating that is beyond what is anticipated or necessary for thermoregulation. Most topical therapies are based on aluminum salts, which work by a chemical reaction that forms plugs in the eccrine sweat ducts. Topical anticholinergics may also be used. Instruction on proper methods and timing of antiperspirants enhances effect and may be effective alone or in combination with other treatments in patients with hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem.

PubMed

Manzar, Md Dilshad; Sony, Peter; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R; Moscovitch, Adam; BaHammam, Ahmed S

2017-01-01

Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART.

Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

PubMed Central

Manzar, Md Dilshad; Sony, Peter; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R; Moscovitch, Adam; BaHammam, Ahmed S

2017-01-01

Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART. PMID:28966741

Prosthetic Consideration in Implant-supported Prosthesis: A Review of Literature

PubMed Central

Gowd, Manga Snigdha; Shankar, Thatapudi; Ranjan, Rajeev; Singh, Arpita

2017-01-01

Modern dentistry has changed tremendously with implant therapy. For the successful implant therapy, making a proper treatment plan considering both surgical and prosthetic part in mind is the key of success. Often practitioners tend to create a treatment plan overlooking the basic principles of prosthetic part. This present review has discussed various prosthetic consideration of implant-supported prosthesis. A step-by-step detailed prosthetic option with their indications has been discussed to help all dental implant practitioners in making of an optimal treatment plan for each case. PMID:28713760

Switching Patients to Home-Based Subcutaneous Immunoglobulin: an Economic Evaluation of an Interprofessional Drug Therapy Management Program.

PubMed

Perraudin, Clemence; Bourdin, Aline; Spertini, Francois; Berger, Jérôme; Bugnon, Olivier

2016-07-01

Home-based subcutaneous immunoglobulin (SCIg) therapy is an alternative to hospital-based intravenous infusions (IVIg). However, SCIg requires patient training and long-term support to ensure proper adherence, optimal efficacy and safety. We evaluated if switching patients to home-based SCIg including an interprofessional drug therapy management program (physician, community pharmacist and nurse) would be cost-effective within the Swiss healthcare system. A 3-year cost-minimization analysis was performed from a societal perspective comparing monthly IVIg in an outpatient clinic and home-based weekly SCIg including an interprofessional program. Healthcare costs (immunoglobulin, professional time, infusion pump and disposables) were derived from administrative data. Transportation and productivity loss were estimated by expert opinion. The results were expressed in Swiss francs (CHF) and converted to Euros and US dollars (1 CHF = 0.92€, 1 CHF = $1.02; www.xe.com , 12/14/2015). Under base case assumptions, SCIg was estimated to cost 35,862 CHF (33,134€; $36,595) per patient during the first year and 30,309 CHF (28,004€; $30,929) in subsequent years versus 35,370 CHF (32,679€; $36,095) per year for IVIg. The total savings from switching to SCIg with the interprofessional program were 9630 CHF (8897€; $9828) per patient over 3 years. The results were relatively sensitive to the cost per gram of IgG, the cost of equipment and the annual number of infusions. Home-based SCIg including an interprofessional therapy management program may be an efficient alternative for patients. The program provides long-term support from self-administration training to the responsible use of therapy (proper adherence, optimal efficacy and safety). Over the short term, additional costs from purchasing equipment and the drug therapy management program were offset by avoiding hospital costs.

Parenting Behaviors and Preschool Children's Social and Emotional Skills: A Question of the Consequential Validity of Traditional Parenting Constructs for Low-Income African Americans

ERIC Educational Resources Information Center

McWayne, C. M.; Owsianik, M.; Green, L. E.; Fantuzzo, J. W.

2008-01-01

Few researchers have questioned the validity of traditional parenting dimensions (based largely on Baumrind's [Baumrind, D. (1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monographs, 75, 43-88; Baumrind, D. (1971). Current patterns of parental authority. Developmental Psychology, 4, 1-103] work)…

Parental Monitoring Predicts Students' Prosocial and Impulsive Tendencies Relevant to Consequence-Based Reasoning in a Blended Learning Environment

ERIC Educational Resources Information Center

Hong, Jon-Chao; Hwang, Ming-Yueh; Tai, Kai-Hsin; Kuo, Yen-Chun

2016-01-01

Consequential reasoning relevant to moral development has not been effectively practised in elementary schools in Taiwan. The present study designed a "To Do or Not To Do" website for students to explore moral dilemma situations and exercise consequence-based moral reasoning. Effective data from 160 fifth-grade students were collected…

Cognitive Ability and Health-Related Behaviors during Adolescence: A Prospective Study across Five Years

ERIC Educational Resources Information Center

Ciarrochi, Joseph; Heaven, Patrick C. L.; Skinner, Timothy

2012-01-01

Longitudinal research on the links between intelligence and health behaviors among adolescents is rare. We report longitudinal data in which we assessed the relationships between intelligence as assessed in Grade 7 and consequential health outcomes in Grade 11. The mean age of respondents (N = 420; 188 males, 232 females) was 12.30 years (SD =…

Math-Related Career Aspirations and Choices within Eccles Et Al.'s Expectancy--Value Theory of Achievement-Related Behaviors

ERIC Educational Resources Information Center

Lauermann, Fani; Tsai, Yi-Miau; Eccles, Jacquelynne S.

2017-01-01

Which occupation to pursue is one of the more consequential decisions people make and represents a key developmental task. Yet the underlying developmental processes associated with either individual or group differences in occupational choices are still not well understood. This study contributes toward filling this gap, focusing in particular on…

Civilian Manning of AE, AFS, and AD Type Support Ships. Volume II. Appendices.

DTIC Science & Technology

1983-04-05

Manpower FYDP Cost Calculations ...... G-1 APPENDIX H - Navy Military Manpower Economic CostLA Calculations ....................................... H...AND AMERICAN MARITIME OFFICERS - Recognizing the serious economic problems confronting the American Merchant Marine with consequential adverse effects...Mindful that certain economic interests both foreign and *" domestic have and are creating substantial damage to an American national resource, our

Comparison of combinations of sighting devices and target objects for establishing circular plots in the field

Treesearch

Sylvio Mannel; Mark A. Rumble; Maribeth Price; Thomas M. Juntti; Dong Hua

2006-01-01

Many aspects of ecological research require measurement of characteristics within plots. Often, the time spent establishing plots is small relative to the time spent collecting and recording data. However, some studies require larger numbers of plots, where the time spent establishing the plot is consequential to the field effort. In open habitats, circular plots are...

The Effect of Teachers Trained in a Fundamental Movement Skills Programme on Children's Self-Perceptions and Motor Competence

ERIC Educational Resources Information Center

Breslin, Gavin; Murphy, Marie; McKee, David; Delaney, Brian; Dempster, Martin

2012-01-01

Perceived and actual motor competence are hypothesized to have potential links to children and young people's physical activity (PA) levels with a potential consequential link to long-term health. In this cross-sectional study, Harter's (1985, "Manual for the Self-perception Profile for Children." Denver, CO: University of Denver)…

The Impact of Being Labeled as a Persistently Lowest Achieving School: Regression Discontinuity Evidence on Consequential School Labeling

ERIC Educational Resources Information Center

Saw, Guan; Schneider, Barbara; Frank, Kenneth; Chen, I-Chien; Keesler, Venessa; Martineau, Joseph

2017-01-01

Since the No Child Left Behind Act was enacted, grading and labeling of schools as low performing have been increasingly used as means to incentivize failing schools to raise student achievement. Using statewide high school data from Michigan, our regression discontinuity analyses show that the bottom 5% of schools identified as persistently…

The Intellectual Foundations of Education: Core Journals and Their Impacts on Scholarship and Practice

ERIC Educational Resources Information Center

Goodyear, Rodney K.; Brewer, Dominic J.; Gallagher, Karen Symms; Tracey, Terence J. G.; Claiborn, Charles D.; Lichtenberg, James W.; Wampold, Bruce E.

2009-01-01

Academic journals are the primary mode of communication among researchers, and they play a central role in the creation, diffusion, and use of knowledge. This article updates previous attempts to identify a core set of journals that most education scholars would acknowledge as consequential sources. On the basis of nominations from a panel of…

The Cultivation of a Prosocial Value Orientation through Community Service: An Examination of Organizational Context, Social Facilitation, and Duration

ERIC Educational Resources Information Center

Horn, Aaron S.

2012-01-01

Community service is widely regarded as a fundamental experience in preparation for good citizenship, but it remains unclear whether common variants of service are consequential for civic outcomes. This study examines changes in the relative importance assigned to prosocial and egoistic values associated with service through different types of…

A partition of Toxoplasma gondii genotypes across spatial gradients and among host species, and decreased parasite diversity towards areas of human settlement in North America

USDA-ARS?s Scientific Manuscript database

Toxoplasma gondii counts among the most consequential food-borne parasites, and although the parasite occurs in a wide range of wild and domesticated animals, farms may constitute a specific and important locus of transmission. If so, parasites in animals that inhabit agricultural landscapes might b...

Application of a Mixed Consequential Ethical Model to a Problem Regarding Test Standards.

ERIC Educational Resources Information Center

Busch, John Christian

The work of the ethicist Charles Curran and the problem-solving strategy of the mixed consequentialist ethical model are applied to a traditional social science measurement problem--that of how to adjust a recommended standard in order to be fair to the test-taker and society. The focus is on criterion-referenced teacher certification tests.…

Children's Callous-Unemotional Traits Moderate Links between Their Positive Relationships with Parents at Preschool Age and Externalizing Behavior Problems at Early School Age

ERIC Educational Resources Information Center

Kochanska, Grazyna; Kim, Sanghag; Boldt, Lea J.; Yoon, Jeung Eun

2013-01-01

Background: Growing research on children's traits as moderators of links between parenting and developmental outcomes has shown that variations in positivity, warmth, or responsiveness in parent-child relationships are particularly consequential for temperamentally difficult or biologically vulnerable children. But very few studies have…

Carbon Mitigation Impacts of Increased Softwood Lumber and Structural Panel Use for Nonresidential Construction in the United States

Treesearch

Prakash Nepal; Kenneth E. Skog; David B. McKeever; Richard D. Bergman; Karen L. Abt; Robert C. Abt

2016-01-01

More wood use in the United States to construct low-rise nonresidential (NR) buildings would increase consumption and production of softwood (SW) lumber, engineered wood products, and structural and nonstructural wood panels. Using a consequential life-cycle analysis, we estimated the change in net CO2 emissions thatwould be caused by increased...

Supporting Parents: Using Research to Inform Policy and Best Practice. Social Policy Report Brief. Volume 30, Issue 5

ERIC Educational Resources Information Center

Bridgman, Anne

2017-01-01

Parenting is one of the most emotionally powerful, demanding, and consequential tasks of adulthood. Previously, the task of parenting was shared with extended family and community members. Today, with less extensive networks of experience and support, parents are frequently not as well prepared. Research has identified the elements of competent…

In the Face of Anti-LGBQ Behaviour: Saskatchewan High School Students' Perceptions of School Climate and Consequential Impact

ERIC Educational Resources Information Center

Morrison, Melanie A.; Jewell, Lisa; McCutcheon, Jessica; Cochrane, Donald B.

2014-01-01

In Canada, there is a dearth of research on school climate for lesbian, gay, bisexual, and questioning (LGBQ) students. Using social networking, 60 students from high schools in Saskatchewan participated in a climate survey. Results indicated that anti-LGBQ speech was widespread, as were other forms of harassment. The more victimization that was…

Worlding Genres through Lifeworld Analysis: New Directions for Genre Pedagogy and Uptake Awareness

ERIC Educational Resources Information Center

Rounsaville, Angela

2017-01-01

Recently, rhetorical genre studies scholars have challenged the field to de-center the study of genre as artifact to focus on the conditions that surround, inform, and constrain how those genres get used by writers: the genre uptakes. While prior research has begun to identify many of these consequential influences, these endeavors would benefit,…

Comparison of Perception toward the Adoption and Intention to Use Smart Education between Elementary and Secondary School Teachers

ERIC Educational Resources Information Center

Kim, Sang-Yon; Kim, Mi-Ryang

2013-01-01

The purposes of this study are to investigate the attitudes and perceptions of teachers toward the adoption of and intention to use Smart Education, to examine empirically the relationship between intention to use Smart Education and the consequential effect factors, and to obtain measures for revitalizing Smart Education. In order to accomplish…

A Generalized Thurstonian Paired Comparison Multicriteria Heuristic Model for Peer Evaluation of Individual Performance on IS Team Projects

ERIC Educational Resources Information Center

Scher, Julian M.

2010-01-01

Information Systems instructors are generally encouraged to introduce team projects into their pedagogy, with a consequential issue of objectively evaluating the performance of each individual team member. The concept of "freeloading" is well-known for team projects, and for this, and other reasons, a peer review process of team members,…

Life stress events and alcohol misuse: distinguishing contributing stress events from consequential stress events.

PubMed

Hart, Kenneth E; Fazaa, Norman

2004-07-01

This study examined the relationship between life stress events and level of alcohol misuse using two stress indices. The first index consisted of stress events that are not likely to be caused by alcohol misuse (i.e., alcohol uncontaminated stress events). The second stress index consisted of items that were judged as being likely consequences of alcohol misuse (i.e., alcohol contaminated stress events). Results based on a questionnaire study of 378 undergraduates in 2000 showed that level of alcohol misuse was much more strongly related to alcohol contaminated life stress events than alcohol uncontaminated life events. Comparative analysis of the coefficients of determination indicated the effect size of the association to alcohol contaminated life stress events was 240% larger than the corresponding effect size for the association to alcohol uncontaminated life events. Results suggest that studies, which are tests of the tension reduction hypothesis, should employ greater methodological rigor to ensure measures of life stress events are not inadvertently assessing the consequences of alcohol misuse. The results highlight the need to distinguish between stressful life events that contribute to alcohol misuse and stressful life events that are consequential to alcohol misuse.

Does observability affect prosociality?

PubMed

Bradley, Alex; Lawrence, Claire; Ferguson, Eamonn

2018-03-28

The observation of behaviour is a key theoretical parameter underlying a number of models of prosociality. However, the empirical findings showing the effect of observability on prosociality are mixed. In this meta-analysis, we explore the boundary conditions that may account for this variability, by exploring key theoretical and methodological moderators of this link. We identified 117 papers yielding 134 study level effects (total n = 788 164) and found a small but statistically significant, positive association between observability and prosociality ( r = 0.141, 95% confidence interval = 0.106, 0.175). Moderator analysis showed that observability produced stronger effects on prosociality: (i) in the presence of passive observers (i.e. people whose role was to only observe participants) versus perceptions of being watched, (ii) when participants' decisions were consequential (versus non-consequential), (iii) when the studies were performed in the laboratory (as opposed to in the field/online), (iv) when the studies used repeated measures (instead of single games), and (v) when the studies involved social dilemmas (instead of bargaining games). These effects show the conditions under which observability effects on prosociality will be maximally observed. We describe the theoretical and practical significance of these results. © 2018 The Authors.

Does observability affect prosociality?

PubMed Central

Lawrence, Claire

2018-01-01

The observation of behaviour is a key theoretical parameter underlying a number of models of prosociality. However, the empirical findings showing the effect of observability on prosociality are mixed. In this meta-analysis, we explore the boundary conditions that may account for this variability, by exploring key theoretical and methodological moderators of this link. We identified 117 papers yielding 134 study level effects (total n = 788 164) and found a small but statistically significant, positive association between observability and prosociality (r = 0.141, 95% confidence interval = 0.106, 0.175). Moderator analysis showed that observability produced stronger effects on prosociality: (i) in the presence of passive observers (i.e. people whose role was to only observe participants) versus perceptions of being watched, (ii) when participants’ decisions were consequential (versus non-consequential), (iii) when the studies were performed in the laboratory (as opposed to in the field/online), (iv) when the studies used repeated measures (instead of single games), and (v) when the studies involved social dilemmas (instead of bargaining games). These effects show the conditions under which observability effects on prosociality will be maximally observed. We describe the theoretical and practical significance of these results. PMID:29593114

Stochastic Technology Choice Model for Consequential Life Cycle Assessment.

PubMed

Kätelhön, Arne; Bardow, André; Suh, Sangwon

2016-12-06

Discussions on Consequential Life Cycle Assessment (CLCA) have relied largely on partial or general equilibrium models. Such models are useful for integrating market effects into CLCA, but also have well-recognized limitations such as the poor granularity of the sectoral definition and the assumption of perfect oversight by all economic agents. Building on the Rectangular-Choice-of-Technology (RCOT) model, this study proposes a new modeling approach for CLCA, the Technology Choice Model (TCM). In this approach, the RCOT model is adapted for its use in CLCA and extended to incorporate parameter uncertainties and suboptimal decisions due to market imperfections and information asymmetry in a stochastic setting. In a case study on rice production, we demonstrate that the proposed approach allows modeling of complex production technology mixes and their expected environmental outcomes under uncertainty, at a high level of detail. Incorporating the effect of production constraints, uncertainty, and suboptimal decisions by economic agents significantly affects technology mixes and associated greenhouse gas (GHG) emissions of the system under study. The case study also shows the model's ability to determine both the average and marginal environmental impacts of a product in response to changes in the quantity of final demand.

Update on Middle Ear Barotrauma after Hyperbaric Oxygen Therapy—Insights on Pathophysiology

PubMed Central

Lima, Marco Antônio Rios; Farage, Luciano; Cury, Maria Cristina Lancia; Bahamad, Fayez

2014-01-01

Introduction Middle ear barotrauma is the most common side effect of hyperbaric oxygen therapy. Knowledge and understanding of its pathophysiology are crucial for an accurate diagnosis and proper decision making about treatment and prevention. Objective Describe up-to-date information on pathophysiology of middle ear barotrauma after hyperbaric oxygen therapy considering the physiology of pressure variation of the middle ear. Data Synthesis Middle ear barotrauma occurs especially during the compression phase of hyperbaric oxygen therapy. The hyperoxic environment in hyperbaric oxygen therapy leads to ventilatory dysfunction of the eustachian tube, especially in monoplace chambers, where the patients are pressurized with 100% O2, favoring middle ear barotrauma. Conclusion The eustachian tube, the tympanic cavity, and mastoid work together in a neural controlled feedback system in which various mechanisms concur for middle ear pressure regulation. PMID:25992091

Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

PubMed

Wise, K; Rief, W; Goebel, G

1998-06-01

Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

The relevance of psychodynamic psychotherapy to understanding therapist-patient sexual abuse and treatment of survivors.

PubMed

Yahav, Rivka; Oz, Sheri

2006-01-01

Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.

Burns induced by cupping therapy in a burn center in northeast china.

PubMed

Jing-Chun, Zhao; Jia-Ao, Yu; Chun-Jing, Xian; Kai, Shi; Lai-Jin, Lu

2014-07-01

Cupping therapy as a curative skill has been developed and applied throughout history. Despite reports of adverse effects, this therapy is considered to be relatively safe with no systemic reviews documenting negative side effects. The aim of this study was to explore methods that avoid the adverse effects sometimes associated with this therapy. Clinical records of 14 outpatients and inpatients that visited the First Hospital of Jilin University (Changchun, China) for management of burn injuries caused by cupping therapy were retrospectively reviewed. Characteristics, history of injury, and treatment of each patient was collected and analyzed. Burn injury induced by cupping therapy was not uncommon. Most of the injuries were mild to moderate and cured by conservative methods without severe complications. The use of wet cupping was more prevalent among injured patients than dry cupping. Cupping therapy as an ancient alternative treatment is still popular with a large number of devoted practitioners. Although there is the potential for injury during the application of this therapy, this is mostly preventable. Standardized training for health care professionals and increased the awareness among the public about the proper methods to administer this therapy to avoid adverse effects is important.

Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study.

PubMed

Zambito, A; Bianchini, D; Gatti, D; Rossini, M; Adami, S; Viapiana, O

2007-11-01

Chronic low back pain due to multiple vertebral fractures is of difficult management. Electrical nerve stimulation is frequently used, but its efficacy has never been properly evaluated. In a randomized placebo-controlled clinical trial, we have shown that both interferential currents and horizontal therapy are more effective than placebo for functional. Multiple vertebral fractures almost invariably ensue in chronic low back pain that remains of difficult management. Electrical nerve stimulation is frequently used but its efficacy has never been properly evaluated. One hundred and fifteen women with chronic back pain due to previous multiple vertebral osteoporotic fractures (CBPMF) were randomly assigned to either interferential currents (IFT), horizontal therapy (HT) or sham HT administered for 30 minutes daily for 5 days per week for two weeks together with a standard exercise program. Efficacy assessment was obtained at baseline and at week 2, 6 and 14 and included a functional questionnaire (Backill), the standard visual analog scale (VAS) and the mean analgesic consumption. At week 2 a significant and similar improvement in both the VAS and Backill score was observed in the three groups. The two scores continued to improve in the two active groups with changes significantly (p < 0.001) greater than those observed in control patients at week 6 and 14. The use of analgesic medications improved only in the HT group. This randomized double-blind controlled study provides the first evidence that IFT and HT therapy are significantly effective in alleviating both pain and disability in patients with CBPMF.

SU-F-J-194: Development of Dose-Based Image Guided Proton Therapy Workflow

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

Pham, R; Sun, B; Zhao, T

Purpose: To implement image-guided proton therapy (IGPT) based on daily proton dose distribution. Methods: Unlike x-ray therapy, simple alignment based on anatomy cannot ensure proper dose coverage in proton therapy. Anatomy changes along the beam path may lead to underdosing the target, or overdosing the organ-at-risk (OAR). With an in-room mobile computed tomography (CT) system, we are developing a dose-based IGPT software tool that allows patient positioning and treatment adaption based on daily dose distributions. During an IGPT treatment, daily CT images are acquired in treatment position. After initial positioning based on rigid image registration, proton dose distribution is calculatedmore » on daily CT images. The target and OARs are automatically delineated via deformable image registration. Dose distributions are evaluated to decide if repositioning or plan adaptation is necessary in order to achieve proper coverage of the target and sparing of OARs. Besides online dose-based image guidance, the software tool can also map daily treatment doses to the treatment planning CT images for offline adaptive treatment. Results: An in-room helical CT system is commissioned for IGPT purposes. It produces accurate CT numbers that allow proton dose calculation. GPU-based deformable image registration algorithms are developed and evaluated for automatic ROI-delineation and dose mapping. The online and offline IGPT functionalities are evaluated with daily CT images of the proton patients. Conclusion: The online and offline IGPT software tool may improve the safety and quality of proton treatment by allowing dose-based IGPT and adaptive proton treatments. Research is partially supported by Mevion Medical Systems.« less

Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

PubMed Central

2012-01-01

Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

When to consider transfusion therapy for patients with non-transfusion-dependent thalassaemia.

PubMed

Taher, A T; Radwan, A; Viprakasit, V

2015-01-01

Non-transfusion-dependent thalassaemia (NTDT) refers to all thalassaemia disease phenotypes that do not require regular blood transfusions for survival. Thalassaemia disorders were traditionally concentrated along the tropical belt stretching from sub-Saharan Africa through the Mediterranean region and the Middle East to South and South-East Asia, but global migration has led to increased incidence in North America and Northern Europe. Transfusionists may be familiar with β-thalassaemia major because of the lifelong transfusions needed by these patients. Although patients with NTDT do not require regular transfusions for survival, they may require transfusions in some instances such as pregnancy, infection or growth failure. The complications associated with NTDT can be severe if not properly managed, and many are directly related to chronic anaemia. Awareness of NTDT is important, and this review will outline the factors that should be taken into consideration when deciding whether to initiate and properly plan for transfusion therapy in these patients in terms of transfusion interval and duration of treatment. © 2014 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion.

An economic evaluation of intravenous versus oral iron supplementation in people on haemodialysis.

PubMed

Wong, Germaine; Howard, Kirsten; Hodson, Elisabeth; Irving, Michelle; Craig, Jonathan C

2013-02-01

Iron supplementation can be administered either intravenously or orally in patients with chronic kidney disease (CKD) and iron deficiency anaemia, but practice varies widely. The aim of this study was to estimate the health care costs and benefits of parenteral iron compared with oral iron in haemodialysis patients receiving erythropoiesis-stimulating agents (ESAs). Using broad health care funder perspective, a probabilistic Markov model was constructed to compare the cost-effectiveness and cost-utility of parenteral iron therapy versus oral iron for the management of haemodialysis patients with relative iron deficiency. A series of one-way, multi-way and probabilistic sensitivity analyses were conducted to assess the robustness of the model structure and the extent in which the model's assumptions were sensitive to the uncertainties within the input variables. Compared with oral iron, the incremental cost-effectiveness ratios (ICERs) for parenteral iron were $74,760 per life year saved and $34,660 per quality-adjusted life year (QALY) gained. A series of one-way sensitivity analyses show that the ICER is most sensitive to the probability of achieving haemoglobin (Hb) targets using supplemental iron with a consequential decrease in the standard ESA doses and the relative increased risk in all-cause mortality associated with low Hb levels (Hb < 9.0 g/dL). If the willingness-to-pay threshold was set at $50,000/QALY, the proportions of simulations that showed parenteral iron was cost-effective compared with oral iron were over 90%. Assuming that there is an overall increased mortality risk associated with very low Hb level (<9.0 g/dL), using parenteral iron to achieve an Hb target between 9.5 and 12 g/L is cost-effective compared with oral iron therapy among haemodialysis patients with relative iron deficiency.

Neonatal Thymulin Gene Therapy Prevents Ovarian Dysgenesis and Attenuates Reproductive Derangements in Nude Female Mice

PubMed Central

Reggiani, Paula C.; Barbeito, Claudio G.; Zuccolilli, Gustavo O.; Cónsole, Gloria M.; Flamini, Alicia M.; Dardenne, Mireille

2012-01-01

Congenitally athymic (nude) female mice show severe ovarian dysgenesis after puberty, which seems to be consequential to a number of neuroendocrine derangements described in these mutants. Thus, considerable evidence suggests that thymulin, a thymic peptide, may be involved in thymus-pituitary communication. In order to clarify the relevance of thymulin for the maturation of the female reproductive system, we assessed at hypothalamic, pituitary, ovarian, and uterine level the preventive action of neonatal thymulin gene therapy (NTGT) on the changes that typically occur after puberty in congenitally athymic female mice. We injected (im) an adenoviral vector harboring a synthetic DNA sequence encoding a biologically active analog of thymulin, methionine-serum thymic factor, in newborn nude mice (which are thymulin deficient) and killed the animals at 70–71 d of age. NTGT in the athymic mice restored the serum thymulin levels. Morphometric analysis revealed that athymic nudes have reduced numbers of brain GnRH neurons and pituitary gonadotropic cells as compared with heterozygous controls. NTGT prevented these changes and also rescued the premature ovarian failure phenotype typically observed in athymic nude mice (marked reduction in the number of antral follicles and corpora lutea, increase in atretic follicles). Serum estrogen, but not progesterone, levels were low in athymic nudes, a reduction that was partially prevented by NTGT. Little to no morphological changes were observed in the endometrium of female nudes. The delay in the age of vaginal opening that occurs in athymic nudes was significantly prevented by NTGT. Our results suggest that thymulin plays a relevant physiologic role in the thymus-hypothalamo-pituitary-gonadal axis. PMID:22700775

Therapies in inborn errors of oxidative metabolism

PubMed Central

Schiff, Manuel; Bénit, Paule; Jacobs, Howard T.; Vockley, Jerry; Rustin, Pierre

2014-01-01

Mitochondrial diseases encompass a wide range of presentations and mechanisms, dictating a need to consider both broad-based and disease-specific therapies. The manifestations of mitochondrial dysfunction and the response to therapy vary between individuals. This probably reflects the genetic complexity of mitochondrial biology, which requires an excess of 2000 genes for proper function, with numerous interfering epigenetic and environmental factors. Accordingly, we are increasingly aware of the complexity of these diseases which involve far more than merely decreased ATP supply. Indeed, recent therapeutic progress has addressed only specific disease entities. In this review present and prospective therapeutic approaches will be discussed on the basis of targets and mechanism of action, but with a broad outlook on their potential applications. PMID:22633959

Cancer stem cell as therapeutic target for melanoma treatment.

PubMed

Alamodi, Abdulhadi A; Eshaq, Abdulaziz M; Hassan, Sofie-Yasmin; Al Hmada, Youssef; El Jamal, Siraj M; Fothan, Ahmed M; Arain, Omair M; Hassan, Sarah-Lilly; Haikel, Youssef; Megahed, Mosaad; Hassan, Mohamed

2016-12-01

Human malignant melanoma is a highly aggressive skin tumor that is characterized by its extraordinary heterogeneity, propensity for dissemination to distant organs and resistance to cytotoxic agents. Although chemo- and immune-based therapies have been evaluated in clinical trials, most of these therapeutics do not show significant benefit for patients with advanced disease. Treatment failure in melanoma patients is attributed mainly to the development of tumor heterogeneity resulting from the formation of genetically divergent subpopulations. These subpopulations are composed of cancer stem-like cells (CSCs) as a small fraction and non-cancer stem cells that form the majority of the tumor mass. In recent years, CSCs gained more attention and suggested as valuable experimental model system for tumor study. In melanoma, intratumoral heterogeneity, progression and drug resistance result from the unique characteristics of melanoma stem cells (MSCs). These MSCs are characterized by their distinct protein signature and tumor growth-driving pathways, whose activation is mediated by driver mutation-dependent signal. The molecular features of MSCs are either in a causal or consequential relationship to melanoma progression, drug resistance and relapse. Here, we review the current scientific evidence that supports CSC hypothesis and the validity of MSCs-dependent pathways and their key molecules as potential therapeutic target for melanoma treatment.

