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Sample records for continuous long-term immunomodulatory

  1. Continuous long-term immunomodulatory therapy in relapsing multiple sclerosis: results from the 15-year analysis of the US prospective open-label study of glatiramer acetate

    PubMed Central

    Ford, C; Goodman, AD; Johnson, K; Kachuck, N; Lindsey, JW; Lisak, R; Luzzio, C; Myers, L; Panitch, H; Preiningerova, J; Pruitt, A; Rose, J; Rus, H; Wolinsky, J

    2010-01-01

    The ongoing US Glatiramer Acetate (GA) Trial is the longest evaluation of continuous immunomodulatory therapy in relapsing-remitting multiple sclerosis (RRMS). The objective of this study was to evaluate up to 15 years of GA as a sole disease-modifying therapy. Two hundred and thirty-two patients received at least one GA dose since study initiation in 1991 (mITT cohort), and 100 (43%, Ongoing cohort) continued as of February 2008. Patients were evaluated every 6 months using the Expanded Disability Status Scale (EDSS). Mean GA exposures were 8.6 ±5.2, 4.81 ±3.69, and 13.6 ± 1.3 years and mean disease durations were 17, 13, and 22 years for mITT, Withdrawn and Ongoing cohorts, respectively. For Ongoing patients, annual relapse rates (ARRs) maintained a decline from 1.12±0.82 at baseline to 0.25 ± 0.34 per year; 57% had stable/improved EDSS scores (change ± 0.5 points); 65% had not transitioned to secondary progressive multiple sclerosis (SPMS); 38%, 18%, and 3% reached EDSS 4, 6, and 8. For all patients on GA therapy (the mITT cohort), ARRs declined from 1.18 ± 0.82 to 0.43 ± 0.58 per year; 54% had stable/improved EDSS scores; 75% had not transitioned to SPMS; 39%, 23%, and 5% reached EDSS 4, 6, and 8. In conclusion, multiple sclerosis patients with mean disease duration of 22 years administering GA for up to 15 years had reduced relapse rates, and decreased disability progression and transition to SPMS. There were no long-term safety issues. PMID:20106943

  2. Evaluation of Long Term Performance of Continuously Running Atomic Fountains

    DTIC Science & Technology

    2014-05-28

    Std Z39-18 | Bureau International des Poids et Mesures Metrologia Metrologia 51 (2014) 263–269 doi:10.1088/0026-1394/51/3/263 Evaluation of long term...MAY 2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Evaluation of long term performance of continuously...engineering and evaluation . The workhorses of the timing community, commercial caesium beams and hydrogen masers, which do not incorporate any laser technology

  3. Long-term results of immunomodulatory treatment in children and adolescents with multiple sclerosis: the Italian experience.

    PubMed

    Ghezzi, Angelo; Amato, Maria Pia; Annovazzi, Pietro; Capobianco, Marco; Gallo, Paolo; La Mantia, Loredana; Marrosu, Maria Giovanna; Martinelli, Vittorio; Milani, Nicoletta; Moiola, Lucia; Patti, Francesco; Pozzilli, Carlo; Trojano, Maria; Zaffaroni, Mauro; Comi, Giancarlo

    2009-06-01

    The main objective of this study is to evaluate the effect of immunomodulatory agents (IMAs) (Interferon-Beta, Glatiramer Acetate) in a large cohort of multiple sclerosis (MS) patients with disease onset in childhood or adolescence, treated before 16 years of age, after a long-term follow-up. A total of 130 patients were identified, 77 were treated with Avonex, 39 with Rebif/Betaferon, 14 with Copaxone. After a mean (SD) treatment duration of 53.6 +/- 27.0, 59.9 +/- 39.5 and 74.6 +/- 35.5 months, respectively, the relapse rate decreased significantly. The final EDSS score was unchanged with respect to the initial score. Similar results were also observed in subjects who continued a long-term follow-up after they were included in an observational study in 2004, and in subjects who were treated before 12 years of age. The frequency of clinical and laboratory adverse events was similar to that observed in adult patients. To conclude, IMAs were effective and well tolerated in paediatric patients with MS.

  4. Evaluation of long term performance of continuously running atomic fountains

    NASA Astrophysics Data System (ADS)

    Peil, Steven; Hanssen, James L.; Swanson, Thomas B.; Taylor, Jennifer; Ekstrom, Christopher R.

    2014-06-01

    An ensemble of rubidium atomic fountain clocks has been put into operation at the US Naval Observatory (USNO). These fountains are used as continuous clocks in the manner of commercial caesium beams and hydrogen masers for the purpose of improved timing applications. Four fountains have been in operation for more than two years and are included in the ensemble used to generate the USNO master clock. Individual fountain performance is characterized by a white-frequency noise level below 2 × 10-13 and fractional-frequency stability routinely reaching the low 10-16 s. The highest performing pair of fountains exhibits stability consistent with each fountain integrating as white frequency noise, with Allan deviation surpassing 6 × 10-17 at 107 s, and with no relative drift between the fountains at the level of 7.5 × 10-19/day. As an ensemble, the fountains generate a timescale with white-frequency noise level of 1 × 10-13 and long-term frequency stability consistent with zero drift relative to the world's primary standards at 1 × 10-18/day. The rubidium fountains are reported to the BIPM as continuously running clocks, as opposed to secondary standards, the only cold-atom clocks so reported. Here we further characterize the performance of the individual fountains and the ensemble during the first two years in an operational environment, presenting the first look at long-term continuous behavior of fountain clocks.

  5. Long-term immunomodulatory effect of amniotic stem cells in an Alzheimer's disease model.

    PubMed

    Kim, Kyung-Sul; Kim, Hyun Sook; Park, Ji-Min; Kim, Han Wool; Park, Mi-Kyung; Lee, Hyun-Seob; Lim, Dae Seog; Lee, Tae Hee; Chopp, Michael; Moon, Jisook

    2013-10-01

    Amyloid beta (Aβ) plays a major role in Alzheimer's disease (AD), and neuroinflammatory processes mediated by Aβ plaque-induced microglial cells and astrocytes contribute to AD pathogenesis. The present study examined human placenta amniotic membrane-derived mesenchymal stem cells (AMSCs), which have potent immunomodulatory and paracrine effects in a Tg2576 (APPswe) transgenic mouse model of AD. AMSCs secreted high levels of transforming growth factor-β under in vitro inflammatory environment conditions. Six weeks after the intravenous injection of AMSCs, APPswe mice showed evidence of improved spatial learning, which significantly correlated with the observation of fewer Aβ plaques in brain. The number of ED1-positive phagocytic microglial cells associated with Aβ plaques was higher in AMSC-injected mice than in phosphate-buffered saline-injected mice, and the level of Aβ-degrading enzymes (matrix metallopeptidase-9 and insulin-degrading enzyme) was also significantly higher. Furthermore, the level of proinflammatory cytokines, interleukin-1 and tumor necrosis factor-α, was lower and that of anti-inflammatory cytokines, interleukin-10 and transforming growth factor-β, was higher in AMSC-injected mice than phosphate-buffered saline-injected mice. These effects lasted until 12 weeks after AMSC injection. Taken together, these results collectively suggest that injection of AMSCs might show significant long-lasting improvement in AD pathology and memory function via immunomodulatory and paracrine mechanisms.

  6. Long-term utilization and continuation of intrauterine devices

    PubMed Central

    DIEDRICH, Justin T.; MADDEN, Tessa; ZHAO, Qiuhong; PEIPERT, Jeffrey F.

    2015-01-01

    OBJECTIVE We compared the 48- and 60-month continuation rates of levonorgestrel (LNG) and copper (Cu) intrauterine devices (IUDs). Our primary outcome was continuation at 48 months. STUDY DESIGN This is a prospective cohort study of women who received an IUD through the Contraceptive CHOICE Project. We randomly selected women who had either LNG- or Cu-IUDs inserted between January 2008 and June 2009 and contacted them by telephone. Once contacted and consented, participants were asked if they were still using their IUD. Women who reported discontinuation of the IUD were asked for reasons for discontinuation. We performed survival analysis using Cox proportional hazards to investigate factors associated with discontinuation and to calculate hazard ratios (HRs) and their respective 95% confidence interval (CI). RESULTS Of the 460 women we attempted to contact, 321 (70%) were reached for telephone interviews. IUD continuation data was available for the remaining 139 women from CHOICE and substudy databases. Continuation rates at 48 and 60 months were 62.3% and 51.7% for LNG-IUD, and 64.2% and 55.9% for the Cu-IUD, respectively. Continuation at 48 months was highest among women over 29 years of age at insertion (LNG-IUD 72.5%; Cu-IUD 77.1%). Women under 24 years of age had the lowest 48-month continuation (LNG-IUD 55.4% and Cu-IUD 53.2%). In univariable and multivariable analysis, demographic characteristics, menstrual profile, and pregnancy history were not associated with discontinuation. Age over 29 years was associated with lower rates of discontinuation than those 24–29 years of age (HR 0.67, 95% CI 0.47 – 0.96). CONCLUSION IUD continuation remains high (> 60%) at 48 months with no difference between Cu- and LNG-IUDs (P=0.08). PMID:26409157

  7. Long-term utilization and continuation of intrauterine devices.

    PubMed

    Diedrich, Justin T; Madden, Tessa; Zhao, Qiuhong; Peipert, Jeffrey F

    2015-12-01

    We compared the 48 and 60 month continuation rates of levonorgestrel (LNG) and copper (Cu) intrauterine devices (IUDs) among women enrolled in the Contraceptive CHOICE Project (CHOICE). Our primary outcome was continuation at 48 months. This is a prospective cohort study of women who received an IUD through CHOICE. We randomly selected women who had either LNG or Cu IUDs inserted between January 2008 and June 2009 and contacted them by telephone. Once contacted and consented, they were asked whether they were still using their IUD. Women who reported discontinuation of the IUD were asked for the reasons and subsequent contraceptive use. Survival analysis using Cox proportional hazards was performed to assess for factors associated with discontinuation and to calculate hazard ratios. Of the 460 women we attempted to contact, 321 (70%) were reached for interviews. Continuation data on the remaining 139 women were available from CHOICE and its substudies. Continuations at 48 and 60 months were 62.3% and 51.7% for LNG IUD and 64.2% and 55.9% for the Cu IUD, respectively. Continuation at 48 months was highest among women older than 29 years of age at insertion (LNG IUD, 72.5%; Cu IUD, 77.1%). Women younger than 24 years of age had the lowest 48 month continuation (LNG IUD, 55.4%, and Cu IUD, 53.2%). In univariable and multivariable analysis, demographic characteristics, menstrual profile, and pregnancy history were not associated with discontinuation. Age older than 29 years was associated with less discontinuation than those 24-29 years of age (hazard ratio, 0.67, 95% confidence interval, 0.47-0.96). IUD continuation remains high (> 60%) at 48 months with no difference between Cu and LNG IUDs. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Long-term performance of hemofilters in continuous hemofiltration.

    PubMed

    Schaeffer, J; Olbricht, C J; Koch, K M

    1996-01-01

    We measured the filter performance of six polyamide hemofilters with a running time exceeding 72 h applied for continuous hemofiltration in intensive care patients. The sieving coefficients for urea and creatinine were close to unity and remained constant. The sieving coefficient of polyfructosan (mean molecular weight 3 kD) was around 0.75 and did not change with running time. The hydraulic permeability remained also unchanged. The relationships between blood pressure and blood flow and between blood flow and filtration rate remained linear, and the gradient did not change with time. We conclude that a daily routine change of polyamide hemofilters applied in continuous arteriovenous hemofiltration and presumably in continuous venovenous hemofiltration is not necessary within the first 72 h of treatment, unless a major decrease in the filtration rate occurs.

  9. Continued support of long-term research - cullars rotation

    USDA-ARS?s Scientific Manuscript database

    The Cullars Rotation (circa 1911) is the oldest continuous soil fertility study in the Southern U.S. In commemoration of the 2011 Centennial Year for this experiment, a comprehensive Alabama Agricultural Experiment Station bulletin was published covering the first 100 years of this experiment. (http...

  10. Continued support of long-term research - the old rotation

    USDA-ARS?s Scientific Manuscript database

    The “Old Rotation” experiment (circa 1896) is the oldest continuous cotton study in the world and the third oldest field crops experiment in the U.S. on the same site. The complete history of this experiment was published in 2008 in the centennial issue of Agronomy Journal (C.C. Mitchell, D.P. Delan...

  11. Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

    PubMed

    Ross, M M; Carswell, A; Dalziel, W B; Aminzadeh, F

    2001-01-01

    The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

  12. Volunteerism as Purpose: Examining the Long-Term Predictors of Continued Community Engagement

    ERIC Educational Resources Information Center

    Barber, Carolyn; Mueller, Conrad T.; Ogata, Sachiko

    2013-01-01

    This study frames continued long-term participation in community engagement activities as indicative of a sense of "purpose" as defined by Damon, Menon, and Cotton Bronk (2003). Using data from US-based National Longitudinal Study of Adolescent Health, we examined factors that predict whether students participating in civic engagement…

  13. Volunteerism as Purpose: Examining the Long-Term Predictors of Continued Community Engagement

    ERIC Educational Resources Information Center

    Barber, Carolyn; Mueller, Conrad T.; Ogata, Sachiko

    2013-01-01

    This study frames continued long-term participation in community engagement activities as indicative of a sense of "purpose" as defined by Damon, Menon, and Cotton Bronk (2003). Using data from US-based National Longitudinal Study of Adolescent Health, we examined factors that predict whether students participating in civic engagement…

  14. [Acceptability and compliance to long-term continuous positive pressure treatment].

    PubMed

    Berkani, K; Dimet, J

    2015-03-01

    Compliance with continuous positive pressure treatment (CPAP) is a determining factor in the management of the obstructive sleep apnea syndrome (OSAS). Long-term compliance has been poorly studied. The probability of long-term continuation of CPAP was evaluated retrospectively by an analysis of survival in 252 patients treated by CPAP after a screening of 472 patients during the years 2002 and 2003. Twenty-eight patients fulfilling the criteria for CPAP immediately refused the treatment. The mean follow-up for the 252 treated patients was 76.9±46.4 months, with 38 patients having died and 75 having discontinued treatment during the period. The 136 patients who continued treatment used CPAP for a mean of 7.4±1.6hours daily. The probability of continuing treatment was 71% at 5 years and 68% at 10 years. The severity of OSAS was a predictive factor for long-term CPAP compliance, with a 10-year compliance of 82% in patients having an apnoea/hypopnoea index >60, versus 68% with an index between 30-60 and 44% with an index <30. Long-term CPAP treatment is globally well accepted, with a 68% probability of continuing treatment for 10 years, particularly in the most severely affected patients. Long-term daily compliance is very satisfactory. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  15. Factors associated with the effectiveness of continuing education in long-term care.

    PubMed

    Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P; Hillier, Loretta M; Keat, Nancy; Feightner, John W

    2005-06-01

    This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups. In Study 2, a Delphi technique was used to refine our list of factors. Consensus was achieved in two survey rounds involving 30 and 27 participants, respectively. Management support was identified as the most important factor impacting the effectiveness of continuing education. Other factors included resources (staff, funding, space) and the need for ongoing expert support. Organizational support is necessary for continuing education programs to be effective and ongoing expert support is needed to enable and reinforce learning.

  16. The toxicity of continuous long-term low-dose formaldehyde inhalation in mice.

    PubMed

    Cheng, Jiaying; Zhang, Long; Tang, Yufu; Li, Zhenhai

    2016-12-01

    Although the toxicity of high-dose formaldehyde (FA) inhalation has been extensively analyzed in animals, the effect of continuous long-term exposure to low-dose FA has not been well documented. This study aims to evaluate the toxicity of continuous long-term low-dose FA inhalation in mice. Forty-eight Kunming male mice were equally randomized to three groups according to the dose of FA inhalation exposure: a control (0 mg/m(3)) group, a low-dose (0.08 mg/m(3)) group and a high-dose (0.8 mg/m(3)) group. The mice have been selected to expose to FA for different consecutive days at 24 h/day. The learning and memory functions, pathological changes in the lung and liver, and the percentage of CD4 (+) T and CD8 (+) T cells were observed and analyzed. It was found that continuous long-term inhalation of FA at relatively low doses could impair the learning and memory functions and induce pathological changes in the lung and liver, but did not seem to significantly affect the number of immune (CD4 (+) T and CD8 (+) T) cells.

  17. Stable and Continuous Long-term Enzymatic Reaction using an Enzyme-Nanofiber Composite

    SciTech Connect

    Lee, Jin Hyung; Hwang, Ee Taek; Kim, Byoung Chan; Lee, Sun Mi; Sang, Byoung-In; Choi, Yong Su; Kim, Jungbae; Gu, Man Bock

    2007-07-01

    This study shows the preparation and application of enzyme-nanofiber composites for long-term stable operation. The enzyme-nanofiber composite was prepared by coating an enzyme-aggregate, the esterase from Rhizopus oryzae, on the surface of the nanofibers. The activity and stability of the esterase-nanofiber composite was evaluated by measuring the production of p-nitrophenol from the hydrolysis of p-nitrophenyl butyrate. It was found that enzyme-nanofiber was very stable, even when the fibers were shaken in glasses, preserving 80 % of the initial activity for 100 days. In addition, the enzyme nanofiber composite was repeatedly used in 30 cycles of substrate hydrolysis and still remained active. Consequently, the esterase-nanofiber composite was finally employed to find its feasibility of long-term and stable continuous substrate hydrolysis reaction. In the sample reactor, the production of p-nitrophenol was consistent for 400 hr. Additionally, it was found that the production of p-nitrophenol proportionally decreased as the dilution rate was increased, showing the relationship between the efficiency of hydrolysis and the retention time within the reactor. This study demonstrates that the enzyme-nanofiber composite can be used in both repeated-batch and continuous modes for long-term stable operation.

  18. [Immunomodulatory treatment with beta-interferon in patients with cervical intraepithelial neoplasia and human papillomavirus infection: long-term follow-up].

    PubMed

    Cazorla, E; Urgal, A; Córdoba, J; Boldó, A; Marín, M; Sánchez Gutiérrez, M; Molina, J M; Llixiona, J

    2005-03-01

    The aim of this study was to evaluate the long-term efficacy of beta-interferon treatment in the management of cervical intraepithelial neoplasia associated with human papillomavirus (HPV) infection in a selected group of patients. Thirty-nine patients who had histologically proven cervical intraepithelial neoplasia I or II with concurrent HPV infection were administered 27,000,000 IU of intramuscular beta-interferon. Periodical controls were carried out based on Papanicolaou smears and/or colposcopic examination and DNA HPV determination was performed by hybridation test, for a maximum of 8 years' follow-up. An initial complete response rate of 75% was obtained, with a recurrence rate of 25%, cervical intraepithelial neoplasia with late manifestation was of higher grade. Treatment interruption due to side-effects was not necessary. Associated viral infections appeared to be a recurrence risk factor, but not smoking or parity. While immunomodulatory treatment with beta-interferon has good long-term results in cervical intraepithelial neoplasia I/II treatment, wider randomized studies are required to obtain conclusive results.

  19. Analysis of long-term durability of superhydrophobic properties under continuous contact with water.

    PubMed

    Boinovich, Ludmila; Emelyanenko, Alexandre M; Pashinin, Andrei S

    2010-06-01

    In view of more and more extending areas of application of hydrophobic and superhydrophobic materials and coatings, the problem of degradation of superhydrophobic state becomes extremely important. In this paper, the results of studies of time evolution of water contact angle on some siloxane-based hydrophobic and superhydrophobic surfaces in the conditions of long-term continuous contact with water are presented. Different mechanisms responsible for reversible and nonreversible deterioration of contact angle values were discussed and experimentally verified. We noted that evolution of water contact angle in time in the conditions of continuous contact with water needs to be considered when studying the durability of superhydrophobic coating because of its high sensitivity to the state of the coating and the details of its chemical structure.

  20. Long-Term Evaluation of Continuous Epidural Anesthesia in an Improved Canine Model

    PubMed Central

    Sasauchi, Kyoko; Sunada, Katsuhisa; Nakamura, Tatsuo

    2016-01-01

    Background Continuous epidural analgesia with catheterization is a useful technique, because it has a wide adaptation range and provides prolonged analgesia. Problems that may arise from long-term epidural analgesia are changes in the analgesic area, duration of analgesia and catheter-related problems. Few articles have evaluated gradual changes of long-term epidural analgesia. In the animal models used in those studies, the catheter was inserted by an invasive surgical procedure. In the present study, we evaluated changes in a canine model in which the catheter was inserted by a minimally invasive procedure. Objectives To evaluate long-term changes in the efficacy of epidural analgesia in an improved canine model in which the epidural catheter was inserted and fixed for 5 weeks using a minimally invasive procedure. Materials and Methods Six beagles underwent epidural catheterization under general anaesthesia. The catheter tip was located in the sixth lumbar region; the catheter peripheral end was passed subcutaneously through the neck. Physiological saline was continuously infused (1.0 mL/h) via the catheter throughout the study. The efficacy of epidural analgesia was assessed weekly with 2% lidocaine once a week in 5 weeks. Peripheral blood analysis including interleukin-6 (IL-6) level in the cerebrospinal fluid (CSF), histological evaluations and epidurography were performed to evaluate the mechanisms underlying the changes. Results No dog died and the catheters were kept in place. The efficacy of analgesia was well maintained until 4 weeks; at 5th week, the efficacy decreased by half. The spread of injected medium was not observed in the cranial direction at 5th week and the tip of catheter was capped with granulation tissue. Throughout the study period, white blood cell counts and C-reactive protein levels were slightly high for catheterization and the IL-6 level in CSF was below detectable limits. Conclusions This was the longest study period with continuous

  1. The strategic skills of business continuity managers: putting business continuity management into corporate long-term planning.

    PubMed

    Wong, Wei Ning Zechariah

    2009-11-01

    Despite its rapid development in the last two decades, business continuity management (BCM) as a discipline and a profession is still regarded by many as an operational entity of management. Two main issues are discussed in this paper: the role of BCM in strategic management and the strategic skills of business continuity managers. These issues are crucial as they represent the role of BCM in high-level corporate management. The paper discusses the importance of BCM in the long-term planning of organisational success and the preservation of future competitiveness. Finally, salient points that underpin the importance of its role in sustaining organisational performance are addressed.

  2. Patient reactions to long-term outpatient treatment with continuous subcutaneous insulin infusion.

    PubMed Central

    Pickup, J C; Keen, H; Viberti, G C; Bilous, R W

    1981-01-01

    Fourteen of the first 15 insulin-dependent diabetics to be treated in our unit by three weeks or more of outpatient continuous subcutaneous insulin infusion with a portable syringe pump completed a questionnaire about their reactions to the system. Motivation was more important to a favourable response than occupation or intelligence. Most patients thought that diabetic control was better with the pump than conventional injection treatment and several felt subjectively better. Features such as the greater flexibility of diet and insulin delivery rates during continuous subcutaneous infusion were appreciated. The most consistent adverse criticism was about the size of the device used, nearly all patients thinking that smaller and lighter infusion systems should be developed. Psychological reactions to the infusion and difficulties with interpersonal relationships were identified; these must be clearly appreciated and discussed with patients and family before and during treatment. Nine of the 14 patients said they would undertake continuous subcutaneous infusion for one year and a further two said they would do so if the infuser was smaller. These results provide guidance on future technological development of continuous subcutaneous insulin infusion and indicate that the major constraint to long-term trials of the present system is the size of the pump. PMID:6783163

  3. Continuous fatigue crack monitoring of bridges: Long-Term Electrochemical Fatigue Sensor (LTEFS)

    NASA Astrophysics Data System (ADS)

    Moshier, Monty A.; Nelson, Levi; Brinkerhoff, Ryan; Miceli, Marybeth

    2016-04-01

    Fatigue cracks in steel bridges degrade the load-carrying capacity of these structures. Fatigue damage accumulation caused by the repetitive loading of everyday truck traffic can cause small fatigue cracks initiate. Understanding the growth of these fatigue cracks is critical to the safety and reliability of our transportation infrastructure. However, modeling fatigue in bridges is difficult due to the nature of the loading and variations in connection integrity. When fatigue cracks reach critical lengths failures occur causing partial or full closures, emergency repairs, and even full structural failure. Given the aging US highway and the trend towards asset management and life extension, the need for reliable, cost effective sensors and monitoring technologies to alert bridge owners when fatigue cracks are growing is higher than ever. In this study, an innovative Long-Term Electrochemical Fatigue Sensor (LTEFS) has been developed and introduced to meet the growing NDT marketplace demand for sensors that have the ability to continuously monitor fatigue cracks. The performance of the LTEFS has been studied in the laboratory and in the field. Data was collected using machined specimens with different lengths of naturally initiated fatigue cracks, applied stress levels, applied stress ratios, and for both sinusoidal and real-life bridge spectrum type loading. The laboratory data was evaluated and used to develop an empirically based algorithm used for crack detection. Additionally, beta-tests on a real bridge structure has been completed. These studies have conclusively demonstrated that LTEFS holds great potential for long-term monitoring of fatigue cracks in steel structures

  4. Long-term continuous-flow left ventricular assist devices (LVAD) as bridge to heart transplantation.

    PubMed

    Pozzi, Matteo; Giraud, Raphaël; Tozzi, Piergiorgio; Bendjelid, Karim; Robin, Jacques; Meyer, Philippe; Obadia, Jean François; Banfi, Carlo

    2015-03-01

    Heart transplantation (HTx) is the treatment of choice for end-stage heart failure but the limited availability of heart's donors still represents a major issue. So long-term mechanical circulatory support (MCS) has been proposed as an alternative treatment option to assist patients scheduled on HTx waiting list bridging them for a variable time period to cardiac transplantation-the so-called bridge-to-transplantation (BTT) strategy. Nowadays approximately 90% of patients being considered for MCS receive a left ventricular assist device (LVAD). In fact, LVAD experienced several improvements in the last decade and the predominance of continuous-flow over pulsatile-flow technology has been evident since 2008. The aim of the present report is to give an overview of continuous-flow LVAD utilization in the specific setting of the BTT strategy taking into consideration the most representative articles of the scientific literature and focusing the attention on the evolution, clinical outcomes, relevant implications on the HTx strategy and future perspectives of the continuous-flow LVAD technology.

  5. Long-term weathering and continued oxidation of oil residues from the Deepwater Horizon spill.

    PubMed

    White, Helen K; Wang, Chloe H; Williams, Patrick L; Findley, David M; Thurston, Alana M; Simister, Rachel L; Aeppli, Christoph; Nelson, Robert K; Reddy, Christopher M

    2016-12-15

    To investigate the long-term weathering of oil from the Deepwater Horizon (DWH) incident, oil-soaked sand patties were collected from Gulf of Mexico beaches from Florida to Alabama over a three-year period from 2012 to 2014. Analysis of oil residues by gas chromatography with flame ionization detection (GC-FID), thin-layer chromatography with flame ionization detection (TLC-FID), and Fourier transform infrared spectroscopy (FT-IR) indicated uniformity in their chemical composition. Some variability within and between samples was observed, arising from differences in exposure to light and water, which increase the amount of weathering. Oxygenated hydrocarbons (OxHC) produced by weathering processes dominate the majority of oil residues. These OxHC have continued recalcitrance in the environment, and increase in relative abundance over time. Analyses of the bulk characteristics of oil residues via TLC-FID and FT-IR should be continued as these techniques provide important insight into the weathering state of oil residues. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Long-term stormwater quantity and quality analysis using continuous measurements in a French urban catchment.

    PubMed

    Sun, Siao; Barraud, Sylvie; Castebrunet, Hélène; Aubin, Jean-Baptiste; Marmonier, Pierre

    2015-11-15

    The assessment of urban stormwater quantity and quality is important for evaluating and controlling the impact of the stormwater to natural water and environment. This study mainly addresses long-term evolution of stormwater quantity and quality in a French urban catchment using continuous measured data from 2004 to 2011. Storm event-based data series are obtained (716 rainfall events and 521 runoff events are available) from measured continuous time series. The Mann-Kendall test is applied to these event-based data series for trend detection. A lack of trend is found in rainfall and an increasing trend in runoff is detected. As a result, an increasing trend is present in the runoff coefficient, likely due to growing imperviousness of the catchment caused by urbanization. The event mean concentration of the total suspended solid (TSS) in stormwater does not present a trend, whereas the event load of TSS has an increasing tendency, which is attributed to the increasing event runoff volume. Uncertainty analysis suggests that the major uncertainty in trend detection results lies in uncertainty due to available data. A lack of events due to missing data leads to dramatically increased uncertainty in trend detection results. In contrast, measurement uncertainty in time series data plays a trivial role. The intra-event distribution of TSS is studied based on both M(V) curves and pollutant concentrations of absolute runoff volumes. The trend detection test reveals no significant change in intra-event distributions of TSS in the studied catchment.

  7. An Optical Oxygen Sensor for Long-Term Continuous Monitoring of Dissolved Oxygen in Perfused Bioreactors

    NASA Technical Reports Server (NTRS)

    Gao, F. G.; Jeevarajan, A. S.; Anderson, M. M.

    2002-01-01

    For long-term growth of man1ITlalian cells in perfused bioreactors, it is essential to monitor the concentration of dissolved oxygen (DO) present in the culture medium to quantitate and control level of DO. Continuous measurement of the amount of DO in the cell culture medium in-line under sterile conditions in NASA's perfused bioreactor requires that the oxygen sensor provide increased sensitivity and be sterilizable and nontoxic. Additionally, long-term cell culture experiments require that the calibration be maintained several weeks or months. Although there are a number of sensors for dissolved oxygen on the market and under development elsewhere, very few meet these stringent conditions. An optical oxygen sensor (BOXY) based on dynamic fluorescent quenching and a pulsed blue LED light source was developed in our laboratory to address these requirements. Tris( 4,7 -diphenyl-l, 1 O-phenanthroline )ruthenium(II) chloride is employed as the fluorescent dye indicator. The sensing element consists of a glass capillary (OD 4.0 mm; ID 2.0 mm) coated internally with a thin layer of the fluorescent dye in silicone matrix and overlayed with a black shielding layer. Irradiation of the sensing element with blue light (blue LED with emission maximum at 475 nm) generates a red fluorescence centered at 626 nm. The fluorescence intensity is correlated to the concentration of DO present in the culture medium, following the modified non-linear Stern-Volmer equation. By using a pulsed irradiating light source, the problem of dye-bleaching, which is often encountered in long-term continuous measurements of tIns type, 'is minimized. To date we achieved sensor resolution of 0.3 mmHg at 50 mmHg p02, and 0.6 mmHg at 100 mmHg p02, with a response time of about one minute. Calibration was accomplished in sterile phosphate-buffered saline with a blood-gas analyzer (BGA) measurement as reference. Stand-alone software was also developed to control the sensor and bioreactor as well as to

  8. Long-term non-invasive and continuous measurements of legume nodule activity.

    PubMed

    Cabeza, Ricardo A; Liese, Rebecca; Fischinger, Stephanie A; Sulieman, Saad; Avenhaus, Ulrike; Lingner, Annika; Hein, Hans; Koester, Beke; Baumgarten, Vanessa; Dittert, Klaus; Schulze, Joachim

    2015-02-01

    Symbiotic nitrogen fixation is a process of considerable economic, ecological and scientific interest. The central enzyme nitrogenase reduces H(+) alongside N2 , and the evolving H2 allows a continuous and non-invasive in vivo measurement of nitrogenase activity. The objective of this study was to show that an elaborated set-up providing such measurements for periods as long as several weeks will produce specific insight into the nodule activity's dependence on environmental conditions and genotype features. A system was developed that allows the air-proof separation of a root/nodule and a shoot compartment. H2 evolution in the root/nodule compartment can be monitored continuously. Nutrient solution composition, temperature, CO2 concentration and humidity around the shoots can concomitantly be maintained and manipulated. Medicago truncatula plants showed vigorous growth in the system when relying on nitrogen fixation. The set-up was able to provide specific insights into nitrogen fixation. For example, nodule activity depended on the temperature in their surroundings, but not on temperature or light around shoots. Increased temperature around the nodules was able to induce higher nodule activity in darkness versus light around shoots for a period of as long as 8 h. Conditions that affected the N demand of the shoots (ammonium application, Mg or P depletion, super numeric nodules) induced consistent and complex daily rhythms in nodule activity. It was shown that long-term continuous measurements of nodule activity could be useful for revealing special features in mutants and could be of importance when synchronizing nodule harvests for complex analysis of their metabolic status. © 2014 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

  9. [Long-term outcomes of children treated with continuous renal replacement therapy].

    PubMed

    Almarza, S; Bialobrzeska, K; Casellas, M M; Santiago, M J; López-Herce, J; Toledo, B; Carrillo, Á

    2015-12-01

    The objective of this study is to analyze long-term outcomes and kidney function in children requiring continuous renal replacement therapy (CRRT) after an acute kidney injury episode. A retrospective observational study was performed using a prospective database of 128 patients who required CRRT admitted to the pediatric intensive care unit between years 2006 and 2012. The subsequent outcomes were assessed in those surviving at hospital discharge. Of the 128 children who required RRT in the pediatric intensive care unit, 71 survived at hospital discharge (54.4%), of whom 66 (92.9%) were followed up. Three patients had chronic renal failure prior to admission to the NICU. Of the 63 remaining patients, 6 had prolonged or relapses of renal function disturbances, but only one patient with atypical Hemolytic Uremic Syndrome developed end-stage renal failure. The rest had normal kidney function at the last check-up. Most of surviving children that required CRRT have a positive outcome later on, presenting low mortality rates and recovery of kidney function in the medium term. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  10. Uncertainties in Air Exchange using Continuous-Injection, Long-Term Sampling Tracer-Gas Methods

    SciTech Connect

    Sherman, Max H.; Walker, Iain S.; Lunden, Melissa M.

    2013-12-01

    The PerFluorocarbon Tracer (PFT) method is a low-cost approach commonly used for measuring air exchange in buildings using tracer gases. It is a specific application of the more general Continuous-Injection, Long-Term Sampling (CILTS) method. The technique is widely used but there has been little work on understanding the uncertainties (both precision and bias) associated with its use, particularly given that it is typically deployed by untrained or lightly trained people to minimize experimental costs. In this article we will conduct a first-principles error analysis to estimate the uncertainties and then compare that analysis to CILTS measurements that were over-sampled, through the use of multiple tracers and emitter and sampler distribution patterns, in three houses. We find that the CILTS method can have an overall uncertainty of 10-15percent in ideal circumstances, but that even in highly controlled field experiments done by trained experimenters expected uncertainties are about 20percent. In addition, there are many field conditions (such as open windows) where CILTS is not likely to provide any quantitative data. Even avoiding the worst situations of assumption violations CILTS should be considered as having a something like a ?factor of two? uncertainty for the broad field trials that it is typically used in. We provide guidance on how to deploy CILTS and design the experiment to minimize uncertainties.

  11. Continuous assessment of work activities and posture in long-term care nurses.

    PubMed

    Hodder, Joanne N; Holmes, Michael W R; Keir, Peter J

    2010-09-01

    The high prevalence of low back injuries in nursing has prompted the use of mechanical lift assists while overall assessment of activities and postures remains limited. The purpose of this study was to chronicle trunk posture and work tasks of long-term healthcare professionals. An inclinometer monitored trunk posture for 27 workers, 20 of whom were also observed continuously throughout their shift. Patient lifts and transfers accounted for less than 4% of the shift while patient care, unloaded standing and walking and miscellaneous tasks accounted for 85%. Manual lifts and transfers occurred twice as often as mechanically assisted lifts but took only half the time. The workers had a median trunk flexion angle of 9.2 degrees , spent 25% of their time flexed beyond 30 degrees and had peak flexion angles greater than 75 degrees in many tasks. Analysis of posture throughout the entire working shift indicates that, in addition to lifts and transfers, emphasis needs to be placed on patient care and miscellaneous activities when assessing injury risk for nurses. STATEMENT OF RELEVANCE: Patient handling has been the focus in the effort to reduce back pain and injury in nursing. In addition to the use of mechanical lifts, there is a need to examine other aspects of nursing, including patient care and other ancillary tasks, which comprise the majority of the work shift and, while often unloaded, exhibit extreme postures that may also lead to injury.

  12. Long term, continuous exposure to panobinostat induces terminal differentiation and long term survival in the TH-MYCN neuroblastoma mouse model.

    PubMed

    Waldeck, Kelly; Cullinane, Carleen; Ardley, Kerry; Shortt, Jake; Martin, Ben; Tothill, Richard W; Li, Jason; Johnstone, Ricky W; McArthur, Grant A; Hicks, Rodney J; Wood, Paul J

    2016-07-01

    Neuroblastoma is the most common extra-cranial malignancy in childhood and accounts for ∼15% of childhood cancer deaths. Amplification of MYCN in neuroblastoma is associated with aggressive disease and predicts for poor prognosis. Novel therapeutic approaches are therefore essential to improving patient outcomes in this setting. The histone deacetylases are known to interact with N-Myc and regulate numerous cellular processes via epigenetic modulation, including differentiation. In this study, we used the TH-MYCN mouse model of neuroblastoma to investigate the antitumor activity of the pan-HDAC inhibitor, panobinostat. In particular we sought to explore the impact of long term, continuous panobinostat exposure on the epigenetically driven differentiation process. Continuous treatment of tumor bearing TH-MYCN transgenic mice with panobinostat for nine weeks led to a significant improvement in survival as compared with mice treated with panobinostat for a three-week period. Panobinostat induced rapid tumor regression with no regrowth observed following a nine-week treatment period. Initial tumor response was associated with apoptosis mediated via upregulation of BMF and BIM. The process of terminal differentiation of neuroblastoma into benign ganglioneuroma, with a characteristic increase in S100 expression and reduction of N-Myc expression, occurred following prolonged exposure to the drug. RNA-sequencing analysis of tumors from treated animals confirmed significant upregulation of gene pathways associated with apoptosis and differentiation. Together our data demonstrate the potential of panobinostat as a novel therapeutic strategy for high-risk neuroblastoma patients.

  13. Time-sharing in the continuous distractor paradigm: a reexamination of the long-term recency effect.

    PubMed

    Sato, K

    1993-06-01

    Long-term recency effects observed in the continuous distractor paradigm are often taken as evidence against the short-term store account of recency effects. In the present study, three experiments examined the function of time-sharing process in the continuous distractor paradigm. In the first two experiments, the effect of distractor difficulty on long-term recency was investigated with easy and hard distractor tasks. Distractor difficulty was manipulated in the recency portion and in the retention interval of a nine-word list and a hard distractor task eliminated long-term recency effects. In Exp. 3, distractor difficulty was manipulated across the first and the second halves of the retention interval. Long-term recency effects were larger if the first half of the retention interval contained an easy distractor task and the second half a hard task than if the order was hard-easy. These results indicate that subjects maintain recent items in short-term store and then transfer them to a long-term store by the time-sharing process during a distraction period. Long-term recency effects to a large extent depend on this time-sharing process.

  14. The Utility of Continuous Temperature Monitoring of Refrigerators in a Long-Term Care Facility.

    PubMed

    Worz, Chad; Postolski, Josh; Williams, Kevin

    2017-04-01

    It is the current practice in most long-term care facilities to use manual logs when documenting refrigerator temperatures. This process is commonly associated with poor or fabricated compliance, little oversight, and documentation errors, both because of overt omissions and unsubstantiated values. It is also well-established that medication storage requirements are mandated by the Centers for Medicare & Medicaid Services (CMS). This analysis demonstrates the potential risk of poor cold-chain management of medications and establishes the possible utility of digitally recorded continuous temperature monitoring over manual logs. This small case-oriented review of a large nursing facility's storage process attempts to expose the risk associated with improper medication storage. The primary outcome of the study was to determine if a difference existed between temperature logs completed manually compared with those done with a continuous monitor. American Thermal Instruments (ATI) thermometers were placed into each of the existing refrigerators in a 147-bed nursing facility. Through a mobile app, the data recorded in each refrigerator were compiled into daily reports. Data were collected from a total of 12 refrigerators, 3 of which were medication refrigerators. Logging intervals were done over a 263-minute period and compiled the lowest recorded temperature, highest recorded temperature, and the average temperature for each refrigerator. In addition, reports showing the real-time results were compiled using the ATI DataNow service. All of the refrigerators analyzed had highest temperature recorded readings exceeding the maximum allowable temperature (50°F for refrigerator). All of the refrigerators had lowest temperature recorded readings below the minimum allowable temperature (32°F for refrigerators). All of the refrigerators also reported average temperatures outside of the allowable temperature range. The results necessitated the replacement of a refrigerator and

  15. Long-term prognosis in patients continuing taking antithrombotics after peptic ulcer bleeding

    PubMed Central

    Wang, Xi-Xu; Dong, Bo; Hong, Biao; Gong, Yi-Qun; Wang, Wei; Wang, Jue; Zhou, Zhen-Yu; Jiang, Wei-Jun

    2017-01-01

    AIM To investigate the long-term prognosis in peptic ulcer patients continuing taking antithrombotics after ulcer bleeding, and to determine the risk factors that influence the prognosis. METHODS All clinical data of peptic ulcer patients treated from January 1, 2009 to January 1, 2014 were retrospectively collected and analyzed. Patients were divided into either a continuing group to continue taking antithrombotic drugs after ulcer bleeding or a discontinuing group to discontinue antithrombotic drugs. The primary outcome of follow-up in peptic ulcer bleeding patients was recurrent bleeding, and secondary outcome was death or acute cardiovascular disease occurrence. The final date of follow-up was December 31, 2014. Basic demographic data, complications, and disease classifications were analyzed and compared by t- or χ2-test. The number of patients that achieved various outcomes was counted and analyzed statistically. A survival curve was drawn using the Kaplan-Meier method, and the difference was compared using the log-rank test. COX regression multivariate analysis was applied to analyze risk factors for the prognosis of peptic ulcer patients. RESULTS A total of 167 patients were enrolled into this study. As for the baseline information, differences in age, smoking, alcohol abuse, and acute cardiovascular diseases were statistically significant between the continuing and discontinuing groups (70.8 ± 11.4 vs 62.4 ± 12.0, P < 0.001; 8 (8.2%) vs 15 (21.7%), P < 0.05; 65 (66.3%) vs 13 (18.8%), P < 0.001). At the end of the study, 18 patients had recurrent bleeding and three patients died or had acute cardiovascular disease in the continuing group, while four patients had recurrent bleeding and 15 patients died or had acute cardiovascular disease in the discontinuing group. The differences in these results were statistically significant (P = 0.022, P = 0.000). The Kaplan-Meier survival curve indicated that the incidence of recurrent bleeding was higher in patients

  16. 21 CFR 310.303 - Continuation of long-term studies, records, and reports on certain drugs for which new drug...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... completion of such long-term studies. In such cases, the Food and Drug Administration may approve the new... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Continuation of long-term studies, records, and... HUMAN USE NEW DRUGS Records and Reports § 310.303 Continuation of long-term studies, records, and...

  17. Continuation of long-term global SO2 pollution monitoring from OMI to OMPS

    NASA Astrophysics Data System (ADS)

    Zhang, Y.; Li, C.; Krotkov, N. A.; Joiner, J.

    2016-12-01

    In the past 12+ years, Ozone Monitoring Instrument (OMI) on board NASA EOS Aura satellite has pioneered the first high-resolution global SO2 pollution monitoring, which enabled new studies of atmospheric chemistry and applications for air quality management. Such long-term SO2 record will be continued with other satellite instruments, i.e., the Ozone Mapping and Profiler Suite (OMPS) Nadir Mapper on board NASA-NOAA Suomi National Polar-orbiting Partnership (S-NPP) satellite and the follow up JPSS series satellites. In this presentation, we demonstrate the first comparison between OMI and OMPS SO2 retrievals from the OMI operational SO2 algorithm, which is our state-of-the-art principal component analysis (PCA) approach. The PCA technique does not use any sort of "soft calibration" corrections required in concurrent satellite SO2 algorithms and enables seamless merging of different satellite datasets. We demonstrate a very good consistency of the retrievals from OMI and OMPS. Four full years of OMI and OMPS SO2 retrievals during 2012-2015 have been analyzed over some of the world's most polluted regions: eastern China, Mexico, and South Africa. In general, the comparisons show high correlations (r =0.79-0.96) of SO2 mass between the two instruments on a daily basis and less than unity regression slopes (0.76-0.97) indicating slightly lower OMPS SO2 mass as compared with OMI. The annual averaged SO2 loading difference between OMI and OMPS is negligible (< 0.03 Dobson Unit (DU)) over South Africa and up to 0.1 DU over eastern China). We also found a very good correlation (r=0.92-0.97) between the spatial distributions of the annual mean SO2 over the three regions. The two instruments also show generally good agreement in terms of the daily spatial distribution in SO2. For example, over the Mexico region for 82% of the days, the two instruments have a spatial correlation coefficient of 0.6 or better. Such consistent retrievals were achieved without any explicit

  18. Bacterial and archaeal ammonia oxidizers respond differently to long-term tillage and fertilizer management at a continuous maize site

    USDA-ARS?s Scientific Manuscript database

    Fertilizer use and tillage affect both the general soil microbial community and speci'c N-utilizing microbial groups, but likely to varying degrees. To assess these impacts, soil was collected on three key dates from a long-term (26+ years), rainfed, continuous maize site where tillage (no-till and ...

  19. Continuation of long-term global SO2 pollution monitoring from OMI to OMPS

    NASA Astrophysics Data System (ADS)

    Zhang, Yan; Li, Can; Krotkov, Nickolay A.; Joiner, Joanna; Fioletov, Vitali; McLinden, Chris

    2017-04-01

    Over the past 20 years, advances in satellite remote sensing of pollution-relevant species have made space-borne observations an increasingly important part of atmospheric chemistry research and air quality management. This progress has been facilitated by advanced UV-vis spectrometers, such as the Ozone Monitoring Instrument (OMI) on board the NASA Earth Observing System (EOS) Aura satellite, and continues with new instruments, such as the Ozone Mapping and Profiler Suite (OMPS) on board the NASA-NOAA Suomi National Polar-orbiting Partnership (SNPP) satellite. In this study, we demonstrate that it is possible, using our state-of-the-art principal component analysis (PCA) retrieval technique, to continue the long-term global SO2 pollution monitoring started by OMI with the current and future OMPS instruments that will fly on the NOAA Joint Polar Satellite System (JPSS) 1, 2, 3, and 4 satellites in addition to SNPP, with a very good consistency of retrievals from these instruments. Since OMI SO2 data have been primarily used for (1) providing regional context on air pollution and long-range transport on a daily basis and (2) providing information on point emission sources on an annual basis after data averaging, we focused on these two aspects in our OMI-OMPS comparisons. Four years of retrievals (2012-2015) have been compared for three regions: eastern China, Mexico, and South Africa. In general, the comparisons show relatively high correlations (r = 0. 79-0.96) of daily regional averaged SO2 mass between the two instruments and near-unity regression slopes (0.76-0.97). The annual averaged SO2 loading differences between OMI and OMPS are small (< 0.03 Dobson unit (DU) over South Africa and up to 0.1 DU over eastern China). We also found a very good correlation (r = 0. 92-0.97) in the spatial distribution of annual averaged SO2 between OMI and OMPS over the three regions during 2012-2015. The emissions from ˜ 400 SO2 sources calculated with the two instruments also

  20. Long-term continuous positive airway pressure therapy improves cardiac autonomic tone during sleep in patients with obstructive sleep apnea.

    PubMed

    Palma, Jose-Alberto; Iriarte, Jorge; Fernandez, Secundino; Alegre, Manuel; Valencia, Miguel; Artieda, Julio; Urrestarazu, Elena

    2015-08-01

    Cardiac autonomic tone after long-term continuous positive airway pressure therapy in patients with obstructive sleep apnea remains unexplored. Thirty patients with obstructive sleep apnea (14 with moderate and 16 with severe obstructive sleep apnea) were studied during a baseline polysomnographic study, after a full night of acute continuous positive airway pressure treatment, and after long-term (~2 years) chronic continuous positive airway pressure therapy. Twenty age- and gender-matched controls with baseline sleep study were selected for comparison purposes. Cross-spectral analysis and the low-frequency (LF) and high-frequency (HF) components of the heart rate variability were computed separately over 10-min ECG epochs during rapid eye movement sleep, non-rapid eye movement sleep, and wakefulness. During the baseline study, obstructive sleep apnea patients exhibited increased LF, decreased HF, and increased LF/HF ratio during sleep when compared to controls. In a multiple regression model, the mean oxygen saturation explained the increased LF during rapid and non-rapid eye movement sleep in obstructive sleep apnea patients. Acute continuous positive airway pressure therapy decreased the LF modulations and the LF/HF ratio and increased the HF modulations during sleep in patients with severe obstructive sleep apnea. Long-term continuous positive airway pressure therapy decreased LF modulations and LF/HF ratio with increased HF modulations during sleep in patients with moderate and severe obstructive sleep apnea. Long-term continuous positive airway pressure reduces the sympathovagal imbalance in patients with moderate and severe obstructive sleep apnea, both during rapid and non-rapid eye movement sleep. Continuous positive airway pressure seems to exert its changes in cardiac autonomic modulation by decreasing the burden of nocturnal hypoxia.

  1. 25 years long-term deformation at Mt. Etna Continuous Borehole Tilt and Vertical GPS Displacements recordings

    NASA Astrophysics Data System (ADS)

    Bonaccorso, Alessandro; Bonforte, Alessandro; Gambino, Salvatore

    2016-04-01

    In the 1980s, shallow borehole tilt measurements saw a reprise in the monitoring of geodynamic active areas, while from the beginning of the 1990s the Global Positioning System (GPS) development also provided the opportunity to repeat geodetic measurements in geodynamic and volcanic areas. At Mt. Etna, the continuous measurements from shallow borehole tiltmeters have been successfully used to infer the mechanisms of magma accumulation and intrusive processes that foreran and accompanied the several eruptions occurring during the last thirty years on this very active volcano. The long-term deformation, associated with unrest and/or eruptive phases, is expected to be larger than tectonic deformation and therefore significant long-lived trends could be detected. For the first time, we present 25 years (1990 - 2014) of continuous borehole tilt recorded at Etna volcano at different stations and vertical displacement periodically measured by GPS. We analyze long-term series that comprise several main flank eruptions, which we believe are unique in the landscape of instrumental monitoring of geodynamic active areas. The good similarity of the patterns obtained from the two independent long-term measurements (borehole tilt and GPS) confirms the long-term stability of the borehole signals, the overall reliability of vertical GPS variations and provides robust support to the interpretation on the volcano dynamics. The tilt and GPS data series reveal that during this lengthy period, there were two primary volcanic phases: i) a major recharging in the period 1994 - 2001 that culminated with the two major explosive-effusive flank eruptions in 2001 and 2002-2003, and ii) a subsequent prolonged period of re-equilibrium that was accompanied by three other effusive flank eruptions and 44 episodes of lava fountains in 2011-2013. This highlights that, in the long-term (tens of years), a single strong recharge phase may not imply a following single main eruption, but could even

  2. Ibu volcano, a center of spectacular dacite dome growth and long-term continuous eruptive discharges

    NASA Astrophysics Data System (ADS)

    Saing, Ugan Boyson; Bani, Philipson; Kristianto

    2014-08-01

    Ibu is one of the most isolated and least accessible volcanoes of Indonesia, located on Halmahera Island, in the province of Maluku, East Indonesia. This volcano is one of the most active volcanoes in Indonesia, but remains poorly studied. Since its resuming activity in 1998, Ibu has injected around 0.7 Tg of SO2 into the atmosphere through 60-100 daily eruptive discharges. This long-term eruptive activity is very well retraced by seismic signals that highlight the progressive dome growth and the supply of new magma into Ibu reservoir. The lava dome which is of dacite composition is developing at a rate of 3182 m3 per day. This decadal dome growth of Ibu requires further attention and warrants monitoring as it is a hazard and risk concern.

  3. Challenges and Opportunities of Long-Term Continuous Stream Metabolism Measurements at the National Ecological Observatory Network

    NASA Astrophysics Data System (ADS)

    Goodman, K. J.; Lunch, C. K.; Baxter, C.; Hall, R.; Holtgrieve, G. W.; Roberts, B. J.; Marcarelli, A. M.; Tank, J. L.

    2013-12-01

    Recent advances in dissolved oxygen sensing and modeling have made continuous measurements of whole-stream metabolism relatively easy to make, allowing ecologists to quantify and evaluate stream ecosystem health at expanded temporal and spatial scales. Long-term monitoring of continuous stream metabolism will enable a better understanding of the integrated and complex effects of anthropogenic change (e.g., land-use, climate, atmospheric deposition, invasive species, etc.) on stream ecosystem function. In addition to their value in the particular streams measured, information derived from long-term data will improve the ability to extrapolate from shorter-term data. With the need to better understand drivers and responses of whole-stream metabolism come difficulties in interpreting the results. Long-term trends will encompass physical changes in stream morphology and flow regime (e.g., variable flow conditions and changes in channel structure) combined with changes in biota. Additionally long-term data sets will require an organized database structure, careful quantification of errors and uncertainties, as well as propagation of error as a result of the calculation of metabolism metrics. Parsing of continuous data and the choice of modeling approaches can also have a large influence on results and on error estimation. The two main modeling challenges include 1) obtaining unbiased, low-error daily estimates of gross primary production (GPP) and ecosystem respiration (ER), and 2) interpreting GPP and ER measurements over extended time periods. The National Ecological Observatory Network (NEON), in partnership with academic and government scientists, has begun to tackle several of these challenges as it prepares for the collection and calculation of 30 years of continuous whole-stream metabolism data. NEON is a national-scale research platform that will use consistent procedures and protocols to standardize measurements across the United States, providing long-term

  4. The Effect of Long-Term Continuous Cropping of Black Pepper on Soil Bacterial Communities as Determined by 454 Pyrosequencing.

    PubMed

    Xiong, Wu; Li, Zhigang; Liu, Hongjun; Xue, Chao; Zhang, Ruifu; Wu, Huasong; Li, Rong; Shen, Qirong

    2015-01-01

    In the present study, 3 replanted black pepper orchards with continuously cropping histories for 10, 21, and 55 years in tropical China, were selected for investigating the effect of monoculture on soil physiochemical properties, enzyme activities, bacterial abundance, and bacterial community structures. Results showed long-term continuous cropping led to a significant decline in soil pH, organic matter contents, enzymatic activities, and resulted in a decrease in soil bacterial abundance. 454 pyrosequencing analysis of 16S rRNA genes revealed that the Acidobacteria and Proteobacteria were the main phyla in the replanted black pepper orchard soils, comprising up to 73.82% of the total sequences; the relative abundances of Bacteroidetes and Firmicutes phyla decreased with long-term continuous cropping; and at genus level, the Pseudomonas abundance significantly depleted after 21 years continuous cropping. In addition, bacterial diversity significantly decreased after 55 years black pepper continuous cropping; obvious variations for community structures across the 3 time-scale replanted black pepper orchards were observed, suggesting monoculture duration was the major determinant for bacterial community structure. Overall, continuous cropping during black pepper cultivation led to a significant decline in soil pH, organic matter contents, enzymatic activities, resulted a decrease in soil bacterial abundance, and altered soil microbial community membership and structure, which in turn resulted in black pepper poor growth in the continuous cropping system.

  5. The Effect of Long-Term Continuous Cropping of Black Pepper on Soil Bacterial Communities as Determined by 454 Pyrosequencing

    PubMed Central

    Xiong, Wu; Li, Zhigang; Liu, Hongjun; Xue, Chao; Zhang, Ruifu; Wu, Huasong; Li, Rong; Shen, Qirong

    2015-01-01

    In the present study, 3 replanted black pepper orchards with continuously cropping histories for 10, 21, and 55 years in tropical China, were selected for investigating the effect of monoculture on soil physiochemical properties, enzyme activities, bacterial abundance, and bacterial community structures. Results showed long-term continuous cropping led to a significant decline in soil pH, organic matter contents, enzymatic activities, and resulted in a decrease in soil bacterial abundance. 454 pyrosequencing analysis of 16S rRNA genes revealed that the Acidobacteria and Proteobacteria were the main phyla in the replanted black pepper orchard soils, comprising up to 73.82% of the total sequences; the relative abundances of Bacteroidetes and Firmicutes phyla decreased with long-term continuous cropping; and at genus level, the Pseudomonas abundance significantly depleted after 21 years continuous cropping. In addition, bacterial diversity significantly decreased after 55 years black pepper continuous cropping; obvious variations for community structures across the 3 time-scale replanted black pepper orchards were observed, suggesting monoculture duration was the major determinant for bacterial community structure. Overall, continuous cropping during black pepper cultivation led to a significant decline in soil pH, organic matter contents, enzymatic activities, resulted a decrease in soil bacterial abundance, and altered soil microbial community membership and structure, which in turn resulted in black pepper poor growth in the continuous cropping system. PMID:26317364

  6. Long-term, continuous formaldehyde measurements in a rural Mid-Western location

    NASA Astrophysics Data System (ADS)

    Dorris, M. R.; Skog, K.; Keutsch, F. N.

    2014-12-01

    The oxidation of volatile organic compounds (VOCs) leads to the formation of secondary pollutants, such as ozone and secondary organic aerosol. Formaldehyde, which has an atmospheric lifetime of a few hours, is a ubiquitous VOC oxidation product so is widely used as a tracer of local to regional VOC processing. Although formaldehyde measurements are widely used, there are few long-term, high-time resolution measurements available. During the spring of 2013 and summer and fall of 2014, the UW-Madison fiber laser induced fluorescence instrument monitored formaldehyde concentration at the Horicon Wildlife Refuge, which houses Wisconsin's National Core Monitoring and National Air Toxics Trends Station. We will present work that uses the formaldehyde measurements in conjunction with other data available at the Horicon site to evaluate different sources of anthropogenic influence on atmospherically rural areas. Particular attention will be paid to implications for SOA and ozone formation in this biogenically controlled area with regularly changing types and amounts of anthropogenic influence.

  7. Long term culture of epithelia in a continuous fluid gradient for biomaterial testing and tissue engineering.

    PubMed

    Minuth, W W; Strehl, R; Schumacher, K; de Vries, U

    2001-01-01

    Epithelia perform barrier functions being exposed to different fluids on the luminal and basal side. For long-term testing of new biomaterials as artificial basement membrane substitutes, it is important to simulate this fluid gradient. Individually-selected biomaterials can be placed in tissue carriers and in gradient containers, where different media are superfused. Epithelia growing on the tissue carriers form a physiological barrier during the whole culture period. Frequently however, pressure differences between the luminal and basal compartments occur. This is caused by a unilateral accumulation of gas bubbles in the container compartments resulting in tissue damage. Consequently, the occurence of gas bubbles has to be minimized. Air bubbles in the perfusion culture medium preferentially accumulate at sites where different materials come into contact. The first development is new screw caps for media bottles, specifically designed to allow fluid contact with only the tube and not the cap material. The second development is the separation of remaining gas bubbles from the liquid phase in the medium using newly-developed gas expander modules. By the application of these new tools, the yield of embryonic renal collecting duct epithelia with intact barrier function on a fragile natural support material can be significantly increased compared to earlier experiments.

  8. Stability and long term continuity of satellite data for rapid land surface monitoring of vegetation condition

    NASA Astrophysics Data System (ADS)

    Brown, J. F.; Howard, D. M.

    2014-12-01

    Satellite-based normalized difference vegetation index, or NDVI, is a commonly used index in applications that require consistent and timely data, including monitoring drought, tracking vegetation phenological transitions, and assessing crop progress and condition. Although many other indices have been developed, the NDVI remains popular in the monitoring community. One reason is the value of NDVI for use in long-term studies necessitating multiple sensor data sources. It is calculated using a standard formula, red minus near-infrared divided by red plus near-infrared. But, this does not mean that all NDVI data are the same. Many factors, ranging from sensor design and raw satellite data ingest to initial data manipulation and post-processing, influence end-product quality and consistency. The purpose of this study was to perform a statistical scientific comparison between multiple NDVI data sources. The NDVI data analyzed in this study were derived from 8-day 250 meter (m) standard Moderate Resolution Imaging Spectroradiometer (MODIS) Terra and Aqua surface reflectance composites (Collection 5, MOD09Q1), 7-day 250 m expedited MODIS (eMODIS) Terra and Aqua NDVI products, and 14-day 1000 m Advanced Very High Resolution Radiometer (AVHRR) NDVI products of central U.S. over the 2003 - 2012 timeframe. Only composites falling within the growing season (between April and October) and temporally coincident were included. All composites were consistently post-processed using standard MODIS quality assurance data and evaluated to calculate spatial statistics (e.g. means and standard deviations) for 160 uniform 150 kilometer2 tiles. The results for seasonal, period-specific and overall correlations indicated the highest agreement was between standard MODIS Terra and Aqua composites, with a Pearson's coefficient of determination of R2 = 0.98, and the lowest agreement was between eMODIS Terra and AVHRR, with a R2 value of 0.84. There was evidence of slight Terra sensor

  9. Short- and Long-Term Mortality Rates of Elderly Acute Kidney Injury Patients Who Underwent Continuous Renal Replacement Therapy

    PubMed Central

    Rhee, Harin; Jang, Keum Sook; Park, Jong Man; Kang, Jin Suk; Hwang, Na Kyoung; Kim, Il Young; Song, Sang Heon; Seong, Eun Young; Lee, Dong Won; Lee, Soo Bong; Kwak, Ihm Soo

    2016-01-01

    Background The world’s population is aging faster and the incidence of acute kidney injury (AKI) needing continuous renal replacement therapy (CRRT) is increasing in elderly population. The outcome of AKI needing CRRT in elderly patients is known to be poor. However, the definitions of elderly used in the previous literatures were diverse and, there were few data that compared the long-term mortality rates of these patients with middle aged patients. This study was aimed to evaluate this issue. Methods This study was a single-center, retrospective cohort study of patients who underwent CRRT from January 2013 to December 2015. The patients were divided into the following four age cohorts: middle-aged (55–64), young-old (65–74), middle-old (75–84), and old-old (≥85). The short- and long-term mortality rates for each age cohort were compared. Results A total of 562 patients met the inclusion criteria. The short-term mortality rate was 57.3% in the entire cohort. Compared with the middle-aged cohort, the middle-old cohort (HR 1.48 (1.09–2.02), p = 0.012) and the old-old cohort (HR 2.33 (1.30–4.19), p = 0.005) showed an increased short-term mortality rate along with an increased SOFA score, acidemia and a prolonged prothrombin time. When we analyzed the long-term mortality rate of the 238 survived patients, the middle-old cohort (HR 3.76 (1.84–7.68), p<0.001), the old-old cohort (HR 4.40(1.20–16.10), p = 0.025), a lower BMI, the presence of liver cirrhosis, the presence of congestive heart failure and a history of sepsis were independent risk factors for the prediction of long-term mortality. Conclusion Compared with the middle-aged cohort, the middle-old and the old-old cohort showed an increased short-term and long-term mortality rate. However, in the young-old cohort, neither the short-term nor the long-term mortality rate was increased. PMID:27875571

  10. Public long-term care insurance: a way to ensure sustainable continuity of care for frail older people.

    PubMed

    Hébert, Réjean

    2011-01-01

    A necessary component of the prescribed continuing care act should be the creation of a long-term care insurance program in Canada. This social innovation has been implemented in many countries in recent decades to address the aging of the population and associated pandemic of chronic diseases. A specific autonomy insurance fund would have to be created and funded through transfers of current funding for long-term care, tax credits for disabled individuals and substantial new investment to make the shift from institutional to home care. Following a standardized assessment by case managers, an autonomy support benefit would be determined to fund "in kind" public or private services or a "cash-for-care" allowance for older people to purchase services. Case managers would be responsible for coordinating the care, controlling the quality of services and reassessing needs according to changes in individuals' conditions. Funding reform of long-term care would prioritize home care and optimize the functioning of integrated care to improve support for frail older people.

  11. Continuous long-term cytotoxicity monitoring in 3D spheroids of beetle luciferase-expressing hepatocytes by nondestructive bioluminescence measurement.

