SatCam: A mobile application for coordinated ground/satellite observation of clouds and validation of satellite-derived cloud mask products.

NASA Astrophysics Data System (ADS)

Gumley, L.; Parker, D.; Flynn, B.; Holz, R.; Marais, W.

2011-12-01

SatCam is an application for iOS devices that allows users to collect observations of local cloud and surface conditions in coordination with an overpass of the Terra, Aqua, or NPP satellites. SatCam allows users to acquire images of sky conditions and ground conditions at their location anywhere in the world using the built-in iPhone or iPod Touch camera at the same time that the satellite is passing overhead and viewing their location. Immediately after the sky and ground observations are acquired, the application asks the user to rate the level of cloudiness in the sky (Completely Clear, Mostly Clear, Partly Cloudy, Overcast). For the ground observation, the user selects their assessment of the surface conditions (Urban, Green Vegetation, Brown Vegetation, Desert, Snow, Water). The sky condition and surface condition selections are stored along with the date, time, and geographic location for the images, and the images are uploaded to a central server. When the MODIS (Terra and Aqua) or VIIRS (NPP) imagery acquired over the user location becomes available, a MODIS or VIIRS true color image centered at the user's location is delivered back to the SatCam application on the user's iOS device. SSEC also proposes to develop a community driven SatCam website where users can share their observations and assessments of satellite cloud products in a collaborative environment. SSEC is developing a server side data analysis system to ingest the SatCam user observations, apply quality control, analyze the sky images for cloud cover, and collocate the observations with MODIS and VIIRS satellite products (e.g., cloud mask). For each observation that is collocated with a satellite observation, the server will determine whether the user scored a "hit", meaning their sky observation and sky assessment matched the automated cloud mask obtained from the satellite observation. The hit rate will be an objective assessment of the accuracy of the user's sky observations. Users with high hit rates will be identified automatically and their observations will be used globally to evaluate the performance of the MODIS cloud mask algorithm for Terra and Aqua and the VIIRS cloud mask algorithm for NPP. The user's assessment of the ground conditions will also be used to evaluate the cloud mask accuracy in selecting the correct surface type at the user's location, which is an important element in the decision path used internally by the cloud mask algorithm. This presentation will describe the SatCam application, how it is used, and show examples of SatCam observations.

A depth-first search algorithm to compute elementary flux modes by linear programming.

PubMed

Quek, Lake-Ee; Nielsen, Lars K

2014-07-30

The decomposition of complex metabolic networks into elementary flux modes (EFMs) provides a useful framework for exploring reaction interactions systematically. Generating a complete set of EFMs for large-scale models, however, is near impossible. Even for moderately-sized models (<400 reactions), existing approaches based on the Double Description method must iterate through a large number of combinatorial candidates, thus imposing an immense processor and memory demand. Based on an alternative elementarity test, we developed a depth-first search algorithm using linear programming (LP) to enumerate EFMs in an exhaustive fashion. Constraints can be introduced to directly generate a subset of EFMs satisfying the set of constraints. The depth-first search algorithm has a constant memory overhead. Using flux constraints, a large LP problem can be massively divided and parallelized into independent sub-jobs for deployment into computing clusters. Since the sub-jobs do not overlap, the approach scales to utilize all available computing nodes with minimal coordination overhead or memory limitations. The speed of the algorithm was comparable to efmtool, a mainstream Double Description method, when enumerating all EFMs; the attrition power gained from performing flux feasibility tests offsets the increased computational demand of running an LP solver. Unlike the Double Description method, the algorithm enables accelerated enumeration of all EFMs satisfying a set of constraints.

Double-stranded RNA targeting calmodulin reveals a potential target for pest management of Nilaparvata lugens.

PubMed

Wang, Weixia; Wan, Pinjun; Lai, Fengxiang; Zhu, Tingheng; Fu, Qiang

2018-07-01

Calmodulin (CaM) is an essential protein in cellular activity and plays important roles in many processes in insect development. RNA interference (RNAi) has been hypothesized to be a promising method for pest control. CaM is a good candidate for RNAi target. However, the sequence and function of CaM in Nilaparvata lugens are unknown. Furthermore, the double-stranded RNA (dsRNA) target to CaM gene in pest control is still unavailable. In the present study, two alternatively spliced variants of CaM transcripts, designated NlCaM1 and NlCaM2, were cloned from N. lugens. The two cDNA sequences exhibited 100% identity to each other in the open reading frame (ORF), and only differed in the 3' untranslated region (UTR). NlCaM including NlCaM1 and NlCaM2 mRNA was detectable in all developmental stages and tissues of N. lugens, with significantly increased expression in the salivary glands. Knockdown of NlCaM expression by RNAi with different dsRNAs led to an inability to molt properly, increased mortality, which ranged from 49.7 to 92.5%, impacted development of the ovaries and led to female infertility. There were no significant reductions in the transcript levels of vitellogenin and its receptor or in the total vitellogenin protein level relative to the control group. However, a significant reduction in vitellogenin protein was detected in ovaries injected with dsNlCaM. In addition, a specific dsRNA of NlCaM for control of N. lugens was designed and tested. NlCaM plays important roles mainly in nymph development and uptake of vitellogenin by ovaries in vitellogenesis in N. lugens. dsRNA derived from the less conserved 3'-UTR of NlCaM shows great potential for RNAi-based N. lugens management. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.

STT Doubles with Large Delta_M - Part VIII: Tau Per Ori Cam Mon Cnc Peg

NASA Astrophysics Data System (ADS)

Knapp, Wilfried; Nanson, John

2017-04-01

The results of visual double star observing sessions suggested a pattern for STT doubles with large delta_M of being harder to resolve than would be expected based on the WDS catalog data. It was felt this might be a problem with expectations on one hand, and on the other might be an indication of a need for new precise measurements, so we decided to take a closer look at a selected sample of STT doubles and do some research. Again like for the other STT objects covered so far several of the components show parameters quite different from the current WDS data.

A Double-Decker Levitation Experiment Using a Sandwich of Superconductors.

ERIC Educational Resources Information Center

Jacob, Anthony T.; And Others

1988-01-01

Shows that the mutual repulsion that enables a superconductor to levitate a magnet and a magnet to levitate a superconductor can be combined into a single demonstration. Uses an overhead projector, two pellets of "1-2-3" superconductor, Nd-Fe-B magnets, liquid nitrogen, and paraffin. Offers superconductor preparation, hazards, and disposal…

Estrogen Enhances Linkage in the Vascular Endothelial Calmodulin Network via a Feedforward Mechanism at the G Protein-coupled Estrogen Receptor 1*

PubMed Central

Tran, Quang-Kim; Firkins, Rachel; Giles, Jennifer; Francis, Sarah; Matnishian, Vahe; Tran, Phuong; VerMeer, Mark; Jasurda, Jake; Burgard, Michelle Ann; Gebert-Oberle, Briana

2016-01-01

Estrogen exerts many effects on the vascular endothelium. Calmodulin (CaM) is the transducer of Ca2+ signals and is a limiting factor in cardiovascular tissues. It is unknown whether and how estrogen modifies endothelial functions via the network of CaM-dependent proteins. Here we show that 17β-estradiol (E2) up-regulates total CaM level in endothelial cells. Concurrent measurement of Ca2+ and Ca2+-CaM indicated that E2 also increases free Ca2+-CaM. Pharmacological studies, gene silencing, and receptor expression-specific cell studies indicated that the G protein-coupled estrogen receptor 1 (GPER/GPR30) mediates these effects via transactivation of EGFR and subsequent MAPK activation. The outcomes were then examined on four distinct members of the intracellular CaM target network, including GPER/GPR30 itself and estrogen receptor α, the plasma membrane Ca2+-ATPase (PMCA), and endothelial nitric-oxide synthase (eNOS). E2 substantially increases CaM binding to estrogen receptor α and GPER/GPR30. Mutations that reduced CaM binding to GPER/GPR30 in separate binding domains do not affect GPER/GPR30-Gβγ preassociation but decrease GPER/GPR30-mediated ERK1/2 phosphorylation. E2 increases CaM-PMCA association, but the expected stimulation of Ca2+ efflux is reversed by E2-stimulated tyrosine phosphorylation of PMCA. These effects sustain Ca2+ signals and promote Ca2+-dependent CaM interactions with other CaM targets. Consequently, E2 doubles CaM-eNOS interaction and also promotes dual phosphorylation of eNOS at Ser-617 and Ser-1179. Calculations using in-cell and in vitro data revealed substantial individual and combined contribution of these effects to total eNOS activity. Taken together, E2 generates a feedforward loop via GPER/GPR30, which enhances Ca2+/CaM signals and functional linkage in the endothelial CaM target network. PMID:26987903

Estrogen Enhances Linkage in the Vascular Endothelial Calmodulin Network via a Feedforward Mechanism at the G Protein-coupled Estrogen Receptor 1.

PubMed

Tran, Quang-Kim; Firkins, Rachel; Giles, Jennifer; Francis, Sarah; Matnishian, Vahe; Tran, Phuong; VerMeer, Mark; Jasurda, Jake; Burgard, Michelle Ann; Gebert-Oberle, Briana

2016-05-13

Estrogen exerts many effects on the vascular endothelium. Calmodulin (CaM) is the transducer of Ca(2+) signals and is a limiting factor in cardiovascular tissues. It is unknown whether and how estrogen modifies endothelial functions via the network of CaM-dependent proteins. Here we show that 17β-estradiol (E2) up-regulates total CaM level in endothelial cells. Concurrent measurement of Ca(2+) and Ca(2+)-CaM indicated that E2 also increases free Ca(2+)-CaM. Pharmacological studies, gene silencing, and receptor expression-specific cell studies indicated that the G protein-coupled estrogen receptor 1 (GPER/GPR30) mediates these effects via transactivation of EGFR and subsequent MAPK activation. The outcomes were then examined on four distinct members of the intracellular CaM target network, including GPER/GPR30 itself and estrogen receptor α, the plasma membrane Ca(2+)-ATPase (PMCA), and endothelial nitric-oxide synthase (eNOS). E2 substantially increases CaM binding to estrogen receptor α and GPER/GPR30. Mutations that reduced CaM binding to GPER/GPR30 in separate binding domains do not affect GPER/GPR30-Gβγ preassociation but decrease GPER/GPR30-mediated ERK1/2 phosphorylation. E2 increases CaM-PMCA association, but the expected stimulation of Ca(2+) efflux is reversed by E2-stimulated tyrosine phosphorylation of PMCA. These effects sustain Ca(2+) signals and promote Ca(2+)-dependent CaM interactions with other CaM targets. Consequently, E2 doubles CaM-eNOS interaction and also promotes dual phosphorylation of eNOS at Ser-617 and Ser-1179. Calculations using in-cell and in vitro data revealed substantial individual and combined contribution of these effects to total eNOS activity. Taken together, E2 generates a feedforward loop via GPER/GPR30, which enhances Ca(2+)/CaM signals and functional linkage in the endothelial CaM target network. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

CAM and Hepatitis C: A Focus on Herbal Supplements

MedlinePlus

... health/clinicaltrials/ Key References Dhiman RK, Chawla YK. Herbal medicines for liver diseases . Digestive Diseases and Sciences . 2005; ... double-blind, placebo-controlled trial. Annals of Internal Medicine ... TM, Szabo G, et al. Herbal product use by persons enrolled in the Hepatitis ...

Curcumin improves the efficacy of cisplatin by targeting cancer stem-like cells through p21 and cyclin D1-mediated tumour cell inhibition in non-small cell lung cancer cell lines

PubMed Central

BAHARUDDIN, PUTERI; SATAR, NAZILAH; FAKIRUDDIN, KAMAL SHAIK; ZAKARIA, NORASHIKIN; LIM, MOON NIAN; YUSOFF, NARAZAH MOHD; ZAKARIA, ZUBAIDAH; YAHAYA, BADRUL HISHAM

2016-01-01

Natural compounds such as curcumin have the ability to enhance the therapeutic effectiveness of common chemotherapy agents through cancer stem-like cell (CSC) sensitisation. In the present study, we showed that curcumin enhanced the sensitivity of the double-positive (CD166+/EpCAM+) CSC subpopulation in non-small cell lung cancer (NSCLC) cell lines (A549 and H2170) to cisplatin-induced apoptosis and inhibition of metastasis. Our results revealed that initial exposure of NSCLC cell lines to curcumin (10–40 µM) markedly reduced the percentage of viability to an average of ~51 and ~54% compared to treatment with low dose cisplatin (3 µM) with only 94 and 86% in both the A549 and H2170 cells. Moreover, sensitisation of NSCLC cell lines to curcumin through combined treatment enhanced the single effect induced by low dose cisplatin on the apoptosis of the double-positive CSC subpopulation by 18 and 20% in the A549 and H2170 cells, respectively. Furthermore, we found that curcumin enhanced the inhibitory effects of cisplatin on the highly migratory CD166+/EpCAM+ subpopulation, marked by a reduction in cell migration to 9 and 21% in the A549 and H2170 cells, respectively, indicating that curcumin may increase the sensitivity of CSCs to cisplatin-induced migratory inhibition. We also observed that the mRNA expression of cyclin D1 was downregulated, while a substantial increased in p21 expression was noted, followed by Apaf1 and caspase-9 activation in the double-positive (CD166+/EpCAM+) CSC subpopulation of A549 cells, suggested that the combined treatments induced cell cycle arrest, therefore triggering CSC growth inhibition via the intrinsic apoptotic pathway. In conclusion, we provided novel evidence of the previously unknown therapeutic effects of curcumin, either alone or in combination with cisplatin on the inhibition of the CD166+/EpCAM+ subpopulation of NSCLC cell lines. This finding demonstrated the potential therapeutic approach of using curcumin that may enhance the effects of cisplatin by targeting the CSC subpopulation in NSCLC. PMID:26531053

Long-Term Chamomile Therapy of Generalized Anxiety Disorder: A Study Protocol for a Randomized, Double-Blind, Placebo- Controlled Trial.

PubMed

Mao, Jun J; Li, Qing S; Soeller, Irene; Rockwell, Kenneth; Xie, Sharon X; Amsterdam, Jay D

2014-11-01

Anxiety symptoms are among the most common reasons for consumers to use Complementary and Alternative Medicine (CAM) therapy. Although many botanicals have been proposed as putative remedies for anxiety symptoms, there has been a paucity of controlled trials of these remedies. A preliminary study of the anxiolytic effect of Chamomile ( Matricaria recutita ) in humans suggests that chamomile may have anxiolytic and antidepressant activity. We now seek to conduct a 5-year randomized, double-blind, placebo-substitution study to examine the short and long-term safety and efficacy of chamomile extract in Generalized Anxiety Disorder (GAD). 180 subjects with moderate to severe GAD will receive initial open-label pharmaceutical-grade chamomile extract 500-1,500 mg daily for 8 weeks. Responders to treatment who remain well for an additional 4 weeks of consolidation therapy, will be randomized to double-blind continuation therapy with either chamomile extract 500-1,500 mg daily or placebo for an additional 26 weeks. The primary outcome will be the time to relapse during study continuation therapy in each treatment condition. Secondary outcomes will include the proportion of subjects in each treatment condition who relapse, as well as the proportion of subjects with treatment-emergent adverse events. Quality of life ratings will also be compared between treatment conditions during short and long-term therapy. Many individuals with mental disorders decline conventional therapy and seek CAM therapies for their symptoms. Thus, the identification of effective CAM therapy is of relevance to reducing the burden of mental illness. This study builds upon our prior findings of significant superiority of chamomile versus placebo in reducing GAD symptoms. We now extend these preliminary findings by conducting a randomized long-term safety and efficacy study of chamomile in GAD.

A depth-first search algorithm to compute elementary flux modes by linear programming

PubMed Central

2014-01-01

Background The decomposition of complex metabolic networks into elementary flux modes (EFMs) provides a useful framework for exploring reaction interactions systematically. Generating a complete set of EFMs for large-scale models, however, is near impossible. Even for moderately-sized models (<400 reactions), existing approaches based on the Double Description method must iterate through a large number of combinatorial candidates, thus imposing an immense processor and memory demand. Results Based on an alternative elementarity test, we developed a depth-first search algorithm using linear programming (LP) to enumerate EFMs in an exhaustive fashion. Constraints can be introduced to directly generate a subset of EFMs satisfying the set of constraints. The depth-first search algorithm has a constant memory overhead. Using flux constraints, a large LP problem can be massively divided and parallelized into independent sub-jobs for deployment into computing clusters. Since the sub-jobs do not overlap, the approach scales to utilize all available computing nodes with minimal coordination overhead or memory limitations. Conclusions The speed of the algorithm was comparable to efmtool, a mainstream Double Description method, when enumerating all EFMs; the attrition power gained from performing flux feasibility tests offsets the increased computational demand of running an LP solver. Unlike the Double Description method, the algorithm enables accelerated enumeration of all EFMs satisfying a set of constraints. PMID:25074068

Releasing yellow birch saplings and poles

Treesearch

Gayne G. Erdmann; Ralph M., Jr. Peterson

1992-01-01

Yellow birch needs moisture, nutrients, overhead light, and enough space for the crown to expand in order to compete successfully with faster-growing northern hardwoods. By releasing crowns early, you can increase the number of future veneer and saw log trees in a stand and double the growth rate, thus cutting rotations in half. If you delay crown release too long,...