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury.

PubMed

Krassioukov, Andrei; Elliott, Stacy

2017-01-01

Objective: To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI). Methods: Narrative review of the latest literature. Results: Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control. SCI, depending on the level of lesion and completeness, can alter this cerebral control, affecting the psychological and reflexogenic potential for genital arousal and also ejaculation and orgasm. During arousal, nitric oxide is the main neurotransmitter for smooth muscle relaxation in both male and female erectile tissue. In men, erection, ejaculation, and orgasm are under separate neurological control and can be individually affected by SCI. Conclusions: Since sexual function is rated amongst the highest priorities by individuals living with SCI, methods employed to affect the neurological changes to maximize sexual neurophysiology prior to initiating medical therapies including paying attention to sexual sensate areas and visceral signals with mindfulness techniques, practicing body mapping, and sexual stimulation of sensate areas to encourage neuroplasticity. Attention should be paid to the biopsychosocial sexual contexts within which persons with SCI live to maximize their sexual and fertility rehabilitation.

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury

PubMed Central

Elliott, Stacy

2017-01-01

Objective: To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI). Methods: Narrative review of the latest literature. Results: Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control. SCI, depending on the level of lesion and completeness, can alter this cerebral control, affecting the psychological and reflexogenic potential for genital arousal and also ejaculation and orgasm. During arousal, nitric oxide is the main neurotransmitter for smooth muscle relaxation in both male and female erectile tissue. In men, erection, ejaculation, and orgasm are under separate neurological control and can be individually affected by SCI. Conclusions: Since sexual function is rated amongst the highest priorities by individuals living with SCI, methods employed to affect the neurological changes to maximize sexual neurophysiology prior to initiating medical therapies including paying attention to sexual sensate areas and visceral signals with mindfulness techniques, practicing body mapping, and sexual stimulation of sensate areas to encourage neuroplasticity. Attention should be paid to the biopsychosocial sexual contexts within which persons with SCI live to maximize their sexual and fertility rehabilitation. PMID:29339872

Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches.

PubMed

Unger, Thomas; Paulis, Ludovit; Sica, Domenic A

2011-11-01

The conventional antihypertensive therapies including renin-angiotensin-aldosterone system antagonists (converting enzyme inhibitors, receptor blockers, renin inhibitors, and mineralocorticoid receptor blockers), diuretics, β-blockers, and calcium channel blockers are variably successful in achieving the challenging target blood pressure values in hypertensive patients. Difficult to treat hypertension is still a commonly observed problem world-wide. A number of drugs are considered to be used as novel therapies for hypertension. Renalase supplementation, vasopeptidase inhibitors, endothelin antagonists, and especially aldosterone antagonists (aldosterone synthase inhibitors and novel selective mineralocorticoid receptor blockers) are considered an option in resistant hypertension. In addition, the aldosterone antagonists as well as (pro)renin receptor blockers or AT(2) receptor agonists might attenuate end-organ damage. This array of medications has now been complemented by a number of new approaches of non-pharmacological strategies including vaccination, genomic interference, controlled breathing, baroreflex activation, and probably most successfully renal denervation techniques. However, the progress on innovative therapies seems to be slow and the problem of resistant hypertension and proper blood pressure control appears to be still persisting. Therefore the regimens of currently available drugs are being fine-tuned, resulting in the establishment of several novel fixed-dose combinations including triple combinations with the aim to facilitate proper blood pressure control. It remains an exciting question which approach will confer the best blood pressure control and risk reduction in this tricky disease.

Educating for the future: adolescent girls' health and education in West Bengal, India.

PubMed

Rees, Chris A; Long, Katelyn N; Gray, Bobbi; West, Joshua H; Chanani, Sheila; Spielberg, Freya; Crookston, Benjamin T

2012-01-01

Adolescent girls in India carry a disproportionate burden of health and social risks; girls that do not finish secondary education are more likely to have an earlier age of sexual initiation, engage in risky sexual behavior, and consequentially be at greater risk of dying from pregnancy-related causes. This paper presents a comparison of girls in school and girls not in school from 665 participants in rural West Bengal, India. The social cognitive theory (SCT), a comprehensive theoretical model, was used as a framework to describe the personal, behavioral, and environmental factors affecting the lives of these adolescent girls. There were significant differences between girls in and out of school in all three categories of the SCT; girls in school were more likely to have heard of sexually transmitted diseases or infections than girls not in school (p<0.0001). Girls in school were also more likely than girls not in school to boil water before drinking (p=0.0078), and girls in school lived in dwellings with 2.3 rooms on average, whereas girls not in school lived in dwellings with only 1.7 rooms (p<0.0001). Indian adolescent girls who are not in school are disadvantaged both economically and by their lack of health knowledge and proper health behaviors when compared with girls who are still in school. In addition, to programs to keep girls in school, efforts should also be made to provide informal education to girls not in school to improve their health knowledge and behaviors.

Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0.

PubMed

Chen, Alice P; Setser, Ann; Anadkat, Milan J; Cotliar, Jonathan; Olsen, Elise A; Garden, Benjamin C; Lacouture, Mario E

2012-11-01

Dermatologic adverse events to cancer therapies have become more prevalent and may to lead to dose modifications or discontinuation of life-saving or prolonging treatments. This has resulted in a new collaboration between oncologists and dermatologists, which requires accurate cataloging and grading of side effects. The Common Terminology Criteria for Adverse Events Version 4.0 is a descriptive terminology and grading system that can be used for uniform reporting of adverse events. A proper understanding of this standardized classification system is essential for dermatologists to properly communicate with all physicians caring for patients with cancer. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

[Focus: baker's asthma. Epidemiology, diagnosis and treatment of baker's asthma].

PubMed

Romano, Canzio

2014-01-01

Baker's asthma, though having been recognized and studied since long time, still stays one of the most common causes of occupational asthma. Moreover, our understanding of the causative agents, the pathophysiological mnechanisms, the usefulness of medical surveillance, the proper treatment and prevention of the disease is still scanty. This is due to either to its complex pathogenesis or to possible confoundings, besides the still inadequate quality and standardization of the tools available as far as the allergologic diagnosis is concerned. Proper medical surveillance, validated causal therapies, efficient primary prevention are still uncertain. Change of employment or relocation is often impossible, particularly among artisan workers. Various evidences have been critically revised and summarized.

"Have you seen your aura lately?" examining boundary-work in holistic health pamphlets.

PubMed

Ho, Evelyn Y

2007-01-01

An increasing number of people in the United States are using holistic therapies. Both encouraging and informing this trend in growth, printed leaflets are a popular and important medium for holistic health practitioners. Using a discourse analytic approach, the author analyzed pamphlets and printed texts distributed at a holistic health fair. These texts reflect and construct specific understandings of holistic health and proper health care. Understood through the notion of boundary-work, pamphlets demarcated holism as the proper way of conceptualizing health and health care. However, holistic medicine's boundaries are quite porous, as these practices are also legitimized through the use of scientific conventions and the practice of integration, both commonly associated with biomedicine.

Measuring Meaningful Outcomes in Consequential Contexts: Searching for a Happy Medium in Educational Technology Research (Phase II)

ERIC Educational Resources Information Center

Ross, Steven M.; Morrison, Jennifer R.

2014-01-01

In a paper published 25 years ago, Ross and Morrison ("Educ Technol Res Dev" 37(1):19-33, 1989) called for a "happy medium" in educational technology research, to be achieved by balancing high rigor of studies (internal validity) with relevance to real-world applications (external validity). In this paper, we argue that,…

The Impact of World Ranking Systems on Graduate Schools of Business: Promoting the Manipulation of Image over the Management of Substance

ERIC Educational Resources Information Center

Rondeau, Kent V.

2017-01-01

This essay explores and examines how rankings and league tables have played (and continue to play) a major and consequential role in how contemporary business schools manage their affairs. It introduces and advances the proposition that rankings promote the short-term manipulation of public reputation (image) projected by business schools at the…

School Improvement under Test-Driven Accountability: A Comparison of High- and Low-Performing Middle Schools in California. CSE Report 717

ERIC Educational Resources Information Center

Mintrop, Heinrich; Trujillo, Tina

2007-01-01

Based on in-depth data from nine demographically similar schools, the study asks five questions in regard to key aspects of the improvement process and that speak to the consequential validity of accountability indicators: Do schools that differ widely according to system performance criteria also differ on the quality of the educational…

Deciding to buy expensive technology. The case of biliary lithotripsy.

PubMed

Weingart, S N

1995-01-01

Acquiring expensive, new medical technology requires an evaluation of the efficacy and effectiveness, safety, profitability, feasibility, and risk of a project in the context of the hospital's social responsibility and institutional strategy. A case study of the decision to bring biliary lithotripsy to Strong Memorial Hospital illustrates how these criteria offer managers a coherent approach to difficult and consequential decisions about acquiring medical technology.

Academic Delay of Gratification and Children's Study Time Allocation as a Function of Proximity to Consequential Academic Goals

ERIC Educational Resources Information Center

Zhang, Lili; Karabenick, Stuart A.; Maruno, Shun'ichi; Lauermann, Fani

2011-01-01

Students (N=302) in Chinese elementary schools were assessed regarding their academic delay of gratification (ADOG) and reported the time they devoted to non-school study and playtime during an extended interval prior to taking a high-stakes final exam. Students high compared those low in ADOG were more likely to spend time studying and less time…

Which factors hinder the decision of Polish HIV-positive patients to take up antiretroviral therapy?

PubMed

Rogowska-Szadkowska, D; Chlabicz, S; Oltarzewska, M A; Sawicka-Powierza, J

2009-03-01

The implementation of highly active antiretroviral therapy (HAART) in 1996 has significantly reduced mortality and morbidity for HIV-positive patients worldwide. However not all eligible persons start HAART. To identify reasons for therapy refusal by HIV-positive persons we performed a questionnaire study. The investigation was conducted among 321 HIV-positive individuals and focused on the decision to take up antiretroviral treatment. Out of 71 untreated patients, 34 (47.9%) admitted that in their case the therapy was not indicated, whereas 20 (28.3%) were afraid of potential side effects that might change their appearance, e.g. face lipoatrophy. Only the treated patients had been prepared to take up therapy, although 17 patients (6.0%) had not received any explanation of the therapy principles, aims or necessity to comply with medication regime. The therapy is generally not discussed with the patients for whom it is not currently indicated, which may contribute to the fixation of fears and prejudices. Doctors who treat HIV-positive patients should be aware of the prejudices and fears their patients have towards antiretroviral therapy in order to react properly and by means of the available antiretroviral drugs help prolong life and improve its quality.

Life of Sugar: Developing Lifecycle Methods to Evaluate the Energy and Environmental Impacts of Sugarcane Biofuels

NASA Astrophysics Data System (ADS)

Gopal, Anand Raja

Lifecycle Assessment (LCA) is undergoing a period of rapid change as it strives to become more policy-relevant. Attributional LCA, the traditional LCA category, is beginning to be seen as particularly ill-equipped to assess the consequences of a policy. This has given birth to a new category of LCA known as Consequential LCA that is designed for use in LCA-based policies but is still largely unknown, even to LCA experts, and suffers from a lack of well developed methods. As a result, many LCA-based policies, like the California Low Carbon Fuel Standard (LCFS), use poor LCA methods that are both scientifically suspect and unable to model many biofuels, especially ones manufactured from byproduct feedstocks. Biofuels made from byproduct feedstocks, primarily molasses ethanol from Asia and the Caribbean, can contribute significantly to LCFS' carbon intensity targets in the near-term at low costs, a desperate need for the policy ever since US corn ethanol was rated as having a worse global warming impact than gasoline. In this dissertation, I develop the first fully consequential lifecycle assessment of a byproduct-based biofuel using a partial equilibrium foundation. I find that the lifecycle carbon content of Indian molasses ethanol is just 5 gCO2/MJ using this method, making it one of the cleanest first generation biofuels in the LCFS. I also show that Indian molasses ethanol remains one of the cleanest first-generation biofuels even when using the flawed methodology ratified for the LCFS, with a lifecycle carbon content of 24 gCO2/MJ. My fully consequential LCA model also shows that India's Ethanol Blending program, which currently subsidizes blending of molasses ethanol and gasoline for domestic consumption, can meet its objective of supporting domestic agriculture more cost-effectively by helping producers export their molasses ethanol to fuel markets that value carbon. However, this objective will be achieved at a significant cost to the poor who will face a 39% increase in the price of sorghum because of the policy.

The greenhouse gas emissions performance of cellulosic ethanol supply chains in Europe

PubMed Central

Slade, Raphael; Bauen, Ausilio; Shah, Nilay

2009-01-01

Background Calculating the greenhouse gas savings that may be attributed to biofuels is problematic because production systems are inherently complex and methods used to quantify savings are subjective. Differing approaches and interpretations have fuelled a debate about the environmental merit of biofuels, and consequently about the level of policy support that can be justified. This paper estimates and compares emissions from plausible supply chains for lignocellulosic ethanol production, exemplified using data specific to the UK and Sweden. The common elements that give rise to the greatest greenhouse gas emissions are identified and the sensitivity of total emissions to variations in these elements is estimated. The implications of including consequential impacts including indirect land-use change, and the effects of selecting alternative allocation methods on the interpretation of results are discussed. Results We find that the most important factors affecting supply chain emissions are the emissions embodied in biomass production, the use of electricity in the conversion process and potentially consequential impacts: indirect land-use change and fertiliser replacement. The large quantity of electricity consumed during enzyme manufacture suggests that enzymatic conversion processes may give rise to greater greenhouse gas emissions than the dilute acid conversion process, even though the dilute acid process has a somewhat lower ethanol yield. Conclusion The lignocellulosic ethanol supply chains considered here all lead to greenhouse gas savings relative to gasoline An important caveat to this is that if lignocellulosic ethanol production uses feedstocks that lead to indirect land-use change, or other significant consequential impacts, the benefit may be greatly reduced. Co-locating ethanol, electricity generation and enzyme production in a single facility may improve performance, particularly if this allows the number of energy intensive steps in enzyme production to be reduced, or if other process synergies are available. If biofuels policy in the EU remains contingent on favourable environmental performance then the multi-scale nature of bioenergy supply chains presents a genuine challenge. Lignocellulosic ethanol holds promise for emission reductions, but maximising greenhouse gas savings will not only require efficient supply chain design but also a better understanding of the spatial and temporal factors which affect overall performance. PMID:19682352

Tumor-Treating Fields: Nursing Implications for an Emerging Technology
.

PubMed

Chang, Alice

2017-06-01

Tumor-treating fields (TTFields) are a new technology used for cancer treatment consisting of battery-powered, insulated electromagnetic transducers that are placed on the scalp. This wearable, adhesive device is a certified physician-prescribed therapy for patients with glioblastoma multiforme, a type of primary brain cancer. TTFields are being used concomitantly with temozolomide (Temodar®) in patients with newly diagnosed glioblastoma and as a monotherapy in patients with recurrent glioblastoma after radiation therapy and chemotherapy. Nursing professionals caring for patients using this emerging technology should be able to educate patients regarding proper use of TTFields and monitor for side effects.
.

[Secondary osteoporosis and glucocorticoid-induced osteoporosis].

PubMed

Orcel, P; Krane, S M

2000-10-01

In order to assess properly the diagnosis of osteoporosis, a short clinical investigation is required to address potential causes for bone loss. Osteoporosis used to be suspected in a patient with vertebral demineralization, but nowadays it is often diagnosed in a patient with a low bone mass on a screening dual-energy X-ray absorptiometry (DEXA). In this setting, it is important for the clinician to look for secondary osteoporosis, especially in men in whom secondary osteoporosis is more frequent than in women, before discussing any specific therapy. The major causes are longterm glucocorticoid therapy, endocrine (hypogonadism, primary hyperparathyroidism, hyperthyroidism), or digestive diseases.

Review of the results of the in vivo dosimetry during total skin electron beam therapy

PubMed Central

Guidi, Gabriele; Gottardi, Giovanni; Ceroni, Paola; Costi, Tiziana

2013-01-01

This work reviews results of in vivo dosimetry (IVD) for total skin electron beam (TSEB) therapy, focusing on new methods, data emerged within 2012. All quoted data are based on a careful review of the literature reporting IVD results for patients treated by means of TSEB therapy. Many of the reviewed papers refer mainly to now old studies and/or old guidelines and recommendations (by IAEA, AAPM and EORTC), because (due to intrinsic rareness of TSEB-treated pathologies) only a limited number of works and reports with a large set of numerical data and proper statistical analysis is up-to-day available in scientific literature. Nonetheless, a general summary of the results obtained by the now numerous IVD techniques available is reported; innovative devices and methods, together with areas of possible further and possibly multicenter investigations for TSEB therapies are highlighted. PMID:24936333

Endoscopic Therapy in Crohn's Disease: Principle, Preparation, and Technique.

PubMed

Chen, Min; Shen, Bo

2015-09-01

Stricture and fistula are common complications of Crohn's disease. Endoscopic balloon dilation and needle-knife stricturotomy has become a valid treatment option for Crohn's disease-associated strictures. Endoscopic therapy is also increasingly used in Crohn's disease-associated fistula. Preprocedural preparations, including routine laboratory testing, imaging examination, anticoagulant management, bowel cleansing and proper sedation, are essential to ensure a successful and safe endoscopic therapy. Adverse events, such as perforation and excessive bleeding, may occur during endoscopic intervention. The endoscopist should be well trained, always be cautious, anticipate for possible procedure-associated complications, be prepared for damage control during endoscopy, and have surgical backup ready. In this review, we discuss the principle, preparation, techniques of endoscopic therapy, as well as the prevention and management of endoscopic procedure-associated complications. We propose that inflammatory bowel disease endoscopy may be a part of training for "super" gastroenterology fellows, i.e., those seeking a career in advanced endoscopy or in inflammatory bowel disease.

Defining pathways for development of disease-modifying therapies in children with type 1 diabetes: a consensus report.

PubMed

Wherrett, Diane K; Chiang, Jane L; Delamater, Alan M; DiMeglio, Linda A; Gitelman, Stephen E; Gottlieb, Peter A; Herold, Kevan C; Lovell, Daniel J; Orchard, Trevor J; Ryan, Christopher M; Schatz, Desmond A; Wendler, David S; Greenbaum, Carla J

2015-10-01

Emerging data suggest that type 1 diabetes is a more aggressive disease in children than in adults, with important differences in pathophysiology and clinical course. Therefore, the efficacy of disease-modifying therapies may be different in the two populations. Understanding the developmental and regulatory pathways for type 1 diabetes-modifying therapies in children will enable industry, academia, funders, advocacy groups, and regulators to translate new science to clinical care. This consensus report characterizes the fundamental differences in type 1 diabetes between children and adults and proposes a thoughtful approach to better understand the development and regulatory pathways for type 1 diabetes therapies. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Options for the management of antiviral resistance during hepatitis B therapy: reflections on battles over a decade

PubMed Central

2013-01-01

Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance. PMID:24133659

Misadministration of radiation therapy in veterinary medicine: a case report and literature review.

PubMed

Arkans, M M; Gieger, T L; Nolan, M W

2017-03-01

Recent technical advancements in radiation therapy have allowed for improved targeting of tumours and sparing nearby normal tissues, while simultaneously decreasing the risk for medical errors by incorporating additional safety checks into electronic medical record keeping systems. The benefits of these new technologies, however, depends on their proper integration and use in the oncology clinic. Despite the advancement of technology for treatment delivery and medical record keeping, misadministration errors have a significant impact on patient care in veterinary oncology. The first part of this manuscript describes a medical incident that occurred at an academic veterinary referral hospital, in a dog receiving a combination of stereotactic radiation therapy and full-course intensity-modulated, image-guided radiation therapy. The second part of the report is a literature review, which explores misadministration errors and novel challenges which arise with the implementation of advancing technologies in veterinary radiation oncology. © 2015 John Wiley & Sons Ltd.

Biomarker-guided antibiotic therapy-strengths and limitations.

PubMed

Nora, David; Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-05-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality.

Clinical use of anti-TNF therapy and increased risk of infections

PubMed Central

Ali, Tauseef; Kaitha, Sindhu; Mahmood, Sultan; Ftesi, Abdul; Stone, Jordan; Bronze, Michael S

2013-01-01

Biologics such as antitumor necrosis factor (anti-TNF) drugs have emerged as important agents in the treatment of many chronic inflammatory diseases, especially in cases refractory to conventional treatment modalities. However, opportunistic infections have become a major safety concern in patients on anti-TNF therapy, and physicians who utilize these agents must understand the increased risks of infection. A literature review of the published data on the risk of bacterial, viral, fungal, and parasitic infections associated with anti-TNF therapy was performed and the clinical presentation, diagnostic tests, management, and prevention of opportunistic infections in patients receiving anti-TNF therapy were reviewed. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from anti-TNF treatments. Patients should be adequately vaccinated when possible and closely monitored for early signs of infection. When serious infections occur, withdrawal of anti-TNF therapy may be necessary until the infection has been identified and properly treated. PMID:23569399

Identification of Reduced-Order Thermal Therapy Models Using Thermal MR Images: Theory and Validation

PubMed Central

2013-01-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate. PMID:22531754

Triadic Model for Working with Parents in Child Therapy Settings

ERIC Educational Resources Information Center

Jeon, Mi-Hee; Myers, Charles E.

2017-01-01

Child therapists face challenges regarding whether they should meet needs of not only their child-clients but needs of the parents of their clients. Their difficulties arise from the fact that although they are specialized in counseling children, the majority of them lack proper training in or education on working with parents (Lolan, 2011). Given…

Mindfullness-Based Cognitive Therapy as a Complementary Treatment for Combat/Operational Stress and Combat Post-Traumatic Stress Disorder

DTIC Science & Technology

2008-01-01

FROM, OR REPRODUCTION OF ALL OR ANY PART OF THIS DOCUMENT IS PERMITTED PROVIDED PROPER ACKNOWLEDGEMENT IS MADE. 111 Table ofContents Page EXECUTIVE...to a threat of toxicity. Hypnotic and sedative medications12 are the final class of drugs to be considered. These decrease anxiety and agitation

Bipolar Disorder.

PubMed

Miller, Thomas H

2016-06-01

Bipolar disorder is a chronic mental health disorder that is frequently encountered in primary care. Many patients with depression may actually have bipolar disorder. The management of bipolar disorder requires proper diagnosis and awareness or referral for appropriate pharmacologic therapy. Patients with bipolar disorder require primary care management for comorbidities such as cardiovascular and metabolic disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

Anesthetic considerations for pediatric electroconvulsive therapy.

PubMed

Franklin, Andrew D; Sobey, Jenna H; Stickles, Eric T

2017-05-01

Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment. Dexmedetomidine is likely the most appropriate preoperative anxiolytic as oral benzodiazepines are relatively contraindicated. Methohexital, though becoming less available at many institutions, remains the gold standard for induction of anesthesia for pediatric electroconvulsive therapy though ketamine, propofol, and sevoflurane are becoming increasingly viable options. Proper planning and communication between the multidisciplinary teams involved in the care of children presenting for electroconvulsive therapy treatments is vital to mitigating risks and achieving the greatest therapeutic benefit. © 2017 John Wiley & Sons Ltd.

Application of photodynamic therapy, laser therapy, and a cellulose membrane for calcaneal pressure ulcer treatment in a diabetic patient: A case report.

PubMed

Rosa, Luciano Pereira; da Silva, Francine Cristina; Vieira, Regiane Lima; Tanajura, Beatriz Rocha; da Silva Gusmão, Alana Gonçalves; de Oliveira, Janeide Muritiba; Dos Santos, Nathalia Aparecida Campanário; Bagnato, Vanderlei Salvador

2017-09-01

Diabetes mellitus is a metabolic disorder in which a person has high blood glucose levels due to inadequate insulin production by the pancreas. Wounds in these individuals cannot heal properly over time due to circulatory changes that hinder and stagnate the healing process. We report the case of an 82-year-old female type 2 diabetes mellitus carrier, presenting to clinical-dermatological examination pressure ulcer (PU) in the right calcaneus region. The patient was treated with photodynamic therapy using curcumin and blue light-emitting diodes (LEDs), laser therapy, and the application of a cellulose membrane in order to promote ulcer decontamination by local action, accelerate wound healing, and maintain favorable conditions of asepsis and moisture, respectively. The ulcer healing occurred after 30days of treatment and total epithelialization was observed. From the results obtained in this case report, we conclude that the combination of photodynamic therapy, laser therapy, and coating with a cellulose membrane is a promising treatment for the healing of PU in diabetic patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Laser Interstitial Thermal Therapy Technology, Physics of Magnetic Resonance Imaging Thermometry, and Technical Considerations for Proper Catheter Placement During Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy.

PubMed

Patel, Nitesh V; Mian, Matthew; Stafford, R Jason; Nahed, Brian V; Willie, Jon T; Gross, Robert E; Danish, Shabbar F

2016-12-01

Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased. There are many technical nuances for laser placement, and, to date, there is not a clear understanding of whether any one technique is better than the other. In this review, we describe the basic physics of magnetic resonance-guided laser-induced thermal therapy and describe the several common techniques for accurate Visualase laser catheter placement in a stepwise fashion. MRg-LITT, magnetic resonance-guided laser-induced thermal therapyPAD, precision aiming device.

An Update on Clinical Burden, Diagnostic Tools, and Therapeutic Options of Staphylococcus aureus

PubMed Central

Reddy, Prakash Narayana; Srirama, Krupanidhi; Dirisala, Vijaya R

2017-01-01

Staphylococcus aureus is an important pathogen responsible for a variety of diseases ranging from mild skin and soft tissue infections, food poisoning to highly serious diseases such as osteomyelitis, endocarditis, and toxic shock syndrome. Proper diagnosis of pathogen and virulence factors is important for providing timely intervention in the therapy. Owing to the invasive nature of infections and the limited treatment options due to rampant spread of antibiotic-resistant strains, the trend for development of vaccines and antibody therapy is increasing at rapid rate than development of new antibiotics. In this article, we have discussed elaborately about the host-pathogen interactions, clinical burden due to S aureus infections, status of diagnostic tools, and treatment options in terms of prophylaxis and therapy. PMID:28579798

Long-term risks of psoralen and UV-A therapy for psoriasis

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

Farber, E.M.; Abel, E.A.; Cox, A.J.

1983-05-01

It has been more than eight years since photochemotherapy with methoxsalen and UV-A (psoralen and UV-A (PUVA)) was introduced for the treatment of psoriasis. This treatment remained under investigation until May 1982 because of concerns about possible chronic toxic effects. With recent Food and Drug Administration approval of PUVA therapy for severe psoriasis, strict drug labeling for administration and patient use and continued monitoring of side effects have become essential. The full effects of PUVA in regard to carcinogenicity, prematurelly induced aging of the skin, pigmentary changes, immunologic alterations, and ocular side effects are still unknown. A review of themore » risks of PUVA therapy is presented, with the aim of maintaining a proper perspective for its limited use in treating selected patients.« less

Management of cutaneous rosacea: emphasis on new medical therapies.

PubMed

Del Rosso, James Q

2014-10-01

Over the past decade, both basic science and clinical research have provided new information on pathophysiology and therapy that has led to advances in the management of rosacea. As rosacea is a very common facial skin disorder in adults of both genders and essentially all races and ethnicities, these advances can provide therapeutic benefit to many affected individuals around the world. This article provides a collective review of more recent information on the pathophysiology and clinical manifestations of rosacea, and discusses individual medical therapies based on PubMed literature searches on 'rosacea', 'rosacea therapies' and each therapy that are included in this article. The perspectives of the author on management of rosacea are also included. Newer therapies and treatment concepts received greater emphasis. Management of cutaneous rosacea involves patient education, integration of proper skin care, differentiation of visible manifestations and symptoms, selecting therapies that correlate with the manifestations that are to be treated, setting realistic patient expectations on anticipated degree and time course of response and designing an overall management plan that addresses needs of the individual patient. In many cases, a combination approach is needed, and due to the chronicity of the disease long-term management is often warranted.

Consumer Search, Rationing Rules, and the Consequence for Competition

NASA Astrophysics Data System (ADS)

Ruebeck, Christopher S.

Firms' conjectures about demand are consequential in oligopoly games. Through agent-based modeling of consumers' search for products, we can study the rationing of demand between capacity-constrained firms offering homogeneous products and explore the robustness of analytically solvable models' results. After algorithmically formalizing short-run search behavior rather than assuming a long-run average, this study predicts stronger competition in a two-stage capacity-price game.

Texas Should Require Homeland Security Standards for High-Speed Rail

DTIC Science & Technology

2015-12-01

conditions. Japanese trains, engineered with earthquakes in mind, all came to a safe stop during the 2011 Fukushima disaster without loss of life or...building—that devastated parts of Japan through immediate effect as well as caused the consequential breach of the Fukushima nuclear reactor.119...119 Ichiro Fujisaki, “Japan’s Recovery Six Months after the Earthquake, Tsunami and Nuclear Crisis,” Brookings Institution, last modified September

Myth, Metaphor, and Imagination: Framing Homeland Security as Art and Archetype

DTIC Science & Technology

2013-03-01

repeatable, patterned, and consequential, science reveals stability and balance. As creative, emergent, mutant, and selfish, art is a self -styled...broader applications. Soft vigilance is open to novelty and takes in more information, while hyper vigilance locks in on an object of attention and...deficiency requirements of physiological needs, safety needs, love and belonging, and esteem, but also the being requirements of self -actualization and

Disability and Deservedness: The Lived Experience of Wounded, Ill, and Injured Members of the U.S. Armed Forces at a Military Treatment Facility

ERIC Educational Resources Information Center

Murphy, Deborah

2013-01-01

My work engages links between notions of disability and notions of deservedness; the ways in which they are consequential; and how they are constructed and sustained. For my dissertation research I studied a select group of people at two sites of high visibility and focused practice: I used ethnographic methodology to collect qualitative data…

Ethical perspectives of children's assent for research participation: deontology and on utilitarianism.