    PubMed

    Yasunaga, Mayu; Fujita, Yasuko; Saito, Rumiko; Oshimura, Mitsuo; Nakajima, Yoshihiro

    2017-06-20

    Three-dimensional (3D) spheroids are frequently used in toxicological study because their morphology and function closely resemble those of tissue. As these properties are maintained over a long term, repeated treatment of the spheroids with a test object is possible. Generally, in the repeated treatment test to assess cytotoxicity in the spheroids, ATP assay, colorimetric measurement using pigments or high-content imaging analysis is performed. However, continuous assessment of cytotoxicity in the same spheroids using the above assays or analysis is impossible because the spheroids must be disrupted or killed. To overcome this technical limitation, we constructed a simple monitoring system in which cytotoxicity in the spheroids can be continuously monitored by nondestructive bioluminescence measurement. Mouse primary hepatocytes were isolated from transchromosomic (Tc) mice harboring a mouse artificial chromosome (MAC) vector expressing beetle luciferase Emerald Luc (ELuc) under the control of cytomegalovirus immediate early enhancer/chicken β-actin promoter/rabbit β-globin intron II (CAG) promoter, and used in 3D cultures. We confirmed that both luminescence and albumin secretion from the spheroids seeded in the 96-well format Cell-able(TM) were maintained for approximately 1 month. Finally, we repetitively treated the luminescent 3D spheroids with representative hepatotoxicants for approximately 1 month, and continuously and nondestructively measured bioluminescence every day. We successfully obtained daily changes of the dose-response bioluminescence curves for the respective toxicants. In this study, we constructed a monitoring system in which cytotoxicity in the same 3D spheroids was continuously and sensitively monitored over a long term. Because this system can be easily applied to other cells, such as human primary cells or stem cells, it is expected to serve as the preferred platform for simple and cost-effective long-term monitoring of cellular events

  12. Long-term therapy for heart failure with continuous ambulatory peritoneal dialysis.

    PubMed

    McKinnie, J J; Bourgeois, R J; Husserl, F E

    1985-06-01

    This article reports the treatment with continuous ambulatory peritoneal dialysis of a patient with intractable congestive heart failure secondary to an ischemic cardiomyopathy. Although the use of peritoneal dialysis to treat refractory heart failure is not new, the advent of an effective continuous peritoneal dialysis system has allowed its use over prolonged periods of time. The two-year treatment interval described herein represents the longest reported application of this technique, to the best of our knowledge.

  13. Long-term continuous acoustical suspended-sediment measurements in rivers - Theory, application, bias, and error

    USGS Publications Warehouse

    Topping, David J.; Wright, Scott A.

    2016-05-04

    these sites. In addition, detailed, step-by-step procedures are presented for the general river application of the method.Quantification of errors in sediment-transport measurements made using this acoustical method is essential if the measurements are to be used effectively, for example, to evaluate uncertainty in long-term sediment loads and budgets. Several types of error analyses are presented to evaluate (1) the stability of acoustical calibrations over time, (2) the effect of neglecting backscatter from silt and clay, (3) the bias arising from changes in sand grain size, (4) the time-varying error in the method, and (5) the influence of nonrandom processes on error. Results indicate that (1) acoustical calibrations can be stable for long durations (multiple years), (2) neglecting backscatter from silt and clay can result in unacceptably high bias, (3) two frequencies are likely required to obtain sand-concentration measurements that are unbiased by changes in grain size, depending on site-specific conditions and acoustic frequency, (4) relative errors in silt-and-clay- and sand-concentration measurements decrease substantially as concentration increases, and (5) nonrandom errors may arise from slow changes in the spatial structure of suspended sediment that affect the relations between concentration in the acoustically ensonified part of the cross section and concentration in the entire river cross section. Taken together, the error analyses indicate that the two-frequency method produces unbiased measurements of suspended-silt-and-clay and sand concentration, with errors that are similar to, or larger than, those associated with conventional sampling methods.

  14. Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

    NASA Astrophysics Data System (ADS)

    Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

    2015-12-01

    In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

  15. Continuous-flow total artificial heart supports long-term survival of a calf.

    PubMed

    Frazier, O H; Cohn, William E; Tuzun, Egemen; Winkler, Jo Anna; Gregoric, Igor D

    2009-01-01

    The development and clinical use of continuous-flow left ventricular assist devices (LVADs) stimulated our interest in developing a total heart replacement with continuous-flow rotary blood pumps. We constructed a continuous-flow total artificial heart (CFTAH) from 2 HeartMate II axial-flow LVADs and used this CFTAH to replace the native heart of a calf. The purpose of this experiment was to study the effects of total continuous flow on physiologic parameters at rest and during exercise after the animal recovered from surgery. We monitored pulmonary and systemic pump performance, and we assessed arterial blood gases, hemodynamic and biochemical variables, and neurohormone levels during the 7 weeks of CFTAH support. At day 36 after CFTAH implantation, the calf was exercised on a treadmill at increasing speeds for 40 minutes; total oxygen consumption, pump flow, blood pressure, and respiratory rate were monitored. Baseline hematologic levels were altered postoperatively but returned to normal by 2 weeks. We saw no signs of hemolysis or thrombosis during CFTAH support. The calf had a normal physiologic response to treadmill exercise. The animal gained weight and appeared to function normally during the study. The CFTAH operated within design specifications throughout the study. Homeostasis, end-organ and vasomotor function, and the ability to exercise are not adversely affected by 7 weeks of totally pulseless circulation in a calf.

  16. Continuous-Flow Total Artificial Heart Supports Long-Term Survival of a Calf

    PubMed Central

    Frazier, O. H.; Cohn, William E.; Tuzun, Egemen; Winkler, Jo Anna; Gregoric, Igor D.

    2009-01-01

    The development and clinical use of continuous-flow left ventricular assist devices (LVADs) stimulated our interest in developing a total heart replacement with continuous-flow rotary blood pumps. We constructed a continuous-flow total artificial heart (CFTAH) from 2 HeartMate II axial-flow LVADs and used this CFTAH to replace the native heart of a calf. The purpose of this experiment was to study the effects of total continuous flow on physiologic parameters at rest and during exercise after the animal recovered from surgery. We monitored pulmonary and systemic pump performance, and we assessed arterial blood gases, hemodynamic and biochemical variables, and neurohormone levels during the 7 weeks of CFTAH support. At day 36 after CFTAH implantation, the calf was exercised on a treadmill at increasing speeds for 40 minutes; total oxygen consumption, pump flow, blood pressure, and respiratory rate were monitored. Baseline hematologic levels were altered postoperatively but returned to normal by 2 weeks. We saw no signs of hemolysis or thrombosis during CFTAH support. The calf had a normal physiologic response to treadmill exercise. The animal gained weight and appeared to function normally during the study. The CFTAH operated within design specifications throughout the study. Homeostasis, end-organ and vasomotor function, and the ability to exercise are not adversely affected by 7 weeks of totally pulseless circulation in a calf. PMID:20069083

  17. Evaluating Long Term Impact of Nursing and Other Health Care Professionals Continuing Education Workshops.

    ERIC Educational Resources Information Center

    Henschke, John A.

    From October, 1977, through December, 1979, 13 one-day continuing education workshops were given by the University of Missouri Extension for nurses and other health-care professionals. A total of 520 different health care professionals attended the sessions, with multiple registrations bringing the total enrollment in the program to 925. Programs…

  18. Environmental Satellites: Planning Required to Mitigate Near-Term Risks and Ensure Long-Term Continuity

    DTIC Science & Technology

    2010-06-29

    work together. For example, climate measurements have allowed scientists to better understand the effect of deforestation on how the earth absorbs...development activities. Until the transition risks are effectively mitigated, and unless components are able to continue scheduled development, it...observations such as greenhouse gas levels (e.g., carbon dioxide), aerosol and dust particles, and moisture concentration. When these data are

  19. Officer Individual Differences: Predicting Long-Term Continuance and Performance in the U.S. Army

    DTIC Science & Technology

    2012-10-01

    et al., 2009; Young, Kubiask, Legree, & Tremble, 2010), competing civilian jobs , stress-inducing events, pre-existing mental or physical problems...predictors of Army continuance include supervisor support (Dupré & Day, 2007), job security and pay (Chaffin, Hamilton, & Czrew, 2008; Johnson, et...influenced intentions to reenlist by affecting job satisfaction. Weiss, Ilgen, and Borman (2010) argued that demographic differences such as marital

  20. Early and continued manual stimulation is required for long-term recovery after facial nerve injury.

    PubMed

    Grosheva, Maria; Rink, Svenja; Jansen, Ramona; Bendella, Habib; Pavlov, Stoyan P; Sarikcioglu, Levent; Angelov, Doychin N; Dunlop, Sarah A

    2017-02-18

    We previously have shown that manual stimulation (MS) of vibrissal muscles for 2 months after facial nerve injury in rats improves whisking and reduces motor end plate polyinnervation. Here, we seek to determine whether discontinuing or delaying MS after facial-facial anastomosis (FFA) leads to similar results. Rats were subjected to FFA and received MS for (1) 4 months (early and continued), (2) the first but not the last 2 months (discontinued), or (3) the last 2 months (delayed). Intact animals and those not receiving MS (no MS) were also examined. Early and continued MS restored whisking amplitude to 43°, a value significantly higher compared with the discontinued, delayed, and no MS groups (32°, 24°, and 10°, respectively). Motor end plate polyinnervation occurred in all experimental groups but was significantly higher in the delayed group. Early and continued MS results in better recovery than when it is either discontinued or delayed. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  1. A Continuous Long-Term Record of Magnetic-Storm Occurrence and Intensity

    NASA Astrophysics Data System (ADS)

    Love, J. J.

    2007-05-01

    Hourly magnetometer data have been produced by ground-based magnetic observatories for over a century. These data are used for a wide variety of applications, including many for space physics. In particular, hourly data from a longitudinal necklace of mid-latitude observatories can be used to construct a time series recording the storm-time disturbance index Dst, one of the most useful scalar summaries of magnetic storm intensity which is generally interpreted in terms of an equivalent equatorial magnetospheric ring current. Dst has been routinely calculated in a temporally piece-wise fashion since the IGY using a subset of the available observatories: four or five stations, typically including Honolulu (HON), San Juan (SJG), Kakioka Japan (KAK), Hermanus South Africa (HER), and Alibag India (ABG). In this presentation we discuss a single continuous Dst time series made using a denser and more uniform distribution of observatories than that which is standard: including, additionally, Watheroo Australia (WAT), Apia Samoa (API), and Vassouras Brazil (VSS). Starting first with the data from each individual observatory, we subtract the geomagnetic secular variation, caused primarily by the core dynamo, and the solar-quiet (Sq) variation, caused primarily by the ionospheric dynamo. The latter requires careful spectral analysis, and those intermediate results are, themselves, of scientific interest. Following this, we combine the disturbance residuals from each station to form the continuous Dst time series. Statistics deduced from this model allow us to quantify the likelihood of storm occurrence and intensity, both of which are modulated in time by the solar cycle. This analysis is accomplished using a 50 year Dst time series. The prospects for constructing a longer continuous Dst time series are discussed.

  2. Assessing long-term climate data continuity of the Deep Blue aerosol products from MODIS to VIIRS

    NASA Astrophysics Data System (ADS)

    Hsu, N. Y. C.; Sayer, A. M.; Lee, J.; Bettenhausen, C.; Tsay, S. C.; Carletta, N.

    2016-12-01

    The impacts of natural and anthropogenic sources of air pollution on climate and human health have continued to gain attention from the scientific community. In order to facilitate these effects, high quality consistent long-term global aerosol data records from satellites are essential. Several EOS-era instruments (e.g., SeaWiFS, MODIS, and MISR) are able to provide such information with a high degree of fidelity. However, with the aging MODIS sensors and the launch of the VIIRS instrument on Suomi NPP in late 2011, the continuation of long-term aerosol data records suitable for climate studies from MODIS to VIIRS is needed urgently. After extensive efforts of modifying the retrieval algorithm and surface database to account for the wavelength differences between MODIS and VIIRS, the Version 1 VIIRS Deep Blue aerosol products are currently scheduled to be released to the public in 2016. We will show the global (land and ocean) distributions of various aerosol products from Version 1 of the VIIRS Deep Blue data set. The preliminary validation results of these new VIIRS Deep Blue aerosol products using data from AERONET sunphotometers over land and ocean will be discussed. We will also compare the monthly averaged Deep Blue aerosol optical thickness (AOT) from VIIRS with the MODIS C6 products to investigate if any systematic biases may exist between MODIS C6 and VIIRS AOT.

  3. Long-Term Continuous Double Station Observation of Faint Meteor Showers.

    PubMed

    Vítek, Stanislav; Páta, Petr; Koten, Pavel; Fliegel, Karel

    2016-09-14

    Meteor detection and analysis is an essential topic in the field of astronomy. In this paper, a high-sensitivity and high-time-resolution imaging device for the detection of faint meteoric events is presented. The instrument is based on a fast CCD camera and an image intensifier. Two such instruments form a double-station observation network. The MAIA (Meteor Automatic Imager and Analyzer) system has been in continuous operation since 2013 and has successfully captured hundreds of meteors belonging to different meteor showers, as well as sporadic meteors. A data processing pipeline for the efficient processing and evaluation of the massive amount of video sequences is also introduced in this paper.

  4. Long-Term Continuous Double Station Observation of Faint Meteor Showers

    PubMed Central

    Vítek, Stanislav; Páta, Petr; Koten, Pavel; Fliegel, Karel

    2016-01-01

    Meteor detection and analysis is an essential topic in the field of astronomy. In this paper, a high-sensitivity and high-time-resolution imaging device for the detection of faint meteoric events is presented. The instrument is based on a fast CCD camera and an image intensifier. Two such instruments form a double-station observation network. The MAIA (Meteor Automatic Imager and Analyzer) system has been in continuous operation since 2013 and has successfully captured hundreds of meteors belonging to different meteor showers, as well as sporadic meteors. A data processing pipeline for the efficient processing and evaluation of the massive amount of video sequences is also introduced in this paper. PMID:27649179

  5. The continuous plankton recorder survey: A long-term, basin-scale oceanic time series

    NASA Technical Reports Server (NTRS)

    Gamble, John C.; Hunt, Harold G.

    1992-01-01

    In the 1920s, before the advent of echo sounders, fishery biologists were greatly concerned with assisting the fisherman to locate schools of pelagic fish. One of the approaches they developed was to relate the distribution of the planktonic food organisms to the presence of the schools of predators such as herring (Clupea harengus). The British planktologist, Alister Hardy, who had already carried out extensive studies on the feeding preferences of herring (Hardy, 1926a), initiated a program to examine the fishermen's contention that herring schools avoided 'green', i.e., phytoplankton-rich, water but could be correlated with high concentrations of zooplankton. This practical program was centered on the use of a specially developed instrument, the 'Plankton Indicator', designed to be used by the fisherman to assist in the search for suitable waters. It had limited success in its main aim but, as a collecting device, it embodied several profoundly important features. It was a simple instrument which was robust enough to be deployed and recovered by the crew of commercial vessels (in this case fishing vessels) while they were underway. The Indicator however, was no more than a high speed net which integrated the plankton over the area of sampling, but Hardy had also become interested in describing the patchiness of planktonic populations. He thus developed the Continuous Plankton Recorder (CPR) where he substituted the fixed filter screen of the Indicator by a continually moving length of silk mesh. The screen traversed at constant speed across the path of the incoming water and the trapped organisms were retained in place by sandwiching beneath an additional second mesh screen. Thus, knowing the speed of the towing vessel and the shooting and hauling positions, the spatial patterns of the plankton could be determined. Hardy took the first CPR to the Antarctic where he used it in the Southern Atlantic (Hardy, 1926b) and later deployed it in the North Sea to make

  6. A Quantitative Analysis of Factors That Influence Participation in Continuing Education among Nurses Employed in Long-Term Care Facilities

    ERIC Educational Resources Information Center

    Murray, Rhoda R.

    2013-01-01

    As the American population ages, the need for more long-term care services will increase. The elderly who are afflicted with a number of chronic illnesses predominantly use long-term care services. By 2020, 12 million older Americans will need long-term care services, and those 65 and older have a 40% chance of entering some type of long-term care…

  7. Long-term statistics of continuous single column model simulations at Cabauw

    NASA Astrophysics Data System (ADS)

    Neggers, R.

    2009-04-01

    Single column model (SCM) simulation has become a valuable and relied-upon tool in the development and evaluation of parameterizations for general circulation models (GCM). In this method, the sub-grid model of a GCM is independently integrated in time, using prescribed large-scale forcings and boundary conditions. Typically, an idealized case is constructed based on observational data from a field experiment. An advantage of the SCM technique is that the model physics is studied in controlled conditions, in an isolated mode from the larger-scale circulation. Combined with the low computational cost involved, this serves to enhance model transparency and facilitates getting insight into the simulated system. A drawback of the SCM as a development tool is that relatively few cases have yet been formulated. Often these idealized cases represent so-called 'golden days', reflecting observed situations thought prototypical for a specific weather regime. One could question the representativeness of such idealized cases; i) they might actually reflect unique situations that rarely occur, and ii) they do not necessarily represent those regimes that cause the most problems in GCMs. As a result, parameterizations might get optimized for rare situations, while their performance for the most 'troublesome' regimes remains unassessed. These issues have inspired efforts to perform SCM evaluations on a more continuous basis, thus automatically covering many different weather regimes. One such project is the recently initiated Cabauw Parameterization Testbed. Short-range (3-day) SCM simulations are performed daily for the Cabauw meteorological site in the Netherlands, operated by the Royal Netherlands Meteorological Institute (KNMI). The multi-year archive of SCM simulations thus generated is evaluated against the wealth of continuous observational datastreams measured at Cabauw, which cover the thermodynamic, kinematic and cloudy state of the atmosphere. The method of

  8. Continuation of long-term care for cervical dystonia at an academic movement disorders clinic.

    PubMed

    Gill, Chandler E; Manus, Neil D; Pelster, Michael W; Cook, Jason A; Title, Wallace; Molinari, Anna L; Charles, David

    2013-04-23

    Patients with cervical dystonia (CD) receive much of their care at university based hospital outpatient clinics. This study aimed to describe the clinical characteristics and treatment experiences of patients who continued care at our university based movement disorders clinic, and to document the reasons for which a subset discontinued care. Seventy patients (77% female) were recruited from all patients at the clinic (n = 323). Most (93%) were treated with botulinum neurotoxin (BoNT) injection, and onabotulinumtoxinA was initially used in 97%. The average dose of onabotulinumtoxinA was 270.4 U (range 50-500) and the median number of injections was 14 (range: 1-39). Twenty one patients later received at least one cycle of rimabotulinumtoxinB (33%); of those, 10 switched back to onabotulinumtoxinA (48%). The initial rimabotulinumtoxinB dose averaged 11,996 units (range: 3000-25,000 over 1-18 injections). Twenty one patients (30%) discontinued care. Reasons cited included suboptimal response to BoNT therapy (62%), excessive cost (24%), excessive travel burden (10%), and side effects of BoNT therapy (10%). Most patients (76%) did not seek further care after leaving the clinic. Patients who terminated care received fewer treatment cycles (5.5 vs. 13.0, p = 0.020). There were no other identifiable differences between groups in gender, age, disease characteristics, toxin dose, or toxin formulation. These results indicate that a significant number of CD patients discontinue care due to addressable barriers to access, including cost and travel burden, and that when leaving specialty care, patients often discontinue treatment altogether. These data highlight the need for new initiatives to reduce out-of-pocket costs, as well as training for community physicians on neurotoxin injection in order to lessen the travel burden patients must accept in order to receive standard-of-care treatments.

  9. Long-term continuous observation of vertical gradient of water temperature on the deep seafloor

    NASA Astrophysics Data System (ADS)

    Suzuki, S.; Hino, R.; Ito, Y.; Kubota, T.; Inazu, D.

    2015-12-01

    We have conducted ocean bottom pressure observations near the Japan Trench and the Kuril Trench using self-pop-up type instruments to detect seafloor vertical displacement accompanied by slip events along the plate boundary faults. Recently, we have started similar observation campaigns in the Hikurangi subduction zone, off the North Island of New Zealand since 2013. As a result of the observations, we have observed an uplift of 5 m due to the 2011 Tohoku-Oki earthquake (Ito et al., 2011) and transient crustal deformations accompanied by slow slip events preceding the earthquake (Ito et al., 2013). Precision thermometer, usually used for temperature compensation of the pressure readings, occasionally recorded strange temperature changes related to occurrence of submarine earthquakes or tsunamis. Arai et al. (2013) interpreted noticeable temperature changes observed after the 2011 Tohoku-Oki earthquake and interpreted it as the result of the turbidity current induced by massive tsunami. Inazu et al. (2015) pointed out a possibility that the temperature disturbance recorded just after the Tohoku-Oki earthquake above the large coseismic slip zone was due to the discharged of submarine groundwater associated with the earthquake. In order to describe these strange temperature signals more quantitatively, we started trial observations allowing investigation of water temperature field on the deep seafloor. In this study, we installed two precision temperature loggers top and bottom of the ocean bottom pressure recorders, with ~ 60 cm in height, to measure vertical gradients of seawater temperature as well as the ocean bottom pressures. Here, we report about 1-year continuous records retrieved from the Japan Trench and off New Zealand. During the observation off New Zealand, an evident slow slip event was identified by the onshore geodetic observations near the locations of our seafloor pressure-temperature monitoring. We are now exploring possible thermal and pressure

  10. Startup and long term operation of enhanced biological phosphorus removal in continuous-flow reactor with granules.

    PubMed

    Li, Dong; Lv, Yufeng; Zeng, Huiping; Zhang, Jie

    2016-07-01

    The startup and long term operation of enhanced biological phosphorus removal (EBPR) in a continuous-flow reactor (CFR) with granules were investigated in this study. Through reducing the settling time from 9min to 3min gradually, the startup of EBPR in a CFR with granules was successfully realized in 16days. Under continuous-flow operation, the granules with good phosphorus and COD removal performance were stably operated for more than 6months. And the granules were characterized with particle size of around 960μm, loose structure and good settling ability. During the startup phase, polysaccharides (PS) was secreted excessively by microorganisms to resist the influence from the variation of operational mode. Results of relative quantitative PCR indicated that granules dominated by polyphosphate-accumulating organisms (PAOs) were easier accumulated in the CFR because more excellent settling ability was needed in the system.

  11. Long Term Prognosis

    MedlinePlus

    ... TERM PROGNOSIS The long-term outlook of pediatric cardiomyopathy continues to be unpredictable because it occurs with ... a child also depends on the type of cardiomyopathy and the stage the disease is first diagnosed. ...

  12. Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty

    PubMed Central

    Alaca, Nuray; Atalay, Ayçe; Güven, Zeynep

    2015-01-01

    [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term. PMID:26696702

  13. Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty.

    PubMed

    Alaca, Nuray; Atalay, Ayçe; Güven, Zeynep

    2015-11-01

    [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term.

  14. Immunomodulatory therapy with tumour necrosis factor α inhibitors in children with antinuclear antibody-associated chronic anterior uveitis: long-term results.

    PubMed

    Doycheva, Deshka; Zierhut, Manfred; Blumenstock, Gunnar; Stuebiger, Nicole; Januschowski, Kai; Voykov, Bogomil; Deuter, Christoph

    2014-04-01

    The aim of the study was to assess the long-term efficacy and tolerability of tumour necrosis factor α (TNFα) inhibitors in the therapy of children with refractory antinuclear antibody (ANA)-associated chronic anterior uveitis. Retrospective analysis of 31 children with ANA-associated uveitis, treated with TNFα inhibitors with a follow-up period of at least 2 years. The outcome measures included: control of inflammation, corticosteroid-sparing potential and side effects. Twenty-three children (74%) were treated with adalimumab, five children (16%) with infliximab and three children (10%) with etanercept. Control of uveitis, defined as 0 anterior chamber cells while on ≤2 drops/day topical corticosteroids, was achieved in 22 of 31 patients (71%) after 1 year (95% CI 52% to 86%), and in 21 of 29 patients (72%) after 2 years of treatment (95% CI 53% to 87%). Control of uveitis was observed in 18 of 23 children (78%) treated with adalimumab, and in two of five children (40%) treated with infliximab. In all children treated with etanercept, no sufficient inflammatory control was found. Systemic corticosteroids could be discontinued in 71% (12/17 children) and topical corticosteroids in 55% (17/31) of the patients. Treatment-related side effects were found in nine children (29%, rate: 0.10/patient-year). Our data show that adalimumab and infliximab have beneficial effects in the therapy of severe ANA-associated anterior uveitis in children.

  15. Long-term maintenance therapy using rituximab-induced continuous B-cell depletion in patients with ANCA vasculitis.

    PubMed

    Pendergraft, William F; Cortazar, Frank B; Wenger, Julia; Murphy, Andrew P; Rhee, Eugene P; Laliberte, Karen A; Niles, John L

    2014-04-01

    Remission in the majority of ANCA vasculitis patients is not sustained after a single course of rituximab, and risk of relapse warrants development of a successful strategy to ensure durable remission. A retrospective analysis of ANCA vasculitis patients who underwent maintenance therapy using rituximab-induced continuous B-cell depletion for up to 7 years was performed. Maintenance therapy with rituximab was initiated after achieving remission or converting from other prior maintenance therapy. Continuous B-cell depletion was achieved in all patients by scheduled rituximab administration every 4 months. Disease activity, serologic parameters, adverse events, and survival were examined. In the study, 172 patients (mean age=60 years, 55% women, 57% myeloperoxidase-ANCA) treated from April of 2006 to March of 2013 underwent continuous B-cell depletion with rituximab. Median remission maintenance follow-up time was 2.1 years. Complete remission (Birmingham Vasculitis Activity Score [BVAS] = 0) was achieved in all patients. Major relapse (BVAS ≥ 3) occurred in 5% of patients and was associated with weaning of other immunosuppression drugs. Remission was reinduced in all patients. Survival mirrored survival of a general age-, sex-, and ethnicity-matched United States population. This analysis provides evidence for long-term disease control using continuous B-cell depletion. This treatment strategy in ANCA vasculitis patients also seems to result in survival rates comparable with rates in a matched reference population. These findings suggest that prospective remission maintenance treatment trials using continuous B-cell depletion are warranted.

  16. Self-adhesive epidermal carbon nanotube electronics for tether-free long-term continuous recording of biosignals

    PubMed Central

    Lee, Seung Min; Byeon, Hang Jin; Lee, Joong Hoon; Baek, Dong Hyun; Lee, Kwang Ho; Hong, Joung Sook; Lee, Sang-Hoon

    2014-01-01

    The long-term, continuous, inconspicuous, and noiseless monitoring of bioelectrical signals is critical to the early diagnosis of disease and monitoring health and wellbeing. However, it is a major challenge to record the bioelectrical signals of patients going about their daily lives because of the difficulties of integrating skin-like conducting materials, the measuring system, and medical technologies in a single platform. In this study, we developed a thin epidermis-like electronics that is capable of repeated self-adhesion onto skin, integration with commercial electronic components through soldering, and conformal contact without serious motion artifacts. Using well-mixed carbon nanotubes and adhesive polydimethylsiloxane, we fabricated an epidermal carbon nanotube electronics which maintains excellent conformal contact even within wrinkles in skin, and can be used to record electrocardiogram signals robustly. The electrode is biocompatible and can even be operated in water, which means patients can live normal lives despite wearing a complicated recording system. PMID:25123356

  17. Self-adhesive epidermal carbon nanotube electronics for tether-free long-term continuous recording of biosignals.

    PubMed

    Lee, Seung Min; Byeon, Hang Jin; Lee, Joong Hoon; Baek, Dong Hyun; Lee, Kwang Ho; Hong, Joung Sook; Lee, Sang-Hoon

    2014-08-15

    The long-term, continuous, inconspicuous, and noiseless monitoring of bioelectrical signals is critical to the early diagnosis of disease and monitoring health and wellbeing. However, it is a major challenge to record the bioelectrical signals of patients going about their daily lives because of the difficulties of integrating skin-like conducting materials, the measuring system, and medical technologies in a single platform. In this study, we developed a thin epidermis-like electronics that is capable of repeated self-adhesion onto skin, integration with commercial electronic components through soldering, and conformal contact without serious motion artifacts. Using well-mixed carbon nanotubes and adhesive polydimethylsiloxane, we fabricated an epidermal carbon nanotube electronics which maintains excellent conformal contact even within wrinkles in skin, and can be used to record electrocardiogram signals robustly. The electrode is biocompatible and can even be operated in water, which means patients can live normal lives despite wearing a complicated recording system.

  18. Self-adhesive epidermal carbon nanotube electronics for tether-free long-term continuous recording of biosignals

    NASA Astrophysics Data System (ADS)

    Lee, Seung Min; Byeon, Hang Jin; Lee, Joong Hoon; Baek, Dong Hyun; Lee, Kwang Ho; Hong, Joung Sook; Lee, Sang-Hoon

    2014-08-01

    The long-term, continuous, inconspicuous, and noiseless monitoring of bioelectrical signals is critical to the early diagnosis of disease and monitoring health and wellbeing. However, it is a major challenge to record the bioelectrical signals of patients going about their daily lives because of the difficulties of integrating skin-like conducting materials, the measuring system, and medical technologies in a single platform. In this study, we developed a thin epidermis-like electronics that is capable of repeated self-adhesion onto skin, integration with commercial electronic components through soldering, and conformal contact without serious motion artifacts. Using well-mixed carbon nanotubes and adhesive polydimethylsiloxane, we fabricated an epidermal carbon nanotube electronics which maintains excellent conformal contact even within wrinkles in skin, and can be used to record electrocardiogram signals robustly. The electrode is biocompatible and can even be operated in water, which means patients can live normal lives despite wearing a complicated recording system.

  19. Exercise during Short-Term and Long-Term Continuous Exposure to Hypoxia Exacerbates Sleep-Related Periodic Breathing

    PubMed Central

    Tellez, Helio Fernandez; Morrison, Shawnda A.; Neyt, Xavier; Mairesse, Olivier; Piacentini, Maria Francesca; Macdonald-Nethercott, Eoin; Pangerc, Andrej; Dolenc-Groselj, Leja; Eiken, Ola; Pattyn, Nathalie; Mekjavic, Igor B.; Meeusen, Romain

    2016-01-01

    Study Objectives: Exposure to hypoxia elevates chemosensitivity, which can lead to periodic breathing. Exercise impacts gas exchange, altering chemosensitivity; however, interactions between sleep, exercise and chronic hypoxic exposure have not been examined. This study investigated whether exercise exacerbates sleep-related periodic breathing in hypoxia. Methods: Two experimental phases. Short-Term Phase: a laboratory controlled, group-design study in which 16 active, healthy men (age: 25 ± 3 y, height: 1.79 ± 0.06 m, mass: 74 ± 8 kg) were confined to a normobaric hypoxic environment (FIO2 = 0.139 ± 0.003, 4,000 m) for 10 days, after random assignment to a sedentary (control, CON) or cycle-exercise group (EX). Long-Term Phase: conducted at the Concordia Antarctic Research Station (3,800 m equivalent at the Equator) where 14 men (age: 36 ± 9 y, height: 1.77 ± 0.09 m, mass: 75 ± 10 kg) lived for 12–14 months, continuously confined. Participants were stratified post hoc based on self-reported physical activity levels. We quantified apnea-hypopnea index (AHI) and physical activity variables. Results: Short-Term Phase: mean AHI scores were significantly elevated in the EX group compared to CON (Night1 = CON: 39 ± 51, EX: 91 ± 59; Night10 = CON: 32 ± 32, EX: 92 ± 48; P = 0.046). Long-Term Phase: AHI was correlated to mean exercise time (R2 = 0.4857; P = 0.008) and the coefficient of variation in night oxyhemoglobin saturation (SpO2; R2 = 0.3062; P = 0.049). Conclusions: Data indicate that exercise (physical activity) per se affects night SpO2 concentrations and AHI after a minimum of two bouts of moderate-intensity hypoxic exercise, while habitual physical activity in hypobaric hypoxic confinement affects breathing during sleep, up to 13+ months' duration Citation: Tellez HF, Morrison SA, Neyt X, Mairesse O, Piacentini MF, Macdonald-Nethercott E, Pangerc A, Dolenc-Groselj L, Eiken O, Pattyn N, Mekjavic IB, Meeusen R. Exercise during short-term and long-term

  20. Long-Term Effects of Continuous Positive Airway Pressure Treatment on Sexuality in Female Patients with Obstructive Sleep Apnea

    PubMed Central

    Petersen, Marian; Kristensen, Ellids; Berg, Søren; Midgren, Bengt

    2013-01-01

    Introduction Results from a previous study showed that sexuality was negatively affected in females with untreated obstructive sleep apnea (OSA). Data are sparse on the long-term effects of nocturnal continuous positive airway pressure (CPAP) treatment on sexual difficulties and sexual distress in female patients with OSA. Aim The aim of the present study was to investigate the effects after 1 year of CPAP treatment on sexual difficulties, sexual distress, and manifest sexual dysfunction in female patients with OSA. The effect of CPAP on life satisfaction was also investigated. Methods Fifty-four therapy-compliant, female patients (age 22–71) received a survey before and after 1 year of nocturnal CPAP treatment. The questions on this survey were drawn from three self-administered questionnaires: two on sexuality and one on life satisfaction. The results were compared with a population sample. The Epworth Sleepiness Scale was used for assessment of daytime sleepiness. Main Outcome Measures The Female Sexual Function Index, Female Sexual Distress Scale, Manifest Female Sexual Dysfunction, four questions from Life Satisfaction 11, and the Epworth Sleepiness Scale were all used to measure outcome. Results In total, 44 patients responded to the survey (81% response rate). The results were a significant, positive change in manifest female sexual dysfunction, but no significant changes in isolated sexual difficulties or sexual distress. Daytime sleepiness significantly decreased after 1 year. The results from the Life Satisfaction 11 questionnaire remained unchanged after 1 year. Conclusions After 1 year of CPAP treatment, female patients with OSA reported reduced manifest sexual dysfunction. However, it cannot be concluded if this result is due to CPAP treatment alone. Furthermore, reduced daytime tiredness was found in the surveyed population. CPAP treatment, per se, does not seem to affect partner relationships. Petersen M, Kristensen E, Berg S, and Midgren B. Long-term

  1. Long-term no-till and stover retention each decrease the global warming potential of irrigated continuous corn.

    PubMed

    Jin, Virginia L; Schmer, Marty R; Stewart, Catherine E; Sindelar, Aaron J; Varvel, Gary E; Wienhold, Brian J

    2017-07-01

    Over the last 50 years, the most increase in cultivated land area globally has been due to a doubling of irrigated land. Long-term agronomic management impacts on soil organic carbon (SOC) stocks, soil greenhouse gas (GHG) emissions, and global warming potential (GWP) in irrigated systems, however, remain relatively unknown. Here, residue and tillage management effects were quantified by measuring soil nitrous oxide (N2 O) and methane (CH4 ) fluxes and SOC changes (ΔSOC) at a long-term, irrigated continuous corn (Zea mays L.) system in eastern Nebraska, United States. Management treatments began in 2002, and measured treatments included no or high stover removal (0 or 6.8 Mg DM ha(-1)  yr(-1) , respectively) under no-till (NT) or conventional disk tillage (CT) with full irrigation (n = 4). Soil N2 O and CH4 fluxes were measured for five crop-years (2011-2015), and ΔSOC was determined on an equivalent mass basis to ~30 cm soil depth. Both area- and yield-scaled soil N2 O emissions were greater with stover retention compared to removal and for CT compared to NT, with no interaction between stover and tillage practices. Methane comprised <1% of total emissions, with NT being CH4 neutral and CT a CH4 source. Surface SOC decreased with stover removal and with CT after 14 years of management. When ΔSOC, soil GHG emissions, and agronomic energy usage were used to calculate system GWP, all management systems were net GHG sources. Conservation practices (NT, stover retention) each decreased system GWP compared to conventional practices (CT, stover removal), but pairing conservation practices conferred no additional mitigation benefit. Although cropping system, management equipment/timing/history, soil type, location, weather, and the depth to which ΔSOC is measured affect the GWP outcomes of irrigated systems at large, this long-term irrigated study provides valuable empirical evidence of how management decisions can impact soil GHG emissions and surface SOC

  2. Geoscience data: Defining policies and workflow tools for long-term storage of continuously and temporarily collected data

    NASA Astrophysics Data System (ADS)

    Gebauer, P.; Kirchner, I.; Peters-Kottig, W.; Klump, J.; Bertelmann, R.; Rusch, B.; Ulbricht, D.; Wattenbach, M.

    2012-04-01

    The intention of the project EWIG (Developing workflow components for long-term archiving of research data in geosciences) is to support geoscientists in transferring their data in a standardized way for storage in digital long-term archives. In the pilot phase test data are provided by two participating research institutions, both producing large amounts of data. One of them - Institut für Meteorologie, Freie Universität Berlin - provides continuously meteorological data, these data are measured every minute at several stations throughout Berlin. The other - Deutsches GeoForschungsZentrum Potsdam - conducts geophysical field experiments and thus produces data temporarily. The digital long-term archive test system is provided by an infrastructure facility - Konrad-Zuse-Zentrum für Informationstechnik Berlin. Both use cases require definite ways for the digital preservation workflows. Policies for the workflow independent from the working area will be defined. At the beginning of the project the actual state of the art in science data preservation policies has to be identified, gaps should be detected and analyzed, so that missing workflow components can be designed. Contact to other institutions, having already policies for their data lifecycle, is necessary to get an overview of existing operating procedures and data management software tools. Assuring the usability of the archived data is necessary during all stages of the project. All information essential for interpreting the data has to be available in a simple way. Usability tests of the archive will be performed together with domain scientists as well as students (bachelor, master, graduate). Questions about the quality of data access, documentation, metadata, etc. should be answered. User feedback and the knowledge of the consortium will be used to compose a university lecture or seminar series on digital data curation, so that future generations of scientists become familiar with the handling of their

  3. Long-term changes of sexual function in men with obstructive sleep apnea after initiation of continuous positive airway pressure.

    PubMed

    Budweiser, Stephan; Luigart, Ruth; Jörres, Rudolf A; Kollert, Florian; Kleemann, Yannick; Wieland, Wolf F; Pfeifer, Michael; Arzt, Michael

    2013-02-01

    Obstructive sleep apnea (OSA), particularly intermittent nocturnal hypoxemia, is associated with erectile dysfunction (ED). We investigated in patients with OSA whether continuous positive airway pressure (CPAP) therapy has a long-term effect on sexual function, including ED, in the presence of other risk factors for ED. Within a long-term observational design, we reassessed 401 male patients who had been referred for polysomnography, with respect to erectile and overall sexual function. Mean ± standard deviation follow-up time was 36.5 ± 3.7 months. Patients with moderate to severe ED were stratified according to the regular use of CPAP. Changes of sexual function were assessed by the 15-item International Index of Erectile Function (IIEF-15) questionnaire, including the domains erectile function (EF), intercourse satisfaction, orgasmic function (OF), sexual desire (SD), and overall satisfaction (OS). Of the 401 patients, 91 returned a valid IIEF-15 questionnaire at follow-up. Their baseline characteristics were not different from those of the total study group. OSA (apnea-hypopnea index >5/hour) had been diagnosed in 91.2% of patients. In patients with moderate to severe ED (EF domain <17), CPAP users (N = 21) experienced an improvement in overall sexual function (IIEF-15 summary score; P = 0.014) compared with CPAP non-users (N = 18), as well as in the subdomains OF (P = 0.012), SD (P = 0.007), and OS (P = 0.033). Similar results were obtained in patients with poor overall sexual dysfunction (IIEF-15 summary score <44). In patients with moderate to severe ED and low mean nocturnal oxygen saturation (≤93%, median), also the EF subdomain improved in CPAP users vs. non-users (P = 0.047). These data indicate that long-term CPAP treatment of OSA and the related intermittent hypoxia can improve or preserve sexual function in men with OSA and moderate to severe erectile or sexual dysfunction, suggesting a certain reversibility of OSA-induced sexual dysfunctions.

  4. Continuing Risk of Ipsilateral Breast Relapse After Breast-Conserving Therapy at Long-Term Follow-up

    SciTech Connect

    Kreike, Bas; Hart, Augustinus A.M.; Velde, Tony van de; Borger, Jacques; Peterse, Hans; Rutgers, Emiel; Bartelink, Harry; Vijver, Marc J. van de

    2008-07-15

    Purpose: Currently, the local treatment of most patients with early invasive breast cancer consists of breast-conserving therapy (BCT). We have previously reported on the risk factors for ipsilateral breast relapse (IBR) in 1,026 patients treated with BCT after a median follow-up of 5.5 years. In the present study, we evaluated the IBR incidence and the risk factors for IBR after prolonged follow-up. Methods and Materials: We updated the disease outcome for all 1,026 patients using the clinical information collected from the medical registration of The Netherlands Cancer Institute and performed step-wise proportional hazard Cox regression analysis to identify the risk factors associated with an increased risk of IBR after BCT at long-term follow-up. Results: After a median follow-up of 13.3 years, 114 patients had developed an IBR as the first event. The IBR rate was 9.3% and 13.8%, respectively, at 10 and 15 years. Also, the increase in IBR was continuous without reaching a plateau, even after 15 years. Univariate analysis showed that involved surgical resection margins, young age, vascular invasion, and the presence and quantity of an in situ component are risk factors for IBR. Multivariate analysis showed that tumor-positive surgical resection margins (hazard ratio, 2.9; 95% confidence interval, 1.7-5.2, p = 0.0002) or the presence of vascular invasion (hazard ratio, 2.0; 95% confidence interval, 1.2-3.2, p = 0.004) is the major independent risk factor for IBR. Conclusions: The data from long-term follow-up showed a constant increase in IBR among patients treated by BCT, even after 15 years, without reaching a plateau. Involved surgical resection margins and vascular invasion were the most important risk factors for IBR.

  5. Efalizumab: results of a 3-year continuous dosing study for the long-term control of psoriasis

    PubMed Central

    Leonardi, C; Menter, A; Hamilton, T; Caro, I; Xing, B; Gottlieb, AB

    2008-01-01

    Background Efalizumab, a T-cell-targeted, recombinant, humanized, monoclonal IgG1 antibody, inhibits key T-cell-mediated steps in the pathogenesis of psoriasis. Efalizumab is approved for the treatment of moderate-to-severe chronic plaque psoriasis in adults in more than 50 countries. Objectives To evaluate the efficacy and safety of long-term, continuous efalizumab therapy in patients with psoriasis. Methods This open-label, multicentre phase III study enrolled 339 patients with moderate-to-severe chronic plaque psoriasis. During the initial 3-month phase, patients received subcutaneous efalizumab 2 mg kg−1 weekly with randomization to receive concomitant fluocinolone acetonide or placebo ointment during month 3. The second phase was a long-term observational period; patients achieving a ≥ 50% improvement in the Psoriasis Area and Severity Index (PASI) score were eligible to receive efalizumab 1 mg kg−1 weekly for up to 33 months. The final 3-month treatment period was an optional transition period for patients who completed the 33-month segment before efalizumab became commercially available. Results After 3 months, 41·3% of patients achieved a ≥ 75% improvement in PASI (PASI-75) and 13·0% achieved a ≥ 90% improvement (PASI-90). Continued improvement was observed: 45·4% and 24·5% achieved PASI-75 and PASI-90, respectively, at the end of the observational phase. The safety profile was stable, with no new or no increase in common events over 36 months of treatment. Conclusions This was the longest continuous study using a biologic therapy for psoriasis. Clinical benefit of efalizumab improved over the first 18 months and was maintained during 36 months of continuous therapy. Long-term efalizumab therapy is appropriate for many patients with plaque psoriasis. Conflicts of interest C.L. with 3M Pharmaceuticals, Abbott, Allergan, Altana, Amgen, Astellas-Biogen, Bristol Myers, Centocor, CombinatoRx, Fujisawa Healthcare, Galderma, Genentech, Merck Serono

  6. Long-Term Maintenance Therapy Using Rituximab-Induced Continuous B-Cell Depletion in Patients with ANCA Vasculitis

    PubMed Central

    Pendergraft, William F.; Cortazar, Frank B.; Wenger, Julia; Murphy, Andrew P.; Rhee, Eugene P.; Laliberte, Karen A.; Niles, John L.

    2014-01-01

    Background and objectives Remission in the majority of ANCA vasculitis patients is not sustained after a single course of rituximab, and risk of relapse warrants development of a successful strategy to ensure durable remission. Design, setting, participants, & measurements A retrospective analysis of ANCA vasculitis patients who underwent maintenance therapy using rituximab-induced continuous B-cell depletion for up to 7 years was performed. Maintenance therapy with rituximab was initiated after achieving remission or converting from other prior maintenance therapy. Continuous B-cell depletion was achieved in all patients by scheduled rituximab administration every 4 months. Disease activity, serologic parameters, adverse events, and survival were examined. Results In the study, 172 patients (mean age=60 years, 55% women, 57% myeloperoxidase–ANCA) treated from April of 2006 to March of 2013 underwent continuous B-cell depletion with rituximab. Median remission maintenance follow-up time was 2.1 years. Complete remission (Birmingham Vasculitis Activity Score [BVAS]=0) was achieved in all patients. Major relapse (BVAS≥3) occurred in 5% of patients and was associated with weaning of other immunosuppression drugs. Remission was reinduced in all patients. Survival mirrored survival of a general age-, sex-, and ethnicity-matched United States population. Conclusion This analysis provides evidence for long-term disease control using continuous B-cell depletion. This treatment strategy in ANCA vasculitis patients also seems to result in survival rates comparable with rates in a matched reference population. These findings suggest that prospective remission maintenance treatment trials using continuous B-cell depletion are warranted. PMID:24626432

  7. Reliable long-term continuous blood glucose monitoring for patients in critical care using microdialysis and infrared spectrometry

    NASA Astrophysics Data System (ADS)

    Heise, H. Michael; Damm, Uwe; Kondepati, Venkata R.

    2006-02-01

    For clinical research, in-vivo blood glucose monitoring is an ongoing important topic to improve glycemic control in patients with non-adequate blood glucose regulation. Critically ill patients received much interest, since the intensive insulin therapy treatment, as established for diabetics, reduces mortality significantly. Despite the existence of commercially available, mainly amperometric biosensors, continued interest is in infrared spectroscopic techniques for reagent-free glucose monitoring. For stable long-term operation, avoiding also sensor recalibration, a bed-side device coupled to a micro-dialysis probe was developed for quasi-continuous glucose monitoring. Multivariate calibration is required for glucose concentration prediction due to the complex composition of dialysates from interstitial body fluid. Measurements were carried out with different test persons, each experiment lasting for more than 8 hours. Owing to low dialysis recovery rates, glucose concentrations in the dialysates were between 0.83 and 4.44 mM. Standard errors of prediction (SEP) obtained with Partial Least Squares (PLS) calibration and different cross-validation strategies were mainly between 0.13 and 0.18 mM based on either full interval data or specially selected spectral variables.

  8. Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs.

    PubMed

    Boutry, Claire; El-Kadi, Samer W; Suryawan, Agus; Steinhoff-Wagner, Julia; Stoll, Barbara; Orellana, Renán A; Nguyen, Hanh V; Kimball, Scot R; Fiorotto, Marta L; Davis, Teresa A

    2016-04-15

    Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have shown previously that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in skeletal muscle compared with continuous feeding alone. To determine the long-term effects of leucine pulses, neonatal piglets (n = 11-12/group) were continuously fed formula via orogastric tube for 21 days, with an additional parenteral infusion of either leucine (CON + LEU; 800 μmol·kg(-1)·h(-1)) or alanine (CON + ALA) for 1 h every 4 h. The results show that body and muscle weights and lean gain were ∼25% greater, and fat gain was 48% lower in CON + LEU than CON + ALA; weights of other tissues were unaffected by treatment. Fractional protein synthesis rates in longissimus dorsi, gastrocnemius, and soleus muscles were ∼30% higher in CON + LEU compared with CON + ALA and were associated with decreased Deptor abundance and increased mTORC1, mTORC2, 4E-BP1, and S6K1 phosphorylation, SNAT2 abundance, and association of eIF4E with eIF4G and RagC with mTOR. There were no treatment effects on PKB, eIF2α, eEF2, or PRAS40 phosphorylation, Rheb, SLC38A9, v-ATPase, LAMTOR1, LAMTOR2, RagA, RagC, and LAT1 abundance, the proportion of polysomes to nonpolysomes, or the proportion of mRNAs encoding rpS4 or rpS8 associated with polysomes. Our results demonstrate that pulsatile delivery of a leucine supplement during 21 days of continuous enteral feeding enhances lean growth by stimulating the mTORC1-dependent translation initiation pathway, leading to protein synthesis in skeletal muscle of neonates.

  9. Long-Term Immunomodulatory Effects of a Mediterranean Diet in Adults at High Risk of Cardiovascular Disease in the PREvención con DIeta MEDiterránea (PREDIMED) Randomized Controlled Trial.

    PubMed

    Casas, Rosa; Sacanella, Emilio; Urpí-Sardà, Mireia; Corella, Dolores; Castañer, Olga; Lamuela-Raventos, Rosa-María; Salas-Salvadó, Jordi; Martínez-González, Miguel-Angel; Ros, Emilio; Estruch, Ramon

    2016-09-01

    The Mediterranean diet (MedDiet) has demonstrated short-term anti-inflammatory effects, but little is known about its long-term immunomodulatory properties. Our goal was to assess the long-term effects of the MedDiet on inflammatory markers related to atherogenesis in adults at high risk of cardiovascular disease (CVD) compared with the effects of a low-fat diet (LFD). We randomly assigned 165 high-risk participants (one-half men; mean age: 66 y) without overt CVD to 1 of 3 diets: a MedDiet supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or an LFD. Follow-up data were collected at 3 and 5 y. Repeated-measures ANOVA, adjusted for potential confounding variables, was used to evaluate changes in diet adherence, CVD risk factors, and inflammatory variables. The 2 MedDiet groups achieved a high degree of adherence to the intervention, and the LFD group had reduced energy intake from fat by 13% by 5 y. Compared with baseline, at 3 and 5 y, both MedDiet groups had significant reductions of ≥16% in plasma concentrations of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor α, and monocyte chemoattractant protein 1 (P ≤ 0.04), whereas there were no significant changes in the LFD group. The reductions in CD49d and CD40 expressions in T lymphocytes and monocytes at 3 y were ≥16% greater in both MedDiet groups than were the changes in the LFD group (P < 0.001) at 3 y. Compared with baseline, at 3 y, the MedDiet groups had increased HDL-cholesterol (≥8%) and decreased blood pressure (>4%) and total cholesterol, LDL-cholesterol, and triglyceride (≥8%) concentrations. At 5 y, concentrations of glucose (13%) and glycated hemoglobin (8%) had increased with the LFD. The MedDiet participants had lower cellular and plasma concentrations of inflammatory markers related to atherosclerosis at 3 and 5 y. This anti-inflammatory role of the MedDiet could explain in part the long-term cardioprotective effect of the MedDiet against

  10. Long-term follow-up of amiodarone therapy in the young: continued efficacy, unimpaired growth, moderate side effects.

    PubMed

    Guccione, P; Paul, T; Garson, A

    1990-04-01

    Long-term follow-up data on young patients receiving amiodarone is lacking, especially in relation to growth and late side effects. The records of 95 young patients (mean age 12.4 years; range 3 weeks to 31.5 years) who received amiodarone were reviewed. Minimal follow-up time for those continuing to take amiodarone was 1.5 years; the mean duration of therapy was 2.3 years (maximal 6.5). The mean maintenance dosage was 7.7 (1.5 to 25) mg/kg body weight per day. Initial success (based on symptoms and 24 h electrocardiogram) was achieved in 23 of 34 patients with ventricular tachycardia, in 32 of 33 with atrial flutter and in 21 of 28 patients with supraventricular tachycardia. However, in 7 of 33 patients with atrial flutter, the arrhythmia returned after 6 months. Patient growth continued in the same percentiles achieved before amiodarone in all but eight patients, improving in six and worsening in two with severe underlying disease. Proarrhythmia occurred in three patients: one had torsade de pointes that disappeared when amiodarone administration was stopped; two with severe anatomic heart disease died suddenly during the loading period (one with atrial flutter and one with ventricular tachycardia). Side effects occurred in 28 (29%) of the 95 patients: keratopathy (in 11), abnormal thyroid function test (in 6), chemical hepatitis (in 3), rash (in 3), peripheral neuropathy (in 2), hypertension (in 1) and vomiting (in 1). All side effects disappeared when amiodarone was discontinued or the dose was reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devices

    PubMed Central

    Tsiouris, Athanasios; Paone, Gaetano; Nemeh, Hassan W; Borgi, Jamil; Williams, Celeste T; Lanfear, David E; Morgan, Jeffrey A

    2015-01-01

    AIM: To study the institutional experience over 8 years with 200 continuous-flow (CF) - left ventricular assist devices (LVAD). METHODS: We evaluated our institution’s LVAD database and analyzed all patients who received a CF LVAD as a bridge to transplant (BTT) or destination therapy from March 2006 until June 2014. We identified 200 patients, of which 179 were implanted with a HeartMate II device (Thoratec Corp., Pleasanton, CA) and 21 received a Heartware HVAD (HeartWare Inc., Framingham, MA). RESULTS: The mean age of our LVAD recipients was 59.3 years (range 17-81), 76% (152/200) were males, and 49% were implanted for the indication of BTT. The survival rate for our LVAD patients at 30 d, 6 mo, 12 mo, 2 years, 3 years, and 4 years was 94%, 86%, 78%, 71%, 62% and 45% respectively. The mean duration of LVAD support was 581 d (range 2-2595 d). Gastrointestinal bleeding (was the most common adverse event (43/200, 21%), followed by right ventricular failure (38/200, 19%), stroke (31/200, 15%), re exploration for bleeding (31/200, 15%), ventilator dependent respiratory failure (19/200, 9%) and pneumonia (15/200, 7%). Our driveline infection rate was 7%. Pump thrombosis occurred in 6% of patients. Device exchanged was needed in 6% of patients. On multivariate analysis, preoperative liver dysfunction, ventilator dependent respiratory failure, tracheostomy and right ventricular failure requiring right ventricular assist device support were significant predictors of post LVAD survival. CONCLUSION: Short and long term survival for patients on LVAD support are excellent, although outcomes still remain inferior compared to heart transplantation. The incidence of driveline infections, pump thrombosis and pump exchange have declined significantly in recent years. PMID:26635927

  12. Long-Term Results of Mandibular Reconstruction of Continuity Defects with Fibula Free Flap and Implant-Borne Dental Rehabilitation.

    PubMed

    Fang, Wei; Liu, Yan-Pu; Ma, Qin; Liu, Bao-Lin; Zhao, Yimin

    2014-12-05

    Purpose: This study evaluated the retrospective outcomes of implant-borne dental rehabilitation in patients with mandibular defects reconstructed with a fibula free flap. Materials and Methods: Patients with segmental mandibular defects were enrolled in this cohort study. Defects in these patients were caused by oral neoplasm, trauma, and osteoradionecrosis. The patients were treated with a fibula free flap procedure and dental implant-borne prostheses between 1988 and 2010. Clinical and radiographic data were evaluated; Kaplan-Meier survival analysis and Poisson regression analysis were used to evaluate implant survival parameters. The statistical significance (α = .05) of the results was determined. Results: Seventy-four patients were selected in this study. All patients were available for continuous follow-up. Nine patients (12.1%) developed fibular graft complications postoperatively: 3 in donor sites and 6 in recipient sites. One hundred ninety-two implants were inserted, and 18 implants failed (9.3%). Overall implant survival in patients was 90.1%, 83.1%, and 69.3% after 5, 10, and 20 years, respectively. In 152 implants, probing depth (PD) ranged from 2 to 3 mm. In 31 implants, PD was greater than 5 mm. In 9 implants, PD was greater than 7 mm. The highest implant failure rates were expected for men (odds ratio [OR] = 2.948; 95% confidence interval [CI], 1.10 to 7.85; P = .031), patients receiving primary fibula free flap reconstruction (OR = 3.696; 95% CI,1.16 to 11.73; P = .027), and patients receiving radiotherapy (OR = 5.269; 95% CI, 1.40 to 19.7; P = .014). Conclusion: Fibula free flap procedures and implant-borne prostheses proved to be reliable approaches for rehabilitation of mandibular defects and oral function. The overall postoperative fibula free flap and peri-implant complication rates proved to be low. Regular follow-up visits and proper oral hygiene maintenance contributed to the long-term successful treatments.

  13. Long-term results of mandibular reconstruction of continuity defects with fibula free flap and implant-borne dental rehabilitation.

    PubMed

    Fang, Wei; Liu, Yan-Pu; Ma, Qin; Liu, Bao-Lin; Zhao, Yimin

    2015-01-01

    This study evaluated the retrospective outcomes of implant-borne dental rehabilitation in patients with mandibular defects reconstructed with a fibula free flap. Patients with segmental mandibular defects were enrolled in this cohort study. Defects in these patients were caused by oral neoplasm, trauma, and osteoradionecrosis. The patients were treated with a fibula free flap procedure and dental implant-borne prostheses between 1988 and 2010. Clinical and radiographic data were evaluated; Kaplan-Meier survival analysis and Poisson regression analysis were used to evaluate implant survival parameters. The statistical significance (α = .05) of the results was determined. Seventy-four patients were selected in this study. All patients were available for continuous follow-up. Nine patients (12.1%) developed fibular graft complications postoperatively: 3 in donor sites and 6 in recipient sites. One hundred ninety-two implants were inserted, and 18 implants failed (9.3%). Overall implant survival in patients was 90.1%, 83.1%, and 69.3% after 5, 10, and 20 years, respectively. In 152 implants, probing depth (PD) ranged from 2 to 3 mm. In 31 implants, PD was greater than 5 mm. In 9 implants, PD was greater than 7 mm. The highest implant failure rates were expected for men (odds ratio [OR] = 2.948; 95% confidence interval [CI], 1.10 to 7.85; P = .031), patients receiving primary fibula free flap reconstruction (OR = 3.696; 95% CI, 1.16 to 11.73; P = .027), and patients receiving radiotherapy (OR = 5.269; 95% CI, 1.40 to 19.7; P = .014). Fibula free flap procedures and implant-borne prostheses proved to be reliable approaches for rehabilitation of mandibular defects and oral function. The overall postoperative fibula free flap and peri-implant complication rates proved to be low. Regular follow-up visits and proper oral hygiene maintenance contributed to the long-term successful treatments.

  14. Transport of Cryptosporidium parvum in porous media: Long-term elution experiments and continuous time random walk filtration modeling

    NASA Astrophysics Data System (ADS)

    Cortis, Andrea; Harter, Thomas; Hou, Lingling; Atwill, E. Robert; Packman, Aaron I.; Green, Peter G.

    2006-12-01

    Complex transport behavior other than advection-dispersion, simple retardation, and first-order removal has been observed in many biocolloid transport experiments in porous media. Such nonideal transport behavior is particularly evident in the late time elution of biocolloids at low concentrations. Here we present a series of saturated column experiments that were designed to measure the breakthrough and long-term elution of Cryptosporidium parvum in medium sand for a few thousand pore volumes after the initial source of oocysts was removed. For a wide range of ionic strengths, I, we consistently observe slower-than-Fickian, power law tailing. The slope of the tail is flatter for higher I. At very high ionic strength the slope decays to a rate slower than t-1. To explain this behavior, we propose a new filtration model based on the continuous time random walk (CTRW) theory. Our theory upscales heterogeneities at both the pore-scale geometry of the flow field and the grain surface physicochemical properties that affect biocolloid attachment and detachment. Pore-scale heterogeneities in fluid flow are shown to control the breakthrough of a conservative tracer but are shown to have negligible effect on oocyst transport. In our experiments, C. parvum transport is dominated by the effects of physicochemical heterogeneities. The CTRW model provides a parsimonious theory of nonreactive and reactive transport. The CTRW filtration process is controlled by three parameters, Λ, β, and c, which are related to the overall breakthrough retardation (R = 1 + Λ), the slope of the power law tail (β), and the transition to a slower than t-1 decay (c).

  15. Long term continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) in children: Initiation criteria in real life.

    PubMed

    Amaddeo, A; Moreau, J; Frapin, A; Khirani, S; Felix, O; Fernandez-Bolanos, M; Ramirez, A; Fauroux, B

    2016-09-01

    Long term noninvasive continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) are increasingly used in children but limited information is available on the criteria and conditions leading to the initiation of these treatments. The aim of the study is to describe the objective overnight respiratory parameters and clinical situations that led to the initiation of CPAP/NIV in a pediatric NIV unit. Retrospective analysis of the data of all the children discharged on home CPAP/NIV over a 1 year period. Seventy-six patients were started on CPAP (n = 64) or NIV (n = 12). CPAP/NIV was initiated because of CPAP/NIV weaning failure (Acute group) in 15 patients. None of these patients had an overnight gas exchange or sleep study before CPAP/NIV initiation. In 18 patients, CPAP/NIV was initiated on abnormal nocturnal gas exchange alone (Subacute group). These patients had a median of three of the following five overnight gas exchange abnormalities: minimal pulse oximetry (SpO2 ) <90%, maximal transcutaneous carbon dioxide (PtcCO2 ) >50 mmHg, time spent with SpO2 <90% or PtcCO2 >50 mmHg ≥2% of recording time, oxygen desaturation index >1.4/hr. In the last 43 patients, CPAP/NIV was initiated after an abnormal sleep study (Chronic group) on a mean of four of the aforementioned criteria and an apnea-hypopnea index >10/hr. In clinical practice, CPAP/NIV was initiated in an acute, subacute and chronic setting with most patients having an association of several abnormal gas exchange or sleep study parameters. Future studies should evaluate the effectiveness and benefits of CPAP/NIV according to the clinical situation and initiation criteria. Pediatr Pulmonol. 2016; 51:968-974. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Long term continuous field survey to assess nutrient emission impact from irrigated paddy field into river catchment

    NASA Astrophysics Data System (ADS)

    Kogure, Kanami; Aichi, Masaatsu; Zessner, Matthias

    2017-04-01

    P balance. N and P surplus are calculated by difference between input and output in a paddy field. As to nutrient balance in 2015 surplus shows minus value between input as fertilizer and output as rice product. However, by taking account of input via irrigation water as nutrient source, N and P input and output balance with errors by 9% and 14%. Results of long term continuous survey suggest that irrigation water is one of nutrient sources in rice cultivation.

  17. Long-term continuous monitoring of mercury in the Russian arctic: winter increase of atmospheric mercury depletion events

    NASA Astrophysics Data System (ADS)

    Pankratov, Fidel; Mahura, Alexander; Popov, Valentin; Katz, Oleg

    2014-05-01

    Among pollutants mercury is a major environmental concern due to its ecological hazard. The mercury can reside in the atmosphere for a long time high, and it is a reason of its global propagation in the Northern Hemisphere and elevated mercury concentrations are reported in the Arctic environment. First time, in 1995, the effect of atmospheric mercury depletion in the troposphere was found at the Canadian station Alert. This phenomenon (called the Atmospheric Mercury Depletion Event - AMDE) is observed during April-June, when the Polar sunrise starts till the end of the snowmelt. The same effect was reported for other polar stations situated to the north of 60° N. Long-term continuous monitoring of gaseous elemental mercury in the surface air at the polar station Amderma (69,720N; 61,620E) using the analyzer Tekran 2537A has been conducted from Jun 2001 to date. Individual measurements were collected every thirty minutes. It has been shown, that during eleven years of observations the AMDEs were observed every year, from the end of March till early June. For the winter period (Dec-Feb) these events of the atmospheric mercury depletion were registered from 2010 to 2013, which had not been observed before. A large number of hours during the day, when the concentration of mercury was recorded at level of below 1 ng/m3, was registered during Dec-Feb. The sun declination above the horizon is negative, and solar activity is still not enough to trigger the photochemical reactions. The these last 3 years confirmed a tendency to displacement of AMDEs to the winter season, which leads to an additional factor entry of mercury in various biological objects, due to the additional deposition of various forms of mercury on the snowpack. At the same time, especially during the winter seasons, there is a substantial increase (up to 8 times) of AMDEs, compared with the previous years. In particular, in winter 2013 the maximum number of AMDs reached 31 cases. The explanation can be

  18. Role of Interleukin-1/Interleukin-1 Receptor Antagonist Family of Cytokines in Long-Term Continuous Glucose Monitoring In Vivo

    PubMed Central

    Klueh, Ulrike; Antar, Omar; Qiao, Yi; Kreutzer, Donald L.

    2013-01-01

    Background Glucose-sensor-induced tissue reactions (e.g., inflammation and wound healing) are known to negatively impact sensor function in vivo. The roles of cytokine networks in controlling these tissue reactions (i.e., sensor biofouling) is not understood. In the present study, we investigated the role of interleukin-1 receptor antagonist (IL-1Ra), a key anti-inflammatory antagonist of the proinflammatory interleukin-1 cytokines [i.e. interleukin-1 (IL-1) alpha and IL-1 beta] in controlling continuous glucose monitoring (CGM). Methods To investigate the role of IL-1Ra in long-term CGM in vivo, we compared CGM in transgenic mice that overexpress IL-1Ra [interleukin-1 receptor antagonist overexpresser (IL-1Ra~OE), B6.Cg-Tg(IL1rn)1Dih/J] or are deficient in IL-1Ra [interleukin-1 receptor antagonist knockout (IL-1Ra~KO), B6.129S-IL1rntm1Dih/J] with mice that have normal levels of IL-1Ra (C57BL/6) over a 28-day time period. Results Mean absolute relative difference (MARD) analysis of CGM results among the mice of varying IL-1Ra levels demonstrated that during the first 21 days, IL-1~KO mice had the greatest tissue inflammation and the poorest sensor performance (i.e., higher MARD values) when compared with normal or IL-1Ra~OE mice. By 28 days post-sensor implantation, the inflammatory reactions had subsided and were replaced by varying degrees of fibrosis. Conclusions These data support our hypothesis on the importance of the IL-1 family of agonists and antagonists in controlling tissue reactions and sensor function in vivo. These data also suggest that local delivery of IL-1Ra genes or recombinant proteins (anakinra) or other IL-1 antagonists such as antibodies or soluble IL-1 receptors would suppress sensor-induced tissue reactions and likely enhance glucose sensor function by inhibiting inflammation and wound healing at sensor implantation sites. PMID:24351180

  19. Rapid and Continued T-Cell Differentiation into Long-term Effector and Memory Stem Cells in Vaccinated Melanoma Patients.