Tumour-associated circulating microparticles: A novel liquid biopsy tool for screening and therapy monitoring of colorectal carcinoma and other epithelial neoplasia.

PubMed

Willms, Arnulf; Müller, Clara; Julich, Henrike; Klein, Niklas; Schwab, Robert; Güsgen, Christoph; Richardsen, Ines; Schaaf, Sebastian; Krawczyk, Marcin; Krawczyk, Marek; Lammert, Frank; Schuppan, Detlef; Lukacs-Kornek, Veronika; Kornek, Miroslaw

2016-05-24

Up to date, novel tools for low-cost, minimal invasive cancer surveillance, cancer screening and treatment monitoring are in urgent need. Physicians consider the so-called liquid biopsy as a possible future tool successfully achieving these ultimate goals. Here, we aimed to identify circulating tumour-associated MPs (taMPs) that could aid in diagnosing minimal-invasively the presence and follow up treatment in non-small cell lung carcinoma (NSCLC), colorectal carcinoma (CRC) and pancreas carcinoma (PaCa). Tumour-associated MPs (taMPs) were quantified after isolation by centrifugation followed by flow cytometry analysis from the serum of cancer patients with CRC (n = 52), NSCLC (n = 40) and PaCa (n = 11). Healthy subjects (n = 55) or patients with struma nodosa (thyroid nodules) (n = 43) served as negative controls. In all three types of tumour entities, the presence of tumour was associated with an increase of circulating EpCAM+ and EpCAM+CD147+ taMPs. The presence of CD147+EpCAM+ taMPs were specific to tumour-bearing patients thus allowing the specific distinction of malignancies from patients with thyroid nodules. Increased level of EpCAM single positive MPs were, in turn, also detected in patients with thyroid nodules. Importantly, EpCAM+CD147+ taMPs correlated with the measured tumour-volume in CRC patients. EpCAM+ taMPs decreased at 7 days after curative R0 tumour resection suggesting a close dependence with tumour presence. AUROC values (up to 0.85 and 0.90), sensitivity/specificity scores, and positive/negative predictive values indicated a high diagnostic accuracy of EpCAM+CD147+ taMPs. Taken together, EpCAM+CD147+ double positive taMPs could potentially serve as novel promising clinical parameter for cancer screening, diagnosis, surveillance and therapy monitoring.

Observation of a possible optical burst of the double star Beta Camelopardalis

NASA Technical Reports Server (NTRS)

Wdowiak, T. J.; Clifton, K. S.

1985-01-01

An intensified SEC Vidicon observation of a brightening of the image of Beta Cam for a duration of about 0.25 sec at 0932 UT on December 4, 1969 is described. The observation was made during airborne observations of meteors over Canada between latitudes of 50 and 60 deg N.

Observation of a possible optical burst of the double star Beta Camelopardalis

NASA Astrophysics Data System (ADS)

Wdowiak, T. J.; Clifton, K. S.

1985-08-01

An intensified SEC Vidicon observation of a brightening of the image of β Cam for a duration of ≡0s.25 at 0932 UT on 1969 December 4 is described. The observation was made during airborne observations of meteors over Canada between latitudes of 50° and 60°N.

Long-Term Chamomile Therapy of Generalized Anxiety Disorder: A Study Protocol for a Randomized, Double-Blind, Placebo- Controlled Trial

PubMed Central

Mao, Jun J; Li, Qing S.; Soeller, Irene; Rockwell, Kenneth; Xie, Sharon X; Amsterdam, Jay D.

2017-01-01

Background Anxiety symptoms are among the most common reasons for consumers to use Complementary and Alternative Medicine (CAM) therapy. Although many botanicals have been proposed as putative remedies for anxiety symptoms, there has been a paucity of controlled trials of these remedies. A preliminary study of the anxiolytic effect of Chamomile (Matricaria recutita) in humans suggests that chamomile may have anxiolytic and antidepressant activity. We now seek to conduct a 5-year randomized, double-blind, placebo-substitution study to examine the short and long-term safety and efficacy of chamomile extract in Generalized Anxiety Disorder (GAD). Methods/Design 180 subjects with moderate to severe GAD will receive initial open-label pharmaceutical-grade chamomile extract 500–1,500 mg daily for 8 weeks. Responders to treatment who remain well for an additional 4 weeks of consolidation therapy, will be randomized to double-blind continuation therapy with either chamomile extract 500–1,500 mg daily or placebo for an additional 26 weeks. The primary outcome will be the time to relapse during study continuation therapy in each treatment condition. Secondary outcomes will include the proportion of subjects in each treatment condition who relapse, as well as the proportion of subjects with treatment-emergent adverse events. Quality of life ratings will also be compared between treatment conditions during short and long-term therapy. Discussion Many individuals with mental disorders decline conventional therapy and seek CAM therapies for their symptoms. Thus, the identification of effective CAM therapy is of relevance to reducing the burden of mental illness. This study builds upon our prior findings of significant superiority of chamomile versus placebo in reducing GAD symptoms. We now extend these preliminary findings by conducting a randomized long-term safety and efficacy study of chamomile in GAD. PMID:29057164

Cogeneration Systems.

DTIC Science & Technology

1980-06-01

43 3000 TYPICAL MID-1978 COSTS, all overhead included 2000- Type of System: Double alkali flue gas desulfurization plus baghouse particulate removal...Figures 5, 6, and 8 also provide cost estimating data for oil- and natural gas -fired steam turbine systems. Figure 5 shows the steam- generating station of...to the ownership and operation of the system. For systems burning oil or natural gas , fuel will typically constitute 65-90% of the total life cycle

Reed Solomon codes for error control in byte organized computer memory systems

NASA Technical Reports Server (NTRS)

Lin, S.; Costello, D. J., Jr.

1984-01-01

A problem in designing semiconductor memories is to provide some measure of error control without requiring excessive coding overhead or decoding time. In LSI and VLSI technology, memories are often organized on a multiple bit (or byte) per chip basis. For example, some 256K-bit DRAM's are organized in 32Kx8 bit-bytes. Byte oriented codes such as Reed Solomon (RS) codes can provide efficient low overhead error control for such memories. However, the standard iterative algorithm for decoding RS codes is too slow for these applications. Some special decoding techniques for extended single-and-double-error-correcting RS codes which are capable of high speed operation are presented. These techniques are designed to find the error locations and the error values directly from the syndrome without having to use the iterative algorithm to find the error locator polynomial.

Environmental Assessment of Proposed Wing Headquarters Facility at Pittsburgh International Airport Air Reserve Station, Pennsylvania

DTIC Science & Technology

2005-05-24

of Intent to Dispose of Soil Contaminated by Virgin Petroleum or equivalent form would be completed. The proposed Wing HQ Facility would include the...quadrant of the base. The overhead feeder, which includes some underground segments , is operated as a closed double loop system and serves the...weekends, weather, and holidays ). Using data from the National Oceanic and Atmospheric Administration, the average soil percent moisture was estimated

A Spectroscopically Confirmed Double Source Plane Lens System in the Hyper Suprime-Cam Subaru Strategic Program

NASA Astrophysics Data System (ADS)

Tanaka, Masayuki; Wong, Kenneth C.; More, Anupreeta; Dezuka, Arsha; Egami, Eiichi; Oguri, Masamune; Suyu, Sherry H.; Sonnenfeld, Alessandro; Higuchi, Ryo; Komiyama, Yutaka; Miyazaki, Satoshi; Onoue, Masafusa; Oyamada, Shuri; Utsumi, Yousuke

2016-08-01

We report the serendipitous discovery of HSC J142449-005322, a double source plane lens system in the Hyper Suprime-Cam Subaru Strategic Program. We dub the system Eye of Horus. The lens galaxy is a very massive early-type galaxy with stellar mass of ˜ 7× {10}11 {M}⊙ located at {z}{{L}}=0.795. The system exhibits two arcs/rings with clearly different colors, including several knots. We have performed spectroscopic follow-up observations of the system with FIRE on Magellan. The outer ring is confirmed at {z}{{S}2}=1.988 with multiple emission lines, while the inner arc and counterimage is confirmed at {z}{{S}1}=1.302. This makes it the first double source plane system with spectroscopic redshifts of both sources. Interestingly, redshifts of two of the knots embedded in the outer ring are found to be offset by {{Δ }}z=0.002 from the other knots, suggesting that the outer ring consists of at least two distinct components in the source plane. We perform lens modeling with two independent codes and successfully reproduce the main features of the system. However, two of the lensed sources separated by ˜0.7 arcsec cannot be reproduced by a smooth potential, and the addition of substructure to the lens potential is required to reproduce them. Higher-resolution imaging of the system will help decipher the origin of this lensing feature and potentially detect the substructure.

Enhancing hatch rate and survival in laboratory-reared hybrid Devils Hole Pupfish through application of antibiotics to eggs and larvae

USGS Publications Warehouse

Feuerbacher, Olin; Bonar, Scott A.; Barrett, Paul J.

2017-01-01

We evaluated the effectiveness of four antibiotics in enhancing the hatch rate, larval survival, and adult survival of hybrid Devils Hole Pupfish Cyprinodon diabolis (hybridized with Ash Meadows Amargosa Pupfish C. nevadensis mionectes). Cephalexin (CEX; concentration = 6.6 mg/L of water), chloramphenicol (CAM; 50 mg/L), erythromycin (ERY; 12.5 mg/L), and trimethoprim sulfamethoxazole (TMP-SMX; 25 mg/L) were applied as a constant bath either to incubating eggs or to larvae that hatched from untreated eggs. Hatch rate was roughly doubled by incubation in the presence of CAM (68% hatch) and TMP-SMX (66%) relative to the control (28%). Cephalexin and ERY conferred no benefit upon the hatch rate. Among fry that hatched from treated eggs, there was no increase in 15-d larval survival. However, fish that hatched from eggs treated with CAM, ERY, and TMP-SMX demonstrated enhanced survival at 360 d (51.2, 38.4, and 43.6%, respectively) and at 540 d (22.6, 6.8, and 20.2%, respectively); the untreated control had no survivors to those time points. All groups of eggs treated with antibiotics showed reductions in bacterial colony-forming units (CFUs) at 24 h posttreatment. At 120 h posttreatment, CEX-treated eggs had CFU counts similar to those of the control, whereas the TMP-SMX-treated eggs had the lowest CFU counts. Eggs treated with CAM and ERY had similar CFU counts, which were significantly reduced from the control counts. Larvae that were treated with CAM and TMP-SMX within 12 h posthatch showed enhanced 15-d survival (74% and 72%, respectively) in comparison with the control (56%). For pupfish rearing efforts in which antibiotic use is appropriate, CAM and TMP-SMX appear to provide the greatest benefit, particularly when applied to incubating eggs rather than to hatched larvae.

Procurement of a fully licensed radioisotope thermoelectric generator transportation system

NASA Astrophysics Data System (ADS)

Adkins, Harold E.; Bearden, Thomas E.

The present transportation system for radioisotope thermoelectric generators and heater units is being developed to comply with all applicable U.S. DOT regulations, including a doubly-contained 'bell jar' concept for the required double-containment of plutonium. Modifications in handling equipment and procedures are entailed by this novel packaging design, and will affect high-capacity forklifts, overhead cranes, He-backfilling equipment, etc. Attention is given to the design constraints involved, and to the Federal procurement process.

KSC-01pp0952

NASA Image and Video Library

2001-05-07

KENNEDY SPACE CENTER, FLA. -- An overhead crane in the Operations and Checkout Building lowers one of four gas tanks onto the Spacelab Logistics Double Pallet while workers help guide it. Part of the STS-104 payload, the storage tanks two gaseous oxygen and two gaseous nitrogen comprise the high pressure gas assembly that will be attached to the Joint Airlock Module during two spacewalks. The tanks will support future spacewalk operations from the Station and augment the Service Module gas resupply system

Reduced levels of TNF alpha in hypercholesterolemic individuals after treatment with pravastatin for 8 weeks.

PubMed

Solheim, S; Seljeflot, I; Arnesen, H; Eritsland, J; Eikvar, L

2001-08-01

cellular adhesion molecules (CAMs) expressed on the endothelial surface play a key role in the inflammatory process of atherosclerosis, and increased expression of CAMs has been shown in hypercholesterolemic individuals. The expression of CAMs is mediated by several cytokines including tumor necrosis factor alpha (TNF alpha) and interleukin 6 (IL-6). The aim of the present study was to assess the influence of pravastatin 40 mg per day on selected soluble CAMs; intercellular adhesion molecule 1 (ICAM-1), vascular cellular adhesion molecule 1 (VCAM-1), E-selectin, P-selectin and some circulating markers of inflammation; C-reactive protein (CRP) and the cytokines TNF alpha and IL-6. 40 non-diabetic men, age below 70 years, with serum total cholesterol 6--10 mmol/l combined with HDL-cholesterol < or =1.2 mmol/l were included. The study was randomized, double blinded, placebo controlled, cross over designed with 8 weeks intervention periods. Fasting blood samples were drawn after 8 and 16 weeks. significant reduction of total cholesterol was achieved after treatment with pravastatin (7.8 on placebo vs. 5.7 mmol/l on pravastatin). TNF alpha was significantly reduced after treatment with pravastatin (1.33 on placebo vs. 1.10 pg/ml on pravastatin, P=0.032), whereas no differences in the levels of the measured sCAMs, CRP and IL-6 were found. Subgroup analysis among smokers versus non-smokers showed a significant reduction in the level of TNF alpha only among the smokers. hypercholesterolemic individuals treated with pravastatin 40 mg per day for 8 weeks showed a statistically significant reduction in the levels of TNF alpha as compared with placebo.

The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

PubMed Central

Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

2015-01-01

Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique. PMID:27582985

Dynamics and Embedded Internet of Things Input Shaping Control for Overhead Cranes Transporting Multibody Payloads.

PubMed

Peláez, Gerardo; Vaugan, Joshua; Izquierdo, Pablo; Rubio, Higinio; García-Prada, Juan Carlos

2018-06-04

Input shaping is an Optimal Control feedforward strategy whose ability to define how and when a flexible dynamical system defined by Ordinary Differential Equations (ODEs) and computer controlled would move into its operative space, without command induced unwanted dynamics, has been exhaustively demonstrated. This work examines the issue of Embedded Internet of Things (IoT) Input Shaping with regard to real time control of multibody oscillatory systems whose dynamics are better described by differential algebraic equations (DAEs). An overhead crane hanging a double link multibody payload has been appointed as a benchmark case; it is a multibody, multimode system. This might be worst scenario to implement Input Shaping. The reasons can be found in the wide array of constraints that arise. Firstly, the reliability of the multibody model was tested on a Functional Mock-Up Interface (FMI) with the two link payload suspended from the trolley by comparing the experimental video tapping signals in time domain faced with the signals extracted from the multibody model. The FFTs of the simulated and the experimental signal contain the same frequency harmonics only with somewhat different power due to the real world light damping in the joints. The application of this approach may be extended to other cases i.e., the usefulness of mobile hydraulic cranes is limited because the payload is supported by an overhead cable under tension that allows oscillation to occur during crane motion. If the payload size is not negligible small when compared with the cable length may introduce an additional oscillatory mode that creates a multibody double pendulum. To give the insight into the double pendulum dynamics by Lagrangian methods two slender rods as payloads are analyzed dealing with the overhead crane and a composite revolute-revolute joint is proposed to model the cable of the hydraulic crane, both assumptions facilitates an affordable analysis. This allows developing a general study of this type of multibody payloads dynamics including its normal modes, modes ratios plus ranges of frequencies expected. Input Shapers were calculated for those multimodes of vibration by convolving Specified Insensitivity (SI) shapers for each mode plus a novel Direct SI-SI shaper well suited to reduce the computational requirements, i.e., the number of the shaper taps, to carry out the convolution sum in real time by the IoT device based on a single microcontroller working as the command generator. Several comparisons are presented for the shaped and unshaped responses using both the multibody model, the experimental FMI set-up and finally a real world hydraulic crane under slewing motion commanded by an analog Joystick connected by two RF modules 802.15.4 to the IoT device that carry out the convolution sum in real time. Input Shaping improves the performances for all the cases.