PubMed

Pieper, Pam

2008-01-01

Is a child's assent to participate in research that does not have the potential to directly benefit the child ethically mandated? Analysis of this particular dilemma of health care research in children using two competing theories results in different answers. Deontology (principle-based ethics) will be contrasted with utilitarianism (consequentialism). Historical cases of research with children will be used as exemplars of these two theoretical positions.

Assessing Consequential Scenarios in a Complex Operational Environment Using Agent Based Simulation

DTIC Science & Technology

2017-03-16

RWISE) 93 5.1.5 Conflict Modeling, Planning, and Outcomes Experimentation Program (COMPOEX) 94 5.1.6 Joint Non -Kinetic Effects Model (JNEM)/Athena... experimental design and testing. 4.3.8 Types and Attributes of Agent-Based Model Design Patterns Using the aforementioned ABM flowchart design methodology ...speed, or flexibility during tactical US Army wargaming. The report considers methodologies to improve analysis of the human domain, identifies

Interpersonal mechanisms linking close relationships to health.

PubMed

Pietromonaco, Paula R; Collins, Nancy L

2017-09-01

Close relationships play a vital role in human health, but much remains to be learned about specific mechanisms of action and potential avenues for intervention. This article provides an evaluation of research on close relationships processes relevant to health, drawing on themes from major relationship science theories to present a broad conceptual framework for understanding the interpersonal processes and intrapersonal pathways linking relationships to health and disease outcomes. The analysis reveals that both social connection and social disconnection broadly shape biological responses and behaviors that are consequential for health. Furthermore, emerging work offers insights into the types of social dynamics that are most consequential for health, and the potential pathways through which they operate. Following from this analysis, the authors suggest several research priorities to facilitate the translation of discoveries from relationship science into relationship-based interventions and public health initiatives. These priorities include developing finer grained theoretical models to guide research, the systematic investigation of potential mediating pathways such as dyadic influences on health behavior and physiological coregulation, and taking into account individual differences and contextual factors such as attachment style, gender, socioeconomic status, and culture. In addition, a pressing need exists for laboratory and field research to determine which types of interventions are both practical and effective. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Factors driving collaboration in natural resource conflict management: Evidence from Romania.

PubMed

Hossu, Constantina Alina; Ioja, Ioan Cristian; Susskind, Lawrence E; Badiu, Denisa L; Hersperger, Anna M

2018-02-03

A critical challenge in natural resource management is to bring all stakeholders together to negotiate solutions to critical problems. However, various collaborative approaches to heading off conflicts and resolving natural resource management disputes have been used. What drives these efforts, however, still needs further research. Our study provides a systematic look at the drivers likely to initiate collaborative problem-solving efforts in four cases in Romania. We use Emerson's et al. (2012) framework for collaborative governance and multi-value qualitative comparative analysis (mvQCA) to analyze cases involving endangered species, restrictions on forest harvest, conflicts associated with infrastructure development projects, and disputes over the management of environmentally sensitive areas. Our findings contribute to the already existing collaborative governance literature indicating which of the four factors: uncertainty, interdependence, consequential incentives, and leadership, in which combination, are necessary and sufficient to spur collaborative resource management efforts. Our results showed that in Romania the initiation of collaboration is best explained by positive consequential incentives (i.e., financial opportunities) which has determined leaders to take initiative. This study provides additional information for the complicated process of natural resource management which is often overriding collaboration by investigating what enables and constrains collaborative efforts in a country where natural resources were managed and used according to the principles of central planning.

Bioenergy production from perennial energy crops: a consequential LCA of 12 bioenergy scenarios including land use changes.

PubMed

Tonini, Davide; Hamelin, Lorie; Wenzel, Henrik; Astrup, Thomas

2012-12-18

In the endeavor of optimizing the sustainability of bioenergy production in Denmark, this consequential life cycle assessment (LCA) evaluated the environmental impacts associated with the production of heat and electricity from one hectare of Danish arable land cultivated with three perennial crops: ryegrass (Lolium perenne), willow (Salix viminalis) and Miscanthus giganteus. For each, four conversion pathways were assessed against a fossil fuel reference: (I) anaerobic co-digestion with manure, (II) gasification, (III) combustion in small-to-medium scale biomass combined heat and power (CHP) plants and IV) co-firing in large scale coal-fired CHP plants. Soil carbon changes, direct and indirect land use changes as well as uncertainty analysis (sensitivity, MonteCarlo) were included in the LCA. Results showed that global warming was the bottleneck impact, where only two scenarios, namely willow and Miscanthus co-firing, allowed for an improvement as compared with the reference (-82 and -45 t CO₂-eq. ha⁻¹, respectively). The indirect land use changes impact was quantified as 310 ± 170 t CO₂-eq. ha⁻¹, representing a paramount average of 41% of the induced greenhouse gas emissions. The uncertainty analysis confirmed the results robustness and highlighted the indirect land use changes uncertainty as the only uncertainty that can significantly change the outcome of the LCA results.

Exposure science in an age of rapidly changing climate: challenges and opportunities

PubMed Central

LaKind, Judy S; Overpeck, Jonathan; Breysse, Patrick N; Backer, Lorrie; Richardson, Susan D; Sobus, Jon; Sapkota, Amir; Upperman, Crystal R; Jiang, Chengsheng; Beard, C Ben; Brunkard, J M; Bell, Jesse E; Harris, Ryan; Chretien, Jean-Paul; Peltier, Richard E; Chew, Ginger L; Blount, Benjamin C

2016-01-01

Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science—Exposures in an Evolving Environment—brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct “consequential science”—doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health. PMID:27485992

Phosphorous Nutritional Level, Carbohydrate Reserves and Flower Quality in Olives.

PubMed

Erel, Ran; Yermiyahu, Uri; Yasuor, Hagai; Cohen Chamus, Dan; Schwartz, Amnon; Ben-Gal, Alon; Dag, Arnon

2016-01-01

The olive tree is generally characterized by relatively low final fruit set consequential to a significant rate of undeveloped pistils, pistil abortion, and flower and fruitlet abscission. These processes are acknowledged to be governed by competition for resources between the developing vegetative and reproductive organs. To study the role of phosphorus (P) nutritional level on reproductive development, trees were grown under four levels of P for three years in large containers. Phosphorus nutritional level was positively related to rate of reproductive bud break, inflorescence weight, rate of hermaphrodite flowers, pistil weight, fruitlet persistence, fruit set and the consequential total number of fruits. The positive impact of P nutrition on the productivity parameters was not related to carbohydrate reserves or to carbohydrate transport to the developing inflorescence. Phosphorous deficient trees showed significant impairment of assimilation rate, and yet, carbohydrates were accumulated in inflorescences at levels comparable to or higher than trees receiving high P. In contrast to female reproductive organs, pollen viability was consistently higher in P deficient trees, possibly due to the enhanced carbohydrate availability. Overall, the positive effect of P on female reproductive development was found to be independent of the total carbohydrate availability. Hence, P is speculated to have a direct influence on reproductive processes.

Industry-Cost-Curve Approach for Modeling the Environmental Impact of Introducing New Technologies in Life Cycle Assessment.

PubMed

Kätelhön, Arne; von der Assen, Niklas; Suh, Sangwon; Jung, Johannes; Bardow, André

2015-07-07

The environmental costs and benefits of introducing a new technology depend not only on the technology itself, but also on the responses of the market where substitution or displacement of competing technologies may occur. An internationally accepted method taking both technological and market-mediated effects into account, however, is still lacking in life cycle assessment (LCA). For the introduction of a new technology, we here present a new approach for modeling the environmental impacts within the framework of LCA. Our approach is motivated by consequential life cycle assessment (CLCA) and aims to contribute to the discussion on how to operationalize consequential thinking in LCA practice. In our approach, we focus on new technologies producing homogeneous products such as chemicals or raw materials. We employ the industry cost-curve (ICC) for modeling market-mediated effects. Thereby, we can determine substitution effects at a level of granularity sufficient to distinguish between competing technologies. In our approach, a new technology alters the ICC potentially replacing the highest-cost producer(s). The technologies that remain competitive after the new technology's introduction determine the new environmental impact profile of the product. We apply our approach in a case study on a new technology for chlor-alkali electrolysis to be introduced in Germany.

Urinary tract infection caused by Chromobacterium violaceum.

PubMed

Pant, Narayan Dutt; Sharma, Manisha

2015-01-01

Chromobacterium violaceum, a proteobacterium, is a facultative anaerobe, which is generally present as the normal flora of water and soil in tropical and subtropical regions. The infection due to Chromobacterium violaceum is rare but mostly fatal. It is responsible for causing fatal cases of septicemia, visceral abscesses, skin and soft tissue infections, meningitis, diarrhea, and rarely urinary tract infection. The bacteria has high propensity to spread causing sepsis. Delayed proper treatment due to limited awareness related to the C. violaceum infection is responsible for the high mortality rate. Here, we describe a rare case of urinary tract infection by C. violaceum in a chronic kidney disease patient, which was managed with timely proper antimicrobial therapy as per the culture sensitivity report.

Therapeutic perspectives in hypertension: novel means for renin–angiotensin–aldosterone system modulation and emerging device-based approaches

PubMed Central

Unger, Thomas; Paulis, Ludovit; Sica, Domenic A.

2011-01-01

The conventional antihypertensive therapies including renin–angiotensin–aldosterone system antagonists (converting enzyme inhibitors, receptor blockers, renin inhibitors, and mineralocorticoid receptor blockers), diuretics, β-blockers, and calcium channel blockers are variably successful in achieving the challenging target blood pressure values in hypertensive patients. Difficult to treat hypertension is still a commonly observed problem world-wide. A number of drugs are considered to be used as novel therapies for hypertension. Renalase supplementation, vasopeptidase inhibitors, endothelin antagonists, and especially aldosterone antagonists (aldosterone synthase inhibitors and novel selective mineralocorticoid receptor blockers) are considered an option in resistant hypertension. In addition, the aldosterone antagonists as well as (pro)renin receptor blockers or AT2 receptor agonists might attenuate end-organ damage. This array of medications has now been complemented by a number of new approaches of non-pharmacological strategies including vaccination, genomic interference, controlled breathing, baroreflex activation, and probably most successfully renal denervation techniques. However, the progress on innovative therapies seems to be slow and the problem of resistant hypertension and proper blood pressure control appears to be still persisting. Therefore the regimens of currently available drugs are being fine-tuned, resulting in the establishment of several novel fixed-dose combinations including triple combinations with the aim to facilitate proper blood pressure control. It remains an exciting question which approach will confer the best blood pressure control and risk reduction in this tricky disease. PMID:21951628

[Metabolic therapy with iodine 131 in patients with chronic renal failure. Clinical case].

PubMed

Vázquez-Rodríguez Barbero, Inmaculada; Espadas-Maeso, María José; Muñoz-Morales, Ana; Flores-Gómez, Pilar; Serrano-Carretero, María Belén; Castedo-Sal, Juan José; Sánchez Rey-Castro, Elena; Zamorano-Córdoba, Antonio

2015-01-01

62 year-old male with CKD stage 5 in dialysis program since 2012 who underwent surgery for papillary thyroid carcinoma with lymph node metastasis. Subsequently, the patient was admitted to the Unit of Metabolic Therapy at his reference hospital, where he is administered 80 millicuries of iodine-131 as a treatment associated with the surgery, unable to have his conventional dialysis, nursing interventions required in various stages of implementation of the continuous extrarenal clearance techniques (TCDE) were performed. The following care values were addressed targeted to patients undergoing treatment with I(131): specific equipment, personal protective measures and major diagnoses and nursing interventions. TCDE, despite being attributed to very critical patients, they can be extrapolated to other patients in a given time. TCDE allowed these patients to undergo dialysis in a safe environment for staff, ensuring proper disposal of contaminated liquids. TCDE were an effective treatment for the removal of I131, a single ssesion being necessary to normalize the levels of radioactivity. Coordination between services allewed ensure proper and effective treatment for the patient. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

PubMed

Korbel, Krzysztof; Kozinoga, Mateusz; Stoliński, Łukasz; Kotwicki, Tomasz

2014-07-28

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

How to allocate limited healthcare resources: Lessons from the introduction of antiretroviral therapy in rural Mozambique

PubMed Central

Dodson, Zan M.; Agadjanian, Victor; Driessen, Julia

2016-01-01

Proper allocation of limited healthcare resources is a challenging task for policymakers in developing countries. Allocation of and access to these resources typically varies based on how need is defined, thus determining how individuals access and acquire healthcare. Using the introduction of antiretroviral therapy in southern Mozambique as an example, we examine alternative definitions of need for rural populations and how they might impact the allocation of this vital health service. Our results show that how need is defined matters when allocating limited healthcare resources and the use of need-based metrics can help ensure more optimal distribution of services. PMID:28596630

The Consequential Challenges of Climate Change

DTIC Science & Technology

2011-03-22

LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a. REPORT UNCLASSIFED b. ABSTRACT UNCLASSIFED c . THIS PAGE...3 precipitation events. As measured by multiple methods, the global annual average temperature rose 0.13˚ C per decade between 1955 and 2005...The IPCC projects global temperatures will rise by approximately 5 C in the next twenty years and 8 C to 4 C by the end of the century.15 These

Linguistics, cognitive psychology, and the Now-or-Never bottleneck.

PubMed

Endress, Ansgar D; Katzir, Roni

2016-01-01

Christiansen & Chater (C&C)'s key premise is that "if linguistic information is not processed rapidly, that information is lost for good" (sect. 1, para. 1). From this "Now-or-Never bottleneck" (NNB), C&C derive "wide-reaching and fundamental implications for language processing, acquisition and change as well as for the structure of language itself" (sect. 2, para. 10). We question both the premise and the consequentiality of its purported implications.

Detectors

DOEpatents

Orr, Christopher Henry; Luff, Craig Janson; Dockray, Thomas; Macarthur, Duncan Whittemore; Bounds, John Alan; Allander, Krag

2002-01-01

The apparatus and method provide techniques through which both alpha and beta emission determinations can be made simultaneously using a simple detector structure. The technique uses a beta detector covered in an electrically conducting material, the electrically conducting material discharging ions generated by alpha emissions, and as a consequence providing a measure of those alpha emissions. The technique also offers improved mountings for alpha detectors and other forms of detectors against vibration and the consequential effects vibration has on measurement accuracy.

Hemorrhoids and fistulas: new solutions to old problems.

PubMed

Rakinic, Jan; Poola, Venkateswara Prasad

2014-03-01

Symptoms thought related to hemorrhoids must be carefully considered before intervention. The first line of therapy for any hemorrhoidal complaint remains conservative management with increased fluid and fiber intake and appropriate modification of toileting behavior. Bleeding in grades 1 and 2 hemorrhoids that does not respond to this can be satisfactorily and safely managed with office-based therapies; some grade 3 hemorrhoids would also respond to this, though more treatment sessions would likely be required. Operative therapy is the best choice for management of persistently symptomatic grade 2 disease and for grades 3 and 4 symptomatic hemorrhoids as well. With proper patient selection and preparation, along with a familiarity with instrumentation and techniques, good results can be obtained with newer operative interventions for internal hemorrhoids. Outcomes must always be compared with those obtained with classic excisional hemorrhoidectomy.

Adverse Effects Associated With Newer Diabetes Therapies.

PubMed

Akiyode, Oluwaranti F; Adesoye, Adebola A

2017-04-01

The increasing number of newer type 2 diabetes therapies has allowed providers an increased armamentarium for the optimal management of patients with diabetes. In fact, these newer agents have unique benefits in the management of type 2 diabetes. However, they are also associated with certain adverse effects. This review article aims to describe the notable adverse effects of these newer antidiabetic therapies including the glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors. The adverse effects reviewed herein include pancreatitis, medullary thyroid carcinoma, heart failure, gastrointestinal disturbances, renal impairment, and genitourinary infections. More clinical data are necessary to solidify the association of some of these adverse effects with the newer diabetes agents. However, it is important for health care practitioners to be well informed and prepared to properly monitor patients for these adverse effects.

New anti-angiogenic strategies in pediatric solid malignancies: agents and biomarkers of a near future.

PubMed

Taylor, Melissa; Rössler, Jochen; Geoerger, Birgit; Vassal, Gilles; Farace, Françoise

2010-07-01

Antiangiogenic strategies are affording considerable interest and have become a major milestone in therapeutics of various adult cancers. However, progress has been slow to expand such therapies to patients with pediatric solid malignancies. This review discusses the principal pathways for angiogenesis in pediatric solid malignancies and summarizes recent preclinical and clinical data on antiangiogenesis strategies in these tumors. The reader will gain state-of-the-art knowledge in the current advancements of antiangiogenic therapies in pediatric clinical trials in regard to supporting preclinical data, and in the status of potential biomarkers investigated for monitoring angiogenesis inhibitors. Mechanisms of resistance to antiangiogenic therapy will also be discussed. Finally, we describe our experience in the monitoring of circulating endothelial cells and progenitors and their potential role as biomarkers of metastatic disease and resistance to antiangiogenic therapies. Evaluation and development of antiangiogenesis protocols are starting and represent a crucial step in the management of pediatric solid malignancies today. Emphasis should be placed on the development of proper surrogate markers to monitor antiangiogenic activity and on the possible long-term effects of these therapies in a pediatric population.

Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

PubMed Central

Noh, Soo Min; Lee, Jeong Hoon; Jung, Hwoon-Yong; AlGhamdi, Zeead; Kim, Hyeong Ryul; Kim, Yong-Hee

2018-01-01

Aim To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. Methods Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. Results All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. Conclusion With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy. PMID:29849581

KIDNEY STONES: AN UPDATE ON CURRENT PHARMACOLOGICAL MANAGEMENT AND FUTURE DIRECTIONS

PubMed Central

Xu, Hongshi; Zisman, Anna L.; Coe, Fredric L.; Worcester, Elaine M.

2013-01-01

Introduction Kidney stones are a common problem worldwide with substantial morbidities and economic costs. Medical therapy reduces stone recurrence significantly. Much progress has been made in the last several decades in improving therapy of stone disease. Areas covered 1) effect of medical expulsive therapy on spontaneous stone passage, 2) pharmacotherapy in the prevention of stone recurrence, 3) future directions in the treatment of kidney stone disease. Expert Opinion fluid intake to promote urine volume of at least 2.5L each day is essential to prevent stone formation. Dietary recommendations should be adjusted based on individual metabolic abnormalities. Properly dosed thiazide treatment is the standard therapy for calcium stone formers with idiopathic hypercalciuria. Potassium alkali therapy is considered for hypocitraturia, but caution should be taken to prevent potential risk of calcium phosphate stone formation. For absorptive hyperoxaluria, low oxalate diet and increased dietary calcium intake are recommended. Pyridoxine has been shown effective in some cases of primary hyperoxaluria type I. Allopurinol is used in calcium oxalate stone formers with hyperuricosuria. Treatment of cystine stones remains challenging. Tiopronin can be used if urinary alkalinization and adequate fluid intake are insufficient. For struvite stones, complete surgical removal coupled with appropriate antibiotic therapy is necessary. PMID:23438422

Monitoring/Imaging and Regenerative Agents for Enhancing Tissue Engineering Characterization and Therapies.

PubMed

Santiesteban, Daniela Y; Kubelick, Kelsey; Dhada, Kabir S; Dumani, Diego; Suggs, Laura; Emelianov, Stanislav

2016-03-01

The past three decades have seen numerous advances in tissue engineering and regenerative medicine (TERM) therapies. However, despite the successes there is still much to be done before TERM therapies become commonplace in clinic. One of the main obstacles is the lack of knowledge regarding complex tissue engineering processes. Imaging strategies, in conjunction with exogenous contrast agents, can aid in this endeavor by assessing in vivo therapeutic progress. The ability to uncover real-time treatment progress will help shed light on the complex tissue engineering processes and lead to development of improved, adaptive treatments. More importantly, the utilized exogenous contrast agents can double as therapeutic agents. Proper use of these Monitoring/Imaging and Regenerative Agents (MIRAs) can help increase TERM therapy successes and allow for clinical translation. While other fields have exploited similar particles for combining diagnostics and therapy, MIRA research is still in its beginning stages with much of the current research being focused on imaging or therapeutic applications, separately. Advancing MIRA research will have numerous impacts on achieving clinical translations of TERM therapies. Therefore, it is our goal to highlight current MIRA progress and suggest future research that can lead to effective TERM treatments.

Selection of physiological parameters for optoelectronic system supporting behavioral therapy of autistic children

NASA Astrophysics Data System (ADS)

Landowska, A.; Karpienko, K.; Wróbel, M.; Jedrzejewska-Szczerska, M.

2014-11-01

In this article the procedure of selection of physiological parameters for optoelectronic system supporting behavioral therapy of autistic children is proposed. Authors designed and conducted an experiment in which a group of 30 health volunteers (16 females and 14 males) were examined. Under controlled conditions people were exposed to a stressful situation caused by the picture or sound (1kHz constant sound, which was gradually silenced and finished with a shot sound). For each of volunteers, a set of physiological parameters were recorded, including: skin conductance, heart rate, peripheral temperature, respiration rate and electromyography. The selected characteristics were measured in different locations in order to choose the most suitable one for the designed therapy supporting system. The bio-statistical analysis allowed us to discern the proper physiological parameters that are most associated to changes due to emotional state of a patient, such as: skin conductance, temperatures and respiration rate. This allowed us to design optoelectronic sensors network for supporting behavioral therapy of children with autism.

Biomarker-guided antibiotic therapy—strengths and limitations

PubMed Central

Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-01-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality. PMID:28603723

Endocannabinoids and the Cardiovascular System in Health and Disease.

PubMed

O'Sullivan, Saoirse Elizabeth

2015-01-01

The endocannabinoid system is widely distributed throughout the cardiovascular system. Endocannabinoids play a minimal role in the regulation of cardiovascular function in normal conditions, but are altered in most cardiovascular disorders. In shock, endocannabinoids released within blood mediate the associated hypotension through CB(1) activation. In hypertension, there is evidence for changes in the expression of CB(1), and CB(1) antagonism reduces blood pressure in obese hypertensive and diabetic patients. The endocannabinoid system is also upregulated in cardiac pathologies. This is likely to be cardioprotective, via CB(2) and CB(1) (lesser extent). In the vasculature, endocannabinoids cause vasorelaxation through activation of multiple target sites, inhibition of calcium channels, activation of potassium channels, NO production and the release of vasoactive substances. Changes in the expression or function of any of these pathways alter the vascular effect of endocannabinoids. Endocannabinoids have positive (CB(2)) and negative effects (CB(1)) on the progression of atherosclerosis. However, any negative effects of CB(1) may not be consequential, as chronic CB(1) antagonism in large scale human trials was not associated with significant reductions in atheroma. In neurovascular disorders such as stroke, endocannabinoids are upregulated and protective, involving activation of CB(1), CB(2), TRPV1 and PPARα. Although most of this evidence is from preclinical studies, it seems likely that cannabinoid-based therapies could be beneficial in a range of cardiovascular disorders.

Drug interactions may be important risk factors for methotrexate neurotoxicity, particularly in pediatric leukemia patients.

PubMed

Forster, Victoria J; van Delft, Frederik W; Baird, Susan F; Mair, Shona; Skinner, Roderick; Halsey, Christina

2016-11-01

Methotrexate administration is associated with frequent adverse neurological events during treatment for childhood acute lymphoblastic leukemia. Here, we present evidence to support the role of common drug interactions and low vitamin B 12 levels in potentiating methotrexate neurotoxicity. We review the published evidence and highlight key potential drug interactions as well as present clinical evidence of severe methotrexate neurotoxicity in conjunction with nitrous oxide anesthesia and measurements of vitamin B 12 levels among pediatric leukemia patients during therapy. We describe a very plausible mechanism for methotrexate neurotoxicity in pediatric leukemia patients involving reduction in methionine and consequential disruption of myelin production. We provide evidence that a number of commonly prescribed drugs in pediatric leukemia management interact with the same folate biosynthetic pathways and/or reduce functional vitamin B 12 levels and hence are likely to increase the toxicity of methotrexate in these patients. We also present a brief case study supporting out hypothesis that nitrous oxide contributes to methotrexate neurotoxicity and a nutritional study, showing that vitamin B 12 deficiency is common in pediatric leukemia patients. Use of nitrous oxide in pediatric leukemia patients at the same time as methotrexate use should be avoided especially as many suitable alternative anesthetic agents exist. Clinicians should consider monitoring levels of vitamin B 12 in patients suspected of having methotrexate-induced neurotoxic effects.

Gene networks specific for innate immunity define post-traumatic stress disorder.

PubMed

Breen, M S; Maihofer, A X; Glatt, S J; Tylee, D S; Chandler, S D; Tsuang, M T; Risbrough, V B; Baker, D G; O'Connor, D T; Nievergelt, C M; Woelk, C H

2015-12-01

The molecular factors involved in the development of Post-Traumatic Stress Disorder (PTSD) remain poorly understood. Previous transcriptomic studies investigating the mechanisms of PTSD apply targeted approaches to identify individual genes under a cross-sectional framework lack a holistic view of the behaviours and properties of these genes at the system-level. Here we sought to apply an unsupervised gene-network based approach to a prospective experimental design using whole-transcriptome RNA-Seq gene expression from peripheral blood leukocytes of U.S. Marines (N=188), obtained both pre- and post-deployment to conflict zones. We identified discrete groups of co-regulated genes (i.e., co-expression modules) and tested them for association to PTSD. We identified one module at both pre- and post-deployment containing putative causal signatures for PTSD development displaying an over-expression of genes enriched for functions of innate-immune response and interferon signalling (Type-I and Type-II). Importantly, these results were replicated in a second non-overlapping independent dataset of U.S. Marines (N=96), further outlining the role of innate immune and interferon signalling genes within co-expression modules to explain at least part of the causal pathophysiology for PTSD development. A second module, consequential of trauma exposure, contained PTSD resiliency signatures and an over-expression of genes involved in hemostasis and wound responsiveness suggesting that chronic levels of stress impair proper wound healing during/after exposure to the battlefield while highlighting the role of the hemostatic system as a clinical indicator of chronic-based stress. These findings provide novel insights for early preventative measures and advanced PTSD detection, which may lead to interventions that delay or perhaps abrogate the development of PTSD.

The comparative morphology of the muscle tissues and changes in constituents in the pig types.

PubMed

Fehér, G; Fazekas, S; Sándor, I; Kollár, N

1990-09-01

The authors have revealed the main value characteristics of pork production by testing in five different types of pig the volume of contractile and collagen proteins, that of proteoglycans, the constituents of blood and the enzymes of the blood plasma. The contractile proteins of the muscle tissues basically determine the quality of pork. The same applies to the water retention capacity, colloidal characteristics and glycogen content of meat. The amount of contractile proteins has decreased in the best meat producing types of pig. Parallel with the decrease of white meat, and with the increase in the volume of ham, chop and chuck the contractile protein content of muscles decreased. The scientific fact according to which there is a certain correlation among the changes in the volume of contractile proteins, blood sugar level, blood serum CPK and the intensity of activity of the LDH enzymes promotes the qualifying of live animals and the work of the geneticists aiming at the increasing of the contractile protein content of the muscle tissues of pigs by selection. According to tests carried out by us the primary cause of PSE changes is a decreased volume of contractile proteins. Increased stress sensitivity and all the other factors have but a secondary importance and are all consequential. The decrease in the quantity of contractile proteins or--it is better to put it this way--the lack of the proper amount of such proteins characterizing a fully developed pig's organism is caused by the nowadays usual breeding technologies and can be well explained by those selection activities which aim at a one-sided kind of pork production.

Virtue and austerity

PubMed Central

Allmark, Peter

2013-01-01

Virtue ethics is often proposed as a third way in health-care ethics, that while consequentialism and deontology focus on action guidelines, virtue focuses on character; all three aim to help agents discern morally right action although virtue seems to have least to contribute to political issues, such as austerity. I claim: (1) This is a bad way to characterize virtue ethics. The 20th century renaissance of virtue ethics was first proposed as a response to the difficulty of making sense of ‘moral rightness’ outside a religious context. For Aristotle the right action is that which is practically best; that means best for the agent in order to live a flourishing life. There are no moral considerations besides this. (2) Properly characterized, virtue ethics can contribute to discussion of austerity. A criticism of virtue ethics is that fixed characteristics seem a bad idea in ever-changing environments; perhaps we should be generous in prosperity, selfish in austerity. Furthermore, empirical evidence suggests that people indeed do change with their environment. However, I argue that virtues concern fixed values not fixed behaviour; the values underlying virtue allow for different behaviour in different circumstances: in austerity, virtues still give the agent the best chance of flourishing. Two questions arise. (a) In austere environments might not injustice help an individual flourish by, say, obtaining material goods? No, because unjust acts undermine the type of society the agent needs for flourishing. (b) What good is virtue to those lacking the other means to flourish? The notion of degrees of flourishing shows that most people would benefit somewhat from virtue. However, in extreme circumstances virtue might harm rather than benefit the agent: such circumstances are to be avoided; virtue ethics thus has a political agenda to enable flourishing. This requires justice, a fortiori when in austerity. PMID:23279583

Virtue and austerity.