    PubMed

    Gannon, Philippe O; Baumgaertner, Petra; Huber, Alexandre; Iancu, Emanuela M; Cagnon, Laurène; Abed Maillard, Samia; Maby-El Hajjami, Hélène; Speiser, Daniel E; Rufer, Nathalie

    2016-11-21

    Purpose: Patients with cancer benefit increasingly from T-cell-based therapies, such as adoptive T-cell transfer, checkpoint blockade, or vaccination. We have previously shown that serial vaccinations with Melan-A(MART-1)26-35 peptide, CpG-B, and incomplete Freund adjuvant (IFA) generated robust tumor-specific CD8 T-cell responses in patients with melanoma. Here, we describe the detailed kinetics of early- and long-term establishment of T-cell frequency, differentiation (into memory and effector cells), polyfunctionality, and clonotype repertoire induced by vaccination.Experimental Design: Twenty-nine patients with melanoma were treated with multiple monthly subcutaneous vaccinations consisting of CpG-B, and either the native/EAA (n = 13) or the analogue/ELA (n = 16) Melan-A(MART-1)26-35 peptide emulsified in IFA. Phenotypes and functionality of circulating Melan-A-specific CD8 T cells were assessed directly ex vivo by multiparameter flow cytometry, and TCR clonotypes were determined ex vivo by mRNA transcript analyses of individually sorted cells.Results: Our results highlight the determining impact of the initial vaccine injections on the rapid and strong induction of differentiated effector T cells in both patient cohorts. Moreover, long-term polyfunctional effector T-cell responses were associated with expansion of stem cell-like memory T cells over time along vaccination. Dominant TCR clonotypes emerged early and persisted throughout the entire period of observation. Interestingly, one highly dominant clonotype was found shared between memory and effector subsets.Conclusions: Peptide/CpG-B/IFA vaccination induced powerful long-term T-cell responses with robust effector cells and stem cell-like memory cells. These results support the further development of CpG-B-based cancer vaccines, either alone or as specific component of combination therapies. Clin Cancer Res; 1-12. ©2016 AACR.

  20. [The long-term course of 60 patients with alveolar echinococcosis in continuous therapy with mebendazole (1976-85)].

    PubMed

    Ammann, R; Tschudi, K; von Ziegler, M; Meister, F; Cotting, J; Eckert, J; Witassek, F; Freiburghaus, A

    1988-11-01

    Since 1976 60 patients with inoperable alveolar echinococcosis caused by Echinococcus multilocularis were treated with high doses of mebendazole and examined at regular intervals prospectively according to our protocol regarding clinical course, liver function, morphology, immunologically and plasma mebendazole levels. The average duration of disease was 8(1-19) years, the average duration of chemotherapy was 4.25 (0.75-9) years. The long term results showed a correlation of the clinical course with the mean plasma mebendazole levels and the duration of chemotherapy, respectively. Death (n = 5) or transient progression of the disease process (n = 14) was observed primarily in patients with low plasma mebendazole levels in the early course and within the first two years of chemotherapy. Only 9 patients showed a decrease of the parasite mass. Immundiagnosis (total serum IgE and serum antibodies against Echinococcus antigen) gave some information with regard to therapy results, but only in the long-term course. The cumulative survival of the patients under study was 96% at 5 years and 84% at 10 years, respectively which is markedly higher compared to historical control series with a letality of greater than 90% within 10 years.

  1. Vibrio anguillarum Is Genetically and Phenotypically Unaffected by Long-Term Continuous Exposure to the Antibacterial Compound Tropodithietic Acid.

    PubMed

    Rasmussen, Bastian Barker; Grotkjær, Torben; D'Alvise, Paul W; Yin, Guangliang; Zhang, Faxing; Bunk, Boyke; Spröer, Cathrin; Bentzon-Tilia, Mikkel; Gram, Lone

    2016-08-01

    Minimizing the use of antibiotics in the food production chain is essential for limiting the development and spread of antibiotic-resistant bacteria. One alternative intervention strategy is the use of probiotic bacteria, and bacteria of the marine Roseobacter clade are capable of antagonizing fish-pathogenic vibrios in fish larvae and live feed cultures for fish larvae. The antibacterial compound tropodithietic acid (TDA), an antiporter that disrupts the proton motive force, is key in the antibacterial activity of several roseobacters. Introducing probiotics on a larger scale requires understanding of any potential side effects of long-term exposure of the pathogen to the probionts or any compounds they produce. Here we exposed the fish pathogen Vibrio anguillarum to TDA for several hundred generations in an adaptive evolution experiment. No tolerance or resistance arose during the 90 days of exposure, and whole-genome sequencing of TDA-exposed lineages and clones revealed few mutational changes, compared to lineages grown without TDA. Amino acid-changing mutations were found in two to six different genes per clone; however, no mutations appeared unique to the TDA-exposed lineages or clones. None of the virulence genes of V. anguillarum was affected, and infectivity assays using fish cell lines indicated that the TDA-exposed lineages and clones were less invasive than the wild-type strain. Thus, long-term TDA exposure does not appear to result in TDA resistance and the physiology of V. anguillarum appears unaffected, supporting the application of TDA-producing roseobacters as probiotics in aquaculture. It is important to limit the use of antibiotics in our food production, to reduce the risk of bacteria developing antibiotic resistance. We showed previously that marine bacteria of the Roseobacter clade can prevent or reduce bacterial diseases in fish larvae, acting as probiotics. Roseobacters produce the antimicrobial compound tropodithietic acid (TDA), and we

  2. Vibrio anguillarum Is Genetically and Phenotypically Unaffected by Long-Term Continuous Exposure to the Antibacterial Compound Tropodithietic Acid

    PubMed Central

    Grotkjær, Torben; D'Alvise, Paul W.; Yin, Guangliang; Zhang, Faxing; Bunk, Boyke; Spröer, Cathrin

    2016-01-01

    ABSTRACT Minimizing the use of antibiotics in the food production chain is essential for limiting the development and spread of antibiotic-resistant bacteria. One alternative intervention strategy is the use of probiotic bacteria, and bacteria of the marine Roseobacter clade are capable of antagonizing fish-pathogenic vibrios in fish larvae and live feed cultures for fish larvae. The antibacterial compound tropodithietic acid (TDA), an antiporter that disrupts the proton motive force, is key in the antibacterial activity of several roseobacters. Introducing probiotics on a larger scale requires understanding of any potential side effects of long-term exposure of the pathogen to the probionts or any compounds they produce. Here we exposed the fish pathogen Vibrio anguillarum to TDA for several hundred generations in an adaptive evolution experiment. No tolerance or resistance arose during the 90 days of exposure, and whole-genome sequencing of TDA-exposed lineages and clones revealed few mutational changes, compared to lineages grown without TDA. Amino acid-changing mutations were found in two to six different genes per clone; however, no mutations appeared unique to the TDA-exposed lineages or clones. None of the virulence genes of V. anguillarum was affected, and infectivity assays using fish cell lines indicated that the TDA-exposed lineages and clones were less invasive than the wild-type strain. Thus, long-term TDA exposure does not appear to result in TDA resistance and the physiology of V. anguillarum appears unaffected, supporting the application of TDA-producing roseobacters as probiotics in aquaculture. IMPORTANCE It is important to limit the use of antibiotics in our food production, to reduce the risk of bacteria developing antibiotic resistance. We showed previously that marine bacteria of the Roseobacter clade can prevent or reduce bacterial diseases in fish larvae, acting as probiotics. Roseobacters produce the antimicrobial compound tropodithietic

  3. Long-Term Care

    MedlinePlus

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... the Escape (Esc) button on your keyboard.) Most Care Provided at Home Long-term care is provided ...

  4. Evaluation of different nitrous oxide production models with four continuous long-term wastewater treatment process data series.

    PubMed

    Spérandio, Mathieu; Pocquet, Mathieu; Guo, Lisha; Ni, Bing-Jie; Vanrolleghem, Peter A; Yuan, Zhiguo

    2016-03-01

    Five activated sludge models describing N2O production by ammonium oxidising bacteria (AOB) were compared to four different long-term process data sets. Each model considers one of the two known N2O production pathways by AOB, namely the AOB denitrification pathway and the hydroxylamine oxidation pathway, with specific kinetic expressions. Satisfactory calibration could be obtained in most cases, but none of the models was able to describe all the N2O data obtained in the different systems with a similar parameter set. Variability of the parameters can be related to difficulties related to undescribed local concentration heterogeneities, physiological adaptation of micro-organisms, a microbial population switch, or regulation between multiple AOB pathways. This variability could be due to a dependence of the N2O production pathways on the nitrite (or free nitrous acid-FNA) concentrations and other operational conditions in different systems. This work gives an overview of the potentialities and limits of single AOB pathway models. Indicating in which condition each single pathway model is likely to explain the experimental observations, this work will also facilitate future work on models in which the two main N2O pathways active in AOB are represented together.

  5. Long-term performance of a 20-L continuous flow microbial fuel cell for treatment of brewery wastewater

    NASA Astrophysics Data System (ADS)

    Lu, Mengqian; Chen, Shing; Babanova, Sofia; Phadke, Sujal; Salvacion, Michael; Mirhosseini, Auvid; Chan, Shirley; Carpenter, Kayla; Cortese, Rachel; Bretschger, Orianna

    2017-07-01

    Microbial fuel cells (MFCs) have been shown as a promising technology for wastewater treatment. Integration of MFCs into current wastewater treatment plant have potential to reduce the operational cost and improve the treatment performance, and scaling up MFCs will be essential. However, only a few studies have reported successful scale up attempts. Fabrication cost, treatment performance and operational lifetime are critical factors to optimize before commercialization of MFCs. To test these factors, we constructed a 20 L MFC system containing two 10 L MFC reactors and operated the system with brewery wastewater for nearly one year. Several operational conditions were tested, including different flowrates, applied external resistors, and poised anodic potentials. The condition resulting in the highest chemical oxygen demand (COD) removal efficiency (94.6 ± 1.0%) was a flow rate of 1 mL min-1 (HRT = 313 h) and an applied resistor of 10 Ω across each MFC circuit. Results from each of the eight stages of operation (325 days total) indicate that MFCs can sustain treatment rates over a long-term period and are robust enough to sustain performance even after system perturbations. possible ways to improve MFC performance were discussed for future studies.

  6. Long-term frequency and amplitude stability of a solid-nitrogen-cooled, continuous wave THz quantum cascade laser

    NASA Astrophysics Data System (ADS)

    Danylov, Andriy A.; Waldman, Jerry; Light, Alexander R.; Goyette, Thomas M.; Giles, Robert H.; Qian, Xifeng; Chandrayan, Neelima; Goodhue, William D.; Nixon, William E.

    2012-02-01

    Operational temperature increase of CW THz QCLs to 77 K has enabled us to employ solid nitrogen (SN2) as the cryogen. A roughing pump was used to solidify liquid nitrogen and when the residual vapor pressure in the nitrogen reservoir reached the pumping system's minimum pressure the temperature equilibrated and remained constant until all the nitrogen sublimated. The hold time compared to liquid helium has thereby increased approximately 70-fold, and at a greatly reduced cost. The milliwatt CW QCL was at a temperature of approximately 60 K, dissipating 5 W of electrical power. To measure the long-term frequency, current, and temperature stability, we heterodyned the free-running 2.31 THz QCL with a CO2 pumped far-infrared gas laser line in methanol (2.314 THz) in a corner-cube Schottky diode and recorded the IF frequency, current and temperature. Under these conditions the performance characteristics of the QCL, which will be reported, exceeded that of a device mounted in a mechanical cryocooler.

  7. Bacterial response to a continuous long-term exposure of silver nanoparticles at sub-ppm silver concentrations in a membrane bioreactor activated sludge system.

    PubMed

    Zhang, Chiqian; Liang, Zhihua; Hu, Zhiqiang

    2014-03-01

    Silver nanoparticles (nanosilver or AgNPs) have excellent antimicrobial properties. Because of their increasing use, there is a concern about the potential impact of AgNPs in wastewater treatment systems. This study investigated the long-term effects of AgNPs (continuous loading for more than 60 days) on membrane bioreactor (MBR) activated sludge performance. At the influent AgNP concentration of 0.10 mg Ag/L, there was no significant difference in effluent water quality or bacterial activities before and after AgNP exposure. Nitrifying bacterial community structure was relatively stable before and after the long-term AgNP loading. Both ammonia-oxidizing bacteria (AOB) Nitrosomonas spp. and Nitrosospira spp. were present while Nitrospira spp. was the dominant nitrite-oxidizing bacterial species throughout this study. Abundance of silver resistance gene silE in the MBR, however, increased by 50-fold 41 days after the AgNP exposure, and then decreased with continuous AgNP exposure. The long-term nanosilver exposure did not change the membrane fouling rate although extracellular polymeric substances (EPS) concentration increased significantly after nanosilver dosing. The results suggest that AgNPs at the influent concentrations of 0.10 mg/L and below have almost no impact on activated sludge wastewater treatment performance, as activated sludge can effectively reduce nanosilver toxicity by adsorbing or precipitating AgNPs and silver ions (Ag(+)) released from the dissolution of AgNPs.

  8. Twenty-five years of continuous borehole tilt and vertical displacement data at Mount Etna: Insights on long-term volcanic dynamics

    NASA Astrophysics Data System (ADS)

    Bonaccorso, A.; Bonforte, A.; Gambino, S.

    2015-12-01

    We report a 25 year-long data set (1990-2014) of combined continuous tilt and GPS vertical displacement series recorded at Etna volcano. To our knowledge, this is the first time that such a data set on an active volcano has been presented. We show the coherence of the two series, which help draw new insights on how the volcano, characterized by frequent flank eruptions, works in the long-term (tens of years). This data set provides evidence that after the 1992-1993 flank eruption (the biggest in the last three centuries) and the following major recharging phase (1994-2001), all the ensuing eruptions fall within a single long-term reequilibrium phase (2001-2014).

  9. Long-term preservation of cone photoreceptors and visual acuity in rd10 mutant mice exposed to continuous environmental enrichment.

    PubMed

    Barone, Ilaria; Novelli, Elena; Strettoi, Enrica

    2014-01-01

    In human patients and animal models of retinitis pigmentosa (RP), a gradual loss of rod photoreceptors and decline in scotopic vision are the primary manifestations of the disease. Secondary death of cones and gradual, regressive remodeling of the inner retina follow and progress at different speeds according to the underlying genetic defect. In any case, the final outcome is near-blindness without a conclusive cure yet. We recently reported that environmental enrichment (EE), an experimental manipulation based on exposure to enhanced motor, sensory, and social stimulation, when started at birth, exerts clear beneficial effects on a mouse model of RP, by slowing vision loss. The purpose of this study was to investigate in the same mouse the long-term effects of chronic exposure to an EE and assess the outcome of this manipulation on cone survival, inner retinal preservation, and visual behavior. Two groups of rd10 mutant mice were maintained in an EE or standard (ST) laboratory conditions up to 1 year of age. Then, retinal preservation was assessed with immunocytochemistry, confocal microscopy examination, cone counts, and electron microscopy of the photoreceptor layer, while visual acuity was tested behaviorally with a Prusky water maze. rd10 mice are a model of autosomal recessive RP with a typical rod-cone, center to the periphery pattern of photoreceptor degeneration. They carry a mutation of the rod-specific phosphodiesterase gene and undergo rod death that peaks at around P24, while cone electroretinogram (ERG) is extinct by P60. We previously showed that early exposure to an EE efficiently delays photoreceptor degeneration in these mutants, extending the time window of cone viability and cone-mediated vision well beyond the phase of maximum rod death. Here we find that a maintained EE can delay the degeneration of cones even in the long term. Confocal and electron microscopy examination of the retinas of the rd10 EE and ST mice at 1 year of age showed major

  10. The Development of a Long-Term, Continually Updated Global Solar Resource at 10 km Resolution: Preliminary Results From Test Processing and Continuing Plans

    NASA Technical Reports Server (NTRS)

    Stackhouse, P.; Perez, R.; Sengupta, M.; Knapp, K.; Cox, Stephen; Mikovitz, J. Colleen; Zhang, T.; Hemker, K.; Schlemmer, J.; Kivalov, S.

    2014-01-01

    Background: Considering the likelihood of global climatic weather pattern changes and the global competition for energy resources, there is an increasing need to provide improved and continuously updated global Earth surface solar resource information. Toward this end, a project was funded under the NASA Applied Science program involving the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC), National Renewable Energy Laboratory (NREL), the State University of New York/Albany (SUNY) and the NOAA National Climatic Data Center (NCDC) to provide NREL with a global long-term advanced global solar mapping production system for improved depiction of historical solar resources and variability and to provide a mechanism for continual updates of solar resource information. This new production system is made possible by the efforts of NOAA and NASA to completely reprocess the International Satellite Cloud Climatology Project (ISCCP) data set that provides satellite visible and infrared radiances together with retrieved cloud and surface properties on a 3-hourly basis beginning from July 1983. The old version of the ISCCP data provided this information for all the world TMs available geosynchronous satellite systems and NOAA TMs AVHRR data sets at a 30 km effective resolution. This new version aims to provide a new and improved satellite calibration at an effective 10 km resolution. Thus, working with SUNY, NASA will develop and test an improved production system that will enable NREL to continually update the Earth TM solar resource. Objective and Methods: In this presentation, we provide a general overview of this project together with samples of the new solar irradiance mapped data products and comparisons to surface measurements at various locations across the world. An assessment of the solar resource values relative to calibration uncertainty and assumptions are presented. Errors resulting assumptions in snow cover and background aerosol

  11. Platinum Compound-Related Ototoxicity in Children: Long-Term Follow-Up Reveals Continuous Worsening of Hearing Loss.

    PubMed

    Bertolini, Patrizia; Lassalle, Mathilde; Mercier, Guilaine; Raquin, Marie Anne; Izzi, Giancarlo; Corradini, Nadege; Hartmann, Olivier

    2004-10-01

    The purpose of this study was to evaluate the severity of hearing loss after cisplatin and/or carboplatin treatment in young children and to analyze its evolution and its relation to different therapy schedules. One hundred twenty patients treated in the Pediatrics Department at the Institut Gustave-Roussy from 1987 to 1997 for neuroblastoma, osteosarcoma, hepatoblastoma, or germ cell tumors were analyzed. Median age at diagnosis was 2.6 (range 0-17) years. Median follow-up was 7 (1-13) years. Chemotherapy regimens contained cisplatin and/or carboplatin. Three patients also received high-dose carboplatin. Cisplatin was administered at a dose of 200 mg/m/course in 72% of cases. The median cumulative dose was 400 mg/m for cisplatin and 1,600 mg/m for carboplatin. Hearing loss of grade 2 or above, according to Brock's grading scale, was revealed with pure tone audiometry and behavioral techniques. Carboplatin alone was not ototoxic. Deterioration of hearing of grade 2 or above was observed in 37% of patients treated with cisplatin and 43% of patients treated with cisplatin plus carboplatin (P = NS). Fifteen percent of patients experienced grade 3 or 4 ototoxicity. Ototoxicity was most often observed after a total cisplatin dose of at least 400 mg/m. No improvement was observed with time; on the contrary, worsening or progression of hearing loss at lower frequencies was detected during follow-up. Only 5% of audiograms showed toxicity of at least grade 2 before the end of therapy; in contrast, this level was observed in 11% of early post-therapy evaluations and in 44% after more than 2 years of follow-up. Children treated with cisplatin at cumulative doses approaching 400 mg/m require long-term surveillance to avoid overlooking hearing deficits. Carboplatin, at a standard dose, does not appear to be a significant risk factor for ototoxicity even in patients who have already been treated with cisplatin.

  12. Long-term time trends in human intake of POPs in the Czech Republic indicate a need for continuous monitoring.

    PubMed

    Bányiová, Katarína; Černá, Milena; Mikeš, Ondřej; Komprdová, Klára; Sharma, Anežka; Gyalpo, Tenzing; Čupr, Pavel; Scheringer, Martin

    2017-11-01

    Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) from the group of persistent organic pollutants are detected in human tissues years or even decades after their ban. Exposure to PCBs and OCPs can pose risks to human health. In the present study, we calculated the daily intakes of PCBs and OCPs in the Czech population and investigated the long-term trends of human exposure to POPs. Data on POP concentrations from a 16-year period of breast-milk monitoring were used. A toxicokinetic model with consideration of compound-specific elimination half-lives was used to calculate the mothers' daily intake of PCBs and OCPs representing the intake of POPs by all exposure routes. The calculated intakes were compared with dietary intakes calculated by the Czech National Institute of Public Health. The comparison shows good agreement of both intake estimates with decreasing intake trends of POPs in the Czech population in the time period studied. However, several fluctuations with peaks of higher levels were observed in both datasets which are not typical for the period after the ban of use and production of POPs. The available evidence suggests that the increases in chemical concentrations might be caused by food contamination. The calculated intakes of compounds with longer elimination half-lives, such as higher-chlorinated PCBs, were higher in older mothers. This "memory effect" was already observed in other studies and indicates higher exposure in earlier life periods of the mother. Our results suggest that exposure to POPs is still relevant for the Czech population in the period after the ban of the use and production of POPs (post-ban period), especially via food ingestion, though the intake trends are decreasing. Possible food contamination by POPs in the post-ban period requires further assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Long-term continuous GIS-based modeling of forest land use changes in Mica Creek watershed in northern Idaho

    NASA Astrophysics Data System (ADS)

    Boll, J.; Brooks, E. S.; Hubbart, J. A.; Link, T. E.; Cundy, T. W.; Elliot, W. J.; Gravelle, J. A.

    2005-12-01

    Long-term effects of land use change on watershed hydrology are difficult to determine experimentally. Usually, many different disturbances occur that may mask the land use changes of interest. In forested watersheds, these disturbances include clear cutting, road building and fires. In this study, we use an extensive data set from the 28 km2Mica Creek Experimental Watershed (MCEW). This watershed was developed in 1990 by Potlatch Corporation to evaluate the effects of modern forest practices on stream resources. The Mica Creek watershed is a large 97 km2 tributary watershed to the St. Joe River near St. Maries, Idaho. The MCEW has a nested study design, which allows for the analysis of cumulative effects as well as the traditional comparison of treatment versus control. Treatments include road building in 1996, and clearcut and partial-cut logging in 2001. Periods of two to five years were included for pre-treatment and post-treatment monitoring. The MCEW has been instrumented since 1990 for discharge, flow proportional suspended sediment sampling, bedload sampling (during events), water temperature, particle size distribution, channel shape, canopy cover, and channel gradients at 32 stream cross-sections, and precipitation at 4 locations and a cooperative SNOTEL site. We applied the Soil Moisture Routing model, and CCHE1D, a channel routing model for water and sediment, to the MCEW data set. Our results include the simulation of a control period (calibration), road building, and logging. Simulation results are evaluated using spatial patterns, stream flow records at seven flumes, and water yield data. After model simulation, we selected several land use change scenarios for further model runs. In these model runs, we analyzed model output for water yield changes and associated hydrologic variables such as evapotranspiration, runoff, and interflow.

  14. Trial-to-trial dynamics of selective long-term-memory retrieval with continuously changing retrieval targets.

    PubMed

    Kizilirmak, Jasmin M; Rösler, Frank; Khader, Patrick H

    2014-10-01

    How do we control the successive retrieval of behaviorally relevant information from long-term memory (LTM) without being distracted by other potential retrieval targets associated to the same retrieval cues? Here, we approach this question by investigating the nature of trial-by-trial dynamics of selective LTM retrieval, i.e., in how far retrieval in one trial has detrimental or facilitatory effects on selective retrieval in the following trial. Participants first learned associations between retrieval cues and targets, with one cue always being linked to three targets, forming small associative networks. In successive trials, participants had to access either the same or a different target belonging to either the same or a different cue. We found that retrieval times were faster for targets that had already been relevant in the previous trial, with this facilitatory effect being substantially weaker when the associative network changed in which the targets were embedded. Moreover, staying within the same network still had a facilitatory effect even if the target changed, which became evident in a relatively higher memory performance in comparison to a network change. Furthermore, event-related brain potentials (ERPs) showed topographically and temporally dissociable correlates of these effects, suggesting that they result from combined influences of distinct processes that aid memory retrieval when relevant and irrelevant targets change their status from trial to trial. Taken together, the present study provides insight into the different processing stages of memory retrieval when fast switches between retrieval targets are required. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Ultrafine particles in four European urban environments: Results from a new continuous long-term monitoring network

    NASA Astrophysics Data System (ADS)

    Hofman, J.; Staelens, J.; Cordell, R.; Stroobants, C.; Zikova, N.; Hama, S. M. L.; Wyche, K. P.; Kos, G. P. A.; Van Der Zee, S.; Smallbone, K. L.; Weijers, E. P.; Monks, P. S.; Roekens, E.

    2016-07-01

    To gain a better understanding on the spatiotemporal variation of ultrafine particles (UFPs) in urban environments, this study reports on the first results of a long-term UFP monitoring network, set up in Amsterdam (NL), Antwerp (BE), Leicester (UK) and London (UK). Total number concentrations and size distributions were assessed during 1-2 years at four fixed urban background sites, supplemented with mobile trailer measurements for co-location monitoring and additional short-term monitoring sites. Intra- and interurban spatiotemporal UFP variation, associations with commonly-monitored pollutants (PM, NOx and BC) and impacts of wind fields were evaluated. Although comparable size distributions were observed between the four cities, source-related differences were demonstrated within specific particle size classes. Total and size-resolved particle number concentrations showed clear traffic-related temporal variation, confirming road traffic as the major UFP contributor in urban environments. New particle formation events were observed in all cities. Correlations with typical traffic-related pollutants (BC and NOx) were obtained for all monitoring stations, except for Amsterdam, which might be attributable to UFP emissions from Schiphol airport. The temporal variation in particle number concentration correlated fairly weakly between the four cities (rs = 0.28-0.50, COD = 0.28-0.37), yet improved significantly inside individual cities (rs = 0.59-0.77). Nevertheless, considerable differences were still obtained in terms of particle numbers (20-38% for total particle numbers and up to 49% for size-resolved particle numbers), confirming the importance of local source contributions and the need for careful consideration when allocating UFP monitoring stations in heterogeneous urban environments.

  16. Functional Analysis in Long-Term Operation of High Power UV-LEDs in Continuous Fluoro-Sensing Systems for Hydrocarbon Pollution.

    PubMed

    Arques-Orobon, Francisco Jose; Nuñez, Neftali; Vazquez, Manuel; Gonzalez-Posadas, Vicente

    2016-02-26

    This work analyzes the long-term functionality of HP (High-power) UV-LEDs (Ultraviolet Light Emitting Diodes) as the exciting light source in non-contact, continuous 24/7 real-time fluoro-sensing pollutant identification in inland water. Fluorescence is an effective alternative in the detection and identification of hydrocarbons. The HP UV-LEDs are more advantageous than classical light sources (xenon and mercury lamps) and helps in the development of a low cost, non-contact, and compact system for continuous real-time fieldwork. This work analyzes the wavelength, output optical power, and the effects of viscosity, temperature of the water pollutants, and the functional consistency for long-term HP UV-LED working operation. To accomplish the latter, an analysis of the influence of two types 365 nm HP UV-LEDs degradation under two continuous real-system working mode conditions was done, by temperature Accelerated Life Tests (ALTs). These tests estimate the mean life under continuous working conditions of 6200 h and for cycled working conditions (30 s ON & 30 s OFF) of 66,000 h, over 7 years of 24/7 operating life of hydrocarbon pollution monitoring. In addition, the durability in the face of the internal and external parameter system variations is evaluated.

  17. Functional Analysis in Long-Term Operation of High Power UV-LEDs in Continuous Fluoro-Sensing Systems for Hydrocarbon Pollution

    PubMed Central

    Arques-Orobon, Francisco Jose; Nuñez, Neftali; Vazquez, Manuel; Gonzalez-Posadas, Vicente

    2016-01-01

    This work analyzes the long-term functionality of HP (High-power) UV-LEDs (Ultraviolet Light Emitting Diodes) as the exciting light source in non-contact, continuous 24/7 real-time fluoro-sensing pollutant identification in inland water. Fluorescence is an effective alternative in the detection and identification of hydrocarbons. The HP UV-LEDs are more advantageous than classical light sources (xenon and mercury lamps) and helps in the development of a low cost, non-contact, and compact system for continuous real-time fieldwork. This work analyzes the wavelength, output optical power, and the effects of viscosity, temperature of the water pollutants, and the functional consistency for long-term HP UV-LED working operation. To accomplish the latter, an analysis of the influence of two types 365 nm HP UV-LEDs degradation under two continuous real-system working mode conditions was done, by temperature Accelerated Life Tests (ALTs). These tests estimate the mean life under continuous working conditions of 6200 h and for cycled working conditions (30 s ON & 30 s OFF) of 66,000 h, over 7 years of 24/7 operating life of hydrocarbon pollution monitoring. In addition, the durability in the face of the internal and external parameter system variations is evaluated. PMID:26927113

  18. Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs

    USDA-ARS?s Scientific Manuscript database

    Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in...

  19. Long-term no-till and stover retention each decrease the global warming potential of irrigated continuous corn

    USDA-ARS?s Scientific Manuscript database

    Over twenty-two million hectares of U.S. croplands are irrigated, but the impacts of continuous crop residue removal and tillage on soil organic carbon (SOC) stocks, soil greenhouse gas (GHG) emissions, and global warming potential (GWP) in irrigated cropping systems are relatively unknown. Residue...

  20. Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia: A Health Technology Assessment

    PubMed Central

    Kabali, Conrad; Xie, Xuanqian; Higgins, Caroline

    2017-01-01

    Background Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of longterm continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006–2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of longterm ambulatory ECG monitors. Results Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of longterm continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval −0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the

  1. Long-term response to high-dose diazepam treatment in continuous spikes and waves during sleep.

    PubMed

    Sánchez Fernández, Iván; Peters, Jurriaan M; An, Sookee; Bergin, Ann Marie; Takeoka, Masanori; Rotenberg, Alexander; Kothare, Sanjeev V; Riviello, James Jim; Loddenkemper, Tobias

    2013-09-01

    This study evaluated whether the reduction in epileptiform activity after treatment with high-dose diazepam in continuous spikes and waves during sleep persists over time. Patients aged 1 to 21 years with continuous spikes and waves during sleep who received high-dose nocturnal diazepam and who had electroencephalogram follow-up were included. Twenty-nine patients met the inclusion criteria and underwent a total of 48 high-dose diazepam treatment cycles. An overnight reduction of the spike wave percentage of at least 25% (i.e., 75-50%) occurred in 29 cycles (20 patients), and persisted within 6 months in 16 of 29 cycles (12 patients), but returned to baseline in three of 29 cycles (three patients). An overnight reduction of at least 50% (i.e., 75-25%) occurred in 15 cycles (13 patients), and persisted within 6 months in eight of 15 cycles (eight patients), but returned to baseline in three cycles (three patients). Twenty of 29 cycles that responded in the short term had persistent response on follow-up. Thirteen cycles of treatment were associated with mild side effects that did not recur with repeated treatment cycles. Treatment with high-dose diazepam reduced epileptiform activity in continuous spikes and waves during sleep in the short term, and improvement persisted for several months in most cycles. Short-term response predicted persistence of this effect on subsequent follow-up. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Integrated bioprocess for long-term continuous cultivation of Clostridium acetobutylicum coupled to pervaporation with PDMS composite membranes.

    PubMed

    Van Hecke, Wouter; Vandezande, Pieter; Claes, Stan; Vangeel, Silvia; Beckers, Herman; Diels, Ludo; De Wever, Heleen

    2012-05-01

    A continuous cultivation of Clostridium acetobutylicum ATCC 824 is described using a two-stage design to mimic the two phases of batch culture growth of the organism. A hydrophobic pervaporation unit was coupled to the second fermentor containing the highest solvent titers. This in situ product recovery technology efficiently decreased butanol toxicity in the fermentor while the permeate was enriched to 57-195 g L(-1) total solvents depending on the solvent concentrations in the fermentor. By the alleviation of product inhibition, the glucose concentration could be increased from 60 to 126 g L(-1) while the productivity increased concomitantly from 0.13 to 0.30 g L(-1)h(-1). The continuous fermentation was conducted for 1172 h during which the pervaporation was coupled to the second fermentor for 475 h with an average flux of 367 g m(-2)h(-1). The energy consumption was calculated for a 2 wt.% n-butanol fermentation broth and compared with the conventional process.

  3. Long-term Continuous EEG Monitoring in Small Rodent Models of Human Disease Using the Epoch Wireless Transmitter System

    PubMed Central

    Zayachkivsky, Andrew; Lehmkuhle, Mark J.; Dudek, F. Edward

    2015-01-01

    Many progressive neurologic diseases in humans, such as epilepsy, require pre-clinical animal models that slowly develop the disease in order to test interventions at various stages of the disease process. These animal models are particularly difficult to implement in immature rodents, a classic model organism for laboratory study of these disorders. Recording continuous EEG in young animal models of seizures and other neurological disorders presents a technical challenge due to the small physical size of young rodents and their dependence on the dam prior to weaning. Therefore, there is not only a clear need for improving pre-clinical research that will better identify those therapies suitable for translation to the clinic but also a need for new devices capable of recording continuous EEG in immature rodents. Here, we describe the technology behind and demonstrate the use of a novel miniature telemetry system, specifically engineered for use in immature rats or mice, which is also effective for use in adult animals. PMID:26274779

  4. Long-Term Continuous Cultivation of Clostridium beijerinckii in a Two-Stage Chemostat with On-Line Solvent Removal

    PubMed Central

    Gapes, J. R.; Nimcevic, D.; Friedl, A.

    1996-01-01

    A two-stage continuous cultivation experiment with Clostridium beijerinckii NRRL B592 is described. This strain maintained its ability to produce neutral solvents (acetone, n-butanol, and ethanol) at an overall dilution rate of 0.13 h(sup-1) and achieved an average overall solvent concentration of 9.27 g/liter and an overall solvent productivity of 1.24 g/liter/h for more than 100 overall retention times. The experiment was performed without pH control on a semisynthetic medium containing yeast extract, and product inhibition was the limiting factor. Solid carrier material was present in both stages, and the solvent productivity in both stages was similar. A membrane evaporation module integrated into the recirculation loop of a second-stage bioreactor after 2,166 h increased solvent productivity and improved the yield of solvents by about 40%. The membrane reduced the concentration of solvents, which would otherwise inhibit the fermentation. Additionally, the integrated membrane evaporation dampened metabolic oscillations, which are characteristic of continuous cultivation of clostridia. It was also demonstrated that a moderate concentration buildup (approximately 30% of bioreactor inflow) caused by water flux through the membrane caused no detrimental effects to the bacterial cells. However, much higher water fluxes through the membrane, associated with a much more dramatic increase in the concentration of salts in the medium, did appear to favor cell degeneration. PMID:16535396

  5. Long-term continuous production of H2 in a microbial electrolysis cell (MEC) treating saline wastewater.

    PubMed

    Carmona-Martínez, Alessandro A; Trably, Eric; Milferstedt, Kim; Lacroix, Rémy; Etcheverry, Luc; Bernet, Nicolas

    2015-09-15

    A biofilm-based 4 L two chamber microbial electrolysis cell (MEC) was continuously fed with acetate under saline conditions (35 g/L NaCl) for more than 100 days. The MEC produced a biogas highly enriched in H2 (≥90%). Both current (10.6 ± 0.2 A/m(2)Anode or 199.1 ± 4.0 A/m(3)MEC) and H2 production (201.1 ± 7.5 LH2/m(2)Cathode·d or 0.9 ± 0.0 m(3)H2/m(3)MEC·d) rates were highly significant when considering the saline operating conditions. A microbial analysis revealed an important enrichment in the anodic biofilm with five main bacterial groups: 44% Proteobacteria, 32% Bacteroidetes, 18% Firmicutes and 5% Spirochaetes and 1% Actinobacteria. Of special interest is the emergence within the Proteobacteria phylum of the recently described halophilic anode-respiring bacteria Geoalkalibacter (unk. species), with a relative abundance up to 14%. These results provide for the first time a noteworthy alternative for the treatment of saline effluents and continuous production of H2.

  6. Effects of long-term continuous cropping on soil nematode community and soil condition associated with replant problem in strawberry habitat

    PubMed Central

    Li, Xingyue; Lewis, Edwin E.; Liu, Qizhi; Li, Heqin; Bai, Chunqi; Wang, Yuzhu

    2016-01-01

    Continuous cropping changes soil physiochemical parameters, enzymes and microorganism communities, causing “replant problem” in strawberry cultivation. We hypothesized that soil nematode community would reflect the changes in soil conditions caused by long-term continuous cropping, in ways that are consistent and predictable. To test this hypothesis, we studied the soil nematode communities and several soil parameters, including the concentration of soil phenolic acids, organic matter and nitrogen levels, in strawberry greenhouse under continuous-cropping for five different durations. Soil pH significantly decreased, and four phenolic acids, i.e., p-hydroxybenzoic acid, ferulic acid, cinnamic acid and p-coumaric acid, accumulated with time under continuous cropping. The four phenolic acids were highly toxic to Acrobeloides spp., the eudominant genus in non-continuous cropping, causing it to reduce to a resident genus after seven-years of continuous cropping. Decreased nematode diversity indicated loss of ecosystem stability and sustainability because of continuous-cropping practice. Moreover, the dominant decomposition pathway was altered from bacterial to fungal under continuous cropping. Our results suggest that along with the continuous-cropping time in strawberry habitat, the soil food web is disturbed, and the available plant nutrition as well as the general health of the soil deteriorates; these changes can be indicated by soil nematode community. PMID:27506379

  7. Effects of long-term continuous cropping on soil nematode community and soil condition associated with replant problem in strawberry habitat

    NASA Astrophysics Data System (ADS)

    Li, Xingyue; Lewis, Edwin E.; Liu, Qizhi; Li, Heqin; Bai, Chunqi; Wang, Yuzhu

    2016-08-01

    Continuous cropping changes soil physiochemical parameters, enzymes and microorganism communities, causing “replant problem” in strawberry cultivation. We hypothesized that soil nematode community would reflect the changes in soil conditions caused by long-term continuous cropping, in ways that are consistent and predictable. To test this hypothesis, we studied the soil nematode communities and several soil parameters, including the concentration of soil phenolic acids, organic matter and nitrogen levels, in strawberry greenhouse under continuous-cropping for five different durations. Soil pH significantly decreased, and four phenolic acids, i.e., p-hydroxybenzoic acid, ferulic acid, cinnamic acid and p-coumaric acid, accumulated with time under continuous cropping. The four phenolic acids were highly toxic to Acrobeloides spp., the eudominant genus in non-continuous cropping, causing it to reduce to a resident genus after seven-years of continuous cropping. Decreased nematode diversity indicated loss of ecosystem stability and sustainability because of continuous-cropping practice. Moreover, the dominant decomposition pathway was altered from bacterial to fungal under continuous cropping. Our results suggest that along with the continuous-cropping time in strawberry habitat, the soil food web is disturbed, and the available plant nutrition as well as the general health of the soil deteriorates; these changes can be indicated by soil nematode community.

  8. Incubator-independent cell-culture perfusion platform for continuous long-term microelectrode array electrophysiology and time-lapse imaging

    PubMed Central

    Saalfrank, Dirk; Konduri, Anil Krishna; Latifi, Shahrzad; Habibey, Rouhollah; Golabchi, Asiyeh; Martiniuc, Aurel Vasile; Knoll, Alois; Ingebrandt, Sven; Blau, Axel

    2015-01-01

    Most in vitro electrophysiology studies extract information and draw conclusions from representative, temporally limited snapshot experiments. This approach bears the risk of missing decisive moments that may make a difference in our understanding of physiological events. This feasibility study presents a simple benchtop cell-culture perfusion system adapted to commercial microelectrode arrays (MEAs), multichannel electrophysiology equipment and common inverted microscopy stages for simultaneous and uninterrupted extracellular electrophysiology and time-lapse imaging at ambient CO2 levels. The concept relies on a transparent, replica-casted polydimethylsiloxane perfusion cap, gravity- or syringe-pump-driven perfusion and preconditioning of pH-buffered serum-free cell-culture medium to ambient CO2 levels at physiological temperatures. The low-cost microfluidic in vitro enabling platform, which allows us to image cultures immediately after cell plating, is easy to reproduce and is adaptable to the geometries of different cell-culture containers. It permits the continuous and simultaneous multimodal long-term acquisition or manipulation of optical and electrophysiological parameter sets, thereby considerably widening the range of experimental possibilities. Two exemplary proof-of-concept long-term MEA studies on hippocampal networks illustrate system performance. Continuous extracellular recordings over a period of up to 70 days revealed details on both sudden and gradual neural activity changes in maturing cell ensembles with large intra-day fluctuations. Correlated time-lapse imaging unveiled rather static macroscopic network architectures with previously unreported local morphological oscillations on the timescale of minutes. PMID:26543581

  9. Long term operation of continuous-flow system with enhanced biological phosphorus removal granules at different COD loading.

    PubMed

    Li, Dong; Lv, Yufeng; Zeng, Huiping; Zhang, Jie

    2016-09-01

    In this study, a continuous-flow system with enhanced biological phosphorus removal (EBPR) granules was operated at different COD concentrations (200, 300 and 400mgL(-)(1)) to investigate the effect of COD loading on this system. The results showed that when the COD concentration in influent was increased to 400mgL(-)(1), the anaerobic COD removal efficiency and total phosphorus removal efficiency reduced obviously and the settling ability of granules deteriorated due to the proliferation of filamentous bacteria. Moreover, high COD loading inhibited the EPS secretion and destroyed the stability of granules. Results of high-through pyrosequencing indicated that filamentous bacteria had a competitive advantage over polyphosphate-accumulating organisms (PAOs) at high COD loading. The performance of system, settling ability of granules and proportion of PAOs gradually recovered to the initial level after the COD concentration was reduced to 200mgL(-)(1) on day 81. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Long-term outcomes after surgical ablation for atrial fibrillation in patients with continuous heart rhythm monitoring devices.

    PubMed

    Charitos, Efstratios I; Ziegler, Paul D; Stierle, Ulrich; Graf, Bernhard; Sievers, Hans-Hinrich; Hanke, Thorsten

    2015-12-01

    Surgical ablation for atrial fibrillation (AF) is an established therapy for the treatment of concomitant AF in cardiac surgery patients. We aim to present our prospective experience with 99 continuously monitored patients and investigate whether enhanced monitoring can identify patterns and factors influencing AF recurrence after surgical AF ablation. Ninety-nine patients (73 males; age: 68.0 ± 9.2 years) with documented preoperative AF (paroxysmal: 29; persistent: 18; long-lasting persistent: 52, mean preoperative duration: 46 ± 53 months) underwent concomitant biatrial surgical ablation (Cox Maze III: 29), full set left atrial cryoablation (n = 22), high-intensity focused ultrasound (HIFU) box lesion (n = 46) or right-sided ablation (n = 2). Postoperative rhythm disclosure was provided via an implantable device. Scheduled follow-up was performed quarterly (mean ± standard deviation: 1.75 ± 1.16 years, 173.7 patient-years). The mean postoperative AF burden during the follow-up was 7 ± 19% (median: 0.2%). Seventy-one and 82 patients had AF burden <1% and <5%, respectively. The preoperative AF duration, preoperative ejection fraction, mitral valve surgery and HIFU in patients with more persistent AF were associated with statistically significant higher postoperative AF burdens. The pattern of AF recurrence during the 3-month blanking period was associated with the amount of later AF recurrence. Continuous rhythm disclosure reveals that very small amounts of AF burden after surgical ablation are common. The preoperative duration of AF and the use of a box lesion only in patients with longer AF persistence history were independently associated with higher postoperative AF burden recurrence. The temporal AF pattern during the blanking period after ablation should be considered for further patient management and might serve as a prognostic factor. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio

  11. Polyvinylidene fluoride/siloxane nanofibrous membranes for long-term continuous CO2 -capture with large absorption-flux enhancement.

    PubMed

    Lin, Yi-Feng; Wang, Chi-Sen; Ko, Chia-Chieh; Chen, Chien-Hua; Chang, Kai-Shiun; Tung, Kuo-Lun; Lee, Kueir-Rarn

    2014-02-01

    In a CO2 membrane contactor system, CO2 passes through a hydrophobic porous membrane in the gas phase to contact the amine absorbent in the liquid phase. Consequently, additional CO2 gas is absorbed by amine absorbents. This study examines highly porous polyvinylidene fluoride (PVDF)/siloxane nanofibrous layers that are modified with hydrophobic fluoroalkylsilane (FAS) functional groups and successfully coated onto a macroporous Al2 O3 membrane. The performance of these materials in a membrane contactor system for CO2 absorption is also investigated. Compared with pristine PVDF nanofibrous membranes, the PVDF/siloxane nanofibrous membranes exhibit greater solvent resistance and mechanical strength, making them more suitable for use in CO2 capture by the membrane contactor. The PVDF/siloxane nanofibrous layer in highly porous FAS-modified membranes can prevent the wetting of the membrane by the amine absorbent; this extends the periods of continuous CO2 absorption and results in a high CO2 absorption flux with a minimum of 500 % enhancement over that of the uncoated membranes. This study suggests the potential use of an FAS-modified PVDF/siloxane nanofibrous membrane in a membrane contactor system for CO2 absorption. The resulting hydrophobic membrane contactor also demonstrates the potential for large-scale CO2 absorption during post-combustion processes in power plants.

  12. Emergence of resistance in staphylococci after long-term mupirocin application in patients on continuous ambulatory peritoneal dialysis.

    PubMed

    Cavdar, Caner; Atay, Tuba; Zeybel, Mujdat; Celik, Ali; Ozder, Ayse; Yildiz, Serkan; Gulay, Zeynep; Camsari, Taner

    2004-01-01

    In the present study, we evaluated the effects of once-weekly mupirocin application to catheter exit sites on Staphylococcus aureus and coagulase-negative staphylococcus (CNS) colonization and investigated the resistance of those bacteria to methicillin (MeR) and mupirocin (MuR). We enrolled 36 continuous ambulatory peritoneal dialysis (CAPD) patients (mean age: 55.1 +/- 1.4 years) into the study. The patients (men/women: 21/15) had been applying mupirocin to the catheter exit site once weekly before the start of the study (mupirocin treatment duration: 3.1 +/- 2.0 years). During the study period, swabs were taken monthly from the nares, axillae, inguinal area, and catheter exit site. The swabs were inoculated on blood plates. Methicillin and mupirocin susceptibility were tested by disc diffusion according to the interpretative criteria of the National Committee for Clinical Laboratory Standards. We evaluated a total of 144 cultures. Among CNS isolates, the MuR was 66%, and the MeR was 38.8%. At the start of the study period, 3 patients were S. aureus nasal carriers. In nasal swabs, no MeR S. aureus was identified, and only 1 MuR S. aureus was found. Once-weekly application of mupirocin at the exit site in CAPD patients led to comparable rates of colonization by MuR S. aureus as did thrice-weekly or more frequent application. Clinical results showing high mupirocin and methicillin resistance in CNS are controversial.

  13. The Practice of Continuous Palliative Sedation in Long-Term Care for Frail Patients with Existential Suffering.

    PubMed

    van Deijck, Rogier H P D; Hasselaar, Jeroen G J; Krijnsen, Petrus J Cc; Gloudemans, Amadea J M; Verhagen, Stans C A H H V M; Vissers, Kris C P; Koopmans, Raymond T C M

    2015-01-01

    Some guidelines and recommendations identify existential suffering as a potential refractory symptom for which continuous palliative sedation (CPS) can be administered under certain conditions. However, there has been little research on the characteristics of patients with existential suffering treated with CPS and the degree to which the preconditions are fulfilled. The aim of this study was to provide insight into this specific indication for CPS. Questionnaires were sent to nursing home physicians in The Netherlands, who described 314 patients. Existential suffering was a refractory symptom in 83 of the patients. For most of the patients with refractory existential suffering, other refractory symptoms were also reported, and life expectancy was seven days or less; informed consent for initiating CPS had been obtained in all cases. Consultation and intermittent sedation before the start of CPS were far less frequently reported than one would expect based on the guidelines. Multivariate analysis showed that being male, having previously requested euthanasia, having a nervous system disease, or having an other diagnosis were positively correlated with the administration of CPS for existential suffering. We conclude that more attention should be paid to the suggested preconditions and to the presence of existential suffering in male patients or patients with a nervous system disease.

  14. Nitrate inhibition of legume nodule growth and activity. I. Long term studies with a continuous supply of nitrate

    SciTech Connect

    Streeter, J.G.

    1985-02-01

    The synthesis and accumulation of nitrite has been suggested as a causative factor in the inhibition of legume nodules supplied with nitrate. Plants were grown in sand culture with a moderate level of nitrate (2.1 to 6.4 millimolar) supplied continuously from seed germination to 30 to 50 days after planting. In a comparison of nitrate treatments, a highly significant negative correlation between nitrite concentration in soybean (Glycine max (L.) Merr.) nodules and nodule fresh weight per shoot dry weight was found even when bacteroids lacked nitrate reductase (NR). However, in a comparison of two Rhizobium japonicum strains, there was only 12% as much nitrite in nodules formed by NR/sup -/ R. japonicum as in nodules formed by NR/sup +/ R. japonicum, and growth and acetylene reduction activity of both types of nodules was about equally inhibited. The very small concentration of nitrite found in P. vulgaris nodules was probably below that required for the inhibition of nitrogenase based on published in vitro experiments, and yet the specific acetylene reduction activity was inhibited 83% by nitrate. The overall results do not support the idea that nitrite plays a role in the inhibition of nodule growth and nitrogenase activity by nitrate.

  15. Mesoporous fluorocarbon-modified silica aerogel membranes enabling long-term continuous CO2 capture with large absorption flux enhancements.

    PubMed

    Lin, Yi-Feng; Chen, Chien-Hua; Tung, Kuo-Lun; Wei, Te-Yu; Lu, Shih-Yuan; Chang, Kai-Shiun

    2013-03-01

    The use of a membrane contactor combined with a hydrophobic porous membrane and an amine absorbent has attracted considerable attention for the capture of CO2 because of its extensive use, low operational costs, and low energy consumption. The hydrophobic porous membrane interface prevents the passage of the amine absorbent but allows the penetration of CO2 molecules that are captured by the amine absorbent. Herein, highly porous SiO2 aerogels modified with hydrophobic fluorocarbon functional groups (CF3 ) were successfully coated onto a macroporous Al2 O3 membrane; their performance in a membrane contactor for CO2 absorption is discussed. The SiO2 aerogel membrane modified with CF3 functional groups exhibits the highest CO2 absorption flux and can be continuously operated for CO2 absorption for extended periods of time. This study suggests that a SiO2 aerogel membrane modified with CF3 functional groups could potentially be used in a membrane contactor for CO2 absorption. Also, the resulting hydrophobic SiO2 aerogel membrane contactor is a promising technology for large-scale CO2 absorption during the post-combustion process in power plants. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Predictors of Long-Term Adherence to Continuous Positive Airway Pressure Therapy in Patients with Obstructive Sleep Apnea and Cardiovascular Disease in the SAVE Study

    PubMed Central

    Chai-Coetzer, Ching Li; Luo, Yuan-Ming; Antic, Nick A.; Zhang, Xi-Long; Chen, Bao-Yuan; He, Quan-Ying; Heeley, Emma; Huang, Shao-Guang; Anderson, Craig; Zhong, Nan-Shan; McEvoy, R. Doug

    2013-01-01

    Study Objectives: To determine the clinical variables that best predict long- term continuous positive airway pressure (CPAP) adherence among patients with cardiovascular disease who have obstructive sleep apnea (OSA). Design: 12-mo prospective within-trial observational study. Setting: Centers in China, Australia, and New Zealand participating in the Sleep Apnea cardioVascular Endpoints (SAVE) study. Patients: There were 275 patients age 45-70 y with cardiovascular disease (i.e., previously documented transient ischemic attack, stroke, or coronary artery disease) and OSA (4% oxygen desaturation index (ODI) > 12) who were randomized into the CPAP arm of the SAVE trial prior to July 1, 2010. Methods: Age, sex, country of residence, type of cardiovascular disease, baseline ODI, severity of sleepiness, and Hospital Anxiety and Depression Scale (HADS) scores plus CPAP side effects and adherence at 1 mo were entered in univariate analyses in an attempt to identify factors predictive of CPAP adherence at 12 mo. Variables with P < 0.2 were then included in a multivariate analysis using a linear mixed model with sites as a random effect and 12-mo CPAP use as the dependent outcome variable. Measurements and Results: CPAP adherence at 1, 6, and 12 mo was (mean ± standard deviation) 4.4 ± 2.0, 3.8 ± 2.3, and 3.3 ± 2.4 h/night, respectively. CPAP use at 1 mo (effect estimate ± standard error, 0.65 ± 0.07 per h increase, P < 0.001) and side effects at 1 mo (-0.24 ± 0.092 per additional side effect, P = 0.009) were the only independent predictors of 12- mo CPAP adherence. Conclusion: Continuous positive airway pressure use in patients with coexisting cardiovascular disease and moderate to severe obstructive sleep apnea decreases significantly over 12 months. This decline can be predicted by early patient experiences with continuous positive airway pressure (i.e., adherence and side effects at 1 month), raising the possibility that intensive early interventions could

  17. Long-Term Continuous Suppression With Once-Yearly Histrelin Subcutaneous Implants for the Treatment of Central Precocious Puberty: A Final Report of a Phase 3 Multicenter Trial

    PubMed Central

    Neely, E. Kirk; Kletter, Gad B.; Lewis, Katherine; Chitra, Surya; Terleckyj, Oksana; Eugster, Erica A.

    2015-01-01

    Context and Objective: The histrelin implant has proven to be an effective method of delivering GnRH analog (GnRHa) therapy to children with central precocious puberty (CPP), yet there are limited data available regarding hormonal suppression and auxological changes during an extended course of therapy. Design: This was a phase 3, prospective, open-label study. Setting and Participants: Thirty-six children with CPP who participated in a phase 3, open-label study and required further GnRHa therapy were eligible to continue treatment receiving a new implant upon removal of the prior 12-month histrelin implant during a long-term extension phase. Outcome Measures: Hormone levels and auxologic parameters were measured periodically for up to 6 years of treatment and up to 1 year of posttreatment follow-up. Results: Hormonal suppression was maintained throughout the study in patients who had prior GnRHa therapy (n = 16) and in treatment-naive patients (n = 20). Bone age to chronological age ratio decreased from 1.417 (n = 20) at baseline to 1.18 (n = 8) at 48 months in treatment-naive children (P < .01). Predicted adult height in girls increased from 151.9 cm at baseline to 166.5 cm at month 60 (n = 6; P < .05), with a 10.7-cm height gain observed among treatment-naive children (n = 5). No adverse effect on growth or recovery of the hypothalamic-pituitary-gonadal axis was observed with hormonal suppression. The histrelin implant was generally well tolerated during long-term therapy. Conclusions: Long-term histrelin implant therapy provided sustained gonadotropin suppression safely and effectively and improved predicted adult height in children with CPP. PMID:25803268

  18. Nitrate sources and sinks in Elkhorn Slough, California: Results from long-term continuous in situ nitrate analyzers

    USGS Publications Warehouse

    Chapin, T.P.; Caffrey, J.M.; Jannasch, H.W.; Coletti, L.J.; Haskins, J.C.; Johnson, K.S.

    2004-01-01

    Nitrate and water quality parameters (temperature, salinity, dissolved oxygen, turbidity, and depth) were measured continuously with in situ NO 3 analyzers and water quality sondes at two sites in Elkhorn Slough in Central California. The Main Channel site near the mouth of Elkhorn Slough was sampled from February to September 2001. Azevedo Pond, a shallow tidal pond bordering agricultural fields further inland, was sampled from December 1999 to July 2001. Nitrate concentrations were recorded hourly while salinity, temperature, depth, oxygen, and turbidity were recorded every 30 min. Nitrate concentrations at the Main Channel site ranged from 5 to 65 ??M. The propagation of an internal wave carrying water from ???100 m depth up the Monterey Submarine Canyon and into the lower section of Elkhorn Slough on every rising tide was a major source of nitrate, accounting for 80-90% of the nitrogen load during the dry summer period. Nitrate concentrations in Azevedo Pond ranged from 0-20 ??M during the dry summer months. Nitrate in Azevedo Pond increased to over 450 ??M during a heavy winter precipitation event, and interannual variability driven by differences in precipitation was observed. At both sites, tidal cycling was the dominant forcing, often changing nitrate concentrations by 5-fold or more within a few hours. Water volume flux estimates were combined with observed nitrate concentrations to obtain nitrate fluxes. Nitrate flux calculations indicated a loss of 4 mmol NO3 m -2 d-1 for the entire Elkhorn Slough and 1 mmol NO 3 m-2 d-1 at Azevedo Pond. These results suggested that the waters of Elkhorn Slough were not a major source of nitrate to Monterey Bay but actually a nitrate sink during the dry season. The limited winter data at the Main Channel site suggest that nitrate was exported from Elkhorn Slough during the wet season. Export of ammonium or dissolved organic nitrogen, which we did not monitor, may balance some or all of the NO 3 flux.

  19. Long-term effects of treatment with nasal continuous positive airway pressure on lung function in patients with overlap syndrome.

    PubMed

    de Miguel, Javier; Cabello, Jorge; Sánchez-Alarcos, José M F; Alvarez-Sala, Rudolfo; Espinós, Domingo; Alvarez-Sala, José L

    2002-03-01

    We assessed the effects of chronic nasal continuous positive airway pressure (CPAP) therapy on lung function in a series of unselected patients with overlap syndrome, and we determined whether there were differences in the response induced by CPAP between hypercapnic (PaCO2 > or =45 mm Hg) and eucapnic patients with overlap syndrome. The study population included 55 unselected patients (48 men, mean age of 58.5 +/- 10.5 years) with a concurrent diagnosis of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea-hypopnea syndrome (OSAHS) who had been referred to the Department of Pulmonology of our hospital over 2 consecutive years and in whom work-up studies resulted in the prescription of nasal CPAP therapy. An apnea-hypopnea index (AHI) greater than or equal to 10 in the cardiorespiratory polygraphy was required for the diagnosis of OSAHS. A forced expiratory volume in one second (FEV1) less than 80% and FEV1-forced vital capacity (FVC) ratio less than 70% of the reference values were required for the diagnosis of COPD. Control lung function studies and arterial blood gas measurements were performed at 6 and 18 months of CPAP therapy. These patients with overlap syndrome accounted for 28.5% of all patients with OSAHS treated with CPAP during the study period. The mean AHI was 37.3 +/- 26.1 and the mean CPAP level 7.3 +/- 1.3 cm H2O. Thirty-three patients were hypercapnic (PaCO2 > or = 45 mm Hg) and 22 eucapnic. The hypercapnic group had higher AHI value (44.3 +/- 26.9) than the eucapnic group (28.6 +/- 21.9) (P < 0.05). After 6 months of CPAP therapy, there were statistically significant increases in PaO2, FEV1, and FVC, accompanied by significant decreases in PaCO2, serum bicarbonate levels, and alveolar-arterial oxygen difference. Response of overlap syndrome patients to CPAP therapy was superior in the hypercapnic group, particularly in relation to improvement of arterial blood gases. However, statistically significant differences in all

  20. Short and long-term effects of continuous versus intermittent loop diuretics treatment in acute heart failure with renal dysfunction.

    PubMed

    Palazzuoli, Alberto; Pellegrini, Marco; Franci, Beatrice; Beltrami, Matteo; Ruocco, Gaetano; Gonnelli, Stefano; Angelini, Gianni D; Nuti, Ranuccio

    2015-02-01

    Intravenous loop diuretics are still the cornerstone of therapy in acute decompensated heart failure, however, the optimal dosage and administration strategies remain poorly defined particularly in patients with an associated renal dysfunction. This is a single-center, pilot, randomized trial involving patients with acute HF and renal dysfunction. Patients were assigned to receive continuous furosemide infusion (cIV) or bolus injections of furosemide (iIV). Primary end points were the evaluation of urine output volumes, renal function, and b-type natriuretic peptide (BNP) levels during treatment time. Secondary end point included: weight loss, length of hospitalization, differences in plasma electrolytes, need for additional treatment, and evaluation of cardiac events during follow-up period. 57 patients were included in the study. The cIV group showed an increase in urine output (2,505 ± 796 vs 2140 ± 468 ml/day, p < 0.04) and a more significant decrease of BNP levels in respect to the iIV group (679.6 ± 397 vs 949 ± 548 pg/ml, p < 0.04). We observed a significant increase in creatinine levels (1.78 ± 0.5 vs 1.41 ± 0.3 mg/dl, p < 0.01), and a reduction of the estimated glomerular filtration rate in cIV (44.8 ± 6.1 vs 46.7 ± 6.1 ml/min, p < 0.05). We observed a significant difference in eGFR (p = 0.01), creatinine (p = 0.02) and BNP levels (p = 0.03) from baseline to the end of treatment in both groups. A significant increase of in-hospital additional treatment as well as length of hospitalization was observed in cIV. Finally, cIV revealed a higher rate of adverse events during the follow-up period (p < 0.03). cIV appears to provide a more efficient diuresis and BNP level reduction during hospitalization, however, it was associated with increased rate of worsening renal function during hospitalization. cIV also appears related to a longer hospitalization and an increased number of adverse events during follow-up. For all

  1. Does the "sleeping Dragon" Really Sleep?: the Case for Continuous Long-Term Monitoring at a Gulf of Mexico Cold Seep Site

    NASA Astrophysics Data System (ADS)

    Wilson, R. M.; Lapham, L.; Farr, N.; Lutken, C.; MacDonald, I. R.; Macelloni, L.; Riedel, M.; Sleeper, K.; Chanton, J.

    2011-12-01

    Continuous porewater monitoring indicates that the methane flux away from exposed hydrate mounds can vary considerably over time. Recently, we retrieved a Pore Fluid Array instrument pack from a hydrate outcrop adjacent to a NEPTUNE Canada observatory node. The sampler was designed to continuously collect and store sediment pore fluids over the course of 9 months. On analysis, we observed a 35mM variation in methane concentrations corresponding with an abrupt shift in current direction at the site. Video and resistivity data have led to previous speculation that hydrate growth and dissolution/dissociation may be seasonally variable. Cumulatively, these findings suggest that the persistence of hydrate outcrops may be extremely dynamic, driven by fluctuations in physical conditions on short time scales. Short-term monitoring in the Gulf of Mexico within Mississippi Canyon lease block 118 (MC118), a known hydrate-bearing site, indicates that physical conditions even at these depths (~540-890m) may be highly variable. Pressure can vary within hours, and recorded temperature changes of ~1.5°C have been associated with passing storms. Moreover, increased particle abundance was observed at the site in 2007 suggesting that organic matter flux to the sediments may vary on the scale of months to years. These inputs have the potential to alter the chemical environment surrounding the hydrate, thereby affecting dissolution rates. Continuous, long-term observations of physical conditions at MC118 could provide information about the potential for natural perturbations to impact hydrate dynamics on the scale of weeks or even days necessary for assessing the long-term persistence of hydrate outcrops. Sleeping Dragon is a massive hydrate outcrop at MC118 that has been monitored since 2006. Three years ago, researchers returning to the site found it visibly diminished relative to previous observations. This apparent shift toward net dissolution of the mound may have been

  2. Chronic Drinking During Adolescence Predisposes the Adult Rat for Continued Heavy Drinking: Neurotrophin and Behavioral Adaptation after Long-Term, Continuous Ethanol Exposure

    PubMed Central

    Fernandez, Gina M.; Stewart, William N.; Savage, Lisa M.

    2016-01-01

    Previous research has found that adolescent ethanol (EtOH) exposure alters drug seeking behaviors, cognition and neuroplasticity. Using male Sprague Dawley rats, differences in spatial working memory, non-spatial discrimination learning and behavioral flexibility were explored as a function of age at the onset (mid-adolescent vs. adult) of chronic EtOH exposure (CET). Concentrations of mature brain-derived neurotrophic factor (mBDNF) and beta-nerve growth factor (β-NGF) in the prefrontal cortex and hippocampus were also assessed at different time-points: during CET, following acute abstinence (48-hrs), and after protracted abstinence (6–8 wks). Our results revealed that an adolescent onset of CET leads to increased EtOH consumption that persisted into adulthood. In both adult and adolescent onset CET groups, there were significant long-term reductions in prefrontal cortical mBDNF and β-NGF levels. However, only adult onset CET rats displayed decreased hippocampal BDNF levels. Spatial memory, assessed by spontaneous alternation and delayed alternation, was not significantly affected by CET as a function of age of drinking onset, but higher blood–EtOH levels were correlated with lower spontaneous alternation scores. Regardless of the age of onset, EtOH exposed rats were impaired on non-spatial discrimination learning and displayed inflexible behavioral patterns upon reversal learning. Our results indicate that adolescent EtOH exposure changes long-term consumption patterns producing behavioral and neural dysfunctions that persist across the lifespan. PMID:26930631

  3. Chronic Drinking During Adolescence Predisposes the Adult Rat for Continued Heavy Drinking: Neurotrophin and Behavioral Adaptation after Long-Term, Continuous Ethanol Exposure.