Toward a more efficient and scalable checkpoint/restart mechanism in the Community Atmosphere Model

NASA Astrophysics Data System (ADS)

Anantharaj, Valentine

2015-04-01

The number of cores (both CPU as well as accelerator) in large-scale systems has been increasing rapidly over the past several years. In 2008, there were only 5 systems in the Top500 list that had over 100,000 total cores (including accelerator cores) whereas the number of system with such capability has jumped to 31 in Nov 2014. This growth however has also increased the risk of hardware failure rates, necessitating the implementation of fault tolerance mechanism in applications. The checkpoint and restart (C/R) approach is commonly used to save the state of the application and restart at a later time either after failure or to continue execution of experiments. The implementation of an efficient C/R mechanism will make it more affordable to output the necessary C/R files more frequently. The availability of larger systems (more nodes, memory and cores) has also facilitated the scaling of applications. Nowadays, it is more common to conduct coupled global climate simulation experiments at 1 deg horizontal resolution (atmosphere), often requiring about 103 cores. At the same time, a few climate modeling teams that have access to a dedicated cluster and/or large scale systems are involved in modeling experiments at 0.25 deg horizontal resolution (atmosphere) and 0.1 deg resolution for the ocean. These ultrascale configurations require the order of 104 to 105 cores. It is not only necessary for the numerical algorithms to scale efficiently but the input/output (IO) mechanism must also scale accordingly. An ongoing series of ultrascale climate simulations, using the Titan supercomputer at the Oak Ridge Leadership Computing Facility (ORNL), is based on the spectral element dynamical core of the Community Atmosphere Model (CAM-SE), which is a component of the Community Earth System Model and the DOE Accelerated Climate Model for Energy (ACME). The CAM-SE dynamical core for a 0.25 deg configuration has been shown to scale efficiently across 100,000 cpu cores. At this scale, there is an increased risk that the simulation could be terminated due to hardware failures, resulting in a loss that could be as high as 105 - 106 titan core hours. Increasing the frequency of the output of C/R files could mitigate this loss but at the cost of additional C/R overhead. We are testing a more efficient C/R mechanism in CAM-SE. Our early implementation has demonstrated a nearly 3X performance improvement for a 1 deg CAM-SE (with CAM5 physics and MOZART chemistry) configuration using nearly 103 cores. We are in the process of scaling our implementation to 105 cores. This would allow us to run ultra scale simulations with more sophisticated physics and chemistry options while making better utilization of resources.

Neuroligins/LRRTMs prevent activity- and Ca2+/calmodulin-dependent synapse elimination in cultured neurons

PubMed Central

Soler-Llavina, Gilberto J.; Fuccillo, Marc V.; Malenka, Robert C.; Südhof, Thomas C.

2011-01-01

Neuroligins (NLs) and leucine-rich repeat transmembrane proteins (LRRTMs) are postsynaptic cell adhesion molecules that bind to presynaptic neurexins. In this paper, we show that short hairpin ribonucleic acid–mediated knockdowns (KDs) of LRRTM1, LRRTM2, and/or NL-3, alone or together as double or triple KDs (TKDs) in cultured hippocampal neurons, did not decrease synapse numbers. In neurons cultured from NL-1 knockout mice, however, TKD of LRRTMs and NL-3 induced an ∼40% loss of excitatory but not inhibitory synapses. Strikingly, synapse loss triggered by the LRRTM/NL deficiency was abrogated by chronic blockade of synaptic activity as well as by chronic inhibition of Ca2+ influx or Ca2+/calmodulin (CaM) kinases. Furthermore, postsynaptic KD of CaM prevented synapse loss in a cell-autonomous manner, an effect that was reversed by CaM rescue. Our results suggest that two neurexin ligands, LRRTMs and NLs, act redundantly to maintain excitatory synapses and that synapse elimination caused by the absence of NLs and LRRTMs is promoted by synaptic activity and mediated by a postsynaptic Ca2+/CaM-dependent signaling pathway. PMID:21788371

A storage gas tank is moved to a pallet in the O&C

NASA Technical Reports Server (NTRS)

2001-01-01

KENNEDY SPACE CENTER, Fla. -- An overhead crane in the Operations and Checkout Building lowers one of four gas tanks onto the Spacelab Logistics Double Pallet while workers help guide it. Part of the STS-104 payload, the storage tanks two gaseous oxygen and two gaseous nitrogen -- comprise the high pressure gas assembly that will be attached to the Joint Airlock Module during two spacewalks. The tanks will support future spacewalk operations from the Station and augment the Service Module gas resupply system.

Enhanced lysis by bispecific oncolytic measles viruses simultaneously using HER2/neu or EpCAM as target receptors

PubMed Central

Hanauer, Jan RH; Gottschlich, Lisa; Riehl, Dennis; Rusch, Tillmann; Koch, Vivian; Friedrich, Katrin; Hutzler, Stefan; Prüfer, Steffen; Friedel, Thorsten; Hanschmann, Kay-Martin; Münch, Robert C; Jost, Christian; Plückthun, Andreas; Cichutek, Klaus; Buchholz, Christian J; Mühlebach, Michael D

2016-01-01

To target oncolytic measles viruses (MV) to tumors, we exploit the binding specificity of designed ankyrin repeat proteins (DARPins). These DARPin-MVs have high tumor selectivity while maintaining excellent oncolytic potency. Stability, small size, and efficacy of DARPins allowed the generation of MVs simultaneously targeted to tumor marker HER2/neu and cancer stem cell (CSC) marker EpCAM. For optimization, the linker connecting both DARPins was varied in flexibility and length. Flexibility had no impact on fusion helper activity whereas length had. MVs with bispecific MV-H are genetically stable and revealed the desired double-target specificity. In vitro, the cytolytic activity of bispecific MVs was superior or comparable to mono-targeted viruses depending on the target cells. In vivo, therapeutic efficacy of the bispecific viruses was validated in an orthotopic ovarian carcinoma model revealing an effective reduction of tumor mass. Finally, the power of bispecific targeting was demonstrated on cocultures of different tumor cells thereby mimicking tumor heterogeneity in vitro, more closely reflecting real tumors. Here, bispecific excelled monospecific viruses in efficacy. DARPin-based targeting domains thus allow the generation of efficacious oncolytic viruses with double specificity, with the potential to handle intratumoral variation of antigen expression and to simultaneously target CSCs and the bulk tumor mass. PMID:27119117

Climate Simulations from Super-parameterized and Conventional General Circulation Models with a Third-order Turbulence Closure

NASA Astrophysics Data System (ADS)

Xu, Kuan-Man; Cheng, Anning

2014-05-01

A high-resolution cloud-resolving model (CRM) embedded in a general circulation model (GCM) is an attractive alternative for climate modeling because it replaces all traditional cloud parameterizations and explicitly simulates cloud physical processes in each grid column of the GCM. Such an approach is called "Multiscale Modeling Framework." MMF still needs to parameterize the subgrid-scale (SGS) processes associated with clouds and large turbulent eddies because circulations associated with planetary boundary layer (PBL) and in-cloud turbulence are unresolved by CRMs with horizontal grid sizes on the order of a few kilometers. A third-order turbulence closure (IPHOC) has been implemented in the CRM component of the super-parameterized Community Atmosphere Model (SPCAM). IPHOC is used to predict (or diagnose) fractional cloudiness and the variability of temperature and water vapor at scales that are not resolved on the CRM's grid. This model has produced promised results, especially for low-level cloud climatology, seasonal variations and diurnal variations (Cheng and Xu 2011, 2013a, b; Xu and Cheng 2013a, b). Because of the enormous computational cost of SPCAM-IPHOC, which is 400 times of a conventional CAM, we decided to bypass the CRM and implement the IPHOC directly to CAM version 5 (CAM5). IPHOC replaces the PBL/stratocumulus, shallow convection, and cloud macrophysics parameterizations in CAM5. Since there are large discrepancies in the spatial and temporal scales between CRM and CAM5, IPHOC used in CAM5 has to be modified from that used in SPCAM. In particular, we diagnose all second- and third-order moments except for the fluxes. These prognostic and diagnostic moments are used to select a double-Gaussian probability density function to describe the SGS variability. We also incorporate a diagnostic PBL height parameterization to represent the strong inversion above PBL. The goal of this study is to compare the simulation of the climatology from these three models (CAM5, CAM5-IPHOC and SPCAM-IPHOC), with emphasis on low-level clouds and precipitation. Detailed comparisons of scatter diagrams among the monthly-mean low-level cloudiness, PBL height, surface relative humidity and lower tropospheric stability (LTS) reveal the relative strengths and weaknesses for five coastal low-cloud regions among the three models. Observations from CloudSat and CALIPSO and ECMWF Interim reanalysis are used as the truths for the comparisons. We found that the standard CAM5 underestimates cloudiness and produces small cloud fractions at low PBL heights that contradict with observations. CAM5-IPHOC tends to overestimate low clouds but the ranges of LTS and PBL height variations are most realistic. SPCAM-IPHOC seems to produce most realistic results with relatively consistent results from one region to another. Further comparisons with other atmospheric environmental variables will be helpful to reveal the causes of model deficiencies so that SPCAM-IPHOC results will provide guidance to the other two models.

Microphysical variability of Amazonian deep convective cores observed by CloudSat and simulated by a multi-scale modeling framework

NASA Astrophysics Data System (ADS)

Brant Dodson, J.; Taylor, Patrick C.; Branson, Mark

2018-05-01

Recently launched cloud observing satellites provide information about the vertical structure of deep convection and its microphysical characteristics. In this study, CloudSat reflectivity data is stratified by cloud type, and the contoured frequency by altitude diagrams reveal a double-arc structure in deep convective cores (DCCs) above 8 km. This suggests two distinct hydrometeor modes (snow versus hail/graupel) controlling variability in reflectivity profiles. The day-night contrast in the double arcs is about four times larger than the wet-dry season contrast. Using QuickBeam, the vertical reflectivity structure of DCCs is analyzed in two versions of the Superparameterized Community Atmospheric Model (SP-CAM) with single-moment (no graupel) and double-moment (with graupel) microphysics. Double-moment microphysics shows better agreement with observed reflectivity profiles; however, neither model variant captures the double-arc structure. Ultimately, the results show that simulating realistic DCC vertical structure and its variability requires accurate representation of ice microphysics, in particular the hail/graupel modes, though this alone is insufficient.

Effect of methyl substituents on the electronic transitions in simple meso-aniline-BODIPY based dyes: RI-CC2 and TD-CAM-B3LYP computational investigation

NASA Astrophysics Data System (ADS)

Petrushenko, Igor K.; Petrushenko, Konstantin B.

2018-02-01

The S0 → Si, i = 1-5 electronic transitions of four 8-(4-aniline)-BODIPY and four 8-(N,N-dimethyl)-BODIPY dyes, differ by number and position of methyl substituents in the BODIPY frame, were investigated theoretically using ab initio the coupled cluster doubles (CC2) and TD-CAM-B3LYP methods. Methyl substituents in the BODIPY frame and the aniline fragment at the meso position disturb energy of local excitations S0 → S1, S0 → S3, and S0 → S4 weakly in comparison with the fully unsubstituted BODIPY molecule. These transitions in experimental spectra form the most long-wave absorption bands at ca. 500 nm as well as absorption bands in the region of 300-400 nm. At the same time, the presence of aniline fragments leads to the appearance of new S0 → S2 transitions of the charge transfer character in electronic spectra of BODIPYs. We also found a linear relationship between vertical energy of these charge transfer transitions and the electron donating power of an aniline fragment and electron accepting power of the BODIPY core depending on the number and position of methyl groups. The CC2 method provides the best overall description of the excitation energies in line with the experimental observations. On average, the quality of TD-CAM-B3LYP is almost equal to that of CC2, however the TD method with the CAM-B3LYP functional slightly underestimates the CT excitation energy.

Interaction of clopidogrel and statins in secondary prevention after cerebral ischaemia – a randomized, double-blind, double-dummy crossover study

PubMed Central

Siepmann, Timo; Heinke, Denise; Kepplinger, Jessica; Barlinn, Kristian; Gehrisch, Siegmund; Grählert, Xina; Schwanebeck, Uta; Reichmann, Heinz; Puetz, Volker; Bodechtel, Ulf; Gahn, Georg

2014-01-01

Aims Variability in responsiveness to clopidogrel is a clinical problem in secondary prevention after cerebral ischaemia which has been suggested to be linked to competitive metabolization of clopidogrel and cytochrome P450 (CYP) 3A4-oxidated statins such as simvastatin. We assessed the hypothesis that simvastatin, in contrast to CYP 2C9-metabolized fluvastatin, reduces clopidogrel-mediated platelet inhibition. Methods We performed a randomized, double-blind, double-dummy, two period crossover study in 13 patients with cerebral ischaemia (8F, 5 M), aged 64.1 ± 8.0 years (mean ± SD). After a 14 day period in which all patients received 75 mg clopidogrel day−1, patients additionally received either 20 mg simvastatin day−1 or 80 mg fluvastatin day−1 for 14 days. Regimens were crossed over after a 14 day wash-out period and switched regimens were continued for another 14 days. Platelet aggregation, clopidogrel active metabolite (CAM) plasma concentrations and routine laboratory parameters including prothrombin time (PT) Quick percent value were assessed at baseline and following each treatment phase. Results Clopidogrel reduced platelet aggregation in all patients as expected. Platelet aggregation and CAM plasma concentrations were unaltered when simvastatin or fluvastatin was added to clopidogrel. Simvastatin decreased PT Quick percent value (decrease from 109 ± 10.5% to 103 ± 11%, P < 0.05) when combined with clopidogrel but there was no such change following treatment with fluvastatin and clopidogrel. Conclusions Our data indicate that treatment with CYP 3A4-metabolized simvastatin does not jeopardize clopidogrel-mediated inhibition of platelet aggregation. After co-administration of simvastatin and clopidogrel we observed a decrease in the PT Quick percent value which could be due to simvastatin-induced reduction of activity of prothrombin fragment 1 + 2. PMID:24803100

Anti-MAdCAM Antibody Increases ß7+ T Cells and CCR9 Gene Expression in the Peripheral Blood of Patients With Crohn’s Disease

PubMed Central

Hassan-Zahraee, Mina; Banerjee, Anindita; Cheng, John B; Zhang, Weidong; Ahmad, Alaa; Page, Karen; von Schack, David; Zhang, Baohong; Martin, Steven W; Nayak, Satyaprakash; Reddy, Padma; Xi, Li; Neubert, Hendrik; Fernandez Ocana, Mireia; Gorelick, Ken; Clare, Robert; Vincent, Michael; Cataldi, Fabio; Hung, Kenneth

2018-01-01

Abstract Objective To define pharmacodynamic biomarkers in the peripheral blood of patients with Crohn’s disease [CD] after treatment with PF-00547659, an anti-human mucosal addressin cell adhesion molecule-1 [MAdCAM-1] monoclonal antibody. Methods In this Phase 2, randomised, double-blind, controlled study [OPERA], blood samples were analysed from patients with moderate to severe active CD who received placebo or 22.5 mg, 75 mg, or 225 mg of PF-00547659 subcutaneously at baseline and at Weeks 4 and 8, with follow-up at Week 12. Soluble MAdCAM [sMAdCAM] was measured by mass spectrometry, β7-expressing T cells by flow cytometry, and gene transcriptome by RNA sequencing. Results A slight increase in sMAdCAM was measured in the placebo group from baseline to Week 12 [6%], compared with significant decreases in all PF-00547659 groups [–87% to –98%]. A slight increase from baseline to Week 12 was observed in frequency and molecules of equivalent soluble fluorochrome for β7+ central memory T cells in the placebo group [4%], versus statistically significant increases in the active treatment groups [48% to 81%]. Similar trends were seen for β7+ effector memory T cells [placebo, 8%; PF-00547659, 84–138%] and β7+ naïve T cells [8%; 13–50%]. CCR9 gene expression had statistically significant up-regulation [p = 1.09e-06; false discovery rate < 0.1] with PF-00547659 treatment, and was associated with an increase in β7+ T cells. Conclusions Results of the OPERA study demonstrate positive pharmacology and dose-dependent changes in pharmacodynamic biomarker measurements in blood, including changes in cellular composition of lymphocytes and corresponding CCR9 gene expression changes. PMID:28961803

Anti-MAdCAM Antibody Increases ß7+ T Cells and CCR9 Gene Expression in the Peripheral Blood of Patients With Crohn's Disease.

PubMed

Hassan-Zahraee, Mina; Banerjee, Anindita; Cheng, John B; Zhang, Weidong; Ahmad, Alaa; Page, Karen; von Schack, David; Zhang, Baohong; Martin, Steven W; Nayak, Satyaprakash; Reddy, Padma; Xi, Li; Neubert, Hendrik; Fernandez Ocana, Mireia; Gorelick, Ken; Clare, Robert; Vincent, Michael; Cataldi, Fabio; Hung, Kenneth

2018-01-05

To define pharmacodynamic biomarkers in the peripheral blood of patients with Crohn's disease [CD] after treatment with PF-00547659, an anti-human mucosal addressin cell adhesion molecule-1 [MAdCAM-1] monoclonal antibody. In this Phase 2, randomised, double-blind, controlled study [OPERA], blood samples were analysed from patients with moderate to severe active CD who received placebo or 22.5 mg, 75 mg, or 225 mg of PF-00547659 subcutaneously at baseline and at Weeks 4 and 8, with follow-up at Week 12. Soluble MAdCAM [sMAdCAM] was measured by mass spectrometry, β7-expressing T cells by flow cytometry, and gene transcriptome by RNA sequencing. A slight increase in sMAdCAM was measured in the placebo group from baseline to Week 12 [6%], compared with significant decreases in all PF-00547659 groups [-87% to -98%]. A slight increase from baseline to Week 12 was observed in frequency and molecules of equivalent soluble fluorochrome for β7+ central memory T cells in the placebo group [4%], versus statistically significant increases in the active treatment groups [48% to 81%]. Similar trends were seen for β7+ effector memory T cells [placebo, 8%; PF-00547659, 84-138%] and β7+ naïve T cells [8%; 13-50%]. CCR9 gene expression had statistically significant up-regulation [p = 1.09e-06; false discovery rate < 0.1] with PF-00547659 treatment, and was associated with an increase in β7+ T cells. Results of the OPERA study demonstrate positive pharmacology and dose-dependent changes in pharmacodynamic biomarker measurements in blood, including changes in cellular composition of lymphocytes and corresponding CCR9 gene expression changes. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Robust effects of cloud superparameterization on simulated daily rainfall intensity statistics across multiple versions of the Community Earth System Model

DOE PAGES

Kooperman, Gabriel J.; Pritchard, Michael S.; Burt, Melissa A.; ...