PubMed

Allmark, Peter

2013-01-01

Virtue ethics is often proposed as a third way in health-care ethics, that while consequentialism and deontology focus on action guidelines, virtue focuses on character; all three aim to help agents discern morally right action although virtue seems to have least to contribute to political issues, such as austerity. I claim: (1) This is a bad way to characterize virtue ethics. The 20th century renaissance of virtue ethics was first proposed as a response to the difficulty of making sense of 'moral rightness' outside a religious context. For Aristotle the right action is that which is practically best; that means best for the agent in order to live a flourishing life. There are no moral considerations besides this. (2) Properly characterized, virtue ethics can contribute to discussion of austerity. A criticism of virtue ethics is that fixed characteristics seem a bad idea in ever-changing environments; perhaps we should be generous in prosperity, selfish in austerity. Furthermore, empirical evidence suggests that people indeed do change with their environment. However, I argue that virtues concern fixed values not fixed behaviour; the values underlying virtue allow for different behaviour in different circumstances: in austerity, virtues still give the agent the best chance of flourishing. Two questions arise. (a) In austere environments might not injustice help an individual flourish by, say, obtaining material goods? No, because unjust acts undermine the type of society the agent needs for flourishing. (b) What good is virtue to those lacking the other means to flourish? The notion of degrees of flourishing shows that most people would benefit somewhat from virtue. However, in extreme circumstances virtue might harm rather than benefit the agent: such circumstances are to be avoided; virtue ethics thus has a political agenda to enable flourishing. This requires justice, a fortiori when in austerity. © 2012 Blackwell Publishing Ltd.

[Risks for atherosclerosis in post-menopausal women and in women with hormonal replacement therapy].

PubMed

Halerz-Nowakowska, B; Warenik-Szymankiewicz, A; Grotowski, W; Słopień, R; Maciejewska, M; Hadaś, K

1997-09-01

The aim of our study was the evaluation of atherogenesis in postmenopausal women and after HRT in correlation with BMI, IGF-I and lipid profile. We have found unfavourable changes in lipid profile in positive correlation with BMI, after three months treatment we have found decrease in concentration of total cholesterol and LDL cholesterol between women with proper BMI.

Biosafety considerations for autopsy.

PubMed

Nolte, Kurt B; Taylor, David G; Richmond, Jonathan Y

2002-06-01

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.

Orthodontic Management in Aggressive Periodontitis

PubMed Central

Bhattarai, Bhagabat

2017-01-01

Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis. PMID:28299350

A comprehensive review and update on the non-biologic treatment of adult noninfectious uveitis: part I.

PubMed

Lee, Kyungmin; Bajwa, Asima; Freitas-Neto, Clovis A; Metzinger, Jamie Lynne; Wentworth, Bailey A; Foster, C Stephen

2014-10-01

Treatment of adult, noninfectious uveitis remains a challenge for ophthalmologists around the world. The disease accounts for almost 10% of preventable blindness in the US and can be idiopathic or associated with infectious and systemic disorders. Strong evidence is still emerging to indicate that pharmacologic strategies presently used in rheumatologic or autoimmune disease may be translated to the treatment of intraocular inflammation. Corticosteroid monotherapy is widely regarded as wholly inappropriate, due to the unfavorable risk/benefit profile and poor long-term outcomes. Treatment plans have shifted away from low-dose, chronic corticosteroid therapy for maintenance, towards medium- to high-dose therapy for acute inflammation, followed immediately by initiation of immunomodulatory therapy. These therapies follow the 'stepladder approach', whereby least to more aggressive therapies are trialed to induce remission of inflammation, eventually without corticosteroids of any form (topical, local and systemic). This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment of ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy. The hazard of chronic corticosteroid use for the treatment of adult, noninfectious uveitis is well-documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted.

Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients: a critical re-appraisal of current evidence.

PubMed

Hansen, Dominique; Stevens, An; Eijnde, Bert O; Dendale, Paul

2012-01-01

In the care of coronary artery disease (CAD) patients, the benefits of exercise therapy are generally established. Even though the selected endurance exercise intensity might affect medical safety, therapy adherence and effectiveness in the rehabilitation of CAD patients in how to determine endurance exercise intensity properly remains difficult. The aim of this review is to describe the available methods for endurance exercise intensity determination in the rehabilitation of CAD patients, accompanied with their (dis)advantages, validity and reproducibility. In general, endurance exercise intensity can objectively be determined in CAD patients by calculating a fraction of maximal exercise tolerance and/or determining ventilatory threshold after execution of a cardiopulmonary exercise test with ergospirometry. This can be translated to a corresponding training heart rate (HR) or workload. In the absence of ergospirometry equipment, target exercise HR can be calculated directly by different ways (fraction of maximal HR and/or Karvonen formula), and/or anaerobic threshold can be determined. However, the use of HR for determining exercise intensity during training sessions seems complicated, because many factors/conditions affect the HR. In this regard, proper standardization of the exercise sessions, as well as exercise testing, might be required to improve the accuracy of exercise intensity determination. Alternatively, subjective methods for the determination of endurance exercise intensity in CAD patients, such as the Borg ratings of perceived exertion and the talk test, have been developed. However, these methods lack proper validity and reliability to determine endurance exercise intensity in CAD patients. In conclusion, a practical and systematic approach for the determination of endurance exercise intensity in CAD patients is presented in this article.

Proper body mechanics from an engineering perspective.

PubMed

Mohr, Edward G

2010-04-01

The economic viability of the manual therapy practitioner depends on the number of massages/treatments that can be given in a day or week. Fatigue or injuries can have a major impact on the income potential and could ultimately reach the point which causes the practitioner to quit the profession, and seek other, less physically demanding, employment. Manual therapy practitioners in general, and massage therapists in particular, can utilize a large variety of body postures while giving treatment to a client. The hypothesis of this paper is that there is an optimal method for applying force to the client, which maximizes the benefit to the client, and at the same time minimizes the strain and effort required by the practitioner. Two methods were used to quantifiably determine the effect of using "poor" body mechanics (Improper method) and "best" body mechanics (Proper/correct method). The first approach uses computer modeling to compare the two methods. Both postures were modeled, such that the biomechanical effects on the practitioner's elbow, shoulder, hip, knee and ankle joints could be calculated. The force applied to the client, along with the height and angle of application of the force, was held constant for the comparison. The second approach was a field study of massage practitioners (n=18) to determine their maximal force capability, again comparing methods using "Improper and Proper body mechanics". Five application methods were tested at three different application heights, using a digital palm force gauge. Results showed that there was a definite difference between the two methods, and that the use of correct body mechanics can have a large impact on the health and well being of the massage practitioner over both the short and long term. Copyright 2009 Elsevier Ltd. All rights reserved.

Models of morality

PubMed Central

Crockett, Molly J.

2013-01-01

Moral dilemmas engender conflicts between two traditions: consequentialism, which evaluates actions based on their outcomes, and deontology, which evaluates actions themselves. These strikingly resemble two distinct decision-making architectures: a model-based system that selects actions based on inferences about their consequences; and a model-free system that selects actions based on their reinforcement history. Here, I consider how these systems, along with a Pavlovian system that responds reflexively to rewards and punishments, can illuminate puzzles in moral psychology. PMID:23845564

Space Station Program threat and vulnerability analysis

NASA Technical Reports Server (NTRS)

Van Meter, Steven D.; Veatch, John D.

1987-01-01

An examination has been made of the physical security of the Space Station Program at the Kennedy Space Center in a peacetime environment, in order to furnish facility personnel with threat/vulnerability information. A risk-management approach is used to prioritize threat-target combinations that are characterized in terms of 'insiders' and 'outsiders'. Potential targets were identified and analyzed with a view to their attractiveness to an adversary, as well as to the consequentiality of the resulting damage.

On NEO Threat Mitigation (Preprint)

DTIC Science & Technology

2007-10-15

Yucatan event is at least a major contributor, if not the direct cause of the extinction of the dinosaurs . Moreover, it is clear that NEO impacts can... extinction of the human race. The probability of these events decreases with the severity of the impact, and size (mass) of the NEO. Figure 1 and Table 1...thus, it is more reasonable to infer that all the large NEOs can be catalogued within a reasonable time, while smaller and less consequential

Preparing for the Speaking Tasks of the "TOEFL iBT"® Test: An Investigation of the Journeys of Chinese Test Takers. "TOEFL iBT"® Research Report. TOEFL iBT-28. ETS Research Report. RR-17-19

ERIC Educational Resources Information Center

Yu, Guoxing; He, Lianzhen; Rea-Dickins, Pauline; Kiely, Richard; Lu, Yanbin; Zhang, Jing; Zhang, Yan; Xu, Shasha; Fang, Lin

2017-01-01

Language test preparation has often been studied within the consequential validity framework in relation to ethics, equity, fairness, and washback of assessment. The use of independent and integrated speaking tasks in the "TOEFL iBT"® test represents a significant development and innovation in assessing speaking ability in academic…

Bioactive Materials in Endodontics: An Evolving Component of Clinical Dentistry.

PubMed

Mohapatra, Satyajit; Patro, Swadheena; Mishra, Sumita

2016-06-01

Achieving biocompatibility in a material requires an interdisciplinary approach that involves a sound knowledge of materials science, bioengineering, and biotechnology. The host microbial-material response is also critical. Endodontic treatment is a delicate procedure that must be planned and executed properly. Despite major advances in endodontic therapy in recent decades, clinicians are confronted with a complex root canal anatomy and a wide selection of endodontic filling materials that, in turn, may not be well tolerated by the periapical tissues and may evoke an immune reaction. This article discusses published reports of various bioactive materials that are used in endodontic therapy, including calcium hydroxide, mineral trioxide aggregate, a bioactive dentin substrate, calcium phosphate ceramics, and calcium phosphate cements.

Root canal irrigants

PubMed Central

Kandaswamy, Deivanayagam; Venkateshbabu, Nagendrababu

2010-01-01

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance. PMID:21217955

The importance of genetic diagnosis for Duchenne muscular dystrophy

PubMed Central

Aartsma-Rus, Annemieke; Ginjaar, Ieke B; Bushby, Kate

2016-01-01

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy are caused by mutations in the dystrophin-encoding DMD gene. Large deletions and duplications are most common, but small mutations have been found as well. Having a correct diagnosis is important for family planning and providing proper care to patients according to published guidelines. With mutation-specific therapies under development for DMD, a correct diagnosis is now also important for assessing whether patients are eligible for treatments. This review discusses different mutations causing DMD, diagnostic techniques available for making a genetic diagnosis for children suspected of DMD and the importance of having a specific genetic diagnosis in the context of emerging genetic therapies for DMD. PMID:26754139

Nanostructured porous Si-based nanoparticles for targeted drug delivery

PubMed Central

Shahbazi, Mohammad-Ali; Herranz, Barbara; Santos, Hélder A.

2012-01-01

One of the backbones in nanomedicine is to deliver drugs specifically to unhealthy cells. Drug nanocarriers can cross physiological barriers and access different tissues, which after proper surface biofunctionalization can enhance cell specificity for cancer therapy. Recent developments have highlighted the potential of mesoporous silica (PSiO2) and silicon (PSi) nanoparticles for targeted drug delivery. In this review, we outline and discuss the most recent advances on the applications and developments of cancer therapies by means of PSiO2 and PSi nanomaterials. Bio-engineering and fine tuning of anti-cancer drug vehicles, high flexibility and potential for sophisticated release mechanisms make these nanostructures promising candidates for “smart” cancer therapies. As a result of their physicochemical properties they can be controllably loaded with large amounts of drugs and coupled to homing molecules to facilitate active targeting. The main emphasis of this review will be on the in vitro and in vivo studies. PMID:23507894

Radioimmunotherapy as the first line of treatment in non-Hodgkin lymphoma.

PubMed

Eskian, Mahsa; Khorasanizadeh, MirHojjat; Zinzani, Pier L; Rezaei, Nima

2018-06-01

Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. The estimated deaths and new cases of NHL in the USA in 2018 have reached 19,910 and 74,680, respectively, with 5-year survival rate of 71%. Therapeutic interventions for NHL consist of chemotherapy, radiation therapy and immunotherapy. Radioimmunotherapy (RIT) is a potential alternative treatment for NHL that is currently used in different lines of treatment. Studies show that nuclear medicine physicians and radiation oncologists are not yet certain about the proper line for administration of RIT. Herein, we have reviewed the efficiency and toxicity of RIT as the first line of treatment, and discussed potential novel indications, and strategies such as modifying induction therapy and using rituximab maintenance to optimize the efficiency of RIT as the first line of treatment. Our review indicates that it is more logical to postpone conventional therapies to the second or third lines of treatment instead of RIT.

[BASIC PRINCIPLES AND METHODS TO THE USE IMMUNOMODULATING PREPARATIONS IN CLINICAL PRACTICE: CLASSIFICATION, INDICATIONS AND CONTRAINDICATIONS].

PubMed

Sepiashvili, R

2015-06-01

This paper is devoted to one of the most pressing issues in modern clinical medicine, the problem of immunomodulators and immunotropic therapy. The materials presented are the logical sequel of the papers published by Revaz I. Sepiashvili in 2001-2015. In these articles, the author proposed the first classification of immunotropic preparations, a brief historical background and chronological emergence of the concept of therapies, as well as definition of immunomodulators. This paper presents an updated classification of immunomodulatory drugs which is valid for January 2015. The paper also outlines basic principles for therapies that allow the clinician not only to select a proper immunomodulator but also to develop strategy and tactics in treatment of the patient, taking into account his/her individual characteristics and the need to use in clinical practice only officially registered immunotropic preparations.

Non-pharmacologic labour pain relief.

PubMed

Prasertcharoensuk, Witoon; Thinkhamrop, Jadsada

2004-10-01

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. The trials included three trials of hypnosis (n = 189), one involving audio-analgesia (n = 25), one involving (n = 22), and one trial of music (n = 30). Women receiving hypnosis were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.55 to 4.71). No differences were seen for women recieving, music or audio analgesia. Hypnosis may be beneficial for the management of pain during labour. However, few complementary therapies have been subjected to proper scientific study.

Gastroparesis: a review of current and emerging treatment options

PubMed Central

Enweluzo, Chijioke; Aziz, Fahad

2013-01-01

Gastroparesis is a motility disorder of the stomach causing delay in food emptying from the stomach without any evidence of mechanical obstruction. The majority of cases are idiopathic. Patients need to be diagnosed properly by formal testing, and the evaluation of the severity of the gastroparesis may assist in guiding therapy. Initially, dietary modifications are encouraged, which include frequent and small semisolid-based meals. Promotility medications, like erythromycin, and antiemetics, like prochlorperazine, are offered for symptom relief. In patients who are refractory to pharmacologic treatment, more invasive options, such as intrapyloric botulinum toxin injections, placement of a jejunostomy tube, or implantation of a gastric stimulator, can be considered. Hemin therapy and gastric electric stimulation are emerging treatment options that are still at different stages of research. Regenerative medicine and stem cell-based therapies also hold promise for gastroparesis in the near future. PMID:24039443

[Reciprocal relationships between orthodontics and periodontics in esthetic treatments].

PubMed

Monnet-Corti, Virginie; Barrin, Arnaud; Goubron, Cyril

2012-06-01

The objective of this article is to review various unsightly periodontal defects and the treatments that have previously been used to eliminate them in order to establish guidelines for future therapy. The inter-relationship between orthodontic and periodontal disciplines is well established and needs no defense here. Periodontal tissues change throughout life and the same is true for the smile. The periodontium is an essential component of the appearance of the face as well as the lips. These are dynamic esthetic criteria while the gingiva and the static character of the dentition also contribute to the character of an individual's smile. In order to conduct orthodontic therapy most effectively it is essential that orthodontists and periodontists utilize a coordinated approach. From the beginning, they must establish an etiological diagnosis of any esthetic defects that will insure that their joint therapy is conducted appropriately and at the proper moment. © EDP Sciences, SFODF, 2012.

Sex therapy and mastectomy.

PubMed

Witkin, M H

1975-01-01

Because the emotional trauma associated with a mastectomy exceeds the physical trauma, the recovery of the woman is greatly affected by the response of her husband or lover. Sex therapy, therefore, involves the couple. The approach described here is aimed at assisting the couple to confront and intergrate the mastectomy experience. The use of a prosthesis is discouraged during intercourse because it delays such confrontation; certain sex therapy exercises (body imagery and sensate focus) are usually recommended because they facilitate confrontation and acceptance. These, modified for the circumstances, are described. It is suggested that intercourse be attempted as early as possible, and that if physical weakness or psychological trepidation intervenes, the physical desire and caring of the husband be expressed nonetheless. The "professional" attitudes that psychotherapy is always indicated for mastectomy patients and that the proper role of the husband is matter-of-fact denial are rejected; emphasis is placed on the beneficial consequences of sharing of all emotions.

Candida Glabrata Esophagitis: new case reports and management

PubMed Central

Macêdo, Danielle Patrícia Cerqueira; da Silva, Vanessa Karina Alves; de Almeida Farias, Aline Mary; de Melo, Luciana Resende Bandeira; Wilheim, Ana Botler; Neves, Rejane Pereira

2008-01-01

Candida esophagitis (CE) is a common opportunistic infection in the immunocompromised host. C. glabrata is rarely cited as agent of CE and has been underestimated due to lack of proper identification. In this study, two cases of C. glabrata esophagitis in AIDS and chagasic patients are reported. Diagnosis of Candida species should be considered an important key for the ideal choice of antifungal therapy against this mycosis. PMID:24031216

Expert opinion on the management of infections in the diabetic foot.

PubMed

Lipsky, B A; Peters, E J G; Senneville, E; Berendt, A R; Embil, J M; Lavery, L A; Urbančič-Rovan, V; Jeffcoate, W J

2012-02-01

This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations. Copyright © 2012 John Wiley & Sons, Ltd.

[Implants for genital prolapse : Contra mesh surgery].

PubMed

Hampel, C

2017-12-01

Alloplastic transvaginal meshes have become very popular in the surgery of pelvic organ prolapse (POP) as did alloplastic suburethral slings in female stress incontinence surgery, but without adequate supporting data. The simplicity of the mesh procedure facilitates its propagation with acceptance of higher revision and complication rates. Since attending physicians do more and more prolapse surgeries without practicing or teaching alternative techniques, expertise in these alternatives, which might be very useful in cases of recurrence, persistence or complications, is permanently lost. It is doubtful that proper and detailed information about alternatives, risks, and benefits of transvaginal alloplastic meshes is provided to every single prolapse patient according to the recommendations of the German POP guidelines, since the number of implanted meshes exceeds the number of properly indicated mesh candidates by far. Although there is no dissent internationally about the available mesh data, thousands of lawsuits in the USA, insolvency of companies due to claims for compensation and unambiguous warnings from foreign urological societies leave German urogynecologists still unimpressed. The existing literature in pelvic organ prolapse exclusively focusses on POP stage and improvement of that stage with surgical therapy. Instead, typical prolapse symptoms should trigger therapy and improvement of these symptoms should be the utmost treatment goal. It is strongly recommended for liability reasons to obtain specific written informed consent.

[Treatment of nontumoral portal vein thrombosis in cirrhosis].

PubMed

Bañares, Rafael; Catalina, María-Vega

2014-07-01

Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives. Copyright © 2014 Elsevier España, S.L. All rights reserved.

A unique tripartite collision tumor of the esophagus

PubMed Central

Schizas, Dimitrios; Michalinos, Adamantios; Alexandrou, Paraskevi; Moris, Demetrios; Baliou, Evangelia; Tsilimigras, Diamantis; Throupis, Theodore; Liakakos, Theodore

2017-01-01

Abstract Rationale: We report a unique case of a tripartite esophageal collision tumor consisting of three separate histologic types. Patients concerns: Therapeutic dilemmas on the proper treatment of those rare neoplasms remain unanswered considering both proper surgical therapy and adjuvant therapy. Diagnose: In this paper, we report a unique case of a patient with a tripartite esophageal collision tumor consisting of a small cell carcinoma, an adenocarcinoma of medium differentiation and a signet ring cell carcinoma. Diagnosis is difficult as clinical presentation of the patient was undistinguishable from other, commoner tumor types. Interventions: The patient's diagnostic and therapeutic course along with available data on the collisions tumor's biological behavior and treatment are briefly discussed. Outcomes: Esophagectomy is the best treatment options for these patients. Unique nature of this tumor demands aggresive oncologic treatment. Lessons: Collision tumors are rare neoplasms consisting of distinct cell populations developing in juxtaposition to one another without any areas of intermingling. Various cell types can be found. However, collision neoplasms of the esophagus combining adenomatous and neuroendocrine components are exceedingly rare, with only 5 cases described to date in the literature. Given their rarity, limited information is available on their tumorigenesis, biological behavior and clinical course. In general, these tumors are aggressive neoplasms and significantly affect patient treatment and prognosis. PMID:29245236

[Role of pediatricians in the diagnosis and therapy of dyslexia, dysgraphia and dyscalculia].

PubMed

Gergely, Katalin; Lakos, Renáta

2013-02-10

Pediatricians play an important role in the diagnosis and therapy of children with dyslexia, dysgraphia or dyscalculia. These syndromes strongly affect children's school performance. Children with dyslexia, dysgraphia or dyscalculia show a significant underachievement in reading, writing or counting and their failure to meet the school requirements undermines their self confidence and positive self-concept. As a result, children with learning problems often become aggressive, frustrated or play the clown in the classroom. According to the Hungarian law children with any learning difficulties have the right to get special education by their specific symptoms. In the realisation of the law and equity the pediatrician's expertise is essential and has an important role in the therapeutical procedures. However, the pediatrician's role is more complex than writing an opinion. Pediatricians can help by giving a detailed description about these syndromes and explain them how they can help their child, what are the main difficulties during the child's studies, what kind of therapies can be efficient and how they can make their child's school years easier. During the assessment most of the parents ask the following questions: What does dyslexia, dyscalculia or dysgraphia exactly mean? Is it a handicap or a learning difficulty? Could the child live a normal life? With the proper answer and with an inclusive attitude pediatricians can help both the parents and the children to create a liveable lifestyle and make their children's schoolwork more successful. The authors' opinions are to close the medical and the pedagogical view, because without the cooperation of these two scientific fields, the theme affected parents, children and teachers cannot get proper help to find better solution and support for their problems. In the survey the authors intend to give a complex view about the symptoms of these syndromes and try to give useful advice for pediatricians how they can support their patients emphasizing the key role of pediatricians and clinical expertises in the early recognition and therapy.

Analysis of Treg cell population alterations in the peripheral blood of patients treated surgically for ovarian cancer - a preliminary report.

PubMed

Wicherek, Lukasz; Jozwicki, Wojciech; Windorbska, Wieslawa; Roszkowski, Krzysztof; Lukaszewska, Ewelina; Wisniewski, Michal; Brozyna, Anna Aneta; Basta, Pawel; Skret-Magierlo, Joanna; Koper, Krzysztof; Rokita, Wojciech; Dutsch-Wicherek, Magdalena

2011-11-01

Treg cells constitute the main cell population that enables cancer cells to evade immune surveillance. An alteration in the Treg cell population might correspond to the diminishment of the tumour mass in patients with cancer and could therefore be a useful marker of the intensity of the selective suppression of the host immune system and also of the degree of radicalism of a procedure. Certainly, it is well known that in order for anti-cancer therapy to succeed the proper immune response against cancer cells must be restored. Furthermore, monitoring the level of selective immune system suppression during cancer therapy might yield information that would support a decision to supplement standard therapy by immunotherapy or to increase the degree of radicalism of the applied therapy. We examined the Treg cell populations in the peripheral blood of a group of patients treated surgically for ovarian cancer. In each patient, the peripheral blood samples were collected both prior to and 1 day after the surgical procedure, and then again 5 days after the procedure. The presence of regulatory T cells in the samples was analyzed by means of flow cytometry. In our study, the percentages of FOXP3(+) cells in the subpopulation of CD4(+) T lymphocytes found in the peripheral blood of the patients before the surgical intervention were statistically significantly higher than those observed in the peripheral blood of these same patients after the surgical procedure. It would seem that the alteration in the Treg cell subpopulation could be a key factor in determining the status of the tumour microenvironment. Most likely, it could provide information about whether the proper level of anti-cancer immune response could be restored. The possibility of restoring the immune response may directly correspond to the degree of radicalism of the surgical intervention. © 2011 John Wiley & Sons A/S.

Periodontal Flap Surgery along with Vestibular Deepening with Diode Laser to Increase Attached Gingiva in Lower Anterior Teeth: A Prospective Clinical Study

PubMed Central

Bhardwaj, Ashu; Jafri, Zeba; Sultan, Nishat; Sawai, Madhuri; Daing, Anika

2018-01-01

Background: Chronic periodontitis in lower anterior teeth results in rapidly progressive gingival recession (GR), loss of alveolar bone, decreased vestibular depth (VD) with consequential tooth mobility, and tooth loss. Treatment option for such cases in this esthetically important area of the oral cavity includes extraction followed by implants for which sufficient bone height and mucogingival complex are a prerequisite. Henceforth, an attempt was made to prolong the life of lower anterior teeth and postpone the need for implants by the treatment of chronic periodontitis with periodontal flap surgery followed by vestibular deepening in single surgical procedure. Materials and Methods: In this clinical, prospective study, conventional periodontal flap surgery was done on 74 sites in lower anterior teeth in 16 patients with attachment loss >5 mm due to chronic periodontitis. Vestibular deepening with diode laser at (wavelength - 810 nm, output power: 0.5–7 W, continuous wave, contact mode) was done after suturing the flap. All the clinical parameters: GR, pocket depth (PD), clinical attachment loss (CAL), width of keratinized gingiva, width of attached gingiva, and VD were assessed preoperatively after Phase I therapy and 6 months postoperatively. Results: At all the 74 sites, there was highly significant gain in attached gingiva, keratinized gingiva, and VD (P ≤ 0.001). Highly significant reduction in PD (P ≤ 00.001), significant reduction in attachment loss (P ≤ 0.01) but no significant reduction in GR (P = 0.897) was observed. Conclusions: The combination of periodontal flap surgery with vestibular deepening with diode laser may be a suitable cost-effective treatment option to prolong the life of periodontally involved lower anterior teeth. The surgical technique can postpone the need for extraction of teeth along with all the intangible benefits of periodontal therapy. PMID:29456397

Green space propulsion: Opportunities and prospects

NASA Astrophysics Data System (ADS)

Gohardani, Amir S.; Stanojev, Johann; Demairé, Alain; Anflo, Kjell; Persson, Mathias; Wingborg, Niklas; Nilsson, Christer

2014-11-01

Currently, toxic and carcinogenic hydrazine propellants are commonly used in spacecraft propulsion. These propellants impose distinctive environmental challenges and consequential hazardous conditions. With an increasing level of future space activities and applications, the significance of greener space propulsion becomes even more pronounced. In this article, a selected number of promising green space propellants are reviewed and investigated for various space missions. In-depth system studies in relation to the aforementioned propulsion architectures further unveil possible approaches for advanced green propulsion systems of the future.

INTRINSIC CURVATURE: A MARKER OF MILLIMETER-SCALE TANGENTIAL CORTICO-CORTICAL CONNECTIVITY?

PubMed Central

RONAN, LISA; PIENAAR, RUDOLPH; WILLIAMS, GUY; BULLMORE, ED; CROW, TIM J.; ROBERTS, NEIL; JONES, PETER B.; SUCKLING, JOHN; FLETCHER, PAUL C.

2012-01-01

In this paper, we draw a link between cortical intrinsic curvature and the distributions of tangential connection lengths. We suggest that differential rates of surface expansion not only lead to intrinsic curvature of the cortical sheet, but also to differential inter-neuronal spacing. We propose that there follows a consequential change in the profile of neuronal connections: specifically an enhancement of the tendency towards proportionately more short connections. Thus, the degree of cortical intrinsic curvature may have implications for short-range connectivity. PMID:21956929

Further Evidence on the Effect of Acquisition Policy and Process on Cost Growth of Major Defense Acquisition Programs

DTIC Science & Technology

2016-06-01

several changes that may prove to be consequential. B. Funding Climates The amount appropriated to DoD each year for procurement over the period FY...important to realize that the turns in the funds appropriated for procurement are a lagging indicator of a change in budget climate . Funding and...each of the events identified to signal major and sustained changes in the defense funding climate , which in fact they did. Analysis of surrounding

Virtue ethics – an old answer to a new dilemma? Part 2. The case for inclusive virtue ethics

PubMed Central

2015-01-01

Summary While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. PMID:25792615

Empathy deficit in antisocial personality disorder: a psychodynamic formulation.

PubMed

Malancharuvil, Joseph M

2012-09-01

Empathic difficulty is a highly consequential characteristic of antisocial personality structure. The origin, maintenance, and possible resolution of this profound deficit are not very clear. While reconstructing empathic ability is of primary importance in the treatment of antisocial personality, not many proven procedures are in evidence. In this article, the author offers a psychodynamic formulation of the origin, character, and maintenance of the empathic deficiency in antisocial personality. The author discusses some of the treatment implications from this dynamic formulation.

[The case of Wegener's granulomatosis of the nose, larynx and ear].