    PubMed

    Fernandez, Gina M; Stewart, William N; Savage, Lisa M

    2016-01-01

    Previous research has found that adolescent ethanol (EtOH) exposure alters drug seeking behaviors, cognition and neuroplasticity. Using male Sprague Dawley rats, differences in spatial working memory, non-spatial discrimination learning and behavioral flexibility were explored as a function of age at the onset (mid-adolescent vs. adult) of chronic EtOH exposure (CET). Concentrations of mature brain-derived neurotrophic factor (mBDNF) and beta-nerve growth factor (β-NGF) in the prefrontal cortex and hippocampus were also assessed at different time-points: during CET, following acute abstinence (48-hrs), and after protracted abstinence (6-8 wks). Our results revealed that an adolescent onset of CET leads to increased EtOH consumption that persisted into adulthood. In both adult and adolescent onset CET groups, there were significant long-term reductions in prefrontal cortical mBDNF and β-NGF levels. However, only adult onset CET rats displayed decreased hippocampal BDNF levels. Spatial memory, assessed by spontaneous alternation and delayed alternation, was not significantly affected by CET as a function of age of drinking onset, but higher blood-EtOH levels were correlated with lower spontaneous alternation scores. Regardless of the age of onset, EtOH exposed rats were impaired on non-spatial discrimination learning and displayed inflexible behavioral patterns upon reversal learning. Our results indicate that adolescent EtOH exposure changes long-term consumption patterns producing behavioral and neural dysfunctions that persist across the lifespan.

  4. Online Continuous Flow Differential Electrochemical Mass Spectrometry with a Realistic Battery Setup for High-Precision, Long-Term Cycling Tests.

    PubMed

    Berkes, Balázs B; Jozwiuk, Anna; Vračar, Miloš; Sommer, Heino; Brezesinski, Torsten; Janek, Jürgen

    2015-06-16

    We describe the benefits of an online continuous flow differential electrochemical mass spectrometry (DEMS) method that allows for realistic battery cycling conditions. We provide a detailed description on the buildup and the role of the different components in the system. Special emphasis is given on the cell design. The retention time and response characteristics of the system are tested with the electrolysis of Li2O2. Finally, we show a practical application in which a Li-ion battery is examined. The value of long-term DEMS measurements for the proper evaluation of electrolyte decomposition is demonstrated by an experiment where a Li(1+x)Ni(0.5)Mn(0.3)Co(0.2)O2 (NMC 532)/graphite cell is cycled over 20 charge/discharge cycles.

  5. Long-term Risedronate Treatment Normalizes Mineralization and Continues to Preserve Trabecular Architecture: Sequential Triple Biopsy Studies with Micro-Computed Tomography

    SciTech Connect

    Borah,B.; Dufresne, T.; Ritman, E.; Jorgensen, S.; Liu, S.; Chmielewski, P.; Phipps, R.; Zhou, X.; Sibonga, J.; Turner, R.

    2006-01-01

    The objective of the study was to assess the time course of changes in bone mineralization and architecture using sequential triple biopsies from women with postmenopausal osteoporosis (PMO) who received long-term treatment with risedronate. Transiliac biopsies were obtained from the same subjects (n = 7) at baseline and after 3 and 5 years of treatment with 5 mg daily risedronate. Mineralization was measured using 3-dimensional (3D) micro-computed tomography (CT) with synchrotron radiation and was compared to levels in healthy premenopausal women (n = 12). Compared to the untreated PMO women at baseline, the premenopausal women had higher average mineralization (Avg-MIN) and peak mineralization (Peak-MIN) by 5.8% (P = 0.003) and 8.0% (P = 0.003), respectively, and lower ratio of low to high-mineralized bone volume (BMR-V) and surface area (BMR-S) by 73.3% (P = 0.005) and 61.7% (P = 0.003), respectively. Relative to baseline, 3 years of risedronate treatment significantly increased Avg-MIN (4.9 {+-} 1.1%, P = 0.016) and Peak-MIN (6.2 {+-} 1.5%, P = 0.016), and significantly decreased BMR-V (-68.4 {+-} 7.3%, P = 0.016) and BMR-S (-50.2 {+-} 5.7%, P = 0.016) in the PMO women. The changes were maintained at the same level when treatment was continued up to 5 years. These results are consistent with the significant reduction of turnover observed after 3 years of treatment and which was similarly maintained through 5 years of treatment. Risedronate restored the degree of mineralization and the ratios of low- to high-mineralized bone to premenopausal levels after 3 years of treatment, suggesting that treatment reduced bone turnover in PMO women to healthy premenopausal levels. Conventional micro-CT analysis further demonstrated that bone volume (BV/TV) and trabecular architecture did not change from baseline up to 5 years of treatment, suggesting that risedronate provided long-term preservation of trabecular architecture in the PMO women. Overall, risedronate provided

  6. Smoking cessation and long-term weight gain in the Framingham Heart Study: an application of the parametric g-formula for a continuous outcome.

    PubMed

    Jain, Priyanka; Danaei, Goodarz; Robins, James M; Manson, JoAnn E; Hernán, Miguel A

    2016-12-01

    Weight gain after smoking cessation can lessen the health benefits of, and reduce the incentives for, quitting smoking. Randomized clinical trials of smoking cessation have estimated this weight gain only over short periods of follow-up. We provide an estimate of long-term post-cessation weight gain in the Framingham Heart Study, a prospective observational study. We identified 2001 smokers free of diabetes, cancer, and cardiovascular disease in 1952. Using the parametric g-formula we estimated mean weight in 1972 if all smokers had quit at baseline versus if all had continued smoking. Our estimates were adjusted for demographic, socio-economic, and clinical factors at baseline and during follow-up. The estimated mean weight (95 % CI) at 20 years if all smokers had quit smoking was 75.2 kg (73.5, 76.6), compared with 70.2 kg (68.7, 71.8) if they had smoked 20 cigarettes/day and 73.4 kg (71.9, 74.6) if they had smoked 5 cigarettes/day (i.e., an estimated mean weight gain of 5.1 kg (3.1, 6.6) and 1.8 kg (0.8, 2.8), respectively). Smokers who were overweight or obese at baseline had a greater post-cessation weight gain on average. Our estimates suggest that smoking cessation can result in increases in body weight over 20 years. While the benefits of smoking cessation outweigh the risks due to post-cessation weight gain, our results highlight the need for long-term weight management interventions in combination with smoking cessation.

  7. Long-term effects of fertilization on soil organic carbon changes in continuous corn of northeast China: RothC model simulations.

    PubMed

    Yang, X M; Zhang, X P; Fang, H J; Zhu, P; Ren, J; Wang, L C

    2003-10-01

    Soil organic C (SOC) content can increase by managing land use practices in which the rates of organic C input exceed those of organic C mineralization. Understanding the changes in SOC content of Black soils (mainly Typic Halpudoll) in northeast China is necessary for sustainable using of soil resources there. We used the RothC model to estimate SOC levels of Black soils under monoculture cropping corn in a long-term fertilization trial at Gongzhuling, Jilin Province, China. The model outputs for the changes in SOC were compared with measured data in this long-term fertilization/manure trial. The sound performance of model in simulating SOC changes suggests that RothC is feasible with Black soils in the temperate climatic region of northeast China. The modeled and measured results indicated that the treatment without fertilizer/farmyard manure (FYM) addition led to a continuous decline in SOC during the study period and N and NPK fertilization were inadequate to maintain the SOC levels in the plow layer (upper 20 cm) unless FYM was added under the current conventional management associated with no above-ground crop residues returning into the soil. Soil organic carbon could follow the same path of decline if the same management practices are maintained. Model results indicate that returning above-ground crop residues to the soil from 2002 to 2022 would increase SOC by 26% for the treatment without fertilization addition, 40% for N treatment, 45% for NPK treatment, and 38% and 46% for N and NPK treatments with FYM addition, compared to the levels in the corresponding treatments in 2002. The simulation results suggest that the RothC model is a feasible tool to assess SOC trend under different management practices, and returning above-ground crop residues into the soil would lead to a remarkable increase in SOC of Black soils in the region.

  8. Influences of operating conditions on continuous lactulose synthesis in an enzymatic membrane reactor system: A basis prior to long-term operation.

    PubMed

    Sitanggang, Azis Boing; Drews, Anja; Kraume, Matthias

    2015-06-10

    Lactulose synthesis was performed in a continuous stirred enzymatic membrane reactor. Each investigated operating condition (agitation, pH, feed molar ratio of lactose to fructose (mL/mF ratio), hydraulic residence time (HRT)) had an influence on reaction performances, in terms of lactulose concentration, productivity and selectivity. Lactulose concentration was maximum at an mL/mF ratio of 1/2. Higher than this ratio, synthesis of galactooligosaccharides was promoted rather than lactulose. At mL/mF ratios lower than 1/2, enzyme inhibition was pronounced to the detriment of lactulose production. At 7 or 9h HRT, higher lactulose concentrations were obtained than at shorter HRTs. Applying an mL/mF ratio of 1/2 and an HRT of 9h in a long-term operation, nearly constant lactulose concentration was reached after 23h and lasted up to 32h with a mean concentration of 14.51±0.07g/L and a reaction selectivity of 0.075-0.080mollactulose/molcons.lactose. After 7d, lactulose concentration reduced by 31%. A continuous synthesis of lactulose at lab-scale was shown to be amenable using a membrane reactor process. Moreover, for process evaluation, this study can bridge the gap between batch laboratory scale and continuous full-scale operation regarding lactulose synthesis. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Safety and comfort of long-term continuous combined transdermal estrogen and intrauterine levonorgestrel administration for postmenopausal hormone substitution - a review.

    PubMed

    Wildemeersch, D

    2016-08-01

    To review the endometrial safety and patient acceptability of long-term use of continuous transdermal estrogen substitution combined with intrauterine release of levonorgestrel (LNG) in postmenopausal women. One-hundred and fifty-three women who utilized the regimen for 2 IUD cycles were followed-up for a period of 10 years. Histology of the endometrium was evaluated at the end of this period to assess endometrial safety and the acceptability of the method was assessed based on the replacement rate of the LNG-IUS and continuation of ET. The regimen, administered over a 10-year period, was very well tolerated and the IUD was retained well and no expulsions occurred. The dominant endometrial histologic picture was that of inactive endometrium characterized by glandular atrophy and stroma decidualization (Kurman classification 5b). No cases of endometrial hyperplasia were found. The low systemic absorption of LNG could be desirable, thus allowing for maximization of the beneficial effects of ET on organ tissues (e.g. cardiovascular tissues and breast). Repeat LNG-IUS is associated with high patient satisfaction. If started before the age of 60, this regimen could be advised for lifelong prevention of cardiovascular disease and other prevention measures. The LNG-IUS was shown to effectively oppose the secondary effects of systemic estrogen on the endometrium tissue resulting in strong suppression during the entire period of EPT.

  10. Establishing a Long-term 30 Year Global Solar Resource at 10 km Resolution: Preliminary Results From Test Processing and Continuing Plans

    NASA Astrophysics Data System (ADS)

    Stackhouse, P. W.; Mikovitz, J. C.; Cox, S. J.; Zhang, T.; Perez, R.; Schlemmer, J.; Sengupta, M.; Knapp, K. R.

    2014-12-01

    As renewable energy system become more prevalent, improved global long-term, up-to-date records are needed to better understand and quantify the solar resource and variability. Toward this end, a project involving NASA, DOE NREL, SUNY-Albany and the NOAA National Climatic Data Center (NCDC) was initiated to provide NREL with a solar resource mapping production system for improved depiction of global long-term solar resources that provides the capacity for continual updates. This new production system is made possible by the efforts of NOAA and NASA to completely reprocess the International Satellite Cloud Climatology Project (ISCCP) data set that provides satellite visible and infrared radiances together with retrieved cloud and surface properties on a 3-hourly basis beginning from July 1983 at an effective 10 km resolution. Thus, working with SUNY and NCDC, NASA will develop and test an improved production system that will yield an operational production system for NREL to continually update the Earth's solar resource. In this presentation, we provide a general overview of this project together with samples of the new solar irradiance mapped data products and comparisons to surface measurements at various locations across the world. Here, a three-year prototype of the anticipated ISCCP data set called GridSat is used to assess the algorithms and demonstrate the production system. GridSat maps together cross-calibrated visible and IR reflectances from all the world's geosynchronous satellites at 10 km and 3-hourly respectively. The results are shown and discussed in comparison to existing solar data products. Additionally, the solar irradiance values are compared to various Baseline Surface Radiation Network surface site measurements and other high quality surface measurements. The statistics of the agreement between the measurements and new satellite estimates are also reviewed. The team is now testing a beta release of the revised ISCCP data set through the NOAA

  11. Effects of Continuous Positive Airway Pressure on Neurocognitive Function in Obstructive Sleep Apnea Patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES)

    PubMed Central

    Kushida, Clete A.; Nichols, Deborah A.; Holmes, Tyson H.; Quan, Stuart F.; Walsh, James K.; Gottlieb, Daniel J.; Simon, Richard D.; Guilleminault, Christian; White, David P.; Goodwin, James L.; Schweitzer, Paula K.; Leary, Eileen B.; Hyde, Pamela R.; Hirshkowitz, Max; Green, Sylvan; McEvoy, Linda K.; Chan, Cynthia; Gevins, Alan; Kay, Gary G.; Bloch, Daniel A.; Crabtree, Tami; Dement, William C.

    2012-01-01

    Study Objective: To determine the neurocognitive effects of continuous positive airway pressure (CPAP) therapy on patients with obstructive sleep apnea (OSA). Design, Setting, and Participants: The Apnea Positive Pressure Long-term Efficacy Study (APPLES) was a 6-month, randomized, double-blind, 2-arm, sham-controlled, multicenter trial conducted at 5 U.S. university, hospital, or private practices. Of 1,516 participants enrolled, 1,105 were randomized, and 1,098 participants diagnosed with OSA contributed to the analysis of the primary outcome measures. Intervention: Active or sham CPAP Measurements: Three neurocognitive variables, each representing a neurocognitive domain: Pathfinder Number Test-Total Time (attention and psychomotor function [A/P]), Buschke Selective Reminding Test-Sum Recall (learning and memory [L/M]), and Sustained Working Memory Test-Overall Mid-Day Score (executive and frontal-lobe function [E/F]) Results: The primary neurocognitive analyses showed a difference between groups for only the E/F variable at the 2 month CPAP visit, but no difference at the 6 month CPAP visit or for the A/P or L/M variables at either the 2 or 6 month visits. When stratified by measures of OSA severity (AHI or oxygen saturation parameters), the primary E/F variable and one secondary E/F neurocognitive variable revealed transient differences between study arms for those with the most severe OSA. Participants in the active CPAP group had a significantly greater ability to remain awake whether measured subjectively by the Epworth Sleepiness Scale or objectively by the maintenance of wakefulness test. Conclusions: CPAP treatment improved both subjectively and objectively measured sleepiness, especially in individuals with severe OSA (AHI > 30). CPAP use resulted in mild, transient improvement in the most sensitive measures of executive and frontal-lobe function for those with severe disease, which suggests the existence of a complex OSA-neurocognitive relationship

  12. Development and Deployment of Mobile Emissions Laboratory for Continuous Long-Term Unattended Measurements of Greenhouse Gases, Fluxes, Isotopes and Pollutants

    NASA Astrophysics Data System (ADS)

    Gardner, A.; Baer, D. S.; Owano, T. G.; Provencal, R. A.; Gupta, M.; Parsotam, V.; Graves, P.; Goldstein, A.; Guha, A.

    2010-12-01

    Development and Deployment of Mobile Emissions Laboratory for Continuous Long-Term Unattended Measurements of Greenhouse Gases, Fluxes, Isotopes and Pollutants A. Gardner(1), D. Baer (1), T. Owano (1), R. Provencal (1), V. Parsotam (1), P. Graves (1), M. Gupta (1), Allen Goldstein (2), Abhinav Guha (2) (1) Los Gatos Research, 67 East Evelyn Avenue, Suite 3, Mountain View, CA 94041-1529 (2) Department of Environmental Science, Policy, and Management, University of California at Berkeley Quantifying the Urban Fossil Fuel Plume: Convergence of top-down and bottom-up approaches (Session A54). We report on the design, development and deployment of a novel Mobile Emissions Laboratory, consisting of innovative laser-based gas analyzers, for rapid measurements of multiple greenhouse gases and pollutants. Designed for real-time mobile and stationery emissions monitoring, the Mobile Emissions Laboratory was deployed at several locations during 2010, including CalNEX 2010, Caldecott Tunnel (Oakland, CA), and Altamont Landfill (Livermore, CA), to record real-time continuous measurements of isotopic CO2 (δ13C, CO2), methane (CH4), acetylene (C2H2), nitrous oxide (N2O), carbon monoxide (CO), and isotopic water vapor (H2O; δ18O, δ2H). The commercial gas analyzers are based on novel cavity-enhanced laser absorption spectroscopy. The portable analyzers provide measurements in real time, require about 150 watts (each) of power and do not need liquid nitrogen to operate. These instruments have been applied in the field for applications that require high data rates (for eddy correlation flux), wide dynamic range (e.g., for chamber flux and other applications with concentrations that can be 10-1000 times higher than typical ambient levels) and highest accuracy (atmospheric monitoring stations). The Mobile Emissions Laboratory, which contains onboard batteries for long-term unattended measurements without access to mains power, can provide regulatory agencies, monitoring stations

  13. Side Effects of Long-Term Continuous Intra-arterial Nimodipine Infusion in Patients with Severe Refractory Cerebral Vasospasm after Subarachnoid Hemorrhage.

    PubMed

    Kieninger, Martin; Flessa, Julia; Lindenberg, Nicole; Bele, Sylvia; Redel, Andreas; Schneiker, André; Schuierer, Gerhard; Wendl, Christina; Graf, Bernhard; Silbereisen, Vera

    2017-07-06

    Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects. All patients treated with CIAN therapy for at least 5 days between May 2011 and December 2015 were included. We retrospectively extracted data from the patient data management system regarding the period between 2 days before the beginning and 5 days after the termination of CIAN therapy to analyze the course of ventilation parameters and pulmonary gas exchange, hemodynamic support, renal and liver function, integrity of the gastrointestinal tract, and the occurrence of infectious complications. In addition, we recorded the mean daily values of intracranial pressure (ICP) and intracerebral problems associated with CIAN therapy. Data from 28 patients meeting inclusion criteria were analyzed. The mean duration of long-term CIAN therapy was 10.5 ± 4.5 days. Seventeen patients (60.7%) reached a good outcome level (Glasgow Outcome Scale [GOS] 4-5) 6 months after SAH. An impairment of the pulmonary gas exchange occurred only at the very beginning of CIAN therapy. The required vasopressor support with norepinephrine was significantly higher on all days during and the first day after CIAN therapy compared to the situation before starting CIAN therapy. Two patients required short-time resuscitation due to cardiac arrest during CIAN therapy. Acute kidney injury was observed in four patients, and one of them required renal replacement therapy with sustained low-efficiency daily dialysis. During CIAN therapy, 23 patients (82.1%) needed the escalation

  14. A Novel Scheme and Evaluations on a Long-Term and Continuous Biosensor Platform Integrated with a Dental Implant Fixture and Its Prosthetic Abutment

    PubMed Central

    Li, Yu-Jung; Lu, Chih-Cheng

    2015-01-01

    A miniature intra-oral dental implant system including a built-in biosensor device is proposed in this article. The dental implant system, or platform, is replaced over maxilla and allows relatively non-invasive procedures for a novel biosensing scheme for human blood analysis. Due to placement of the implant fixture, periodontal ligaments and the pulp structure, which are regarded as the main origin of pain, are thus removed, and long-term, continuous blood analysis and management through maxillary bone marrow becomes achievable through the dental implant platform. The new pathway of biological sensing is for the first time presented to realize an accurate and painless approach without injections. The dental implant system mainly consists of an implant fixture and a prosthetic abutment, a biosensor module, a bluetooth 4.0 wireless module and a dc button cell battery. The electrochemical biosensor possesses three electrodes, including working, reference and counter ones, which are arranged to pass through the titanium implant fixture below the biosensor module. The electrodes are exposed to the blood pool inside the maxillary bone marrow and perform oxidation/reduction reactions with the coating of biosensing enzyme. To prove the proposed platform, the immobilization process of glucose oxidase (GOD) enzyme and in vitro detections of glucose levels are successfully carried out, and proven sensitivity, linearity and repeatability of the glucose biosensor system are obtained. Moreover, a preliminary canine animal model adopting the new pathway shows significant consistency with the traditional method through dermal pricks for blood sugar detection. Despite the prospective results, further challenges in engineering implementation and clinical practices are addressed and discussed. In brief, the novel biosensing pathway and intra-oral biosensor platform may increasingly reveal their promising value and feasibilities in current bio-medical analysis, diagnosis, drug

  15. A Novel Scheme and Evaluations on a Long-Term and Continuous Biosensor Platform Integrated with a Dental Implant Fixture and Its Prosthetic Abutment.

    PubMed

    Li, Yu-Jung; Lu, Chih-Cheng

    2015-09-25

    A miniature intra-oral dental implant system including a built-in biosensor device is proposed in this article. The dental implant system, or platform, is replaced over maxilla and allows relatively non-invasive procedures for a novel biosensing scheme for human blood analysis. Due to placement of the implant fixture, periodontal ligaments and the pulp structure, which are regarded as the main origin of pain, are thus removed, and long-term, continuous blood analysis and management through maxillary bone marrow becomes achievable through the dental implant platform. The new pathway of biological sensing is for the first time presented to realize an accurate and painless approach without injections. The dental implant system mainly consists of an implant fixture and a prosthetic abutment, a biosensor module, a bluetooth 4.0 wireless module and a dc button cell battery. The electrochemical biosensor possesses three electrodes, including working, reference and counter ones, which are arranged to pass through the titanium implant fixture below the biosensor module. The electrodes are exposed to the blood pool inside the maxillary bone marrow and perform oxidation/reduction reactions with the coating of biosensing enzyme. To prove the proposed platform, the immobilization process of glucose oxidase (GOD) enzyme and in vitro detections of glucose levels are successfully carried out, and proven sensitivity, linearity and repeatability of the glucose biosensor system are obtained. Moreover, a preliminary canine animal model adopting the new pathway shows significant consistency with the traditional method through dermal pricks for blood sugar detection. Despite the prospective results, further challenges in engineering implementation and clinical practices are addressed and discussed. In brief, the novel biosensing pathway and intra-oral biosensor platform may increasingly reveal their promising value and feasibilities in current bio-medical analysis, diagnosis, drug

  16. Survey of state health information exchanges regarding inclusion of Continuity of Care Documents for long-term post-acute care (LTPAC) patient assessment.

    PubMed

    Hassol, Andrea; Goodman, Laura; Younkin, Jim; Honicker, Mary; Chaundy, Kimberly; Walker, James M

    2014-01-01

    This study aimed to measure awareness and interest among state health information exchanges (HIEs) in a tool that translates long-term post-acute care (LTPAC) patient assessment information to a Continuity of Care Document (CCD) format for sharing; whether any state HIEs currently integrate patient information from LTPAC providers; and the anticipated benefits and barriers to using such a tool. The study consisted of an online survey of state HIEs. Responses were received from representatives of 29 of the 51 HIEs (57 percent). Eleven of the 29 respondents (38 percent) were aware of the LTPAC-to-CCD translation tool, and 24 (83 percent of respondents) were interested in it or felt LTPAC providers in their state would be interested. Twenty-one of the 24 interested respondents (88 percent) indicated a desire for more information about this technology. Skilled nursing facilities and home health agencies receive no incentives for adoption of electronic health record systems and are not commonly included in HIEs. These organizations do, however collect extensive structured data about their patients (Minimum Data Set for nursing facilities, Outcome and Assessment Information Set for home health agencies) and transmit the data electronically to the Centers for Medicare and Medicaid Services (CMS). A tool is now available that will intercept the transmissions to CMS, transform content extracted from patient assessments into CCDs, and send the CCDs to a designated HIE. Responding HIEs reported almost no experience exchanging patient assessment information from LTPAC providers. Anticipated benefits include safer care transitions; anticipated barriers include information technology constraints in LTPAC settings.

  17. Biodegradation of natural organic matter in long-term, continuous-flow experiments simulating artificial ground water recharge for drinking water production.

    PubMed

    Kolehmainen, Reija E; Kortelainen, Nina M; Langwaldt, Jörg H; Puhakka, Jaakko A

    2009-01-01

    The role of biodegradation in the attenuation of natural organic matter (NOM) was investigated in long-term experiments that simulate artificial ground water recharge (AGR) for drinking water production. Lake water containing 5.8 mg L(-1) total organic carbon (TOC) was continuously fed into an 18.5-m-long sand column. During the 941 d of operation, on average 76 and 81% of TOC was removed within the first 0.6 m and the entire column length, respectively. Large molecular size fractions (approximately 1800-2200 Da) of NOM were removed more efficiently than smaller ones (approximately 250-1400 Da). The biodegradation of dissolved organic carbon (DOC) within the first 0.6 m, measured by the stable inorganic carbon isotope (delta13C) method, depended on temperature and hydraulic load: The extent of mineralization was 32% at 6 degrees C (Day 442) and 38% at 23 degrees C (Day 708) with a 0.3 m3 (m2d)(-1) hydraulic load and 52% at 5.5 degrees C (Day 883) with a 3.1 m3 (m2d) (-1) hydraulic load. The rest of the DOC removal was likely due to entrapment or sorption onto the sand particles. Decreases in DOC and the total cell counts in the water along the column were positively correlated (r = 0.99; P = 0.001). The accumulation of biomass was minor, with the highest concentration amounting to 7.2 mg g(-1) dw of sand. In summary, this study demonstrated that biodegradation has a key role in NOM removal in AGR and is dependent on temperature.

  18. Survey of State Health Information Exchanges Regarding Inclusion of Continuity of Care Documents for Long-Term Post-Acute Care (LTPAC) Patient Assessment

    PubMed Central

    Hassol, Andrea; Goodman, Laura; Younkin, Jim; Honicker, Mary; Chaundy, Kimberly; Walker, James M.

    2014-01-01

    Objectives This study aimed to measure awareness and interest among state health information exchanges (HIEs) in a tool that translates long-term post-acute care (LTPAC) patient assessment information to a Continuity of Care Document (CCD) format for sharing; whether any state HIEs currently integrate patient information from LTPAC providers; and the anticipated benefits and barriers to using such a tool. Materials and Methods The study consisted of an online survey of state HIEs. Results Responses were received from representatives of 29 of the 51 HIEs (57 percent). Eleven of the 29 respondents (38 percent) were aware of the LTPAC-to-CCD translation tool, and 24 (83 percent of respondents) were interested in it or felt LTPAC providers in their state would be interested. Twenty-one of the 24 interested respondents (88 percent) indicated a desire for more information about this technology. Discussion Skilled nursing facilities and home health agencies receive no incentives for adoption of electronic health record systems and are not commonly included in HIEs. These organizations do, however collect extensive structured data about their patients (Minimum Data Set for nursing facilities, Outcome and Assessment Information Set for home health agencies) and transmit the data electronically to the Centers for Medicare and Medicaid Services (CMS). A tool is now available that will intercept the transmissions to CMS, transform content extracted from patient assessments into CCDs, and send the CCDs to a designated HIE. Conclusion Responding HIEs reported almost no experience exchanging patient assessment information from LTPAC providers. Anticipated benefits include safer care transitions; anticipated barriers include information technology constraints in LTPAC settings. PMID:25593573

  19. Selection of bacteria capable of dissimilatory reduction of Fe(III) from a long-term continuous culture on molasses and their use in a microbial fuel cell.

    PubMed

    Sikora, Anna; Wójtowicz-Sieńko, Justyna; Piela, Piotr; Zielenkiewicz, Urszula; Tomczyk-Zak, Karolina; Chojnacka, Aleksandra; Sikora, Radosław; Kowalczyk, Paweł; Grzesiuk, Elzbieta; Błaszczyk, Mieczysław

    2011-03-01

    Ferric ion-respiring microorganisms (FRMs) are a group of prokaryotes that use Fe(III) as well as other metals as terminal electron acceptors in the process of anaerobic respiration. Special attention is paid to a biotechnological significance of FRMs because of their potential role in electricity production in microbial fuel cells (MFCs) where the terminal acceptor of the electrons during anaerobic respiration is not a ferric ion but the anode. One of the best known FRMs is the Shewanellaceae family. Most of the Shewanella species have been isolated from marine environments. In this report, sugar beet molasses and ferric oxide were successfully used in the selection of a bacterial consortium capable of dissimilatory Fe(III) reduction in a long-term continuous culture. The inoculum was a sample of eutrophic lake bottom sediment. Among the bacteria present in this culture were representatives of the Enterobacteriaceae, and the genera Pseudomonas, Arcobacter, and Shewanella. Two non-marine Fe(III)-reducing Shewanella-related clones named POL1 and POL2 were isolated. The abilities of the POL1 and POL2 isolates to metabolize a panel of 190 carbon sources were examined using a BIOLOG assay. The results confirmed the abilities of the shewanellas to utilize a broad range of carbon substrates. The utility of the POL1 and POL2 isolates in H-type MFCs operating on pyruvate or molasses was demonstrated. The operation of the MFC with shewanellas cultured on molasses was shown for the first time. A two-stage character of the fuel cell polarization curves, not previously noted in Shewanella MFC studies, was observed.

  20. Long-Term Fate Mapping Using Conditional Lentiviral Vectors Reveals a Continuous Contribution of Radial Glia-Like Cells to Adult Hippocampal Neurogenesis in Mice

    PubMed Central

    Aelvoet, Sarah-Ann; Pascual-Brazo, Jesus; Libbrecht, Sarah; Reumers, Veerle; Gijsbers, Rik; Van den Haute, Chris; Baekelandt, Veerle

    2015-01-01

    Newborn neurons are generated throughout life in two neurogenic regions, the subventricular zone and the hippocampal dentate gyrus. Stimulation of adult neurogenesis is considered as an attractive endogenous repair mechanism to treat different neurological disorders. Although tremendous progress has been made in our understanding of adult hippocampal neurogenesis, important questions remain unanswered, regarding the identity and the behavior of neural stem cells in the dentate gyrus. We previously showed that conditional Cre-Flex lentiviral vectors can be used to label neural stem cells in the subventricular zone and to track the migration of their progeny with non-invasive bioluminescence imaging. Here, we applied these Cre-Flex lentiviral vectors to study neurogenesis in the dentate gyrus with bioluminescence imaging and histological techniques. Stereotactic injection of the Cre-Flex vectors into the dentate gyrus of transgenic Nestin-Cre mice resulted in specific labeling of the nestin-positive neural stem cells. The labeled cell population could be detected with bioluminescence imaging until 9 months post injection, but no significant increase in the number of labeled cells over time was observed with this imaging technique. Nevertheless, the specific labeling of the nestin-positive neural stem cells, combined with histological analysis at different time points, allowed detailed analysis of their neurogenic potential. This long-term fate mapping revealed that a stable pool of labeled nestin-positive neural stem cells continuously contributes to the generation of newborn neurons in the mouse brain until 9 months post injection. In conclusion, the Cre-Flex technology is a valuable tool to address remaining questions regarding neural stem cell identity and behavior in the dentate gyrus. PMID:26600383

  1. Variation of rhizosphere bacterial community in watermelon continuous mono-cropping soil by long-term application of a novel bioorganic fertilizer.

    PubMed

    Ling, Ning; Deng, Kaiying; Song, Yang; Wu, Yunchen; Zhao, Jun; Raza, Waseem; Huang, Qiwei; Shen, Qirong

    2014-01-01

    The application method for a novel bioorganic fertilizer (BIO) was developed to improve its biocontrol efficacy of Fusarium wilt (Ling et al. 2010). However, its efficacy on controlling Fusarium wilt and the variations of microbial community after long-term application for watermelon production had not been elucidated. To clarify, a 4-years pot experiment of mono-cropping watermelon was conducted. The results revealed that though the disease incidences were increased in all treatments with the increase of continuous cropping years, the treatment of BIO application both in nursery and pot soil always maintained the lowest disease incidence. The real-time PCR results showed that the population of Paenibacillus polymyxa was decreased with continuous cropping years, but in all seasons, the treatment with BIO application both in nursery and pot soil had a highest population of P. polymyxa than the other treatments. On the other hand, the abundance of the pathogen FON was increased with the increase of continuous cropping years and the lowest rate of increase was found by BIO application in both nursery and pot soil. DGGE patterns showed that the bacterial diversity was weakened after mono-cropping of watermelon for 4 years, but the consecutive applications of BIO at nursery and transplanting stage resulted in the minimal change of bacterial diversity. More detailed differences on bacterial diversity between control and double application of BIO treatment after 4-years monoculture were analyzed by 454 pyrosequencing, which showed the dominant phyla found in both samples were Firmicutes, Proteobacteria and Actinobacteria, and the consecutive applications of BIO recruited more beneficial bacteria than control, such as Bacillus, Paenibacillus, Haliangium, Streptomyces. Overall, these results, to a certain extent, approved that the consecutive applications of BIO at nursery and transplanting stage could effectively suppress watermelon Fusarium wilt by regulating the

  2. Long-term investigations of summertime chlorophyll a, particulate organic carbon and continuously observations of vertical particle flux in Fram Strait and the central Arctic Ocean

    NASA Astrophysics Data System (ADS)

    Nöthig, Eva-Maria; Bauerfeind, Eduard; Bracher, Astrid; Cherkasheva, Alexandra; Fahl, Kirsten; Lalande, Catherine; Metfies, Katja; Peeken, Ilka; Salter, Ian; Boetius, Antje; Soltwedel, Thomas

    2016-04-01

    patterns for the summertime show slightly different results than chlorophyll a. POC flux rates were at least one order of magnitude lower in the CAO than in eastern Fram Strait. Whereas in the CAO ice algae dominate the recognizable flux fraction, fecal material prevailed in eastern Fram Strait traps, pointing towards different systems of organic matter production and modification. These results were also confirmed by the biomarker composition pattern. Since 2014, investigations continue within a greater framework of the Arctic long-term observatory 'Frontiers of Arctic Marine Monitoring' (FRAM) that is established to improve our knowledge by using new developments and proven technologies to enable the recording of environmental and biological data in high temporal and spatial resolution.

  3. Long-term continuous measurement of near-road air pollution in Las Vegas: Seasonal variability in traffic emissions impact on local air quality

    EPA Science Inventory

    Excess air pollution along roadways is an issue of public health concern and motivated a long-term measurement effort established by the U.S. Environmental Protection Agency in Las Vegas, Nevada. Measurements of air pollutants – including black carbon (BC), carbon monoxide (CO),...

  4. 21 CFR 310.303 - Continuation of long-term studies, records, and reports on certain drugs for which new drug...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... approval, the applicant is required to establish and maintain records and make reports related to clinical... effectiveness of long-term use of such drugs, extensive animal and clinical tests are required as a condition of... the public interest to delay the availability of the drugs for widespread clinical use pending...

  5. Long-term continuous measurement of near-road air pollution in Las Vegas: Seasonal variability in traffic emissions impact on local air quality

    EPA Science Inventory

    Excess air pollution along roadways is an issue of public health concern and motivated a long-term measurement effort established by the U.S. Environmental Protection Agency in Las Vegas, Nevada. Measurements of air pollutants – including black carbon (BC), carbon monoxide (CO),...

  6. Future Flight Opportunities and Calibration Protocols for CERES: Continuation of Observations in Support of the Long-Term Earth Radiation Budget Climate Data Record

    NASA Technical Reports Server (NTRS)

    Priestley, Kory J.; Smith, George L.

    2010-01-01

    The goal of the Clouds and the Earth s Radiant Energy System (CERES) project is to provide a long-term record of radiation budget at the top-of-atmosphere (TOA), within the atmosphere, and at the surface with consistent cloud and aerosol properties at climate accuracy. CERES consists of an integrated instrument-algorithm validation science team that provides development of higher-level products (Levels 1-3) and investigations. It involves a high level of data fusion, merging inputs from 25 unique input data sources to produce 18 CERES data products. Over 90% of the CERES data product volume involves two or more instruments. Continuation of the Earth Radiation Budget (ERB) Climate Data Record (CDR) has been identified as critical in the 2007 NRC Decadal Survey, the Global Climate Observing System WCRP report, and in an assessment titled Impacts of NPOESS Nunn-McCurdy Certification on Joint NASA-NOAA Climate Goals . Five CERES instruments have flown on three different spacecraft: TRMM, EOS-Terra and EOS-Aqua. In response, NASA, NOAA and NPOESS have agreed to fly the existing CERES Flight Model (FM-5) on the NPP spacecraft in 2011 and to procure an additional CERES Sensor with modest upgrades for flight on the JPSS C1 spacecraft in 2014, followed by a CERES follow-on sensor for flight in 2018. CERES is a scanning broadband radiometer that measures filtered radiance in the SW (0.3-5 m), total (TOT) (0.3-200 m) and WN (8-12 m) regions. Pre-launch calibration is performed on each Flight Model to meet accuracy requirements of 1% for SW and 0.5% for outgoing LW observations. Ground to flight or in-flight changes are monitored using protocols employing onboard and vicarious calibration sources. Studies of flight data show that SW response can change dramatically due to optical contamination. with greatest impact in blue-to UV radiance, where tungsten lamps are largely devoid of output. While science goals remain unchanged for ERB Climate Data Record, it is now understood

  7. Online Dementia Care Training for Healthcare Teams in Continuing and Long-Term Care Homes: A Viable Solution for Improving Quality of Care and Quality of Life for Residents

    ERIC Educational Resources Information Center

    MacDonald, Colla J.; Stodel, Emma J.; Casimiro, Lynn

    2006-01-01

    The purpose of this research was to design, develop, deliver, and evaluate an online dementia care program aimed at enabling healthcare teams deliver better service to residents with dementia in continuing (CC) and long-term care (LTC) facilities. A Community-Based Participatory Research (CBPR) orientation (Minkler & Wallerstein, 2003) was adopted…

  8. Online Dementia Care Training for Healthcare Teams in Continuing and Long-Term Care Homes: A Viable Solution for Improving Quality of Care and Quality of Life for Residents

    ERIC Educational Resources Information Center

    MacDonald, Colla J.; Stodel, Emma J.; Casimiro, Lynn

    2006-01-01

    The purpose of this research was to design, develop, deliver, and evaluate an online dementia care program aimed at enabling healthcare teams deliver better service to residents with dementia in continuing (CC) and long-term care (LTC) facilities. A Community-Based Participatory Research (CBPR) orientation (Minkler & Wallerstein, 2003) was adopted…

  9. Long-Term Continuous Monitoring of Fluid Chemistry and Flux at the Bush Hill Gas Hydrate Field, Gulf of Mexico Using a New Flow Meter, The MOSQUITO

    NASA Astrophysics Data System (ADS)

    Solomon, E.; Kastner, M.; Jannasch, H.; Weinstein, Y.; Robertson, G.; Aubrey, A.

    2004-12-01

    Long-term monitoring of fluid, solute, and methane fluxes that influence marine gas hydrate formation and dissociation has important implications for the seafloor biochemical environment, ocean chemistry, and potentially the atmosphere. Four newly designed flux meters called the MOSQUITO (Multiple Orifice Sampler and Quantitative Injection Tracer Observer) and two temperature loggers were deployed adjacent to the Bush Hill hydrate mound in the northern Gulf of Mexico (GC185) in order to understand how chemistry, physics, biology, and subsurface hydrology dynamically influence the growth and dissociation of the hydrate mound. The MOSQUITO contains a network of osmotic samplers and a tracer injection device, each connected to a titanium capillary tube that penetrates the sediment. The tracer is injected as a point source, and fluid chemistry and tracer concentrations are continuously sampled simultaneously at multiple depths below the seafloor in a three dimensional array with respect to the tracer injection point. Bottom water chemistry is also sampled continuously. Vertical and horizontal flow rates as low as 1 cm/yr are determined by modeling the variability in tracer concentration at each depth over time. MOSQUITOs can be deployed at passive margins, ridge crests, ridge flanks, subduction zones, and lakes. MOSQUITOs were deployed over a period of 430 days from June 2002 to August 2003 and were sampled at weekly resolution. The temperature loggers were attached to the MOSQUITOs and recorded seafloor temperature every 40 minutes. Three MOSQUITOs were deployed within 3 m of the hydrate mound and ˜ 5 m apart, adjacent to transient methane seeps; in a mussel field, in a bacterial mat, and in a tubeworm field. The fourth MOSQUITO was placed ˜150 m southwest of the hydrate mound to monitor background fluid flow, geochemistry, and temperature. The average bottom water temperature over the 430-day deployment period was 7.94° C, with minimum temperatures occurring every

  10. Evidence-based long term care design.

    PubMed

    Calkins, Margaret P

    2009-01-01

    Research on the impact of the built environment in long-term care settings continues to grow. This article focuses on work conducted and published since 2000, when an earlier review on research on dementia and design was published. The vast majority of research that addressed neurological conditions in residents in long-term care settings (assisted living and nursing homes) relates to Alzheimer's disease and related dementias.

  11. Continuous real-time monitoring of chloride in geothermal areas in Yellowstone National Park: initial results from newly developed long-term in-situ chloride analyzers.

    NASA Astrophysics Data System (ADS)

    Chapin, T.; Heasler, H.; Hurwitz, S.

    2007-12-01

    Chloride in the surface waters of Yellowstone National Park is primarily derived from magmatic/hydrothermal sources. Discrete chloride measurements, collected at weekly to monthly intervals, are a key component of the ongoing geothermal monitoring program conducted by Yellowstone Volcano Observatory and National Park Service scientists. Chloride flux, estimated from discrete chloride measurements and streamflow data, could potentially be used as a proxy for geothermal heat flux and volcanic-geothermal unrest in the Park. However, infrequent chloride sampling restricts our understanding of dynamic geothermal processes, and the lack of real- time chloride data limits our ability to provide early warning and timely response to geologic hazards in Yellowstone. We seek to combine real-time chloride and streamflow data to examine variations in chloride flux due to changes in the volcanic-geothermal system and to determine if real-time chloride flux data can be used as an early warning indicator of volcanic hazards in the park. To address these objectives, we have developed a low-cost instrument for long-term, real-time, in-situ chemical analysis, the Field Sequential Injection Analyzer (Field-SIA). The Field-SIA is self-calibrating, performs hourly analyses for over two months between service visits, and integrates with existing USGS streamflow gaging stations which provide solar power and satellite telemetry of real-time chloride data. The Field-SIA greatly increases chemical data collection while significantly decreasing the cost of sampling and analysis. We will present data from long-term, high-resolution, real-time chloride monitoring of: 1) Tantalus Creek which drains the Norris Geyser Basin; 2) the Firehole River which drains the Upper, Middle, and Lower Geyser Basins; and 3) the Yellowstone River near Gardiner, MT. Initial results suggest that chloride fluctuations at Tantalus Creek were linked to diel temperature cycling while chloride fluctuations at the

  12. Long-term testing

    SciTech Connect

    Ferber, M.; Graves, G.A. Jr.

    1994-12-31

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000--10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  13. Long-Term Continuous Isotopic Ratio Measurements of Atmospheric CO2 Using a 4.3 Micron Pulsed Quantum Cascade Laser

    NASA Astrophysics Data System (ADS)

    Nelson, D. D.; McManus, J. B.; Herndon, S. C.; Zahniser, M. S.

    2007-12-01

    Real time methods to monitor the stable isotopic ratios of carbon dioxide are needed to quantify the sources and sinks of this centrally important greenhouse gas. This is an extreme instrumental challenge since the ratios need to be measured with an accuracy of at least one part in ten thousand or 0.1 ". We use tunable infrared laser differential absorption spectroscopy with pulsed QC lasers (QC-TILDAS) to address this challenge. QC lasers are attractive optical sources due to: 1) absence of cryogenic fluids, 2) stable single mode spectral output, 3) optical simplicity. Our optical system employs a dual-cell arrangement with ambient air flowing through the sample cell and a reference gas flowing through the reference cell. Both 13C/12C and 18O/16O ratios can be obtained in a single spectral window near 2310 cm-1. Spectral analysis is applied to the ratio of the sample and reference spectra, canceling correlated noise components. Because the absorption lines of the isotopic species have different temperature dependences, temperature stability is critical. The optical system is temperature controlled and the two multipass cells are thermally coupled and individually monitored with a precision of 1 mK. The ratio technique compensates for temperature sensitivity, as well as for drifts in laser line width, frequency, tuning rate and power variation. The long term stability of the thermally stabilized dual-cell QCL system has been evaluated using the Allan variance technique. The Allan plot shows a 1-sec RMS noise of 0.2 per mil, and a minimum RMS noise of 0.03 per mil after 300 sec integration using a liquid nitrogen cooled detector. We have used this instrument to perform long term (more than 6 months) monitoring of ambient air from the roof top of our laboratory. The data show variations in R13 and R18 that follow diurnal cycles. Winter data show clear correlations with morning and evening signatures of local automobile traffic. Data collected during spring are

  14. Long-term continuous acoustical suspended-sediment measurements in rivers – Theory, evaluation, and results from 14 stations on five rivers

    USGS Publications Warehouse

    Topping, David; Wright, Scott A.; Griffiths, Ronald; Dean, David

    2016-01-01

    We have developed a physically based method for using two acoustic frequencies to measure suspended-silt-and-clay concentration, suspended-sand concentration, and suspended-sand median grain size in river cross sections at 15-minute intervals over decadal timescales. The method is strongly grounded in the extensive scientific literature on the scattering of sound by suspensions of small particles. In particular, the method takes advantage of the specific theoretical relations among acoustic frequency, acoustic attenuation, acoustic backscatter, suspended-sediment concentration, and suspended-sediment grain-size distribution. We briefly describe the theory and methods, demonstrate the application of the method, and compute biases and errors in the method at 14 stations in the Colorado River and Rio Grande basins, where large numbers of suspended-sediment samples have been collected concurrently with acoustical measurements over many years. Quantification of errors in sediment-transport measurements made using this method is essential if the measurements are to be used effectively, e.g., to evaluate uncertainty in long-term sediment loads and budgets

  15. Serum adiponectin level in obstructive sleep apnea: Relation of adiponectin to obesity and long-term continuous positive airway pressure therapy.

    PubMed

    Hobzová, Milada; Salzman, Richard; Stejskal, David; Zapletalová, Jana; Kolek, Vítězslav

    2016-03-01

    The study aimed to determine the effect of OSA and obesity on the plasma levels of adiponectin and the long-term effect of CPAP on its plasma levels and obesity parameters. A prospective observational study included 159 newly diagnosed OSA patients. The cohort was divided into CPAP treated (n=82) and control group (n=77). Both groups were examined at the beginning and a year later. The CPAP-treated patients were additionally tested after a month of therapy. The examinations included Epworth Sleepiness Scale questionnaire, anthropometric and polysomnographic measurements, and blood serum tests. Changes in the studied parameters of OSA, obesity, and adiponectin obtained at the beginning and after follow-up period were compared in each group. In CPAP group, all studied OSA parameters improved already after a month of CPAP therapy. Contrarily, obesity parameters (except of neck and waist circumference) remained unchanged after CPAP therapy. Serum adiponectin levels dropped during CPAP therapy. In the control group, both obesity and OSA parameters did not show changes. The only exceptions were deteriorated mean SpO2 and decreased hip circumference. Adiponectin remained unchanged in this group. In neither group, the Spearman correlation analyses showed any association of serum adiponectin levels with obesity or OSA parameters, except of mean SpO2. Only correlation found was between adiponectin and mean SpO2. Although CPAP therapy improves all OSA parameters, it did not change most obesity parameters. Additionally in the CPAP group, there was a significant drop in adiponectin levels, suggesting its protective role in this group of patients. Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  16. Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health-An Appeal for Continuous Family Care and Interdisciplinary Communication.

    PubMed

    Arabin, Birgit; Baschat, Ahmet A

    2017-01-01

    thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal-fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources.

  17. Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

    PubMed Central

    Arabin, Birgit; Baschat, Ahmet A.

    2017-01-01

    cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal–fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources. PMID:28451583

  18. Thresholds and gradients in a semi-arid grassland: long-term grazing treatments induce slow, continuous, and reversible vegetation change

    USDA-ARS?s Scientific Manuscript database

    Semiarid ecosystems can exhibit non-reversible shifts among alternative stable ecosystem states (thresholds and hysteresis), but can also be characterized by slow, continuous, and reversible changes in plant composition (successional gradients). Conceptual state-and-transition models (STMs) attempt ...

  19. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  20. Long-term urethral catheterisation.

    PubMed

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  1. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  2. Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself.

    PubMed

    Stanković-Popović, Verica; Popović, Dragan; Dimković, Nada; Maksić, Djoko; Vasilijić, Sasa; Colić, Miodrag; Vucinić, Zarko; Radjen, Slavica; Milicić, Biljana

    2013-04-01

    Morbidity and mortality of continous ambulatory peritoneal dialysis (CAPD) patients is still very high. The aim of the study was to evaluate the effects of peritoneal dialysis (PD) solutions (standard vs biocompatible) on long-term patients' and the techique survival. A total of 42 stable patients on CAPD participated in this cross-sectional study. They were prospectively followed-up during the twelve years. Patients with severe anemia (Hb < 10 g/L) and malignant disease ware excluded. Twenty one (50%/0) patients were treated with the standard PD solutions (CAPDP-1) while the other 21 (500/0) were treated with biocompatible PD solutions [(lower level of glucose degradation products, lower concentration of Ca(2+) and neutral pH (CAPDP-2)]. All patients were analyzed for a presence of vascular calcification, nutrition status, and parameters of inflammation after 2.5 +/- 0.6 years of starting CAPD, and these variables considered in the analysis as risk factors. The patients from the group CAPDP-2 compared to those from the group CAPDP-1 had lower level of high-sensitivity C-reactive protein (hs-CRP) (p = 0.003), and better nutritional status as confirmed by the mid-arm circumference (p = 0.015), and mid-arm muscle circumference (p = 0.002) and subjective global assessment (p = 0.000). Also, they had lower vascular calcifications as confirmed by intima media thickness (IMT) (p = 0.003), degree of carotid narrowing (p = 0.001) and calcified plaques of common carotid arteries (CCA) (p = 0.008). Kaplan-Meier analysis confirmed better survival of patients from the group CAPDP-2 than those from the group CAPDP-1 (1-, 5-, and 10-year patients survival rate was: 100%, 61.9% and 14.3% for the group CAPDP-1, and 100%, 85.7%, and 52.4% for the group CAPDP-2, respectively; p = 0.0345). The 1-, 5-, and 10-year technique survival rate was: 100%, 71.4%, and 38.1% for the group CAPDP-1, and 100%, 85.7%, and 76.2% for the group CAPDP-2, respectively; (p = 0.0719). Duration of dialysis

  3. Continued Slow Decay of the Residual Plasma Viremia Level in HIV-1–Infected Adults Receiving Long-term Antiretroviral Therapy

    PubMed Central

    Riddler, Sharon A.; Aga, Evgenia; Bosch, Ronald J.; Bastow, Barbara; Bedison, Margaret; Vagratian, David; Vaida, Florin; Eron, Joseph J.; Gandhi, Rajesh T.; Mellors, John W.

    2016-01-01

    We measured plasma human immunodeficiency virus type 1 (HIV-1) RNA levels by means of single-copy assay in 334 participants receiving virologically suppressive antiretroviral therapy (ART). A residual viremia load of ≥1 copy/mL after 4 years of ART was predicted by a higher pre-ART HIV-1 RNA level, higher CD8+ T-cell count during treatment, and a lower ratio of CD4+ T cells to CD8+ T cells during treatment but not by initial ART regimen. In a longitudinal subset of 64 individuals, continued decay of the plasma HIV-1 RNA level was observed, with an average annual decrease of 6% and an estimated half-life of 11.5 years. In contrast to prior reports, the persistent viremia level continues to slowly decline during years 4–12 of suppressive ART. Clinical Trials Registration: NCT00001137. PMID:26333941

  4. Reducing environmental risk of excessively fertilized soils and improving cucumber growth by Caragana microphylla-straw compost application in long-term continuous cropping systems.

    PubMed

    Tian, Yongqiang; Wang, Qing; Zhang, Weihua; Gao, Lihong

    2016-02-15

    Continuous cropping is a common agricultural practice in the word. In China, farmers often apply excessive fertilizers to fields in an attempt to maintain yields in continuous cropping systems. However, this practice often results in high nutrient concentrations in soils, nutrient pollution in leaching water and more crop disease. Here, we investigated 8 different soils from continuously cropped cucumbers in Northern China that grouped into those with extremely high nutrient levels (EHNL) and those with lower nutrient levels (LNL). All soils were treated with Caragana microphylla-straw (CMS) compost addition, and then were used to measure soil physiochemical and microbial properties, leaching water quality, plant root growth and cucumber fruit yield. In general, the EHNL-soil showed higher nitrate, phosphorus and potassium concentrations in the leaching water compared to the LNL-soil. However, the CMS compost application increased soil nutrient and water holding capacities, total microbial biomass (bacteria and fungi), root length, plant biomass and fruit yields, but decreased nutrient concentrations in the leaching water from the EHNL-soil. In addition, the CMS compost decreased the number of Fusarium oxysporum f. sp. cucumerinum in soils with very high concentration of mineral nitrogen. Our results infer that CMS compost application was an effective method for reducing environmental risk of excessively fertilized soils.

  5. Long-Term Care Research and Policy

    ERIC Educational Resources Information Center

    Kemper, Peter

    2003-01-01

    This article provides a framework for understanding how long-term care (LTC) research contributes to policy, develops a typology of research contributions to policy with examples of each type, and suggests ways to ensure that contributions continue in the future. The article draws on in-depth interviews with LTC experts working at the interface…

  6. Continuous positive airway pressure for sleep apnoea/hypopnoea syndrome: usefulness of a 2 week trial to identify factors associated with long term use

    PubMed Central

    Popescu, G; Latham, M; Allgar, V; Elliott, M

    2001-01-01

    BACKGROUND—The sleep apnoea/hypopnoea syndrome (SAHS) is common and treatment with continuous positive airway pressure (CPAP) is effective. However, not all patients can cope with the demands of using mask positive pressure. Compliance can be improved with an intensive educational programme and patient support, but this is not practical in most centres given the large numbers of patients coming forward for treatment. Several studies have evaluated correlations between various parameters at diagnosis in order to anticipate patients' behaviour and to avoid the social and health implications of undertreated SAHS. We have evaluated the use of additional data derived during a 2 week home CPAP trial to identify factors associated with longer term use of CPAP and compliance.
METHODS—Following a diagnostic study, 209 patients were offered a CPAP machine for a 2 week home trial. After completing the trial, patients were reassessed and scored their overall satisfaction with CPAP treatment on a five point scale ranging from "much worse" to "much better" and an Epworth score relating to the loan period. Machine run time was recorded from the integral clock. These data were added to those available at diagnosis to construct models indicative of continuing CPAP and average nightly use at 1year.
RESULTS—209 patients were offered the 2 week loan at least a year before June 1999 (90.9% men, mean (SD) age 51.0 (10.6) years, body mass index (BMI) 34.6 (7.7) kg/m2, Epworth score 15 (IQR 11-18), apnoea/hypopnoea index (AHI) 38.1(22.9) events/h). 153 patients (73.2%) opted to continue CPAP and 56 declined. One year later data were available for 187 patients; 128 (68.5% on an intention to treat analysis) continued to use the machine with a mean use of 5.0 (2.4) hours/night. A logistic regression model indicated that mean CPAP use during the loan period and the overall satisfaction score accurately defined continuing CPAP and "satisfactory" CPAP use at 1 year. For patients with

  7. Continued neurocognitive development and prevention of cardiopulmonary complications after successful BMT for I-cell disease: a long-term follow-up report.

    PubMed

    Grewal, S; Shapiro, E; Braunlin, E; Charnas, L; Krivit, W; Orchard, P; Peters, C

    2003-11-01

    I-cell disease or mucolipidosis type II, a rare inherited storage disorder of lysosomal enzyme localization, is characterized by dysostosis multiplex, progressive severe psychomotor retardation and death by 5-8 years from congestive heart failure and recurrent pulmonary infections. A 19-month old girl with I-cell disease received a bone marrow transplant (BMT) from an HLA-identical carrier brother. At the age of 7 years, 5 years after BMT, she has no history of respiratory infections. Her cardiac function remains normal with a shortening fraction of 47%, and she continues to gain neurodevelopmental milestones, albeit at a very slow rate. Musculoskeletal deformities have worsened despite BMT. This is the first report describing neurodevelopmental gains and prevention of cardiopulmonary complications in I-cell disease after BMT.

  8. Performance assessment of a commonly used "accumulation and wash-off" model from long-term continuous road runoff turbidity measurements.

    PubMed

    Sage, Jérémie; Bonhomme, Céline; Al Ali, Saja; Gromaire, Marie-Christine

    2015-07-01

    The suitability of a commonly used accumulation and wash-off model for continuous modelling of urban runoff contamination was evaluated based on 11-month turbidity and flow-rate records from an urban street. Calibration and uncertainty analysis were performed using a Markov Chain Monte-Carlo sampling method for both suspended solids loads (discharge rates) and concentration modelling. Selected models failed at replicating suspended solids concentration over the complete monitoring period. The studied dataset indeed suggests that the accumulation process is rather unpredictable and cannot be satisfactorily represented with usual accumulation models unless short periods are considered. Regarding suspended solid loads modelling, noticeably better performance was achieved, but similar results could as well be obtained with much simpler constant concentration models. Unless providing very accurate estimates of concentrations in runoff, accounting for their temporal variability during rain events may therefore not always be necessary for pollutant loads modelling, as loads are in fact mostly explained by runoff volumes.

  9. Long-term performance of side-stream deammonification in a continuous flow granular-activated sludge process for nitrogen removal from high ammonium wastewater.

    PubMed

    Rezania, Babak; Mavinic, Donald S; Kelly, Harlan G

    2015-01-01

    An innovative granular sludge deammonification system was incorporated into a conventional-activated sludge process. The process incorporated an internal baffle in the bioreactor for continuous separation of granular biomass from flocculent biomass, which allowed for controlling the solids retention time of flocculent sludge. The process was evaluated for ammonium removal from municipal digested sludge dewatering centrate under various operating conditions lasting over 450 days. The process successfully removed, on average, 90% of the ammonium from centrate at various ammonium loading reaching 1.4 kg/m³d at 20 hours hydraulic retention time. Controlling the retention time of the flocculent biomass and maintaining low nitrite concentration were both found to be effective for nitrite oxidizing bacteria management, resulting in a low nitrate concentration (below 50 mg/L) over a wide range of flocculent biomass concentration in the bioreactor.

  10. Long-term bio-H2 and bio-CH4 production from food waste in a continuous two-stage system: Energy efficiency and conversion pathways.

    PubMed

    Algapani, Dalal E; Qiao, Wei; di Pumpo, Francesca; Bianchi, David; Wandera, Simon M; Adani, Fabrizio; Dong, Renjie

    2017-05-29

    Anaerobic digestion is a well-established technology for treating organic waste, but it is still under challenge for food waste due to process stability problems. In this work, continuous H2 and CH4 production from canteen food waste (FW) in a two-stage system were successfully established by optimizing process parameters. The optimal hydraulic retention time was 5d for H2 and 15d for CH4. Overall, around 59% of the total COD in FW was converted into H2 (4%) and into CH4 (55%). The fluctuations of FW characteristics did not significantly affect process performance. From the energy point view, the H2 reactor contributed much less than the methane reactor to total energy balance, but it played a key role in maintaining the stability of anaerobic treatment of food waste. Microbial characterization indicated that methane formation was through syntrophic acetate oxidation combined with hydrogenotrophic methanogenesis pathway. Copyright © 2017. Published by Elsevier Ltd.

  11. Long-term continuous administration of a hydro-ethanolic extract of Synedrella nodiflora (L) Gaertn in male Sprague-Dawley rats: biochemical, haematological and histopathological changes.

    PubMed

    Amoateng, Patrick; Adjei, Samuel; Osei-Safo, Dorcas; Ahedor, Believe; Mahmood, Seidu A; N'guessan, Benoit B; Asiedu-Gyekye, Isaac J; Nyarko, Alexander K

    2016-09-01

    Conflicting reports about the toxicity of Synedrella nodiflora (L) Gaertn (family Asteraceae), a plant traditionally used in Ghana for the management of epilepsy, abound in literature. The present study evaluates the effect of a 90-day continuous oral administration of a hydro-ethanolic whole plant extract of Synedrella nodiflora (SNE) in male Sprague-Dawley rats. The toxicological evaluation of the extract (100, 300 and 1000 mgkg(-1)) was focused on haematological, serum biochemical parameters and histopathological changes of some isolated organs. The extract produced no mortality in the rats treated during the study period. Only SNE 100 mgkg(-1) produced significant decrease in white blood cell and neutrophil counts and an increase in albumin, globulin, total bilirubin, total protein and potassium levels. The higher doses (SNE 300 and 1000 mgkg(-1)) had no significant effect on all the haematological and biochemical parameters measured. Histopathological assessment of the liver, kidney and heart revealed no abnormalities in rats treated with the extracts. Only the SNE 1000 mgkg(-1) produced distortions of the branching arrangements of the myocardial fibres and a congested vessel which indicates a healed infarction. The findings suggest hydro-ethanolic extract of Synedrella nodiflora (L) Gaertn generally has a low toxicity profile following a 90-day continuous oral administration in male Sprague-Dawley rats under the present laboratory conditions. However patients with renal or cardiac problems should use the plant with caution. Jointly supported by the International Foundation for Science, Stockholm, Sweden, through a grant (# F/5191-1) to Dr. Patrick Amoateng and the Office of Research, Innovation and Development (ORID), University of Ghana, Accra, Ghana, grant awarded to Dr. Patrick Amoateng (reference number: URF/6/ILG-002/2012-2013).

  12. Effects of intermittent compared to continuous energy restriction on short-term weight loss and long-term weight loss maintenance.

    PubMed

    Keogh, J B; Pedersen, E; Petersen, K S; Clifton, P M

    2014-06-01

    Effective strategies are needed to help individuals lose weight and maintain weight loss. The primary aim of this study was to investigate the effect of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on weight loss after 8 weeks and weight loss maintenance after 12 months. Secondary aims were to determine changes in waist and hip measurements and diet quality. In a randomized parallel study, overweight and obese (body mass index [BMI] ≥ 27 kg m(-2)) women were stratified by age and BMI before randomization. Participants undertook an 8-week intensive period with weight, waist and hip circumference measured every 2 weeks, followed by 44 weeks of independent dieting. A food frequency questionnaire was completed at baseline and 12 months, from which diet quality was determined. Weight loss was not significantly different between the two groups at 8 weeks (-3.2 ± 2.1 kg CER, n = 20, -2.0 ± 1.9 kg IER, n = 25; P = 0.06) or at 12 months (-4.2 ± 5.6 kg CER, n = 17 -2.1 ± 3.8 kg IER, n = 19; P = 0.19). Weight loss between 8 and 52 weeks was -0.7 ± 49 kg CER vs. -1 ± 1.1 kg IER; P = 0.6. Waist and hip circumference decreased significantly with time (P < 0.01), with no difference between groups. There was an increase in the Healthy Eating Index at 12 months in the CER compared with the IER group (CER 8.4 ± 9.1 vs. IER -0.3 ± 8.4, P = 0.006). This study indicates that intermittent dieting was as effective as continuous dieting over 8 weeks and for weight loss maintenance at 12 months. This may be useful for individuals who find CER too difficult to maintain.

  13. Long-term health economic benefits of sensor-augmented pump therapy vs continuous subcutaneous insulin infusion alone in type 1 diabetes: a U.K. perspective.

    PubMed

    Roze, Stéphane; Smith-Palmer, Jayne; Valentine, William J; Cook, Mark; Jethwa, Manisha; de Portu, Simona; Pickup, John C

    2016-01-01

    Continuous subcutaneous insulin infusion (CSII) is an important treatment option for type 1 diabetes patients unable to achieve adequate glycemic control with multiple daily injections (MDI). Combining CSII with continuous glucose monitoring (CGM) in sensor-augmented pump therapy (SAP) with a low glucose-suspend (LGS) feature may further improve glycemic control and reduce the frequency of hypoglycemia. A cost-effectiveness analysis of SAP + LGS vs. CSII plus self-monitoring of blood glucose (SMBG) was performed to determine the health economic benefits of SAP + LGS in type 1 diabetes patients using CSII in the U.K. Cost-effectiveness analysis was performed using the CORE diabetes model. Treatment effects were sourced from the literature, where SAP + LGS was associated with a projected HbA1c reduction of -1.49% vs. -0.62% for CSII, and a reduced frequency of severe hypoglycemia. The time horizon was that of patient lifetimes; future costs and clinical outcomes were discounted at 3.5% and 1.5% per annum, respectively. Projected outcomes showed that SAP + LGS was associated with higher mean quality-adjusted life expectancy (17.9 vs. 14.9 quality-adjusted life years [QALYs], SAP + LGS vs. CSII), and higher life expectancy (23.8 vs. 21.9 years), but higher mean lifetime direct costs (GBP 125,559 vs. GBP 88,991), leading to an incremental cost-effectiveness ratio (ICER) of GBP 12,233 per QALY gained for SAP + LGS vs. CSII. Findings of the base-case analysis remained robust in sensitivity analyses. For UK-based type 1 diabetes patients with poor glycemic control, the use of SAP + LGS is likely to be cost-effective compared with CSII plus SMBG.