2016-02-01

This study evaluates several important statistics of daily rainfall based on frequency and amount distributions as simulated by a global climate model whose precipitation does not depend on convective parameterization—Super-Parameterized Community Atmosphere Model (SPCAM). Three superparameterized and conventional versions of CAM, coupled within the Community Earth System Model (CESM1 and CCSM4), are compared against two modern rainfall products (GPCP 1DD and TRMM 3B42) to discriminate robust effects of superparameterization that emerge across multiple versions. The geographic pattern of annual-mean rainfall is mostly insensitive to superparameterization, with only slight improvements in the double-ITCZ bias. However, unfolding intensity distributions reveal several improvementsmore » in the character of rainfall simulated by SPCAM. The rainfall rate that delivers the most accumulated rain (i.e., amount mode) is systematically too weak in all versions of CAM relative to TRMM 3B42 and does not improve with horizontal resolution. It is improved by superparameterization though, with higher modes in regions of tropical wave, Madden-Julian Oscillation, and monsoon activity. Superparameterization produces better representations of extreme rates compared to TRMM 3B42, without sensitivity to horizontal resolution seen in CAM. SPCAM produces more dry days over land and fewer over the ocean. Updates to CAM’s low cloud parameterizations have narrowed the frequency peak of light rain, converging toward SPCAM. Poleward of 50°, where more rainfall is produced by resolved-scale processes in CAM, few differences discriminate the rainfall properties of the two models. Lastly, these results are discussed in light of their implication for future rainfall changes in response to climate forcing.« less

MATLAB Algorithms for Rapid Detection and Embedding of Palindrome and Emordnilap Electronic Watermarks in Simulated Chemical and Biological Image Data

DTIC Science & Technology

2004-12-01

digital watermarking http:// ww*.petitcolas .net/ fabien/ steganography / email: fapp2@cl.cam.ac.uk a=double(imread(’custom-a.jpg’)); %load in image ...MATLAB Algorithms for Rapid Detection and Embedding of Palindrome and Emordnilap Electronic Watermarks in Simulated Chemical and Biological Image ...approach (Ref 2-4) to watermarking involves be used to inform the viewer of data (such as photographs putting the cover image in the first 4

Computer-aided fabrication of a zirconia 14-unit removable dental prosthesis: a technical report.

PubMed

Grösser, Julian; Sachs, Caroline; Stadelmann, Markus; Schweiger, Josef; Güthe, Jan-Frederik; Beuer, Florian

2014-01-01

Double crown systems with primary crowns made from zirconia are used to support removable dental prostheses (RDPs). However, the fabrication of RDPs is labor-intensive and costly. Manufacturing primary and secondary crowns from zirconia with a CAD/CAM system might simplify the fabrication protocol and reduce costs. Furthermore, only ceramic materials are used in this method, providing an RDP with the highest possible biocompatibility and greatest possible esthetics. This article describes the fabrication protocol step by step.

Subcellular distributions of rat CaM kinase phosphatase N and other members of the CaM kinase regulatory system.

PubMed

Kitani, Takako; Okuno, Sachiko; Takeuchi, Masayuki; Fujisawa, Hitoshi

2003-07-01

Ca2+/Calmodulin-dependent protein kinase (CaM kinase) regulatory system is composed of multifunctional CaM kinases such as CaM kinases IV and I, upstream CaM kinases such as CaM kinase kinases alpha and beta, which activate multifunctional CaM kinases, and CaM kinase phosphatases such as CaM kinase phosphatase and CaM kinase phosphatase N, which deactivate the activated multifunctional CaM kinases. To understand the combinations of CaM kinases I and IV, CaM kinase kinases alpha and beta, and CaM kinase phosphatases, the locations of the enzymes in the cell were examined by immunocytochemical studies of cultured cells. The results indicate that CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase occur in the cytoplasm and that CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N occur inside the cellular nucleus, suggesting that there are at least two different sets of CaM kinase regulatory systems, one consisting of CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase in the cytoplasm and the other consisting of CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N in the nucleus.

Measurement of SIFT operating system overhead

NASA Technical Reports Server (NTRS)

Palumbo, D. L.; Butler, R. W.

1985-01-01

The overhead of the software implemented fault tolerance (SIFT) operating system was measured. Several versions of the operating system evolved. Each version represents different strategies employed to improve the measured performance. Three of these versions are analyzed. The internal data structures of the operating systems are discussed. The overhead of the SIFT operating system was found to be of two types: vote overhead and executive task overhead. Both types of overhead were found to be significant in all versions of the system. Improvements substantially reduced this overhead; even with these improvements, the operating system consumed well over 50% of the available processing time.

Use of complementary and alternative medicine in Israel: 2000 vs. 1993.

PubMed

Shmueli, Amir; Shuval, Judith

2004-01-01

Complementary and alternative medical care has gained increasing popularity in western societies in recent years. To provide a cross-sectional and temporal (2000 vs. 1993) analysis of the use of complementary and alternative medicine in Israel. The subjects studied represented the Israeli Jewish urban population aged 45-75 years. Full sit-down interviews were conducted with 2,003 respondents in 1993 and 2,505 respondents in 2000. For 1993, 6% of the population reported on consultations with CAM providers during the previous year. For 2000, that proportion increased to 10%. Being a woman, having higher education, enjoying better economic status, being younger, living in a big city, and being dissatisfied with specialists' care were all positively related to the use of non-conventional medicine, particularly in 2000. In both years, more than 50% of the consultations were with acupuncturists and homeopaths. However, chiropractors have doubled their market shares, and lower back pain became the leading problem for which care was sought. The main reason for consulting CAM was a reluctance to use too many drugs or to undergo an invasive procedure. However, a significant proportion of the users continue to use conventional medicine concurrently. Seventy-five percent in 2000 and 60% in 1993 reported that the treatment helped. Between 1993 and 2000, CAM in Israel changed from an infant industry into a mainstream medical commodity, reflected in both prevalence and different patterns of consumption.

Non-preconditioned conjugate gradient on cell and FPGA based hybrid supercomputer nodes

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

Dubois, David H; Dubois, Andrew J; Boorman, Thomas M

2009-01-01

This work presents a detailed implementation of a double precision, non-preconditioned, Conjugate Gradient algorithm on a Roadrunner heterogeneous supercomputer node. These nodes utilize the Cell Broadband Engine Architecture{sup TM} in conjunction with x86 Opteron{sup TM} processors from AMD. We implement a common Conjugate Gradient algorithm, on a variety of systems, to compare and contrast performance. Implementation results are presented for the Roadrunner hybrid supercomputer, SRC Computers, Inc. MAPStation SRC-6 FPGA enhanced hybrid supercomputer, and AMD Opteron only. In all hybrid implementations wall clock time is measured, including all transfer overhead and compute timings.

Non-preconditioned conjugate gradient on cell and FPCA-based hybrid supercomputer nodes

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

Dubois, David H; Dubois, Andrew J; Boorman, Thomas M

2009-03-10

This work presents a detailed implementation of a double precision, Non-Preconditioned, Conjugate Gradient algorithm on a Roadrunner heterogeneous supercomputer node. These nodes utilize the Cell Broadband Engine Architecture{trademark} in conjunction with x86 Opteron{trademark} processors from AMD. We implement a common Conjugate Gradient algorithm, on a variety of systems, to compare and contrast performance. Implementation results are presented for the Roadrunner hybrid supercomputer, SRC Computers, Inc. MAPStation SRC-6 FPGA enhanced hybrid supercomputer, and AMD Opteron only. In all hybrid implementations wall clock time is measured, including all transfer overhead and compute timings.

A bilayer Double Semion Model with Symmetry-Enriched Topological Order

NASA Astrophysics Data System (ADS)

Ortiz, Laura; Martin-Delgado, Miguel Angel

We construct a new model of two-dimensional quantum spin systems that combines intrinsic topological orders and a global symmetry called flavour symmetry. It is referred as the bilayer Doubled Semion model (bDS) and is an instance of symmetry-enriched topological order. A honeycomb bilayer lattice is introduced to combine a Double Semion Topolgical Order with a global spin-flavour symmetry to get the fractionalization of its quasiparticles. The bDS model exhibits non-trival braiding self-statistics of excitations and its dual model constitutes a Symmetry-Protected Topological Order with novel edge states. This dual model gives rise to a bilayer Non-Trivial Paramagnet that is invariant under the flavour symmetry and the well-known spin flip symmetry. We acknowledge financial support from the Spanish MINECO Grants FIS2012-33152, FIS2015-67411, and the CAM research consortium QUITEMAD+, Grant No. S2013/ICE-2801. The research of M.A.M.-D. has been supported in part by the U.S. Army Research Office throu.

Does infection with Chlamydia pneumoniae and/or Helicobacter pylori increase the expression of endothelial cell adhesion molecules in humans?

PubMed

Schumacher, A; Seljeflot, I; Lerkerød, A B; Sommervoll, L; Otterstad, J E; Arnesen, H

2002-10-01

To investigate if Chlamydia pneumoniae and/or Helicobacter pylori seropositivity is associated with elevated levels of soluble endothelial cell adhesion molecules (sCAMs) as markers of atherosclerotic activity. Immunoglobulin A (IgA) and IgG antibodies to the two bacteria, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin were measured in coronary heart disease (CHD) patients (n = 193) and age- and sex-matched controls (n = 193). Two different serological methods were used for the detection of Chlamydia antibodies: Labsystems microimmunofluorescence to detect species-specific C. pneumoniae antibodies and Medac's recombinant enzyme-linked immunosorbent assay to detect genus-specific lipopolysaccharide antibodies. The concentrations of sICAM-1 and E-selectin were higher in CHD patients with positive vs. negative Chlamydia lipopolysaccharide IgA (P = 0.044 for both). H. pylori antibodies alone did not predict raised levels of sCAMs, but in CHD patients sICAM-1 was increased with IgA seropositivity to both bacteria compared to double seronegativity (P = 0.034). Concentrations of sVCAM-1 were elevated in CHD patients with double IgA seropositivity compared to those with Chlamydia lipopolysaccharide IgA seropositivity alone (P = 0.018). Our results may indicate that C. pneumoniae contributes to increased inflammation in CHD, and that this contribution is even more pronounced when present in combination with H. pylori IgA antibodies.

75 FR 25210 - Procurement List Proposed Additions and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

...-9276--Multi Cam NSN: 8415-01-579-9272--Multi Cam NSN: 8415-01-579-9267--Multi Cam NSN: 8415-01-579-9260--Multi Cam NSN: 8415-01-579-9219--Multi Cam NSN: 8415-01-579-9210--Multi Cam NSN: 8415-01-579-9197--Multi Cam NSN: 8415-01-579-9189--Multi Cam NSN: 8415-01-579-9182--Multi Cam NSN: 8415-01-579-9175--Multi Cam...

Mist and water condensation inside incubators reduce the efficacy of phototherapy.

PubMed

de Carvalho, Manoel; Torrao, Carolina Turano; Moreira, Maria Elisabeth Lopes

2011-03-01

To measure the irradiance in humidified incubator under three different overhead phototherapy devices. The effective irradiance of three phototherapy devices was assessed by taking a series of irradiance measurements in the illuminated field. Measurements were made with a fixed bandwidth broadband radiometer (380-530 nm). The distance between the light source and the radiometer was 35 cm for the daylight fluorescent lamp, 40 cm for the light emitting diode (LED) and 50 cm for the halogen phototherapy. A double-wall incubator was kept at 36°C and set at three different levels of humidity (60-70%, 80% and equal or above 90%). The irradiance under the overhead daylight fluorescent lamp phototherapy did not change with the increasing humidity. However, above 90% humidity, when water vapour inside the incubator was so saturated to the point of totally condensing in the incubator walls, the measured irradiance decreased 15% of the initial values with the blue LED phototherapy and 45% with the halogen spotlight phototherapy. Highly humidified incubators are frequently used to treat very low birthweight infants. Health professionals should be aware that mist and water condensation inside an incubator may significantly reduce the efficacy of treatment.

Use of complementary and alternative medicine by lymphoma survivors in South Korea.

PubMed

Kim, Kisook; Kim, Soo Hyun; Ok, Oh Nam; Kim, Im-Ryung; Lee, Suyeon; Kim, So Hee; Kim, Won Seog; Ryu, Min-Hee; Lee, Moon Hee

2018-04-01

We aimed to examine the experience of complementary and alternative medicine (CAM) use and its association with health-related quality of life (HRQOL) in lymphoma survivors in South Korea. The participants were 869 lymphoma survivors from three hospitals in South Korea, all diagnosed with lymphoma at least 24 months prior to participation. Self-reported questionnaires were used to assess CAM use. The questionnaire addressed types of CAM used, sources of information about CAM, reason for CAM use, satisfaction with CAM use, discussion of CAM use with doctors, experience of side effects, costs of CAM use, and intentions to continue using CAM. HRQOL was measured with the EORTC QLQ-C30. Of the 869 participants, 42.2% had experience using CAM, and there were statistically significant differences among CAM users and non-users in terms of sex, religion, and time since diagnosis. A special diet (e.g., ginseng, chitosan, mixed cereals) was the most commonly used type of CAM, and most CAM users (82.1%) were satisfied with their CAM use. Most CAM users (77.5%) did not discuss the use of CAM with their doctors, and only 9.2% reported any side effects from CAM. CAM users showed significantly lower HRQOL scores than did non-users. A significant number of lymphoma survivors in Korea have used CAM, and most CAM users are satisfied with their CAM use. Oncology nurses should be aware of the range of CAM use among patients and reflect their responses in their treatment and/or follow-up care. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cryogenic expansion machine

DOEpatents

Pallaver, Carl B.; Morgan, Michael W.

1978-01-01

A cryogenic expansion engine includes intake and exhaust poppet valves each controlled by a cam having adjustable dwell, the valve seats for the valves being threaded inserts in the valve block. Each cam includes a cam base and a ring-shaped cam insert disposed at an exterior corner of the cam base, the cam base and cam insert being generally circular but including an enlarged cam dwell, the circumferential configuration of the cam base and cam dwell being identical, the cam insert being rotatable with respect to the cam base. GI CONTRACTUAL ORIGIN OF THE INVENTION The invention described herein was made in the course of, or under, a contract with the UNITED STATES ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION.

Oil well pump drive

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

Sanford, G.A.

1980-02-12

An oil well pump drive is disclosed including a drive unit that is hydraulically actuated by a double-acting hydraulic cylinder to reciprocate vertically. An endless chain is entrained over vertically spaced sprockets carried by the unit, with one flight of the chain anchored against vertical movement and the other flight is secured to the pump polish rod so that the vertical motion imparted to the polish rod is double that hydraulically imparted to the drive unit. The polish rod load on the chain is opposed by a counterweight connected thereto by a chain extending over an elevated pulley. The outputmore » of the hydraulic pump supplying the hydraulic cylinder is cam controlled so that the motion of the drive unit is smoothly decelerated and accelerated as the unit approaches and moves from the upper and lower limits of its movement.« less

[Influence of different designs and porcelain/glaze firing on the marginal and internal fit of implant-supported zirconia crowns].

PubMed

Cuiling, Liu; Xu, Gao; Yuping, Qi; Liyuan, Yang

2016-02-01

This study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns. Three groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0. HMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05). The marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

30 CFR 57.16014 - Operator-carrying overhead cranes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Operator-carrying overhead cranes. 57.16014 Section 57.16014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage and Handling § 57.16014 Operator-carrying overhead cranes. Operator-carrying overhead cranes shall...

30 CFR 56.16014 - Operator-carrying overhead cranes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Operator-carrying overhead cranes. 56.16014 Section 56.16014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage and Handling § 56.16014 Operator-carrying overhead cranes. Operator-carrying overhead cranes shall...

30 CFR 56.16014 - Operator-carrying overhead cranes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Operator-carrying overhead cranes. 56.16014 Section 56.16014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage and Handling § 56.16014 Operator-carrying overhead cranes. Operator-carrying overhead cranes shall...