PubMed

Wojciechowski, I; Piotrowski, S; Zaniewska-Kulesza, I; Komorowska, E

2001-01-01

We have described a rare case of Wegener's granulomatosis in our 41-year old patient, located in the nose, larynx and ear. The disease usually presents as a triad of respiratory, vascular and kidney location. It may occur as a rapid or indolent progress. We have shown in our paper diagnostic difficulties connected with this disease. The biopsies of involved organs and blood tests are the best steps of establish proper diagnosis. Antineutrophil cytoplasmic antibodies (ANCA) are typical markers of Wegeners's granulomatosis. The conservative therapy including immunosuppression and surgical treatment (laserotherapy) are main methods of management. Our patient was given antibiotic therapy, and immunosuppressive therapy. Her condition improved during the first hospitalisation. Remission lasted very short, and she was admitted to the hospital again and underwent intensive investigations and therapy. We observed dyspnea caused by subglottic stenosis. The histologic examination of the tracheal mucosa showed granulomatous inflammation. After intensive therapy our patient felt better. She has been in our records till now, we observe no progress of disease. Finally, we would like to pay attention to the fact, that early diagnosis is important to prevent complications such subglottic stenosis which can lead to death.

DNA/RNA-based formulations for treatment of breast cancer.

PubMed

Xie, Zhaolu; Zeng, Xianghui

2017-12-01

To develop a successful formulation for the gene therapy of breast cancer, an effective therapeutic nucleic acid and a proper delivery system are essential. Increased understanding of breast cancer, and developments in biotechnology, material science and nanotechnology have provided a major impetus in the development of effective formulations for the gene therapy of breast cancer. Areas covered: We discuss DNA/RNA-based formulations that can inhibit the growth of breast cancer cells and control the progress of breast cancer. Targets for the gene therapy of breast cancer, DNA/RNA-based therapeutics and delivery systems are summarized. And examples of successful DNA/RNA-based formulations for breast cancer gene therapy are reviewed. Expert opinion: Several challenges remain in developing effective DNA/RNA-based formulations for treatment of breast cancer. Firstly, most of the currently utilized targets are not effective enough as monotherapy for breast cancer. Secondly, the requirements for co-delivery system make the preparation of formulation more complicated. Thirdly, nanoparticles with the modification of tumor-targeting ligands could be more unstable in circulation and normal tissues. Lastly, immune responses against the viral vectors are unfavorable for the gene therapy of breast cancer because of the damage to the host and the impaired therapeutic ability.

Therapeutic group therapy improved self-efficacy of school age children.

PubMed

Cleodora, Cindy; Mustikasari; Gayatri, Dewi

2018-02-01

The survival of children against disaster can be seen from their confidence in their ability (self-efficacy). Self-efficacy can help children to determine their ability against disaster as preparedness. The proper intervention to increase self-efficacy as a protective factor is a therapeutic group therapy. The aim of this research is to measure the increase of self-efficacy of school age children against earthquake and Tsunami through therapeutic group therapy. This research used quasi-experimental design with pre-post-tests with control group. The sample involved in this study is 69 children, where 35 of them are in the experimental group while the rest 34 children are in the control group consisting of school children at the IV and V graders of elementary school. The result of the research showed that the self-efficacy of school children is improved significantly after being treated with therapeutic group therapy (p value < 0,05), those who were not treated with therapeutic group therapy have no significant improvement (p value > 0,05). This research is recommended to be conducted on school age children to improve their self-efficacy against disaster through health education. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

A comprehensive review and update on the biologic treatment of adult noninfectious uveitis: part II.

PubMed

Lee, Kyungmin; Bajwa, Asima; Freitas-Neto, Clovis A; Metzinger, Jamie Lynne; Wentworth, Bailey A; Foster, C Stephen

2014-11-01

Treatment of adult, noninfectious uveitis remains a major challenge for ophthalmologists around the world, especially in regard to recalcitrant cases. It is reported to comprise approximately 10% of preventable blindness in the USA. The cause of uveitis can be idiopathic or associated with infectious and systemic disorders. The era of biologic medical therapies provides new options for patients with otherwise treatment-resistant inflammatory eye disease. This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy. In part II, emerging therapies are discussed, including biologic response modifiers, experimental treatments and ongoing clinical studies for uveitis. The hazard of chronic corticosteroid use in the treatment of adult, noninfectious uveitis is well documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted. Although nothing is currently approved for on-label use in this indication, many therapies, through either translation or novel basic science research, have the potential to fill the currently exposed gaps.

Neuromuscular stimulation therapy after incomplete spinal cord injury promotes recovery of interlimb coordination during locomotion

NASA Astrophysics Data System (ADS)

Jung, R.; Belanger, A.; Kanchiku, T.; Fairchild, M.; Abbas, J. J.

2009-10-01

The mechanisms underlying the effects of neuromuscular electrical stimulation (NMES) induced repetitive limb movement therapy after incomplete spinal cord injury (iSCI) are unknown. This study establishes the capability of using therapeutic NMES in rodents with iSCI and evaluates its ability to promote recovery of interlimb control during locomotion. Ten adult female Long Evans rats received thoracic spinal contusion injuries (T9; 156 ± 9.52 Kdyne). 7 days post-recovery, 6/10 animals received NMES therapy for 15 min/day for 5 days, via electrodes implanted bilaterally into hip flexors and extensors. Six intact animals served as controls. Motor function was evaluated using the BBB locomotor scale for the first 6 days and on 14th day post-injury. 3D kinematic analysis of treadmill walking was performed on day 14 post-injury. Rodents receiving NMES therapy exhibited improved interlimb coordination in control of the hip joint, which was the specific NMES target. Symmetry indices improved significantly in the therapy group. Additionally, injured rodents receiving therapy more consistently displayed a high percentage of 1:1 coordinated steps, and more consistently achieved proper hindlimb touchdown timing. These results suggest that NMES techniques could provide an effective therapeutic tool for neuromotor treatment following iSCI.

[A Case of Recurrent Gastric Cancer with Grade 3 Proteinuria Caused by Ramucirumab plus Paclitaxel Therapy].

PubMed

Kimura, Yutaka; Makari, Yoichi; Mikami, Jota; Hiraki, Yoko; Kato, Hiroaki; Iwama, Mitsuru; Shiraishi, Osamu; Yasuda, Atsushi; Shinkai, Masayuki; Imano, Motohiro; Imamoto, Haruhiko; Fujita, Junya; Furukawa, Hiroshi; Yasuda, Takushi

2017-11-01

Proteinuria is one of the characteristic adverse events by ramucirumab(RAM)plus paclitaxel(PTX)combination therapy for advanced gastric cancer. We reported a case of recurrent gastric cancer with grade(gr)3 proteinuria caused by RAM plus PTX therapy. 77-year-old woman was underwent distal gastrectomy in 76 years old for gastric cancer that was diagnosed mucinous adenocarcinoma, fStage III C(T4aN3H0P0CY0M0)and received adjuvant chemotherapy of S-1 for 1 year. She suffered from peritoneal recurrence with ascites after 1 year and 4 months of the operation and RAM(8mg/kg; day 1 and 15)plus PTX(80mg/m2; day 1, 8 and 15)therapy was administrated as second-line chemotherapy. After 1 course, weekly PTX has been continued for gr 3 proteinuria and the ascites disappeared after 4 courses. This successful case might indicate that it was important for patients with gr 3 proteinuria as adverse event to consider discontinuance of RAM and continuation of PTX according to the proper usage guide of RAM.

Corticosteroid Therapy in Childhood Asthma

PubMed Central

Tollackson, Kenneth A.

1965-01-01

Fortunately, nearly all cases of asthma in childhood can be managed successfully without the use of adrenal corticosteroids. However, when used properly the corticoids enable that small group of children who have not responded to traditional allergic management to lead normal lives. The action of these compounds is a pharmacologic and not a physiologic one. The adrenal corticosteroids suppress the symptoms of childhood asthma but in no way serve as curative agents of allergic disease. PMID:14347975

The evolution of chronic opioid therapy and recognizing addiction.

PubMed

Daum, Akiva M; Berkowitz, Oren; Renner, John A

2015-05-01

Chronic pain is one of the most common complaints in the United States. Opioids have become a frequently prescribed treatment for patients with chronic nonmalignant pain. Concurrently, opioid use disorders have risen to epidemic levels. Studies investigating iatrogenic opioid addiction have been of limited quality. Aberrant drug-related behaviors may be warning signs of impending addiction. Proper screening and close monitoring are essential for managing patients on opioids for chronic nonmalignant pain.

Vaginitis. Reducing the number of refractory cases.

PubMed

Josey, W E

1977-09-01

Therapeutic failure in vaginitis can be minimized if all cases are properly diagnosed and specific therapy is given. Use of wet mounts combined with liberal use of cultures, especially for Corynebacterium vaginale, should result in an accurate diagnosis in over 90% of cases. Treatment of choice for candidiasis is nystatin or miconazole nitrate applied topically. For trichomoniasis, metronidazole should be given orally to both sexual partners. Ampicillin, cephalexin, or cephradine are recommended for C vaginale infection.

The American History of PTSD: Civil War -- Vietnam

DTIC Science & Technology

2011-03-21

ABSTRACTION FROM, OR REPRODUCTION OF ALL OR ANY PART OF TillS DOCUI\\1ENT IS PERl\\flTTED PROVIDED PROPER ACKNOWLEDGEI\\1ENT IS MADE. Acknowledgments I would...treatment procedure for "shell shock" involved administering a hypnotic therapy designed to restore the victim’s memory through the trancelike repetition and...of the most effective methods of ensuring long lasting recovery. However, the negative cmmotations associated with hypnotism ensured that only a

CHANGING OUR DIAGNOSTIC PARADIGM: MOVEMENT SYSTEM DIAGNOSTIC CLASSIFICATION

PubMed Central

Kamonseki, Danilo H.; Staker, Justin L.; Lawrence, Rebekah L.; Braman, Jonathan P.

2017-01-01

Proper diagnosis is a first step in applying best available treatments, and prognosticating outcomes for clients. Currently, the majority of musculoskeletal diagnoses are classified according to pathoanatomy. However, the majority of physical therapy treatments are applied toward movement system impairments or pain. While advocated within the physical therapy profession for over thirty years, diagnostic classification within a movement system framework has not been uniformly developed or adopted. We propose a basic framework and rationale for application of a movement system diagnostic classification for atraumatic shoulder pain conditions, as a case for the broader development of movement system diagnostic labels. Shifting our diagnostic paradigm has potential to enhance communication, improve educational efficiency, facilitate research, directly link to function, improve clinical care, and accelerate preventive interventions. PMID:29158950

High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program

PubMed Central

Moningi, Shalini; Armour, Elwood P.; Terezakis, Stephanie A.; Efron, Jonathan E.; Gearhart, Susan L.; Bivalacqua, Trinity J.; Kumar, Rachit; Le, Yi; Kien Ng, Sook; Wolfgang, Christopher L.; Zellars, Richard C.; Ellsworth, Susannah G.; Ahuja, Nita

2014-01-01

High-dose-rate intraoperative radiation therapy (HDR-IORT) has historically provided effective local control (LC) for patients with unresectable and recurrent tumors. However, IORT is limited to only a few specialized institutions and it can be difficult to initiate an HDR-IORT program. Herein, we provide a brief overview on how to initiate and implement an HDR-IORT program for a selected group of patients with gastrointestinal and pelvic solid tumors using a multidisciplinary approach. Proper administration of HDR-IORT requires institutional support and a joint effort among physics staff, oncologists, surgeons, anesthesiologists, and nurses. In order to determine the true efficacy of IORT for various malignancies, collaboration among institutions with established IORT programs is needed. PMID:24790628

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans.

PubMed

Robles-Bykbaev, Vladimir; López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-07-01

Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs' work and leads to more accurate, consistent, and complete therapy plans for their patients. We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were "better than" or "as good as" what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects.

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans

PubMed Central

López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-01-01

Background Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. Objective We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs’ work and leads to more accurate, consistent, and complete therapy plans for their patients. Methods We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. Results The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were “better than” or “as good as” what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. Conclusions The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects. PMID:27370070

Psychotherapy of an aging transvestite.

PubMed

Wise, T N

1979-01-01

Proper categorization of individuals with gender dysphoria allows rational psychotherapy. The treatment of an aging transvestite who requested sexual reassignment is presented to demonstrate the clinical features of the disorder and the course of the illness. The initial task was to place the patient into the proper clinical category of individuals with gender dysphorias. The clinical details of this disorder include an episoidic course with individuals who have previously had clear masculine identities. In the past they have been labeled secondary or marginal transsexuals as well as fetishtic cross-dressers. The patient, who had a long-standing history of cross-dressing, reacted to specific life stresses by the symptomatic wish for sexual reassignment. The individual psychotherapy consisted of phases of symptomatic expression, emerging depression, interpersonal awareness, symptom resolution and disavowel of the wish for sexual reassignment. The genesis of this perversion appears to be identification with a phallic maternal figure. Discussion of the descriptive and dynamic literature is reported in relation to the reported case. Identification of important losses in this patient's recent life allowed proper diagnosis and appropriate ongoing therapy to prevent the patient from irreversible surgery for a condition that was a symptom not an ingrained belief of gender dysphoria.

Impact of Compliance on Dysphagia Rehabilitation in Head and Neck Cancer Patients – Results from a Multi-center Clinical Trial

PubMed Central

Krisciunas, Gintas P.; McCulloch, Timothy M.; Lazarus, Cathy L.; Pauloski, Barbara R.; Meyer, Tanya K.; Graner, Darlene; Van Daele, Douglas J.; Silbergleit, Alice K.; Crujido, Lisa R.; Rybin, Denis; Doros, Gheorghe; Kotz, Tamar; Langmore, Susan E.

2016-01-01

Purpose A 5yr, 16 site, randomized controlled trial enrolled 170 HNC survivors into active (estim + swallow exercise) or control (sham estim + swallowing exercise) arms. Primary analyses showed that estim did not enhance swallowing exercises. This secondary analysis determined if/how patient compliance impacted outcomes. Methods A home program, performed 2×/day, 6d/wk, for 12wks included stretches and 60 swallows paired with real or sham estim. Regular clinic visits ensured proper exercise execution and detailed therapy checklists tracked patient compliance which was defined by mean number of sessions performed per week (0-12 times) over the 12wk intervention period. “Compliant” was defined as performing 10-12 sessions/wk. Outcomes were change in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12wks of therapy. Results Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/wk (median=10.25). Fifty four percent of patients (n=83) were considered “compliant”. After 12wks of therapy, compliant patients in the sham estim group realized significantly better PAS scores than compliant patients in the active estim group (p=0.0074). When pooling all patients together, there were no significant differences in outcomes between compliant and non-compliant patients. Conclusions The addition of estim to swallowing exercises resulted in worse swallowing outcomes than exercises alone, which was more pronounced in compliant patients. Since neither compliant nor non-compliant patients benefitted from swallowing exercises, the proper dose and/or efficacy of swallowing exercises must also be questioned in this patient population. PMID:27848021

Impact of Compliance on Dysphagia Rehabilitation in Head and Neck Cancer Patients: Results from a Multi-center Clinical Trial.

PubMed

Krisciunas, Gintas P; Castellano, Kerlly; McCulloch, Timothy M; Lazarus, Cathy L; Pauloski, Barbara R; Meyer, Tanya K; Graner, Darlene; Van Daele, Douglas J; Silbergleit, Alice K; Crujido, Lisa R; Rybin, Denis; Doros, Gheorghe; Kotz, Tamar; Langmore, Susan E

2017-04-01

A 5-year, 16-site, randomized controlled trial enrolled 170 HNC survivors into active (estim + swallow exercise) or control (sham estim + swallowing exercise) arms. Primary analyses showed that estim did not enhance swallowing exercises. This secondary analysis determined if/how patient compliance impacted outcomes. A home program, performed 2 times/day, 6 days/week, for 12 weeks included stretches and 60 swallows paired with real or sham estim. Regular clinic visits ensured proper exercise execution, and detailed therapy checklists tracked patient compliance which was defined by mean number of sessions performed per week (0-12 times) over the 12-week intervention period. "Compliant" was defined as performing 10-12 sessions/week. Outcomes were changes in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12 weeks of therapy. Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/week (median = 10.25). Fifty-four percent of patients (n = 83) were considered "compliant." After 12 weeks of therapy, compliant patients in the sham estim group realized significantly better PAS scores than compliant patients in the active estim group (p = 0.0074). When pooling all patients together, there were no significant differences in outcomes between compliant and non-compliant patients. The addition of estim to swallowing exercises resulted in worse swallowing outcomes than exercises alone, which was more pronounced in compliant patients. Since neither compliant nor non-compliant patients benefitted from swallowing exercises, the proper dose and/or efficacy of swallowing exercises must also be questioned in this patient population.

Introduction of a PCT-based algorithm to guide antibiotic prescription in COPD exacerbation.

PubMed

Picart, J; Moiton, M P; Gaüzère, B-A; Gazaille, V; Combes, X; DiBernardo, S

2016-12-01

Prescribing antibiotics for COPD exacerbations is not easy. Procalcitonin (PCT) is a useful biomarker that helps reduce the rate of antibiotic therapies. However, its proper cut-off levels are often unknown. We aimed to assess the impact of a PCT-based algorithm to guide antibiotic therapy prescription in COPD exacerbations. We conducted an observational, retrospective, and before/after study. We reviewed physician practices regarding PCT test and antibiotic therapy prescription to all patients hospitalized for COPD exacerbation. We then analyzed the rate of antibiotic prescriptions and the number of PCT tests prescribed before and after the introduction of a protocol validated by previous high-power studies. The primary endpoint was the rate of antibiotic prescriptions. A total of 124 patients before protocol and 121 patients after protocol were included. Antibiotic prescriptions decreased by 41% after protocol introduction (59% vs. 35%, P<0.001), with no increase in morbidity and mortality at Day 30. Compliance with protocol was complete in 60% of cases and partial (no PCT guidance to discontinue antibiotics) in 8% of cases. Both antibiotic duration (8.3 days vs. 8.7 days) and length of hospital stay (8.5 days vs. 8.3 days, P=0.78) did not change. Hospital physicians are already using PCT-based algorithm to guide antibiotic prescription in COPD exacerbations. Disseminating information on the appropriate PCT cut-off level to use to decide whether or not to initiate antibiotics is effective. Its proper use should be clarified to reduce antibiotic prescriptions to these overexposed patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[The Learning Effectiveness of Nurses Participating in a Simulated Radiation Therapy Skin Care Workshop].

PubMed

Lee, Yu-San; Kao, Yu-Hsiu

2016-08-01

The skin reaction rate is 60-95% in cancer patients that receive radiation therapy. This therapy is likely to cause physical and mental discomfort and prolong treatment for patients. The current emphasis on lectures rather than practice to help nurses learn proper skin care practices likely imposes difficulties for nurses to handle various clinical situations. To investigate the learning effectiveness of a simulated radiation therapy skin care workshop for nurses. A total of 34 nurses at a hospital in one health system in northern Taiwan who had never used radiation therapy to provide care to patients were enrolled in this quasi-experimental study. A single group pretest, posttest and post-posttest (6 weeks after intervention) approach was used. At the simulated radiation therapy skin care workshop, we used teaching strategies including Ausubel's direct instruction teaching method and practice on simulated wounds on pig skins. Outcomes were evaluated using "the questionnaire of radiation therapy skin care" and "direct observation of procedural skills checklist". The results from the simulated radiation therapy skin care workshop were analyzed using GEE (generalized estimating equation). The post-posttest and posttest scores increased significantly; knowledge mean score 3.14 (< .001) vs 2.64 (< .001), attitude mean score 2.06 (p < .05) vs 2.24 (p < .001), and skill mean score 2.79 (p < .001) vs 1.68 (p < .001). The simulated radiation therapy skin care workshop demonstrated significant and positive effects on learning outcomes. Therefore, we recommend incorporating this workshop into clinical nursing education and training strategies in the future.

Dual Drug Targeting of Mutant Bcr-Abl Induces Inactive Conformation: New Strategy for the Treatment of Chronic Myeloid Leukemia and Overcoming Monotherapy Resistance.

PubMed

El Rashedy, Ahmed A; Olotu, Fisayo A; Soliman, Mahmoud E S

2018-03-01

Bcr-Abl is an oncogenic fusion protein which expression enhances tumorigenesis, and has been highly associated with chronic myeloid leukemia (CML). Acquired drug resistance in mutant Bcr-Abl has enhanced pathogenesis with the use of single therapy agents such as nilotinib. Moreover, allosteric targeting has been identified to consequentially inhibit Bcr-Abl activity, which led to the recent development of ABL-001 (asciminib) that selectively binds the myristoyl pocket. Experimental studies have revealed that the combination of nilotinib and ABL-001 induced a 'bent' conformation in the C-terminal helix of Bcr-Abl; a benchmark of inhibition, thereby exhibiting a greater potency in the treatment of CML, surmounting the setbacks of drug resistance, disease regression and relapse. Therefore, we report the first account of the dynamics and conformational analysis of oncogenic T334I Bcr-Abl by dual targeting. Our findings revealed that unlike in the Bcr-Abl-Nilotinib complex, dual targeting by both inhibitors induced the bent conformation in the C-terminal helix that varied with time. This was coupled with significant alteration in Bcr-Abl stability, flexibility, and compactness and an overall structural re-orientation inwards towards the hydrophobic core, which reduced the solvent-exposed residues indicative of protein folding. This study will facilitate allosteric targeting and the design of more potent allosteric inhibitors for resistive target proteins in cancer. © 2018 Wiley-VHCA AG, Zurich, Switzerland.

Children's experiences of cystic fibrosis: a systematic review of qualitative studies.

PubMed

Jamieson, Nathan; Fitzgerald, Dominic; Singh-Grewal, Davinder; Hanson, Camilla S; Craig, Jonathan C; Tong, Allison

2014-06-01

Cystic fibrosis (CF) is a common life-shortening genetic disease and is associated with poor psychosocial and quality of life outcomes. The objective of this study was to describe the experiences and perspectives of children and adolescents with CF to direct care toward areas that patients regard as important. MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature were searched from inception to April 2013. We used thematic synthesis to analyze the findings. Forty-three articles involving 729 participants aged from 4 to 21 years across 10 countries were included. We identified 6 themes: gaining resilience (accelerated maturity and taking responsibility, acceptance of prognosis, regaining control, redefining normality, social support), lifestyle restriction (limited independence, social isolation, falling behind, physical incapacity), resentment of chronic treatment (disempowerment in health management, unrelenting and exhausting therapy, inescapable illness), temporal limitations (taking risks, setting achievable goals, valuing time), emotional vulnerability (being a burden, heightened self-consciousness, financial strain, losing ground, overwhelmed by transition), and transplant expectations and uncertainty (confirmation of disease severity, consequential timeliness, hope and optimism). Adolescents and children with CF report a sense of vulnerability, loss of independence and opportunities, isolation, and disempowerment. This reinforces the importance of the current model of multidisciplinary patient-centered care that promotes shared decision-making, control and self-efficacy in treatment management, educational and vocational opportunities, and physical and social functioning, which can lead to optimal treatment, health, and quality of life outcomes. Copyright © 2014 by the American Academy of Pediatrics.

Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis

PubMed Central

2015-01-01

It is important to fast diagnosis and management of the pediatric patients of the endocrine metabolic emergencies because the signs and symptoms of these disorders are nonspecific. Delayed diagnosis and treatment may lead to serious consequences of the pediatric patients, for example, cerebral dysfunction leading to coma or death of the patients with hypoglycemia, hypocalcemia, adrenal insufficiency, or diabetic ketoacidosis. The index of suspicion of the endocrine metabolic emergencies should be preceded prior to the starting nonspecific treatment. Importantly, proper diagnosis depends on the collection of blood and urine specimen before nonspecific therapy (intravenous hydration, electrolytes, glucose or calcium injection). At the same time, the taking of precise history and searching for pathognomonic physical findings should be performed. This review was described for fast diagnosis and proper management of hypoglycemic emergencies, hypocalcemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis. PMID:26817004

[THE ROLE OF PRESSURE ULCER SURROUNDING SKIN PREPARATION PRIOR TO THE APPLICATION OF WOUND DRESSING].

PubMed

Kulišić, S Marinović

2016-01-01

Pressure ulcer develops as a result of many factors, primarily pressure, tensile forces and ischemia with immobility and incontinence. Targeted and properly designed preventive measures reduce the incidence and complications of pressure ulcers, among which the most common are infections. An important preventive measure is protection of the surrounding skin before the application of wound dressings. Skin changes dictate the use of emollients and topical therapy according to dermatological status.

Critical Care of Pet Birds.

PubMed

Jenkins, Jeffrey Rowe

2016-05-01

Successful care of the critical pet bird patient is dependent on preparation and planning and begins with the veterinarian and hospital staff. An understanding of avian physiology and pathophysiology is key. Physical preparation of the hospital or clinic includes proper equipment and understanding of the procedures necessary to provide therapeutic and supportive care to the avian patient. An overview of patient intake and assessment, intensive care environment, and fluid therapy is included. Copyright © 2016 Elsevier Inc. All rights reserved.

Children's UTIs in the new millennium. Diagnosis, investigation, and treatment of childhood urinary tract infections in the year 2001.

PubMed Central

White, C. T.; Matsell, D. G.

2001-01-01

OBJECTIVE: To provide an effective approach for family physicians treating children presenting with urinary tract infections (UTIs). QUALITY OF EVIDENCE: The information presented, and articles quoted, are drawn from both review of the literature and recent consensus guidelines. Data and recommendations come from prospective multicentre trials; retrospective reviews; expert consensus statements; and some smaller trials, commentaries, and editorials. MAIN MESSAGE: Urinary tract infections are often seen in family practice. Diagnosis requires suspicion and a realization that children, especially those younger than 2 years, often have very few, nonspecific signs of infection. Obtaining a proper urine sample is vital, because true infections require radiographic studies. Antibiotic prophylaxis is promoted because of the link between vesicoureteral reflux, recurrent UTIs, and renal scarring and hypertension. We generally provide prophylaxis until children are 3 or 4 years, when risk of damage from reflux is lessened and timely urine samples are easier to obtain for prompt therapy. Surgical opinion is sought only when medical management has failed. Failure is defined as either recurrent infections and pyelonephritis or poor renal growth. CONCLUSION: To diagnose UTIs in children, physicians must suspect them, obtain proper urine samples, order appropriate investigations to rule out underlying anatomic abnormalities, and treat with appropriate antibiotics considering both organism sensitivities and length of therapy. PMID:11561337

Complete remission of a case of hepatocellular carcinoma with tumor invasion in inferior vena cava and with pulmonary metastasis successfully treated with repeated arterial infusion chemotherapy.

PubMed

Kogure, Takayuki; Iwasaki, Takao; Ueno, Yoshiyuki; Kanno, Noriatsu; Fukushima, Koji; Yamagiwa, Yoko; Nagasaki, Futoshi; Kakazu, Eiji; Matsuda, Yasunori; Kido, Osamu; Nakagome, Yu; Ninomiya, Masashi; Shimosegawa, Tooru

2007-01-01

We report the case of a patient having hepatocellular carcinoma with tumor invasion to the inferior vena cava and with multiple pulmonary metastases who was treated with repeated one-shot administration of epirubicin, cisplatin, and mitomycin C by hepatic artery and bronchial artery, which led to complete remission. A 72-year-old woman was diagnosed with infiltrative hepatocellular carcinoma with Vv3, multiple intrahepatic metastases, and multiple pulmonary metastases associated with compensated liver cirrhosis. One-shot infusion of epirubicin, cisplatin, and mitomycin C was performed through proper hepatic artery and bronchial artery for twice at eight weeks of intervals. Pulmonary metastases disappeared and intrahepatic lesions indicated marked shrinkage leaving a scar-like lesion with decreases in tumor markers. After six months and 20 months, tumor markers indicated increasing tendency but no evident recurrence was found by computed tomography or hepatic arteriography. One-shot infusion of the same regimens through proper hepatic artery was performed and tumor markers decreased to normal levels. After 14 months of the last therapy, no evidence of recurrence has been found on image analysis or in tumor markers. This arterial infusion therapy is well tolerated for the patients with compensated liver cirrhosis and might be promising for the effective treatment of advanced hepatocellular carcinoma with pulmonary metastases.

How nutritional status, diet and dietary supplements can affect autism. A review.