  14. [Comparison of manual versus automatic titration in pressure determination for long-term therapy of continuous positive airway pressure in patients with obstructive sleep apnea hypopnea syndrome].

    PubMed

    Lu, Dong-xiao; Wu, Hai-gui; Luo, Jia-ying; Wu, Ying-xin; Yan, Hui-chan; Hong, Jia-xu; Luo, Yuan-ming

    2013-09-24

    To compare the continuous positive airway pressure (CPAP) of automatic titration with that of manual titration. A total of 58 patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) diagnosed by overnight polysomnography at sleep center of First Affiliated Hospital, Guangzhou Medical University were studied between December 2010 and December 2012. Manual titration was performed under full polysmnography and auto-titration at home for 3-7 nights. There were 52 males and 6 females with an age range of (48 ± 11) years. CPAP pressure titrated by automatic device (10.0 ± 2.2) cm H2O (1 cm H2O = 0.098 kPa) was significantly higher than that titrated manually (7.5 ± 1.5) cm H2O (P = 0.000). Apnea-hyponea index decreased significantly from (54.0 ± 21.0) events/h pre-treatment to (3.8 ± 2.5) events/h post-treatment under manual titration (P < 0.01). CPAP pressure titrated by automatic device is usually higher than that titrated manually. Manual titration should be performed if a patient can not tolerate the CPAP pressure titrated by an automatic device.

  15. A long-term cultivation of an anaerobic methane-oxidizing microbial community from deep-sea methane-seep sediment using a continuous-flow bioreactor.

    PubMed

    Aoki, Masataka; Ehara, Masayuki; Saito, Yumi; Yoshioka, Hideyoshi; Miyazaki, Masayuki; Saito, Yayoi; Miyashita, Ai; Kawakami, Shuji; Yamaguchi, Takashi; Ohashi, Akiyoshi; Nunoura, Takuro; Takai, Ken; Imachi, Hiroyuki

    2014-01-01

    Anaerobic oxidation of methane (AOM) in marine sediments is an important global methane sink, but the physiological characteristics of AOM-associated microorganisms remain poorly understood. Here we report the cultivation of an AOM microbial community from deep-sea methane-seep sediment using a continuous-flow bioreactor with polyurethane sponges, called the down-flow hanging sponge (DHS) bioreactor. We anaerobically incubated deep-sea methane-seep sediment collected from the Nankai Trough, Japan, for 2,013 days in the bioreactor at 10°C. Following incubation, an active AOM activity was confirmed by a tracer experiment using 13C-labeled methane. Phylogenetic analyses demonstrated that phylogenetically diverse Archaea and Bacteria grew in the bioreactor. After 2,013 days of incubation, the predominant archaeal components were anaerobic methanotroph (ANME)-2a, Deep-Sea Archaeal Group, and Marine Benthic Group-D, and Gammaproteobacteria was the dominant bacterial lineage. Fluorescence in situ hybridization analysis showed that ANME-1 and -2a, and most ANME-2c cells occurred without close physical interaction with potential bacterial partners. Our data demonstrate that the DHS bioreactor system is a useful system for cultivating fastidious methane-seep-associated sedimentary microorganisms.

  16. A Long-Term Cultivation of an Anaerobic Methane-Oxidizing Microbial Community from Deep-Sea Methane-Seep Sediment Using a Continuous-Flow Bioreactor

    PubMed Central

    Aoki, Masataka; Ehara, Masayuki; Saito, Yumi; Yoshioka, Hideyoshi; Miyazaki, Masayuki; Saito, Yayoi; Miyashita, Ai; Kawakami, Shuji; Yamaguchi, Takashi; Ohashi, Akiyoshi; Nunoura, Takuro; Takai, Ken; Imachi, Hiroyuki

    2014-01-01

    Anaerobic oxidation of methane (AOM) in marine sediments is an important global methane sink, but the physiological characteristics of AOM-associated microorganisms remain poorly understood. Here we report the cultivation of an AOM microbial community from deep-sea methane-seep sediment using a continuous-flow bioreactor with polyurethane sponges, called the down-flow hanging sponge (DHS) bioreactor. We anaerobically incubated deep-sea methane-seep sediment collected from the Nankai Trough, Japan, for 2,013 days in the bioreactor at 10°C. Following incubation, an active AOM activity was confirmed by a tracer experiment using 13C-labeled methane. Phylogenetic analyses demonstrated that phylogenetically diverse Archaea and Bacteria grew in the bioreactor. After 2,013 days of incubation, the predominant archaeal components were anaerobic methanotroph (ANME)-2a, Deep-Sea Archaeal Group, and Marine Benthic Group-D, and Gammaproteobacteria was the dominant bacterial lineage. Fluorescence in situ hybridization analysis showed that ANME-1 and -2a, and most ANME-2c cells occurred without close physical interaction with potential bacterial partners. Our data demonstrate that the DHS bioreactor system is a useful system for cultivating fastidious methane-seep-associated sedimentary microorganisms. PMID:25141130

  17. Long-term Impact of Continuous Positive Airway Pressure Therapy on Arrhythmia and Heart Rate Variability in Patients With Sleep Apnea.

    PubMed

    Grau, Nuria; Bazan, Victor; Kallouchi, Mohamed; Rodriguez, Diego; Estirado, Cristina; Corral, Maria Isabel; Valls, Maria Teresa; Ramos, Pablo; Sanjuas, Carles; Felez, Miquel; Valles, Ermengol; Benito, Begoña; Gea, Joaquim; Bruguera-Cortada, Jordi; Martí-Almor, Julio

    2016-01-01

    Autonomic dysfunction can alter heart rate variability and increase the incidence of arrhythmia. We analyzed the impact of continuous positive airway pressure (CPAP) on this pathophysiological phenomenon in patients with severe sleep apnea-hypopnea syndrome. Consecutive patients with recently diagnosed severe sleep apnea-hypopnea syndrome were prospectively considered for inclusion. Incidence of arrhythmia and heart rate variability (recorded on a 24-hour Holter monitoring device) were analyzed before starting CPAP therapy and 1 year thereafter. A total of 26 patients were included in the study. CPAP was administered for 6.6 ± 1.8 hours during Holter monitoring. After starting CPAP, we observed a marginally significant reduction in mean HR (80 ± 9 to 77 ± 11 bpm, p=.05). CPAP was associated with partial modulation (only during waking hours) of r-MSSD (p=.047) and HF (p=.025) parasympathetic parameters and LF (p=.049) sympathetic modulation parameters. None of these parameters returned completely to normal levels (p<.001). The number of unsustained episodes of atrial tachycardia diminished (p=.024), but no clear effect on other arrhythmias was observed. CPAP therapy only partially improves heart rate variability, and exclusively during waking hours, and reduces incidence of atrial tachycardia, both of which can influence cardiovascular morbidity and mortality in sleep apnea-hypopnea syndrome patients. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  18. A long-term study on the effect of magnetite supplementation in continuous anaerobic digestion of dairy effluent - Enhancement in process performance and stability.

    PubMed

    Baek, Gahyun; Kim, Jaai; Lee, Changsoo

    2016-12-01

    Interspecies electron transfer (IET) between microbial populations with different functions is critical to stable anaerobic digestion. This study, in an attempt to facilitate IET, investigated the effect of magnetite supplementation on the biomethanation of dairy effluent in continuous mode. The magnetite-added reactor (RM) was significantly more resistant and resilient to process imbalance than the reactor run without magnetite addition (RC). RC showed unstable performance with repeated process upsets, but its performance improved to be comparable to that of RM after applying magnetite supplementation. Magnetite was particularly effective in stabilizing a build-up of propionic acid and therefore improving the process robustness and reliability. The enhanced biomethanation in terms of productivity and stability was attributed to the facilitated direct IET (DIET) between exoelectrogens and methanogens via magnetite particles. Methanosaeta was the predominant methanogen group in the experimental reactors and likely played a key role in both DIET-mediated carbon dioxide-reducing and aceticlastic methanogenesis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Impact of long-term high-intensity interval and moderate-intensity continuous training on subclinical inflammation in overweight/obese adults.

    PubMed

    Gerosa-Neto, José; Antunes, Barbara M M; Campos, Eduardo Z; Rodrigues, Jhennyfer; Ferrari, Gustavo D; Rosa Neto, José C; Bueno, Carlos R; Lira, Fábio S

    2016-12-01

    Obesity is a risk factor able to trigger several inflammatory alterations and the imbalance between pro- and anti-inflammatory cytokine productions. Physical exercise is an important strategy for reduction of inflammatory established process. The aim of this study was to evaluate the effect of 16 weeks of three exercise training programs in the inflammatory profile and insulin resistance in overweight/obesity. Thirty two men and women (46.4±10.1 years; 162.0±9.1 cm; 82.0±13.6 kg) were divided into three groups for training on a treadmill: continuous at 70% maximum heart rate (HRmax) 5 times a week (CONT); 1×4 min (1-bout) and 4×4 min (high intensity interval training, HIIT) at 90% HRmax 3 times a week. Interleukin (IL) 6 and IL-10, tumor necrosis factor-alpha (TNF-α), insulin and adiponectin levels were analyzed by enzyme-linked immunosorbent assay, and homeostasis model assessment insulin resistance was calculated. After 16 weeks of training blood concentrations of IL-6 decreased in the HIIT group (P=0.035), TNF-α decreased in the CONT (P=0.037) and increased in HIIT (P=0.001) and adiponectin decreased in the three training models. There was a trend towards decreased body weight and body mass index (BMI) after HIIT only (P=0.059 and P=0.060, respectively). Despite the decrease of adiponectin and the increase of TNF-α in HIIT group, insulin sensitivity showed a trend for improvement (P=0.08). HIIT program decreased IL-6 at rest and although not significant was the only who tended to decrease total body weight and BMI. Taken together, our data suggest that both HIIT as well as CONT exercises training program promotes changes in inflammatory profile in overweight/obesity, but dissimilar response is seen in TNF-α levels.

  20. Continuous accelerated 7-days-a-week radiotherapy for head-and-neck cancer: Long-term results of Phase III clinical trial

    SciTech Connect

    Skladowski, Krzysztof . E-mail: skladowski@io.gliwice.pl; Maciejewski, Boguslaw; Golen, Maria; Tarnawski, Rafal; Slosarek, Krzysztof; Suwinski, Rafal; Sygula, Mariusz; Wygoda, Andrzej

    2006-11-01

    Purpose: To update 5-year results of a previously published study on special 7-days-a-week fractionation continuous accelerated irradiation (CAIR) for head-and-neck cancer patients. Methods and Materials: One hundred patients with squamous cell carcinoma of head and neck in Stage T{sub 2-4}N{sub 0-1}M were randomized between two definitive radiation treatments: accelerated fractionation 7 days a week including weekends (CAIR) and conventional 5 days a week (control). Hence the overall treatment time was 2 weeks shorter in CAIR. Results: Five-year local tumor control was 75% in the CAIR group and 33% in the control arm (p < 0.00004). Tumor-cure benefit corresponded with significant improvement in disease-free survival and overall survival rates. Confluent mucositis was the main acute toxicity, with the incidence significantly higher in CAIR patients than in control (respectively, 94% vs. 53%). When 2.0-Gy fractions were used, radiation necrosis developed in 5 patients (22%) in the CAIR group as a consequential late effect (CLE), but when fraction size was reduced to 1.8 Gy no more CLE occurred. Actuarial 5-year morbidity-free survival rate was similar for both treatments. Conclusions: Selected head-and-neck cancer patients could be treated very effectively with 7-days-a-week radiation schedule with no compromise of total dose and with slight 10% reduction of fraction dose (2 Gy-1.8 Gy), which article gives 1 week reduction of overall treatment time compared with standard 70 Gy in 35 fractions over 47-49 days. Although this report is based on the relatively small group of patients, its results have encouraged us to use CAIR fractionation in a standard radiation treatment for moderately advanced head-and-neck cancer patients.

  1. Immediate Epileptogenesis after Kainate-Induced Status Epilepticus in C57BL/6J Mice: Evidence from Long Term Continuous Video-EEG Telemetry

    PubMed Central

    Puttachary, Sreekanth; Sharma, Shaunik; Tse, Karen; Beamer, Edward; Sexton, Abby; Crutison, Joseph; Thippeswamy, Thimmasettappa

    2015-01-01

    The C57BL/6J mouse as a model of seizure/epilepsy is challenging due to high mortality and huge variability in response to kainate. We have recently demonstrated that repeated administration of a low dose of kainate by intraperitoneal route can induce severe status epilepticus (SE) with 94% survival rate. In the present study, based on continuous video-EEG recording for 4-18 weeks from epidurally implanted electrodes on the cortex, we demonstrate that this method also induces immediate epileptogenesis (<1-5 days post-SE). This finding was based on identification of two types of spontaneous recurrent seizures; behavioral convulsive seizures (CS) and electrographic nonconvulsive seizures (NCS). The identification of the spontaneous CS, stage 3-5 types, was based on the behaviors (video) that were associated with the EEG characteristics (stage 3-5 epileptiform spikes), the power spectrum, and the activity counts. The electrographic NCS identification was based on the stage 1-2 epileptiform spike clusters on the EEG and their associated power spectrum. Severe SE induced immediate epileptogenesis in all the mice. The maximum numbers of spontaneous CS were observed during the first 4-6 weeks of the SE and they decreased thereafter. Mild SE also induced immediate epileptogenesis in some mice but the CS were less frequent. In both the severe and the mild SE groups, the spontaneous electrographic NCS persisted throughout the 18 weeks observation period, and therefore this could serve as a chronic model for complex seizures. However, unlike rat kainate models, the C57BL/6J mouse kainate model is a unique regressive CS model of epilepsy. Further studies are required to understand the mechanism of recovery from spontaneous CS in this model, which could reveal novel therapeutic targets for epilepsy. PMID:26161754

  2. Effects of Nitrogen Dioxide and Anoxia on Global Gene and Protein Expression in Long-Term Continuous Cultures of Nitrosomonas eutropha C91

    PubMed Central

    Kartal, Boran; Wessels, Hans J. C. T.; van der Biezen, Erwin; Francoijs, Kees-Jan; Jetten, Mike S. M.; Klotz, Martin G.

    2012-01-01

    Nitrosomonas eutropha is an ammonia-oxidizing betaproteobacterium found in environments with high ammonium levels, such as wastewater treatment plants. The effects of NO2 on gene and protein expression under oxic and anoxic conditions were determined by maintaining N. eutropha strain C91 in a chemostat fed with ammonium under oxic, oxic-plus-NO2, and anoxic-plus-NO2 culture conditions. Cells remained viable but ceased growing under anoxia; hence, the chemostat was switched from continuous to batch cultivation to retain biomass. After several weeks under each condition, biomass was harvested for total mRNA and protein isolation. Exposure of N. eutropha C91 to NO2 under either oxic or anoxic conditions led to a decrease in proteins involved in N and C assimilation and storage and an increase in proteins involved in energy conservation, including ammonia monooxygenase (AmoCAB). Exposure to anoxia plus NO2 resulted in increased representation of proteins and transcripts reflective of an energy-deprived state. Several proteins implicated in N-oxide metabolism were expressed and remained unchanged throughout the experiment, except for NorCB nitric oxide reductase, which was not detected in the proteome. Rather, NorY nitric oxide reductase was expressed under oxic-plus-NO2 and anoxic-plus-NO2 conditions. The results indicate that exposure to NO2 results in an energy-deprived state of N. eutropha C91 and that anaerobic growth could not be supported with NO2 as an oxidant. PMID:22562996

  3. Relationship between uric acid and technique failure in patients on continuous ambulatory peritoneal dialysis: a long-term observational cohort study.

    PubMed

    Hsieh, Yao-Peng; Chang, Chia-Chu; Kor, Chew-Teng; Yang, Yu; Wen, Yao-Ko; Chiu, Ping-Fang; Lin, Chi-Chen

    2017-04-07

    Uric acid (UA) is the product of purine or nucleotide metabolism via the pathway of xanthine oxidase or xanthine dehydrogenase. Although epidemiological studies assessing the role of UA in cardiovascular disease or mortality have produced inconsistent results, the correlation between UA and technique failure in patients on continuous ambulatory peritoneal dialysis (CAPD) remains to be assessed. A retrospective cohort study. Patients starting CAPD between 2001 and 2009 in a single centre in Taiwan. A total of 371 patients on CAPD. All-cause and peritonitis-related technique failure. A cohort of 371 participants (43.9% male) was enrolled in the study with a mean age of 55.7±15.9 years at the start of CAPD. During the study period, technique failure occurred in 41 (34.4%) patients in the hyperuricaemia group compared with 49 (19.4%) in the normouricaemia group (p=0.003). In the multivariate Cox regression models, hyperuricaemia at baseline was significantly associated with both a higher risk of technique failure (HR 1.24; 95% CI 1.09 to 1.42, p=0.001) and peritonitis-related technique failure (HR 1.29; 95% CI 1.07 to 1.57, p=0.008). UA was shown to be associated with all-cause and peritonitis-related technique failure in our study. Patients on CAPD with hyperuricaemia should be closely monitored and strategies of increasing survival on CAPD should be taken. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Relationship between uric acid and technique failure in patients on continuous ambulatory peritoneal dialysis: a long-term observational cohort study

    PubMed Central

    Hsieh, Yao-Peng; Chang, Chia-Chu; Kor, Chew-Teng; Yang, Yu; Wen, Yao-Ko; Chiu, Ping-Fang; Lin, Chi-Chen

    2017-01-01

    Objectives Uric acid (UA) is the product of purine or nucleotide metabolism via the pathway of xanthine oxidase or xanthine dehydrogenase. Although epidemiological studies assessing the role of UA in cardiovascular disease or mortality have produced inconsistent results, the correlation between UA and technique failure in patients on continuous ambulatory peritoneal dialysis (CAPD) remains to be assessed. Design A retrospective cohort study. Setting Patients starting CAPD between 2001 and 2009 in a single centre in Taiwan. Participants A total of 371 patients on CAPD. Primary outcome measures All-cause and peritonitis-related technique failure. Results A cohort of 371 participants (43.9% male) was enrolled in the study with a mean age of 55.7±15.9 years at the start of CAPD. During the study period, technique failure occurred in 41 (34.4%) patients in the hyperuricaemia group compared with 49 (19.4%) in the normouricaemia group (p=0.003). In the multivariate Cox regression models, hyperuricaemia at baseline was significantly associated with both a higher risk of technique failure (HR 1.24; 95% CI 1.09 to 1.42, p=0.001) and peritonitis-related technique failure (HR 1.29; 95% CI 1.07 to 1.57, p=0.008). Conclusions UA was shown to be associated with all-cause and peritonitis-related technique failure in our study. Patients on CAPD with hyperuricaemia should be closely monitored and strategies of increasing survival on CAPD should be taken. PMID:28389481

  5. Impact of long-term high-intensity interval and moderate-intensity continuous training on subclinical inflammation in overweight/obese adults

    PubMed Central

    Gerosa-Neto, José; Antunes, Barbara M.M.; Campos, Eduardo Z.; Rodrigues, Jhennyfer; Ferrari, Gustavo D.; Rosa Neto, José C.; Bueno, Carlos R.; Lira, Fábio S.

    2016-01-01

    Obesity is a risk factor able to trigger several inflammatory alterations and the imbalance between pro- and anti-inflammatory cytokine productions. Physical exercise is an important strategy for reduction of inflammatory established process. The aim of this study was to evaluate the effect of 16 weeks of three exercise training programs in the inflammatory profile and insulin resistance in overweight/obesity. Thirty two men and women (46.4±10.1 years; 162.0±9.1 cm; 82.0±13.6 kg) were divided into three groups for training on a treadmill: continuous at 70% maximum heart rate (HRmax) 5 times a week (CONT); 1×4 min (1-bout) and 4×4 min (high intensity interval training, HIIT) at 90% HRmax 3 times a week. Interleukin (IL) 6 and IL-10, tumor necrosis factor-alpha (TNF-α), insulin and adiponectin levels were analyzed by enzyme-linked immunosorbent assay, and homeostasis model assessment insulin resistance was calculated. After 16 weeks of training blood concentrations of IL-6 decreased in the HIIT group (P=0.035), TNF-α decreased in the CONT (P=0.037) and increased in HIIT (P=0.001) and adiponectin decreased in the three training models. There was a trend towards decreased body weight and body mass index (BMI) after HIIT only (P=0.059 and P=0.060, respectively). Despite the decrease of adiponectin and the increase of TNF-α in HIIT group, insulin sensitivity showed a trend for improvement (P=0.08). HIIT program decreased IL-6 at rest and although not significant was the only who tended to decrease total body weight and BMI. Taken together, our data suggest that both HIIT as well as CONT exercises training program promotes changes in inflammatory profile in overweight/obesity, but dissimilar response is seen in TNF-α levels. PMID:28119880

  6. A Simple Microfluidic Platform for Long-Term Analysis and Continuous Dual-Imaging Detection of T-Cell Secreted IFN-γ and IL-2 on Antibody-Based Biochip

    PubMed Central

    Baganizi, Dieudonné R.; Leroy, Loïc; Laplatine, Loïc; Fairley, Stacie J.; Heidmann, Samuel; Menad, Samia; Livache, Thierry; Marche, Patrice N.; Roupioz, Yoann

    2015-01-01

    The identification and characterization, at the cellular level, of cytokine productions present a high interest for both fundamental research and clinical studies. However, the majority of techniques currently available (ELISA, ELISpot, flow cytometry, etc.) have several shortcomings including, notably, the assessment of several cytokines in relation to individual secreting cells and the monitoring of living cell responses for a long incubation time. In the present work, we describe a system composed of a microfluidic platform coupled with an antibody microarray chip for continuous SPR imaging and immunofluorescence analysis of cytokines (IL-2 and IFN-γ) secreted by T-Lymphocytes, specifically, and stably captured on the biochip under flow upon continued long-term on-chip culture (more than 24 h). PMID:26690235

  7. Precision intrauterine contraception may significantly increase continuation of use: a review of long-term clinical experience with frameless copper-releasing intrauterine contraception devices

    PubMed Central

    Wildemeersch, Dirk; Pett, Ansgar; Jandi, Sohela; Hasskamp, Thomas; Rowe, Patrick; Vrijens, Marc

    2013-01-01

    Objective The purpose of this paper is to review the experience with the frameless, anchored, GyneFix copper-releasing intrauterine contraceptive devices (IUCDs/IUDs) (Contrel Europe, Belgium), and to demonstrate their high acceptability and low rate of discontinuation of use, which could contribute to current efforts that aim to reduce radically the high number of unintended pregnancies and induced abortions, particularly in young women. Materials and methods This paper is based on studies that examined the differences in uterine volume and cavity size, related to age and parity, and on original clinical research data and practical experience with frameless copper IUDs, as well as on literature data on the IUD–endometrial cavity relationship of conventional IUDs, with special reference to side effects and user discontinuation. Results The mean transverse diameter in nulliparous and parous women is significantly less than the length of the transverse arm of the TCu380A IUD (ParaGard, Duramed, NY, USA) or the levonorgestrel intrauterine system (Mirena, Bayer, Germany). Small, frameless, flexible, and unidimensional copper IUDs appear to be well tolerated, with less impact on menstrual bleeding, resulting in low discontinuation rates when compared with standard-size conventional IUDs, which often result in increased expulsion rates, complaints of pain and erratic or increased menstrual bleeding, and subsequent high rates of discontinuation, particularly in young women. Conclusion The unidimensional GyneFix IUDs fit the majority of uterine cavities. An IUD that fits is likely to result in increased tolerance and continued use of the method. As this would appeal to women, the logical result should be greater use of the method and fewer unintended pregnancies and induced abortions. Recommending the standard TCu380A (ParaGard) IUD or the Mirena levonorgestrel intrauterine system, primarily developed for use in parous women, for general use in nulliparous and adolescent

  8. Geodynamical Processes between Antarctica and India as revealed by very long baselines between the continents estimated from continuous and long-term GPS measurements

    NASA Astrophysics Data System (ADS)

    N, R.; Ec, M.; Akilan, A.

    2006-12-01

    To holistically understand the geodynamical and crustal deformation processes in the south of Indian peninsula between India and Antarctica, two global networks have been chosen that geodetically connect the two continents, the IGS Station at Diego Garcia (DGAR) being the common station between the two networks. 8 years of data from 1997 to 2005 were used. Very long baselines have been estimated from HYDE to other chosen IGS stations in and around India including DGAR. Similarly in the other network, very long baselines have been estimated from Kerguelen to other stations in and around Antarctica again including DGAR. Since the baseline length between HYDE, India and MAITRI, Antarctica is more than 10,000 km, it is mandatory to form these two different networks to improve the accuracy of the baseline measurements by GPS. This is to circumvent the limitation in the estimation of maximum base line length by GPS is of 6,900 km only due to the availability of less number of double difference observables in the GPS data analysis. Our analysis and results show increase of baseline lengths between Kerguelen in Antarctic plate and other stations and shortening of baseline lengths between HYDE in Indian plate and other common stations. By this global network analyses, the stations HYDE and MAITRI are geodetically tied through DGAR. With this geodetic tie up, having got the first geodetic signatures of the geodynamical processes between India and Antarctica, continuous monitoring and estimation would help enhancing the understanding the crustal deformation processes between these two continents despite many plates, micro plates and ridges in this study region.These estimations reveal clearly that the stations in the Australian plate are moving away from the Indian plate conforming to the recent Plate tectonic theory that India and Australia lie in two different plates with a diffuse boundary separating them. GPS derived velocity vectors for the Australian Plate also

  9. Continuity and change?: Exploring reactions to a guided self-management intervention in a randomised controlled trial for IBS with reference to prior experience of managing a long term condition

    PubMed Central

    Rogers, Anne; Lee, Victoria; Kennedy, Anne

    2007-01-01

    Self-care interventions are promoted as effective strategies for improving the quality of life and health outcomes for individuals with long-term health conditions. Outcome measures used in evaluations using Randomised Controlled Trials (RCTs) are not designed to consider patients' prior management strategies and experience of illness. Yet the experience of illness literature suggests that adjusting to living with chronic illness, together with broader contextual influences, are likely to be relevant to understanding responses to self-management initiatives. Using group and individual interview data we attempt to illuminate the transposition of IBS from a condition unsatisfactorily managed by medicine to one successfully managed within the life worlds of individuals. If routine embedding of complex interventions depends on the accomplishment of integration and workability in patients' everyday lives then the design and evaluation of such interventions should view participation as part of a process of continuity as well as change. Responses to formal self-management can be extended beyond psychological and other quantitatively measured outcomes. A useful addendum to trial outcomes for self-management education is an understanding of change as being inextricably linked to people's previous attempts to, and experience of, managing long-term conditions. We suggest that the benefits of understanding the prior experience of managing illness and contact with health services include the acceptability and workability of complex interventions in patients' everyday lives. PMID:17316438

  10. The long term characteristics of greenschist

    NASA Astrophysics Data System (ADS)

    Jang, Bo-An

    2016-04-01

    The greenschist in the Jinping II Hydropower Station in southwest China exhibits continuous creep behaviour because of the geological conditions in the region. This phenomenon illustrates the time-dependent deformation and progressive damage that occurs after excavation. In this study, the responses of greenschist to stress over time were determined in a series of laboratory tests on samples collected from the access tunnel walls at the construction site. The results showed that the greenschist presented time-dependent behaviour under long-term loading. The samples generally experienced two stages: transient creep and steady creep, but no accelerating creep. The periods of transient creep and steady creep increased with increasing stress levels. The long-term strength of the greenschist was identified based on the variation of creep strain and creep rate. The ratio of long-term strength to conventional strength was around 80% and did not vary much with confining pressures. A quantitative method for predicting the failure period of greenschist, based on analysis of the stress-strain curve, is presented and implemented. At a confining pressure of 40 MPa, greenschist was predicted to fail in 5000 days under a stress of 290 MPa and to fail in 85 days under the stress of 320 MPa, indicating that the long-term strength identified by the creep rate and creep strain is a reliable estimate.

  11. Long-term parenteral nutrition

    PubMed Central

    Ladefoged, Karin; Jarnum, Stig

    1978-01-01

    Nineteen patients (11 women and eight men) aged 20-68 received long-term parenteral nutrition, mostly at home, for six to 63 months (mean 19 months). Indications for LTPN were extensive, active Crohn's disease in three patients, intestinocutaneous fistulas in three, and short-bowel syndrome in the remaining 13 patients. Subclavian or intra-atrial (Broviac) catheters were most commonly used, for which the average life was four and seven months respectively. Complications of long-term parenteral nutrition included pneumothorax in four out of 48 subclavian vein punctures. Catheter-induced thrombosis of central veins was shown by phlebography 17 times in nine patients, and eight episodes of total occlusion occurred. Two of these patients had pulmonary infarction. Nineteen episodes of catheter sepsis occurred in 11 patients, but only one was fatal. Complications related to intestinal disease included intra-abdominal abscesses and intestinal fistulas, and disturbances of liver function. Five patients died, though in only two was death related to long-term parenteral nutrition. One of these patients died from catheter sepsis, the other had subdural haematoma possibly caused by anticoagulant treatment. Eight of the 14 surviving patients still needed parenteral nutrition. All received a disability pension, but six had an acceptable quality of life with almost normal social activities. Despite problems such as difficulties in maintaining standardised infusion programmes, it was concluded that long-term parenteral nutrition at home is practicable and consistent with an acceptable quality of life. ImagesFIG 2 PMID:98199

  12. Long-Term Monitoring of Global Climate Forcings and Feedbacks

    NASA Technical Reports Server (NTRS)

    Hansen, J. (Editor); Rossow, W. (Editor); Fung, I. (Editor)

    1993-01-01

    A workshop on Long-Term Monitoring of Global Climate Forcings and Feedbacks was held February 3-4, 1992, at NASA's Goddard Institute for Space Studies to discuss the measurements required to interpret long-term global temperature changes, to critique the proposed contributions of a series of small satellites (Climsat), and to identify needed complementary monitoring. The workshop concluded that long-term (several decades) of continuous monitoring of the major climate forcings and feedbacks is essential for understanding long-term climate change.

  13. Long-term data archiving

    SciTech Connect

    Moore, David Steven

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  14. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long-term debt. The CPA's workpapers must document that he/she: (a) Confirmed RUS, FFB, and RTB debt to...

  15. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long-term debt. The CPA's workpapers must document that he/she: (a) Confirmed RUS, FFB, and RTB debt to...

  16. Continued Risk of Relapse Independent of Treatment Modality in Limited-Stage Diffuse Large B-Cell Lymphoma: Final and Long-Term Analysis of Southwest Oncology Group Study S8736

    PubMed Central

    Stephens, Deborah M.; Li, Hongli; LeBlanc, Michael L.; Puvvada, Soham D.; Persky, Daniel; Friedberg, Jonathan W.

    2016-01-01

    Purpose Utility of combined-modality therapy for patients with limited-stage diffuse large B-cell lymphoma (DLBCL) was shown in the Southwest Oncology Group (SWOG) S8736 study, where three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus radiotherapy (CHOP3RT) improved 5-year progression-free (PFS) and overall survival (OS) compared with eight cycles of CHOP (CHOP8). Subsequent analysis showed an unexpected overlap of the PFS curves. We aimed to confirm and investigate this observation by performing long-term analysis of SWOG S8736 and evaluating these data alongside data from similar patients receiving rituximab and CHOP3RT (SWOG S0014 study). Patients and Methods A subset of patients with limited-stage DLBCL randomly assigned to CHOP8 (n = 150) or CHOP3RT (n = 158) in S8736 was analyzed along with a 56-patient subset treated in S0014 for long-term PFS and OS. Results Median follow-up in S8736 was 17.7 years. In patients receiving CHOP8 and CHOP3RT, median PFS was 12.0 (95% CI, 8.8 to 14.3) and 11.1 years (95% CI, 8.9 to 14.4), respectively. There were no statistically significant differences in PFS between the groups (P = .73). Median OS was 13.0 (95% CI, 10.4 to 15.2) and 13.7 years (95% CI, 11.1 to 19.4) for patients treated with CHOP8 and CHOP3RT, respectively. Similarly, there were no statistically significant differences in OS between the groups (P = .38). With a median follow-up time 12 years in S0014, 5- and 10-year OS were 82% and 67%, respectively, with a persistent pattern of relapse despite the addition of rituximab. Conclusion Although 5-year PFS and OS were improved after early analysis in patients with limited-stage DLBCL receiving CHOP3RT versus CHOP8, extended survival data showed similar PFS and OS, with continuous treatment failure. The addition of rituximab (S0014) to combined-modality therapy did not mitigate the continued relapse risk, underscoring the value of prolonged clinical trial patient observation and

  17. CLIPPERS and the need for long-term immunosuppression.

    PubMed

    Abkur, Tarig M; Kearney, Hugh; Hennessy, Michael J

    2017-02-01

    Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) is a rare chronic inflammatory disorder of the central nervous system. Herein, we describe the case of a 62-year-old female who presented with right sided facial tingling, gait ataxia and diplopia. Neuroimaging revealed pontine curvilinear enhancing lesions with extension into cerebellar peduncles, characteristic of CLIPPERS. This report discusses the differential diagnosis and the importance of prolonged immunomodulatory treatment for this rare neuro-inflammatory disorder. Long-term immunosuppression appears to be mandatory in order to achieve sustained remission and prevent disability related to atrophy of the structures involved in repeated attacks.

  18. Long term therapy of generalized anxiety disorder.

    PubMed

    Rouillon, Frédéric

    2004-04-01

    Generalized anxiety disorder (GAD) is a common (lifetime prevalence: 5.1%), recurrent condition, which often heralds other psychiatric disorders, notably depression. As by definition it is a disorder progressing over months, treatment should be designed on a long term basis. And yet, few studies have been conducted beyond the classical 6-8 weeks characterizing the acute treatment phase. This is especially true of anxiolytics, but also of antidepressants, with the exception of paroxetine and venlafaxine, which are the only drugs approved in this indication in Western countries. The efficacy of psychotherapy, notably relaxation and cognitive-behavioral therapy, is established in the treatment of GAD, but its preferred indications and possible combination with antidepressants are still to be specified. Long term, not to say very long term studies of GAD, as well as depression, will still be required in the future to improve its management and specify therapeutic modalities (combination treatment, optimal duration, continuous or intermittent therapy, choice of psychotherapeutic techniques or agents, em leader ). Early and adequately prolonged treatment should not only result in more numerous remission periods, but also in decreased frequency of co-morbidities whether depressive, addictive, or of another nature, and should also reduce the social impact of GAD.

  19. Link of the mechanisms of action of glatiramer acetate to its long-term clinical data.

    PubMed

    Moreau, Thibault

    2009-02-01

    A consequence of the long-term nature of progression in multiple sclerosis is that treatment needs to be provided over the long term. Gathering evidence for long term clinical efficacy, safety and patient acceptance of immunomodulatory therapies is thus a critically important issue. However, pivotal trials, which generally last no more than two years, cannot address this issue. Glatiramer acetate is the only immunomodulatory treatment for which prospective data is available covering a treatment period of over a decade. In the long-term extension of the pivotal trial of glatiramer acetate, 108 patients have been followed for a mean treatment duration of 10.1 years. At the end of the treatment period, patients were experiencing a relapse only once every five years and 92% remained ambulatory throughout. Similar findings have been made in observational studies in the long-term follow-up of patients with relapsing remitting multiple sclerosis treated with glatiramer acetate under a compassionate use programme in France and in a patient registry in Argentina. Such data strongly suggest that a reduced risk of relapse represents a real long-term treatment effect. The cumulative evidence for the long-term clinical efficacy of glatiramer acetate is consistent with its dual mechanism of action, reassures the physician that glatiramer acetate can really help improve patient care over the long term, and may contribute to a more positive view of prognosis for patients with multiple sclerosis.

  20. Long-term course of opioid addiction.

    PubMed

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

    2015-01-01

    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  1. Effects of pantoprazole 20 mg in mildgastroesophageal reflux disease: Once-daily treatment in the acute phase, and comparison of on-demand versus continuous treatment in the long term

    PubMed Central

    Janssen, Werner; Meier, Eberhard; Gatz, Gudrun; Pfaffenberger, Bernd

    2005-01-01

    Background: Gastroesophageal reflux disease (GERD) is a chronic disorder,and although effective short-term treatment strategies are known, the rate of relapse within 1 year is as high as 90% despite successful acute treatment. Consequently, most patients with GERD require an effective long-term management strategy to achieve adequate symptom control and maintain mucosal healing. Objective: The present study was undertaken to compare the control ofGERD symptoms during long-term (24-week) treatment with pantoprazole 20 mg used on-demand or continuously in patients with mild GERD after complete relief of acute GERD symptoms. Methods: Patients with endoscopically confirmed Savary/Miller grade 0(normal mucosa) or I (patchy red lesions without white coating or with central white coating) GERD were enrolled in this multinational, multicenter study comprising 2 phases. In the first phase, which was open label, patients were treated with pantoprazole 20 mg QD for 4 weeks. The presence and intensity of the symptoms of heartburn, acid regurgitation, and pain on swallowing were assessed. In the second phase, which was an open-label, 24-week, randomized design, only patients completely free of GERD symptoms after acute treatment were included. During this phase, on-demand treatment with pantoprazole 20 mg was directly compared with continuous treatment. The rate of failure to control GERD symptoms after 24 weeks of treatment was estimated using the Kaplan-Meier method. Subsequently, the difference between treatments (on-demand minus continuous) and its 95% CI were calculated, and the on-demand treatment was tested for noninferiority using a predefined noninferiority margin of 20%. The mean daily symptom loads were compared between the treatment groups using the 1-sided Wilcoxon rank sum test on a 5% α level. The point estimate of the difference was determined using the Hodges-Lehman estimator and the 1-sided 95% CI according to Moses. The number of patients unwilling to

  2. Long Term Three-dimensional Model Parameterization and Evaluation By The Use of Combined Continuous Ozone Lidar Profiles, Vertical Wind Profiles and Ground Based Monitors Obtained During The Escompte Campaign

    NASA Astrophysics Data System (ADS)

    Frejafon, E.; Robin, D.; Kalthoff, N.; Pesch, M.

    ESCOMPTE 2001 is a field experiment that took place in the southeast of France, in order to understand chemical transformation and transport and then to improve numer- ical models devoted to pollution study and forecasting. To achieve this goal, a stand alone ozone LIDAR was installed from June 11th to July 13th in Cadarache, 30 km northeast of the cities of Marseilles and Aix-en-Provence, downwind from the ozone precursors emissions zones in case of sea-breeze development conditions. This full automatic LIDAR provided vertical profiles of ozone concentration and also the mix- ing height dynamics, between 100 m and 2 500 m, with a spatial resolution of less than 100 m and a temporal resolution of 3 minutes. Data obtained with the LIDAR were connected to ground based ozone monitor installed on the same location by the air quality network, in order to evaluate the data quality and to obtain ozone verti- cal profiles from the ground level up to the free troposphere, which is an optimized support for tree-dimensional photochemical models parameterization and evaluation. The ozone diurnal cycles and the daily atmospheric stratification recorded during this month show the fast dynamics during pollution episodes, resulting from combined photochemical and transport effects in case of sea-breeze. They also specify the re- maining ozone vertical structure during non polluted episodes. Such long-term infor- mation is then a consistent support for model parameterization and evaluation, as it can specify the ozone concentration and the PBL dynamics from the beginning to the last end of a pollution episode. This one month vertical ozone profiles, which were compiled in a movie, will be presented and discussed more precisely. The obtained results, combined with continuous vertical wind profiles obtained with a SODAR and a ground based meteorological station installed on the same location, give access to the continuous ozone flux vertical profiles and the PBL dynamics.

  3. Environmental Management Long-Term Stewardship Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after the completion of facility cleanup. Long-term stewardship is administered and overseen by the U.S. Department of Energy Environmental Management Office of Science and Technology. This report describes the background of long-term stewardship and gives general guidance about considerations when ownership and/or responsibility of a site should be transferred to a long-term stewardship program. This guidance document will assist the U.S. Department of Energy in: (a) ensuring that the long-term stewardship program leads transition planning with respect to facility and site areas, and (b) describing the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete.

  4. Sleep-disordered breathing in acute ischemic stroke and transient ischemic attack: effects on short- and long-term outcome and efficacy of treatment with continuous positive airways pressure--rationale and design of the SAS CARE study.

    PubMed

    Cereda, Carlo W; Petrini, Liliane; Azzola, Andrea; Ciccone, Alfonso; Fischer, Urs; Gallino, Augusto; Györik, Sandor; Gugger, Matthias; Mattis, Johannes; Lavie, Lena; Limoni, Costanzo; Nobili, Lino; Manconi, Mauro; Ott, Sebastian; Pons, Marco; Bassetti, Claudio L

    2012-10-01

    Sleep-disordered breathing represents a risk factor for cardiovascular morbidity and mortality and negatively affects short-term and long-term outcome after an ischemic stroke or transient ischemic attack. The effect of continuous positive airways pressure in patients with sleep-disordered breathing and acute cerebrovascular event is poorly known. The SAS CARE 1 study assesses the effects of sleep-disordered breathing on clinical evolution, vascular functions, and markers within the first three-months after an acute cerebrovascular event. The SAS CARE 2 assesses the effect of continuous positive airways pressure on clinical evolution, cardiovascular events, and mortality as well as vascular functions and markers at 12 and 24 months after acute cerebrovascular event. SAS CARE 1 is an open, observational multicenter study in patients with acute cerebrovascular event acutely admitted in a stroke unit: a sample of 200 acute cerebrovascular event patients will be included. Vascular functions and markers (blood pressure, heart rate variability, endothelial function by peripheral arterial tonometry and specific humoral factors) will be assessed in the acute phase and at three-months follow-up. SAS CARE 2 will include a sample of patients with acute cerebrovascular event in the previous 60-90 days. After baseline assessments, the patients will be classified according to their apnea hypopnea index in four arms: non-sleep-disordered breathing patients (apnea hypopnea index <10), patients with central sleep-disordered breathing, sleepy patients with obstructive apnea hypopnea index ≥20, which will receive continuous positive airways pressure treatment, nonsleepy patients with obstructive sleep-disordered breathing (apnea hypopnea index ≥20), which will be randomized to receive continuous positive airways pressure treatment or not. The SAS CARE study will improve our understanding of the clinical sleep-disordered breathing in patients with acute cerebrovascular event and

  5. Long-term oxygen therapy.

    PubMed

    Christopher, Kent L; Porte, Phillip

    2011-02-01

    This article provides an overview of the status of long-term oxygen therapy (LTOT). In the United States, payment cutbacks are occurring as a result of congressionally mandated competitive bidding and capped rental programs. These Medicare programs are discussed. These legislative and regulatory changes may result in reduced patient access to appropriate oxygen-delivery systems that meet medical needs, including optimal ambulation. Prescribing LTOT is addressed in this article, as is the need for adequate patient education. The importance of appropriate monitoring and reassessment is presented. The use of an LTOT collaborative care model is discussed. Although the new intermittent flow oxygen-delivery systems have potential benefits, there is consensus that each patient should be tested on the specific device because of variability in delivery and patient response. Feasible locations for patient education and monitoring are identified.

  6. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.

    PubMed

    Davies, Christina; Pan, Hongchao; Godwin, Jon; Gray, Richard; Arriagada, Rodrigo; Raina, Vinod; Abraham, Mirta; Medeiros Alencar, Victor Hugo; Badran, Atef; Bonfill, Xavier; Bradbury, Joan; Clarke, Michael; Collins, Rory; Davis, Susan R; Delmestri, Antonella; Forbes, John F; Haddad, Peiman; Hou, Ming-Feng; Inbar, Moshe; Khaled, Hussein; Kielanowska, Joanna; Kwan, Wing-Hong; Mathew, Beela S; Mittra, Indraneel; Müller, Bettina; Nicolucci, Antonio; Peralta, Octavio; Pernas, Fany; Petruzelka, Lubos; Pienkowski, Tadeusz; Radhika, Ramachandran; Rajan, Balakrishnan; Rubach, Maryna T; Tort, Sera; Urrútia, Gerard; Valentini, Miriam; Wang, Yaochen; Peto, Richard

    2013-03-09

    For women with oestrogen receptor (ER)-positive early breast cancer, treatment with tamoxifen for 5 years substantially reduces the breast cancer mortality rate throughout the first 15 years after diagnosis. We aimed to assess the further effects of continuing tamoxifen to 10 years instead of stopping at 5 years. In the worldwide Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial, 12,894 women with early breast cancer who had completed 5 years of treatment with tamoxifen were randomly allocated to continue tamoxifen to 10 years or stop at 5 years (open control). Allocation (1:1) was by central computer, using minimisation. After entry (between 1996 and 2005), yearly follow-up forms recorded any recurrence, second cancer, hospital admission, or death. We report effects on breast cancer outcomes among the 6846 women with ER-positive disease, and side-effects among all women (with positive, negative, or unknown ER status). Long-term follow-up still continues. This study is registered, number ISRCTN19652633. Among women with ER-positive disease, allocation to continue tamoxifen reduced the risk of breast cancer recurrence (617 recurrences in 3428 women allocated to continue vs 711 in 3418 controls, p=0·002), reduced breast cancer mortality (331 deaths vs 397 deaths, p=0·01), and reduced overall mortality (639 deaths vs 722 deaths, p=0·01). The reductions in adverse breast cancer outcomes appeared to be less extreme before than after year 10 (recurrence rate ratio [RR] 0·90 [95% CI 0·79–1·02] during years 5–9 and 0·75 [0·62–0·90] in later years; breast cancer mortality RR 0·97 [0·79–1·18] during years 5–9 and 0·71 [0·58–0·88] in later years). The cumulative risk of recurrence during years 5–14 was 21·4% for women allocated to continue versus 25·1% for controls; breast cancer mortality during years 5–14 was 12·2% for women allocated to continue versus 15·0% for controls (absolute mortality reduction 2·8%). Treatment allocation

  7. Long-term use of stimulants in children with attention deficit hyperactivity disorder: safety, efficacy, and long-term outcome.

    PubMed

    Hechtman, Lily; Greenfield, Brian

    2003-01-01

    The purpose of this review is to summarize existing data on the long-term safety and efficacy of stimulant treatment, and how long-term stimulant treatment of children with attention deficit hyperactivity disorder (ADHD) affects their outcome. Existing controlled studies of children with ADHD treated and untreated with stimulants, as well as long-term prospective follow-up studies, are reviewed. Children with ADHD treated with stimulants for as long as 2 years continue to benefit from the treatment, with improvements observed in ADHD symptoms, comorbid oppositional defiant disorder, and academic and social functioning, with no significant problems of tolerance or adverse effects. Long-term, prospective follow-up studies into adulthood show that stimulant treatment in childhood has slight benefits regarding social skills and self-esteem. Long-term adverse effects from stimulant treatment in childhood regarding adult height or future substance abuse have not been supported by existing studies.

  8. Long term efficacy of a pen injector.

    PubMed

    Dinneen, S F; Cronin, C C; O'Sullivan, D J

    1991-09-01

    We assessed the long term efficacy of Novopen as a form of insulin administration. Records were obtained on 48 patients who were treated with Novopen between January '86 and October '88. Six patients were excluded due to insufficient data. The study group of 42 patients comprised 22 females and 20 males of average age 33 years (range 17-66). Mean Hb.A1 rose from 10.6% to 12.1% after Novopen therapy, a rise of 14.1%. This rise is both clinically and statistically significant (p less than 0.001; 99% confidence limits 0.59-2.78). Increases in weight and insulin dose were also noted, but did not reach statistical significance. The majority of patients felt Novopen was superior to twice daily insulin in terms of ease of administration (81%) and flexibility of lifestyle (95%), and all who were using Novopen wished to continue with it. More than 50% of patients admitted to altering their dietary habits while using Novopen. Despite continuing patient satisfaction with this form of insulin administration, its long-term use may be associated with sub-optimal metabolic control.

  9. Asthma Medicines: Long-Term Control

    MedlinePlus

    ... Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic versions of ... form, they are used exclusively for long-term control; they are not very effective for acute symptoms. ...

  10. Consumer Direction in Long-Term Care.

    ERIC Educational Resources Information Center

    Generations, 2000

    2000-01-01

    Issue includes 17 theme articles on long-term care, covering legal issues, federal role, state programs, demonstration programs, family caregivers, home health care, home care workers, culturally appropriate long-term care, financial support, and cognitive impairments. (SK)

  11. Long-Term Recency in Anterograde Amnesia

    PubMed Central

    Talmi, Deborah; Caplan, Jeremy B.; Richards, Brian; Moscovitch, Morris

    2015-01-01

    Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant’s recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation. PMID:26046770

  12. Long-Term Recency in Anterograde Amnesia.

    PubMed

    Talmi, Deborah; Caplan, Jeremy B; Richards, Brian; Moscovitch, Morris

    2015-01-01

    Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant's recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation.

  13. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)

    Schmitt, Raymond W.; Brown, Neil L.

    2005-01-01

    Our long-term goal is to establish a reliable system for monitoring surface salinity around the global ocean. Salinity is a strong indicator of the freshwater cycle and has a great influence on upper ocean stratification. Global salinity measurements have potential to improve climate forecasts if an observation system can be developed. This project is developing a new internal field conductivity cell that can be protected from biological fouling for two years. Combined with a temperature sensor, this foul-proof cell can be deployed widely on surface drifters. A reliable in-situ network of surface salinity sensors will be an important adjunct to the salinity sensing satellite AQUARIUS to be deployed by NASA in 2009. A new internal-field conductivity cell has been developed by N Brown, along with new electronics. This sensor system has been combined with a temperature sensor to make a conductivity - temperature (UT) sensor suitable for deployment on drifters. The basic sensor concepts have been proven on a high resolution CTD. A simpler (lower cost) circuit has been built for this application. A protection mechanism for the conductivity cell that includes antifouling protection has also been designed and built. Mr. A.Walsh of our commercial partner E-Paint has designed and delivered time-release formulations of antifoulants for our application. Mr. G. Williams of partner Clearwater Instrumentation advised on power and communication issues and supplied surface drifters for testing.

  14. AB055. Long term NIV

    PubMed Central

    Siopi, Dimitra

    2016-01-01

    During the last decades, non-invasive mechanical ventilation has evolved into one of the most evidence-based areas of respiratory medicine, with many indications in acute or chronic respiratory failure. From the first application of negative pressure models during poliomyelitis epidemics to the new sophisticated positive pressure models, and the development of the “intelligent ventilators”, there has been a long time course. Undoubtedly the spur was given by better understanding of respiratory physiology during sleep and the shift of healthcare towards a chronic base. Novel randomized controlled trials (RCTs) established the use of NIV in acute respiratory failure due to exacerbations of COPD, as well as acute pulmonary edema and weaning from invasive mechanical ventilation. Long-term NIV has been used in neuromuscular diseases for many decades, first in Duchenne muscular dystrophy, and then spreading to other disorders of this category, increasing survival in inherited neuromuscular diseases. NIV should be initiated early in the course of the disease, when symptomatic nocturnal hypoventilation is detected. Combined with cough augmentation (physiotherapy, insufflation-exsufflation devices) and percutaneous gastrostomy feeding, it can delay tracheostomy and invasive ventilation. In ALS patients NIV improves the quality of life and increases survival, especially when there is no bulbar involvement. The right time to initiate ventilation in this group of patients is not well established since it is difficult to detect signs and symptom of respiratory impairment. Patients seem to benefit from an early application of NIV, and their personal decisions should always be considered before any intervention. In patients with chest wall disorders NIV—despite the fact that RCTs are lacking—has proved its value in many uncontrolled trials and numerous reports. It seems to improve the work of breathing, sleep architecture, nocturnal and daytime arterial blood gases. The

  15. Stapedectomy - long-term report.

    PubMed

    Shea, J J

    1982-01-01

    The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the case of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response.

  16. Long-term corrosion studies

    SciTech Connect

    Gdowski, G.

    1998-05-29

    The scope of this activity is to assess the long-term corrosion properties of metallic materials under consideration for fabricating waste package containers. Three classes of metals are to be assessed: corrosion resistant, intermediate corrosion resistant, and corrosion allowance. Corrosion properties to be evaluated are general, pitting and crevice corrosion, stress-corrosion cracking, and galvanic corrosion. The performance of these materials will be investigated under conditions that are considered relevant to the potential emplacement site. Testing in four aqueous solutions, and vapor phases above them, and at two temperatures are planned for this activity. (The environmental conditions, test metals, and matrix are described in detail in Section 3.0.) The purpose and objective of this activity is to obtain the kinetic and mechanistic information on degradation of metallic alloys currently being considered for waste package containers. This information will be used to provide assistance to (1) waste package design (metal barrier selection) (E-20-90 to E-20-92), (2) waste package performance assessment activities (SIP-PA-2), (3) model development (E-20-75 to E-20-89). and (4) repository license application.

  17. Long-Term Planning in Higher Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This report presents the concepts and issues discussed at a Regional Symposium on Long-term Planning in Higher Education held in Dhaka, Bangladesh, September 21-30, 1986. Chapter 1 explores some fundamental issues about the rationale for the objectives of long-term planning. It defines long-term planning in higher education, considers its…

  18. Long Term TOA - M Data and Information

    Atmospheric Science Data Center

    2015-06-30

    A Long-Term TOA and Constrained Surface Radiation Budget Project A Long-Term TOA and Constrained Surface Readiation Budget Dataset Using Merged CERES, ... and apply the knowledge to existing data to develop long-term (nearly 30 years) consistent and calibrated data product (TOA irradiances ...

  19. Fast and long term lipid droplet tracking with CARS microscopy.

    PubMed

    Jüngst, Christian; Winterhalder, Martin J; Zumbusch, Andreas

    2011-06-01

    Photobleaching of organic fluorophores commonly used in fluorescence microscopy puts a limit to the number of images which can be acquired. Label-free imaging techniques therefore offer advantages both for rapid image acquisition and for long-term observations. CARS microscopy is a label-free imaging technique offering molecule specific contrast. Here we demonstrate that CARS microscopy allows video-rate tracking of intracellular transport of lipid droplets, but also continuous long-term observation of cells over several hours.

  20. Clinical review: Long-term noninvasive ventilation

    PubMed Central

    Robert, Dominique; Argaud, Laurent

    2007-01-01

    Noninvasive positive ventilation has undergone a remarkable evolution over the past decades and is assuming an important role in the management of both acute and chronic respiratory failure. Long-term ventilatory support should be considered a standard of care to treat selected patients following an intensive care unit (ICU) stay. In this setting, appropriate use of noninvasive ventilation can be expected to improve patient outcomes, reduce ICU admission, enhance patient comfort, and increase the efficiency of health care resource utilization. Current literature indicates that noninvasive ventilation improves and stabilizes the clinical course of many patients with chronic ventilatory failure. Noninvasive ventilation also permits long-term mechanical ventilation to be an acceptable option for patients who otherwise would not have been treated if tracheostomy were the only alternative. Nevertheless, these results appear to be better in patients with neuromuscular/-parietal disorders than in chronic obstructive pulmonary disease. This clinical review will address the use of noninvasive ventilation (not including continuous positive airway pressure) mainly in diseases responsible for chronic hypoventilation (that is, restrictive disorders, including neuromuscular disease and lung disease) and incidentally in others such as obstructive sleep apnea or problems of central drive. PMID:17419882

  1. Long-term Caspian Sea level change

    NASA Astrophysics Data System (ADS)

    Chen, J. L.; Pekker, T.; Wilson, C. R.; Tapley, B. D.; Kostianoy, A. G.; Cretaux, J.-F.; Safarov, E. S.

    2017-07-01

    Caspian Sea level (CSL) has undergone substantial fluctuations during the past several hundred years. The causes over the entire historical period are uncertain, but we investigate here large changes seen in the past several decades. We use climate model-predicted precipitation (P), evaporation (E), and observed river runoff (R) to reconstruct long-term CSL changes for 1979-2015 and show that PER (P-E + R) flux predictions agree very well with observed CSL changes. The observed rapid CSL increase (about 12.74 cm/yr) and significant drop ( -6.72 cm/yr) during the periods 1979-1995 and 1996-2015 are well accounted for by integrated PER flux predictions of +12.38 and -6.79 cm/yr, respectively. We show that increased evaporation rates over the Caspian Sea play a dominant role in reversing the increasing trend in CSL during the past 37 years. The current long-term decline in CSL is expected to continue into the foreseeable future, under global warming scenarios.

  2. Long-term phenotypic evolution of bacteria.

    PubMed

    Plata, Germán; Henry, Christopher S; Vitkup, Dennis

    2015-01-15

    For many decades comparative analyses of protein sequences and structures have been used to investigate fundamental principles of molecular evolution. In contrast, relatively little is known about the long-term evolution of species' phenotypic and genetic properties. This represents an important gap in our understanding of evolution, as exactly these proprieties play key roles in natural selection and adaptation to diverse environments. Here we perform a comparative analysis of bacterial growth and gene deletion phenotypes using hundreds of genome-scale metabolic models. Overall, bacterial phenotypic evolution can be described by a two-stage process with a rapid initial phenotypic diversification followed by a slow long-term exponential divergence. The observed average divergence trend, with approximately similar fractions of phenotypic properties changing per unit time, continues for billions of years. We experimentally confirm the predicted divergence trend using the phenotypic profiles of 40 diverse bacterial species across more than 60 growth conditions. Our analysis suggests that, at long evolutionary distances, gene essentiality is significantly more conserved than the ability to utilize different nutrients, while synthetic lethality is significantly less conserved. We also find that although a rapid phenotypic evolution is sometimes observed within the same species, a transition from high to low phenotypic similarity occurs primarily at the genus level.

  3. Improving quality of care and long-term health outcomes through continuity of care with the use of an electronic or paper patient-held portable health file (COMMUNICATE): study protocol for a randomized controlled trial.

    PubMed

    Lassere, Marissa Nichole; Baker, Sue; Parle, Andrew; Sara, Anthony; Johnson, Kent Robert

    2015-06-04

    The advantages of patient-held portable health files (PHF) and personal health records (PHR), paper or electronic, are said to include improved health-care provider continuity-of-care and patient empowerment in maintaining health. Top-down approaches are favored by public sector government and health managers. Bottom-up approaches include systems developed directly by health-care providers, consumers and industry, implemented locally on devices carried by patient-consumers or shared via web-based portals. These allow individuals to access, manage and share their health information, and that of others for whom they are authorized, in a private, secure and confidential environment. Few medical record technologies have been evaluated in randomized trials to determine whether there are important clinical benefits of these interventions. The COMMUNICATE trial will assess the acceptability and long-term clinical outcomes of an electronic and paper patient-held PHF. This is a 48-month, open-label pragmatic, superiority, parallel-group design randomized controlled trial. Subjects (n = 792) will be randomized in a 1:1:1 ratio to each of the trial arms: the electronic PHF added to usual care, the paper PHF added to usual care and usual care alone (no PHF). Inclusion criteria include those 60 years or older living independently in the community, but who have two or more chronic medical conditions that require prescription medication and regular care by at least three medical practitioners (general and specialist care). The primary objective is whether use of a PHF compared to usual care reduces a combined endpoint of deaths, overnight hospitalizations and blindly adjudicated serious out-of-hospital events. All primary analyses will be undertaken masked to randomized arm allocation using intention-to-treat principles. Secondary outcomes include quality of life and health literacy improvements. Lack of blinding creates potential for bias in trial conduct and ascertainment of

  4. Long-Term Stewardship Baseline Report and Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  5. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial

    PubMed Central

    Davies, Christina; Pan, Hongchao; Godwin, Jon; Gray, Richard; Arriagada, Rodrigo; Raina, Vinod; Abraham, Mirta; Alencar, Victor Hugo Medeiros; Badran, Atef; Bonfill, Xavier; Bradbury, Joan; Clarke, Michael; Collins, Rory; Davis, Susan R; Delmestri, Antonella; Forbes, John F; Haddad, Peiman; Hou, Ming-Feng; Inbar, Moshe; Khaled, Hussein; Kielanowska, Joanna; Kwan, Wing-Hong; Mathew, Beela S; Müller, Bettina; Nicolucci, Antonio; Peralta, Octavio; Pernas, Fany; Petruzelka, Lubos; Pienkowski, Tadeusz; Rajan, Balakrishnan; Rubach, Maryna T; Tort, Sera; Urrútia, Gerard; Valentini, Miriam; Wang, Yaochen; Peto, Richard

    2013-01-01

    Summary Background For women with oestrogen receptor (ER)-positive early breast cancer, treatment with tamoxifen for 5 years substantially reduces the breast cancer mortality rate throughout the first 15 years after diagnosis. We aimed to assess the further effects of continuing tamoxifen to 10 years instead of stopping at 5 years. Methods In the worldwide Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial, 12 894 women with early breast cancer who had completed 5 years of treatment with tamoxifen were randomly allocated to continue tamoxifen to 10 years or stop at 5 years (open control). Allocation (1:1) was by central computer, using minimisation. After entry (between 1996 and 2005), yearly follow-up forms recorded any recurrence, second cancer, hospital admission, or death. We report effects on breast cancer outcomes among the 6846 women with ER-positive disease, and side-effects among all women (with positive, negative, or unknown ER status). Long-term follow-up still continues. This study is registered, number ISRCTN19652633. Findings Among women with ER-positive disease, allocation to continue tamoxifen reduced the risk of breast cancer recurrence (617 recurrences in 3428 women allocated to continue vs 711 in 3418 controls, p=0·002), reduced breast cancer mortality (331 deaths vs 397 deaths, p=0·01), and reduced overall mortality (639 deaths vs 722 deaths, p=0·01). The reductions in adverse breast cancer outcomes appeared to be less extreme before than after year 10 (recurrence rate ratio [RR] 0·90 [95% CI 0·79–1·02] during years 5–9 and 0·75 [0·62–0·90] in later years; breast cancer mortality RR 0·97 [0·79–1·18] during years 5–9 and 0·71 [0·58–0·88] in later years). The cumulative risk of recurrence during years 5–14 was 21·4% for women allocated to continue versus 25·1% for controls; breast cancer mortality during years 5–14 was 12·2% for women allocated to continue versus 15·0% for controls (absolute mortality

  6. Equity of access under Korean national long-term care insurance: implications for long-term care reform.

    PubMed

    Park, Ju Moon

    2015-09-15

    The national long-term care insurance was implemented in July 2008. Few studies have been conducted with representative national survey data since the long-term care insurance was introduced. Therefore, this study examines the extent to which equity in the use of long-term care has been achieved in Korea. The Aday-Andersen model was used as a conceptual model, based on the Korean Health Panel Study which was conducted in 2011. Descriptive and logistic regression analysis was performed to examine the relationship between the dependent and independent variables and the relative importance of factors as predictors of utilization. The results of this study indicated that those who rated his or her health to be fair, good, and very good, had no limited activities, were disabled, and had insurance coverage were more likely to use long-term care services, respectively. Their decision to use long-term care was primarily affected by need (health status, limited activity, disability) and enabling (insurance coverage) factors. The findings also indicated that the introduction of a national long-term care insurance program did not yield a fully equitable distribution of services. Long-term care reforms in Korea should continue to concentrate on expanding insurance coverage and reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans. The subsequent impact on managed care and expenditures need to be more fully understood.

  7. Long term cryogenic storage facility systems study

    NASA Technical Reports Server (NTRS)

    Schuster, John R.

    1987-01-01

    The Long Term Cryogenic Storage Facility Systems Study (LTCSFSS) is a Phase A study of a large capacity propellant depot for the space based, cryogenic orbital transfer vehicle. The study is being performed for Marshall Space Flight Center by General Dynamics Space Systems Division and has five principal objectives: (1) Definition of preliminary concept designs for four storage facility concepts; (2) Selection of preferred concepts through the application of trade studies to candidate propellant management system components; (3) Preparation of a conceptual design for an orbital storage facility; (4) Development of supporting research and technology requirements; and (5) Development of a test program to demonstrate facility performance. The initial study has been completed, and continuation activities are just getting under way to provide greater detail in key areas and accommodate changes in study guidelines and assumptions.

  8. Long term performance of radon mitigation systems

    SciTech Connect

    Prill, R.; Fisk, W.J.