30 CFR 57.16014 - Operator-carrying overhead cranes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Operator-carrying overhead cranes. 57.16014 Section 57.16014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage and Handling § 57.16014 Operator-carrying overhead cranes. Operator-carrying overhead cranes shall...

Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: a qualitative study.

PubMed

Nichol, James; Thompson, Elizabeth A; Shaw, Alison

2011-02-01

The rise in complementary and alternative medicine (CAM) use is well documented. Surveys provide varying estimates of the prevalence of CAM use. Qualitative research has explored individuals' decision-making regarding CAM. This study aimed to examine the family as a context for beliefs, decision-making, and dialogue about CAM. Families were recruited via the Avon Longitudinal Study of Parents and Children. A subsample of CAM users was targeted using purposeful sampling. Focus groups and interviews were conducted with 15 families and the data were analyzed thematically. Family understandings and beliefs about CAM: CAM was understood as treatments provided outside mainstream care, offering a more "natural" and "holistic" approach, tailored to individual needs and overlapping with wider healthy lifestyle practices. Hierarchies of acceptability of CAM: Physical and "mainstream" therapies were widely supported, with "fringe" therapies producing the most polarized views. There was a belief particularly among fathers and young people that certain therapies rely on "placebo" effects and their value was contested. Types of CAM users within families: Family members were predominantly "pragmatic" CAM users, with "committed" users (all mothers) characterized by deeper philosophical commitment to CAM and skepticism toward conventional medicine. Family dynamics of CAM decision-making: Mothers tended to "champion" CAM within families, while not determining family CAM use. Fathers largely positioned themselves as lacking expertise or skeptical of CAM. Young people were beginning to articulate independent and more critical views of CAM, some directly challenging their mother's perspective. However, all families shared openness to CAM as part of broader beliefs in proactive healthy lifestyles. Family focus groups and interviews allow a window on beliefs, decision-making, and dialogue about CAM within families, illuminating the CAM "champion" role held by mothers, and young people's developing autonomy regarding health beliefs and decision-making.

Impact of methionine oxidation on calmodulin structural dynamics

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

McCarthy, Megan R.; Thompson, Andrew R.; Nitu, Florentin

2015-01-09

Highlights: • We measured the distance distribution between two spin labels on calmodulin by DEER. • Two structural states, open and closed, were resolved at both low and high Ca. • Ca shifted the equilibrium toward the open state by a factor of 13. • Methionine oxidation, simulated by glutamine substitution, decreased the Ca effect. • These results have important implications for aging in muscle and other tissues. - Abstract: We have used electron paramagnetic resonance (EPR) to examine the structural impact of oxidizing specific methionine (M) side chains in calmodulin (CaM). It has been shown that oxidation of eithermore » M109 or M124 in CaM diminishes CaM regulation of the muscle calcium release channel, the ryanodine receptor (RyR), and that mutation of M to Q (glutamine) in either case produces functional effects identical to those of oxidation. Here we have used site-directed spin labeling and double electron–electron resonance (DEER), a pulsed EPR technique that measures distances between spin labels, to characterize the structural changes resulting from these mutations. Spin labels were attached to a pair of introduced cysteine residues, one in the C-lobe (T117C) and one in the N-lobe (T34C) of CaM, and DEER was used to determine the distribution of interspin distances. Ca binding induced a large increase in the mean distance, in concert with previous X-ray crystallography and NMR data, showing a closed structure in the absence of Ca and an open structure in the presence of Ca. DEER revealed additional information about CaM’s structural heterogeneity in solution: in both the presence and absence of Ca, CaM populates both structural states, one with probes separated by ∼4 nm (closed) and another at ∼6 nm (open). Ca shifts the structural equilibrium constant toward the open state by a factor of 13. DEER reveals the distribution of interprobe distances, showing that each of these states is itself partially disordered, with the width of each population ranging from 1 to 3 nm. Both mutations (M109Q and M124Q) decrease the effect of Ca on the structure of CaM, primarily by decreasing the closed-to-open equilibrium constant in the presence of Ca. We propose that Met oxidation alters CaM’s functional interaction with its target proteins by perturbing this Ca-dependent structural shift.« less

29 CFR 1926.1438 - Overhead & gantry cranes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false Overhead & gantry cranes. 1926.1438 Section 1926.1438 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Cranes and Derricks in Construction § 1926.1438 Overhead & gantry cranes. (a) Permanently installed overhead and gantry cranes. The requirements of § 1910...

What Does It Cost? An Essay on Overheads.

ERIC Educational Resources Information Center

Abrahamson, Brian

1989-01-01

Issues in determination of overhead for cost recovery from research funding sources are discussed, including the need to collect overhead, principles involved in charging for overhead, range of activity types to be considered, classification and calculation of costs, pricing policy, and payment to the university versus payment to its components.…

KSC-02pd0736

NASA Image and Video Library

2002-05-16

KENNEDY SPACE CENTER, FLA. - Suspended from the overhead crane, the SHI Research Double Module (SHI/RDM) travels across the Space Station Processing Facility to the payload canister waiting at right. The module will be placed in the canister for transport to the Orbiter Processing Facility where it will be installed in Columbia's payload bay for mission STS-107. SHI/RDM is the primary payload of the research mission, with experiments ranging from material sciences to life sciences (many rats). Also part of the payload is the Fast Reaction Experiments Enabling Science, Technology, Applications and Research (FREESTAR) that incorporates eight high priority secondary attached shuttle experiments. STS-107 is scheduled to launch July 19, 2002

VIEW OF INTERIOR OF SOUTHERN DUCTILE CASTING COMPANY, CENTERVILLE FOUNDRY ...

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

VIEW OF INTERIOR OF SOUTHERN DUCTILE CASTING COMPANY, CENTERVILLE FOUNDRY SHOWING MOLD MAKING WITH PNEWMATIC JOLT SQUEEZE COPE AND DRAG MOLDING MACHINES THAT INDIVIDUALLY MADE EITHER A COPE OR DRAG AND A SMALL WHEELED MATCHPLATE JOLT-SQUEEZE MACHINE THAT COMPRESSED AN ENTIRE MOLD AT A SINGLE TIME USING A DOUBLE-SIDED PATTERN (MATCHPLATE). ALSO SHOWN ARE RAILED PALLET CAR CONVEYORS THAT CARRIED COMPLETED MOLDS FROM MOLDING MACHINES TO POURING AREAS WHERE WORKERS USED SMALL OVERHEAD CRANE TO LIFT JACKETS AND WEIGHTS ONTO THE MOLDS TO HOLD THEM TOGETHER WHILE POURING. - Southern Ductile Casting Company, Centerville Foundry, 101 Airport Road, Centreville, Bibb County, AL

Voltages induced by lightning strokes and ground-faults on a coaxial telecom circuit enclosed inside a composite earthwire. Part II: lightning induced voltages ant composite earthwire tehnical design

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

Anzanel, P.; Kouteynikoff, P.

1985-02-01

This Part II presents theorical and experimental work about interference generated by lightning strokes in a telecommunication coaxial circuit enclosed inside a composite earthwire for overhead transmission lines. Sinusoidal steady state and surge measurements of the composite earthwire susceptibility to interference (transfer impedance) have been carried out. Induced voltages have been calculated using an original double sampling FFT method whose validity has been checked by measurements on a test line. Finally, it is shown how the cable design can be improved and maximum induced voltage values are given.

Complementary and alternative medicine (CAM) among hospitalised patients: reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio-demographic determinants of CAM users.

PubMed

Shorofi, Seyed Afshin

2011-11-01

This paper reports a study to examine hospitalised patients' frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients' socio-demographic variables and use of each individual CAM/CAM domain. A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio-demographic variables. The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non-herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind-body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal-botanical therapies, self-prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an 'only when needed' basis. The most common reason nominated for using CAMs was that '[it] fits into my way of life/philosophy' (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body-based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non-herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio-demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients). The use of CAMs is pervasive amongst surgical in-patients, making it feasible to initially assess these patients for CAM use and provide them with clinically approved CAMs where possible. Notwithstanding that CAM use is fairly predictable by socio-demographic variables, further studies should be directed to know the variables useful for predicting the use of each CAM approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

Complementary and Alternative Therapies for Pediatric Attention Deficit Hyperactivity Disorder: A Descriptive Review

PubMed Central

Searight, H. Russell; Robertson, Kayla; Smith, Todd; Perkins, Scott; Searight, Barbara K.

2012-01-01

Attention deficit hyperactivity disorder (AD/HD), characterized by impulsivity, distractibility, and inattention, has an estimated pediatric population prevalence of 6–8%. Family physicians and pediatricians evaluate and treat the majority of children with this condition. The evidence-based treatment of choice for ADHD, stimulant medication, continues to be a source of public controversy. Surveys suggest that among parents of children with ADHD, there is considerable interest in complementary and alternative medicine (CAM). These therapies include herbal preparations, mineral supplements, sugar restriction, and polyunsaturated fatty acids. Other AD/HD therapies include neuro-feedback, cognitive training, mindfulness meditation, and exposure to “green space.” In order to assist physicians and mental health professionals in responding to patient and parent queries, this paper briefly describes these CAM therapies and current research regarding their effectiveness. While investigations in this area are hampered by research design issues such as sample size and the absence of double-blind placebo-controlled trials, there is some evidence that omega three fatty acids, zinc supplements, and neuro-feedback may have some efficacy. PMID:23762770

Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital.

PubMed

Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan

2018-06-01

Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P < .001) on CAM communications. Both oncologists and patients expected that CAM could improve the immune system. They both agreed that oncologists usually discouraged their patients from using CAM. Regarding the effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.

The possibility to increase the rated output as a result of index tests performed in Iron Gates II- Romania

NASA Astrophysics Data System (ADS)

Novac, D.; Pantelimon, D.; Popescu, E.

2010-08-01

The Index Tests have been used for many years to obtain the optimized cam corellation between wicket gates and runner blades for double regulated turbines (Kaplan, bulb). The cam is based on homologous model tests and is verified by site measurements, as model tests generally do not reproduce the exact intake configuration. Index Tests have also a considerable importance for checking of the relative efficiency curve of all type of turbines and can demonstrate if the prototype efficiency curve at plant condition has the shape expected from the test of the homologues model. During the Index Tests measurements the influence of all losses at multiple points of turbine operation can be proved. This publication deals with an overview on the Index Tests made after modernization of large bulb units in Iron Gates II - Romania. These field tests, together with the comparative, fully homologous tests for the new hydraulic shape of the runner blades have confirmed the smooth operational behavior and the guaranteed performance. Over the whole "guaranteed operating range" for H = 8m, the characteristic of the Kaplan curve (enveloping curve to the proppeler curves), agreed very well to the predicted efficiency curve from the hydraulic prototype hill chart. The new cam correlation have been determined for different head and realised in the governor, normally based on model tests. The guaranteed, maximum turbine output for H = 7,8m is specified with 32, 5 MW. The maximum measured turbine output during the Index Tests on cam operation was 35,704 MW at the net head of 7,836 m. This coresponds to 35,458 MW for the specified head H= 7, 8 m. All these important improvements ensure a significant increase of annual energy production without any change of the civil construction and without increasing the runner diameter. Also the possibility to increase the turbine rated output is evident.

Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation.

PubMed

Kubota, So; Inaba, Yutaka; Kobayashi, Naomi; Choe, Hyonmin; Tezuka, Taro; Saito, Tomoyuki

2017-10-16

While cam resection is essential to achieve a good clinical result with respect to femoroacetabular impingement (FAI), it is unclear whether it should also be performed in cases of borderline developmental dysplasia of the hip (DDH) with a cam deformity. The aim of this study was to evaluate improvements in range of motion (ROM) in cases of cam-type FAI and borderline DDH after virtual osteochondroplasty using a computer impingement simulation. Thirty-eight symptomatic hips in 31 patients (11male and 20 female) diagnosed with cam-type FAI or borderline DDH were analyzed. There were divided into a cam-type FAI group (cam-FAI group: 15 hips), borderline DDH without cam group (DDH W/O cam group: 12 hips), and borderline DDH with cam group (DDH W/ cam group: 11 hips). The bony impingement point on the femoral head-neck junction at 90° flexion and maximum internal rotation of the hip joint was identified using ZedHip® software. Virtual osteochondroplasty of the impingement point was then performed in all cases. The maximum flexion angle and maximum internal rotation angle at 90° flexion were measured before and after virtual osteochondroplasty at two resection ranges (i.e., slight and sufficient). The mean improvement in the internal rotation angle in the DDH W/ cam group after slight resection was significantly greater than that in the DDH W/O cam group (P = 0.046). Furthermore, the mean improvement in the internal rotation angle in the DDH W/ cam and cam-FAI groups after sufficient resection was significantly greater than that in the DDH W/O cam group (DDH W/ cam vs DDH W/O cam: P = 0.002, cam-FAI vs DDH W/O cam: P = 0.043). Virtual osteochondroplasty resulted in a significant improvement in internal rotation angle in DDH W/ cam group but not in DDH W/O cam group. Thus, borderline DDH cases with cam deformity may be better to consider performing osteochondroplasty.

The fallacy of the overhead quick fix.

PubMed

Blaxill, M F; Hout, T M

1991-01-01

Facing pressure from a few large, low-cost competitors, Thornton, an old-guard specialty-equipment manufacturer, fought back by eliminating overhead. Over two-years, it outsourced components and consolidated operations. But instead of cutting overhead, it added more and became still more uncompetitive. Thornton is not alone in either its predicament or its failed reaction. Many large manufacturing companies are finding themselves at a cost disadvantage in markets they have dominated for years. One reason is excessive overhead structures, the result of an unchecked buildup of indirect employees needed to control rising organizational complexity. Another reason is the emergence of the "robust" competitor, comparable in size and product scope but able to produce at a lower unit overhead cost. Data collected from more than 100 manufacturing plants worldwide illustrate the differences between overhead cost structures of bureaucratic, niche, and robust companies. The gulf between these groups highlights the need for action by bureaucratic companies, and, in some cases, by niche companies. But high-overhead companies are doomed if they cut overhead out of the system either by outsourcing or downsizing. If they expect to retain their size and also become more cost competitive, they must rethink their manufacturing systems. Well-designed and well-controlled processes mean higher product quality, faster cycle time, improved flexibility, and lower overhead costs. Sustainable overhead reduction means a commitment to continuous improvement. This includes segmenting, mapping, and measuring existing processes and then working to improve them.(ABSTRACT TRUNCATED AT 250 WORDS)

[Arthroscopic double-row reconstruction of high-grade subscapularis tendon tears].

PubMed

Plachel, F; Pauly, S; Moroder, P; Scheibel, M

2018-04-01

Reconstruction of tendon integrity to maintain glenohumeral joint centration and hence to restore shoulder functional range of motion and to reduce pain. Isolated or combined full-thickness subscapularis tendon tears (≥upper two-thirds of the tendon) without both substantial soft tissue degeneration and cranialization of the humeral head. Chronic tears of the subscapularis tendon with higher grade muscle atrophy, fatty infiltration, and static decentration of the humeral head. After arthroscopic three-sided subscapularis tendon release, two double-loaded suture anchors are placed medially to the humeral footprint. Next to the suture passage, the suture limbs are tied and secured laterally with up to two knotless anchors creating a transosseous-equivalent repair. The affected arm is placed in a shoulder brace with 20° of abduction and slight internal rotation for 6 weeks postoperatively. Rehabilitation protocol including progressive physical therapy from a maximum protection phase to a minimum protection phase is required. Overhead activities are permitted after 6 months. While previous studies have demonstrated superior biomechanical properties and clinical results after double-row compared to single-row and transosseous fixation techniques, further mid- to long-term clinical investigations are needed to confirm these findings.

Use of complementary and alternative medicine among patients: classification criteria determine level of use.

PubMed

Kristoffersen, Agnete Egilsdatter; Fønnebø, Vinjar; Norheim, Arne Johan

2008-10-01

Self-reported use of complementary and alternative medicine (CAM) among patients varies widely between studies, possibly because the definition of a CAM user is not comparable. This makes it difficult to compare studies. The aim of this study is to present a six-level model for classifying patients' reported exposure to CAM. Prayer, physical exercise, special diets, over-the-counter products/CAM techniques, and personal visits to a CAM practitioner are successively removed from the model in a reductive fashion. By applying the model to responses given by Norwegian patients with cancer, we found that 72% use CAM if the user was defined to include all types of CAM. This proportion was reduced successively to only 11% in the same patient group when a CAM user was defined as a user visiting a CAM practitioner four or more times. When considering a sample of 10 recently published studies of CAM use among patients with breast cancer, we found 98% use when the CAM user was defined to include all sorts of CAM. This proportion was reduced successively to only 20% when a CAM user was defined as a user of a CAM practitioner. We recommend future surveys of CAM use to report at more than one level and to clarify which intensity level of CAM use the report is based on.

Facultative crassulacean acid metabolism (CAM) plants: powerful tools for unravelling the functional elements of CAM photosynthesis.