PubMed

Kawicka, Anna; Regulska-Ilow, Bozena

2013-01-01

Autism is a neurodevelopmental disorder with symptoms arising that are apparent throughout the patient's lifespan. Autism Spectrum Disorders (ASD) are characterised by impaired social and communication interactions as well as restricted, repetitive interests and behaviour. Currently in Poland, about 50 000 people suffer from autism, of which 1/5 are children. Epidemiological studies show that the incidence of autism is increasing, which may be due to the diagnostic category of ASD having been developed. Of vital importance in the treatment of autism, is early diagnosis which is conducive to more rapidly improving the quality of patients' health. It is believed that both genetic and environmental factors may affect the development of the disease. Moreover, expert opinion emphasises the importance of making an adequate diagnosis when the first symptoms of autism start appearing which can be both psychological, gastro-intestinal and metabolic ones. Conventional treatment is based on the combination of behavioural and dietary therapy together with pharmacotherapy. For example, adapting an appropriate diet could help alleviate the disease severity, as well as the psychological and gastrointestinal symptoms. Much scientific research has indicated that pathogenesis of autism may have a beginning already in foetal life. During pregnancy, specialists should take special heed of metabolic disorders, which can increase the risk ofASD in children. One of the dietician's tasks are to properly assess the nutritional status of mothers before and during pregnancy, thereby allowing changes in nutrition to be made wherever necessary in order that metabolic indicators be improved. Thus an important part of autism therapy is the improving patient's nutritional status to prevent the onset of gastrointestinal symptoms. Adopting diets and tailored to individual disease symptoms, is linked to the nutritional requirements and food preferences of the patient. Specialists also emphasise that continual monitoring of the diet and nutritional status of children with ASD is required. It is also essential to start adequate dietary management in autistic patients with overweight, obesity or wasting, caused by improper nutrition. Frequently only a dietary therapy is insufficient to effectively treat autism. Many studies demonstrate the need to supplement the nutritional deficiencies of autistic patients with fatty acids omega-3, probiotics, vitamins and minerals in combination with medical and psychological interventions. A properly designed elimination diet adapted to the patient's individual may also lead to relief of the autism symptoms and the occurrence of gastrointestinal disorders. Parents and caregivers should therefore be aware of the benefits of nutritional therapy and need for proper monitoring the treatment of patients with ASD. A review of nutritional factors, dietary treatments and diet supplementation in patients with ASD is presented.

[Evaluation and classification of drug therapy for breast cancer with bone-only metastasis].

PubMed

Meng, X Y; Song, S T

2017-03-23

Skeleton is one of the most common metastatic organs for breast cancer, which has a better prognosis than visceral metastases. Bone-only metastasis was defined"non-measurable" in the RECIST (Response Evaluation Criteria in Solid Tumors) criteria, and was excluded by clinical trials. However, patients with bone-only metastasis are also in need of effective treatment to prolong survival. Endocrine therapy is the most important treatment for bone metastatic patients. Tumor response of bone metastases can be determined objectively by bone-window CT. Effective treatment should be continued if the symptoms are relieved or osteogenesis is observed. Osteoblastic change in bone-window CT is a sign of improvement after treatment. Endocrine therapy is proper for ER-positive patients. The patients with initial osteoblastic metastasis should not be treated with salvage chemotherapy or anti-HER2 treatment, only if osteolytic metastasis or visceral metastasis is observed. Bishosphonates are just auxiliary drugs in bone metastasis, which should not be abused.

Hemiplegic shoulder pain: implications for occupational therapy treatment.

PubMed

Gilmore, Paula E; Spaulding, Sandi J; Vandervoort, Anthony A

2004-02-01

Hemiplegic shoulder pain is common after stroke causing hemiplegia. It adversely affects the recovery of arm function and independence in activities of daily living. Subluxation, abnormal tone and limited range of motion or capsular constrictions have been reported as potential causes. Other factors such as rotator cuff tears, brachial plexus injury, shoulder-hand syndrome and other pre-existing pathological conditions may also be associated with hemiplegic shoulder pain. The etiology remains unclear, but hemiplegic shoulder pain may result from a combination of the above factors. This literature review examines the possible causes of hemiplegic shoulder pain and discusses the implications for occupational therapy treatment. Occupational therapy interventions include proper positioning, facilitation of movement through purposeful therapeutic activities, increasing passive range of motion, implementation of external supports and treatment of shoulder-hand syndrome. Understanding the processes involved will assist with effective assessment, treatment and prevention of hemiplegic shoulder pain. This will facilitate clients' participation in rehabilitation programs and move them towards attainment of optimal function.

An abbreviated history of osseous surgery.

PubMed

Rudy, Robert J; Marcuschamer, Eduardo

2011-01-01

Various forms of periodontal therapy, including surgery, have been advocated and documented in the dental literature during the last three centuries. This variety of treatment modalities has been developed to address the anatomical consequences (pocket formation and bone loss) sustained from chronic periodontal disease. The marked differences in techniques have created significant controversies between the greatest leaders in dentistry and their equally influential disciples. Nevertheless, these leaders have always shared a common goal: the preservation of the natural dentition in a harmonious environment of health, comfort, and proper function. This article discusses the history of periodontal osseous surgery, including not only the technical issues, but also the conceptual underpinnings of this form of therapeutic intervention. In the process of examining this subject closely, three main controversies in the field of periodontics are brought into sharper focus: non-surgical versus surgical periodontal therapy; gingivectomy versus osseous resective periodontal therapy; and the nature of clinical decision-making: scientific and evidenced-based versus subjective clinical judgement.

A new appraisal of iodine refractory thyroid cancer.

PubMed

Vaisman, Fernanda; Carvalho, Denise P; Vaisman, Mario

2015-12-01

Thyroid cancer incidence is increasing all over the world - mostly due to an increase in the detection of small tumors that were previously undetected. A small percentage of these tumors lose the ability to uptake and/or to respond to radioiodine (RAI) therapy, especially in metastatic patients. There are several new therapeutic options that have emerged in the last 5 years to treat RAI refractory thyroid cancer patients, however, it is very important to properly identify RAI refractory patients and to clarify those appropriate for these treatments. In this review, we discuss the RAI refractory definitions and the criteria that have been suggested based on RAI uptake in the post therapy scan, as well as the response after RAI therapy and the possible molecular mechanisms involved in this process. We offer a review of the therapeutic options available at the moment and the therapeutic considerations based on a patient's individualized personal characteristics, primary tumor histology, tumor burden and location and velocity of lesion growth. © 2015 Society for Endocrinology.

Low back pain in physical therapists: a cultural approach to analysis and intervention.

PubMed

Hanson, Heather; Wagner, Mairead; Monopoli, Vanessa; Keysor, Julie

2007-01-01

Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain [9]. Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.

The Promise of Cell Based Therapies for Diabetic Complications: challenges and solutions

PubMed Central

Jarajapu, Yagna P.R.; Grant, Maria B.

2013-01-01

The discovery of endothelial progenitor cells (EPCs) in human peripheral blood advanced the field of cell-based therapeutics for many pathological conditions. Despite the lack of agreement about the existence and characteristics of EPCs, autologous EPC populations represent a novel treatment option for complications requiring therapeutic revascularization and vascular repair. Patients with diabetic complications represent a population of patients that may benefit from cellular therapy yet their broadly dysfunctional cells may limit the feasibility of this approach. Diabetic EPCs have decreased migratory prowess and reduced proliferative capacity and an altered cytokine/ growth factor secretory profile that can accelerates deleterious repair mechanisms rather than support proper vascular repair. Furthermore, the diabetic environment poses additional challenges for the autologous transplantation of cells. The present review is focused on correcting diabetic EPC dysfunction and the challenges involved in the application of cell-based therapies for treatment of diabetic vascular complications. In addition, ex vivo and in vivo functional manipulation(s) of EPCs to overcome these hurdles are discussed. PMID:20299675

Optimizing Surveillance Performance of Alpha-Fetoprotein by Selection of Proper Target Population in Chronic Hepatitis B

PubMed Central

Chung, Jung Wha; Kim, Beom Hee; Lee, Chung Seop; Kim, Gi Hyun; Sohn, Hyung Rae; Min, Bo Young; Song, Joon Chang; Park, Hyun Kyung; Jang, Eun Sun; Yoon, Hyuk; Kim, Jaihwan; Shin, Cheol Min; Park, Young Soo; Hwang, Jin-Hyeok; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho; Lee, Jaebong; Ahn, Soyeon

2016-01-01

Although alpha-fetoprotein (AFP) is the most widely used biomarker in hepatocellular carcinoma (HCC) surveillance, disease activity may also increase AFP levels in chronic hepatitis B (CHB). Since nucleos(t)ide analog (NA) therapy may reduce not only HBV viral loads and transaminase levels but also the falsely elevated AFP levels in CHB, we tried to determine whether exposure to NA therapy influences AFP performance and whether selective application can optimize the performance of AFP testing in CHB during HCC surveillance. A retrospective cohort of 6,453 CHB patients who received HCC surveillance was constructed from the electronic clinical data warehouse. Covariates of AFP elevation were determined from 53,137 AFP measurements, and covariate-specific receiver operating characteristics regression analysis revealed that albumin levels and exposure to NA therapy were independent determinants of AFP performance. C statistics were largest in patients with albumin levels ≥ 3.7 g/dL who were followed without NA therapy during study period, whereas AFP performance was poorest when tested in patients with NA therapy during study and albumin levels were < 3.7 g/dL (difference in C statics = 0.35, p < 0.0001). Contrary to expectation, CHB patients with current or recent exposure to NA therapy showed poorer performance of AFP during HCC surveillance. Combination of concomitant albumin levels and status of NA therapy can identify subgroup of CHB patients who will show optimized AFP performance. PMID:27997559

Patient-reported outcomes to support medical product labeling claims: FDA perspective.

PubMed

Patrick, Donald L; Burke, Laurie B; Powers, John H; Scott, Jane A; Rock, Edwin P; Dawisha, Sahar; O'Neill, Robert; Kennedy, Dianne L

2007-01-01

This article concerns development and use of patient-reported outcomes (PROs) in clinical trials to evaluate medical products. A PRO is any report coming directly from patients, without interpretation by physicians or others, about how they function or feel in relation to a health condition and its therapy. PRO instruments are used to measure these patient reports. PROs provide a unique perspective on medical therapy, because some effects of a health condition and its therapy are known only to patients. Properly developed and evaluated PRO instruments also have the potential to provide more sensitive and specific measurements of the effects of medical therapies, thereby increasing the efficiency of clinical trials that attempt to measure the meaningful treatment benefits of those therapies. Poorly developed and evaluated instruments may provide misleading conclusions or data that cannot be used to support product labeling claims. We review selected major challenges from Food and Drug Administration's perspective in using PRO instruments, measures, and end points to support treatment benefit claims in product labeling. These challenges highlight the need for sponsors to formulate desired labeling claim(s) prospectively, to acquire and document information needed to support these claim(s), and to identify existing instruments or develop new and more appropriate PRO instruments for evaluating treatment benefit in the defined population in which they will seek claims.

Adoptive natural killer cell therapy is effective in reducing pulmonary metastasis of Ewing sarcoma

PubMed Central

Tong, Alexander A.; Hashem, Hasan; Eid, Saada; Allen, Frederick; Kingsley, Daniel

2017-01-01

ABSTRACT The survival of patients with metastatic or relapsed Ewing sarcoma (ES) remains dismal despite intensification of combination chemotherapy and radiotherapy, precipitating the need for novel alternative therapies with minimal side effects. Natural killer (NK) cells are promising additions to the field of cellular immunotherapy. Adoptive NK cell therapy has shown encouraging results in hematological malignancies. Despite these initial promising successes, however, NK cell therapy for solid tumors remains to be investigated using in vivo tumor models. The purpose of this study is to evaluate the efficacy of ex vivo expanded human NK cells in controlling primary and metastatic ES tumor growth in vitro and in vivo. Using membrane-bound IL-21 containing K562 (K562-mbIL-21) expansion platform, we were able to obtain sufficient numbers of expanded NK (eNK) cells that display favorable activation phenotypes and inflammatory cytokine secretion, along with a strong in vitro cytotoxic effect against ES. Furthermore, eNK therapy significantly decreased lung metastasis without any significant therapeutic effect in limiting primary tumor growth in an in vivo xenograft model. Our data demonstrate that eNK may be effective against pulmonary metastatic ES, but challenges remain to direct proper trafficking and augmenting the cytotoxic function of eNK to target primary tumor sites. PMID:28507811

Diagnosis and treatment of gastroesophageal reflux disease

PubMed Central

Badillo, Raul; Francis, Dawn

2014-01-01

Gastroesophageal reflux disease (GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms, these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations, further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis, peptic stricture, Barrett’s esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification, medical therapy and surgical therapy. Lifestyle modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gastroesophageal reflux disease. PMID:25133039

Insights into cell-free therapeutic approach: Role of stem cell "soup-ernatant".

PubMed

Raik, Shalini; Kumar, Ajay; Bhattacharyya, Shalmoli

2018-03-01

Current advances in medicine have revolutionized the field of regenerative medicine dramatically with newly evolved therapies for repair or replacement of degenerating or injured tissues. Stem cells (SCs) can be harvested from different sources for clinical therapeutics, which include fetal tissues, umbilical cord blood, embryos, and adult tissues. SCs can be isolated and differentiated into desired lineages for tissue regeneration and cell replacement therapy. However, several loopholes need to be addressed properly before this can be extended for large-scale therapeutic application. These include a careful approach for patient safety during SC treatments and tolerance of recipients. SC treatments are associated with a number of risk factors and require successful integration and survival of transplanted cells in the desired microenvironment with concurrent tissue regeneration. Recent studies have focused on developing alternatives that can replace the cell-based therapy using paracrine factors. The development of stem "cell free" therapies can be devoted mainly to the use of soluble factors (secretome), extracellular vesicles, and mitochondrial transfer. The present review emphasizes on the paradigms related to the use of SC-based therapeutics and the potential applications of a cell-free approach as an alternative to cell-based therapy in the area of regenerative medicine. © 2017 International Union of Biochemistry and Molecular Biology, Inc.

Magneto-therapy of human joint cartilage.

PubMed

Wierzcholski, Krzysztof; Miszczak, Andrzej

2017-01-01

The topic of the present paper concerns the human joint cartilage therapy performed by the magnetic induction field. There is proved the thesis that the applied magnetic field for concrete cartilage illness should depend on the proper relative and concrete values of applied magnetic induction, intensity as well the time of treatment duration. Additionally, very important are frequencies and amplitudes of magnetic field as well as magnetic permeability of the synovial fluid. The research methods used in this paper include: magnetic induction field produced by a new Polish and German magneto electronic devices for the therapy of human joint cartilage diseases, stationary and movable magnetic applicators, magnetic bandage, ferrofluid injections, author's experience gained in Germany research institutes and practical results after measurements and information from patients. The results of this paper concern concrete parameters of time dependent electro-magnetic field administration during the joint cartilage therapy duration and additionally concern the corollaries which are implied from reading values gained on the magnetic induction devices. The main conclusions obtained in this paper are as follows: Time dependent magnetic induction field increases the dynamic viscosity of movable synovial fluid and decreases symptoms of cartilage illness for concrete intensity of magnetic field and concrete field line architecture. The ferrofluid therapy and phospholipids bilayer simultaneously with the administrated external electromagnetic field, increases the dynamic viscosity of movable synovial fluid.

Controlling diameter distribution of catalyst nanoparticles in arc discharge.

PubMed

Li, Jian; Volotskova, Olga; Shashurin, Alexey; Keidar, Michael

2011-11-01

It is demonstrated that the diameter distribution of catalyst nanoparticles in arc discharge can be controlled by a magnetic field. The magnetic field affects the arc shape, shortens the diffusing time of the catalyst nanoparticles through the nucleation zone, and consequentially reduces the average diameters of nanoparticles. The average diameter is reduced from about 7.5 nm without magnetic field to about 5 nm is the case of a magnetic field. Decrease of the catalyst nanoparticle diameter with magnetic field correlates well with decrease in the single-wall carbon nanotube and their bundles diameters.

Policies of Inclusion

PubMed Central

Fairchild, Amy L.

2004-01-01

The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders. PMID:15053996

Comparison of methods for accurate end-point detection of potentiometric titrations

NASA Astrophysics Data System (ADS)

Villela, R. L. A.; Borges, P. P.; Vyskočil, L.

2015-01-01

Detection of the end point in potentiometric titrations has wide application on experiments that demand very low measurement uncertainties mainly for certifying reference materials. Simulations of experimental coulometric titration data and consequential error analysis of the end-point values were conducted using a programming code. These simulations revealed that the Levenberg-Marquardt method is in general more accurate than the traditional second derivative technique used currently as end-point detection for potentiometric titrations. Performance of the methods will be compared and presented in this paper.

Family Relationships and Well-Being

PubMed Central

Thomas, Patricia A; Liu, Hui; Umberson, Debra

2017-01-01

Abstract Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses. PMID:29795792

INVASIVESNET towards an International Association for Open Knowledge on Invasive Alien Species

USGS Publications Warehouse

Lucy, Frances; Roy, Helen; Simpson, Annie; Carlton, James T.; Hanson, John Mark; Magellan, Kit; Campbell, Marnie L.; Costello, Mark J.; Pagad, Shyama; Hewitt, Chad L; McDonald, Justin; Cassey, Phillip; Thomaz, Sidinei M; Katsanevakis, Stelios; Zenetos, Argyro; Tricarico, Elena; Boggero, Angela; Groom, Quentin J.; Adriaens, Tim; Vanderhoeven, Sonia; Torchin, Mark E.; Hufbauer, Ruth A.; Fuller, Pam; Carman, Mary R; Conn, David Bruce; Vitule, Jean R. S.; Canning-Clode, João; Galil, Bella S; Ojaveer, Henn; Bailey, Sarah A; Therriault, Thomas W; Claudi, Renata; Gazda, Anna; Dick, Jaimie T A; Caffrey, Joe; Witt, Arne; Kenis, Marc; Lehtiniemi, Maiju; Helmisaari, Harry; Panov, Vadim E

2016-01-01

To date, the sustainability of many strategic national and international initiatives on IAS have unfortunately been hampered by time-limited grants or funding cycles. Recognising that IAS initiatives need to be globally coordinated and ongoing, we aim to develop a sustainable knowledge sharing association to connect the outputs of IAS research and to inform the consequential management and societal challenges arising from IAS introductions. INVASIVESNET will provide a dynamic and enduring network of networks to ensure the continuity of connections among the IAS community of practice, science and management.

My contribution to broadening the base of chemical engineering.

PubMed

Sargent, Roger W H

2011-01-01

This paper is a short account, from a personal viewpoint, of the various contributions I have made to expand the academic basis of chemical engineering from its origin in the unifying concept of unit operations, focussed on process design, to encompassing all the professional activities of industrial chemical engineers. This includes all aspects of planning and scheduling the operations as well as designing and controlling the process plant. The span of my career also happens to include the birth of the age of computing, with all the consequential implications.

Disclosure of Adverse Events in Pediatrics.

PubMed

2016-12-01

Despite increasing attention to issues of patient safety, preventable adverse events (AEs) continue to occur, causing direct and consequential injuries to patients, families, and health care providers. Pediatricians generally agree that there is an ethical obligation to inform patients and families about preventable AEs and medical errors. Nonetheless, barriers, such as fear of liability, interfere with disclosure regarding preventable AEs. Changes to the legal system, improved communications skills, and carefully developed disclosure policies and programs can improve the quality and frequency of appropriate AE disclosure communications. Copyright © 2016 by the American Academy of Pediatrics.

Virtue ethics--an old answer to a new dilemma? Part 2. The case for inclusive virtue ethics.

PubMed

Misselbrook, David

2015-03-01

While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. © The Royal Society of Medicine.

Modified Beer-Lambert law for blood flow.

PubMed

Baker, Wesley B; Parthasarathy, Ashwin B; Busch, David R; Mesquita, Rickson C; Greenberg, Joel H; Yodh, A G

2014-11-01

We develop and validate a Modified Beer-Lambert law for blood flow based on diffuse correlation spectroscopy (DCS) measurements. The new formulation enables blood flow monitoring from temporal intensity autocorrelation function data taken at single or multiple delay-times. Consequentially, the speed of the optical blood flow measurement can be substantially increased. The scheme facilitates blood flow monitoring of highly scattering tissues in geometries wherein light propagation is diffusive or non-diffusive, and it is particularly well-suited for utilization with pressure measurement paradigms that employ differential flow signals to reduce contributions of superficial tissues.

Consequences of the Introduction of Insensitive Munitions on Safety, Collateral Damage and Operations (consequenties van de invoering van mkm-munitie op veiligheid, gevolgschade en (internationaal) opereren

DTIC Science & Technology

2006-06-01

van de werkzaamheden In dit rapport worden de gevolgen van initiatie van munitie door een ongewilde externe stimulus beschouwd aan de hand van reele...operationele scenario’s. Dit wordt vergeleken met de gevolgen in dezelfde scenario’s, waarin gebruik is gemaakt van Minder Kwetsbare Munitie (MKM). Naast...de historie van MKM wordt uitgelegd wat Inleiding of terroristische activiteiten, maar ook door MKM is. Vervolgens worden de gevolgen Munitie en de

The importance of being dead: cell death mechanisms assessment in anti-sarcoma therapy.

PubMed

Rello-Varona, Santiago; Herrero-Martín, David; Lagares-Tena, Laura; López-Alemany, Roser; Mulet-Margalef, Núria; Huertas-Martínez, Juan; Garcia-Monclús, Silvia; García Del Muro, Xavier; Muñoz-Pinedo, Cristina; Tirado, Oscar Martínez

2015-01-01

Cell death can occur through different mechanisms, defined by their nature and physiological implications. Correct assessment of cell death is crucial for cancer therapy success. Sarcomas are a large and diverse group of neoplasias from mesenchymal origin. Among cell death types, apoptosis is by far the most studied in sarcomas. Albeit very promising in other fields, regulated necrosis and other cell death circumstances (as so-called "autophagic cell death" or "mitotic catastrophe") have not been yet properly addressed in sarcomas. Cell death is usually quantified in sarcomas by unspecific assays and in most cases the precise sequence of events remains poorly characterized. In this review, our main objective is to put into context the most recent sarcoma cell death findings in the more general landscape of different cell death modalities.

Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

PubMed Central

Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

2007-01-01

Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

WAO Guideline for the Management of Hereditary Angioedema

PubMed Central

2012-01-01

Hereditary Angioedema (HAE) is a rare disease and for this reason proper diagnosis and appropriate therapy are often unknown or not available for physicians and other health care providers. For this reason we convened a group of specialists that focus upon HAE from around the world to develop not only a consensus on diagnosis and management of HAE, but to also provide evidence based grades, strength of evidence and classification for the consensus. Since both consensus and evidence grading were adhered to the document meets criteria as a guideline. The outcome of the guideline is to improve diagnosis and management of patients with HAE throughout the world and to help initiate uniform care and availability of therapies to all with the diagnosis no matter where the residence of the individual with HAE exists. PMID:23282420

Gestational trophoblastic disease.

PubMed

Soper, John T

2006-07-01

This review summarizes the primary management of molar pregnancies, surveillance after evacuation, and the evaluation and management of malignant gestational trophoblastic neoplasia (GTN). Most women with gestational trophoblastic disease can be successfully managed with preservation of their normal reproductive function. It is important to manage molar pregnancies properly to minimize acute complications and identify malignant sequelae promptly. Current International Federation of Gynecology and Obstetrics (FIGO) guidelines for making the diagnosis and staging of GTN allow uniformity for reporting results of treatment. It is important to individualize treatment for women with malignant GTN based upon risk factors, using less toxic therapy for patients with low-risk disease and aggressive multiagent therapy for those with high-risk disease. Patients with malignant GTN should be managed in consultation with an individual experienced in the complex, multimodality treatment of these patients.

The Role of Aspirin in the Prevention of Cardiovascular Disease

PubMed Central

Ittaman, Sunitha V.; VanWormer, Jeffrey J.; Rezkalla, Shereif H.

2014-01-01

Aspirin therapy is well-accepted as an agent for the secondary prevention of cardiovascular events and current guidelines also define a role for aspirin in primary prevention. In this review, we describe the seminal trials of aspirin use in the context of current guidelines, discuss factors that may influence the effectiveness of aspirin therapy for cardiovascular disease prevention, and briefly examine patterns of use. The body of evidence supports a role for aspirin in both secondary and primary prevention of cardiovascular events in selected population groups, but practice patterns may be suboptimal. As a simple and inexpensive prophylactic measure for cardiovascular disease, aspirin use should be carefully considered in all at-risk adult patients, and further measures, including patient education, are necessary to ensure its proper use. PMID:24573704

Positron emission tomography and gene therapy: basic concepts and experimental approaches for in vivo gene expression imaging.

PubMed

Peñuelas, Iván; Boán, JoséF; Martí-Climent, Josep M; Sangro, Bruno; Mazzolini, Guillermo; Prieto, Jesús; Richter, José A

2004-01-01

More than two decades of intense research have allowed gene therapy to move from the laboratory to the clinical setting, where its use for the treatment of human pathologies has been considerably increased in the last years. However, many crucial questions remain to be solved in this challenging field. In vivo imaging with positron emission tomography (PET) by combination of the appropriate PET reporter gene and PET reporter probe could provide invaluable qualitative and quantitative information to answer multiple unsolved questions about gene therapy. PET imaging could be used to define parameters not available by other techniques that are of substantial interest not only for the proper understanding of the gene therapy process, but also for its future development and clinical application in humans. This review focuses on the molecular biology basis of gene therapy and molecular imaging, describing the fundamentals of in vivo gene expression imaging by PET, and the application of PET to gene therapy, as a technology that can be used in many different ways. It could be applied to avoid invasive procedures for gene therapy monitoring; accurately diagnose the pathology for better planning of the most adequate therapeutic approach; as treatment evaluation to image the functional effects of gene therapy at the biochemical level; as a quantitative noninvasive way to monitor the location, magnitude and persistence of gene expression over time; and would also help to a better understanding of vector biology and pharmacology devoted to the development of safer and more efficient vectors.

Integrative medicine in hematology/oncology: benefits, ethical considerations, and controversies.

PubMed

Rosenthal, David S; Dean-Clower, Elizabeth

2005-01-01

Integrative Medicine (IM), a newly emerging field, has evolved from Complementary and Alternative Medicine (CAM). CAM refers to diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine and generally have limited scientific evidence. In the US, CAM is a multi-billion dollar, unregulated industry with potential benefits and risks to consumers, including cancer patients, who are high utilizers of complementary therapies. Patients' CAM use often is unsupervised by physicians, yet patients need the advice and guidance of their hematologists/oncologists as part of total cancer care. Ethical and legal issues physicians need to address include inquiring about and educating patients regarding potential interactions (e.g., drug-herb, radiation-antioxidant) or product contaminants, while discussing other therapies that may alleviate symptoms and/or improve quality of life. Administratively, CAM offerings in medical settings require relevant policies and procedures, such as properly credentialing practitioners and providing financial assistance counseling for those who cannot afford fee-for-service. Unlike "Alternative Medicine," the goal of IM is to combine mainstream medical therapies and CAM therapies (e.g., acupuncture, meditation, music therapy) that have some high-quality scientific evidence of safety and effectiveness. The Society for Integrative Oncology (SIO), a new international organization of oncology professionals studying and integrating effective complementary therapies in cancer care, serves as a forum for presenting scientific data on these therapies while emphasizing the importance of developing infrastructure that promotes IM principles and practices. The ultimate goal is to develop multidisciplinary expertise and therapeutic synergy between conventional and complementary therapies.

Enhancing Cold Atmospheric Plasma Treatment Efficiency for Cancer Therapy

NASA Astrophysics Data System (ADS)

Cheng, Xiaoqian

To improve efficiency and safety of anti-cancer therapies the researchers and clinicians alike are prompted to develop targeted combined therapies that especially minimize damage to healthy tissues while eradicating the body of cancerous tissues. Previous research in cold atmospheric plasma (CAP) and cancer cell interaction has repeatedly proven that cold plasma induced cell death. In this study, we seek to integrate the medical application of CAP. We proposed and implemented 3 novel ideas to enhance efficacy and selectivity of cancer therapy. It is postulated that the reactive oxygen species (ROS) and reactive nitrogen species (RNS) play a major role in the CAP cancer therapy. We determined a mechanism of CAP therapy on glioblastoma cells (U87) through an understanding of the composition of CAP, including output voltage, treatment time, and gas flow-rate. We varied the characteristics of the cold plasma in order to obtain different major species (such as O, OH, N2+, and N2 lines). "plasma dosage" D ~ Q * V * t. is defined, where D is the entire "plasma dosage"; Q is the flow rate of feeding gas; V is output voltage; t is treatment time. The proper CAP dosage caused 3-fold cell death in the U87 cells compared to the normal human astrocytes E6/E7 cells. We demonstrated there is a synergy between AuNPS and CAP in cancer therapy. Specifically, the concentration of AuNPs plays an important role on plasma therapy. At an optimal concentration, gold nanoparticles can significantly induce U87 cell death up to a 30% overall increase compared to the control group with the same plasma dosage but no AuNPs applied. The ROS intensity of the corresponding conditions has a reversed trend compared to cell viability. This matches with the theory that intracellular ROS accumulation results in oxidative stress, which further changes the intracellular pathways, causing damage to the proteins, lipids and DNA. Our results show that this synergy has great potential in improving the efficiency of cancer therapy and reducing harm to normal cells. Finally, we propose a novel idea to combine static magnetic field (SMF) with CAP as a tool for cancer therapy. The breast cancer cells MDA-MB-231 showed a significant decrease in viability after direct plasma treatment with SMF (compared to only plasma treatment). In addition, cancer cells treated by the CAP-SMF-activated media (indirect treatment) also showed viability decrease but slightly weaker than the direct plasma-MF treatment. When treated by plasma with MF, mouse wild type dermal fibroblasts (WTDF) show no difference from the plasma treatment, both directly and indirectly. By integrating the use of MF and CAP, we are able to discover their advantages that are yet to be utilized. Although plasma can selectively kill cancer cells, long time exposure can still damage the normal cells around the tumor. This prompts researchers to seek for novel ideas in the designing of plasma treatment. This study provides the idea of combining the proper dosage of cold atmospheric plasma, AuNPs and MF in order to achieve the enhanced killing effect on cancer cells.

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

Kantor, H.G.