    2002-03-01

    Researchers installed radon mitigation systems in 12 houses in Spokane, Washington and Coeur d'Alene, Idaho during the heating season 1985--1986 and continued to monitor indoor radon quarterly and annually for ten years. The mitigation systems included active sub-slab ventilation, basement over-pressurization, and crawlspace isolation and ventilation. The occupants reported various operational problems with these early mitigation systems. The long-term radon measurements were essential to track the effectiveness of the mitigation systems over time. All 12 homes were visited during the second year of the study, while a second set 5 homes was visited during the fifth year to determine the cause(s) of increased radon in the homes. During these visits, the mitigation systems were inspected and measurements of system performance were made. Maintenance and modifications were performed to improve system performance in these homes.

  9. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary...

  10. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary...

  11. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary...

  12. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary...

  13. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary...

  14. Long-term solar-terrestrial observations

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

  15. Finance issue brief: long-term care insurance: year end report-2003.

    PubMed

    Tanner, Rachel C

    2003-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  16. Managing soils for long-term productivity

    PubMed Central

    Syers, J. K.

    1997-01-01

    Meeting the goal of long-term agricultural productivity requires that soil degradation be halted and reversed. Soil fertility decline is a key factor in soil degradation and is probably the major cause of declining crop yields. There is evidence that the contribution of declining soil fertility to soil degradation has been underestimated.
    Sensitivity to soil degradation is implicit in the assessment of the sustainability of land management practices, with wide recognition of the fact that soils vary in their ability to resist change and recover subsequent to stress. The concept of resilience in relation to sustainability requires further elaboration and evaluation.
    In the context of soil degradation, a decline in soil fertility is primarily interpreted as the depletion of organic matter and plant nutrients. Despite a higher turnover rate of organic matter in the tropics there is no intrinsic difference between the organic matter content of soils from tropical and temperate regions. The level of organic matter in a soil is closely related to the above and below ground inputs. In the absence of adequate organic material inputs and where cultivation is continuous, soil organic matter declines progressively. Maintaining the quantity and quality of soil organic matter should be a guiding principle in developing management practices.
    Soil microbial biomass serves as an important reservoir of nitrogen (N), phosphorus (P) and sulphur (S), and regulates the cycling of organic matter and nutrients. Because of its high turnover rate, microbial biomass reacts quickly to changes in management and is a sensitive indicator for monitoring and predicting changes in soil organic matter. Modelling techniques have been reasonably successful in predicting changes in soil organic matter with different organic material inputs, but there is little information from the tropics.
    Nutrient depletion through harvested crop components and residue removal, and by leaching and soil

  17. [Perspectives in long-term care insurance].

    PubMed

    Pick, P

    2007-03-01

    Twelve years after its introduction, long-term care insurance is back on the agenda and up for political reform. This paper shows why long-term care insurance needs to be reformed. The two central aspects on which reform projects focus are addressed: firstly, the structural improvement of nursing care and long-term care insurance and, secondly, the creation of a sustained financing. The principal conclusion is that, while there is a broad consensus about the structural improvement of long-term care insurance, opinions differ widely in the matter of its sustained financing. As a consequence, a coherent financing concept has yet to emerge.

  18. Managing Records for the Long Term - 12363

    SciTech Connect

    Montgomery, John V.; Gueretta, Jeanie

    2012-07-01

    The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship and long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the Office of Legacy

  19. Virtual Models of Long-Term Care

    ERIC Educational Resources Information Center

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  20. Virtual Models of Long-Term Care

    ERIC Educational Resources Information Center

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  1. Long Term Preservation of Digital Information.

    ERIC Educational Resources Information Center

    Lorie, Raymond A.

    The preservation of digital data for the long term presents a variety of challenges from technical to social and organizational. The technical challenge is to ensure that the information, generated today, can survive long term changes in storage media, devices, and data formats. This paper presents a novel approach to the problem. It distinguishes…

  2. Long-Term Nutrition: A Clinician's Guide to Successful Long-Term Enteral Access in Adults.

    PubMed

    Bechtold, Matthew L; Mir, Fazia A; Boumitri, Christine; Palmer, Lena B; Evans, David C; Kiraly, Laszlo N; Nguyen, Douglas L

    2016-09-22

    Long-term nutrition support requires long-term enteral access. To ensure the success of long-term enteral access, many factors need to be taken into consideration. This article represents a guide to placing and maintaining access in patients requiring long-term nutrition and addresses many of the common questions regarding long-term enteral access, such as indications, types of access, feeding after access placed, and recognition and treatment of potential complications. This guide will help the clinician establish and maintain access to maximize nutrition in patients requiring long-term nutrition.

  3. Paying for long-term care.

    PubMed Central

    Estes, C L; Bodenheimer, T

    1994-01-01

    Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage. PMID:8128712

  4. Long-term treatment of major depressive disorder with paroxetine.

    PubMed

    Duboff, E A

    1993-12-01

    Recurrent unipolar depression is a common, but undertreated disorder. Many patients require long-term maintenance therapy, and full doses of antidepressant agents may be preferred for the prevention of relapse. We report results of a 1-year, multicenter, open-label study of paroxetine (10 to 50 mg/day) in 433 patients with major depressive disorder, with additional data from 110 patients who entered a long-term extension of the study. The primary measures of efficacy were the Hamilton Rating Scale for Depression (HAM-D) total and Clinical Global Impression (CGI) severity of illness scores. During the first 6 weeks of therapy, the mean HAM-D total declined approximately 50% (from 27.9 to 13.5), with continued improvement, at an attenuated rate, throughout the first year. At the end of 1 year, the mean HAM-D total was 6.9. Similarly, the CGI severity of illness score declined from 4.6 at baseline to 2.8 at week 6 and to 1.7 at the end of 1 year. Remission was maintained in the population that entered the long-term extension, with mean HAM-D total and CGI severity of illness scores of 6.4 and 1.8, respectively, after 2.5 years, and 4.2 and 1.3 after 4 years. The most common adverse events reported during long-term treatment with paroxetine were somnolence, nausea, headache, and sweating. Pharmacokinetic analysis showed no clear correlation between the concentrations of paroxetine in plasma and either clinical efficacy or tolerability. There was no increased drug accumulation during long-term treatment. Side effects tended to occur early during therapy; and no new side effects emerged during the long-term extension. These results suggest that paroxetine is effective and well tolerated in the long-term treatment of depression.

  5. Hospital diversification into long-term care.

    PubMed

    Shah, A; Fennell, M; Mor, V

    2001-01-01

    In the 1990s, acute care hospitals in the United States encountered an unstable operating environment created by a series of transformations in the health care delivery system and long-term-care market. Confronted with an array of economic pressures and demographic changes, hospitals were motivated to engage in long-term-care diversification, such as establishing a long-term-care unit or providing home health services, as a means of entering new markets and ensuring financial stability. This article examines the organizational, market, and community factors associated with this strategic activity among a national sample of urban and rural hospitals.

  6. Long-term stability test of a triple GEM detector

    NASA Astrophysics Data System (ADS)

    Adak, R. P.; Biswas, S.; Das, S.; Ghosal, D.; Ghosh, S. K.; Mondal, A.; Nag, D.; Nayak, T. K.; Patra, R. N.; Prasad, S. K.; Raha, S.; Sahu, P. K.; Sahu, S.; Swain, S.

    2016-10-01

    The main aim of the study is to perform the long-term stability test of gain of the single mask triple GEM detector. A simple method is used for this long-term stability test using a radioactive X-ray source with high activity. The test is continued till accumulation of charge per unit area > 12.0 mC/mm2. The details of the chamber fabrication, the test set-up, the method of measurement and the test results are presented in this paper.

  7. Long-term treatment outcome in acromegaly.

    PubMed

    Holdaway, I M; Rajasoorya, C R; Gamble, G D; Stewart, A W

    2003-08-01

    A number of groups have developed guidelines to indicate whether an individual with acromegaly has been cured by treatment. However, studies to date do not provide a robust definition of biochemical remission of the disorder based on correlation with long-term outcome. Available data suggest that those with a random serum growth hormone (GH) level of <2.5 microg/l, or a glucose-suppressed GH level of <1 microg/l following treatment have mortality figures indistinguishable from the general population. However, the confidence limits for these mortality estimates are quite wide. It remains possible that growth hormone levels lower than 1 microg/l for random samples, or even lower when using ultrasensitive GH assays, may indicate superior outcome, but this remains to be confirmed. There are limited data relating serum insulin-like growth factor-I (IGF-I) levels to outcome, although normalisation of serum IGF-I clearly improves outcome compared with continued elevation of measurements after treatment. Current evidence suggests that a post-treatment random serum GH <2.5 microg/l and a normal serum IGF-I value defines biochemical cure. Available data suggest that achieving similar growth hormone levels after treatment also reduces the prevalence of chronic complications of the disorder, which is subsequently reflected in improved mortality.

  8. Long-term in vivo pineal microdialysis.

    PubMed

    Sun, Xing; Liu, Tiecheng; Deng, Jie; Borjigin, Jimo

    2003-09-01

    This study describes the development of a new technique for long-term measurement of daily 5-hydroxytryptamine (5-HT) and melatonin contents in the pineal gland of freely moving rats. The technique features a number of novel improvements over previous protocols. It allows visualization of the pineal gland for accurate targeting of the guide cannula, which minimizes bleeding; incurs no direct injury to the surrounding brain tissues; and causes no interference with the sympathetic innervation from the superior cervical ganglia. Robust releases of melatonin and indole precursors were continuously monitored quantitatively and reproducibly for more than 2 wk in the same animal. In addition, effects of pharmacological agents on in vivo pineal circadian rhythms can be studied reproducibly over time, and gene expression profiles can be correlated with physiological consequences in single animals. Using these approaches, it is found that beta-adrenergic activation leads to decreased release of 5-HT, and that increased cAMP signaling in vivo results in activation of N-acetyltransferase gene induction and melatonin production. These studies will enhance the understanding of signaling pathways that regulate pineal 5-HT and melatonin synthesis and secretion.

  9. Long Term Effects of Food Poisoning

    MedlinePlus

    ... develop chronic arthritis. Brain and nerve damage A Listeria infection can lead to meningitis, an inflammation of ... brain. If a newborn infant is infected with Listeria , long-term consequences may include mental retardation, seizures, ...

  10. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  11. Roadmap to Long-Term Monitoring Optimization

    EPA Pesticide Factsheets

    This roadmap focuses on optimization of established long-term monitoring programs for groundwater. Tools and techniques discussed concentrate on methods for optimizing the monitoring frequency and spatial (three-dimensional) distribution of wells ...

  12. Long-term-care legal update.

    PubMed

    Fiesta, J

    1998-04-01

    As more nurses move from the acute care setting to long-term-care and home health care, different practice issues arise. To maximize liability protection, nurses must understand the legal issues unique to each delivery system.

  13. Long Term Outcomes after Pediatric Liver Transplantation

    PubMed Central

    2013-01-01

    Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers addressing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life productivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle. PMID:24511516

  14. [Psoriasis arthritis--long-term treatment of two patients with leflunomide].

    PubMed

    Schmitt, Jochen; Wozel, Gottfried

    2004-09-01

    The prodrug leflunomide is an immunomodulatory agent whose M1 metabolite inhibits the proliferation of T- and B-lymphocytes. The efficacy of leflunomide in rheumatoid arthritis suggests it may be useful psoriasis arthritis. Two patients with psoriasis arthritis in whom NSAIDs, glucocorticosteroids, sulfasalazine, cyclosporine and methotrexate were not as effective as expected were treated with leflunomide for 18 and 27 months. At regular visits examination of the joints (according to the ACR criteria) and the skin (PASI), the visual analogue scale for pain, and the quality of life (HAQ) were assessed. In both patients progression of the joint disease was arrested, pain reduced and quality of life improved. The cutaneous findings did not change, even though topical therapy was continued. Leflunomide is a long-term treatment option for patients with predominantly joint disease. In case of insufficient response, combination with other anti-inflammatory drugs, e.g. methotrexate, is possible. As leflunomide has little effect on psoriatic skin lesions, additional topical therapy is necessary.

  15. Immunomodulatory treatment for dermatomyositis.

    PubMed

    Callen, Jeffrey P

    2008-07-01

    Dermatomyositis and polymyositis are classified as members of idiopathic inflammatory myopathies. It has recently become evident that the pathogenesis of the muscle disease for these two entities is likely not the same. Despite this observation, therapies directed at the muscle disease are similar, although therapy for the skin differs slightly. Corticosteroids remain the initial approach to management. The systemic dose of corticosteroids needed to control the disease, particularly the skin disease, is quite high; therefore, most authorities add a corticosteroid-sparing agent early. Some patients will naturally "burn out" the inflammatory component of their disease, but many have continuing disease activity that requires maintenance therapy. In this article, we briefly define the disease state of dermatomyositis, discuss the associated systemic manifestations, and update the selection and evaluation of immunomodulatory, corticosteroid-sparing agents.

  16. Corn and soybean grain yields in a long-term tillage and cropping systems study

    USDA-ARS?s Scientific Manuscript database

    Reports on the long-term effects of tillage and cropping systems on corn and soybean yields are limited. Yields have been measured in a long-term experiment (30+ years) with three cropping systems [continuous corn (CC), continuous soybean (CSB), and soybean-corn (SB-C)] in six primary tillage system...

  17. Long-term symptom relief after septoplasty.

    PubMed

    Sundh, Carolina; Sunnergren, Ola

    2015-10-01

    The results for long-term symptom relief after septoplasty are contradictory in reviewed publications but the findings suggest that results are unsatisfactory. In this study, we analyzed and compared short- and long-term symptom relief after septoplasty and factors possibly associated with symptom relief. 111 patients that underwent septoplasty between 2008 and 2010 were included in the study. Medical charts were reviewed for preoperative characteristics and assessments. Data on short-term symptom relief (6 months) were retrieved from the Swedish National Quality Registry for Septoplasty; data on long-term symptom relief (34-70 months) were collected through a questionnaire. Upon the 34-70 month follow-up, 53% of the patients reported that symptoms either remained or had worsened and 83% reported nasal obstruction. Degree of symptom relief was significantly higher among patients not reporting nasal obstruction than among patients reporting nasal obstruction at long-term follow-up. The proportion of patients that reported "my symptoms are gone" declined from 53% after 6 months to 18% after 34-70 months. None of the factors taken into consideration, age at surgery, gender, follow-up time, primary operation/reoperation, history of nasal trauma, self-reported allergy, rhinometric obstruction, or same sided rhinometric, clinical and subjective nasal obstruction were associated with symptom relief. The long-term results after septoplasty are unsatisfactory. A majority of patients report that their symptoms remain after septoplasty.

  18. Long-term outcomes of autoimmune pancreatitis

    PubMed Central

    Ikeura, Tsukasa; Miyoshi, Hideaki; Shimatani, Masaaki; Uchida, Kazushige; Takaoka, Makoto; Okazaki, Kazuichi

    2016-01-01

    Autoimmune pancreatitis (AIP) has been considered a favorable-prognosis disease; however, currently, there is limited information on natural course of AIP during long-term follow-up. Recently published studies regarding the long-term outcomes of AIP has demonstrated the developments of pancreatic stone formation, exocrine insufficiency, and endocrine insufficiency are observed in 5%-41%, 34%-82%, and 38%-57% of patients having the disease. Furthermore, the incidence rate of developing pancreatic cancer ranges from 0% to 4.8% during the long-term follow-up. The event of death from AIP-related complications other than accompanying cancer is likely to be rare. During follow-up of AIP patients, careful surveillance for not only relapse of the disease but also development of complications at regular intervals is needed. PMID:27678359

  19. Valuing a long-term care facility.

    PubMed

    Mellen, C M

    1992-10-01

    The business valuation industry generally uses at least one of three basic approaches to value a long-term care facility: the cost approach, sales comparison approach, or income approach. The approach that is chosen and the resulting weight that is applied to it depend largely on the circumstances involved. Because a long-term care facility is a business enterprise, more weight usually is given to the income approach which factors into the estimate of value both the tangible and intangible assets of the facility.

  20. Keratoprosthesis: a long-term review.

    PubMed Central

    Barnham, J. J.; Roper-Hall, M. J.

    1983-01-01

    A keratoprosthesis (KP), is an artificial cornea which is inserted into an opacified cornea in an attempt to restore useful vision or, less commonly, to make the eye comfortable in painful keratopathy. Results o a retrospective study of 35 patients, with 55 KP insertions, are reviewed with regard to visual acuity, length of time vision is maintained, retention time, and complication. Overall there were a number of long-term real successes, eith retention of the KP and maintenance of improved vision in eyes not amenable to conventional treatment. Careful long-term follow-up was needed, with further surgical procedures often being necessary. Images PMID:6860613

  1. Long-term Outcomes after Severe Shock

    PubMed Central

    Pratt, Cristina M.; Hirshberg, Eliotte L.; Jones, Jason P.; Kuttler, Kathryn G.; Lanspa, Michael J.; Wilson, Emily L.; Hopkins, Ramona O.; Brown, Samuel M.

    2014-01-01

    Background Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Methods Seventy-six patients who were alive 90 days after severe shock (received ≥1 mcg/kg/min of norepinephrine equivalent) were eligible for the study. We measured three-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. Results The mean long-term survival was 5.1 years: 82% (62/76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of five years after hospital admission. The patients’ Physical Functioning scores were below US population norms (p<0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full time. Conclusions Early survivors of severe shock had a high three-year survival rate. Patients’ long term physical and psychological outcomes were similar to those reported for cohorts of less severely ill ICU survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term

  2. [Fetal pain: immediate and long term consequences].

    PubMed

    Houfflin Debarge, Véronique; Dutriez, Isabelle; Pusniak, Benoit; Delarue, Eléonore; Storme, Laurent

    2010-06-01

    Several situations are potentially painful for fetuses, such as malformations and invasive procedures. Nociceptive pathways are known to be functional at 26 weeks. Even if it is not possible to evaluate the fetal experience of pain, it is essential to examine its immediate and long-term consequences. As early as the beginning of the second trimester, hemodynamic and hormonal responses are observed following fetal nociceptive stimulation, In experimental studies, long-term changes have been noted in the corticotrop axis, subsequent responses to pain, and behavior after perinatal nociceptive stimulation.

  3. Long-term outcomes after severe shock.

    PubMed

    Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

    2015-02-01

    Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P < 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely

  4. Long-term prognosis of depression in primary care.

    PubMed Central

    Simon, G. E.

    2000-01-01

    This article uses longitudinal data from a primary care sample to examine long-term prognosis of depression. A sample of 225 patients initiating antidepressant treatment in primary care completed assessments of clinical outcome (Hamilton Depression Rating Scale and the mood module of the Structured Clinical Interview for DSM-IIIR) 1, 3, 6, 9, 12, 18 and 24 months after initiating treatment. The proportion of patients continuing to meet criteria for major depression fell rapidly to approximately 10% and remained at approximately that level throughout follow-up. The proportion meeting criteria for remission (Hamilton Depression score of 7 or less) rose gradually to approximately 45%. Long-term prognosis (i.e. probability of remission at 6 months and beyond) was strongly related to remission status at 3 months (odds ratio 3.65; 95% confidence interval, 2.81-4.76) and only modestly related to various clinical characteristics assessed at baseline (e.g. prior history of recurrent depression, medical comorbidity, comorbid anxiety symptoms). The findings indicate that potentially modifiable risk factors influence the long-term prognosis of depression. This suggests that more systematic and effective depression treatment programmes might have an important effect on long-term course and reduce the overall burden of chronic and recurrent depression. PMID:10885162

  5. Long-term results after robotically assisted coronary bypass surgery

    PubMed Central

    Ramahi, Jehad; Hasan, Faisal; Edris, Ahmad; Bartel, Thomas; Nair, Ravi; Tuzcu, Murat; Suri, Rakesh; Mihaljevic, Tomislav

    2016-01-01

    Background Robotically-assisted coronary bypass grafting (CABG) was introduced in 1998 and dedicated centers have continuously applied and developed this minimally invasive method of coronary bypass surgery. While short-term results are relatively well published, data on long-term outcome are limited. In this literature review, we assessed the outcomes after robotic CABG following the first postoperative year. Methods We searched PubMed for articles containing the terms “robotic” or “robotically assisted” and “coronary bypass”. A total of 11 papers contained long-term results. We specifically investigated survival, graft patency, freedom from angina and re-intervention, as well as freedom from major adverse cardiac and cerebrovascular events (MACCE). Results Five-year survival after robotic CABG was consistently consistently greater than 90% and graft patency between 3 and 5 years was reported to be above 90%. Fifteen percent to 26% of patients re-experienced angina at 3 to 5 years postoperatively. Long-term freedom from re-intervention reached the range and the 5-year freedom from MACCE rate was approximately 75%. Conclusions According to data in the literature, long-term results after CABG carried out with the assistance of a surgical robot appear to be in line with results achieved after conventional CABG. PMID:27942487

  6. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  7. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  8. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  9. Long-Term Impacts of Educational Interventions

    ERIC Educational Resources Information Center

    Deming, David James

    2010-01-01

    The school accountability movement has led to a marked increase in the use of standardized test scores to measure school and teacher productivity, yet little is known about the correlation between test score gains and improvements in long-term outcomes. In the first chapter of my dissertation, I study the impact of a school choice policy in…

  10. Long-term studies of dopamine agonists.

    PubMed

    Hubble, Jean P

    2002-02-26

    Dopamine agonists have long been used as adjunctive therapy for the treatment of Parkinson's disease (PD). In more recent years these drugs have also been proved safe and effective as initial therapy in lieu of levodopa in the treatment of PD. Long-term levodopa therapy is associated with motor complications, including fluctuating response patterns and dyskinesia. By initially introducing a dopamine agonist as symptomatic drug therapy, it may be possible to postpone the use of levodopa and delay or prevent the development of motor complications. Recently, four clinical trials have explored this hypothesis by comparing the long-term response and side effects of levodopa with dopamine agonist therapy. The drugs studied have included ropinirole, pramipexole, cabergoline, and pergolide. In each of these projects, the occurrence of motor complications, such as wearing off and dyskinesia, was significantly less in the subjects assigned to initiation of therapy with a dopamine agonist. The addition of levodopa could be postponed by many months or even several years. Therefore, these long-term studies of dopamine agonists support the initiation of a dopamine agonist instead of levodopa in an effort to postpone levodopa-related motor complications. This therapeutic approach may be particularly appropriate in PD patients with a long treatment horizon on the basis of age and general good health. The extension phase of the long-term study comparing pramipexole with levodopa is ongoing, and follow-up information may help to establish the value of this treatment strategy.

  11. Long Term Care Aide. Course Outline.

    ERIC Educational Resources Information Center

    Wilbee, Judy

    This course outline is intended to assist the instructor in the development of a curriculum for a long-term care aide program by specifying one component of the curriculum--the objectives. These objectives, or competencies expected as outcomes for student performance on completion of the program, describe the capabilities an individual must…

  12. Long-term lysimeter data on evapotranspiration

    USDA-ARS?s Scientific Manuscript database

    Long term crop evapotranspiration (ET) data measured using large weighing lysimeters have only been gathered in a few places in the world, yet are of great importance for ground truthing of many models of plant water use, mesoscale climate, remote sensing estimation of ET, climate change and climate...

  13. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  14. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  15. Evaluating Long-Term Disability Insurance Plans.

    ERIC Educational Resources Information Center

    Powell, Jan

    1992-01-01

    This report analyzes the factors involved in reviewing benefits and services of employer-sponsored group long-term disability plans for higher education institutions. Opening sections describe the evolution of disability insurance and its shape today. Further sections looks at the complex nature of "value" within a plan, relationship…

  16. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  17. Long-Term Stability of Tutor Performance.

    ERIC Educational Resources Information Center

    Dolmans, Diana H. J. M.; And Others

    1996-01-01

    Examined the extent to which tutor ratings remained stable in the long term by evaluating 291 ratings of 140 tutors at Maastricht University in the Netherlands between 1992 and 1995. The results indicated that, if the aggregated score and overall judgement are used to interpret the precision of individual scores, four and two occasions,…

  18. Urethroplasty for hypospadias: long-term results.

    PubMed

    Glassman, C N; Machlus, B J; Kelalis, P P

    1980-06-01

    A retrospective study of patients who had undergone multi-staged hypospadias repair at the Mayo Clinic was undertaken to identify long-term problems associated with this surgery. Patients were queried concerning their satisfaction with quality of urinary stream; penile erection and ejaculation; sexual function and fertility; and cosmetic appearance.

  19. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  20. Very Long Term Memory for Tacit Knowledge.

    ERIC Educational Resources Information Center

    Allen, Rhianon; Reber, Arthur S.

    1980-01-01

    Very long-term memory for abstract materials was examined for subjects who had served in a synthetic grammar learning experiment two years earlier. Knowledge of these grammars was retained. The form and structure of knowledge and the manner in which it is put to use remained similar to the original. (Author/RD)

  1. Long-term opioid therapy reconsidered.

    PubMed

    Von Korff, Michael; Kolodny, Andrew; Deyo, Richard A; Chou, Roger

    2011-09-06

    In the past 20 years, primary care physicians have greatly increased prescribing of long-term opioid therapy. However, the rise in opioid prescribing has outpaced the evidence regarding this practice. Increased opioid availability has been accompanied by an epidemic of opioid abuse and overdose. The rate of opioid addiction among patients receiving long-term opioid therapy remains unclear, but research suggests that opioid misuse is not rare. Recent studies report increased risks for serious adverse events, including fractures, cardiovascular events, and bowel obstruction, although further research on medical risks is needed. New data indicate that opioid-related risks may increase with dose. From a societal perspective, higher-dose regimens account for the majority of opioids dispensed, so cautious dosing may reduce both diversion potential and patient risks for adverse effects. Limiting long-term opioid therapy to patients for whom it provides decisive benefits could also reduce risks. Given the warning signs and knowledge gaps, greater caution and selectivity are needed in prescribing long-term opioid therapy. Until stronger evidence becomes available, clinicians should err on the side of caution when considering this treatment.

  2. Long-term fixed income market structure

    NASA Astrophysics Data System (ADS)

    Grilli, Luca

    2004-02-01

    Long-term fixed income market securities present a strong positive correlation in daily returns. By using a metrical approach and considering “modified” time series, I show how it is possible to show a more complex structure which depends strictly on the maturity date.

  3. Long-term function after restorative proctocolectomy.

    PubMed

    Wheeler, J M D; Banerjee, A; Ahuja, N; Jewell, D P; Mortensen, N J McC

    2005-05-01

    Early functional outcome after restorative proctocolectomy and formation of an ileoanal pouch is known to be good, but there are minimal data on the long-term function of the pouch. The aim of this study was to look at the long-term functional outcome in patients who had undergone restorative proctocolectomy and formation of an ileoanal pouch. A total of 151 consecutive patients (96 males, 55 females) who underwent ileoanal pouch surgery between April 1983 and May 1993 were identified. Functional outcomes from the previous 12 months were appraised by a standardized questionnaire. The median age at surgery was 31 years (range, 6-63 years), with a median follow-up of 142 months (range, 100-221 months). Eighteen patients have had their pouches excised, with another patient being defunctioned. Therefore 19 patients (13 percent) had suffered pouch failure. Altogether, 115 patients were available for follow-up, and 98 patients (85 percent) returned questionnaires. The median pouch-emptying frequency was five times (range, 1-17) during the day and one time (range, 0-6) at night. A total of 74 percent of patients had perfect continence during the day. Most of the patients had no life-style restrictions related to the pouch, and 98 percent of patients would recommend a pouch to others. Long-term functional outcome after ileoanal pouch surgery is good in most patients. For patients requiring proctocolectomy, ileoanal pouch surgery can now be recommended as an excellent long-term option.

  4. Long-Term Impacts of Educational Interventions

    ERIC Educational Resources Information Center

    Deming, David James

    2010-01-01

    The school accountability movement has led to a marked increase in the use of standardized test scores to measure school and teacher productivity, yet little is known about the correlation between test score gains and improvements in long-term outcomes. In the first chapter of my dissertation, I study the impact of a school choice policy in…

  5. Long-Term Stability of Tutor Performance.

    ERIC Educational Resources Information Center

    Dolmans, Diana H. J. M.; And Others

    1996-01-01

    Examined the extent to which tutor ratings remained stable in the long term by evaluating 291 ratings of 140 tutors at Maastricht University in the Netherlands between 1992 and 1995. The results indicated that, if the aggregated score and overall judgement are used to interpret the precision of individual scores, four and two occasions,…

  6. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  7. Long-term disability in anxiety disorders.

    PubMed

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H; Beekman, Aartjan T F

    2016-07-19

    This longitudinal study aims to investigate differences in long-term disability between social anxiety disorder (SAD), panic disorder with agoraphobia (PDA), panic disorder without agoraphobia (PD), generalized anxiety disorder (GAD) and multiple anxiety disorders (multiple AD), focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal and avoidance behaviour). Data were used from participants with no psychiatric diagnosis (healthy controls, n = 647) or with a current anxiety disorder (SAD, n = 191; PDA, n = 90; PD, n = 84; GAD, n = 110; multiple AD, n = 480). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. The World Health Organization Disability Assessment Schedule II was used to measure disability. Long-term disability was most prevalent in participants with SAD and multiple AD, and lowest in PDA and PD. GAD had an intermediate position. Anxiety arousal and avoidance behaviour were associated with more long-term disability in anxiety disorders than course trajectories. Various anxiety disorders have different disability levels over 4 years of time, therefore diagnostic distinction is important for treatment focus. Anxiety arousal and avoidance behaviour are major predictors for long-term disability in anxiety disorders.

  8. Long-Term Stability of Social Participation

    ERIC Educational Resources Information Center

    Hyyppa, Markku T.; Maki, Juhani; Alanen, Erkki; Impivaara, Olli; Aromaa, Arpo

    2008-01-01

    The long-term stability of social participation was investigated in a representative urban population of 415 men and 579 women who had taken part in the nationwide Mini-Finland Health Survey in the years 1978-1980 and were re-examined 20 years later. Stability was assessed by means of the following tracking coefficients: kappa, proportion of…

  9. Workshop on long-term contraceptives.

    PubMed

    1996-01-01

    The National Population Council Secretariat (NPCS) of Ghana held a three-day workshop on long-term contraceptives in 1996 in collaboration with the Ministry of Health, the Association of Voluntary Surgical Contraception, and the Johns Hopkins Population Communication Services. The session was funded by USAID. The executive director of NPCS, Dr. Richard Turkson, said that the slow rate of contraceptive acceptance was an obstacle to population control despite political concern that rapid population growth exerted an adverse impact on the economy. Only 10% of married women were using long-term or permanent methods of contraception. The hope was voiced that the participants would devise practical and cost-effective education, information, and communication (IEC) strategies to boost the demand for long-term contraceptive methods among sexually active people in Ghana. It was essential that these strategies and activities were based on a realist assessment of the demographic and social situation of the country. The examination of case studies in cultures similar to Ghana would also offer valuable lessons. The factors that hinder the acceptance of long-term methods include misconceptions, myths, and false rumors rooted in a general lack of knowledge among the people. Participants were urged to come up with strategies to counter these problems, and service providers were encouraged to improve their knowledge about contraceptive methods and counseling skills. Male involvement in contraception was also advocated. Statistics show that most Ghanians practicing contraception were using short-term methods such as foaming tablets, pills, and condoms. However, it is necessary to shift to long-term methods such as injectables, implants, and sterilization in order to achieve significant reductions in fertility.

  10. Long-term biological investigations in space.

    PubMed

    Lotz, R G; Fuchs, H; Bertsche, U

    1975-01-01

    Missions in space within the next two decades will be of longer duration than those carried out up to the present time, and the effects of such long-term flights on biological organisms are unknown. Results of biological experiments that have been performed to date cannot be extrapolated to results in future flights because of the unknown influence of adaptation over a long period of time. Prior experiments with Axolotl, fishes, and vertebrates by our research team (in part with sounding rockets) showed that these specimens did not appear to be suitable for long-term missions on which minimization of expense, technique, and energy is required. Subsequent investigations have shown the suitability of the leech (Hirudo medicinalis), which consumes blood of mammals up to ten times its own weight (1 g) and can live more than 2 years without further food supply. Emphasis in the experiments with Hirudo medicinalis is placed on metabolic rhythm and motility. Resorption and diffusion in tissue, development, and growth under long-term effects of cosmic proton radiation and zero-gravity are other focal points. The constancy of cellular life in the mature animals is a point in favor of these specimens. We have also taken into account the synergistic effects of the space environment on the problems just mentioned. The life-support system constructed for the leech has been tested successfully in four sounding rocket flights and, on that basis, has been prepared for a long-term mission. Long-term investigations out of the terrestrial biosphere will provide us with information concerning the degree of adaptation of certain physiological and biochemical functions and as to what extent biological readjustment or repair processes can occur under the specific stress conditions of space flight.

  11. Long-Term Hearing Results After Ossiculoplasty.

    PubMed

    Cox, Matthew D; Trinidade, Aaron; Russell, James Shep; Dornhoffer, John L

    2017-04-01

    To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. Case series with retrospective chart review. Tertiary care otology practice. Adult and pediatric patients (3-88 years of age). Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9 dB vs. 19.8 dB, respectively; p = 0.544), long-term hearing results (average final PTA-ABG was 19.3 dB vs. 19.4 dB, respectively; p = 0.922), or rate of ABG closure to less than 20 dB (63.1% vs. 58.0%, p = 0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρ = 0.983; p < 0.001; 2-tailed), as well as average long-term PTA-ABG (ρ = 0.950, p < 0.001; 2-tailed). The OOPS index makes it possible to accurately prognosticate hearing outcomes in adult and pediatric patients undergoing ossiculoplasty in both the short term and the long term.

  12. Physiological, Molecular and Genetic Mechanisms of Long-Term Habituation

    SciTech Connect

    Calin-Jageman, Robert J

    2009-09-12

    Work funded on this grant has explored the mechanisms of long-term habituation, a ubiquitous form of learning that plays a key role in basic cognitive functioning. Specifically, behavioral, physiological, and molecular mechanisms of habituation have been explored using a simple model system, the tail-elicited siphon-withdrawal reflex (T-SWR) in the marine mollusk Aplysia californica. Substantial progress has been made on the first and third aims, providing some fundamental insights into the mechanisms by which memories are stored. We have characterized the physiological correlates of short- and long-term habituation. We found that short-term habituation is accompanied by a robust sensory adaptation, whereas long-term habituation is accompanied by alterations in sensory and interneuron synaptic efficacy. Thus, our data indicates memories can be shifted between different sites in a neural network as they are consolidated from short to long term. At the molecular level, we have accomplished microarray analysis comparing gene expression in both habituated and control ganglia. We have identified a network of putatively regulated transcripts that seems particularly targeted towards synaptic changes (e.g. SNAP25, calmodulin) . We are now beginning additional work to confirm regulation of these transcripts and build a more detailed understanding of the cascade of molecular events leading to the permanent storage of long-term memories. On the third aim, we have fostered a nascent neuroscience program via a variety of successful initiatives. We have funded over 11 undergraduate neuroscience scholars, several of whom have been recognized at national and regional levels for their research. We have also conducted a pioneering summer research program for community college students which is helping enhance access of underrepresented groups to life science careers. Despite minimal progress on the second aim, this project has provided a) novel insight into the network mechanisms by

  13. Globalization, women's migration, and the long-term-care workforce.

    PubMed

    Browne, Colette V; Braun, Kathryn L

    2008-02-01

    With the aging of the world's population comes the rising need for qualified direct long-term-care (DLTC) workers (i.e., those who provide personal care to frail and disabled older adults). Developed nations are increasingly turning to immigrant women to fill these needs. In this article, we examine the impact of three global trends-population aging, globalization, and women's migration-on the supply and demand for DLTC workers in the United States. Following an overview of these trends, we identify three areas with embedded social justice issues that are shaping the DLTC workforce in the United States, with a specific focus on immigrant workers in these settings. These include world poverty and economic inequalities, the feminization and colorization of labor (especially in long-term care), and empowerment and women's rights. We conclude with a discussion of the contradictory effects that both population aging and globalization have on immigrant women, source countries, and the long-term-care workforce in the United States. We raise a number of policy, practice, and research implications and questions. For policy makers and long-term-care administrators in receiver nations such as the United States, the meeting of DLTC worker needs with immigrants may result in greater access to needed employees but also in the continued devaluation of eldercare as a profession. Source (supply) nations must balance the real and potential economic benefits of remittances from women who migrate for labor with the negative consequences of disrupting family care traditions and draining the long-term-care workforce of those countries.

  14. Long-term surveillance plan for the Mexican Hat disposal site, Mexican Hat, Utah

    SciTech Connect

    1996-01-01

    This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSPC documents the land ownership interests and details how the long-term care of the disposal site will be accomplished.

  15. Long-term tillage frequency effects on dryland soil physical and hydraulic properties

    USDA-ARS?s Scientific Manuscript database

    Long-term tillage influences physical, chemical, and biological properties of the soil environment and thereby crop production and quality. We evaluated the effect of long-term (> 22 years) tillage frequency [no-till (NT), spring till (ST), and fall and spring till (FST)] under continuous spring whe...

  16. Escambia Experimental Forest: A Living Laboratory for Long Term Longleaf Pine Research

    Treesearch

    Charles K. McMahon

    2000-01-01

    Experimental Forests have been used for many years by research organizations as "living laboratories" where long-term research studies can be conducted. For forestry and related natural resources research, "long term" can often mean decades of continuous study before meaningful results can be obtained. The Escambia Experimental Forest was...

  17. Long-term consequences of foodborne infections.

    PubMed

    Batz, Michael B; Henke, Evan; Kowalcyk, Barbara

    2013-09-01

    Foodborne infections with Campylobacter, E. coli O157:H7, Listeria monocytogenes, Salmonella, Shigella, Toxoplasma gondii, and other pathogens can result in long-term sequelae to numerous organ systems. These include irritable bowel syndrome, inflammatory bowel disease, reactive arthritis, hemolytic uremic syndrome, chronic kidney disease, Guillain-Barré Syndrome, neurological disorders from acquired and congenital listeriosis and toxoplasmosis, and cognitive and developmental deficits due to diarrheal malnutrition or severe acute illness. A full understanding of the long-term sequelae of foodborne infection is important both for individual patient management by clinicians, as well as to inform food safety and public health decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Case presentation: long-term treatment.

    PubMed

    Glucksman, Myron L

    2013-01-01

    The long-term (14 years) psychodynamic psychotherapy and pharmacotherapy of a depressed, suicidal, self-mutilating female patient is described. Her diagnoses included Chronic Posttraumatic Stress Disorder, Borderline Personality Disorder, and Recurrent Major Depression. Treatment was punctuated with repeated hospitalizations for self-mutilation (cutting) and suicidal ideation. A major determinant for her psychopathology was sexual abuse by her father from ages 6 to 14. This resulted in feelings of guilt and rage that she repressed and acted out through self-mutilating and suicidal behavior. A prolonged negative transference gradually became ambivalent, then positive. This was associated with her internalization of the healing qualities of the therapeutic relationship. She also gained insight into the reasons for her need to punish herself. Her initial self-representation as unworthy and bad was transformed into perceiving herself as a worthwhile, loving person. This case illustrates the role of long-term treatment for a complex, life-threatening, psychiatric disorder.

  19. Modeling long-term collider performance

    SciTech Connect

    Ritson, D. Superconducting Super Collider Lab., Dallas, TX )

    1991-07-01

    A model for the SSC arcs is described with multipole lattice field errors agglomerated into 32 lattice points, and with first order lattice errors and modulation provided by discrete transfer elements. Numerical solutions for long term dynamic aperture studies are obtained by multipole kick-drift tracking. The CPU time required to track through one turn is minimal, and comparable to that required to implement a one-turn fifth-order Taylor series map. Comparisons with tracking results using a fine grained representation of the lattice are made, and found to be satisfactory. The effects of tune modulation are studied and can substantially degrade long-term dynamic aperture. The effects of small relativistic momentum corrections, usually neglected for the large momenta at the SSC, are shown to have negligible influence on tracking results. 5 refs., 7 figs.

  20. Natural history of imatinib-naive GISTs: a retrospective analysis of 929 cases with long-term follow-up and development of a survival nomogram based on mitotic index and size as continuous variables.

    PubMed

    Rossi, Sabrina; Miceli, Rosalba; Messerini, Luca; Bearzi, Italo; Mazzoleni, Guido; Capella, Carlo; Arrigoni, Gianluigi; Sonzogni, Aurelio; Sidoni, Angelo; Toffolatti, Luisa; Laurino, Licia; Mariani, Luigi; Vinaccia, Vincenza; Gnocchi, Chiara; Gronchi, Alessandro; Casali, Paolo G; Dei Tos, Angelo P

    2011-11-01

    Gastrointestinal stromal tumor (GIST) natural history per se has not been extensively investigated yet, with most data being drawn from large studies with a relevant referral bias. Hence, the estimation of prognosis still remains a critical issue. We retrospectively evaluated 929 GISTs resected between 1980 and 2000 in 35 Italian institutions. A total of 526 patients were found to be suitable for refining risk assessment through the development of a survival nomogram. Median follow-up was 126 months. On testing for potential prognostic parameters, age, tumor site, size, and mitotic index proved to be predictors of OS on both univariable and multivariable Cox model analyses, whereas necrosis and cytonuclear atypia were significant on univariable analysis only. The discriminative ability of the model, including the parameters selected after a backward procedure (C=0.72), improved compared with the National Institutes of Health 2002 (C=0.64) and the National Comprehensive Cancer Network 2007 (C=0.63). On the basis of these data we developed a prognostic nomogram for survival that considers site, size, and mitotic index as continuous variables, providing estimates stratified for patients aged ≤65 and >65 years. This nomogram is a tool based on survival. It overcomes problems that result from artificial categorization of continuous variables. We believe that in the future this should also be attempted by nomograms based on the risk of relapse.

  1. [Ambulatory long-term EEG monitors].

    PubMed

    John, K; Komärek, V; Lehovský, M

    1990-06-01

    Ambulatory EEG monitoring is indicated in patients with attacks of uncertain origin. The method is useful to distinguish non-epileptic and epileptic attacks and to differentiate the kind of epileptic seizures which is important for the choice of antiepileptic drugs and for prognosis. It is necessary to describe in detail behaviour and seizures of patient during monitoring. EEG long term monitoring is only useful if attacks were seen frequently, at least once or twice a week.

  2. LOP - Long-Term Orbit Predictor

    NASA Technical Reports Server (NTRS)

    Kwok, Johnny H.

    1992-01-01

    Long-Term Orbit Preditor (LOP) trajectory-propagation computer program is useful tool in analysis of lifetime of orbiting spacecraft. Suitable for studying planetary-orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Includes sample data for study of drift cycle of geosynchronous station, strategy for radar mapping of Venus, frozen orbit about Mars, and orbit characterized by repeating ground trace. Executed faster than such programs based on Cowell's method. Written in FORTRAN 77.

  3. Long term economic relationships from cointegration maps

    NASA Astrophysics Data System (ADS)

    Vicente, Renato; Pereira, Carlos de B.; Leite, Vitor B. P.; Caticha, Nestor

    2007-07-01

    We employ the Bayesian framework to define a cointegration measure aimed to represent long term relationships between time series. For visualization of these relationships we introduce a dissimilarity matrix and a map based on the sorting points into neighborhoods (SPIN) technique, which has been previously used to analyze large data sets from DNA arrays. We exemplify the technique in three data sets: US interest rates (USIR), monthly inflation rates and gross domestic product (GDP) growth rates.

  4. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  5. Breakthroughs in long term care design.

    PubMed

    Hiatt, L

    1991-01-01

    In summary, here is what design is trying to accomplish in long term care facilities: Functional access; Privacy as entitlement; Sensory optimization to improve vision and hearing; Reduced walking and wheeling distances that still allow people to be mobile; Effective or functional placement of space and equipment; The option of smaller scale, so neither residents nor staff feel like they are hanging out with a unit full of, perhaps 68, people all the time; Flexibility and adaptability

  6. Long-term maternal morbidity associated with repeat cesarean delivery.

    PubMed

    Clark, Erin A S; Silver, Robert M

    2011-12-01

    Concern regarding the association between cesarean delivery and long-term maternal morbidity is growing as the rate of cesarean delivery continues to increase. Observational evidence suggests that the risk of morbidity increases with increasing number of cesarean deliveries. The dominant maternal risk in subsequent pregnancies is placenta accreta spectrum disorder and its associated complications. A history of multiple cesarean deliveries is the major risk factor for this condition. Pregnancies following cesarean delivery also have increased risk for other types of abnormal placentation, reduced fetal growth, preterm birth, and possibly stillbirth. Chronic maternal morbidities associated with cesarean delivery include pelvic pain and adhesions. Adverse reproductive effects may include decreased fertility and increased risk of spontaneous abortion and ectopic pregnancy. Clinicians and patients need to be aware of the long-term risks associated with cesarean delivery so that they can be considered when determining the method of delivery for first and subsequent births.

  7. Related studies in long term lithium battery stability

    NASA Astrophysics Data System (ADS)

    Horning, R. J.; Chua, D. L.

    1984-09-01

    The continuing growth of the use of lithium electrochemical systems in a wide variety of both military and industrial applications is primarily a result of the significant benefits associated with the technology such as high energy density, wide temperature operation and long term stability. The stability or long term storage capability of a battery is a function of several factors, each important to the overall storage life and, therefore, each potentially a problem area if not addressed during the design, development and evaluation phases of the product cycle. Design (e.g., reserve vs active), inherent material thermal stability, material compatibility and self-discharge characteristics are examples of factors key to the storability of a power source.

  8. Related Studies in Long Term Lithium Battery Stability

    NASA Technical Reports Server (NTRS)

    Horning, R. J.; Chua, D. L.

    1984-01-01

    The continuing growth of the use of lithium electrochemical systems in a wide variety of both military and industrial applications is primarily a result of the significant benefits associated with the technology such as high energy density, wide temperature operation and long term stability. The stability or long term storage capability of a battery is a function of several factors, each important to the overall storage life and, therefore, each potentially a problem area if not addressed during the design, development and evaluation phases of the product cycle. Design (e.g., reserve vs active), inherent material thermal stability, material compatibility and self-discharge characteristics are examples of factors key to the storability of a power source.

  9. Long-term operational testing of quantum cascade lasers

    NASA Astrophysics Data System (ADS)

    Myers, Tanya L.; Cannon, Bret D.; Brauer, Carolyn S.; Phillips, Mark C.; Taubman, Matthew S.; Bernacki, Bruce E.

    2016-05-01

    In this paper, we present the results of long-term operational testing of several quantum cascade laser (QCL) variants to illustrate their robustness and long lifetimes. Performance factors are investigated including power and spectral stability over different timescales ranging from days to years. The effects of burn-in, packaging, mounting, and facet coatings are considered with respect to their influence on long-term laser performance. In addition, the results from the several years' operation of a custom external cavity quantum cascade laser-based trace gas sensor are presented to highlight the reliable performance of QCL-based sensor systems. This sensor monitored the laboratory air for multiple chemicals and operated continuously for two years without any evidence of degradation in performance. The data from all of these experiments will be discussed to demonstrate the reliability and robust performance of QCLs.

  10. Infective endocarditis: determinants of long term outcome

    PubMed Central

    Netzer, R O M; Altwegg, S C; Zollinger, E; Täuber, M; Carrel, T; Seiler, C

    2002-01-01

    Objective: To evaluate predictors of long term prognosis in infective endocarditis. Design: Retrospective cohort study. Setting: Tertiary care centre. Patients: 212 consecutive patients with infective endocarditis between 1980 and 1995 Main outcome measures: Overall and cardiac mortality; event-free survival; and the following events: recurrence, need for late valve surgery, bleeding and embolic complications, cerebral dysfunction, congestive heart failure. Results: During a mean follow up period of 89 months (range 1–244 months), 56% of patients died. In 180 hospital survivors, overall and cardiac mortality amounted to 45% and 24%, respectively. By multivariate analysis, early surgical treatment, infection by streptococci, age < 55 years, absence of congestive heart failure, and > 6 symptoms or signs of endocarditis during active infection were predictive of improved overall long term survival. Independent determinants of event-free survival were infection by streptococci and age < 55 years. Event-free survival was 17% at the end of follow up both in medically–surgically treated patients and in medically treated patients. Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis. PMID:12067947

  11. Long-term OH variability of Miras

    NASA Astrophysics Data System (ADS)

    Etoka, S.; Le Squeren, A. M.

    2000-10-01

    We present here the results and interpretation of a long-term OH variability program conducted with the French {Nançay} Radiotelescope from 1980 to 1995. It concerns seven Mira stars: R Aql, RS Vir, S CrB, R LMi, RR Aql, U Her and UX Cyg. This study deals with the three OH maser lines observed in the Miras at 1612, 1665 and 1667 MHz. These OH variable stars have periods ranging from 290 to 580 days. The study presents the first insight of the long-term temporal behaviour of OH integrated flux variations as well as spectral component variations. The main aims are to determine the temporal behaviour of the OH maser emission and the longevity and variability of the spectral components. We find that the shapes of the OH curve are closer to the IR than the optical shapes and that the emissions at 1665 and 1667 MHz have a very similar behaviour while the emission at 1612 MHz behaves differently. The 1612 MHz emission shows smoother temporal variations and greater component longevity than the main line emission, leading to the conclusion that the 1612 MHz emission is coming from an outer part of the circumstellar shell and is more saturated than the main line emission. The study also shows the existence of inhomogeneities, especially differences between the front and back parts of the shell can be seen, and that OH variability curves undergo long term variations over several cycles.

  12. Electrodes for long-term esophageal electrocardiography.

    PubMed

    Niederhauser, Thomas; Haeberlin, Andreas; Marisa, Thanks; Jungo, Michael; Goette, Josef; Jacomet, Marcel; Abacherli, Roger; Vogel, Rolf

    2013-09-01

    The emerging application of long-term and high-quality ECG recording requires alternative electrodes to improve the signal quality and recording capability of surface skin electrodes. The esophageal ECG has the potential to overcome these limitations but necessitates novel recorder and lead designs. The electrode material is of particular interest, since the material has to ensure conflicting requirements like excellent biopotential recording properties and inertness. To this end, novel electrode materials like PEDOT and silver-PDMS as well as established electrode materials such as stainless steel, platinum, gold, iridium oxide, titanium nitride, and glassy carbon were investigated by long-term electrochemical impedance spectroscopy and model-based signal analysis using the derived in vitro interfacial properties in conjunction with a dedicated ECG amplifier. The results of this novel approach show that titanium nitride and iridium oxide featuring microstructured surfaces did not degrade when exposed to artificial acidic saliva. These materials provide low electrode potential drifts and insignificant signal distortion superior to surface skin electrodes making them compatible with accepted standards for ambulatory ECG. They are superior to the noble and polarizable metals such as platinum, silver, and gold that induced more signal distortions and are superior to esophageal stainless steel electrodes that corrode in artificial saliva. The study provides rigorous criteria for the selection of electrode materials for prolonged ECG recording by combining long-term in vitro electrode material properties with ECG signal quality assessment.

  13. Long-term prophylaxis in bipolar disorder.

    PubMed

    Taylor, Matthew J; Goodwin, Guy M

    2006-01-01

    Bipolar disorder is a major cause of disability, and the prevention of relapse is a key management goal. Pharmacological interventions, effectively delivered through enhanced clinical care, are central to long-term management. This article summarises the available evidence for a range of pharmacological options, and provides guidance on common issues in clinical management in line with current practice guidelines. The use of medications for long-term prophylaxis should be considered in all patients meeting criteria for bipolar I disorder. Increasing high-quality evidence from randomised trials informs management decisions relating to both novel agents, such as lamotrigine and olanzapine, and longer-established therapies, such as lithium and valproate, in monotherapy. Medications taken long-term in bipolar disorder differ in the extent to which they protect against manic and depressive relapse. Consequently, the emerging challenge is to understand how combination treatments can enhance efficacy and effectiveness based on data from controlled trials rather than random polypharmacy. Clinical care can be enhanced with effective education about the illness, and the use of strategies to improve treatment adherence and the recognition and management of stressors or prodromal symptoms. Where available, a range of specific psychological interventions can be effective as an adjunct to medication. When discontinuation of prophylaxis is necessary, gradual tapering of dose over weeks or months is recommended.

  14. Titanium for long-term tritium storage

    SciTech Connect

    Heung, L.K.

    1994-12-01

    Due to the reduction of nuclear weapon stockpile, there will be an excess of tritium returned from the field. The excess tritium needs to be stored for future use, which might be several years away. A safe and cost effective means for long term storage of tritium is needed. Storing tritium in a solid metal tritide is preferred to storing tritium as a gas, because a metal tritide can store tritium in a compact form and the stored tritium will not be released until heat is applied to increase its temperature to several hundred degrees centigrade. Storing tritium as a tritide is safer and more cost effective than as a gas. Several candidate metal hydride materials have been evaluated for long term tritium storage. They include uranium, La-Ni-Al alloys, zirconium and titanium. The criteria used include material cost, radioactivity, stability to air, storage capacity, storage pressure, loading and unloading conditions, and helium retention. Titanium has the best combination of properties and is recommended for long term tritium storage.

  15. Effects of continuous long-term testosterone therapy (TTh) on anthropometric, endocrine and metabolic parameters for up to 10 years in 115 hypogonadal elderly men: real-life experience from an observational registry study.

    PubMed

    Yassin, A A; Nettleship, J; Almehmadi, Y; Salman, M; Saad, F

    2016-09-01

    Subnormal levels of testosterone are associated with significant negative health consequences, with higher risks of all-cause and cardiovascular mortality. The numbers of studies reporting on the benefits of normalisation of testosterone is increasing but longer-term data on (elderly) men receiving testosterone treatment are almost nonexistent. In this single-centre, cumulative, prospective, registry study, 115 hypogonadal men (mean age 59.05 years) received injections with testosterone undecanoate in 12-week intervals for up to 10 years. Waist circumference, body weight and mean BMI dropped progressively with statistical significance versus previous year for 7 years and, respectively, 8 years for weight and body mass index. Similarly, fasting glucose displayed a significant decrease after the first year continuing to decrease thereafter. A decline in HbA1c , from 6.4% to 5.6% (mean <6%), was observed from year 2 on, together with a decrease in the ratio of triglycerides:high-density lipoprotein (HDL), a surrogate marker of insulin resistance, with an increase in HDL levels. The total cholesterol:HDL ratio and non-HDL cholesterol declined significantly. A decrease was also observed in systolic and diastolic blood pressure, with a decrease in levels of the inflammation marker C-reactive protein. No major adverse cardiovascular events were observed throughout the study.

  16. Pernicious effects of long-term, continuous 900-MHz electromagnetic field throughout adolescence on hippocampus morphology, biochemistry and pyramidal neuron numbers in 60-day-old Sprague Dawley male rats.

    PubMed

    Kerimoğlu, Gökçen; Hancı, Hatice; Baş, Orhan; Aslan, Ali; Erol, Hüseyin Serkan; Turgut, Alpgiray; Kaya, Haydar; Çankaya, Soner; Sönmez, Osman Fikret; Odacı, Ersan

    2016-11-01

    The central nervous system (CNS) begins developing in the intrauterine period, a process that continues until adulthood. Contact with chemical substances, drugs or environmental agents such as electromagnetic field (EMF) during adolescence therefore has the potential to disturb the development of the morphological architecture of components of the CNS (such as the hippocampus). The hippocampus is essential to such diverse functions as memory acquisition and integration and spatial maneuvering. EMF can result in severe damage to both the morphology of the hippocampus and its principal functions during adolescence. Although children and adolescents undergo greater exposure to EMF than adults, the information currently available regarding the effects of exposure to EMF during this period is as yet insufficient. This study investigated the 60-day-old male rat hippocampus following exposure to 900 megahertz (MHz) EMF throughout the adolescent period using stereological, histopathological and biochemical analysis techniques. Eighteen male Sprague Dawley rats aged 21days were assigned into control, sham and EMF groups on a random basis. No procedure was performed on the control group rats. The EMF group (EMFGr) was exposed to a 900-MHz EMF for 1h daily from beginning to end of adolescence. The sham group rats were held in the EMF cage but were not exposed to EMF. All rats were sacrificed at 60days of age. Their brains were extracted and halved. The left hemispheres were set aside for biochemical analyses and the right hemispheres were subjected to stereological and histopathological evaluation. Histopathological examination revealed increased numbers of pyknotic neurons with black or dark blue cytoplasm on EMFGr slides stained with cresyl violet. Stereological analyses revealed fewer pyramidal neurons in EMFGr than in the other two groups. Biochemical analyses showed an increase in malondialdehyde and glutathione levels, but a decrease in catalase levels in EMFGr. Our

  17. Continuous monitoring of carbon dioxide, methane and carbon monoxide west of London, UK: use of long term records and isotopes to identify changes in source emissions in the regional and local atmosphere

    NASA Astrophysics Data System (ADS)

    Fisher, R.; Lowry, D.; Sriskantharajah, S.; Nisbet, E.

    2003-04-01

    The Royal Holloway atmospheric laboratory measures CH4, CO2 and CO continuously, and δ 13C of methane is also measured in spot samples, all to high precision and accuracy. The records date back to 1995 for CH4, 1996 for CO and 1999 for CO2. The collection site is on a campus rooftop, at Egham, on the first hill west of London. This allows sampling both of relatively clean background air from the SW and London air from the east. During still anticyclonal events, gentle daytime SW winds are often replaced by nocturnal easterlies from the urban heat island. Overall, in the past 2-3 years the major pollution events appear to have been less marked than in previous years: this may be meteorological accident (i.e. more wet windy Atlantic-type weather; less anticyclonic and Eurasian air), but may also record improvement in urban air quality. For example, the annual averaged CO concentration recorded at the Egham site dropped from 580 ppb for 1997 to 380 ppb for 2001. The yearly concentration of methane has also decreased since the records began from 2032ppb in 1996 to 1995ppb in 2001. On a daily time scale, by using CH4 emissions as a relative constant the effects of meteorological variability can be removed from the dataset and the periods of excess CO2 and CO calculated. These correspond closely with rush hour traffic periods with minimum excess at 04:00 GMT. Deviations from normal abundance ratios between CO2, CO and CH4 identify distinct emission traits in each gas. High precision isotopic analysis of methane in air samples allows changing source emissions to be identified. The methane record has been compared with the Atlantic background CH4 concentrations and δ 13C recorded at Mace Head. The methane concentration in air arriving at Royal Holloway from the SW is commonly 25-30 ppb greater than at Mace Head and there is a small enrichment in δ 13C (0-0.2 permil). During anticyclonic events the isotopes of CH4 and CO2 can be used to identify local sources and the

  18. Non-intrusive long-term monitoring approaches

    SciTech Connect

    Smathers, D.; Mangan, D.

    1998-08-01

    In order to promote internatinal confidence that the US and Russia are disarming per their commitments under Article 6 of the Non-Proliferation Treaty, an international verification regime may be applied to US and Russian excess fissile materials. Initially, it is envisioned that this verification regime would be applied at storage facilities; however, it should be anticipated that the verificatino regime would continue throughout any material disposition activities, should such activities be pursued. once the materials are accepted into the verification regime, it is assumed that long term monitoring will be used to maintain continuity of knowledge. The requirements for long term storage monitoring include unattended operation for extended periods of time, minimal intrusiveness on the host nation`s safety and security activities, data collection incorporating data authentication, and monitoring redundancy to allow resolution of anomalies and to continue coverage in the event of equipment failures. Additional requirements include effective data review and analysis processes, operation during storage facility loading, procedure for removal of inventory items for safety-related surveillance, and low cost, reliable equipment. A monitoring system might include both continuous monitoring of storagecontainers and continuous area monitoring. These would be complemented with periodic on-site inspections. A fissile material storage facility is not a static operation. The initial studies have shown there are a number of volid reasions why a host nation may need them to remove material from the storage facility. A practical monitoring system must be able to accommodate necessary material movements.

  19. Long-term forecasting of internet backbone traffic.

    PubMed

    Papagiannaki, Konstantina; Taft, Nina; Zhang, Zhi-Li; Diot, Christophe

    2005-09-01

    We introduce a methodology to predict when and where link additions/upgrades have to take place in an Internet protocol (IP) backbone network. Using simple network management protocol (SNMP) statistics, collected continuously since 1999, we compute aggregate demand between any two adjacent points of presence (PoPs) and look at its evolution at time scales larger than 1 h. We show that IP backbone traffic exhibits visible long term trends, strong periodicities, and variability at multiple time scales. Our methodology relies on the wavelet multiresolution analysis (MRA) and linear time series models. Using wavelet MRA, we smooth the collected measurements until we identify the overall long-term trend. The fluctuations around the obtained trend are further analyzed at multiple time scales. We show that the largest amount of variability in the original signal is due to its fluctuations at the 12-h time scale. We model inter-PoP aggregate demand as a multiple linear regression model, consisting of the two identified components. We show that this model accounts for 98% of the total energy in the original signal, while explaining 90% of its variance. Weekly approximations of those components can be accurately modeled with low-order autoregressive integrated moving average (ARIMA) models. We show that forecasting the long term trend and the fluctuations of the traffic at the 12-h time scale yields accurate estimates for at least 6 months in the future.

  20. Review article: the long-term management of ulcerative colitis.

    PubMed

    Hanauer, S B

    2004-10-01

    After the induction of remission, the second priority of therapy for ulcerative colitis is sustained clinical remission, defined as the absence of inflammatory symptoms (diarrhoea, bleeding, rectal urgency) and the maintenance of an intact mucosa, with the absence of ulcers, friability or significant granularity at endoscopy. The 'optimal' maintenance strategy will depend on the therapy needed to induce remission. Thus, the transition from induction to maintenance therapy will be determined by the intensity of acute therapy necessary to induce remission and the duration of therapy required to complete the resolution of clinical symptoms. There are few controlled clinical trials pertaining to maintenance after each induction regimen. However, experience dictates that aminosalicylates are efficacious after aminosalicylate-induced remissions, that steroids should be tapered according to the time required to induce remission, that patients requiring ciclosporin will benefit from the addition of long-term immunomodulation with azathioprine or mercaptopurine, and that many patients with distal colitis who require topical mesalazine (mesalamine) will continue to need topical therapy to maintain remission, albeit at reduced frequency. The expectations for maintenance therapy require patient adherence to the prescribed treatment regimen. Patients require education with regard to the long-term goals of maintenance therapy (e.g. prevention of relapse, reduction of long-term complications of disease activity or risks of acute therapy with steroids), and should be warned against the use of nonsteroidal anti-inflammatory drugs and cautioned about the cessation of smoking, when applicable, due to potential risks of relapse or chronic activity.

  1. Timber beams subjected to long - term loading

    NASA Astrophysics Data System (ADS)

    Sógel, K.

    2010-09-01

    Wood is a significant structural material, which is often used for timber bearing structures. Elements of timber structures must especially satisfy safety requirements, which are expressed by the ultimate limit states in the established standards. The structure must also satisfy the serviceability limit states. Local and global deformations make it impossible for the structure to serve the purpose it was designed for. It is important to take the deflections and their possible increase into account in the design to provide a structure which can be used during the whole period of service. Based on earlier examinations, it is known that a timber element over the course of long-term loading shows creep behavior. The structure of wood is able to adapt to the conditions of the surrounding environment. The properties of wood are especially affected by the relative humidity of the air and then by the type, intensity and duration of the loading. The most important factors affecting the serviceability of timber structures are volume changes caused by humidity and additional deflections caused by the effects of long-term loading. These phenomena emphasize the importance of serviceability limit states for timber structures. The paper deals with a long-term experimental investigation of timber girders that are currently often used. The aim was to obtain the deflection curves and mark the time dependence and the final deflections. The paper will also define the approximations for simulating the time-dependent deflections and obtain the creep coefficients for calculating the final deflections of the girders investigated.

  2. Health reform: setting the agenda for long term care.

    PubMed

    Hatch, O G; Wofford, H; Willging, P R; Pomeroy, E

    1993-06-01

    The White House Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, is expected to release its prescription for health care reform this month. From the outset, Clinton's mandate was clear: to provide universal coverage while reining in costs for delivering quality health care. Before President Clinton was even sworn into office, he had outlined the major principles that would shape the health reform debate. Global budgeting would establish limits on all health care expenditures, thereby containing health costs. Under a system of managed competition, employers would form health alliances for consumers to negotiate for cost-effective health care at the community level. So far, a basic approach to health care reform has emerged. A key element is universal coverage--with an emphasis on acute, preventive, and mental health care. Other likely pieces are employer-employee contributions to health care plans, laws that guarantee continued coverage if an individual changes jobs or becomes ill, and health insurance alliances that would help assure individual access to low-cost health care. What still is not clear is the extent to which long term care will be included in the basic benefits package. A confidential report circulated by the task force last month includes four options for long term care: incremental Medicaid reform; a new federal/state program to replace Medicaid; a social insurance program for home and community-based services; or full social insurance for long term care. Some work group members have identified an additional option: prefunded long term care insurance.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Murine model of long-term obstructive jaundice.

    PubMed

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-11-01

    With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Overall, 70% (7 of 10) of tCL mice died by day 7, whereas majority 67% (10 of 15) of pCL mice survived with loss of jaundice. A total of 19% (3 of 16) of LMHL mice died; however, jaundice continued beyond day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 d after ligation but jaundice rapidly decreased by day 7. The LHML group developed portal hypertension and severe fibrosis by day 14 in addition to prolonged jaundice. The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice, but long-term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Long-term management of prolactinomas.