PubMed

Winter, Klaus; Holtum, Joseph A M

2014-07-01

Facultative crassulacean acid metabolism (CAM) describes the optional use of CAM photosynthesis, typically under conditions of drought stress, in plants that otherwise employ C3 or C4 photosynthesis. In its cleanest form, the upregulation of CAM is fully reversible upon removal of stress. Reversibility distinguishes facultative CAM from ontogenetically programmed unidirectional C3-to-CAM shifts inherent in constitutive CAM plants. Using mainly measurements of 24h CO2 exchange, defining features of facultative CAM are highlighted in five terrestrial species, Clusia pratensis, Calandrinia polyandra, Mesembryanthemum crystallinum, Portulaca oleracea and Talinum triangulare. For these, we provide detailed chronologies of the shifts between photosynthetic modes and comment on their usefulness as experimental systems. Photosynthetic flexibility is also reviewed in an aquatic CAM plant, Isoetes howellii. Through comparisons of C3 and CAM states in facultative CAM species, many fundamental biochemical principles of the CAM pathway have been uncovered. Facultative CAM species will be of even greater relevance now that new sequencing technologies facilitate the mapping of genomes and tracking of the expression patterns of multiple genes. These technologies and facultative CAM systems, when joined, are expected to contribute in a major way towards our goal of understanding the essence of CAM. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

30 CFR 57.16015 - Work or travel on overhead crane bridges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Work or travel on overhead crane bridges. 57... MINES Materials Storage and Handling § 57.16015 Work or travel on overhead crane bridges. No person shall work from or travel on the bridge of an overhead crane unless the bridge is provided with...

30 CFR 56.16015 - Work or travel on overhead crane bridges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Work or travel on overhead crane bridges. 56... Materials Storage and Handling § 56.16015 Work or travel on overhead crane bridges. No person shall work from or travel on the bridge of an overhead crane unless the bridge is provided with substantial...

Effective Determination of Overhead Rates for Pricing Goods and Services.

ERIC Educational Resources Information Center

Smith, Christopher A.

This publication presents a system of gathering overhead data and describes several methods for assigning overhead costs to specific contract prices. It is intended to provide facility production supervisors with a means of ensuring adequate cost recovery in bid prices and gaining a measure of overhead cost control. The seven steps in the overhead…

30 CFR 57.16015 - Work or travel on overhead crane bridges.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Work or travel on overhead crane bridges. 57... MINES Materials Storage and Handling § 57.16015 Work or travel on overhead crane bridges. No person shall work from or travel on the bridge of an overhead crane unless the bridge is provided with...

30 CFR 56.16015 - Work or travel on overhead crane bridges.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Work or travel on overhead crane bridges. 56... Materials Storage and Handling § 56.16015 Work or travel on overhead crane bridges. No person shall work from or travel on the bridge of an overhead crane unless the bridge is provided with substantial...

A systematic review of the traits and cognitions associated with use of and belief in complementary and alternative medicine (CAM).

PubMed

Galbraith, Niall; Moss, Tim; Galbraith, Victoria; Purewal, Satvinder

2018-08-01

Complementary and alternative medicine (CAM) use is widespread despite the controversy over its effectiveness. Although previous reviews have examined the demographics and attitudes of CAM users, there is no existing review on the traits or cognitions which characterise either CAM users or those who believe in CAM effectiveness. The current systematic review set out to address these gaps in the literature by applying a narrative synthesis. A bibliographic search and manual searches were undertaken and key authors were contacted. Twenty-three papers were selected. The trait openness to experience was positively associated with CAM use but not CAM belief. Absorption and various types of coping were also positively associated with CAM use and belief. No other trait was reliably associated with CAM use or belief. Intuitive thinking and ontological confusions were positively associated with belief in CAM effectiveness; intuitive thinking was also positively associated with CAM use. Studies researching cognitions in CAM use/belief were mostly on non-clinical samples, whilst studies on traits and CAM use/belief were mostly on patients. The quality of studies varied but unrepresentative samples, untested outcome measures and simplistic statistical analyses were the most common flaws. Traits and cognition might be important correlates of CAM use and also of faith in CAM.

Reasons for continuing use of Complementary and Alternative Medicine (CAM) in students: a consumer commitment model.

PubMed

Sirois, Fuschia M; Salamonsen, Anita; Kristoffersen, Agnete E

2016-02-24

Research on continued CAM use has been largely atheoretical and has not considered the broader range of psychological and behavioral factors that may be involved. The purpose of this study was to test a new conceptual model of commitment to CAM use that implicates utilitarian (trust in CAM) and symbolic (perceived fit with CAM) in psychological and behavioral dimensions of CAM commitment. A student sample of CAM consumers, (N = 159) completed a survey about their CAM use, CAM-related values, intentions for future CAM use, CAM word-of-mouth behavior, and perceptions of being an ongoing CAM consumer. Analysis revealed that the utilitarian, symbolic, and CAM commitment variables were significantly related, with r's ranging from .54 to .73. A series hierarchical regression analyses controlling for relevant demographic variables found that the utilitarian and symbolic values uniquely accounted for significant and substantial proportion of the variance in each of the three CAM commitment indicators (R(2) from .37 to .57). The findings provide preliminary support for the new model that posits that CAM commitment is a multi-dimensional psychological state with behavioral indicators. Further research with large-scale samples and longitudinal designs is warranted to understand the potential value of the new model.

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution

PubMed Central

Halling, D. Brent; Kenrick, Sophia A.; Riggs, Austen F.

2014-01-01

Ca2+ activates SK Ca2+-activated K+ channels through the protein Ca2+ sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca2+ regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca2+ concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca2+, SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca2+, 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca2+, the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca2+ and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca2+ or with CaM in molar excess. In low Ca2+ both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca2+. These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating. PMID:24420768

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution.

PubMed

Halling, D Brent; Kenrick, Sophia A; Riggs, Austen F; Aldrich, Richard W

2014-02-01

Ca(2+) activates SK Ca(2+)-activated K(+) channels through the protein Ca(2+) sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca(2+) regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca(2+) concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca(2+), SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca(2+), 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca(2+), the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca(2+) and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca(2+) or with CaM in molar excess. In low Ca(2+) both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca(2+). These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

PubMed

Shorofi, Seyed Afshin; Arbon, Paul

2017-05-01

This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person. Copyright © 2017 Elsevier Ltd. All rights reserved.

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication.

PubMed

Murthy, Vijayendra; Sibbritt, David W; Adams, Jon

2015-08-01

Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers' decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Cryogenic Cam Butterfly Valve

NASA Technical Reports Server (NTRS)

McCormack, Kenneth J. (Inventor)

2016-01-01

A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.

Complementary and Alternative Medicine: A Clinical Study in 1,016 Hematology/Oncology Patients.

PubMed

Hierl, Marina; Pfirstinger, Jochen; Andreesen, Reinhard; Holler, Ernst; Mayer, Stephanie; Wolff, Daniel; Vogelhuber, Martin

2017-01-01

Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital. Subsequently, a chart review of all CAM users was performed. Questionnaires of 1,016 patients were analyzed. Of these patients, 30% used CAM, preferably vitamins and micronutrients. Main information sources for CAM methods were physicians/nonmedical practitioners and friends/relatives. CAM therapies were provided mainly by licensed physicians (29%), followed by nonmedical practitioners (14%) and the patients themselves (13%). Although 62% of the CAM users agreed that the oncologist may know about their CAM therapy, a chart entry about CAM use was found only in 41%. CAM is frequently used by hematology/oncology patients. Systematic communication about CAM is essential to avoid possible drug interactions. © 2017 S. Karger AG, Basel.

CAM practitioners in the Australian health workforce: an underutilized resource

PubMed Central

2012-01-01

Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion. PMID:23116374

CAM practitioners in the Australian health workforce: an underutilized resource.

PubMed

Grace, Sandra

2012-11-02

CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion.

Video multiple watermarking technique based on image interlacing using DWT.

PubMed

Ibrahim, Mohamed M; Abdel Kader, Neamat S; Zorkany, M

2014-01-01

Digital watermarking is one of the important techniques to secure digital media files in the domains of data authentication and copyright protection. In the nonblind watermarking systems, the need of the original host file in the watermark recovery operation makes an overhead over the system resources, doubles memory capacity, and doubles communications bandwidth. In this paper, a robust video multiple watermarking technique is proposed to solve this problem. This technique is based on image interlacing. In this technique, three-level discrete wavelet transform (DWT) is used as a watermark embedding/extracting domain, Arnold transform is used as a watermark encryption/decryption method, and different types of media (gray image, color image, and video) are used as watermarks. The robustness of this technique is tested by applying different types of attacks such as: geometric, noising, format-compression, and image-processing attacks. The simulation results show the effectiveness and good performance of the proposed technique in saving system resources, memory capacity, and communications bandwidth.

The utilisation of Complementary and Alternative Medicine (CAM) among ethnic minorities in South Korea

PubMed Central

2014-01-01

Background Race has been reported to affect the use of complementary and alternative medicine (CAM), but there is very little research on the use of CAM by ethnicity in Korea. This study explores the prevalence of CAM use among ethnic minorities in South Korea. Methods The design is a descriptive and cross-sectional study. A convenience sample of ethnic minorities was recruited from two public healthcare centres in Gyeonggi province. The survey instrument included 37 questions regarding CAM use, factors influencing use of CAM, self-health management, and the socio-demographic profile of study participants. Results Sixty-two percent of study participants reported the use of CAM. Multivitamins (53.3%), acupuncture (48.9%), and traditional Korean herbal medicine (38.9%) were popular CAM modalities in our sample. Other notable CAM modalities included herbal plants, therapeutic massage, and moxibustion therapy. The majority of CAM users (52.2%) received CAM services to treat diseases or as a secondary treatment while receiving conventional care. Having positive perceptions toward the effectiveness of CAM was a major determining factor in CAM use. Conclusions Physicians need to be aware of the fact that many ethnic minorities use CAM therapies. Many CAM users reported that they want doctors to know about their CAM use and have a basic understanding of traditional medicine in their home country. Overcoming language and cultural barriers will help reduce unwanted medical complications. High prevalence of CAM use among ethnic minorities in our study warrants further studies using larger sample population. PMID:24641983

Backbone resonance assignments of complexes of human voltage-dependent sodium channel NaV1.2 IQ motif peptide bound to apo calmodulin and to the C-domain fragment of apo calmodulin.

PubMed

Mahling, Ryan; Kilpatrick, Adina M; Shea, Madeline A

2017-10-01

Human voltage-gated sodium channel Na V 1.2 has a single pore-forming α-subunit and two transmembrane β-subunits. Expressed primarily in the brain, Na V 1.2 is critical for initiation and propagation of action potentials. Milliseconds after the pore opens, sodium influx is terminated by inactivation processes mediated by regulatory proteins including calmodulin (CaM). Both calcium-free (apo) CaM and calcium-saturated CaM bind tightly to an IQ motif in the C-terminal tail of the α-subunit. Our thermodynamic studies and solution structure (2KXW) of a C-domain fragment of apo 13 C, 15 N- CaM (CaM C ) bound to an unlabeled peptide with the sequence of rat Na V 1.2 IQ motif showed that apo CaM C (a) was necessary and sufficient for binding, and (b) bound more favorably than calcium-saturated CaM C . However, we could not monitor the Na V 1.2 residues directly, and no structure of full-length CaM (including the N-domain of CaM (CaM N )) was determined. To distinguish contributions of CaM N and CaM C , we used solution NMR spectroscopy to assign the backbone resonances of a complex containing a 13 C, 15 N-labeled peptide with the sequence of human Na V 1.2 IQ motif (Na V 1.2 IQp ) bound to apo 13 C, 15 N-CaM or apo 13 C, 15 N-CaM C . Comparing the assignments of apo CaM in complex with Na V 1.2 IQp to those of free apo CaM showed that residues within CaM C were significantly perturbed, while residues within CaM N were essentially unchanged. The chemical shifts of residues in Na V 1.2 IQp and in the C-domain of CaM were nearly identical regardless of whether CaM N was covalently linked to CaM C . This suggests that CaM N does not influence apo CaM binding to Na V 1.2 IQp .

78 FR 68477 - Overhead and Gantry Cranes; Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

...] Overhead and Gantry Cranes; Extension of the Office of Management and Budget's (OMB) Approval of... requirements specified in the Standard on Overhead and Gantry Cranes (29 CFR 1910.179). DATES: Comments must be... information (29 U.S.C. 657). The paperwork provisions of the Standard on Overhead and Gantry Cranes specify...

Behavioral economics. Avoiding overhead aversion in charity.

PubMed

Gneezy, Uri; Keenan, Elizabeth A; Gneezy, Ayelet

2014-10-31

Donors tend to avoid charities that dedicate a high percentage of expenses to administrative and fundraising costs, limiting the ability of nonprofits to be effective. We propose a solution to this problem: Use donations from major philanthropists to cover overhead expenses and offer potential donors an overhead-free donation opportunity. A laboratory experiment testing this solution confirms that donations decrease when overhead increases, but only when donors pay for overhead themselves. In a field experiment with 40,000 potential donors, we compared the overhead-free solution with other common uses of initial donations. Consistent with prior research, informing donors that seed money has already been raised increases donations, as does a $1:$1 matching campaign. Our main result, however, clearly shows that informing potential donors that overhead costs are covered by an initial donation significantly increases the donation rate by 80% (or 94%) and total donations by 75% (or 89%) compared with the seed (or matching) approach. Copyright © 2014, American Association for the Advancement of Science.

Allosteric Effects of the Anti-Psychotic Drug Trifluoperazine on the Energetics of Calcium Binding by Calmodulin

PubMed Central

Feldkamp, Michael D.; O'Donnell, Susan E.; Yu, Liping; Shea, Madeline A.

2010-01-01

Trifluoperazine (TFP; Stelazine™) is an antagonist of calmodulin (CaM), an essential regulator of calcium-dependent signal transduction. Reports differ regarding whether, or where, TFP binds to apo CaM. Three crystallographic structures (1CTR, 1A29, 1LIN) show TFP bound to (Ca2+)4-CaM in ratios of 1, 2 or 4 TFP per CaM. In all of these, CaM domains adopt the “open” conformation seen in CaM-kinase complexes having increased calcium affinity. Most reports suggest TFP also increases calcium affinity of CaM. To compare TFP binding to apo CaM and (Ca2+)4-CaM, and explore differential effects on the N- and C-domains of CaM, stoichiometric TFP titrations of CaM were monitored by 15N-HSQC NMR. Two TFP bound to apo CaM, while four bound to (Ca2+)4-CaM. In both cases, the preferred site was in the C-domain. During the titrations, biphasic responses for some resonances suggested inter-site interactions. TFP-binding sites in apo CaM appeared distinct from those in (Ca2+)4-CaM. In equilibrium calcium titrations at defined ratios of TFP:CaM, TFP reduced calcium affinity at most levels tested; this is similar to the effect of many IQ-motifs on CaM. However, at the highest level tested, TFP raised the calcium affinity of the N-domain of CaM. A model of conformational switching is proposed to explain how TFP can exert opposing allosteric effects on calcium affinity by binding to different sites in the “closed”, “semi-open” and “open” domains of CaM. In physiological processes, apo CaM, as well as (Ca2+)4-CaM, needs to be considered a potential target of drug action. PMID:20544963

How Difficult is it to Reduce Low-Level Cloud Biases With the Higher-Order Turbulence Closure Approach in Climate Models?

NASA Technical Reports Server (NTRS)

Xu, Kuan-Man

2015-01-01

Low-level clouds cover nearly half of the Earth and play a critical role in regulating the energy and hydrological cycle. Despite the fact that a great effort has been put to advance the modeling and observational capability in recent years, low-level clouds remains one of the largest uncertainties in the projection of future climate change. Low-level cloud feedbacks dominate the uncertainty in the total cloud feedback in climate sensitivity and projection studies. These clouds are notoriously difficult to simulate in climate models due to its complicated interactions with aerosols, cloud microphysics, boundary-layer turbulence and cloud dynamics. The biases in both low cloud coverage/water content and cloud radiative effects (CREs) remain large. A simultaneous reduction in both cloud and CRE biases remains elusive. This presentation first reviews the effort of implementing the higher-order turbulence closure (HOC) approach to representing subgrid-scale turbulence and low-level cloud processes in climate models. There are two HOCs that have been implemented in climate models. They differ in how many three-order moments are used. The CLUBB are implemented in both CAM5 and GDFL models, which are compared with IPHOC that is implemented in CAM5 by our group. IPHOC uses three third-order moments while CLUBB only uses one third-order moment while both use a joint double-Gaussian distribution to represent the subgrid-scale variability. Despite that HOC is more physically consistent and produces more realistic low-cloud geographic distributions and transitions between cumulus and stratocumulus regimes, GCMs with traditional cloud parameterizations outperform in CREs because tuning of this type of models is more extensively performed than those with HOCs. We perform several tuning experiments with CAM5 implemented with IPHOC in an attempt to produce the nearly balanced global radiative budgets without deteriorating the low-cloud simulation. One of the issues in CAM5-IPHOC is that cloud water content is much higher than in CAM5, which is combined with higher low-cloud coverage to produce larger shortwave CREs in some low-cloud prevailing regions. Thus, the cloud-radiative feedbacks are exaggerated there. The turning exercise is focused on microphysical parameters, which are also commonly used for tuning in climate models. The results will be discussed in this presentation.