In 1978, 89 patients were treated for (S. pneumoniae) pneumonia at New York Hospital-Cornell Medical Center. Only 40 cases met rather strict diagnostic criteria. Of these, 12 demonstrated the classical consolidative (air space) pattern usually ascribed to this disease. A bronchopneumonic (patch) pattern was demonstrated in an equal number of patients; interstitial (irregular linear) infiltrates were manifest in nine cases and a mixed interstitial and patchy presentation shown in seven cases. Absence of the consolidative pattern does not exclude pneumococcal pneumonia. Bacteriologic investigation is required to determine the proper diagnosis and course of therapy.

Renal rickets-practical approach

PubMed Central

Sahay, Manisha; Sahay, Rakesh

2013-01-01

Rickets/osteomalacia is an important problem in a tropical country. Many cases are due to poor vitamin D intake or calcium deficient diets and can be corrected by administration of calcium and vitamin D. However, some cases are refractory to vitamin D therapy and are related to renal defects. These include rickets of renal tubular acidosis (RTA), hypophosphatemic rickets, and vitamin D dependent rickets (VDDR). The latter is due to impaired action of 1α-hydroxylase in renal tubule. These varieties need proper diagnosis and specific treatment. PMID:24251212

[Diabetes type 1 therapy individualization among children suffering from autism spectrum disorder].

PubMed

Kamińska, Halla; Jarosz-Chobot, Przemysława

2011-01-01

Over the last years studies suggest an association between type 1 diabetes (DM1) and autism spectrum disorder (ASD). In this case study two children suffering from DM 1 and ASD were presented. Both are treated in the Centrum Zdrowia Dziecka in Katowice, Poland. The authors highligh everyday problems and challenges that patients, tutors and doctors have to face. The key to effective treatment is its individualization connected with proper education of the patient and his caregivers.

Cryptosporidiosis: Environmental, therapeutic, and preventive challenges

PubMed Central

Collinet-Adler, Stefan; Ward, Honorine D.

2014-01-01

Cryptosporidium spp. are responsible for endemic and epidemic disease worldwide. Clinical manifestations may include acute, persistent, or chronic diarrhea, biliary, and pulmonary disease. Disease severity ranges from asymptomatic or mild to severe, intractable diarrhea with wasting depending on immune status, nutrition, and age. Transmission is fecal-oral with both human and animal reservoirs. Disease is often self limited in healthy individuals, but therapy remains a challenge in the immune-compromised. Prevention currently depends on appropriate hygiene and proper water management and treatment. PMID:20521158

Nanotechnology-Based Surface Plasmon Resonance Affinity Biosensors for In Vitro Diagnostics

PubMed Central

Antiochia, Riccarda; Bollella, Paolo; Favero, Gabriele

2016-01-01

In the last decades, in vitro diagnostic devices (IVDDs) became a very important tool in medicine for an early and correct diagnosis, a proper screening of targeted population, and also assessing the efficiency of a specific therapy. In this review, the most recent developments regarding different configurations of surface plasmon resonance affinity biosensors modified by using several nanostructured materials for in vitro diagnostics are critically discussed. Both assembly and performances of the IVDDs tested in biological samples are reported and compared. PMID:27594884

Predictive potential of IL-28B genetic testing for interferon based hepatitis C virus therapy in Pakistan: Current scenario and future perspective.

PubMed

Afzal, Muhammad Sohail

2016-09-18

In Pakistan which ranked second in terms of hepatitis C virus (HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy response prediction. Interleukin 28B (IL-28B) genetic testing is widely used throughout the world for interferon based therapy prediction for HCV patients and is quite helpful not only for health care workers but also for the patients. There is a strong relationship between single nucleotide polymorphisms at or near the IL-28B gene and the sustained virological response with pegylated interferon plus ribavirin treatment for chronic hepatitis C. Pakistan is a resource limited country, with very low per capita income and there is no proper social security (health insurance) system. The allocated health budget by the government is very low and is used on other health emergencies like polio virus and dengue virus infection. Therefore it is proposed that there should be a well established diagnostic test on the basis of IL-28B which can predict the antiviral therapy response to strengthen health care set-up of Pakistan. This test once established will help in better management of HCV infected patients.

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

Camingue, Pamela; Christian, Rochelle; Ng, Davin

The purpose of this study was to compare 4 different external beam radiation therapy treatment techniques for the treatment of T1-2, N0, M0 glottic cancers: traditional lateral beams with wedges (3D), 5-field intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and proton therapy. Treatment plans in each technique were created for 10 patients using consistent planning parameters. The photon treatment plans were optimized using Philips Pinnacle{sub 3} v.9 and the IMRT and VMAT plans used the Direct Machine Parameter Optimization algorithm. The proton treatment plans were optimized using Varian Eclipse Proton v.8.9. The prescription used for each plan wasmore » 63 Gy in 28 fractions. The contours for spinal cord, right carotid artery, left carotid artery, and normal tissue were created with respect to the patient's bony anatomy so that proper comparisons of doses could be made with respect to volume. An example of the different isodose distributions will be shown. The data collection for comparison purposes includes: clinical treatment volume coverage, dose to spinal cord, dose to carotid arteries, and dose to normal tissue. Data comparisons will be displayed graphically showing the maximum, mean, median, and ranges of doses.« less

Variable permanent mandibular first molar: Review of literature

PubMed Central

Ballullaya, Srinidhi V; Vemuri, Sayesh; Kumar, Pabbati Ravi

2013-01-01

Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals. PMID:23716959

Practical aspects of inhaler use in the management of chronic obstructive pulmonary disease in the primary care setting.

PubMed

Yawn, Barbara P; Colice, Gene L; Hodder, Rick

2012-01-01

Sustained bronchodilation using inhaled medications in moderate to severe chronic obstructive pulmonary disease (COPD) grades 2 and 3 (Global Initiative for Chronic Obstructive Lung Disease guidelines) has been shown to have clinical benefits on long-term symptom control and quality of life, with possible additional benefits on disease progression and longevity. Aggressive diagnosis and treatment of symptomatic COPD is an integral and pivotal part of COPD management, which usually begins with primary care physicians. The current standard of care involves the use of one or more inhaled bronchodilators, and depending on COPD severity and phenotype, inhaled corticosteroids. There is a wide range of inhaler devices available for delivery of inhaled medications, but suboptimal inhaler use is a common problem that can limit the clinical effectiveness of inhaled therapies in the real-world setting. Patients' comorbidities, other physical or mental limitations, and the level of inhaler technique instruction may limit proper inhaler use. This paper presents information that can overcome barriers to proper inhaler use, including issues in device selection, steps in correct technique for various inhaler devices, and suggestions for assessing and monitoring inhaler techniques. Ensuring proper inhaler technique can maximize drug effectiveness and aid clinical management at all grades of COPD.

Practical aspects of inhaler use in the management of chronic obstructive pulmonary disease in the primary care setting

PubMed Central

Yawn, Barbara P; Colice, Gene L; Hodder, Rick

2012-01-01

Sustained bronchodilation using inhaled medications in moderate to severe chronic obstructive pulmonary disease (COPD) grades 2 and 3 (Global Initiative for Chronic Obstructive Lung Disease guidelines) has been shown to have clinical benefits on long-term symptom control and quality of life, with possible additional benefits on disease progression and longevity. Aggressive diagnosis and treatment of symptomatic COPD is an integral and pivotal part of COPD management, which usually begins with primary care physicians. The current standard of care involves the use of one or more inhaled bronchodilators, and depending on COPD severity and phenotype, inhaled corticosteroids. There is a wide range of inhaler devices available for delivery of inhaled medications, but suboptimal inhaler use is a common problem that can limit the clinical effectiveness of inhaled therapies in the real-world setting. Patients’ comorbidities, other physical or mental limitations, and the level of inhaler technique instruction may limit proper inhaler use. This paper presents information that can overcome barriers to proper inhaler use, including issues in device selection, steps in correct technique for various inhaler devices, and suggestions for assessing and monitoring inhaler techniques. Ensuring proper inhaler technique can maximize drug effectiveness and aid clinical management at all grades of COPD. PMID:22888221

Evaluating holistic environmental consequences of brownfield management options using consequential life cycle assessment for different perspectives.

PubMed

Lesage, Pascal; Deschênes, Louise; Samson, Réjean

2007-08-01

Brownfields are abandoned, idled, or underused sites whose reuse necessitates some sort of intervention. These sites are largely urban and are frequently contaminated. Brownfield management options can be associated with three types of environmental consequences: those resulting from changes in the site's environmental quality (primary impacts); those resulting from the actual intervention stage (secondary impacts); and, if the vocation of the site changes, those resulting from effects on regional land use (tertiary impacts). Different stakeholders and decision-making contexts will place a different importance on each of these types of impacts. This article proposes a framework for comparing brownfield management options in regard to these three types of environmental impacts and for interpreting these results from different perspectives. The assessment framework is based on consequential life cycle assessment (LCA), which is shown to provide environmental information on the three types of impacts. The results for a case study are presented, where a "rehabilitation" option allowing residential redevelopment is compared to an "exposure minimization" option not resulting in the site being reused. Calculated primary and tertiary impacts are favorable to the rehabilitation option, whereas secondary impacts are favorable to the exposure minimization option. A ternary diagram presents the favorable option for different stereotypical perspectives. Tertiary impacts are much greater than secondary impacts, and consequently all perspectives that consider tertiary impacts favor rehabilitation. The perspective that considers primary and secondary impacts receives conflicting information. The ternary diagram, showing results for all perspectives, could possibly be useful for consensus-building among stakeholders.

Evaluating Holistic Environmental Consequences of Brownfield Management Options Using Consequential Life Cycle Assessment for Different Perspectives

NASA Astrophysics Data System (ADS)

Lesage, Pascal; Deschênes, Louise; Samson, Réjean

2007-08-01

Brownfields are abandoned, idled, or underused sites whose reuse necessitates some sort of intervention. These sites are largely urban and are frequently contaminated. Brownfield management options can be associated with three types of environmental consequences: those resulting from changes in the site’s environmental quality (primary impacts); those resulting from the actual intervention stage (secondary impacts); and, if the vocation of the site changes, those resulting from effects on regional land use (tertiary impacts). Different stakeholders and decision-making contexts will place a different importance on each of these types of impacts. This article proposes a framework for comparing brownfield management options in regard to these three types of environmental impacts and for interpreting these results from different perspectives. The assessment framework is based on consequential life cycle assessment (LCA), which is shown to provide environmental information on the three types of impacts. The results for a case study are presented, where a “rehabilitation” option allowing residential redevelopment is compared to an “exposure minimization” option not resulting in the site being reused. Calculated primary and tertiary impacts are favorable to the rehabilitation option, whereas secondary impacts are favorable to the exposure minimization option. A ternary diagram presents the favorable option for different stereotypical perspectives. Tertiary impacts are much greater than secondary impacts, and consequently all perspectives that consider tertiary impacts favor rehabilitation. The perspective that considers primary and secondary impacts receives conflicting information. The ternary diagram, showing results for all perspectives, could possibly be useful for consensus-building among stakeholders.

A Systems-Based Risk Assessment Framework for Intentional Electromagnetic Interference (IEMI) on Critical Infrastructures.

PubMed

Oakes, Benjamin Donald; Mattsson, Lars-Göran; Näsman, Per; Glazunov, Andrés Alayón

2018-06-01

Modern infrastructures are becoming increasingly dependent on electronic systems, leaving them more vulnerable to electrical surges or electromagnetic interference. Electromagnetic disturbances appear in nature, e.g., lightning and solar wind; however, they may also be generated by man-made technology to maliciously damage or disturb electronic equipment. This article presents a systematic risk assessment framework for identifying possible, consequential, and plausible intentional electromagnetic interference (IEMI) attacks on an arbitrary distribution network infrastructure. In the absence of available data on IEMI occurrences, we find that a systems-based risk assessment is more useful than a probabilistic approach. We therefore modify the often applied definition of risk, i.e., a set of triplets containing scenario, probability, and consequence, to a set of quadruplets: scenario, resource requirements, plausibility, and consequence. Probability is "replaced" by resource requirements and plausibility, where the former is the minimum amount and type of equipment necessary to successfully carry out an attack scenario and the latter is a subjective assessment of the extent of the existence of attackers who possess the motivation, knowledge, and resources necessary to carry out the scenario. We apply the concept of intrusion areas and classify electromagnetic source technology according to key attributes. Worst-case scenarios are identified for different quantities of attacker resources. The most plausible and consequential of these are deemed the most important scenarios and should provide useful decision support in a countermeasures effort. Finally, an example of the proposed risk assessment framework, based on notional data, is provided on a hypothetical water distribution network. © 2017 Society for Risk Analysis.

Understanding Recession and Self-Rated Health with the Partial Proportional Odds Model: An Analysis of 26 Countries.

PubMed

Mayer, Adam; Foster, Michelle

2015-01-01

Self-rated health is demonstrated to vary substantially by both personal socio-economic status and national economic conditions. However, studies investigating the combined influence of individual and country level economic indicators across several countries in the context of recent global recession are limited. This paper furthers our knowledge of the effect of recession on health at both the individual and national level. Using the Life in Transition II study, which provides data from 19,759 individuals across 26 European nations, we examine the relationship between self-rated health, personal economic experiences, and macro-economic change. Data analyses include, but are not limited to, the partial proportional odds model which permits the effect of predictors to vary across different levels of our dependent variable. Household experiences with recession, especially a loss of staple good consumption, are associated with lower self-rated health. Most individual-level experiences with recession, such as a job loss, have relatively small negative effects on perceived health; the effect of individual or household economic hardship is strongest in high income nations. Our findings also suggest that macroeconomic growth improves self-rated health in low-income nations but has no effect in high-income nations. Individuals with the greatest probability of "good" self-rated health reside in wealthy countries ($23,910 to $50, 870 GNI per capita). Both individual and national economic variables are predictive of self-rated health. Personal and household experiences are most consequential for self-rated health in high income nations, while macroeconomic growth is most consequential in low-income nations.

Transforming Parent-Child Interaction in Family Routines: Longitudinal Analysis with Families of Children with Developmental Disabilities.

PubMed

Lucyshyn, Joseph M; Fossett, Brenda; Bakeman, Roger; Cheremshynski, Christy; Miller, Lynn; Lohrmann, Sharon; Binnendyk, Lauren; Khan, Sophia; Chinn, Stephen; Kwon, Samantha; Irvin, Larry K

2015-12-01

The efficacy and consequential validity of an ecological approach to behavioral intervention with families of children with developmental disabilities was examined. The approach aimed to transform coercive into constructive parent-child interaction in family routines. Ten families participated, including 10 mothers and fathers and 10 children 3-8 years old with developmental disabilities. Thirty-six family routines were selected (2 to 4 per family). Dependent measures included child problem behavior, routine steps completed, and coercive and constructive parent-child interaction. For each family, a single case, multiple baseline design was employed with three phases: baseline, intervention, and follow-up. Visual analysis evaluated the functional relation between intervention and improvements in child behavior and routine participation. Nonparametric tests across families evaluated the statistical significance of these improvements. Sequential analyses within families and univariate analyses across families examined changes from baseline to intervention in the percentage and odds ratio of coercive and constructive parent-child interaction. Multiple baseline results documented functional or basic effects for 8 of 10 families. Nonparametric tests showed these changes to be significant. Follow-up showed durability at 11 to 24 months postintervention. Sequential analyses documented the transformation of coercive into constructive processes for 9 of 10 families. Univariate analyses across families showed significant improvements in 2- and 4-step coercive and constructive processes but not in odds ratio. Results offer evidence of the efficacy of the approach and consequential validity of the ecological unit of analysis, parent-child interaction in family routines. Future studies should improve efficiency, and outcomes for families experiencing family systems challenges.

Impacts of enhanced fertilizer applications on tropospheric ozone and crop damage over sub-Saharan Africa

NASA Astrophysics Data System (ADS)

Huang, Yaoxian; Hickman, Jonathan E.; Wu, Shiliang

2018-05-01

Fertilizer-induced nitrogen oxides (NOx) emissions in sub-Saharan Africa are expected to increase substantially in the coming decades, driven by increasing application of fertilizers to increase crop yields in an effort to attain food security across the continent. In many parts of sub-Saharan Africa, surface ozone (O3) is sensitive to increasing atmospheric concentrations of NOx. In this study, we employ the GEOS-Chem chemical transport model to conduct a preliminary investigation of the impacts on O3 air quality and the consequential crop damage associated with increasing fertilizer-induced NOx emissions in sub-Saharan Africa. Our simulation results, constrained by field NO flux measurements for the years 2011 and 2012 in response to a variety of fertilizer application rates in western Kenya, show that the enhancements in NO flux with fertilizer application rate of 150 kg N ha-1 can increase surface NOx and O3 concentrations by up to 0.36 and 2.8 ppbv respectively during the growing season. At the same time, accumulated O3 exposure during the crop growing season (expressed as AOT40 values) could increase by up to 496 ppb h, leading to crop yield decline of about 0.8% for O3-sensitive crops. Our results suggest that, when accounting for the consequential impacts on surface O3 air quality and crop damage over sub-Saharan Africa, agricultural intensification is possible without substantial impacts on crop productivity because the relatively small decline of crop yield resulting from O3 damage appears unlikely to outweigh the gain in crop yield from fertilization.

Proper muscle layer damage affects ulcer healing after gastric endoscopic submucosal dissection.

PubMed

Horikawa, Yohei; Mimori, Nobuya; Mizutamari, Hiroya; Kato, Yuhei; Shimazu, Kazuhiro; Sawaguchi, Masayuki; Tawaraya, Shin; Igarashi, Kimihiro; Okubo, Syunji

2015-11-01

Endoscopic submucosal dissection (ESD) is the established therapy for superficial gastrointestinal neoplasms. However, management of the artificial ulcers associated with ESD has become important and the relationship between ulcer healing factors and treatment is still unclear. We aimed to evaluate ESD-related artificial ulcer reduction ratio at 4 weeks to assess factors associating with ulcer healing after ESD that may lead to optimal treatment. Between January 2009 and December 2013, a total of 375 lesions fulfilled the expanded criteria for ESD. We defined ulcer reduction rate <90% as (A) poor-healing group; and rate ≥90% as (B) well-healing group. After exclusion, 328 lesions were divided into two groups and analyzed. These two groups were compared based on clinicopathological/endoscopic features, concomitant drugs, and treatment. Ulcer reduction rate was significantly correlated with factors related to the ESD procedure (i.e. procedure time, submucosal fibrosis, and injury of the proper muscle layer, in univariate analysis. Multivariate logistic regression analysis showed that submucosal fibrosis (F2) (P = 0.03; OR, 16.46; 95% CI, 1.31-206.73) and injury of the proper muscle layer (P = 0.01; OR, 4.27; 95% CI, 2.04-8.92) were statistically significant predictors of delayed healing. This single-center retrospective study indicated that ESD-induced artificial ulcer healing was affected by submucosal fibrosis and injury of the proper muscle layer, which induced damage to the muscle layer. Therefore, the preferable pharmacotherapy can be determined on completion of the ESD procedure. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

Efficacy, safety and proper dose analysis of PEGylated granulocyte colony-stimulating factor as support for dose-dense adjuvant chemotherapy in node positive Chinese breast cancer patients.

PubMed

Zhang, Fan; LingHu, RuiXia; Zhan, XingYang; Li, Ruisheng; Feng, Fan; Gao, Xudong; Zhao, Lei; Yang, Junlan

2017-10-03

For high-risk breast cancer patients with positive axillary lymph nodes, dose-dense every-two-week epirubicin/cyclophosphamide-paclitaxel (ddEC-P) regimen is the optimal postoperative adjuvant therapy. However, this regimen is limited by the grade 3/4 neutropenia and febrile neutropenia (FN). There is an urgent need to explore the efficacy, safety and proper dosage of PEGylated granulocyte colony-stimulating factor (PEG-G-CSF) as support for ddEC-P in Chinese breast cancer patients with positive axillary lymph nodes. Prospectively, 40 women with stage IIIA to IIIC breast cancer received ddEC-P ± trastuzumab as adjuvant treatment. PEG-G-CSF was injected subcutaneously in a dose of 6 mg or 3 mg on the 2 th day of each treatment cycle. With administration of PEG-G-CSF, all of the 40 patients completed 8 cycles of ddEC-P ± trastuzumab regimen without dose reductions or treatment delays. Moreover, no FN cases were observed. Further analysis showed that the proper dosage of PEG-G-CSF was 6 mg for ddEC treatment, and 3 mg for ddP treatment. PEG-G-CSF exhibits advantages compared with G-CSF in convenient of administration and tolerance for high risk Chinese breast cancer patients. More importantly, the proper dose of PEG-G-CSF for high risk Chinese breast cancer patients during ddEC-P chemotherapy may be 6 mg for ddEC treatment and 3 mg for ddP treatment.

Fully functional hair follicle regeneration through the rearrangement of stem cells and their niches

PubMed Central

Toyoshima, Koh-ei; Asakawa, Kyosuke; Ishibashi, Naoko; Toki, Hiroshi; Ogawa, Miho; Hasegawa, Tomoko; Irié, Tarou; Tachikawa, Tetsuhiko; Sato, Akio; Takeda, Akira; Tsuji, Takashi

2012-01-01

Organ replacement regenerative therapy is purported to enable the replacement of organs damaged by disease, injury or aging in the foreseeable future. Here we demonstrate fully functional hair organ regeneration via the intracutaneous transplantation of a bioengineered pelage and vibrissa follicle germ. The pelage and vibrissae are reconstituted with embryonic skin-derived cells and adult vibrissa stem cell region-derived cells, respectively. The bioengineered hair follicle develops the correct structures and forms proper connections with surrounding host tissues such as the epidermis, arrector pili muscle and nerve fibres. The bioengineered follicles also show restored hair cycles and piloerection through the rearrangement of follicular stem cells and their niches. This study thus reveals the potential applications of adult tissue-derived follicular stem cells as a bioengineered organ replacement therapy. PMID:22510689

Pathophysiological Mechanisms of Chronic Venous Disease and Implications for Venoactive Drug Therapy.

PubMed

Mansilha, Armando; Sousa, Joel

2018-06-05

Chronic venous disease (CVD) is a common pathology, with significant physical and psychological impacts for patients and high economic costs for national healthcare systems. Throughout the last decades, several risk factors for this condition have been identified, but only recently, have the roles of inflammation and endothelial dysfunction been properly assessed. Although still incompletely understood, current knowledge of the pathophysiological mechanisms of CVD reveals several potential targets and strategies for therapeutic intervention, some of which are addressable by currently available venoactive drugs. The roles of these drugs in the clinical improvement of venous tone and contractility, reduction of edema and inflammation, as well as in improved microcirculation and venous ulcer healing have been studied extensively, with favorable results reported in the literature. Here, we aim to review these pathophysiological mechanisms and their implications regarding currently available venoactive drug therapies.

Mechanical and dynamic aspects of voice production as related to voice therapy and phonosurgery.

PubMed

Isshiki, N

2000-06-01

Laryngeal framework surgery can change the position and tension of the vocal folds safely without direct surgical intervention in the vocal fold proper. Some 23 years of experience with phonosurgery have proved its usefulness in treating dysphonia related to unilateral vocal fold paralysis, vocal fold atrophy, and pitch-related dysphonias. Meanwhile, much information about the mechanism of voice production has been obtained through intraoperative findings of voice and fiberscopic examination of the larynx. Based on such knowledge together with information obtained through model experiments, the human vocal organ was reconsidered mainly from the mechanical view point, and the roles of voice therapy and singing pedagogy were discussed in relation to phonosurgery. The vocal organ may not be an ideal musical organ and is rather vulnerable, but its potential is enormous.

Mechanical and dynamic aspects of voice production as related to voice therapy and phonosurgery.

PubMed

Isshiki, N

1998-06-01

Laryngeal framework surgery can change the position and tension of the vocal folds safely without direct surgical intervention in the vocal fold proper. Some 23 years of experience with phonosurgery have proved its usefulness in treating dysphonia related to unilateral vocal fold paralysis, vocal fold atrophy, and pitch-related dysphonias . Meanwhile, much information about the mechanism of voice production has been obtained through intraoperative findings of voice and fiberscopic examination of the larynx . Based on such knowledge together with information obtained through model experiments, the human vocal organ was reconsidered mainly from the mechanical view point, and the roles of voice therapy and singing pedagogy were discussed in relation to phonosurgery. The vocal organ may not be an ideal musical organ and is rather vulnerable, but its potential is enormous.

Analysis of dental supportive structures in orthodontic therapy.

PubMed

Pavicin, Ivana Savić; Ivosević-Magdalenić, Natasa; Badel, Tomislav; Basić, Kresimir; Keros, Jadranka

2012-09-01

The purpose was to define the impact of orthodontic appliances on the density of the underlying dental bone tissue. Radiographic images of teeth were made in 27 study subjects before and twelve months after fixed orthodontic appliances were carried. The radiographs were digitalized and the levels of gray at sites where the greatest bone resorption was expected were transformed into optic density. In the standardization and comparison of values from the first and the second measurements the copper calibration wedge--a stepwedge--was used. Optic densities in the observed sites were compared with optic densities of the calibration wedge and expressed as their thickness equivalent. The study results showed no statistically significant difference in bone densities, indicating that the orthodontic therapy was properly planned and carried out and that excessive forces were not used in the applied correctional procedures.

Random laser in biological tissues impregnated with a fluorescent anticancer drug

NASA Astrophysics Data System (ADS)

Lahoz, F.; Martín, I. R.; Urgellés, M.; Marrero-Alonso, J.; Marín, R.; Saavedra, C. J.; Boto, A.; Díaz, M.

2015-04-01

We have demonstrated that chemically modified anticancer drugs can provide random laser (RL) when infiltrated in a biological tissue. A fluorescent biomarker has been covalently bound to tamoxifen, which is one of the most frequently used drugs for breast cancer therapy. The light emitted by the drug-dye composite is scattered in tissue, which acts as a gain medium. Both non-coherent and coherent RL regimes have been observed. Moreover, the analysis of power Fourier transforms of coherent RL spectra indicates that the tissues show a dominant random laser cavity length of about 18 µm, similar to the average size of single cells. These results show that RL could be obtained from other drugs, if properly marked with a fluorescent tag, which could be appealing for new forms of combined opto-chemical therapies.

Radiation exposure after 177Lu-DOTATATE and 177Lu-PSMA-617 therapy.

PubMed

Mair, Christian; Warwitz, Boris; Fink, Katharina; Scarpa, Lorenza; Nilica, Bernhard; Maffey-Steffan, Johanna; Buxbaum, Sabine; Virgolini, Irene J

2018-05-23

As radionuclide therapy is gaining importance in palliative treatment of patients suffering from neuroendocrine tumour (NET) as well as castration resistant prostate cancer (CRPC), the radiation protection of patients, staff, family members and the general public is of increasing interest. Here, we determine patient discharge dates according to European guidelines. In 40 patients with NET and 25 patients with CRPC organ and tumour doses based on the MIRD concept were calculated from data obtained during the first therapy cycle. Planar whole body images were recorded at 0.5, 4, 20, 68 und 92 h postinjection. Residence times were calculated from the respective time-activity-curves based on the conjugated view method. Residence times for critical organs were fitted into the commercially available OLINDA software to calculate the organ doses. The doses of tumours and salivary glands were calculated via their self-irradiation by approximation with spheres of equivalent volume. Kidney volumes were gained by organ segmentation, volumes of all other organs were estimated by means of OLINDA and hence were lean body mass corrected. Out of the whole body curves reference points for patient discharge were estimated. In patients with NET discharge dates could be properly estimated from dosimetric data, which is not only crucial for radiation protection, but also makes therapy planning easier. For 177 Lu-PSMA-617 ligand therapy it is difficult to seriously estimate a generalized discharge date due to large interpatient variation resulting from different tumor loads and heavy pre-treatment. Patient release is predictable for 177 Lu-DOTATATE therapy but not for 177 Lu-PSMA ligand therapy.

Nanobiotechnology can boost crop production and quality: first evidence from increased plant biomass, fruit yield and phytomedicine content in bitter melon (Momordica charantia).

PubMed

Kole, Chittaranjan; Kole, Phullara; Randunu, K Manoj; Choudhary, Poonam; Podila, Ramakrishna; Ke, Pu Chun; Rao, Apparao M; Marcus, Richard K

2013-04-26

Recent research on nanoparticles in a number of crops has evidenced for enhanced germination and seedling growth, physiological activities including photosynthetic activity and nitrogen metabolism, mRNA expression and protein level, and also positive changes in gene expression indicating their potential use in crop improvement. We used a medicinally rich vegetable crop, bitter melon, as a model to evaluate the effects of seed treatment with a carbon-based nanoparticle, fullerol [C60(OH)20], on yield of plant biomass and fruit characters, and phytomedicine contents in fruits. We confirmed the uptake, translocation and accumulation of fullerol through bright field imaging and Fourier transform infra-red spectroscopy. We observed varied effects of seed treatment at five concentrations, including non-consequential and positive, on plant biomass yield, fruit yield and its component characters, and content of five phytomedicines in fruits. Fullerol-treatment resulted in increases up to 54% in biomass yield and 24% in water content. Increases of up to 20% in fruit length, 59% in fruit number, and 70% in fruit weight led to an improvement up to 128% in fruit yield. Contents of two anticancer phytomedicines, cucurbitacin-B and lycopene, were enhanced up to 74% and 82%, respectively, and contents of two antidiabetic phytomedicines, charantin and insulin, were augmented up to 20% and 91%, respectively. Non-significant correlation inter se plant biomass, fruit yield, phytomedicine content and water content evidenced for separate genetic control and biosynthetic pathways for production of plant biomass, fruits, and phytomedicines in fruits, and also no impact of increased water uptake. While our results indicated possibility of improving crop yield and quality by using proper concentrations of fullerol, extreme caution needs to be exercised given emerging knowledge about accumulation and toxicity of nanoparticles in bodily tissues.