    PubMed

    Schlechte, Janet A

    2007-08-01

    Prolactinomas are a frequent cause of gonadal dysfunction and infertility, especially in young women. The regulation of prolactin secretion and the efficacy of dopamine agonists in the therapy of prolactinomas are well established. The current challenges in management of prolactinomas are related to follow-up after successful therapy. Issues and questions to be addressed in this approach to long-term management of prolactinomas include the frequency of radiographic monitoring, effect of pregnancy and menopause, safety of estrogen in women taking oral contraceptives, and the potential for discontinuation of dopamine agonist therapy.

  5. Human Behaviour in Long-Term Missions

    NASA Technical Reports Server (NTRS)

    1997-01-01

    In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

  6. Long-Term Wind Power Variability

    SciTech Connect

    Wan, Y. H.

    2012-01-01

    The National Renewable Energy Laboratory started collecting wind power data from large commercial wind power plants (WPPs) in southwest Minnesota with dedicated dataloggers and communication links in the spring of 2000. Over the years, additional WPPs in other areas were added to and removed from the data collection effort. The longest data stream of actual wind plant output is more than 10 years. The resulting data have been used to analyze wind power fluctuations, frequency distribution of changes, the effects of spatial diversity, and wind power ancillary services. This report uses the multi-year wind power data to examine long-term wind power variability.

  7. Transverse dimension and long-term stability.

    PubMed

    Vanarsdall, R L

    1999-09-01

    This article emphasizes the critical importance of the skeletal differential between the width of the maxilla and the width of the mandible. Undiagnosed transverse discrepancy leads to adverse periodontal response, unstable dental camouflage, and less than optimal dentofacial esthetics. Hundreds of adult retreatment patients corrected for significant maxillary transverse deficiency using surgically assisted maxillary expansion (similar to osseous distraction) has produced excellent stability. Eliciting tooth movement for children (orthopedics, lip bumper, Cetlin plate) in all three planes of space by muscles, eruption, and growth, develops the broader arch form (without the mechanical forces of fixed or removable appliances) and has also demonstrated impressive long term stability.

  8. Terminating a long-term clinical trial.

    PubMed

    Klimt, C R; Canner, P L

    1979-05-01

    Long-term trials often include more than one active treatment group. These may be discontinued independently if found ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet anouther kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  9. Terminating a long-term clinical trial.

    PubMed

    Klimt, C R

    1981-05-01

    Long-term clinical trials often include more than one active treatment group. These may be discontinued independently if found to be ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet another kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  10. A long-term climatology of medicanes

    NASA Astrophysics Data System (ADS)

    Cavicchia, Leone; von Storch, Hans; Gualdi, Silvio

    2014-09-01

    Medicanes, intense and destructive mesoscale cyclones exhibiting several similarities with tropical hurricanes, are known to struck occasionally the Mediterranean Sea. Thanks to a high-resolution dynamical downscaling effort, we are able to study for the first time the long-term climatology of those rare storms in a systematic way. The distribution of medicanes frequency in space and time is discussed, and the environmental factors responsible for their formation are investigated. We find that medicanes develop in those areas of the Mediterranean region where intrusions of cold air in the upper troposphere can produce configurations of thermodynamical disequilibrium of the atmosphere similar to those associated with the formation of tropical cyclones.

  11. Performance considerations in long-term spaceflight

    NASA Technical Reports Server (NTRS)

    Akins, F. R.

    1979-01-01

    Maintenance of skilled performance during extended space flight is of critical importance to both the health and safety of crew members and to the overall success of mission goals. An examination of long term effects and performance requirements is therefore a factor of immense importance to the planning of future missions. Factors that were investigated include: definition of performance categories to be investigated; methods for assessing and predicting performance levels; in-flight factors which can affect performance; and factors pertinent to the maintenance of skilled performance.

  12. Long-term efficacy and safety of human papillomavirus vaccination

    PubMed Central

    De Vincenzo, Rosa; Conte, Carmine; Ricci, Caterina; Scambia, Giovanni; Capelli, Giovanni

    2014-01-01

    In this paper, we review the published evidence about the long-term efficacy of the available human papillomavirus (HPV) vaccines and their safety profile. Two prophylactic HPV vaccines – bivalent (bHPV) and quadrivalent (qHPV) – are now available, and vaccination programs are being widely implemented, primarily targeting adolescent girls. Efficacy has been widely demonstrated for both vaccines. Since the risk of HPV exposure potentially persists throughout a woman’s sexual life, vaccine duration of protection is critical to overall effectiveness. Interpreting the results of long-term efficacy studies for the two HPV vaccines can be puzzling, due to the heterogeneity of studies, different methods used in the assessment of immunogenicity, histopathological and virological end points, and statistical power issues. Moreover, an immunologic correlate of protection has not yet been established, and it is unknown whether higher antibody levels will really result in a longer duration of protection. Disease prevention remains the most important measure of long-term duration of vaccine efficacy. To date, the longest follow-up of an HPV vaccine has been 9.4 years for the bHPV vaccine. Long-term follow-up for qHPV vaccine goes up to 8 years. The vaccine continues to be immunogenic and well tolerated up to 9 years following vaccination. All randomized controlled clinical trials of the bHPV and the qHPV vaccines provide evidence of an excellent safety profile. The most common complaint reported is pain in the injection site, which is self-limiting and spontaneously resolved. The incidence of systemic adverse events (AEs), serious AEs, and discontinuations due to a serious AE reported in clinical studies are similar between the two vaccines and their control groups. In particular, no increased risk of autoimmune disease has been shown among HPV-vaccinated subjects in long-term observation studies. As these are crucial topics in HPV vaccination, it is important to establish

  13. Long-Term Care Policy: Singapore's Experience.

    PubMed

    Chin, Chee Wei Winston; Phua, Kai-Hong

    2016-01-01

    Singapore, like many developed countries, is facing the challenge of a rapidly aging population and the increasing need to provide long-term care (LTC) services for elderly in the community. The Singapore government's philosophy on care for the elderly is that the family should be the first line of support, and it has relied on voluntary welfare organizations (VWOs) or charities for the bulk of LTC service provision. For LTC financing, it has emphasized the principles of co-payment and targeting of state support to the low-income population through means-tested government subsidies. It has also instituted ElderShield, a national severe disability insurance scheme. This paper discusses some of the challenges facing LTC policy in Singapore, particularly the presence of perverse financial incentives for hospitalization, the pitfalls of over-reliance on VWOs, and the challenges facing informal family caregivers. It discusses the role of private LTC insurance in LTC financing, bearing in mind demand- and supply-side failures that have plagued the private LTC insurance market. It suggests the need for more standardized needs assessment and portable LTC benefits, with reference to the Japanese Long-Term Care Insurance program, and also discusses the need to provide more support to informal family caregivers.

  14. Sleep facilitates long-term face adaptation

    PubMed Central

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as ‘storage’. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation—which are usually not considered to play a relevant role in mnemonic processes—with learning and memory, and at the same time reveal a new function of sleep in cognition. PMID:23986109

  15. Craniopharyngioma in Children: Long-term Outcomes

    PubMed Central

    STEINBOK, Paul

    2015-01-01

    The survival rate for childhood craniopharyngioma has been improving, with more long-term survivors. Unfortunately it is rare for the patient to be normal, either from the disease itself or from the effects of treatment. Long-term survivors of childhood craniopharyngioma suffer a number of impairments, which include visual loss, endocrinopathy, hypothalamic dysfunction, cerebrovascular problems, neurologic and neurocognitive dysfunction. Pituitary insufficiency is present in almost 100%. Visual and hypothalamic dysfunction is common. There is a high risk of metabolic syndrome and increased risk of cerebrovascular disease, including stroke and Moyamoya syndrome. Cognitive, psychosocial, and emotional problems are prevalent. Finally, there is a higher risk of premature death among survivors of craniopharyngioma, and often this is not from tumor recurrence. It is important to consider craniopharyngioma as a chronic disease. There is no perfect treatment. The treatment has to be tailored to the individual patient to minimize dysfunction caused by tumor and treatments. So “cure” of the tumor does not mean a normal patient. The management of the patient and family needs multidisciplinary evaluation and should involve ophthalmology, endocrinology, neurosurgery, oncology, and psychology. Furthermore, it is also important to address emotional issues and social integration. PMID:26345668

  16. Long-term Trend of Sunspot Numbers

    NASA Astrophysics Data System (ADS)

    Gao, P. X.

    2016-10-01

    Using the Hilbert-Huang Transform method, we investigate the long-term trend of yearly mean total sunspot numbers in the time interval of 1700-2015, which come from the World Data Center—the sunspot Index and long-term solar observations. The main findings of this study are summarized below. (1) From the adaptive trend, which is extracted from the yearly mean total sunspot numbers, we can find that the value gradually increases during the time period 1700-1975, then decreases gradually from 1975 to 2015. (2) The Centennial Gleissberg Cycle is extracted from the yearly mean total sunspot numbers and confirms that a new grand minimum is in progress; the Dalton Minimum, the Gleissberg Minimum, and low level of solar activity during solar cycle 24 (the part of the new grand minimum) all can be understood as minima of the Centennial Gleissberg Cycle. (3) Based on the adaptive (overall) trend, and the 100-year and longer timescale trend of yearly mean total sunspot numbers, we can infer that the level of solar activity during the new grand minimum may be close to that during the Gleissberg Minimum, slightly higher than that during the Dalton Minimum, and significantly higher than that during the Maunder Minimum. Our results do not support the suggestion that a new grand minimum, somewhat resembling the Maunder Minimum, is in progress.

  17. Sleep facilitates long-term face adaptation.

    PubMed

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-10-22

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

  18. Long term changes in the polar vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2015-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented.

  19. Climate Predictability and Long Term Memory

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Blender, R.; Fraedrich, K.; Liu, Z.

    2010-09-01

    The benefit of climate Long Term Memory (LTM) for long term prediction is assessed using data from a millennium control simulation with the atmosphere ocean general circulation model ECHAM5/MPIOM. The forecast skills are evaluated for surface temperature time series at individual grid points. LTM is characterised by the Hurst exponent in the power-law scaling of the fluctuation function which is determined by detrended fluctuation analysis (DFA). LTM with a Hurst exponent close to 0.9 occurs mainly in high latitude oceans, which are also characterized by high potential predictability. Climate predictability is diagnosed in terms of potentially predictable variance fractions. Explicit prediction experiments for various time steps are conducted on a grid point basis using an auto-correlation (AR1) predictor: in regions with LTM, prediction skills are beyond that expected from red noise persistence; exceptions occur in some areas in the southern oceans and over the northern hemisphere continents. Extending the predictability analysis to the fully forced simulation shows large improvement in prediction skills.

  20. Long term perfusion system supporting adipogenesis

    PubMed Central

    Abbott, Rosalyn D.; Raja, Waseem K.; Wang, Rebecca Y.; Stinson, Jordan A.; Glettig, Dean L.; Burke, Kelly A.; Kaplan, David L.

    2015-01-01

    Adipose tissue engineered models are needed to enhance our understanding of disease mechanisms and for soft tissue regenerative strategies. Perfusion systems generate more physiologically relevant and sustainable adipose tissue models, however adipocytes have unique properties that make culturing them in a perfusion environment challenging. In this paper we describe the methods involved in the development of two perfusion culture systems (2D and 3D) to test their applicability for long term in vitro adipogenic cultures. It was hypothesized that a silk protein biomaterial scaffold would provide a 3D framework, in combination with perfusion flow, to generate a more physiologically relevant sustainable adipose tissue engineered model than 2D cell culture. Consistent with other studies evaluating 2D and 3D culture systems for adipogenesis we found that both systems successfully model adipogensis, however 3D culture systems were more robust, providing the mechanical structure required to contain the large, fragile adipocytes that were lost in 2D perfused culture systems. 3D perfusion also stimulated greater lipogenesis and lipolysis and resulted in decreased secretion of LDH compared to 2D perfusion. Regardless of culture configuration (2D or 3D) greater glycerol was secreted with the increased nutritional supply provided by perfusion of fresh media. These results are promising for adipose tissue engineering applications including long term cultures for studying disease mechanisms and regenerative approaches, where both acute (days to weeks) and chronic (weeks to months) cultivation are critical for useful insight. PMID:25843606

  1. Long-term experience with indapamide.

    PubMed

    Beling, S; Vukovich, R A; Neiss, E S; Zisblatt, M; Webb, E; Losi, M

    1983-07-01

    Indapamide, 2.5 mg administered once daily for periods up to 36 months, was found to be safe and effective for the long-term control of mild to moderate hypertension. The effects of hydrochlorothiazide, 50 mg, and indapamide, 2.5 mg, were studied in two randomized, double-blind, multicenter trials. Data from the two multicenter trials (20 study sites) were pooled for purposes of comparison. Significant reductions in systolic and diastolic blood pressure, with patients in both supine and standing positions, occurred in both groups within the first 8 weeks of treatment. This effect was maintained throughout the active treatment period. Success, as determined by the therapeutic success rate (percentage of patients with decreases of standing phase V diastolic blood pressure of at least 10 mm Hg or to below 90 mm Hg), occurred in 53% of the patients given hydrochlorothiazide and in 56% of the indapamide-treated patients. During the study period, the nature, frequency, and severity of adverse reactions were similar for both groups. There was no clinically significant difference between the treatment groups for the laboratory assessments. Patients who completed the multicenter trials were eligible for participation in an ongoing long-term extension study of the safety of indapamide. Data are available for periods up to 36 months and demonstrate neither augmentation of clinical or laboratory adverse effects nor any potentially harmful indicators that could be attributed to prolonged treatment.

  2. Long Term Changes in the Polar Vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2016-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented. The unusual meteorological conditions of the 2015 south polar vortex and the 2010/11 and 2015/16 north polar vortices will be compared to other recent years.

  3. Long term effects of Escherichia coli mastitis.

    PubMed

    Blum, Shlomo E; Heller, Elimelech D; Leitner, Gabriel

    2014-07-01

    Escherichia coli is one of the most frequently diagnosed causes of bovine mastitis, and is typically associated with acute, clinical mastitis. The objective of the present study was to evaluate the long term effects of intramammary infections by E. coli on milk yield and quality, especially milk coagulation. Twenty-four Israeli Holstein cows diagnosed with clinical mastitis due to intramammary infection by E. coli were used in this study. Mean lactation number, days in milk (DIM) and daily milk yield (DMY) at the time of infection was 3.3 ± 1.3, 131.7 days ± 78.6 and 45.7 L ± 8.4, respectively. DMY, milk constituents, somatic cells count (SCC), differential leukocytes count and coagulation parameters were subsequently assessed. Two patterns of inflammation were identified: 'short inflammation', characterized by <15% decrease in DMY and <30 days until return to normal (n = 5), and 'long inflammation', characterized by >15% decrease in DMY and >30 days to reach a new maximum DMY (n = 19). The estimated mean loss of marketable milk during the study was 200 L/cow for 'short inflammation' cases, and 1,500 L/cow for 'long inflammation' ones. Significant differences between 'short' and 'long inflammation' effects were found in almost all parameters studied. Long-term detrimental effects on milk quality were found regardless of clinical or bacteriological cure of affected glands.

  4. 17 CFR 256.225 - Unamortized premium on long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... COMMISSION (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.225 Unamortized premium on...

  5. 17 CFR 256.226 - Unamortized discount on long-term debt-debit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... COMMISSION (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.226 Unamortized discount on...

  6. 17 CFR 256.226 - Unamortized discount on long-term debt-debit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... COMMISSION (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.226 Unamortized discount on...

  7. 17 CFR 256.427 - Interest on long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Income and Expense Accounts § 256.427 Interest on long-term debt. This... company to nonassociate persons. ...

  8. 17 CFR 256.427 - Interest on long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Income and Expense Accounts § 256.427 Interest on long-term debt. This... company to nonassociate persons. ...

  9. What Should Stay Put? Campus Landscape Planning for the Long Term.

    ERIC Educational Resources Information Center

    Yahres, Mike Van

    2000-01-01

    Discusses campus landscape long-term planning and design decision making during campus alterations and upgrades. Those campus landscape elements that tend to remain in place and planning for their continued existence are discussed. (GR)

  10. 2016 RFA for Great Lakes Long-Term Biology Monitoring Program: Phytoplankton Component

    EPA Pesticide Factsheets

    This Request for Applications solicits applications from eligible entities for a cooperative agreement to be awarded for a project to continue the long-term monitoring of phytoplankton in the open waters of the Great Lakes.

  11. Long-term macrolide treatment of chronic inflammatory airway diseases: risks, benefits and future developments.

    PubMed

    Cameron, E J; McSharry, C; Chaudhuri, R; Farrow, S; Thomson, N C

    2012-09-01

    Macrolide antibiotics were discovered over 50 years ago and following their use as antimicrobials it became apparent that this group of antibiotics also possessed anti-inflammatory properties. Subsequent clinical trials showed benefits of macrolides as long-term adjuncts in the treatment of a spectrum of chronic inflammatory respiratory diseases, particularly diffuse panbronchiolitis, cystic fibrosis, post-transplant bronchiolitis obliterans and more recently chronic obstructive pulmonary disease (COPD). The evidence for efficacy of macrolides in the long-term treatment of chronic asthma and bronchiectasis is less well established. The mechanism(s) of action of macrolides in the treatment of these diseases remains unexplained, but may be due to their antibacterial and/or anti-inflammatory actions, which include reductions in interleukin-8 production, neutrophil migration and/or function. Macrolides have additional potentially beneficial properties including anti-viral actions and an ability to restore corticosteroid sensitivity. The increased prescribing of macrolides for long-term treatment could result in the development of microbial resistance and adverse drug effects. New macrolides have been developed which do not possess any antimicrobial activity and hence lack the ability to produce microbial resistance, but which still retain immunomodulatory effects. Potentially novel macrolides may overcome a significant barrier to the use of this type of drug for the long-term treatment of chronic inflammatory airway diseases.

  12. Home health, long-term care, and other compliance activities.

    PubMed

    Anderson, T D; Sadoff, J W

    1999-04-01

    The Federal government continues to crack down on fraud and abuse in the healthcare industry with such initiatives and tools as Operation Restore Trust and intermediate tax sanctions. Home health and long-term care organizations are the latest entities under study by the Office of Inspector General, and the result of these studies likely will be more antifraud and abuse measures being taken against these entities. All healthcare organizations should pay particular attention to their tax risk exposure. Healthcare organizations that put effective compliance programs in place should be able to reduce the overall risk of challenges to their financial practices.

  13. Long-term complications associated with permanent dermal fillers.

    PubMed

    Kunjur, Jayanth; Witherow, Helen

    2013-12-01

    We report a case series of patients with serious long-term complications associated with the injection of permanent dermal fillers. Although such complications are relatively rare, the consequences are potentially life-long, and the psychological and medical effects can often have a profound impact on the patient. The continued routine offering of these treatments will require doctors to communicate effectively with patients about the nature of the complications and the probability of risk compared with alternative treatments. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Long-term motor cortex stimulation for phantom limb pain.

    PubMed

    Pereira, Erlick A C; Moore, Tom; Moir, Liz; Aziz, Tipu Z

    2015-04-01

    We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance.

  15. Long-term surveillance plan for the Mexican Hat Disposal Site, Mexican Hat, Utah

    SciTech Connect

    1996-02-01

    This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSP (based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program), documents the land ownership interests and details how the long-term care of the disposal site will be accomplished.

  16. 27. CPHA patient care data system for long-term care facilities.

    PubMed

    Slee, V N

    1976-05-01

    Earlier efforts of the Commission on Professional and Hospital Activities (CPHA) to develop a patient care data system for long-term care facilities were discontinued for lack of user interest and shortage of funds; however, the facilities were encouraged to participate in the hospital data system (PAS) and to use optional data enteries for their special needs. New requirements by external agencies, however, have increased the demands for information on and by long-term care facilities for administration, continued stay review, medical care evaluation, and discharge planning. In its current developmental work, CPHA is giving special attention to methods of classifying long-term care patients, to integrating long-term and hospital inpatient data systems, and to educational programs for long-term care personnel in the use of data to carry out the requirements for quality control and utilization review.

  17. Cervical cancer survivorship: Long-term quality of life and social support

    PubMed Central

    Pfaendler, Krista S.; Wenzel, Lari; Mechanic, Mindy B.; Penner, Kristine R.

    2015-01-01

    Purpose Surgery, radiotherapy and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5 year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. Methods Pertinent articles were identified through searches of PubMed for literature published from 1993-2014. We summarize quality of life data from long-term follow up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. Findings Data is varied in terms of the long term impact of treatment on quality of life but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. Implications Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment, and evaluating the effects of supportive care, may reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care. PMID:25592090

  18. Neurotoxicity testing during long-term studies.

    PubMed

    Ivens, I

    1990-01-01

    Several tests and methods for the investigation of neurotoxicity were performed with female Wistar rats for up to 187 days. The methods were validated by testing 10 rats treated with beta,beta'-iminodipropionitrile (IDPN) and 10 control rats. Cage side observation of the animals revealed signs of altered behavior and motor dysfunction of the IDPN-treated rats. Results of a neuromuscular screen indicated changes in gait, righting reflex, grip strength and performance of the negative geotropism test. Investigation of the animals in activity monitors and on the accelerating rotarod showed changes of several parameters. The motor nerve conduction velocity, measured 6 months after the first treatment, was reduced by 6.7 meters per second in the IDPN group compared to controls. From the results of the tests it can be concluded that the methods chosen can be used during long-term studies but may be most useful for animals not older than 12 months.

  19. Reducing long-term reservoir performance uncertainty

    SciTech Connect

    Lippmann, M.J.

    1988-04-01

    Reservoir performance is one of the key issues that have to be addressed before going ahead with the development of a geothermal field. In order to select the type and size of the power plant and design other surface installations, it is necessary to know the characteristics of the production wells and of the produced fluids, and to predict the changes over a 10--30 year period. This is not a straightforward task, as in most cases the calculations have to be made on the basis of data collected before significant fluid volumes have been extracted from the reservoir. The paper describes the methodology used in predicting the long-term performance of hydrothermal systems, as well as DOE/GTD-sponsored research aimed at reducing the uncertainties associated with these predictions. 27 refs., 1 fig.

  20. Long-term monitoring for closed sites

    SciTech Connect

    Golchert, N.W.; Sedlet, J.; Veluri, V.R.

    1985-01-01

    A procedure is presented for planning and implementing a long-term environmental monitoring program for closed low-level radioactive waste disposal sites. The initial task in this procedure is to collect the available information on the legal/regulatory requirements, site and area characteristics, source term, pathway analysis, and prior monitoring results. This information is coupled with parameters such as half-life and retardation factors to develop a monitoring program. As examples, programs are presented for a site that has had little or no waste migration, and for sites where waste has been moved by suface water, by ground water, and by air. Sampling techniques and practices are discussed relative to how a current program would be structured and projections are made on techniques and practices expected to be available in the future. 8 refs., 2 figs.

  1. Emotional behavior in long-term marriage.

    PubMed

    Carstensen, L L; Gottman, J M; Levenson, R W

    1995-03-01

    In exploring the emotional climate of long-term marriages, this study used an observational coding system to identify specific emotional behaviors expressed by middle-aged and older spouses during discussions of a marital problem. One hundred and fifty-six couples differing in age and marital satisfaction were studied. Emotional behaviors expressed by couples differed as a function of age, gender, and marital satisfaction. In older couples, the resolution of conflict was less emotionally negative and more affectionate than in middle-aged marriages. Differences between husbands and wives and between happy and unhappy marriages were also found. Wives were more affectively negative than husbands, whereas husbands were more defensive than wives, and unhappy marriages involved greater exchange of negative affect than happy marriages.

  2. Long Term Hydrological (Radiological) Site Monitoring Data

    EPA Pesticide Factsheets

    Quality Data Asset includes all current and historical data on the quality of water with regard to the presence of water pollutants of all kinds regulated by the Clean Water Act. Under the new Interagency Agreement with the Department of Energy (DOE), the Radiation & Indoor Environments National Laboratory (R&IE), Office of Radiation and Indoor Air (ORIA), EPA, located in Las Vegas, NV, conducts a Long-Term Hydrological Monitoring Program (LTHMP) providing laboratory sampling/analysis and Quality Assurance and Control to measure radioactivity concentrations in the water sources near the sites of former underground nuclear explosions. The results of the LTHMP provide assurance that radioactive material from the tests have not migrated into water supplies.

  3. Long-term U. S. energy outlook

    SciTech Connect

    Friesen, G.

    1984-01-01

    Each year Chase Econometrics offers its clients a brief summary of the assumptions underlying the long-term energy forecast for the U.S. To illustrate the uncertainty involved in forecasting for the period to the year 2000, they choose to compare forecasts with some recent projections prepared by the Department of Energy's Office of Policy, Planning and Analysis for the annual National Energy Policy Plan supplement. Particular emphasis is placed on Scenario B, which is the mid-range reference case. As the introduction to the supplement emphasizes, the NEPP projections should not be considered a statement of the policy goals of the Reagan Administration. They represent an analysis of the possible evolution of U.S. energy markets, given current information and existing policies. The purpose of providing Scenario B as a reference case as well as Scenarios A and C as alternate cases is to show the sensitivity of oil price projections to small swings in energy demand.

  4. Advanced long term cryogenic storage systems

    NASA Technical Reports Server (NTRS)

    Brown, Norman S.

    1987-01-01

    Long term, cryogenic fluid storage facilities will be required to support future space programs such as the space-based Orbital Transfer Vehicle (OTV), Telescopes, and Laser Systems. An orbital liquid oxygen/liquid hydrogen storage system with an initial capacity of approximately 200,000 lb will be required. The storage facility tank design must have the capability of fluid acquisition in microgravity and limit cryogen boiloff due to environmental heating. Cryogenic boiloff management features, minimizing Earth-to-orbit transportation costs, will include advanced thick multilayer insulation/integrated vapor cooled shield concepts, low conductance support structures, and refrigeration/reliquefaction systems. Contracted study efforts are under way to develop storage system designs, technology plans, test article hardware designs, and develop plans for ground/flight testing.

  5. Withdrawal from long-term benzodiazepine treatment.

    PubMed Central

    Petursson, H; Lader, M H

    1981-01-01

    Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety. PMID:6114776

  6. [Enteral nutrition through long-term jejunostomy].

    PubMed

    Fernández, T; Neira, P; Enríquez, C

    2008-01-01

    We present the case of a female patient suffering a peritonitis episode after subtotal gastrectomy due to gastric neoplasm in relation to lesser curvature necrosis extending to the anterior esophageal wall. This an uncommon andsevere complication that made mandatory further aggressive surgery: transection of the abdominal esophagus, transection of the gastric stump, and cervical esophagostomy with creation of a jejunostomy with a needle catheter for feeding. This digestive tube access technique is generally used during major abdominal post-surgery until oral intake is reestablished. Our patient has been 187 days with this therapy since reconstruction of the GI tract was ruled out due to tumoral infiltration of the colon and tumor recurrence at the gastrohepatic omentum. To date, there has been no complication from permanence and/or long-term use of this technique.

  7. [Childhood liver transplantation. Long-term results].

    PubMed

    Jara, Paloma; Hierro, Loreto

    2010-05-01

    Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons.

  8. Long-term leaching of photovoltaic modules

    NASA Astrophysics Data System (ADS)

    Nover, Jessica; Zapf-Gottwick, Renate; Feifel, Carolin; Koch, Michael; Metzger, Jörg W.; Werner, Jürgen H.

    2017-08-01

    Some photovoltaic module technologies use toxic materials. We report long-term leaching on photovoltaic module pieces of 5 × 5 cm2 size. The pieces are cut out from modules of the four major commercial photovoltaic technologies: crystalline and amorphous silicon, cadmium telluride as well as from copper indium gallium diselenide. To simulate different environmental conditions, leaching occurs at room temperature in three different water-based solutions with pH 3, 7, and 11. No agitation is performed to simulate more representative field conditions. After 360 days, about 1.4% of lead from crystalline silicon module pieces and 62% of cadmium from cadmium telluride module pieces are leached out in acidic solutions. The leaching depends heavily on the pH and the redox potential of the aqueous solutions and it increases with time. The leaching behavior is predictable by thermodynamic stability considerations. These predictions are in good agreement with the experimental results.

  9. Technology for long-term care.

    PubMed

    Tak, Sunghee H; Benefield, Lazelle E; Mahoney, Diane Feeney

    2010-01-01

    Severe staff shortages in long-term care (LTC) make it difficult to meet the demands of the growing aging population. Further, technology-savvy Baby Boomers are expected to reshape the current institutional environments toward gaining more freedom and control in their care and lives. Voices from business, academia, research, advocacy organizations, and government bodies suggest that innovative technological approaches are the linchpin that may prepare society to cope with these projected demands. In this article, we review the current state of aging-related technology, identify potential areas for efficacy testing on improving the quality of life of LTC residents in future research, and discuss barriers to implementation of LTC technology. Finally, we present a vision of future technology use that could transform current care practices.

  10. Radiation risk during long-term spaceflight.

    PubMed

    Petrov, V M

    2002-01-01

    Cosmonauts' exposure to cosmic rays during long-term spaceflight can cause unfavorable effects in health and risk for the crew members' lives. All unfavorable effects induced by exposure should be taken into consideration for the risk estimation. They should include both the acute deterministic effects and delayed effects called stochastic. On the ground the limitation of unfavorable consequences of acute exposure is achieved by means of establishing dose limits. But in space applications this approach can't be acceptable. Establishing a fixed dose limit is adequate to introducing indefinite reserve coefficient and therefore ineffective usage of spacecraft resource. The method of radiation risk calculation caused by acute and delayed effects of cosmonauts' exposure is discussed and substantiated in the report. Peculiarities of the impact of permanent radiation sources (galactic cosmic rays and trapped radiation) and the variable one (solar cosmic rays) are taken into consideration. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  11. Long-term control of root growth

    SciTech Connect

    Burton, F.G.; Cataldo, D.A.; Cline, J.F.; Skiens, W.E.

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin. 7 figs.

  12. Long-term control of root growth

    DOEpatents

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin.

  13. Long-term dynamics of Typha populations

    USGS Publications Warehouse

    Grace, J.B.; Wetzel, R.G.

    1998-01-01

    The zonation of Typha populations in an experimental pond in Michigan was re-examined 15 years after the original sampling to gain insight into the long-term dynamics. Current distributions of Typha populations were also examined in additional experimental ponds at the site that have been maintained for 23 years. The zonation between T. latifolia and T. angustifolia in the previously studied pond 15 years after the initial sampling revealed that the density and distribution of shoots had not changed significantly. Thus, it appears that previously reported results (based on 7- year old populations) have remained consistent over time. Additional insight into the interaction between these two taxa was sought by comparing mixed and monoculture stands in five experimental ponds that have remained undisturbed for their 23-year history. The maximum depth of T. latifolia, the shallow- water species, was not significantly reduced when growing in the presence of the more flood tolerant T. angustifolia. In contrast, the minimum depth of T. angustifolia was reduced from 0 to 37 cm when in the presence of T. latifolia. When total populations were compared between monoculture and mixed stands, the average density of T. angustifolia shoots was 59.4 percent lower in mixed stands while the density of T. latifolia was 32 percent lower, with T. angustifolia most affected at shallow depths (reduced by 92 percent) and T. latifolia most affected at the deepest depths (reduced by 60 percent). These long-term observations indicate that competitive displacement between Typha taxa has remained stable over time.

  14. Reconstructing the long-term aa index

    NASA Astrophysics Data System (ADS)

    Clilverd, Mark A.; Clarke, Ellen; Ulich, Thomas; Linthe, Joachim; Rishbeth, Henry

    2005-07-01

    The robustness of the aa geomagnetic index is of critical importance to the debate about the previously reported doubling of the solar coronal magnetic field in the last 100 years, inferred from an increasing trend in this index. To test the trend in aa, we have reconstructed the aa index using two long-running European stations (Sodankylä from 1914 and Niemegk from 1890) to provide data for the northern component of the index that are independent of data from the UK observatories used in the "official" aa index. Both the fully "reconstructed" aa series, based on Sodankylä (67°N, L = 5.2 RE) and Niemegk (52°N, L = 2.3 RE) data in combination with the official aa Southern Hemisphere data, confirm the increasing trend in the index. The Niemegk-based index shows little solar cycle variation in its deviation from the official index, probably because of the midlatitude location of the station. The high-latitude station, Sodankylä, is more affected by active geomagnetic conditions during solar maximum because of the proximity of the auroral oval to the station. Nevertheless, its index also clearly confirms the increasing trend in the aa index and hence supports the idea of a long-term increase in solar coronal magnetic field strength. As an added test, we reconstructed the aa index from a single site using data from two long-running UK stations, Eskdalemuir and Lerwick, applying a technique known as interhourly variation (IHV) proposed by Svalgaard et al. (2004). The resulting series is designed to be primarily sensitive to solar wind conditions. Both the reconstructed aaIHV also showed an increasing trend with time and high consistency with the official aa index. Overall, we conclude that the robustness of the trend in the aa index supports the idea of a long-term increase in solar coronal magnetic field strength.

  15. Posterior urethral valves: long-term outcome.

    PubMed

    Caione, Paolo; Nappo, Simona Gerocarni

    2011-10-01

    Posterior urethral valves represent the most common cause of bladder outlet obstruction in infancy that impairs renal and bladder function. Long-term outcome of patients with previous PUV is evaluated. Patients over 18 years of age, treated from 1982 to 1995 before the age of 3 years were considered. Previous surgery, renal function, bladder activity, urinary incontinence, and fertility/sexual activity were evaluated. Clinical interview, creatinine clearance, uroflowmetry with ultrasound post-void urine residue, and self-administered questionnaire were recorded. Out of 45 identified records, 24 patients (53.3%) accepted to be enrolled (age 18-34 years, mean 23 years). The mean follow-up was 19.5 years (16-30 years). Out of the 21 excluded patients, 20 did not reply to the clinical interview and 1 died at age of 6 years. All the 24 patients had early endoscopic section of PUV; nine also received transient ureterocutaneostomy or vesicostomy. Ureteroneocystostomy was performed in five patients and ureterocystoplasty with unilateral nephrectomy in two. At follow-up chronic renal failure was detected in 13 patients (54.1%) and 9 (37.5%) had arterial hypertension. End-stage renal disease developed in five patients (20.8%): three had successful renal transplantation and two were in dialysis. Lower urinary tract symptoms were present in seven patients (29.1%). No significant fertility deficit and sexual dysfunction were observed in 23 patients, while 1 patient was azoospermic. No paternity was reported so far. Long-term outcome of patients with previously treated PUV is mandatory. Kidney, bladder, and sexual functions should be monitored till adulthood to verify any modified behaviour.

  16. Long term results of pneumatic retinopexy

    PubMed Central

    Ellakwa, Amin F

    2012-01-01

    Background Rhegmatogenous retinal detachment is a commonly encountered retinal problem where rapid treatment can prevent irreversible vision loss. Pneumatic retinopexy (PR) is a simple, minimally invasive procedure for retinal reattachment. Purpose This study aimed to assess the long-term anatomical and functional outcome of pneumatic retinopexy in primary rhegmatogenous retinal detachment. Patients and methods A prospective interventional study was performed. Subjects with rhegmatogenous retinal detachment who underwent pneumatic retinopexy from May 2006 to May 2007 at Menoufiya University Hospital were included in this study with at least 3 years follow-up. Results A total of 40 cases were included in the study. The mean age of patients was 44.25 ± 10.85 years. Reattachment of the retina was achieved in 100% of cases. In 75% of cases, the primary intervention was successful. However, the retina redetached in 20% of these during the first 6 months, requiring reinjection or another procedure. Three years after the first intervention, follow-up measurement of the mean visual acuity of the eyes without reoperation was 0.40 ± 0.21 while the mean visual acuity of the eyes which needed additional operations was 0.22 ± 0.13. Conclusion Sixty percent of the cases obtained long-term retinal reattachment with a single operation success (SOS), with good visual recovery and less morbidity than other more invasive procedures like scleral buckling or pars plana vitrectomy, translating to higher productivity for the patient. This procedure, being quicker than the alternatives, also saves the surgeon’s time, making PR a good choice for managing primary rhegmatogenous retinal detachment in developing countries. PMID:22275808

  17. Dynamics of long-term genomic selection

    PubMed Central

    2010-01-01

    Background Simulation and empirical studies of genomic selection (GS) show accuracies sufficient to generate rapid gains in early selection cycles. Beyond those cycles, allele frequency changes, recombination, and inbreeding make analytical prediction of gain impossible. The impacts of GS on long-term gain should be studied prior to its implementation. Methods A simulation case-study of this issue was done for barley, an inbred crop. On the basis of marker data on 192 breeding lines from an elite six-row spring barley program, stochastic simulation was used to explore the effects of large or small initial training populations with heritabilities of 0.2 or 0.5, applying GS before or after phenotyping, and applying additional weight on low-frequency favorable marker alleles. Genomic predictions were from ridge regression or a Bayesian analysis. Results Assuming that applying GS prior to phenotyping shortened breeding cycle time by 50%, this practice strongly increased early selection gains but also caused the loss of many favorable QTL alleles, leading to loss of genetic variance, loss of GS accuracy, and a low selection plateau. Placing additional weight on low-frequency favorable marker alleles, however, allowed GS to increase their frequency earlier on, causing an initial increase in genetic variance. This dynamic led to higher long-term gain while mitigating losses in short-term gain. Weighted GS also increased the maintenance of marker polymorphism, ensuring that QTL-marker linkage disequilibrium was higher than in unweighted GS. Conclusions Losing favorable alleles that are in weak linkage disequilibrium with markers is perhaps inevitable when using GS. Placing additional weight on low-frequency favorable alleles, however, may reduce the rate of loss of such alleles to below that of phenotypic selection. Applying such weights at the beginning of GS implementation is important. PMID:20712894

  18. Managing Osteoporosis Patients after Long-Term Bisphosphonate Treatment

    PubMed Central

    Adler, Robert A.; Fuleihan, Ghada El-Hajj; Bauer, Douglas C.; Camacho, Pauline M.; Clarke, Bart L.; Clines, Gregory A.; Compston, Juliet E.; Drake, Matthew T.; Edwards, Beatrice J.; Favus, Murray J.; Greenspan, Susan L.; McKinney, Ross; Pignolo, Robert J.; Sellmeyer, Deborah E.

    2016-01-01

    Bisphosphonates (BPs) are the most commonly used medications for osteoporosis, but optimal duration of therapy is unknown. This ASBMR report provides guidance on BP therapy duration with a risk benefit perspective. Two trials provided evidence for long-term BP use. In the Fracture Intervention Trial Long-term Extension (FLEX), postmenopausal women receiving alendronate for 10 years had fewer clinical vertebral fractures than those switched to placebo after 5 years. In the HORIZON extension, women who received 6 annual infusions of zoledronic acid had fewer morphometric vertebral fractures compared with those switched to placebo after 3 years. Low hip T-score between −2 and −2.5 in FLEX and below −2.5 in HORIZON extension predicted a beneficial response to continued therapy. Hence, the Task Force suggests that after 5 years of oral BP or 3 years of intravenous BP, women should be reassessed. Women with previous major osteoporotic fracture, those who fracture on therapy, or others at high risk should generally continue therapy for up to 10 years (oral) or 6 years (intravenous), with periodic risk-benefit evaluation. Older women, those with a low hip T-score or high fracture risk score are considered high risk. The risk of osteonecrosis of the jaw and atypical femoral fracture increases with BP therapy duration, but such rare events are far outweighed by fracture risk reduction with BPs in high risk patients. For women not at high fracture risk after 3–5 years of BP treatment, a drug holiday of 2–3 years can be considered, with periodic reassessment. The algorithm provided for long term BP use is based on limited evidence in mostly Caucasian postmenopausal women and only for vertebral fracture reduction. It is probably applicable to men and patients with glucocorticoid-induced osteoporosis, with some adaptations. It is unlikely that future osteoporosis trials will provide data for formulating definitive recommendations. PMID:26350171

  19. Long-Term Trends Derived from Satellite PMC Data

    NASA Astrophysics Data System (ADS)

    Deland, M. T.

    2003-12-01

    The recent availability of long-term PMC data sets from satellites provides the opportunity to evaluate possible PMC trends over the past few decades. Satellite PMC data have daily coverage to characterize seasonal variations, sufficient detections for each season to give good statistics, quantitative information for physical analysis, and coverage of both hemispheres to evaluate global behavior. Multiple PMC data sets are available from the SBUV and SBUV/2 instruments on the Nimbus-7 and NOAA TIROS polar orbiting satellites. These overlapping data sets now provide more than 24 years of continuous data from November 1978 to the present, typically with concurrent measurements from multiple instruments during each PMC season. The SAGE II instrument has also accumulated more than 17 years of PMC data since 1985. Analysis of these lengthy data sets shows a clear anti-correlation between seasonally averaged PMC occurrence frequency and solar UV activity over the past two solar cycles, in agreement with model predictions. The SBUV data also show a significant long-term increase in PMC brightness in both hemispheres, approximately +4%/decade in the Northern Hemisphere and +7%/decade in the Southern Hemisphere. These results can be compared with information about trends in plausible source mechanisms such as mesospheric water vapor and temperature. Model results suggest that PMC brightness changes are consistent with observed long-term water vapor changes. Additional factors probably contribute to the overall PMC response for individual seasons. Future satellite instruments (SBUV/2, OMPS) will continue the SBUV PMC data record for an additional 10-20 years. Hopefully, further improvements in modeling will allow these data to become useful in characterizing the trends in atmospheric parameters.

  20. Long-term runoff forecasting by combining hydrological models and meteorological records

    NASA Astrophysics Data System (ADS)

    Yang, Tao-Chang; Yu, Pao-Shan; Chen, Chiang-Chi

    2005-06-01

    Reservoir operation is generally based on the inflows of the upstream catchment of the reservoir. If the arriving inflows can be forecasted, that can benefit reservoir operation and management. This study attempts to construct a long-term inflow-forecasting model by combining a continuous rainfall-runoff model with the long-term weather outlook from the Central Weather Bureau of Taiwan. The analytical results demonstrate that the continuous rainfall-runoff model has good inflow simulation performance by using 10-day meteorological and inflow records over a 33-year period for model calibration and verification. The long-term inflow forecasting during the dry season was further conducted by combining the continuous rainfall-runoff model and the long-term weather outlook, which was found to have good performance.

  1. The Starkey project: long-term research for long-term management solutions.

    Treesearch

    Thomas M. Quigley; Michael J. Wisdom

    2004-01-01

    The Starkey Project is a unique, long-term research program designed to study the effects of key resource uses of national forests on mule deer (Odocoileus hemionus) and elk (Cervus elaphus) habitats and populations located at the Starkey Experimental Forest and Range (Starkey). The purpose of the project was to fill knowledge...

  2. The long-term recency effect in recognition memory.

    PubMed

    Talmi, Deborah; Goshen-Gottstein, Yonatan

    2006-05-01

    Three classes of theories explain the recency effect: the modal model, single-store models, and the composite view, which integrates the two positions. None could explain the absence of a long-term recency effect in recognition memory in previous studies. We suggest that prior work did not obtain a recency effect because testing used a multiple-probe rather than a single-probe recognition procedure. Here we tested memory using a single-probe recognition procedure. Experimental conditions included an immediate test, a delayed test after a filled interval, and a continuous-distractor paradigm in which the same filled delay preceded the first word and followed every study word. The long-term recency effect in continuous-distractor recognition was equivalent to the recency effect in immediate recognition. Its absence in the delayed recognition condition demonstrated that it was not attributed to the use of a putative short-term memory store. Single-store models and the composite view can account for this novel finding.

  3. Norfloxacin-releasing urethral catheter for long-term catheterization.

    PubMed

    Park, Jae Hyung; Cho, Yong Woo; Cho, Yong-Hyun; Choi, Joong Myung; Shin, Hee Jong; Bae, You Han; Chung, Hesson; Jeong, Seo Young; Kwon, Ick Chan

    2003-01-01

    Norfloxacin-releasing urethral catheters were prepared for the purpose of preventing urinary tract infections during long-term catheterization. The outer and inner surfaces of the catheters were coated with poly(ethylene-co-vinyl acetate) (EVA) and an amphiphilic multiblock co-polymer (PEO2kPDMS), composed of poly(ethylene oxide) and poly(dimethyl siloxane). Norfloxacin, a fluoroquinolone synthetic antibiotic, was impregnated into a coating layer. The in vitro drug release behavior was monitored for 30 days, the surface topography was investigated using scanning electron microscopy (SEM) and the antibacterial activity against different bacteria implicated in urinary tract infection was evaluated by the in vitro inhibition zone test. All the coated catheters showed continuous delivery of norfloxacin for up to 30 days owing to hydrophobic natures of norfloxacin and EVA. PEO2kPDMS incorporated in a coating layer produced a smooth and uniform surface. The coated catheters created considerable inhibition zones for 10 days against Escherichia coli. Klebsiella pneumoniae and Proteus vulgaris, indicating the continuous release of norfloxacin. Overall, it was evident that the catheters coated with EVA/PEO2kPDMS blends containing norfloxacin have a promising potential for the clinical use in patients undergoing long-term catheterization.

  4. Long-term methylphenidate intake in chronic fatigue syndrome.

    PubMed

    Blockmans, Daniel; Persoons, Philippe

    2016-12-01

    Concentration disturbances are frequent in chronic fatigue syndrome (CFS). In a placebo-controlled double-blind crossover study, methylphenidate over 4 weeks was superior to placebo in the relief of fatigue and concentration disturbance. This observational study describes the effect of long-term methylphenidate intake on fatigue, concentration, and daily life activities, as reported by the patients themselves. A questionnaire was sent to all CFS patients who were prescribed methylphenidate at the general internal medicine department of a university hospital between August 2004 and February 2007, for possible improvement of concentration difficulties and fatigue. Out of 194 consecutive patients, 149 (76.8%) sent the questionnaire back. At the time of the questionnaire, 65.3% had stopped the intake of methylphenidate, 34.7% still took it daily or occasionally. Among the patients who continued methylphenidate, 48% reported an at least 50% improvement of fatigue, and 62% reported an at least 50% improvement of concentration difficulties. This continued intake of methylphenidate resulted in more working hours in these patients. Side effects (agitation, palpitations, and dry mouth) were reported significantly more in patients who had stopped methylphenidate than in those who still took it. The long-term intake of methylphenidate by CFS patients with concentration difficulties has a positive effect in about one out of three patients.

  5. Future Demand For Long-Term Care Workers Will Be Influenced By Demographic And Utilization Changes.

    PubMed

    Spetz, Joanne; Trupin, Laura; Bates, Timothy; Coffman, Janet M

    2015-06-01

    A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use and staffing of long-term care, project demand for long-term care services and workers through 2030, and assess how projections varied if we changed assumptions about utilization patterns. If current trends continue, the occupations anticipated to grow the most over the period are counselors and social workers (94 percent), community and social services workers (93 percent), and home health and personal care aides (88 percent). Alternative projections were computed for scenarios that assumed changing racial and ethnic patterns of long-term care use or shifts toward noninstitutional care. For instance, if Hispanics used services at the same rate as non-Hispanic blacks, the projected demand for long-term care workers would be 5 percent higher than if current trends continued. If 20 percent of nursing home care were shifted to home health services, total employment growth would be about 12 percent lower. Demographic and utilization changes would have little effect on projections of robust long-term care employment growth between now and 2030. Policy makers and educators should redouble efforts to create and sustainably fund programs to recruit, train, and retain long-term care workers.

  6. Long-term surveillance plan for the Ambrosia Lake, New Mexico disposal site

    SciTech Connect

    1996-07-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Ambrosia Lake disposal site in McKinley County, New Mexico, describes the U.S. Department of Energy`s (DOE) long-term care program for the disposal site. The DOE will carry out this program to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials.

  7. Long-term surveillance plan for the Ambrosia Lake, New Mexico disposal site

    SciTech Connect

    1995-11-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Ambrosia Lake disposal site in McKinley County, New Mexico, describes the US Department of Energy`s (DOE) long-term care program for the disposal site. The DOE will carry out this program to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials.

  8. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all long...

  9. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all long...

  10. Treatment for childhood cancer -- long-term risks

    MedlinePlus

    ... ency/patientinstructions/000849.htm Treatment for childhood cancer - long-term risks To use the sharing features on this ... has. Being aware of your child's risk of long-term health problems can help you follow-up with ...

  11. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES FINANCED BY USAID Conditions Governing Source and Nationality of Commodity Procurement Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease...

  12. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  13. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  14. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  15. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES FINANCED BY USAID Conditions Governing Source and Nationality of Commodity Procurement Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease...

  16. LONG-TERM MONITORING SENSOR NETWORK

    SciTech Connect

    Stephen P. Farrington; John W. Haas; Neal Van Wyck

    2003-10-16

    Long-term monitoring (LTM) associated with subsurface contamination sites is a key element of Long Term Stewardship and Legacy Management across the Department of Energy (DOE) complex. However, both within the DOE and elsewhere, LTM is an expensive endeavor, often exceeding the costs of the remediation phase of a clean-up project. The primary contributors to LTM costs are associated with labor. Sample collection, storage, preparation, analysis, and reporting can add a significant financial burden to project expense when extended over many years. Development of unattended, in situ monitoring networks capable of providing quantitative data satisfactory to regulatory concerns has the potential to significantly reduce LTM costs. But survival and dependable operation in a difficult environment is a common obstacle to widespread use across the DOE complex or elsewhere. Deploying almost any sensor in the subsurface for extended periods of time will expose it to chemical and microbial degradation. Over the time-scales required for in situ LTM, even the most advanced sensor systems may be rendered useless. Frequent replacement or servicing (cleaning) of sensors is expensive and labor intensive, offsetting most, if not all, of the cost savings realized with unattended, in situ sensors. To enable facile, remote monitoring of contaminants and other subsurface parameters over prolonged periods, Applied Research Associates, Inc has been working to develop an advanced LTM sensor network consisting of three key elements: (1) an anti-fouling sensor chamber that can accommodate a variety of chemical and physical measurement devices based on electrochemical, optical and other techniques; (2) two rapid, cost effective, and gentle means of emplacing sensor packages either at precise locations directly in the subsurface or in pre-existing monitoring wells; and (3) a web browser-based data acquisition and control system (WebDACS) utilizing field-networked microprocessor-controlled smart

  17. Robotics for Long-Term Monitoring

    SciTech Connect

    Shahin, Sarkis; Duran, Celso

    2002-07-01

    While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

  18. Long-term Changes in Tropospheric Ozone

    NASA Astrophysics Data System (ADS)

    Oltmans, S.; Lefohn, A.; Galbally, I.; Scheel, E.; Bodeker, G.; Brunke, E.; Claude, H.; Tarasick, D.; Simmonds, P.; Anlauf, K.; Schmidlin, F.; Akagi, K.; Redondas, A.

    2006-05-01

    Tropospheric ozone measurements from a selected network of surface and ozonesonde sites are used to give a broad geographic picture of long-term variations. The picture of long-term tropospheric ozone changes is a varied one in terms of both the sign and magnitude of trends and in the possible causes for the changes. At mid latitudes of the S.H. three time series of ~20 years in length agree in showing increases that are strongest in the austral spring (August-October). Profile measurements show this increase extending through the mid troposphere but not into the highest levels of the troposphere. In the N.H. in the Arctic a period of declining ozone in the troposphere through the 1980s into the mid 1990s has reversed and the overall change is small. The decadal-scale variations in the troposphere in this region are related in part to changes in the lowermost stratosphere. At mid latitudes in the N.H., continental Europe and Japan showed significant increases in the 1970s and 1980s. Over North America rises in the 1970s are less than those seen in Europe and Japan, suggesting significant regional differences. In all three of these mid latitude, continental regions tropospheric ozone amounts appear to have leveled off or in some cases declined in the more recent decades. Over the North Atlantic three widely separated sites show significant increases since the late 1990s that may have peaked in recent years. In the N.H. tropics both the surface record and the ozonesondes in Hawaii show a significant increase in the autumn months in the most recent decade compared to earlier periods that drives the overall increase seen in the 30 year record. This appears to be related to a shift in the transport pattern during this season with more frequent flow from higher latitudes in the latest decade. The pattern of change, with the largest increases in the N.H. coming prior to the mid 1980s, suggests that increased positive radiative forcing due to tropospheric ozone was felt

  19. General practitioners' management of the long-term sick role.

    PubMed

    Higgins, Angela; Porter, Sam; O'Halloran, Peter

    2014-04-01

    In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

  20. Long-term outcomes after simultaneous pancreas-kidney transplant.

    PubMed

    Wai, Philip Y; Sollinger, Hans W

    2011-02-01

    Simultaneous pancreas-kidney (SPK) transplantation represents the only proven long-term therapeutic approach for type 1 diabetic, dialysis-dependent patients. This procedure potentially liberates these patients from dialysis and the need for exogenous insulin replacement. For the first time, data on the long-term natural history of patients receiving SPK have recently been analyzed. In this review, we discuss the outcomes and complications for patients receiving SPK in the context of the current literature. In our analysis of 1000 SPKs performed at our center, we demonstrated that SPK increases patient survival compared with live-donor kidney alone or deceased donor kidney alone transplantation. The 5-year, 10-year, and 20-year patient survival for SPK recipients was 89, 80, and 58%, respectively. Enteric drainage improves quality of life, but not allograft survival, when compared with bladder drainage. After transplantation, approximately 50% of bladder-drained transplants undergo enteric conversion and late conversion after transplantation is associated with a higher complication rate. Surgical complications are higher in enteric-drained compared with bladder-drained pancreas transplants. Selecting the appropriate therapy for a type 1 diabetic recipient with renal failure continues to be a critical decision for programs offering pancreas transplantation. The principles and guidelines at our center are driven by the potential benefit of the SPK transplant needing to outweigh the increased morbidity of the surgical procedure and the use of lifelong immunosuppression. Results from long-term studies demonstrating improved patient survival suggest that the treatment of choice for an appropriate type 1 diabetic recipient is an SPK transplant.

  1. Evaluating Long-Term Care Through the Humanbecoming Lens.

    PubMed

    Hart, Judith D

    2015-10-01

    The author describes evaluating long-term care from the humanbecoming perspective. Three core ideas are presented related to dignity and living quality, and how the humanbecoming perspective can be incorporated into long-term care evaluations that make a difference to the residents, caregivers, management, and to the outcomes of long-term care. This approach from the humanbecoming perspective can enrich evaluative information, influence long-term care outcomes, and ensure human dignity for all concerned.

  2. Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

    2010-01-01

    The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

  3. Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

    2010-01-01

    The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

  4. Long-term Variability of Beach Cusps

    NASA Astrophysics Data System (ADS)

    Pianca, C.; Holman, R. A.; Siegle, E.

    2016-02-01

    The most curious morphological features observed on beaches are the cusps. Due to their rhythmic spacing, beach cusps have attracted many observers and many, often contradictory, theories as to their form. Moreover, most of the research about beach cusps has focused on their formation. Few had available long time series to study such things as the variability of alongshore and cross-shore position and spacing on the cusp field, the presence, longevity and interactions between higher and lower sets of cusps, and the processes by which cusp fields extend, shrink or change length scale. The purpose of this work is to use long-term data sets of video images from two study sites, an intermediate (Duck, USA, 26 years) and a reflective beach (Massaguaçu, Brazil, 3 years), to investigate the temporal and spatial changes of cusps conditions. Time-evolving shoreline data were first extracted using an algorithm called ASLIM (Pianca et al 2015). Cusps were then identified based on the band-passed variability of time exposure image data about this shoreline as a function of elevation relative to MSL. The identified beaches cusps will be analyzed for cusp spacing, positions (upper or lower cusps), alongshore variability, merging events, percentage of cusp events, patterns of the events and time scales of variability. Finally, the relationship of these characteristics to environmental conditions (wave, tides, beach conditions) will be studied.

  5. Long-term adequacy of metal resources

    USGS Publications Warehouse

    Singer, D.A.

    1977-01-01

    Although the earth's crust contains vast quantities of metals, extraction technologies and associated costs are inextricably bound to three fundamental geological factors - the amount of metal available in the earth's crust in each range of grades, the mineralogical form and chemical state of the metal, and the spatial distribution of the metal. The energy required to recover a given amount of metal increases substantially as grade declines. Most metal is produced from sulphide or oxide minerals, whereas most metal in the crust may be locked in the structures of the more refractory silicates. Recovery from silicate minerals could require orders of magnitude more energy than that used at present as also could exploitation of small, widely scattered or thin, deeply buried deposits. Although specific information on the fundamental factors is not available, each factor must in turn tend to further restrict exploitation. Independence of average grade and tonnage for many deposit types further reduces the availability of rock as a source of metal. In the long term, effects of these factors will be large increases in price for many metals. ?? 1977.

  6. Long term results of childhood dysphonia treatment.

    PubMed

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr

    2014-05-01

    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Long-term corrosion testing pan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2008-08-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing needs. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to meet all future testing needs, given that all testing is consolidated to a single location. This report is a revision to SAND2007-7027 to address DOE comments and add a series of tests to address NWTRB recommendations.

  8. Long-term data storage in diamond.

    PubMed

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A

    2016-10-01

    The negatively charged nitrogen vacancy (NV(-)) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV(-) optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV(-) ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center's charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV(-) ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies.

  9. Long-term physiological consequences of pneumonectomy.

    PubMed

    Deslauriers, Jean; Ugalde, Paula; Miro, Santiago; Deslauriers, Deborah R; Ferland, Sylvie; Bergeron, Sébastien; Lacasse, Yves; Provencher, Steeve

    2011-01-01

    Ever since the first successful pneumonectomy for lung cancer was performed in 1933, a number of largely historical reports have attempted to look at the physiological consequences of this operation in order to define patient long-term functional status. The pertinence of these contributions is, however, limited because most were performed in patients who had their pneumonectomy for benign diseases or were carried out in small and heterogeneous populations. Thus, several surgical myths and beliefs such as phrenic nerve interruption at the time of operation might be desirable, marked hyperinflation of the residual lung is associated with reduced lung function, and patients develop pulmonary hypertension over time and have poor exercise tolerance have persisted over the years. Our findings based on a study of 100 patients evaluated 5 or more years after surgery (mean follow-up time, 9.1 ± 2.8 years [5.0-14.7 years]) show that most patients can adjust to living with only one lung and are thus able to live a near-normal life. Although diaphragmatic paralysis is characterized by significant alterations in respiratory function, hyperinflation of the residual lung is beneficial. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Long-term predictions using natural analogues

    SciTech Connect

    Ewing, R.C.

    1995-09-01

    One of the unique and scientifically most challenging aspects of nuclear waste isolation is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10{sup 3}-10{sup 5} years) required by regulatory agencies for performance assessment. The direct validation of these extrapolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the lay public that there is a demonstrable and reasonable basis for accepting the long-term extrapolations. Natural systems (e.g., {open_quotes}natural analogues{close_quotes}) provide perhaps the only means of partial {open_quotes}validation,{close_quotes} as well as data that may be used directly in the models that are used in the extrapolation. Natural systems provide data on very large spatial (nm to km) and temporal (10{sup 3}-10{sup 8} years) scales and in highly complex terranes in which unknown synergisms may affect radionuclide migration. This paper reviews the application (and most importantly, the limitations) of data from natural analogue systems to the {open_quotes}validation{close_quotes} of performance assessments.

  11. Long-term corrosion testing plan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2009-02-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing program. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to accommodate all future testing, given that all testing is consolidated to a single location. This report is a revision to SAND2008-4922 to address DOE comments.

  12. Dental hygienists and long-term care.

    PubMed

    Ablah, C R; Pickard, R B

    1998-01-01

    This study examined the willingness of dental hygienists to work in long-term care (LTC) facilities providing oral health care to the elderly. In August 1995, a mail survey of all 839 licensed and practicing dental hygienists in Kansas was conducted. Respondents were asked about their reasons for choosing dental hygiene as a career, perceptions of the adequacy of their education, satisfaction with their work, interest in working with elderly patients, and whether general supervision would influence their willingness to practice in LTC settings. Response rate was 69 percent, with 582 usable questionnaires returned. Data were analyzed using descriptive statistics and chi-square tests of significance. The results showed an overwhelming majority (94 percent) of respondents would be willing to work, at least on occasion, in a LTC facility. However, few were interested in full-time geriatric practice. Those indicating a willingness to practice regularly with the elderly, at least part time, were typically less experienced in their field and more likely to perceive their education as having adequately prepared them to care for older patients. The findings demonstrate dental hygienists' willingness to provide dental care for older adults. To optimize this resource, appropriate education is needed so that students and current practitioners master the distinctive skills necessary to care for this population.

  13. Long-Term Consequences of Neonatal Injury

    PubMed Central

    Beggs, Simon

    2015-01-01

    The maturation of the central nervous system’s (CNS’s) sensory connectivity is driven by modality-specific sensory input in early life. For the somatosensory system, this input is the physical, tactile interaction with the environment. Nociceptive circuitry is functioning at the time of birth; however, there is still considerable organization and refinement of this circuitry that occurs postnatally, before full discrimination of tactile and noxious input is possible. This fine-tuning involves separation of tactile and nociceptive afferent input to the spinal cord’s dorsal horn and the maturation of local and descending inhibitory circuitry. Disruption of that input in early postnatal life (for example, by tissue injury or other noxious stimulus), can have a profound influence on subsequent development, and consequently the mature functioning of pain systems. In this review, the impact of neonatal surgical incision on nociceptive circuitry is discussed in terms of the underlying developmental neurobiology. The changes are complex, occurring at multiple anatomical sites within the CNS, and including both neuronal and glial cell populations. The altered sensory input from neonatal injury selectively modulates neuronal excitability within the spinal cord, disrupts inhibitory control, and primes the immune system, all of which contribute to the adverse long-term consequences of early pain exposure. PMID:26174217

  14. Intermediate- and long-term earthquake prediction.

    PubMed

    Sykes, L R

    1996-04-30

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study.

  15. Intermediate- and long-term earthquake prediction.

    PubMed Central

    Sykes, L R

    1996-01-01

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study. Images Fig. 1 PMID:11607658

  16. Transuranic waste: long-term planning

    SciTech Connect

    Young, K.C.

    1985-07-01

    Societal concerns for the safe handling and disposal of toxic waste are behind many of the regulations and the control measures in effect today. Transuranic waste, a specific category of toxic (radioactive) waste, serves as a good example of how regulations and controls impact changes in waste processing - and vice versa. As problems would arise with waste processing, changes would be instituted. These changes improved techniques for handling and disposal of transuranic waste, reduced the risk of breached containment, and were usually linked with regulatory changes. Today, however, we face a greater public awareness of and concern for toxic waste control; thus, we must anticipate potential problems and work on resolving them before they can become real problems. System safety analyses are valuable aids in long-term planning for operations involving transuranic as well as other toxic materials. Examples of specific system safety analytical methods demonstrate how problems can be anticipated and resolution initiated in a timely manner having minimal impacts upon allocation of resource and operational goals. 7 refs., 1 fig.

  17. The long-term variability of Vega

    NASA Astrophysics Data System (ADS)

    Butkovskaya, V.; Plachinda, S.; Valyavin, G.; Baklanova, D.; Lee, B.-C.

    2011-12-01

    Over the time of 60 years Vega (α Lyrae = HD 172167, A0V) has been generally accepted as a standard star in the near-infrared, optical, and ultraviolet regions. But is the spectrophotometric standard Vega really non-variable star? Researchers give very different answers to this question. We aim to search a periodicity in our results of spectropolarimetric study of Vega, namely periodic variations in equivalent width of the spectral lines and longitudinal magnetic field measurements. High-accuracy spectropolarimetric observations of Vega have been performed during 26 nights from 1997 to 2010 using the Coudé spectrograph of the 2.6-m Shain reflector at the Crimean Astrophysical Observatory (CrAO, Ukraine) and during 4 nights in 2007 and 2008 using the echelle spectrograph BOES at the Bohyunsan Optical Astronomy Observatory (BOAO, South Korea). The long-term (year-to-year) variability of Vega was confirmed. It was concluded that this variability does not have magnetic nature. The paper is dedicated to the memory of V.P. Merezhin.

  18. Economic efficiency, IRPs and long term contracts

    SciTech Connect

    Sutherland, R.J.

    1993-04-30

    There is no market failure that warrants utility regulation of the construction of new generating plants, the supply of energy efficiency or the purchase of fuel under contract. The natural monopoly problem applies to the distribution of electricity and gas, not to generation, energy conservation, or gas purchases. Utility regulation magnifies a market failure, which is the principal agent problem. Regulatory allowance of utilities signing long term fixed price contracts and undertaking conservation measures result in costs and risks being shifted to ratepayers that would not occur under competitive market conditions. Economic efficiency would be enhanced if cost of service regulation of electric and gas utilities were replaced by a competitive market process for the construction of new power plants, utility conservation programs and contracts to purchase fuel. Conservation measures could be supplied by energy service companies. Gas merchants could provide gas and energy conservation directly to ultimate customers, if they had access to LDC pipelines. With a competitive market established to sell gas and energy services, contracts and conservation measures would not require cost-of- service regulation.