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa.

PubMed

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-02-04

The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US50 dollars). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage.

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa

PubMed Central

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-01-01

Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage. PMID:15018622

Neurotactin functions in concert with other identified CAMs in growth cone guidance in Drosophila.

PubMed

Speicher, S; García-Alonso, L; Carmena, A; Martín-Bermudo, M D; de la Escalera, S; Jiménez, F

1998-02-01

We have isolated and characterized mutations in Drosophila neurotactin, a gene that encodes a cell adhesion protein widely expressed during neural development. Analysis of both loss and gain of gene function conditions during embryonic and postembryonic development revealed specific requirements for neurotactin during axon outgrowth, fasciculation, and guidance. Furthermore, embryos of some double mutant combinations of neurotactin and other genes encoding adhesion/signaling molecules, including neuroglian, derailed, and kekkon1, displayed phenotypic synergy. This result provides evidence for functional cooperativity in vivo between the adhesion and signaling pathways controlled by neurotactin and the other three genes.

Observations of H II regions around Zeta OPH and other O-B stars

NASA Astrophysics Data System (ADS)

Shestakova, L. I.; Kutirev, A. S.; Ataev, A. Sh.

1988-01-01

A Fabry-Perot spectrometer was used to measure the emission intensities in H-beta near Zeta Oph, Alpha Vir, Alpha Cam, and HD 188209. The spectrometer sensitivity is 0.2 rayleighs, the intensity measurement accuracy is 20 percent. Ionization zone boundaries are determined for Zeta Oph and Alpha Vir; the angular diameters of both regions are about 15 deg. The contour of the H II region near Zeta Oph on the level of the double background in the southwest does not close; instead, it expands again and incorporates the region associated with the B-association II Sco.

Survey of practices and policies relating to the use of complementary and alternative medicines and therapies in New South Wales cancer services.

PubMed

Raszeja, V M; Jordens, C F C; Kerridge, I H

2013-01-01

To examine policies and practices relating to the provision, prescription and monitoring of complementary and alternative medicine and therapies (CAM) in conventional cancer services in NSW. Self-administered questionnaire sent to directors of all 65 eligible cancer services in NSW in 2009. Forty-three services responded to the survey (response rate 66%). Only six (14%) services reported having formal policies about CAM. Most (n = 33, 77%) expected that patients would be asked about CAM use during their initial assessment. Eight services (19%) provided and/or prescribed CAM for patients, and most of these (n = 7) recorded details of CAM use in patients' records. Only four (9%) services permitted CAM practitioners from the community to attend inpatients, whereas 24 (56%) permitted inpatients to bring in their own CAM. Most of these services (n = 17) required medical approval for the use of CAM. Of the latter, most (n = 13) recorded the use of approved CAM, but only seven recorded use of unapproved CAM and only three refused permission to continue use of unapproved CAM. Most cancer services in NSW recognise potential CAM use by patients and expect medical staff to ask patients about their use of CAM. While few cancer services provided or prescribed CAM, over half permitted inpatients to bring their own CAM into hospital. There was little control over the use of CAM, however, and monitoring was lax. Given the wide usage of CAM by patients with cancer, this lack of control may compromise clinical outcomes, with potentially dangerous consequences. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women.

PubMed

Liu, Chenglong; Yang, Yang; Gange, Stephen J; Weber, Kathleen; Sharp, Gerald B; Wilson, Tracey E; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Ganhdi, Monica; Merenstein, Dan

2009-11-01

To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1,377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4,689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind-body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence.

Disclosure of Complementary and Alternative Medicine Use to Health Care Providers among HIV-Infected Women

PubMed Central

Yang, Yang; Gange, Stephen J.; Weber, Kathleen; Sharp, Gerald B.; Wilson, Tracey E.; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Merenstein, Dan

2009-01-01

Abstract To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind–body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence. PMID:19821723

Complementary and alternative medicine use among paediatric emergency department patients.

PubMed

Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E

2015-09-01

To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P < 0.001), those with European ethnicity (P = 0.046) and among those with chronic disease (P < 0.01). Fish oil, garlic, chamomile and acidophilus were the most commonly used CAM. Only 4.4% of CAM use was reported to the ED doctor. There were reports of potentially dangerous CAM use (St John's wort, ginseng). Parents/carers who had administered CAM were more likely to report that CAMs are safe, drug free and could prevent illness (P < 0.01). In addition, a number of this group reported that CAMs are more effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Classification of CAM use and its correlates in patients with early-stage breast cancer.

PubMed

Saquib, Juliann; Madlensky, Lisa; Kealey, Sheila; Saquib, Nazmus; Natarajan, Loki; Newman, Vicky A; Patterson, Ruth E; Pierce, John P

2011-06-01

Self-reported use of complementary and alternative medicine (CAM) has been shown to increase following a cancer diagnosis, and breast cancer survivors are the heaviest users among cancer survivors. The aim of this study was to determine whether the prevalence estimate of CAM use varied according to classification of CAM. The authors used a comprehensive system to classify CAM users and test differences in demographic, lifestyle, quality of life, and cancer characteristics among them. Participants were 2562 breast cancer survivors participating in the Women's Healthy Eating and Living (WHEL) Study, aged 28 to 74 years. A structured telephone interview assessed CAM use, questioning about specific CAM practices, and whether use was related to cancer. This study examined CAM use in relation to demographics, health behaviors, and quality of life. Approximately 80% of the women used CAM for general purposes but only 50% reported CAM use for cancer purposes. Visual imagery, spiritual healing, and meditation were the most frequently used practices for cancer purposes. CAM use, defined as consulting a CAM practitioner and regular use, was significantly related to younger age, higher education, increased fruit and vegetable intake, and lower body mass index (P < .05). CAM users who had seen a practitioner were also more likely to report poor physical and mental health than non-CAM users (P < .05). CAM use was not associated with changes in physical and mental health between study baseline and 1-year follow-up. This study addressed important differences in the classification of CAM use among breast cancer survivors. Future studies need to further test the potential benefits and risks associated with CAM use.

EpCAM and the biology of hepatic stem/progenitor cells

PubMed Central

Theise, Neil D.; Schmelzer, Eva; Boulter, Luke; Gires, Olivier; van Grunsven, Leo A.

2014-01-01

Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein, which is frequently and highly expressed on carcinomas, tumor-initiating cells, selected tissue progenitors, and embryonic and adult stem cells. During liver development, EpCAM demonstrates a dynamic expression, since it can be detected in fetal liver, including cells of the parenchyma, whereas mature hepatocytes are devoid of EpCAM. Liver regeneration is associated with a population of EpCAM-positive cells within ductular reactions, which gradually lose the expression of EpCAM along with maturation into hepatocytes. EpCAM can be switched on and off through a wide panel of strategies to fine-tune EpCAM-dependent functional and differentiative traits. EpCAM-associated functions relate to cell–cell adhesion, proliferation, maintenance of a pluripotent state, regulation of differentiation, migration, and invasion. These functions can be conferred by the full-length protein and/or EpCAM-derived fragments, which are generated upon regulated intramembrane proteolysis. Control by EpCAM therefore not only depends on the presence of full-length EpCAM at cellular membranes but also on varying rates of the formation of EpCAM-derived fragments that have their own regulatory properties and on changes in the association of EpCAM with interaction partners. Thus spatiotemporal localization of EpCAM in immature liver progenitors, transit-amplifying cells, and mature liver cells will decisively impact the regulation of EpCAM functions and might be one of the triggers that contributes to the adaptive processes in stem/progenitor cell lineages. This review will summarize EpCAM-related molecular events and how they relate to hepatobiliary differentiation and regeneration. PMID:25477371

The welcoming attitude of dermatologists towards complementary and alternative medicine despite their lack of knowledge and training.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Asiri, Yousif

2017-09-01

Background / aim: Although complementary and alternative medicine (CAM) use is highly prevalent, there is very limited information on dermatologists' attitudes and knowledge about CAM. In this survey, we aimed to study the knowledge and attitude of dermatologists in Saudi Arabia towards CAM. Furthermore, we assessed dermatologists' intention to receive CAM education and training. Methods and design: We collected data through an online cross-sectional survey sent to email addresses of dermatologists in Saudi Arabia. Questions included socio-demographic data, knowledge and attitudes towards CAM practice. Results: A total of 93 questionnaires were returned from dermatologists in various regions of Saudi Arabia. The mean age was 41.7 ± 10.3 (range, 25-63) years. A total of 67% of dermatologists had welcoming attitudes towards CAM. We did not find any significant relationship between age, gender, experience or any other factor and positive attitudes towards CAM. More than 70% of participants reported an interest in learning about CAM. However, only 9 (9.7%) dermatologists had attended CAM courses. Sixty-one participants (65.6%) were eager to receive CAM-specific education, and 66% of dermatologists acknowledged having previously discussed CAM with their patients. The most important reason that dermatologists did not discuss CAM with their patients was a lack of studies supporting CAM (66.7%) and the belief that doctors' knowledge on CAM is insufficient (58.1%). Conclusion: A greater number of dermatologists have an affirmative attitude towards CAM. The willingness to improve knowledge and training indicates that the CAM field could potentially grow in dermatology.

75 FR 33320 - Notice of Issuance of Final Determination Concerning a Lift Unit for an Overhead Patient Lift...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... Determination Concerning a Lift Unit for an Overhead Patient Lift System; Correction AGENCY: U.S. Customs and... origin of a lift unit for an overhead patient lift system. The document contained two errors that this... origin of a lift unit for an overhead patient lift system. This document corrects in the DATES section of...

Pattern and predictors of complementary and alternative medicine (CAM) use among pediatric patients with epilepsy.

PubMed

Doering, Jan H; Reuner, Gitta; Kadish, Navah E; Pietz, Joachim; Schubert-Bast, Susanne

2013-10-01

Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the high importance of these treatment options for parents. On the other hand, communication concerning CAM with the child neurologist is largely insufficient despite the wish to speak about CAM. Complementary and alternative medicine users' high compliance with conventional treatment and high perceived effectiveness of CAM support an integrative approach to CAM for pediatric patients with epilepsy. Our study implies that in addition to open parent-child neurologist communication, active inquiry on CAM treatments is necessary to enable informed decision making by parents and to establish the suitability of CAM treatment for the patient. Reliable predictors for CAM use, which allow for improved identification of patients with a high likelihood to receive CAM treatment, are the duration of the illness, use of CAM by the parents themselves, and the desire of the parents to receive a holistic and natural treatment for their child. © 2013.

Geneva mechanism. [including star wheel and driver

NASA Technical Reports Server (NTRS)

Summers, R. H.; Kenney, R. L. (Inventor)

1974-01-01

An improved Geneva mechanism is characterized by a driven star-wheel having a segmented cam-follower surface. Star-wheel driver includes a restraining cam having a segmented cam surface for engaging the cam-follower surface of the star-wheel and antifriction rollers pinned to the restraining cam for engaging the cam-follower surface.

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed Central

Herrera, Ana

2009-01-01

Background In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO2 assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO2 fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C3-CAM) and CAM-cycling plants drought-induced dark CO2 fixation may only be, with few exceptions, a small proportion of C3 CO2 assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO2 fixation represents on average 11 % of C3 CO2 assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival – carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus – and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output. PMID:18708641

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed

Herrera, Ana

2009-02-01

In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO(2) assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO(2) fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C(3)-CAM) and CAM-cycling plants drought-induced dark CO(2) fixation may only be, with few exceptions, a small proportion of C(3) CO(2) assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO(2) fixation represents on average 11 % of C(3) CO(2) assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival--carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus--and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output.

A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer

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

Moran, Meena S., E-mail: meena.moran@yale.edu; Department of Radiation Therapy, William W. Backus Hospital, Norwich, Connecticut; Ma Shuangge

Purpose: Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation. Materials/Methods: A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers. Results: CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reportedmore » activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017). Conclusion: This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast cancer.« less

A Diagnostic PDF Cloud Scheme to Improve Subtropical Low Clouds in NCAR Community Atmosphere Model (CAM5)

NASA Astrophysics Data System (ADS)

Qin, Yi; Lin, Yanluan; Xu, Shiming; Ma, Hsi-Yen; Xie, Shaocheng

2018-02-01

Low clouds strongly impact the radiation budget of the climate system, but their simulation in most GCMs has remained a challenge, especially over the subtropical stratocumulus region. Assuming a Gaussian distribution for the subgrid-scale total water and liquid water potential temperature, a new statistical cloud scheme is proposed and tested in NCAR Community Atmospheric Model version 5 (CAM5). The subgrid-scale variance is diagnosed from the turbulent and shallow convective processes in CAM5. The approach is able to maintain the consistency between cloud fraction and cloud condensate and thus alleviates the adjustment needed in the default relative humidity-based cloud fraction scheme. Short-term forecast simulations indicate that low cloud fraction and liquid water content, including their diurnal cycle, are improved due to a proper consideration of subgrid-scale variance over the southeastern Pacific Ocean region. Compared with the default cloud scheme, the new approach produced the mean climate reasonably well with improved shortwave cloud forcing (SWCF) due to more reasonable low cloud fraction and liquid water path over regions with predominant low clouds. Meanwhile, the SWCF bias over the tropical land regions is also alleviated. Furthermore, the simulated marine boundary layer clouds with the new approach extend further offshore and agree better with observations. The new approach is able to obtain the top of atmosphere (TOA) radiation balance with a slightly alleviated double ITCZ problem in preliminary coupled simulations. This study implies that a close coupling of cloud processes with other subgrid-scale physical processes is a promising approach to improve cloud simulations.

Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia

PubMed Central

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2015-01-01

Background Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy. Methodology A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires. Results A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71). Conclusion While the findings indicated that there was no significant difference between users and non-users of CAM in terms of QOL, CAM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that CAM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using CAM with their healthcare providers. PMID:26451732

Prayer-for-health and complementary alternative medicine use among Malaysian breast cancer patients during chemotherapy.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2014-10-30

The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The objective of this study was to assess PFH and CAM use among breast cancer patients undergoing chemotherapy. A cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy. A total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15-3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40-3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18-2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10-0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM. CAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the differences in CAM use when PFH is included in, and excluded from, the definition of CAM.

Collecting Information About a CAM Practitioner’s Practice: A Preliminary Report of a Self-Interview Methodology

PubMed Central

Elder, William G.; Purdy, Hunter; Bentley, Andrew

2009-01-01

To prepare allopathic providers to advise patients about complementary and alternative medicine (CAM) therapies, the University of Kentucky CAM curriculum integration project has identified and trained CAM practitioners to coteach, precept, and demonstrate their respective practices. This project is interested in integrating CAM practitioners as teachers into this university and has formed a multidisciplinary committee for advice. The committee has recognized the importance of increased understanding of CAM practices to enhance communication within itself and to decide to which CAM practices students should receive exposure. This article reports our attempt to create a CAM practice description, based on questions general to CAM practice and specific to a particular approach. Because there is limited existing systematic research on CAM practice characteristics, these questions may interest researchers conducting qualitative studies, especially those seeking an example of questions to ask CAM practitioners. We also believe this practice description will be of general interest. PMID:19890441

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232

Consequences of systematic model drift in DYNAMO MJO hindcasts with SP-CAM and CAM5

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

Hannah, Walter M.; Maloney, Eric D.; Pritchard, Michael S.