Nanobiotechnology can boost crop production and quality: first evidence from increased plant biomass, fruit yield and phytomedicine content in bitter melon (Momordica charantia)

PubMed Central

2013-01-01

Background Recent research on nanoparticles in a number of crops has evidenced for enhanced germination and seedling growth, physiological activities including photosynthetic activity and nitrogen metabolism, mRNA expression and protein level, and also positive changes in gene expression indicating their potential use in crop improvement. We used a medicinally rich vegetable crop, bitter melon, as a model to evaluate the effects of seed treatment with a carbon-based nanoparticle, fullerol [C60(OH)20], on yield of plant biomass and fruit characters, and phytomedicine contents in fruits. Results We confirmed the uptake, translocation and accumulation of fullerol through bright field imaging and Fourier transform infra-red spectroscopy. We observed varied effects of seed treatment at five concentrations, including non-consequential and positive, on plant biomass yield, fruit yield and its component characters, and content of five phytomedicines in fruits. Fullerol-treatment resulted in increases up to 54% in biomass yield and 24% in water content. Increases of up to 20% in fruit length, 59% in fruit number, and 70% in fruit weight led to an improvement up to 128% in fruit yield. Contents of two anticancer phytomedicines, cucurbitacin-B and lycopene, were enhanced up to 74% and 82%, respectively, and contents of two antidiabetic phytomedicines, charantin and insulin, were augmented up to 20% and 91%, respectively. Non-significant correlation inter se plant biomass, fruit yield, phytomedicine content and water content evidenced for separate genetic control and biosynthetic pathways for production of plant biomass, fruits, and phytomedicines in fruits, and also no impact of increased water uptake. Conclusions While our results indicated possibility of improving crop yield and quality by using proper concentrations of fullerol, extreme caution needs to be exercised given emerging knowledge about accumulation and toxicity of nanoparticles in bodily tissues. PMID:23622112

Personalized Drug Therapy in Cystic Fibrosis: From Fiction to Reality.

PubMed

de Lima Marson, Fernando Augusto; Bertuzzo, Carmen Silvia; Ribeiro, Jose Dirceu

2015-01-01

Personalized drug therapy for cystic fibrosis (CF) is a long-term dream for CF patients, caregivers, physicians and researchers. After years of study, the fiction of personalized treatment has turned to hope. Basic information about CFTR mutations classes and new treatments is needed if we are to deal properly with the new CF era. The problems involved in this issue, however, should be evaluated with greater care and attention. VX-770 is a new drug available to treat CF patients with some class III CFTR mutations and other drugs are being studied regarding other classes. The scientific literature has constantly given information about each therapy, both in vitro and in vivo. The hope is increasing. Nevertheless the "scientific world" still lacks information about patients' reality and daily health related practical needs. Clinical trials have showed good evaluation of some drugs so far, but clinical response is a wide spectrum yet to be analyzed: CFTR mutations spectrum, costs related to the treatment with new drugs (for VX-770 therapy), variability of CF clinical expression, limitations to test in vitro drugs, absence of good clinical markers to evaluate drug response, absence of long-term studies and with patients below six years old, multidrug treatment used to improve the expression response, and finally, the most important problem, who will benefit from the new drugs therapy, are issues that constitute a barrier that should be overcome. Personalized drug therapy may not be a fiction anymore, but it is not yet a reality for all CF patients.

Access to artemisinin-based combination therapies and other anti-malarial drugs in Kinshasa.

PubMed

Nkoli Mandoko, P; Sinou, V; Moke Mbongi, D; Ngoyi Mumba, D; Kahunu Mesia, G; Losimba Likwela, J; Bi Shamamba Karhemere, S; Muepu Tshilolo, L; Tamfum Muyembe, J-J; Parzy, D

2018-06-01

Artemisinin-based combination therapies have been available since 2005 in the Democratic Republic of the Congo to treat malaria and to overcome the challenge of anti-malarial drug resistance as well as to improve access to effective treatments. The private sector is the primary distribution source for anti-malarial drugs and thus, has a key position among the supply chain actors for a rational and proper use of anti-malarial drugs. We aimed to assess access to nationally recommended anti-malarial drugs in private sector pharmacies of the capital-city of Kinshasa. We performed a cross-sectional survey of 404 pharmacies. Anti-malarial drugs were stocked in all surveyed pharmacies. Non-artemisinin-based anti-malarial therapies such as quinine or sulfadoxine-pyrimethamine, were the most frequently stocked drugs (93.8% of pharmacies). Artemisinin-based combination therapies were stocked in 88% of pharmacies. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies), but less than 3% were quality-assured products. Other non-officially recommended artemisinin-based therapies including oral monotherapies were widely available. Artemisinin-based combination therapies were widely available in the private pharmacies of Kinshasa. However, the private sector does not guarantee the use of nationally recommended anti-malarial drugs nor does it give priority to quality-assured anti-malarial drugs. These practices contribute to the risk of emergence and spread of resistance to anti-malarial drugs and to increasing treatment costs. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Lithium Clinics in Berlin and Dresden: a 50-Year Experience.

PubMed

Felber, Werner; Bauer, Michael; Lewitzka, Ute; Müller-Oerlinghausen, Bruno

2018-06-14

Although lithium's serendipitous discovery as a medication for depression dates back more than 200 years, the first scientific evidence that it prevents mania and depression arose only in the 1960s. However, at that time there was a lack of knowledge about how to administer and monitor lithium therapy safely and properly. The lithium clinics in Dresden and Berlin were remarkably similar in their beginnings in the late 1960s regarding patient numbers and scientific expertise without being aware of one another due to the Iron Curtain separating Germany into a western and eastern part until 1990. In what were initially lithium-care programs run independently from one another, the lithium clinics embedded in academic settings in Dresden and Berlin represent a milestone in the history of psychopharmacological treatment of affective disorders in Germany and trailblazers for today's lithium therapy. Nowadays, lithium's clinical applications are unquestioned, such as its use in strategies to prevent mood episodes and suicide, and to treat depression. The extensively documented knowledge of lithium treatment is the fruit of more than 50 years of observing disease courses and of studying side effects and influencing factors of lithium prophylaxis. Its safe and proper administration-in determining the correct indication, baseline and follow-up examinations, recommended dosages, monitoring, or the management of side effects-is well established. Subsequently, both national and international guidelines continue recommending lithium as the gold standard in treating patients with unipolar and bipolar disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Chronic pelvic pain syndrome and semen quality of Korean men in their fourth decade.

PubMed

Byun, Jae Sang; Yoon, Tae Ki; Rhee, Hong Woo; Kim, Jin Hong; Shin, Jun Shik; Kim, Hong Seok; Bak, Chong Won

2012-01-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition that adversely affects men across a wide range of ages. A number of pharmacologic and nonpharmacologic therapies for CP/CPPS have been investigated. Our study aimed to evaluate the prevalence of CPPS in Korean men in their thirties and to investigate the effect of CPPS and medical treatment on semen quality. Of 314 men with prostatitis, 74 patients with CPPS class IIIA (23.6%) were eligible for the study; these patients underwent combined α-blocker and cyclo-oxygenase 2 inhibitor therapy. These 74 men were prospectively studied at a medical center in Seoul, Korea. A number of parameters, including ejaculations per month, semen variables, and the levels of hormones (such as follicle-stimulating hormone, estradiol [E(2)], luteinizing hormone [LH], testosterone, and prolactin) were evaluated. The mean number of ejaculations per month, the mean number of daily hours spent sitting at work, smoking, body mass index, LH and E(2) levels, and semen parameters all showed significant differences (P < .0001) between the study patients and the controls. The combined regimen was effective in improving all aspects of semen quality except morphology (P < .05). CPPS class IIIA, which is notably prevalent among Korean men in the fourth decade of life, affects semen quality and poses a challenge to fertility. Proper treatment of CPPS class IIIA results in improved semen quality. Men with CPPS therefore require proper evaluation and treatment by andrologists/urologists before planning a natural conception.

Current status of gastroesophageal reflux disease : diagnosis and treatment.

PubMed

Chuang, Tang-Wei; Chen, Shou-Chien; Chen, Kow-Tong

2017-01-01

The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the contemporary approaches to GERD. GERD has a variety of symptomatic manifestations, which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of other alarming symptoms, these symptoms allow one to make a presumptive diagnosis of GERD and initiate empiric therapy. GERD-associated complications include erosive esophagitis, peptic stricture, Barrett's esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modifications, medical and surgical therapy. Medical therapy involves acid suppression, which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The management of this disease requires a complex approach. Maintenance therapy of GERD after using anti-secretory drugs should be continuously monitored. © Acta Gastro-Enterologica Belgica.

Legionella Pneumophila and Dendrimers-Mediated Antisense Therapy.

PubMed

Pashaei-Asl, Roghiyeh; Khodadadi, Khodadad; Pashaei-Asl, Fatima; Haqshenas, Gholamreza; Ahmadian, Nasser; Pashaiasl, Maryam; Hajihosseini Baghdadabadi, Reza

2017-06-01

Finding novel and effective antibiotics for treatment of Legionella disease is a challenging field. Treatment with antibiotics usually cures Legionella infection; however, if the resultant disease is not timely recognized and treated properly, it leads to poor prognosis and high case fatality rate. Legionella pneumophila DrrA protein (Defects in Rab1 recruitment protein A)/also known as SidM affects host cell vesicular trafficking through modification of the activity of cellular small guanosine triphosphatase )GTPase( Rab (Ras-related in brain) function which facilitates intracellular bacterial replication within a supporter vacuole. Also, Legionella pneumophila LepA and LepB (Legionella effector protein A and B) proteins suppress host-cell Rab1 protein's function resulting in the cell lysis and release of bacteria that subsequently infect neighbour cells. Legionella readily develops resistant to antibiotics and, therefore, new drugs with different modes of action and therapeutic strategic approaches are urgently required among antimicrobial drug therapies;gene therapy is a novel approach for Legionnaires disease treatment. On the contrary to the conventional treatment approaches that target bacterial proteins, new treatment interventions target DNA (Deoxyribonucleic acid), RNA (Ribonucleic acid) species, and different protein families or macromolecular complexes of these components. The above approaches can overcome the problems in therapy of Legionella infections caused by antibiotics resistance pathogens. Targeting Legionella genes involved in manipulating cellular vesicular trafficking using a dendrimer-mediated antisense therapy is a promising approach to inhibit bacterial replication within the target cells.

Impact of educational programme regarding chelation therapy on the quality of life for B-thalassemia major children.

PubMed

Abu Samra, Omayma; Auda, Wafaa; Kamhawy, Heba; Al-Tonbary, Youssef

2015-06-01

Objectives Thalassemia is the most common genetic disorder in Egypt, with an estimated carrier rate of 9-10%. It is a genetic blood disorder which can be fatal if proper chelation is not received. The introduction of chelating agents capable of removing excessive iron from the body has dramatically increased life expectancy and improved the overall quality of life. The aim of this study was to assess the impact of educational programmes regarding chelation therapy on the quality of life of thalassemic children. Methods The study was carried out at the Mansoura University Children's Hospital in the period between March 2010 and May 2011. It included 173 B-thalassemia children (84 boys and 89 girls) with age ranging between 8-18 years. The researcher used a predesigned interviewing questionnaire to collect data regarding children's knowledge about thalassemia and its management, especially regarding chelation therapy. The paediatric quality-of-life inventory tool (Peds QL 4.0 generic core) was also used to assess the studied children's quality of life. Results There was a significant statistical difference of the studied children's knowledge regarding chelation therapy and their quality of life. Conclusion There was a positive effect of the educational programme in improving children's knowledge score and their quality of life. Application of educational programmes for thalassemic children and their nurses regarding chelation therapy and its importance in preventing thalassemia complications is established.

Trends of breast cancer treatment in Sabah, Malaysia: a problem with lack of awareness.

PubMed

Leong, B D K; Chuah, J A; Kumar, V M; Rohamini, S; Siti, Z S; Yip, C H

2009-08-01

Sabah, formerly known as North Borneo, is part of East Malaysia. 52.2 percent of patients with breast cancer in Sabah presented at advanced stages and up to 20.4 percent of patients defaulted proper treatment, opting for traditional therapy. We performed a two-year prospective study looking at the treatment trends of breast cancer in Sabah. Our subjects were all newly-diagnosed breast cancer cases seen at the hospital in 2005 and 2006. Type of surgery, chemotherapy, radiotherapy, hormonal therapy and surgical complication for each patient were studied. Out of 186 newly-diagnosed cases, 152 (81.7 percent) had surgery, 126 (67.7 percent) had chemotherapy, 118 (63.4 percent) had radiotherapy and 92 (49.5 percent) had hormonal therapy. 18.3 percent did not have surgery either due to refusal of treatment or advanced disease. They were more likely to be non-Chinese (91.1 percent, p-value is 0.02). Only 15.8 percent had breast-conserving surgery. The most frequent surgical complication was seroma formation (15.0 percent) . The commonest chemotherapy regime and hormonal therapy were anthracycline-based regime (88.1 percent) and tamoxifen (95.8 percent), respectively. The proportion of breast-conserving surgery and usage of modern adjuvant therapies are low in Sabah. This can be attributed to lack of breast cancer awareness leading to late presentation and refusal of treatment, coupled with insufficient health service funding.

Electron anions and the glass transition temperature.

PubMed

Johnson, Lewis E; Sushko, Peter V; Tomota, Yudai; Hosono, Hideo

2016-09-06

Properties of glasses are typically controlled by judicious selection of the glass-forming and glass-modifying constituents. Through an experimental and computational study of the crystalline, molten, and amorphous [Ca12Al14O32](2+) ⋅ (e(-))2, we demonstrate that electron anions in this system behave as glass modifiers that strongly affect solidification dynamics, the glass transition temperature, and spectroscopic properties of the resultant amorphous material. The concentration of such electron anions is a consequential control parameter: It invokes materials evolution pathways and properties not available in conventional glasses, which opens a unique avenue in rational materials design.

Virtue ethics - an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics.

PubMed

Misselbrook, David

2015-02-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.

Close up detail of the underside of the Orbiter Discovery ...

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

Close up detail of the underside of the Orbiter Discovery in the Vehicle Assembly Building at NASA's Kennedy Space Center. This view is from underneath the aft section looking forward. It is a close-up view of the High-temperature Reusable Surface Insulation tiles showing the wear patterns from the heat of reentry, consequential replacement of worn and damaged tiles. The wear and replacement patters are unique to each Orbiter which can serve as their particular "fingerprint". - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

The theoretical tenability of the doctrine of double effect.

PubMed

Bole, T J

1991-10-01

The doctrine of double effect shows that for which the moral agent is responsible, by explicating the relationship between the act directly intended and the consequences of that act. I contend that this doctrine is necessary not only for natural law absolutism, but also for Donagan's Kantianism and for Quinn's revised construal of the doctrine, and even for consequentialism, as bioethical implications of the doctrine make clear. For those who do not accept this necessity, I contend that it is necessary metatheoretically, in order to deal with those moral agents with irreconcilably different notions of the morally good.

Matrimonial Causes Amendment Act, 1987 (No. 11 of 1987).

PubMed

1987-01-01

This Act amends the Matrimonial Causes Act, 1985, a) to extend the grounds for divorce applicable to civil marriages to marriages solemnized in terms of the African Marriages Act; and b) to widen the powers of the court to make a division of assets on divorce by authorizing it to make consequential and supplemental provisions necessary to give full effect to any order it makes and to make an order relating to the property of one or another spouse that is held by another person and thereby order that person to transfer the property as the court directs. full text

Cognitive Impairment and Dementia in Patients with Parkinson Disease

PubMed Central

Leverenz, James B.; Quinn, Joseph F.; Zabetian, Cyrus; Zhang, Jing; Montine, Kathleen S.; Montine, Thomas J.

2009-01-01

Parkinson disease (PD) is an already prevalent neurodegenerative disease that is poised to at least double over the next 25 years. Although best known for its characteristic movement disorder, PD is now appreciated commonly to cause cognitive impairment, including dementia, and behavioral changes. Dementia in patients with PD is consequential and has been associated with reduced quality of life, shortened survival, and increased caregiver distress. Here we review clinical presentation and progression, pathological bases, identification of genetic risk factors, development of small molecule biomarkers, and emerging treatments for cognitive impairment in patients with PD. PMID:19754405

Virtue ethics – an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics

PubMed Central

2015-01-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. PMID:25721113

Guest-Release Control in Enzyme-Sensitive, Amphiphilic-Dendrimer-Based Nanoparticles through Photochemical Crosslinking

PubMed Central

Raghupathi, Krishna R.; Azagarsamy, Malar A.; Thayumanavan, S.

2012-01-01

Stimuli sensitive, facially amphiphilic dendrimers have been synthesized and their enzyme-responsive nature has been determined with dual fluorescence responses of both covalently conjugated and non-covalently bound reporter units. These dual responses are correlated to ascertain the effect of enzymatic action on micellar aggregates and the consequential guest release. The release of the guest molecule is conveniently tuned by stabilizing the micellar aggregates through photochemical crosslinking of hydrophobic coumarin units. This photo-crosslinking is also utilized as a tool to investigate the mode of enzyme-substrate interaction in the context of aggregate-monomer equilibrium. PMID:21887830

Light-weight DC to very high voltage DC converter

DOEpatents

Druce, Robert L.; Kirbie, Hugh C.; Newton, Mark A.

1998-01-01

A DC-DC converter capable of generating outputs of 100 KV without a transformer comprises a silicon opening switch (SOS) diode connected to allow a charging current from a capacitor to flow into an inductor. When a specified amount of charge has flowed through the SOS diode, it opens up abruptly; and the consequential collapsing field of the inductor causes a voltage and current reversal that is steered into a load capacitor by an output diode. A switch across the series combination of the capacitor, inductor, and SOS diode closes to periodically reset the SOS diode by inducing a forward-biased current.

Modified Beer-Lambert law for blood flow

PubMed Central

Baker, Wesley B.; Parthasarathy, Ashwin B.; Busch, David R.; Mesquita, Rickson C.; Greenberg, Joel H.; Yodh, A. G.

2014-01-01

We develop and validate a Modified Beer-Lambert law for blood flow based on diffuse correlation spectroscopy (DCS) measurements. The new formulation enables blood flow monitoring from temporal intensity autocorrelation function data taken at single or multiple delay-times. Consequentially, the speed of the optical blood flow measurement can be substantially increased. The scheme facilitates blood flow monitoring of highly scattering tissues in geometries wherein light propagation is diffusive or non-diffusive, and it is particularly well-suited for utilization with pressure measurement paradigms that employ differential flow signals to reduce contributions of superficial tissues. PMID:25426330

Electron anions and the glass transition temperature

DOE PAGES

Johnson, Lewis E.; Sushko, Peter V.; Tomota, Yudai; ...

2016-08-24

Properties of glasses are typically controlled by judicious selection of the glass-forming and glass-modifying constituents. Through an experimental and computational study of the crystalline, molten, and amorphous [Ca 12Al 14O 32] 2+ ∙ (e –) 2, we demonstrate that electron anions in this system behave as glass-modifiers that strongly affect solidification dynamics, the glass transition temperature, and spectroscopic properties of the resultant amorphous material. Concentration of such electron anions is a consequential control parameter: it invokes materials evolution pathways and properties not available in conventional glasses, which opens a new avenue in rational materials design.

[Microorganism test systems and antibiograms useful for the proper use of antibacterial agents].

PubMed

Takahashi, Shunji

2010-07-01

Antimicrobial agents are used for the accurate diagnosis of infectious diseases and effective implementation of antibacterial chemotherapy. The role of microbiological technologists is to provide data from microorganism tests useful for rapid infection treatment. Gram strain can be used to observe microorganisms and neutrophils from specimens of a patient. It is also possible to estimate the kinds of microorganism. If bacterial infectious disease is negative, there is no need for antibacterial chemotherapy. The applied dose of antibacterial agents is different in every hospital. Also, there is a difference in the percentage antibacterial agent susceptibility of isolates. Antibiograms must be created to investigate local factors. For empiric therapy, antibiograms are useful when choosing antibacterial agents showing marked efficacy against the clinical isolate. Microorganism test systems which are useful for the proper use of antibacterial agents are necessary to facilitate safe antibacterial chemotherapy and prevent the development of resistant bacteria. We report a microorganism test system employed at the Sapporo City General Hospital.

A Review of the “Bolus Guide,” A New Insulin Bolus Dosing Support Tool Based on Selection of Carbohydrate Ranges

PubMed Central

Pańkowska, Ewa

2010-01-01

In this issue of Journal of Diabetes Science and Technology, Shapira and colleagues present new concepts of carbohydrate load estimation in intensive insulin therapy. By using a mathematical model, they attempt to establish how accurately carbohydrate food content should be maintained in order to keep postprandial blood glucose levels in the recommended range. Their mathematical formula, the “bolus guide” (BG), is verified by simulating prandial insulin dosing and responding to proper blood glucose levels. Different variants such as insulin sensitivity factor, insulin-to-carbohydrate ratio, and target blood glucose were taken into this formula in establishing the calculated proper insulin dose. The new approach presented here estimates the carbohydrate content by rearranging the carbohydrate load instead of the simple point estimation that the current bolus calculators (BCs) use. Computerized estimations show that the BG directives, as compared to a BC, result in more glucose levels above 200 mg/dl and thus indicate less hypoglycemia readings. PMID:20663454

Role of Orthodontics in Forensic Odontology- A Social Responsibility

PubMed Central

Reddy, Vinay P; Sharma, Meenakshi; Aggarwal, Monika

2016-01-01

Orthodontics like any other specialty has much to offer law enforcement in the detection and solution of crime or in civil proceedings. Forensic odontology often requires an interdisciplinary approach towards dentistry for the purpose of proper diagnosis of cases. In cases where the forensic odontologist has to establish a person’s identity, an orthodontist can be of great help at times. Teeth, with their anatomic/physiologic variations and therapy such as orthodontic treatment, restorations and prosthesis may record information that remains throughout life and beyond. The teeth may also be used as weapons for defense or offense and as such may leave information about the identity of the biter at the time of crime. Forensic odontology also plays an important role in the recognition of crime and abuse among people of all ages. Orthodontists like all other dental professionals can play a major role by maintaining proper dental records and thus providing important or vital information or clues to the legal authorities in order to help them in their search. PMID:27190968

Gold nanostructure materials in diabetes management

NASA Astrophysics Data System (ADS)

Si, Satyabrata; Pal, Arttatrana; Mohanta, Jagdeep; Sagar Satapathy, Smith

2017-04-01

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia, and is now one of the most non-communicable diseases globally and can be lethal if not properly controlled. Prolonged exposure to chronic hyperglycemia, without proper management, can lead to various vascular complications and represents the main cause of morbidity and mortality in diabetes patients. Studies have indicated that major long-term complications of diabetes arise from persistent oxidative-nitrosative stress and dysregulation in multiple metabolic pathways. Presently, the main focus for diabetes management is to optimize the available techniques to ensure adequate blood sugar level, blood pressure and lipid profile, thereby minimizing the diabetes complications. In this regard, nanomedicine utilizing gold nanostructures has great potential and seems to be a promising option. The present review highlights the basic concepts and up-to-date literature survey of gold nanostructure materials in management of diabetes in several ways, which include sensing, imaging, drug delivery and therapy. The work can be of interest to various researchers working on basic and applied sciences including nanosciences.

[Diagnosis and treatment of Pompe disease].

PubMed

Bravo-Oro, Antonio; de la Fuente-Cortez, Beatriz; Molina-García, Avril; Romero-Díaz, Víktor; Rodríguez-Leyva, Ildefonso; Esmer-Sánchez, María del Carmen

2013-01-01

Pompe disease is a rare, progressive and often fatal neuromuscular disorder. It is caused by a deficiency of the lysosomal alpha-glucosidase. Among glycogen storage disorders, it is one of the most common. Its clinical manifestations can start at any moment of life, with a very variable symptomatology. In this article, we show an extended revision of the literature in regards to the main medical aspects of Pompe disease: etiology, psychopathology, epidemiology, clinical variants, pathological diagnosis, and enzyme replacement therapy. With this information, we created a diagnostic and therapeutic guide, which is addressed to specialists and to first-level physicians, in order to let them identify both the classic and the late forms of this disease. We describe as well the best, timely, multidisciplinary treatment in use. Also, we show some suggestions to the proper functioning of health institutions, and routes to diagnosis. We conclude that Pompe disease may be properly diagnosed and treated if health care professionals follow the internationally approved recommendations.

Are Prescription Opioids Driving the Opioid Crisis? Assumptions vs Facts.

PubMed

Rose, Mark Edmund

2018-04-01

Sharp increases in opioid prescriptions, and associated increases in overdose deaths in the 2000s, evoked widespread calls to change perceptions of opioid analgesics. Medical literature discussions of opioid analgesics began emphasizing patient and public health hazards. Repetitive exposure to this information may influence physician assumptions. While highly consequential to patients with pain whose function and quality of life may benefit from opioid analgesics, current assumptions about prescription opioid analgesics, including their role in the ongoing opioid overdose epidemic, have not been scrutinized. Information was obtained by searching PubMed, governmental agency websites, and conference proceedings. Opioid analgesic prescribing and associated overdose deaths both peaked around 2011 and are in long-term decline; the sharp overdose increase recorded in 2014 was driven by illicit fentanyl and heroin. Nonmethadone prescription opioid analgesic deaths, in the absence of co-ingested benzodiazepines, alcohol, or other central nervous system/respiratory depressants, are infrequent. Within five years of initial prescription opioid misuse, 3.6% initiate heroin use. The United States consumes 80% of the world opioid supply, but opioid access is nonexistent for 80% and severely restricted for 4.1% of the global population. Many current assumptions about opioid analgesics are ill-founded. Illicit fentanyl and heroin, not opioid prescribing, now fuel the current opioid overdose epidemic. National discussion has often neglected the potentially devastating effects of uncontrolled chronic pain. Opioid analgesic prescribing and related overdoses are in decline, at great cost to patients with pain who have benefited or may benefit from, but cannot access, opioid analgesic therapy.

Comparative effectiveness and adverse effects of interferon alpha-2b plus ribavirin therapy in hepatitis 'C' for 26 weeks.

PubMed

Ali, Shafqut; Iram, Samia

2009-01-01

Hepatitis C is major emerging challenge for pathologists and treating physicians all over the world. Already 10 million Pakistani population has become anti-HCV positive. It is not only affecting hepatobiliary system but with passage of time research is revealing that Hepatitis C is going to involve almost every organ of the body. With timely diagnosis and treatment, millions of patients can be saved from morbidity and mortality. The nation has to sacrifice initial economic allocations to avoid later millions of mortalities and greater economic losses on affected patients and to support their families. The objective of this study was to evaluate effectiveness of combine therapy of Hepatitis C in local population of Pakistan. This case series study was done at CMH Okara, Kohat, Abbottabad, and PAF Hospital, Shorkot from August 2000 to August 2009. All 1,000 patients from 10 to 60 years of age, confirmed anti-HCV Positive by ELISA and PCR Positive for HCV RNA, were subjected to Interferon alpha-2b and Ribavirin therapy for similar period of time. Response and adverse affects were observed by clinical examination, blood complete picture including platelet count and ALT fortnightly. PCR for HCV RNA and ultrasound abdomen (hepatobilliary system) was done quarterly during treatment and 6 monthly for 2 years after treatment to review the sustained response and relapse. Over all cure rate after 2 years was 855 (85.5%) excluding the 50 (5%) of initial resistant to one year treatment and 95 (9.5%) re-treated relapse cases. One hundred and forty-five (14.5%) patients were found to be resistant to treatment. Hepatitis C must be treated timely after proper diagnosis. Interferon and Ribavirin combination have shown high 'cure' rate in Hepatitis C. In spite of high cure rate of 85.5% with timely and proper treatment, low socio-economic status is a major problem for poor individuals to get treatment. Preventive aspect must be strictly followed and implemented.

Catheter ablation in patients with persistent atrial fibrillation

PubMed Central

Kirchhof, Paulus; Calkins, Hugh

2017-01-01

Catheter ablation is increasingly offered to patients who suffer from symptoms due to atrial fibrillation (AF), based on a growing body of evidence illustrating its efficacy compared with antiarrhythmic drug therapy. Approximately one-third of AF ablation procedures are currently performed in patients with persistent or long-standing persistent AF. Here, we review the available information to guide catheter ablation in these more chronic forms of AF. We identify the following principles: Our clinical ability to discriminate paroxysmal and persistent AF is limited. Pulmonary vein isolation is a reasonable and effective first approach for catheter ablation of persistent AF. Other ablation strategies are being developed and need to be properly evaluated in controlled, multicentre trials. Treatment of concomitant conditions promoting recurrent AF by life style interventions and medical therapy should be a routine adjunct to catheter ablation of persistent AF. Early rhythm control therapy has a biological rationale and trials evaluating its value are underway. There is a clear need to generate more evidence for the best approach to ablation of persistent AF beyond pulmonary vein isolation in the form of adequately powered controlled multi-centre trials. PMID:27389907