  19. Long-Term Soft Denture Lining Materials

    PubMed Central

    Chladek, Grzegorz; Żmudzki, Jarosław; Kasperski, Jacek

    2014-01-01

    Long-term soft denture lining (LTSDL) materials are used to alleviate the trauma associated with wearing complete dentures. Despite their established clinical efficacy, the use of LTSDLs has been limited due to the unfavorable effects of the oral environment on some of their mechanical and performance characteristics. The unresolved issue of LTSDL colonization by Candida albicans is particularly problematic. Silicone-based LTSDL (SLTSDL) materials, which are characterized by more stable hardness, sorption and solubility than acrylic-based LTSDLs (ALTSDLs), are currently the most commonly used LTSDLs. However, SLTSDLs are more prone to debonding from the denture base. Moreover, due to their limitations, the available methods for determining bond strength do not fully reflect the actual stability of these materials under clinical conditions. SLTSDL materials exhibit favorable viscoelastic properties compared with ALTSDLs. Furthermore, all of the lining materials exhibit an aging solution-specific tendency toward discoloration, and the available cleansers are not fully effective and can alter the mechanical properties of LTSDLs. Future studies are needed to improve the microbiological resistance of LTSDLs, as well as some of their performance characteristics. PMID:28788163

  20. Long-term data storage in diamond

    PubMed Central

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A.

    2016-01-01

    The negatively charged nitrogen vacancy (NV−) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV− optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV− ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center’s charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV− ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies. PMID:27819045

  1. Long-term potentiation: peeling the onion.

    PubMed

    Nicoll, Roger A; Roche, Katherine W

    2013-11-01

    Since the discovery of long-term potentiation (LTP), thousands of papers have been published on this phenomenon. With this massive amount of information, it is often difficult, especially for someone not directly involved in the field, not to be overwhelmed. The goal of this review is to peel away as many layers as possible, and probe the core properties of LTP. We would argue that the many dozens of proteins that have been implicated in the phenomenon are not essential, but rather modulate, often in indirect ways, the threshold and/or magnitude of LTP. What is required is NMDA receptor activation followed by CaMKII activation. The consequence of CaMKII activation is the rapid recruitment of AMPA receptors to the synapse. This recruitment is independent of AMPA receptor subunit type, but absolutely requires an adequate pool of surface receptors. An important unresolved issue is how exactly CaMKII activation leads to modifications in the PSD to allow rapid enrichment. This article is part of the Special Issue entitled 'Glutamate Receptor-Dependent Synaptic Plasticity'.

  2. Neurological long term consequences of deep diving.

    PubMed Central

    Todnem, K; Nyland, H; Skeidsvoll, H; Svihus, R; Rinck, P; Kambestad, B K; Riise, T; Aarli, J A

    1991-01-01

    Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean age 34.0 (range 22-48) years. The divers reported significantly more symptoms from the nervous system. Concentration difficulties and paraesthesia in feet and hands were common. They had more abnormal neurological findings by neurological examination compatible with dysfunction in the lumbar spinal cord or roots. They also had a larger proportion of abnormal electroencephalograms than the controls. The neurological symptoms and findings were highly significantly correlated with exposure to deep diving (depth included), but even more significantly correlated to air and saturation diving and prevalence of decompression sickness. Visual evoked potentials, brainstem auditory evoked potentials, and magnetic resonance imaging of the brain did not show more abnormal findings in the divers. Four (10%) divers had had episodes of cerebral dysfunction during or after the dives; two had had seizures, one had had transitory cerebral ischaemia and one had had transitory global amnesia. It is concluded that deep diving may have a long term effect on the nervous system of the divers. PMID:2025592

  3. [Long-term stability of orthodontic treatment].

    PubMed

    Kuijpers-Jagtman, A M; Al Yami, E A; van 't Hof, M A

    2000-04-01

    Aim of this study was to assess long-term stability of orthodontic treatment in a sample of 1016 patients until 10 years postretention. Treatment outcome was measured with the PAR-index at 6 different stages. The mean age of the patients was 12.0 +/- 3.1 year at the start of treatment to 26.3 +/- 2.9 year 10 years postretention. The results show that 67% of the orthodontic treatment result, as measured with the PAR-index, was maintained 10 years postretention. The PAR-scores for the midline and the open bite remained about the same over the years. However, the scores for the lateral occlusion, overjet, reversed overjet, overbite, and contact point displacement of the upper and lower front teeth increased gradually over time. Nearly 50% of the total relapse took place the first two years after retention. The largest change was found for the position of the lower incisors. Ten years postretention their position was even worse than at the start of treatment.

  4. Legislation on Long-Term Care Insurance. Report No. 11.

    ERIC Educational Resources Information Center

    Wisconsin State Legislative Council, Madison.

    This report presents Wisconsin state legislation on long-term care insurance. Part I summarizes key provisions of six 1987 assembly bills concerned with long-term care insurance. Part II describes activities of the Wisconsin State Legislative Council's Special Committee on Long-Term Health Care Insurance. Part III provides background information…

  5. 3 CFR - Long-Term Gulf Coast Restoration Support Plan

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Long-Term Gulf Coast Restoration Support Plan Presidential Documents Other Presidential Documents Memorandum of June 30, 2010 Long-Term Gulf Coast... help the Gulf Coast and its people recover from this tragedy. A long-term plan to restore the unique...

  6. ATMOS: Long term atmospheric measurements for mission to planet Earth

    NASA Technical Reports Server (NTRS)

    1992-01-01

    A long-term, space-based measurement program, together with continued balloon and aircraft-borne investigations, is essential to monitor the predicted effects in the atmosphere, to determine to what extent the concentration measurements agree with current models of stratospheric chemistry, and to determine the condition of the ozone layer. The Atmospheric Trace Molecule Spectroscopy (ATMOS) Experiment is currently making comprehensive, global measurements of Earth's atmosphere as part of the Atmospheric Laboratory for Applications and Science (ATLAS) program on the Space Shuttle. Part of NASA's Mission to Planet Earth, ATLAS is a continuing series of missions to study Earth and the Sun and provide a more fundamental understanding of the solar influences on Earth's atmosphere. The ATMOS program, instruments, and science results are presented.

  7. INL-Site Idaho Completion Project Long Term Stewardship Strategic Plan

    SciTech Connect

    Olaveson, B.

    2007-09-17

    This Strategic Plan provides a brief historical overview of ICP long-term stewardship at the INL Site and the major goals and strategies that will drive the continued implementation of long-term stewardship in the future. The specific activities and processes that will be required to implement these goals should be outlined within an implementation plan and within implementing procedures and work plans.

  8. B lymphocyte-directed immunotherapy promotes long-term islet allograft survival in nonhuman primates.

    PubMed

    Liu, Chengyang; Noorchashm, Hooman; Sutter, Jennifer A; Naji, Mina; Prak, Eline Luning; Boyer, Jean; Green, Taryn; Rickels, Michael R; Tomaszewski, John E; Koeberlein, Brigitte; Wang, Zhonglin; Paessler, Michelle E; Velidedeoglu, Ergun; Rostami, Susan Y; Yu, Ming; Barker, Clyde F; Naji, Ali

    2007-11-01

    We found that an induction immunotherapy regimen consisting of rabbit anti-thymocyte globulin (Thymoglobulin) and the monoclonal antibody to CD20 rituximab (Rituxan) promoted long-term islet allograft survival in cynomolgus macaques maintained on rapamycin monotherapy. B lymphocyte reconstitution after rituximab-mediated depletion was characterized by a preponderance of immature and transitional cells, whose persistence was associated with long-term islet allograft survival. Development of donor-specific alloantibodies was abrogated only in the setting of continued rapamycin monotherapy.

  9. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    NASA Astrophysics Data System (ADS)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  10. The neuronal response at extended timescales: long-term correlations without long-term memory

    PubMed Central

    Soudry, Daniel; Meir, Ron

    2014-01-01

    Long term temporal correlations frequently appear at many levels of neural activity. We show that when such correlations appear in isolated neurons, they indicate the existence of slow underlying processes and lead to explicit conditions on the dynamics of these processes. Moreover, although these slow processes can potentially store information for long times, we demonstrate that this does not imply that the neuron possesses a long memory of its input, even if these processes are bidirectionally coupled with neuronal response. We derive these results for a broad class of biophysical neuron models, and then fit a specific model to recent experiments. The model reproduces the experimental results, exhibiting long term (days-long) correlations due to the interaction between slow variables and internal fluctuations. However, its memory of the input decays on a timescale of minutes. We suggest experiments to test these predictions directly. PMID:24744724

  11. Long-term urinary adverse effects of pelvic radiotherapy

    PubMed Central

    Malaeb, Bahaa S.

    2011-01-01

    Objective Radiation for tumors arising in the pelvis has been utilized for over a 100 years. Adverse effects (AEs) of radiotherapy (RT) continue to accumulate with time and are reported to show decades after treatment. The benefit of RT for pelvic tumors is well described as is their acute AEs. Late AEs are less well described. The burden of treatment for the late AEs is large given the high utilization of RT. Review For prostate cancer, 37% of patients will receive radiation during the first 6 months after diagnosis. Low-and high-grade AEs are reported to occur in 20–43 and 5–13%, respectively, with a median follow-up of ∼60 months. For bladder cancer, the grade 2 and grade 3 late AEs occur in 18–27 and 6–17% with a median follow-up of 29–76 months. For cervical cancer, the risk of low-grade AEs following radiation can be as high as 28%. High-grade AEs occur in about 8% at 3 years and 14.4% at 20 years or ∼0.34% per year. Radiation AEs appear to be less common or at least less well studied after radiation for rectal and endometrial cancers. Conclusion Properly delineating the rate of long-term AEs after pelvic RT is instrumental to counseling patients about their options for cancer treatment. Further studies are needed that are powered to specifically evaluate long-term AEs. PMID:20959990

  12. Long-term decline of the Amazon carbon sink.

    PubMed

    Brienen, R J W; Phillips, O L; Feldpausch, T R; Gloor, E; Baker, T R; Lloyd, J; Lopez-Gonzalez, G; Monteagudo-Mendoza, A; Malhi, Y; Lewis, S L; Vásquez Martinez, R; Alexiades, M; Álvarez Dávila, E; Alvarez-Loayza, P; Andrade, A; Aragão, L E O C; Araujo-Murakami, A; Arets, E J M M; Arroyo, L; Aymard C, G A; Bánki, O S; Baraloto, C; Barroso, J; Bonal, D; Boot, R G A; Camargo, J L C; Castilho, C V; Chama, V; Chao, K J; Chave, J; Comiskey, J A; Cornejo Valverde, F; da Costa, L; de Oliveira, E A; Di Fiore, A; Erwin, T L; Fauset, S; Forsthofer, M; Galbraith, D R; Grahame, E S; Groot, N; Hérault, B; Higuchi, N; Honorio Coronado, E N; Keeling, H; Killeen, T J; Laurance, W F; Laurance, S; Licona, J; Magnussen, W E; Marimon, B S; Marimon-Junior, B H; Mendoza, C; Neill, D A; Nogueira, E M; Núñez, P; Pallqui Camacho, N C; Parada, A; Pardo-Molina, G; Peacock, J; Peña-Claros, M; Pickavance, G C; Pitman, N C A; Poorter, L; Prieto, A; Quesada, C A; Ramírez, F; Ramírez-Angulo, H; Restrepo, Z; Roopsind, A; Rudas, A; Salomão, R P; Schwarz, M; Silva, N; Silva-Espejo, J E; Silveira, M; Stropp, J; Talbot, J; ter Steege, H; Teran-Aguilar, J; Terborgh, J; Thomas-Caesar, R; Toledo, M; Torello-Raventos, M; Umetsu, R K; van der Heijden, G M F; van der Hout, P; Guimarães Vieira, I C; Vieira, S A; Vilanova, E; Vos, V A; Zagt, R J

    2015-03-19

    Atmospheric carbon dioxide records indicate that the land surface has acted as a strong global carbon sink over recent decades, with a substantial fraction of this sink probably located in the tropics, particularly in the Amazon. Nevertheless, it is unclear how the terrestrial carbon sink will evolve as climate and atmospheric composition continue to change. Here we analyse the historical evolution of the biomass dynamics of the Amazon rainforest over three decades using a distributed network of 321 plots. While this analysis confirms that Amazon forests have acted as a long-term net biomass sink, we find a long-term decreasing trend of carbon accumulation. Rates of net increase in above-ground biomass declined by one-third during the past decade compared to the 1990s. This is a consequence of growth rate increases levelling off recently, while biomass mortality persistently increased throughout, leading to a shortening of carbon residence times. Potential drivers for the mortality increase include greater climate variability, and feedbacks of faster growth on mortality, resulting in shortened tree longevity. The observed decline of the Amazon sink diverges markedly from the recent increase in terrestrial carbon uptake at the global scale, and is contrary to expectations based on models.

  13. Adapting Advances in Remediation Science to Long-Term Surveillance

    SciTech Connect

    Peterson, Dave

    2006-03-01

    Several facets of groundwater remediation stand to gain from the advances made during recent years in disciplines that contribute to remediation science. Engineered remedies designed to aggressively remove subsurface contamination should benefit from this progress, and more passive cleanup methods and the long-term monitoring of such passive approaches may benefit equally well if not more. The U.S. Department of Energy Office of Legacy Management (LM) has adopted a strategic plan that is designed to take advantage of technological improvements in the monitoring and assessment of both active and passive groundwater remedies. Flexible adaptation of new technologies, as they become available, to long-term surveillance at LM sites is expected to reduce site stewardship costs while ensuring the future protection of human health and the environment. Some of the technologies are expected to come from government initiatives that focus on the needs of subsurface monitoring. Additional progress in monitoring science will likely result from continual improvements in our understanding of contaminant fate-and-transport processes in the groundwater and the vadose zone.

  14. Medical constructions of long-term exhaustion, past and present.

    PubMed

    Lian, Olaug S; Bondevik, Hilde

    2015-07-01

    Culture and history affect the ways in which medical knowledge is shaped, sustained and changed. The less knowledge we have, the larger the space for the cultural imprint becomes. Based on these assumptions, we ask: how have medical constructions of long-term exhaustion changed over time, and how are changing constructions related to societal change? To discuss these questions we conducted a comparative study of medical texts from two historical periods: 1860-1930 and 1970-2013. Our data are limited to two diagnoses: neurasthenia and encephalomyelitis. After comparing the two periods by identifying diverging and converging aspects, we interpreted observed continuities and interruptions in relation to historical developments. We found that in the medical literature, long-term exhaustion became transformed from a somatic ailment bred by modern civilisation to a self-inflicted psychiatric ailment. At the same time, it changed from being a male-connoted high-status condition to a female-connoted low-status condition. We interpret these changes as contingent upon culturally available modes of interpretations. Medical knowledge thereby becomes infused with cultural norms and values which give them a distinct cultural bias. The historical controversies surrounding this medically contested condition neatly display the socially contingent factors that govern the social construction of medical knowledge. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  15. Long-term safety issues associated with mixer pump operation

    SciTech Connect

    Kubic, W.L. Jr.

    1994-12-31

    In this report, we examine several long-term issues: the effect of pump operation on future gas release events (GREs), uncontrolled chemical reactions, chronic toxic gas releases, foaming, and erosion and corrosion. Heat load in excess of the design limit, uncontrolled chemical reactions, chronic toxic gas releases, foaming, and erosion and corrosion have been shown not to be safety concerns. The effect of pump operation on future GREs could not be quantified. The problem with evaluating the long-term effects of pump operation on GREs is a lack of knowledge and uncertainty. In particular, the phenomena governing gas retention, particle size distribution, and settling are not well understood, nor are the interactions among these factors understood. There is a possibility that changes in these factors could increase the size of future GREs. Bounding estimates of the potential increase in size of GREs are not possible because of a lack of engineering data. Proper management of the hazards can reduce, but not eliminate, the possibility of undesirable changes. Maintaining temperature within the historical limits can reduce the possibility of undesirable changes. A monitoring program to detect changes in the gas composition and crust thickness will help detect slowly occurring changes. Because pump operation has be shown to eliminate GREs, continued pump operation can eliminate the hazards associated with future GREs.

  16. Long-term results of trismus release in noma patients.

    PubMed

    Bisseling, P; Bruhn, J; Erdsach, T; Ettema, A M; Sautter, R; Bergé, S J

    2010-09-01

    Noma, also known as cancrum oris, is an infectious disease that results in a loss of orofacial tissue, due to gangrene of soft and bony tissue. It is especially seen in young children in the sub-Saharan region. Among the sequelae of patients who survive noma, trismus is one of the most disabling. This retrospective research studied the long-term results of trismus release in noma patients. Thirty-six patients could be traced in the villages and were included in the study. The mean mouth opening in this group was 10.3mm (95% CI: 7.0; 13.6mm) and the mean period after discharge from hospital was 43 months. Better mouth opening was observed in patients who continued physiotherapy after discharge, were older, and those with a 'soft' (vs. 'hard') inner and outer cheek on palpation. The result of trismus release in noma patients in the long term was extremely poor in this study. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Modeling Maintenance of Long-Term Potentiation in Clustered Synapses: Long-Term Memory without Bistability

    PubMed Central

    Smolen, Paul

    2015-01-01

    Memories are stored, at least partly, as patterns of strong synapses. Given molecular turnover, how can synapses maintain strong for the years that memories can persist? Some models postulate that biochemical bistability maintains strong synapses. However, bistability should give a bimodal distribution of synaptic strength or weight, whereas current data show unimodal distributions for weights and for a correlated variable, dendritic spine volume. Thus it is important for models to simulate both unimodal distributions and long-term memory persistence. Here a model is developed that connects ongoing, competing processes of synaptic growth and weakening to stochastic processes of receptor insertion and removal in dendritic spines. The model simulates long-term (>1 yr) persistence of groups of strong synapses. A unimodal weight distribution results. For stability of this distribution it proved essential to incorporate resource competition between synapses organized into small clusters. With competition, these clusters are stable for years. These simulations concur with recent data to support the “clustered plasticity hypothesis” which suggests clusters, rather than single synaptic contacts, may be a fundamental unit for storage of long-term memory. The model makes empirical predictions and may provide a framework to investigate mechanisms maintaining the balance between synaptic plasticity and stability of memory. PMID:25945261

  18. Modeling maintenance of long-term potentiation in clustered synapses: long-term memory without bistability.

    PubMed

    Smolen, Paul

    2015-01-01

    Memories are stored, at least partly, as patterns of strong synapses. Given molecular turnover, how can synapses maintain strong for the years that memories can persist? Some models postulate that biochemical bistability maintains strong synapses. However, bistability should give a bimodal distribution of synaptic strength or weight, whereas current data show unimodal distributions for weights and for a correlated variable, dendritic spine volume. Thus it is important for models to simulate both unimodal distributions and long-term memory persistence. Here a model is developed that connects ongoing, competing processes of synaptic growth and weakening to stochastic processes of receptor insertion and removal in dendritic spines. The model simulates long-term (>1 yr) persistence of groups of strong synapses. A unimodal weight distribution results. For stability of this distribution it proved essential to incorporate resource competition between synapses organized into small clusters. With competition, these clusters are stable for years. These simulations concur with recent data to support the "clustered plasticity hypothesis" which suggests clusters, rather than single synaptic contacts, may be a fundamental unit for storage of long-term memory. The model makes empirical predictions and may provide a framework to investigate mechanisms maintaining the balance between synaptic plasticity and stability of memory.

  19. A security/safety survey of long term care facilities.

    PubMed

    Acorn, Jonathan R

    2010-01-01

    What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

  20. LONG TERM IN SITU DISPOSAL ENGINEERING STUDY

    SciTech Connect

    ADAMS; CARLSON; BROCKMAN

    2003-07-23

    Patent application pulled per Ken Norris (FH General Counsel). The objective of this study is to devise methods, produce conceptual designs, examine and select alternatives, and estimate costs for the demonstration of long-term (300-year) in situ disposal of an existing waste disposal site. The demonstration site selected is the 216-A-24 Crib near the 200 East Area. The site contains a fission product inventory and has experienced plant, animal, and inadvertent than intrusion. Of the potential intrusive events and transport pathways at the site, potential human intrusion has been given primary consideration in barrier design. Intrusion by wind, plants, and animals has been given secondary consideration. Groundwater modeling for a number of barrier configurations has been carried out to help select a barrier that will minimize water infiltration and waste/water contact time. The estimated effective lifetime and cost of 20 barrier schemes, using a variety of materials, have been evaluated. The schemes studied include single component surface barriers, multicomponent barriers, and massively injected grout barriers. Five barriers with high estimated effective lifetimes and relatively low costs have been selected for detailed evaluation. They are basalt riprap barriers, massive soil barriers, salt basin barriers, multi-component fine/coarse barriers, and cemented basalt barriers. A variety of materials and configurations for marking the site have also been considered. A decision analysis was completed to select a barrier scheme for demonstration. The analysis indicated that the basalt riprap alternative would be the preferred choice for a full-scale demonstration. The recommended approach is to demonstrate the basalt riprap barrier at the 216-A-24 Crib as soon as possible. Methods and costs of assessing effectiveness of the demonstration are also described. Preliminary design modifications and costs for applying the five selected barrier schemes to other site types are

  1. Long-term Behavior of DNAPL Residuals

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Illangasekare, T.; Kitanidis, P. K.

    2012-12-01

    Understanding and being able to predict the long-term behavior of DNAPL (i.e., TCE) residuals in the source zone are significant in the evaluation of plume spreading. We apply both theoretical analysis and pore-scale simulations to investigate the mass transfer and the effect of reductive dechlorination, in which the contaminant behaves as electron acceptor. At the upfront of the source zone, where the boundary layer has not fully developed, the mass transfer increases as a power-law function of the Peclet number, and is enhanced by biodegradation. These results are consistent with past findings. Under certain conditions, further downstream inside the source zone, the rate of dissolution is slower due to the diluted mass from upstream. Widely applied first-order biodegradation implicitly assumes that the reaction solely depends on the concentration of the contaminant. However, in the slow dilution region, the limitation of electron donor on biodegradation is not negligible. For the reaction between an electron donor and an electron acceptor with intrinsic second-order kinetics, the late-time bio-reaction demonstrates a first-order decay macroscopically with respect to the mass of electron donor, not with respect to that of the contaminant. The late-time decay rate only depends on the intrinsic rate and the solubility of the contaminant. During the intermediate time, affecting by both the concentrations of electron donor and electron acceptor, the first-order decay is not valid. We show that the electron donor decays as exp(-t^2), instead of exp(-t). Moreover, the intermediate-time decay rate is a function of the spatial distribution of DNAPL residuals and the initial conditions.he relationship of the Sherwood number and Peclet number (Comparison of pore-scale simulations and best-fitting curve) he decay of electron donor as a function of t^2

  2. Long term cultivation of larger benthic Foraminifera

    NASA Astrophysics Data System (ADS)

    Wöger, Julia; Eder, Wolfgang; Kinoshita, Shunichi; Antonino, Briguglio; Carles, Ferrandes-Cañadell; Hohenegger, Johann

    2015-04-01

    Benthic Foraminifera are used in a variety of applications employing numerous different methods, i.e. ecological monitoring, studying the effects of ocean acidification, reconstructing palaeo-bathymetry or investigating palaeo-salinity and palaeo-temperature to name only a few. To refine our understanding of ecological influences on larger benthic foraminiferal biology and to review inferences from field observations, culture experiments have become an indispensable tool. While culture experiments on smaller benthic foraminifera have become increasingly frequent in the past century, reports of the cultivation of symbiont bearing larger Foraminifera are rare. Generally, cultivation experiments can be divided into two groups: Culturing of populations and cultivation of single specimens allowing individual investigation. The latter differ form the former by several restrictions resulting from the need to limit individual motility without abridging microenvironmental conditions in the Foraminiferans artificial habitat, necessary to enable the individual to development as unfettered as possible. In this study we present first experiences and preliminary results of the long-term cultivation of larger benthic Foraminifera conducted at the 'Tropical Biosphere Research Station Sesoko Island, University of the Ryukyus', Japan, trying to reproduce natural conditions as closely as possible. Individuals of three species of larger benthic Foraminifera (Heterostegina depressa, Palaeonummulites venosus and Operculina complanata) have been cultured since April 2014. At the time of the general assembly the cultivation experiments will have been going on for more than one year, with the aim to investigate growth rates, longevities and reproduction strategies for comparison with results statistically inferred from application of the of the 'natural laboratory' method. The most important factor influencing foraminiferal health and development was found to be light intensity and light

  3. The Long-Term Inflow and Structural Test Program

    SciTech Connect

    SUTHERLAND,HERBERT J; JONES,PERRY L.; NEAL,BYRON A.

    2000-10-17

    The Long-term Inflow and Structural Test (LIST) program is collecting long-term, continuous inflow and structural response data to characterize the extreme loads on wind turbines. A heavily instrumented Micon 65/13M turbine with SERI 8-m blades is being used as the first test turbine for this test program. This turbine and its two sister turbines are located in Bushland, TX a test site that exposes the turbines to a wind regime that is representative of a Great Plains commercial site. The turbines and their inflow are being characterized with 60 measurements: 34 to characterize the inflow, 19 to characterize structural response, and 7 to characterize the time-varying state of the turbine. The primary characterization of the inflow into the LIST turbine relies upon an array of five sonic anemometers. These three-axis anemometers are placed approximately 2-diameters upstream of the turbine in a pattern designed to describe the inflow. Primary characterization of the structural response of the turbine uses several sets of strain gauges to measure bending loads on the blades and the tower and two accelerometers to measure the motion of the nacelle. Data from the various instruments are sampled at a rate of 30 Hz using a newly developed data acquisition system that features a time-synchronized continuous data stream that is telemetered from the turbine rotor. The data, taken continuously, are automatically divided into 10-minute segments and archived for analysis. Preliminary data are presented to illustrate the operation of the turbine and the data acquisition and analysis system.

  4. Long-term neuropsychological outcomes following mild traumatic brain injury.

    PubMed

    Vanderploeg, Rodney D; Curtiss, Glenn; Belanger, Heather G

    2005-05-01

    Mild traumatic brain injury (MTBI) is common, yet few studies have examined neuropsychological outcomes more than 1 year postinjury. Studies of nonreferred individuals with MTBI or studies with appropriate control groups are lacking, but necessary to draw conclusions regarding natural recovery from MTBI. We examined the long-term neuropsychological outcomes of a self-reported MTBI an average of 8 years postinjury in a nonreferred community-dwelling sample of male veterans. This was a cross-sectional cohort study derived from the Vietnam Experience Study. Three groups matched on premorbid cognitive ability were examined, those who (1) had not been injured in a MVA nor had a head injury (Normal Control; n = 3214), (2) had been injured in a motor vehicle accident (MVA) but did not have a head injury (MVA Control; n = 539), and (3) had a head injury with altered consciousness (MTBI; n = 254). A MANOVA found no group differences on a standard neuropsychological test battery of 15 measures. Across 15 measures, the average neuropsychological effect size of MTBI compared with either control group was -.03. Subtle aspects of attention and working memory also were examined by comparing groups on Paced Auditory Serial Addition Test (PASAT) continuation rate and California Verbal Learning Test (CVLT) proactive interference (PI). Compared with normal controls, the MTBI group evidenced attention problems in their lower rate of continuation to completion on the PASAT (odds ratio = 1.32, CI = 1.0-1.73) and in excessive PI (odds ratio = 1.66, CI = 1.11-2.47). Unique to the MTBI group, PASAT continuation problems were associated with left-sided visual imperceptions and excessive PI was associated with impaired tandem gait. These results show that MTBI can have adverse long-term neuropsychological outcomes on subtle aspects of complex attention and working memory.

  5. Long term effects of oral contraception.

    PubMed

    Koetsawang, S; Chiemprasert, T; Premyodhin, M

    1972-01-01

    This study attempts to assess the long-term effects of oral contraceptives on Asian women. At the Family Planning Clinic, Siniray Hospital, Thailand, 181 of the more than 800 women who had used oral contraceptives for more than 4 years prior to May 31, 1971, were studied. All had completed premedical examinations before beginning the drugs. In addition to being studied for changes in body weight, blood pressure, hematocrit, liver function, thyroid function, oral glucose tolerance, and blood urea nitrogen, they were interviewed on their experience with oral contraception. Most were between ages 25-29 years, had only primary education, were housewives, and more than half were in the lower income group. Living children ranged from 1 to 10 with 52.5% having 4 or more. They had been started on a variety or oral contraceptives but in the last 2 years all were given Ovral (norgestrel .5 mg with ethinyl estradiol .05 mg). A total of 10,830 cycles were recorded. Only 9 requested anotehr method. Culdoscopic tubal sterilization was done on 6 and 3 discontinued because they wanted to get pregnant. All had heard rumors of adverse effects but few believed them because 89.3% had no adverse effects. 81.2% said they were in better physical and mental condition because of absence of pregnancy and a majority reported better socioeconomic status. Neurotic complaints were noted in 6.1%. Libido was unchanged in a majority, decreased in a few, but rarely increased. Weight gain of 2.5 kg or more was present in 68%. Slight increase in blood pressure was noted in 17.1%, mostly in those starting with increased pressure. Hematocrit values changed only slightly may have been due to other causes. Liver function tests showed prolonged bromsulphthalein retention in a considerable number. Thyroid function tests were normal except for increased TBG level in 17.8%. Carbohydrate metabolism remained normal in all but a few. Pretreatment glucose tolerance tests not been recorded. Normal findings were

  6. LOP- LONG-TERM ORBIT PREDICTOR

    NASA Technical Reports Server (NTRS)

    Kwok, J. H.

    1994-01-01

    The Long-Term Orbit Predictor (LOP) trajectory propagation program is a useful tool in lifetime analysis of orbiting spacecraft. LOP is suitable for studying planetary orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Sample data is included for a geosynchronous station drift cycle study, a Venus radar mapping strategy, a frozen orbit about Mars, and a repeat ground trace orbit. LOP uses the variation-of-parameters method in formulating the equations of motion. Terms involving the mean anomaly are removed from numerical integrations so that large step sizes, on the order of days, are possible. Consequently, LOP executes much faster than programs based on Cowell's method, such as the companion program ASAP (the Artificial Satellite Analysis Program, NPO-17522, also available through COSMIC). The program uses a force model with a gravity field of up to 21 by 21, lunisolar perturbation, drag, and solar radiation pressure. The input includes classical orbital elements (either mean or oscillating), orbital elements of the sun relative to the planet, reference time and dates, drag coefficients, gravitational constants, planet radius, rotation rate. The printed output contains the classical elements for each time step or event step, and additional orbital data such as true anomaly, eccentric anomaly, latitude, longitude, periapsis altitude, and the rate of change per day of certain elements. Selected output is additionally written to a plot file for postprocessing by the user. LOP is written in FORTRAN 77 for batch execution on IBM PC compatibles running MS-DOS with a minimum of 256K RAM. Recompiling the source requires the Lahey F77 v2.2 compiler. The LOP package includes examples that use LOTUS 1-2-3 for graphical displays, but any graphics software package should be able to handle the ASCII plot file. The program is available on two 5.25 inch 360K MS-DOS format diskettes. The program was written in 1986 and last updated in 1989. LOP is

  7. LOP- LONG-TERM ORBIT PREDICTOR

    NASA Technical Reports Server (NTRS)

    Kwok, J. H.

    1994-01-01

    The Long-Term Orbit Predictor (LOP) trajectory propagation program is a useful tool in lifetime analysis of orbiting spacecraft. LOP is suitable for studying planetary orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Sample data is included for a geosynchronous station drift cycle study, a Venus radar mapping strategy, a frozen orbit about Mars, and a repeat ground trace orbit. LOP uses the variation-of-parameters method in formulating the equations of motion. Terms involving the mean anomaly are removed from numerical integrations so that large step sizes, on the order of days, are possible. Consequently, LOP executes much faster than programs based on Cowell's method, such as the companion program ASAP (the Artificial Satellite Analysis Program, NPO-17522, also available through COSMIC). The program uses a force model with a gravity field of up to 21 by 21, lunisolar perturbation, drag, and solar radiation pressure. The input includes classical orbital elements (either mean or oscillating), orbital elements of the sun relative to the planet, reference time and dates, drag coefficients, gravitational constants, planet radius, rotation rate. The printed output contains the classical elements for each time step or event step, and additional orbital data such as true anomaly, eccentric anomaly, latitude, longitude, periapsis altitude, and the rate of change per day of certain elements. Selected output is additionally written to a plot file for postprocessing by the user. LOP is written in FORTRAN 77 for batch execution on IBM PC compatibles running MS-DOS with a minimum of 256K RAM. Recompiling the source requires the Lahey F77 v2.2 compiler. The LOP package includes examples that use LOTUS 1-2-3 for graphical displays, but any graphics software package should be able to handle the ASCII plot file. The program is available on two 5.25 inch 360K MS-DOS format diskettes. The program was written in 1986 and last updated in 1989. LOP is

  8. Pulmonary complications after long term amiodarone treatment.

    PubMed Central

    Roca, J; Heras, M; Rodriguez-Roisin, R; Magriñà, J; Xaubet, A; Sanz, G

    1992-01-01

    BACKGROUND: Amiodarone hydrochloride is an antiarrhythmic agent useful in arrhythmias refractory to standard therapy. Although interstitial pneumonitis is known to be its most serious side effect, several aspects of amiodarone lung toxicity are still controversial. METHODS: Pulmonary side effects were examined in a sample of 61 symptomless patients (mean (SD) age 55 (7) years) who had had long term treatment with amiodarone (daily maintenance dose 400 mg), selected from 482 men attending the University of Barcelona myocardial infarction project. To allow for the confounding effects of coronary artery disease and tobacco history on lung function, 46 patients who had taken amiodarone for more than one year were matched with a control group from the same population. Subjects underwent measurement of lung volumes, arterial blood gas analysis and an incremental bicycle exercise test. RESULTS: Most lung function values were close to predicted values, though there was a small increase in resting alveolar-arterial oxygen tension difference (A-aDO2) at rest (4.8 (1.4) kPa in both groups). There were no differences in the results of forced spirometry or static lung volumes between the two groups, or in the fall in A-aDO2 from rest to exercise. There was a small difference between the amiodarone and the control group in transfer factor for carbon monoxide corrected for lung volume (KCO 1.67 (0.3) and 1.83 (0.3) mmol min-1 kPa-1 l-1 respectively) and in exercise capacity (140 (25) and 120 (30)w). Only three patients showed lung function impairment consistent with pneumonitis. No relation between lung function measures and cumulative doses of amiodarone or desethylamiodarone was found. CONCLUSIONS: The prevalence of clinically evident pulmonary side effects was 4.9%, which is lower than that reported in studies in which higher daily maintenance doses of amiodarone were given. The slightly lower KCO values and lower work load achieved by the patients taking amiodarone suggest a

  9. Long-Term Space Astrophysics Program

    NASA Technical Reports Server (NTRS)

    Nowark, Michael A.

    2001-01-01

    This is the final report for our Long-Term Space Astrophysics Program (NRA 94-OSS-12) grant NAG 5-3225. The proposal is entitled 'Spectral and Temporal Properties of Black Hole Candidates', and began funding in May 1995, and ran through 31 Aug 2000. The project summary from the original proposal was as follows: 'We will study the spectral and temporal properties of black hole candidates (BHC) by using data from archival sources (e.g., EXOSAT, Ginga, ROSAT) and proposed follow-up observations with modern instruments (e.g., ASCA, XTE). Our spectral studies will focus on identifying the basic characteristics and luminosities of the emission components in the various 'states' of BHC. We hope to understand and quantify the global energetics of these states. Our temporal studies will focus on expanding and classifying our knowledge of BHC variability properties in each state. We will explore the nature of quasi-periodic oscillations in BHC. We will combine our spectral and temporal studies by analyzing time lags and variability coherence between energy channels. In addition, we will investigate ways of correlating observed variability behavior with specific emission components.' We have accomplished many of these goals laid out within the original proposal. As originally proposed, we have utilized both archival and proprietary satellite data. In terms of archival data, we have utilized data from the Advanced Satellite for Cosmology and Astrophysics (ASCA), ROSAT, and the Rossi X-ray Timing Explorer (RXTE). We also obtained proprietary data from ASCA, RXTE, and the Extreme Ultraviolet Explorer (EUVE). In terms of sources, we have examined a wide variety of both galactic black hole candidates and extra-galactic black holes. For the galactic black holes we have observed and analyzed both the low/hard state and the high/soft state. We have performed both spectral and timing analyses on all of these objects. In addition, we have also examined a number of neutron stars or

  10. Immunomodulatory gene therapy in lysosomal storage disorders.

    PubMed

    Koeberl, Dwight D; Kishnani, Priya S

    2009-12-01

    Significant advances in therapy for lysosomal storage disorders have occurred with an accelerating pace over the past decade. Although enzyme replacement therapy has improved the outcome of lysosomal storage disorders, antibody responses have occurred and sometimes prevented efficacy, especially in cross-reacting immune material negative patients with Pompe disease. Preclinical gene therapy experiments have revealed the relevance of immune responses to long-term efficacy. The choice of regulatory cassette played a critical role in evading humoral and cellular immune responses to gene therapy in knockout mouse models, at least in adult animals. Liver-specific regulatory cassettes prevented antibody formation and enhanced the efficacy of gene therapy. Regulatory T cells prevented transgene directed immune responses, as shown by adoptive transfer of antigen-specific immune tolerance to enzyme therapy. Immunomodulatory gene therapy with a very low vector dose could enhance the efficacy of enzyme therapy in Pompe disease and other lysosomal storage disorders.

  11. Immunomodulatory gene therapy in lysosomal storage disorders

    PubMed Central

    Koeberl, D.D.; Kishnani, P.S.

    2010-01-01

    Significant advances in therapy for lysosomal storage disorders have occurred with an accelerating pace over the past decade. Although enzyme replacement therapy has improved the outcome of lysosomal storage disorders, antibody responses have occurred and sometimes prevented efficacy, especially in cross-reacting immune material negative patients with Pompe disease. Preclinical gene therapy experiments have revealed the relevance of immune responses to long-term efficacy. The choice of regulatory cassette played a critical role in evading humoral and cellular immune responses to gene therapy in knockout mouse models, at least in adult animals. Liver-specific regulatory cassettes prevented antibody formation and enhanced the efficacy of gene therapy. Regulatory T cells prevented transgene directed immune responses, as shown by adoptive transfer of antigen-specific immune tolerance to enzyme therapy. Immunomodulatory gene therapy with a very low vector dose could enhance the efficacy of enzyme therapy in Pompe disease and other lysosomal storage disorders. PMID:19807648

  12. Long-term surveillance plan for the Green River, Utah, disposal site

    SciTech Connect

    1997-06-01

    The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  13. Long-term surveillance plan for the Shiprock Disposal site, Shiprock, New Mexico

    SciTech Connect

    Not Available

    1994-09-01

    The long-term surveillance plan (LTSP) for the Shiprock, New Mexico, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Shiprock disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents the land ownership interests and details how the long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  14. Long-term surveillance plan for the Green River, Utah disposal site. Revision 1

    SciTech Connect

    Not Available

    1994-08-01

    The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  15. Strategic alliance: adapting to the business environment in long-term care.

    PubMed

    Mara, Cynthia Massie; Ziegenfuss, James T

    2002-01-01

    This article is addressed to long-term-care administrators and planners as well as purchasers of long-term care. Believing the current and future business environment will force continued adaptation in long-term-care organizations, the authors utilize nine categories to map pressures for change: cultural, technological, educational, political, legal, natural resource, demographic, sociologic, and economic. Long-term-care organizations, especially those that are not-for-profit, are becoming members of alliances as one way of addressing these pressures. This article describes and presents a case example of a composite alliance to demonstrate the advantages of membership in a strategic alliance. We also present examples of ways in which alliance members use strategic partnerships to improve their ability to manage these forces.

  16. Long-term Surveillance Plan for the Falls City Disposal Site, Falls City, Texas. Revision 1

    SciTech Connect

    1995-08-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  17. Long-term surveillance plan for the Falls City Disposal Site, Falls City, Texas

    SciTech Connect

    1995-06-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. DOE will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  18. Long-term surveillance plan for the Collins Ranch disposal site, Lakeview, Oregon

    SciTech Connect

    Not Available

    1994-08-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Collins Ranch disposal site, Lakeview, Oregon, describes the surveillance activities for the disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  19. Long-term surveillance plan for the Collins Ranch Disposal Site, Lakeview, Oregon. Revision 2

    SciTech Connect

    Not Available

    1993-12-01

    This long-term surveillance plan (LTSP) for the Lakeview, Oregon, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Lakeview (Collins Ranch) disposal cell, which will be referred to as the Collins Ranch disposal cell throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States or an Indian tribe, and details how the long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  20. Immunomodulatory spherical nucleic acids.

    PubMed

    Radovic-Moreno, Aleksandar F; Chernyak, Natalia; Mader, Christopher C; Nallagatla, Subbarao; Kang, Richard S; Hao, Liangliang; Walker, David A; Halo, Tiffany L; Merkel, Timothy J; Rische, Clayton H; Anantatmula, Sagar; Burkhart, Merideth; Mirkin, Chad A; Gryaznov, Sergei M

    2015-03-31

    Immunomodulatory nucleic acids have extraordinary promise for treating disease, yet clinical progress has been limited by a lack of tools to safely increase activity in patients. Immunomodulatory nucleic acids act by agonizing or antagonizing endosomal toll-like receptors (TLR3, TLR7/8, and TLR9), proteins involved in innate immune signaling. Immunomodulatory spherical nucleic acids (SNAs) that stimulate (immunostimulatory, IS-SNA) or regulate (immunoregulatory, IR-SNA) immunity by engaging TLRs have been designed, synthesized, and characterized. Compared with free oligonucleotides, IS-SNAs exhibit up to 80-fold increases in potency, 700-fold higher antibody titers, 400-fold higher cellular responses to a model antigen, and improved treatment of mice with lymphomas. IR-SNAs exhibit up to eightfold increases in potency and 30% greater reduction in fibrosis score in mice with nonalcoholic steatohepatitis (NASH). Given the clinical potential of SNAs due to their potency, defined chemical nature, and good tolerability, SNAs are attractive new modalities for developing immunotherapies.

  1. Immunomodulatory spherical nucleic acids

    PubMed Central

    Radovic-Moreno, Aleksandar F.; Chernyak, Natalia; Mader, Christopher C.; Nallagatla, Subbarao; Kang, Richard S.; Hao, Liangliang; Walker, David A.; Halo, Tiffany L.; Merkel, Timothy J.; Rische, Clayton H.; Anantatmula, Sagar; Burkhart, Merideth; Mirkin, Chad A.; Gryaznov, Sergei M.

    2015-01-01

    Immunomodulatory nucleic acids have extraordinary promise for treating disease, yet clinical progress has been limited by a lack of tools to safely increase activity in patients. Immunomodulatory nucleic acids act by agonizing or antagonizing endosomal toll-like receptors (TLR3, TLR7/8, and TLR9), proteins involved in innate immune signaling. Immunomodulatory spherical nucleic acids (SNAs) that stimulate (immunostimulatory, IS-SNA) or regulate (immunoregulatory, IR-SNA) immunity by engaging TLRs have been designed, synthesized, and characterized. Compared with free oligonucleotides, IS-SNAs exhibit up to 80-fold increases in potency, 700-fold higher antibody titers, 400-fold higher cellular responses to a model antigen, and improved treatment of mice with lymphomas. IR-SNAs exhibit up to eightfold increases in potency and 30% greater reduction in fibrosis score in mice with nonalcoholic steatohepatitis (NASH). Given the clinical potential of SNAs due to their potency, defined chemical nature, and good tolerability, SNAs are attractive new modalities for developing immunotherapies. PMID:25775582

  2. Long-term prescribing of antidepressants in the older population: a qualitative study

    PubMed Central

    Dickinson, Rebecca; Knapp, Peter; House, Allan O; Dimri, Vandana; Zermansky, Arnold; Petty, Duncan; Holmes, John; Raynor, David K

    2010-01-01

    Background High rates of long-term antidepressant prescribing have been identified in the older population. Aims To explore the attitudes of older patients and their GPs to taking long-term antidepressant therapy, and their accounts of the influences on long-term antidepressant use. Design of study Qualitative study using in-depth semi-structured interviews. Setting One primary care trust in North Bradford. Method Thirty-six patients aged ≥75 years and 10 GPs were interviewed. Patients were sampled to ensure diversity in age, sex, antidepressant type, and home circumstances. Results Participants perceived significant benefits and expressed little apprehension about taking long-term antidepressants, despite being aware of the psychological and social factors involved in onset and persistence of depression. Barriers to discontinuation were identified following four themes: pessimism about the course and curability of depression; negative expectations and experiences of ageing; medicine discontinuation perceived by patients as a threat to stability; and passive (therapeutic momentum) and active (therapeutic maintenance) decisions to accept the continuing need for medication. Conclusion There is concern at a public health level about high rates of long-term antidepressant prescribing, but no evidence was found of a drive for change either from the patients or the doctors interviewed. Any apprehension was more than balanced by attitudes and behaviours supporting continuation. These findings will need to be incorporated into the planning of interventions aimed at reducing long-term antidepressant prescribing in older people. PMID:20353660

  3. Long-term disability due to guinea worm disease.

    PubMed

    Hours, M; Cairncross, S

    1994-01-01

    The village-based surveillance system for guinea worm disease (dracunculiasis), which has been established in all endemic villages in Ghana, was used to carry out a retrospective study of long-term disability due to the disease. A sample of 195 cases was interviewed and examined, 12-18 months after emergence of the worm. Currently continuing pain when walking or working, attributable by its location and date of onset to the episode of dracunculiasis, was reported by 55 persons (28.2%). Some difficulty in performing at least one of 6 everyday physical activities, attributable after careful interview to the episode, was reported by 66 respondents (34.0%), of whom 10 (5.1%) were unable to carry out one of the activities. In one case, the disease had caused impairment of movement of the joints of the right thumb. The prevalence of serious permanent physical impairment among the cases in the study was thus 0.5%.

  4. Electronic Health Records in Long-Term Care: Staff Perspectives.

    PubMed

    Meehan, Rebecca

    2015-10-12

    As long-term post-acute care (LTPAC) settings continue to increase their adoption of electronic health records (EHRs), it is important to learn from end users currently working with the technology to identify clinical implications and opportunities to improve systems and surrounding processes. This study utilized one-on-one interviews of direct care nurses (n = 20) in a Midwest United States LTPAC setting to describe patterns of use, and areas to improve. The majority of respondents evaluated the EHR as easy to use, with a positive impact on quality of care, through efficiencies gained in communication with the care team. Staff responses outline desired modifications to the software, including fixes to data fields for more accurate medication administration and accurate reports on bowel protocol follow-up. Recommendations for LTPAC organizations are made regarding improved staff training on the EHR, and modifications to the EHR and related processes to improve quality of care and staff retention.

  5. Summary of Terra and Aqua MODIS Long-Term Performance

    NASA Technical Reports Server (NTRS)

    Xiong, Xiaoxiong (Jack); Wenny, Brian N.; Angal, Amit; Barnes, William; Salomonson, Vincent

    2011-01-01

    Since launch in December 1999, the MODIS ProtoFlight Model (PFM) onboard the Terra spacecraft has successfully operated for more than 11 years. Its Flight Model (FM) onboard the Aqua spacecraft, launched in May 2002, has also successfully operated for over 9 years. MODIS observations are made in 36 spectral bands at three nadir spatial resolutions and are calibrated and characterized regularly by a set of on-board calibrators (OBC). Nearly 40 science products, supporting a variety of land, ocean, and atmospheric applications, are continuously derived from the calibrated reflectances and radiances of each MODIS instrument and widely distributed to the world-wide user community. Following an overview of MODIS instrument operation and calibration activities, this paper provides a summary of both Terra and Aqua MODIS long-term performance. Special considerations that are critical to maintaining MODIS data quality and beneficial for future missions are also discussed.

  6. Long-term survival after chronic subdural haematoma.

    PubMed

    Manickam, Appukutty; Marshman, Laurence A G; Johnston, Ross

    2016-12-01

    Outcome after chronic subdural haematoma (CSDH) is invariably assumed favourable: however, little data regarding long term survival (LTS) exists. One study reported excess mortality restricted to year 1, but with expected actuarial rates thereafter. We aimed to determine LTS after CSDH in a retrospective analysis relative to actuarial data from age-matched controls. Data was obtained in n=155, (M:F 97:58, 69.3±2.3years). Follow-up maxima was 14.19years (mean: 4.02±3.07years, median: 5.2years). Mortality in-hospital, at 6months, 1year, 2years and 5years was n=13 (8.39%), n=22 (14.19%), n=31 (20.35%), n=42 (27.1%) and n=54 (34.84%). LTS was significantly worse than controls (5.29±0.59years vs. 17.74±1.8years, hazard ratio [HR]: 3.52, P<0.0001). Death most frequently related to pneumonia/sepsis and ischemic heart disease (IHD). Median modified Rankin score (mRS) in those discharged home (n=94, 60.65%) was 2 [IQR: 1-3]. Discharge mRS in those who died at 6months, 1year, 2years and 5years was 5 [IQR: 3-6], 5 [IQR: 4-6], 3 [IQR: 1-3], 4 [IQR: 2-5]. Discharge mRS was significantly worse with year 1 mortality (P=0.014). LTS related to discharge mRS (HR: 37.006, P<0.001), post-operative motor-score (HR: 0.581, P=0.0026), IHD (HR: 5.186, P=0.005), warfarin-use (HR: 5.93, P=0.036) and dementia (HR: 5.39, P=0.031). No long term recurrences (LTR) were recorded. Although most were discharged home with mRS=2, LTS was markedly less than previously reported: peers lived 12.4years longer. Although greater in year 1, excess mortality was not restricted to year 1, but continued throughout prolonged follow-up. LTS related to discharge disability and dependence, and co-morbid risk factors for cerebral atrophy. No LTR suggests that, once ultimately closed, the 'subdural space' remains closed. CSDH patients represent a vulnerable group who require continued long-term medical surveillance.

  7. Short- and long-term health consequences of sleep disruption

    PubMed Central

    Medic, Goran; Wille, Micheline; Hemels, Michiel EH

    2017-01-01

    Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health

  8. Long-term and preventative treatment for seasonal affective disorder.

    PubMed

    Westrin, Asa; Lam, Raymond W

    2007-01-01

    Recurrent major depressive disorder with regular seasonal patterns, commonly known as seasonal affective disorder (SAD), has evoked substantial research in the last two decades. It is now recognised that SAD is a common condition with prevalence rates between 0.4% and 2.9% of the general population, and that patients with SAD experience significant morbidity and impairment in psychosocial function. There is good evidence that bright light therapy and antidepressant medications are effective for the short-term treatment of SAD; however, given that SAD is characterised by recurrent major depressive episodes, long-term and maintenance treatment must be considered. Unfortunately, there are few studies of longer term (>8 weeks) and maintenance (preventative) treatments for SAD. The weight of evidence suggests that light therapy usually needs to be continued daily throughout the winter season because of rapid relapse when light is stopped too early in the treatment period. However, some studies support the use of antidepressants to continue the response from a brief (1-2 weeks) course of light therapy early in the depressive episode, as soon as the first symptoms emerge in autumn. Only small studies have examined preventative treatment (before onset of symptoms) with light therapy, all of which have methodological limitations. The best evidence for preventative treatment in SAD comes from antidepressant studies. Three large, randomised, placebo-controlled studies have shown that preventative treatment with bupropion XL reduces the recurrence rate of depressive episodes in patients with SAD. Given the limitations in the evidence base and the inconsistent recurrence rate of winter depressive episodes, clinical recommendations for long-term and preventative treatment must individualise treatment choices and weigh potential benefits against possible adverse effects.

  9. Long-term impact of interferon or Glatiramer acetate in multiple sclerosis: A systematic review and meta-analysis.

    PubMed

    Signori, Alessio; Gallo, Fabio; Bovis, Francesca; Di Tullio, Nicolò; Maietta, Ilaria; Sormani, Maria Pia

    2016-03-01

    In recent years the impact of disease-modifying drugs on long-term progression in multiple sclerosis (MS) was assessed both in observational studies and in extension of randomized controlled trial (RCT). Aim of this work was to quantitatively summarize by a meta-analysis the long-term impact of immunomodulatory drugs (Interferon-Beta (IFN-β) or Glatiramer Acetate (GA)) in relapsing-remitting (RR) MS patients. We collected all published observational studies reporting the long-term efficacy of IFN-β or GA in RRMS patients. The primary outcome was the treatment effect on progression to a sustained EDSS score of 6 or to the Secondary Progressive (SP) phase. A non-parametric approach was adopted to test the overall treatment effect significance, while a random effect model was used to obtain a pooled quantitative estimate of the treatment benefit, in terms of hazard-ratios (HR) or Relative Risks, with their 95% confidence interval (CI). Fourteen studies, on a total of 13,238 RRMS patients, were included in the meta-analysis. All studies but two reported a consistent effect of immunomodulatory treatment on long-term disease progression; the pooled effect on progression to EDSS 6 or SP was significant (p<0.01) when tested by the non-parametric test. The quantitative estimate of the treatment effect in reducing progression to EDSS 6 in the subset of studies reporting this outcome was HRpooled=0.49 (95% CI: 0.34-0.69), p<0.001. Treatment with immunomodulators seems to reduce long-term probability of disability progression. Additional well-designed observational studies could help to confirm these findings. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Long-Term Sustained Effects of Chapter I Participation, 1979-1982.

    ERIC Educational Resources Information Center

    Claus, Richard N.; Girrbach, Charmaine J.

    The long-term sustained impact of the Saginaw School District Chapter I Supplemental Teacher Participation (STP) program on third grade students during the 1979-80 school year was examined. A total of 256 students were classified into one of four categories: 1 year, 2 year continuous, 3 year continuous, and 2 year interrupted. Two different…

  11. Stochastic Induction of Long-Term Potentiation and Long-Term Depression

    PubMed Central

    Antunes, G.; Roque, A. C.; Simoes-de-Souza, F. M.

    2016-01-01

    Long-term depression (LTD) and long-term potentiation (LTP) of granule-Purkinje cell synapses are persistent synaptic alterations induced by high and low rises of the intracellular calcium ion concentration ([Ca2+]), respectively. The occurrence of LTD involves the activation of a positive feedback loop formed by protein kinase C, phospholipase A2, and the extracellular signal-regulated protein kinase pathway, and its expression comprises the reduction of the population of synaptic AMPA receptors. Recently, a stochastic computational model of these signalling processes demonstrated that, in single synapses, LTD is probabilistic and bistable. Here, we expanded this model to simulate LTP, which requires protein phosphatases and the increase in the population of synaptic AMPA receptors. Our results indicated that, in single synapses, while LTD is bistable, LTP is gradual. Ca2+ induced both processes stochastically. The magnitudes of the Ca2+ signals and the states of the signalling network regulated the likelihood of LTP and LTD and defined dynamic macroscopic Ca2+ thresholds for the synaptic modifications in populations of synapses according to an inverse Bienenstock, Cooper and Munro (BCM) rule or a sigmoidal function. In conclusion, our model presents a unifying mechanism that explains the macroscopic properties of LTP and LTD from their dynamics in single synapses. PMID:27485552

  12. Long-term depression of excitatory synaptic transmission and its relationship to long-term potentiation.

    PubMed

    Artola, A; Singer, W

    1993-11-01

    In many brain areas, including the cerebellar cortex, neocortex, hippocampus, striatum and nucleus accumbens, brief activation of an excitatory pathway can produce long-term depression (LTD) of synaptic transmission. In most preparations, induction of LTD has been shown to require a minimum level of postsynaptic depolarization and a rise in the intracellular Ca2+ concentration [Ca2+]i in the postsynaptic neurone. Thus, induction conditions resemble those described for the initiation of associative long-term potentiation (LTP). However, data from structures susceptible to both LTD and LTP suggest that a stronger depolarization and a greater increase in [Ca2+]i are required to induce LTP than to initiate LTD. The source of Ca2+ appears to be less critical for the differential induction of LTP and LTD than the amplitude of the Ca2+ surge, since the activation of voltage- and ligand-gated Ca2+ conductances as well as the release from intracellular stores have all been shown to contribute to both LTD and LTP induction. LTD is induceable even at inactive synapses if [Ca2+]i is raised to the appropriate level by antidromic or heterosynaptic activation, or by raising the extracellular Ca2+ concentration [Ca2+]o. These conditions suggest a rule (called here the ABS rule) for activity-dependent synaptic modifications that differs from the classical Hebb rule and that can account for both homosynaptic LTD and LTP as well as for heterosynaptic competition and associativity.

  13. Shortcuts to Long-Term Career Paths.

    ERIC Educational Resources Information Center

    Johnston, Cynthia W.; Nelson, Gary L.

    In the continuing search for skilled workers, employers are increasingly looking to community colleges as the primary training providers for welfare recipients, unemployed workers, and those seeking to increase skills and improve careers. Central Piedmont Community College (CPCC) (North Carolina) provides individuals with the skills and education…

  14. Simulated Climate Response to Long-term Solar Geoengineering

    NASA Astrophysics Data System (ADS)

    Cao, L.; Bala, G.; Caldeira, K.; Duan, L.

    2016-12-01

    that we should implement solar geoengineering for a long period. Instead, our simulations indicate that solar geoengineering, if implemented continuously, may be able to stabilize many aspects of CO2-induced climate change over long terms.

  15. Complications and management of forgotten long-term biliary stents

    PubMed Central

    Sohn, Se Hoon; Park, Jae Hyun; Kim, Kook Hyun; Kim, Tae Nyeun

    2017-01-01

    AIM To evaluate complications and management outcomes of retained long-term plastic biliary stents. METHODS Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents. Continuous variables were analyzed using the t test. Observed frequencies in subsets of the study population were compared using Fisher’s exact test and χ2 tests. Statistical significance was defined as P < 0.05 (two-tailed). RESULTS Mean age of patients was 73.7 ± 12 years and male-to-female ratio was 2.2:1. Indications of plastic biliary stent insertion were bile duct stones (63.2%, 24/38) and benign bile duct stricture (52.6%, 20/38). Mean duration of retained plastic stent was 22.6 ± 12.2 mo, and in 10 cases (26.3%), stents were retained for more than 24 mo. Common bile duct (CBD) stones or sludge were found in most cases (92.1%, 35/38). The most common complication was acute cholangitis (94.7%, 36/38). Stent removal by endoscopic approach was successfully performed in 92.1% (35/38) of the cases. In 3 cases, an additional plastic stent was inserted alongside the previous stent due to failure of the stent removal. Endoscopic removal of bile duct stones was successful in 73.7% (28/38) of the cases. When patients were divided into two groups by duration of stent placement (12 to 24 mo vs over 24 mo), there were no differences in the development of cholangitis, presence of biliary stones, and success rate of endoscopic removal of stones and biliary stents. CONCLUSION The most common complication of retained long-term plastic biliary stents was acute cholangitis associated with CBD stones. Endoscopic management was successfully

  16. Complications and management of forgotten long-term biliary stents.

    PubMed

    Sohn, Se Hoon; Park, Jae Hyun; Kim, Kook Hyun; Kim, Tae Nyeun

    2017-01-28

    To evaluate complications and management outcomes of retained long-term plastic biliary stents. Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents. Continuous variables were analyzed using the t test. Observed frequencies in subsets of the study population were compared using Fisher's exact test and χ(2) tests. Statistical significance was defined as P < 0.05 (two-tailed). Mean age of patients was 73.7 ± 12 years and male-to-female ratio was 2.2:1. Indications of plastic biliary stent insertion were bile duct stones (63.2%, 24/38) and benign bile duct stricture (52.6%, 20/38). Mean duration of retained plastic stent was 22.6 ± 12.2 mo, and in 10 cases (26.3%), stents were retained for more than 24 mo. Common bile duct (CBD) stones or sludge were found in most cases (92.1%, 35/38). The most common complication was acute cholangitis (94.7%, 36/38). Stent removal by endoscopic approach was successfully performed in 92.1% (35/38) of the cases. In 3 cases, an additional plastic stent was inserted alongside the previous stent due to failure of the stent removal. Endoscopic removal of bile duct stones was successful in 73.7% (28/38) of the cases. When patients were divided into two groups by duration of stent placement (12 to 24 mo vs over 24 mo), there were no differences in the development of cholangitis, presence of biliary stones, and success rate of endoscopic removal of stones and biliary stents. The most common complication of retained long-term plastic biliary stents was acute cholangitis associated with CBD stones. Endoscopic management was successfully performed in most cases.

  17. Consider long-term care as service alternative.

    PubMed

    Loria, L S

    1987-04-01

    The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

  18. Antisocial symptoms decrease to normal levels in long-term abstinence.

    PubMed

    Fein, George; Fein, David

    2013-01-01

    We have previously shown highly elevated antisocial symptoms and measures of social deviance proneness and antisocial disposition in long-term abstinent alcohol dependence versus non-substance-abusing controls (NSAC). Current antisocial symptoms were reduced to subdiagnostic levels in long-term abstinence; however, the number of current symptoms was not measured beyond its being subdiagnostic. Here we measured social deviance proneness, antisocial disposition, and both lifetime and current antisocial symptoms in short-term and long-term abstinent substance-dependent and NSAC samples. Lifetime antisocial symptoms (and diagnoses) and social deviance proneness and antisocial disposition were highly elevated in both short- and long-term abstinence, replicating earlier findings. Current antisocial symptoms were dramatically reduced in long-term versus short-term abstinent samples, close to levels in controls. In contrast, social deviance proneness and antisocial disposition remain highly elevated in long-term abstinence. These findings suggest that antisocial behavior is reduced in extended abstinence, despite continued elevated social deviance proneness an antisocial disposition. This suggests a top-down model in extended abstinence, whereby executive control inhibits deviance-prone tendencies. Copyright © 2012 by the Research Society on Alcoholism.

  19. Coupling giant impacts and long-term evolution models

    NASA Astrophysics Data System (ADS)

    Golabek, G.; Jutzi, M.; Emsenhuber, A.; Gerya, T.; Asphaug, E. I.

    2015-12-01

    The crustal dichotomy [1] is the dominant geological feature on planet Mars. The exogenic approach to the origin of the crustal dichotomy [2-6] assumes that the northern lowlands correspond to a giant impact basin formed after primordial crust formation. However these simulations only consider the impact phase without studying the long-term repercussions of such a collision. The endogenic approach [7], suggesting a degree-1 mantle upwelling underneath the southern highlands [8-11], relies on a high Rayleigh number and a particular viscosity profile to form a low degree convective pattern within the geological constraints for the dichotomy formation. Such vigorous convection, however, results in continuous magmatic resurfacing, destroying the initially dichotomous crustal structure in the long-term. A further option is a hybrid exogenic-endogenic approach [12-15], which proposes an impact-induced magma ocean and subsequent superplume in the southern hemisphere. However these models rely on simple scaling laws to impose the thermal effects of the collision. Here we present the first results of impact simulations performed with a SPH code [16,17] serially coupled with geodynamical computations performed using the code I3VIS [18] to improve the latter approach and test it against observations. We are exploring collisions varying the impactor velocities, impact angles and target body properties, and are gauging the sensitivity to the handoff from SPH to I3VIS. As expected, our first results indicate the formation of a transient hemispherical magma ocean in the impacted hemisphere, and the merging of the cores. We also find that impact angle and velocity have a strong effect on the post-impact temperature field [5] and on the timescale and nature of core merger.

  20. Coupling giant impacts and long-term evolution models

    NASA Astrophysics Data System (ADS)

    Golabek, G. J.; Emsenhuber, A.; Jutzi, M.; Gerya, T. V.; Asphaug, E. I.

    2015-10-01

    The crustal dichotomy [1] is the dominant geological feature on planet Mars. The exogenic approach to the origin of the crustal dichotomy [2-6] assumes that the northern lowlands correspond to a giant impact basin formed after primordial crust formation. However these simulations only consider the impact phase without studying the long-term repercussions of such a collision. The endogenic approach [7], suggesting a degree-1 mantle upwelling underneath the southern highlands [8-11], relies on a high Rayleigh number and a particular viscosity profile to form a low degree convective pattern within the geological constraints for the dichotomy formation. Such vigorous convection, however, results in continuous magmatic resurfacing, destroying the initially dichotomous crustal structure in the long-term. A further option is a hybrid exogenic-endogenic approach [12-15], which proposes an impact-induced magma ocean and subsequent superplume in the southern hemisphere. However these models rely on simple scaling laws to impose the thermal effects of the collision. Here we present the first results of impact simulations performed with a SPH code [16,17] serially coupled with geodynamical computations performed using the code I3VIS [18] to improve the latter approach and test it against observations. We are exploring collisions varying the impactor velocities, impact angles and target body properties, and are gauging the sensitivity to the handoff from SPH to I3VIS. As expected, our first results indicate the formation of a transient hemispherical magma ocean in the impacted hemisphere, and the merging of the cores. We also find that impact angle and velocity have a strong effect on the post-impact temperature field [5] and on the timescale and nature of core merger.