Hindcast simulations of MJO events during the dynamics of the MJO (DYNAMO) field campaign are conducted with two models, one with conventional parameterization (CAM5) and a comparable model that utilizes superparameterization (SP–CAM). SP–CAM is shown to produce a qualitatively better reproduction of the fluctuations of precipitation and low–level zonal wind associated with the first two DYNAMO MJO events compared to CAM5. Interestingly, skill metrics using the real–time multivariate MJO index (RMM) suggest the opposite conclusion that CAM5 has more skill than SP–CAM. This inconsistency can be explained by a systematic increase of RMM amplitude with lead time, which results frommore » a drift of the large–scale wind field in SP–CAM that projects strongly onto the RMM index. CAM5 hindcasts exhibit a contraction of the moisture distribution, in which extreme wet and dry conditions become less frequent with lead time. SP–CAM hindcasts better reproduce the observed moisture distribution, but also have stronger drift patterns of moisture budget terms, such as an increase in drying by meridional advection in SP–CAM. This advection tendency in SP–CAM appears to be associated with enhanced off–equatorial synoptic eddy activity with lead time. In conclusion, systematic drift moisture tendencies in SP–CAM are of similar magnitude to intraseasonal moisture tendencies, and therefore are important for understanding MJO prediction skill.« less

Complementary and conventional medicine: a concept map

PubMed Central

Baldwin, Carol M; Kroesen, Kendall; Trochim, William M; Bell, Iris R

2004-01-01

Background Despite the substantive literature from survey research that has accumulated on complementary and alternative medicine (CAM) in the United States and elsewhere, very little research has been done to assess conceptual domains that CAM and conventional providers would emphasize in CAM survey studies. The objective of this study is to describe and interpret the results of concept mapping with conventional and CAM practitioners from a variety of backgrounds on the topic of CAM. Methods Concept mapping, including free sorts, ratings, and multidimensional scaling was used to organize conceptual domains relevant to CAM into a visual "cluster map." The panel consisted of CAM providers, conventional providers, and university faculty, and was convened to help formulate conceptual domains to guide the development of a CAM survey for use with United States military veterans. Results Eight conceptual clusters were identified: 1) Self-assessment, Self-care, and Quality of Life; 2) Health Status, Health Behaviors; 3) Self-assessment of Health; 4) Practical/Economic/ Environmental Concerns; 5) Needs Assessment; 6) CAM vs. Conventional Medicine; 7) Knowledge of CAM; and 8) Experience with CAM. The clusters suggest panelists saw interactions between CAM and conventional medicine as a critical component of the current medical landscape. Conclusions Concept mapping provided insight into how CAM and conventional providers view the domain of health care, and was shown to be a useful tool in the formulation of CAM-related conceptual domains. PMID:15018623

Complementary alternative medicine for children with autism: a physician survey.

PubMed

Golnik, Allison E; Ireland, Marjorie

2009-07-01

Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and discouraged withholding immunizations (76%), chelation (61%), anti-infectives (57%), delaying immunizations (55%) and secretin (43%). Physicians encouraging CAM were more likely to desire CAM training, inquire about CAM use, be female, be younger, and report greater autism visits, autism education and CAM knowledge. Physicians were more likely to desire CAM training, inquire about CAM and view CAM as a challenge for children with autism compared to children with other neurodevelopmental and chronic/complex conditions.

Abnormal placental development and early embryonic lethality in EpCAM-null mice.

PubMed

Nagao, Keisuke; Zhu, Jianjian; Heneghan, Mallorie B; Hanson, Jeffrey C; Morasso, Maria I; Tessarollo, Lino; Mackem, Susan; Udey, Mark C

2009-12-31

EpCAM (CD326) is encoded by the tacstd1 gene and expressed by a variety of normal and malignant epithelial cells and some leukocytes. Results of previous in vitro experiments suggested that EpCAM is an intercellular adhesion molecule. EpCAM has been extensively studied as a potential tumor marker and immunotherapy target, and more recent studies suggest that EpCAM expression may be characteristic of cancer stem cells. To gain insights into EpCAM function in vivo, we generated EpCAM -/- mice utilizing an embryonic stem cell line with a tacstd1 allele that had been disrupted. Gene trapping resulted in a protein comprised of the N-terminus of EpCAM encoded by 2 exons of the tacstd1 gene fused in frame to betageo. EpCAM +/- mice were viable and fertile and exhibited no obvious abnormalities. Examination of EpCAM +/- embryos revealed that betageo was expressed in several epithelial structures including developing ears (otocysts), eyes, branchial arches, gut, apical ectodermal ridges, lungs, pancreas, hair follicles and others. All EpCAM -/- mice died in utero by E12.5, and were small, developmentally delayed, and displayed prominent placental abnormalities. In developing placentas, EpCAM was expressed throughout the labyrinthine layer and by spongiotrophoblasts as well. Placentas of EpCAM -/- embryos were compact, with thin labyrinthine layers lacking prominent vascularity. Parietal trophoblast giant cells were also dramatically reduced in EpCAM -/- placentas. EpCAM was required for differentiation or survival of parietal trophoblast giant cells, normal development of the placental labyrinth and establishment of a competent maternal-fetal circulation. The findings in EpCAM-reporter mice suggest involvement of this molecule in development of vital organs including the gut, kidneys, pancreas, lungs, eyes, and limbs.

Use of complementary and alternative medicine (CAM) in autism spectrum disorder (ASD): comparison of Chinese and western culture (Part A).

PubMed

Wong, V C N

2009-03-01

A cross-sectional survey of the use of CAM by children was undertaken in the Duchess of Kent Children's Hospital in Hong Kong (March-December 2006). A questionnaire survey concerning the use of CAM was administered to chief caretakers (only the mothers) who accompanied children with neurodevelopmental disabilities followed up in our Neurodevelopmental paediatrics clinics. Four hundred and thirty agreed for interview of which 98 (22.8%) had Autism Spectrum Disorder (ASD). CAM was used in 40.8% for ASD and 21.4% of non-ASD (p < 0.001). We describe the profile of use of CAM in ASD in this part A paper. The three most common type of CAM use was Acupuncture (47.5%), Sensory Integration (42.5%), and Chinese Medicine (30%). About 76.9% of interviewees expected CAM to augment conventional treatment. Although 47.5% used both conventional western medicine and CAM, only 22.4% disclosed the use of CAM to Doctors. The following factors were significantly related to CAM use: father's job and mother's religion. Our frequency of CAM used in children with ASD was lower in Canada (52%) and USA (74%, 92%). The main CAM use in western culture was biological-based therapy whereas acupuncture was the most common CAM used in our locality.

Integrating CAM into nursing curricula: CAM camp as an educational intervention.

PubMed

Cornman, B Jane; Carr, Catherine A; Heitkemper, Margaret M

2006-05-01

In 2002, the University of Washington School of Nursing (SON) partnered with Bastyr University on a five-year plan to offer a four-week intensive "CAM Camp" (CAMp) for SON faculty members and medical students from across the country. The four-week educational program introduced attendees to various complementary and alternative medicine (CAM) modalities through didactic and experiential learning. To enhance complementary and alternative medicine content in a SON curriculum and to increase SON faculty knowledge and understanding about (1) the range of CAM therapies, (2) the theoretic and cultural backgrounds of these therapies, and (3) their potential contributions to the health of diverse populations. A descriptive pretest, posttest design was used to compare pre-CAMp CAM knowledge and CAM course content with post-CAMp knowledge levels of faculty and course CAM content. On post-CAMp surveys, familiarity with CAM modalities was rated with mixed results as compared with positive reports on the qualitative interviews. Interview results were more positive about CAM in general and were less specific about individual CAM topics. Statistically significant increases in competences were evident in each of 13 competencies rated with four competencies at P < .01. The number of required and elective courses containing CAM content increased as did the CAM content in continuing education conferences offered by the SON.

Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study.

PubMed

Liem, Andrian; Newcombe, Peter A; Pohlman, Annie

2017-08-01

This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements. The self-reporting questionnaire consisted of four scales including: knowledge of CAM (6 items), attitudes towards CAM (10 items), CAM experiences (4 items), and CAM educational needs (6 items). All scales, except CAM Experiences, were assessed on a 7-point Likert scale. Sixty provisional psychologists were eligible to complete the questionnaire with a response rate of 73% (N=44). The results showed that the CAM questionnaire was reliable (Cronbach's coefficient alpha range=0.62-0.96; item-total correlation range=0.14-0.92) and demonstrated content validity. Following further psychometric evaluation, the CAM questionnaire may provide the evidence-based information to inform the education and practice of Indonesian clinical psychologists. Copyright © 2017 Elsevier Ltd. All rights reserved.

Attitudes towards complementary and alternative medicine among medical and psychology students.

PubMed

Ditte, Darja; Schulz, Wolfgang; Ernst, Gundula; Schmid-Ott, Gerhard

2011-03-01

The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.

Perturbative universal state-selective correction for state-specific multi-reference coupled cluster methods

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

Brabec, Jiri; Banik, Subrata; Kowalski, Karol

2016-10-28

The implementation details of the universal state-selective (USS) multi-reference coupled cluster (MRCC) formalism with singles and doubles (USS(2)) are discussed on the example of several benchmark systems. We demonstrate that the USS(2) formalism is capable of improving accuracies of state specific multi-reference coupled-cluster (MRCC) methods based on the Brillouin-Wigner and Mukherjee’s sufficiency conditions. Additionally, it is shown that the USS(2) approach significantly alleviates problems associated with the lack of invariance of MRCC theories upon the rotation of active orbitals. We also discuss the perturbative USS(2) formulations that significantly reduce numerical overhead of the full USS(2) method.

Rotor Systems Research Aircraft /RSRA/ canopy explosive severance/fracture

NASA Technical Reports Server (NTRS)

Bement, L. J.

1976-01-01

The Rotor Systems Research Aircraft (RSRA), a compound rotor/fixed-wing aircraft, incorporates an emergency escape system for the three crew members; to achieve unobstructed egress, the overhead acrylic canopies of each crew member will be explosively severed and fractured into predictably small, low-mass pieces. A canopy explosive severance/fracture system was developed under this investigation that included the following system design considerations: selection of canopy and explosive materials, determining the acrylic's explosive severance and fracture characteristics, evaluating the effects of installation variables and temperature, determining the most effective explosive patterns, conducting full-scale, flat and double-curvature canopy tests, and evaluating the effects of back-blast of the explosive into the cockpit.

Fusion and Compatibility of Camphor and Octane Plasmids in Pseudomonas

PubMed Central

Chou, George I. N.; Katz, Dvorah; Gunsalus, I. C.

1974-01-01

The octane (OCT) plasmid in Pseudomonas putida derived from the ω-hydroxylase-carrying strain of Coon and coworkers is transferable to the camphor (CAM) plasmid-bearing strain by conjugation or by transduction. While the majority of the Cam +Oct+ exconjugants segregate Cam+ or Oct+ cells, exconjugants with stable Cam +Oct+ phenotype (CAM-OCT) can be detected at a low frequency. The transductants are all of the CAM-OCT phenotype. In the stable Cam +Oct+ strains, the OCT plasmid resembles the CAM plasmid with respect to curing by mitomycin C, transfer in conjugation, and reaction to ts (temperature-sensitive) mutation specifically affecting CAM plasmid replication. Therefore, it is suggested that certain regions of homology exist between the CAM and OCT plasmids that enable them to recombine to form a single plasmid, and to overcome the incompatibility barrier that prevents their coexisting. PMID:4527812

Concentration of clarithromycin and 14-R-hydroxy-clarithromycin in plasma of patients with Mycobacterium avium complex infection, before and after the addition of rifampicin.

PubMed

Yamamoto, F; Harada, S; Mitsuyama, T; Harada, Y; Kitahara, Y; Yoshida, M; Nakanishi, Y

2004-02-01

Clarithromycin (CAM) and rifampicin (RFP) have both been recognized to be effective antibiotic agents against Mycobacterium avium complex (MAC) infection. Rifamycin derivatives including RFP and rifabutin modulate the CAM metabolism by inducing the hepatic cytochrome p-450 3A4. To clarify the effect of RFP on the CAM metabolism, we measured the plasma concentration of CAM and 14-R-hydroxyclarithromycin (M-5), the major metabolite of CAM, in 9 patients suffering from MAC infection before and after the addition of RFP. After the addition of RFP, the mean plasma concentration of CAM significantly decreased, while that of M-5 did not. In addition, the amount of CAM + M-5 concentration also significantly decreased. As M-5 is less effective against MAC infection than CAM, more attention should thus be paid to the plasma CAM concentration in patients administered CAM and RFP concomitantly.

The use of complementary and alternative medicine among people living with diabetes in Sydney.

PubMed

Manya, Kiran; Champion, Bernard; Dunning, Trisha

2012-01-12

Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.

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

Ge Jin; Fishman, Jessica; Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was usedmore » to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.« less

Complementary and alternative medicine use in radiotherapy: what are patients using?

PubMed

Gillett, John; Ientile, Clare; Hiscock, Joanne; Plank, Ashley; Martin, Jarad M

2012-11-01

Complementary and alternative medicine (CAM) use by patients could interact in unpredictable ways with conventional therapies. This trial was designed to study the prevalence, types, and clinical implications of CAM use in patients with cancer who are receiving radiotherapy. A validated questionnaire was given to consenting outpatients in this ethics-approved study. Questions specified types of CAM used, clinician knowledge, reason for use, perceived effectiveness, safety, and cost. Of the 101 assessable questionnaires, 38 patients (38%) of the total patient group used CAM, with vitamins (53%), antioxidants (29%), spiritual/meditation practices (29%), and herbs (18%) being the most commonly used. The intention of CAM use was to improve quality of life in 69% of patients and for either hope of cure or to assist other forms of treatment in 26%. The majority of patients (58%) were using CAM prior to their diagnosis of cancer, with 40% starting at diagnosis or during conventional treatment. Patients spent up to $300/month on CAM use. Patients using CAM were significantly more likely to also receive chemotherapy versus non-CAM users (45% versus 24%, p=0.045). Significantly fewer CAM users expected cure from conventional therapy, compared to non-CAM users (50% versus 75%, p=0.016). More CAM users expected conventional therapy to prolong life (58% versus 32%, p<0.001). Only 40% discussed CAM use with their oncologists. CAM is commonly used by patients with cancer. CAMs, particularly antioxidants, are being taken which could negate the underlying free-radical tumorcidal effects of radiotherapy. Oncologists need to have greater awareness of this use and of its potential adverse consequences.

Report on Analyses of WAC Samples of Evaporator Overheads - 2004

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

OJI, LAWRENCE

2004-08-16

All water received into ETF requires characterization versus the defined Waste Acceptance Criteria. Currently much of the water received by ETF comes from the F and H Evaporator Overheads. Concentration, Storage and Transfer Engineering issued a modified list of species to be determined. In March of 2004, the Tank Farm submitted annual samples from 2F, 2H and 3H Evaporator Overhead streams for characterization to verify compliance with the Effluent Treatment Facility (ETF) Waste Acceptance Criteria (WAC) and to look for organic species. With the exception of high silicon in the 2H and slightly high tritium in 2F evaporator overheads, allmore » the overheads samples were found to be in compliance with the Effluent Treatment Facility WAC. The silicon concentration in the 2H-evaporator overhead, at 44 mg/L, was above the ETF WAC limit of 5 mg/L and tritium at 2.11E+05 dpm/mL in 2F overhead sample was above the ETF WAC limit of 1.2E+05 dpm/mL.« less

Calcium-Dependent Energetics of Calmodulin Domain Interactions with Regulatory Regions of the Ryanodine Receptor Type 1 (RyR1)

PubMed Central

Newman, Rhonda A.; Sorensen, Brenda R.; Kilpatrick, Adina M.; Shea, Madeline A.

2014-01-01

Calmodulin (CaM) plays a vital role in calcium homeostasis by allosterically modulating intracellular calcium channels including the homo-tetrameric human Ryanodine Receptor Type 1 (hRyR1). Apo (calcium-free) CaM activates hRyR1 while calcium-saturated CaM inhibits it. Two CaM-binding regions (residues 1975–1999 and 3614–3643) identified in each RyR1 monomer were proposed to allow CaM to bridge adjacent RyR1 subunits. We explored the distinct roles of CaM domains by using fluorescence anisotropy to determine the affinity of CaM1–148 (full-length), CaM1–80 (N-domain) and CaM76–148 (C-domain) for peptides encompassing hRyR1 residues 1975–1999 or 3614–3643. Both CaM1–148 and CaM76–148 associated in a calcium-independent manner with similar affinities for hRyR1(3614–3643)p while CaM1–80 required calcium and bound ~250-fold more weakly. Association of CaM1–148, CaM1–80 and CaM76–148 with hRyR1(1975–1999)p was much less favorable than with hRyR1(3614–3643)p; differences between the two CaM domains were smaller. Equilibrium calcium titrations monitored by steady-state fluorescence demonstrated that both hRyR1 peptides increased the calcium-binding affinity of both CaM domains. These thermodynamic properties support a prior model in which the CaM C-domain associates with RyR1(3614–3643) at low levels of calcium, positioning CaM to rapidly respond to calcium efflux. However, the affinity of the N-domain of CaM for hRyR1(1975–1999)p is insufficient to explain a model in which CaM bridges adjacent RyR1 subunits within the tetramer. This indicates that other protein factors or properties of the tertiary or quaternary structure of hRyR1 contribute to the energetics of CaM-mediated regulation. PMID:25145833

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Al-Natour, Sahar H; Alghamdi, Waleed; Mubki, Thamer; Alzolibani, Abdulatif; Hafez, Dhafer Mohammed Y; AlDraibi, Mohammed

2015-01-01

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia. This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained. Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists. There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM. © The Author(s) 2015.

The Synaptic Cell Adhesion Molecule, SynCAM1, Mediates Astrocyte-to-Astrocyte and Astrocyte-to-GnRH Neuron Adhesiveness in the Mouse Hypothalamus

PubMed Central

Sandau, Ursula S.; Mungenast, Alison E.; McCarthy, Jack; Biederer, Thomas; Corfas, Gabriel

2011-01-01

We previously identified synaptic cell adhesion molecule 1 (SynCAM1) as a component of a genetic network involved in the hypothalamic control of female puberty. Although it is well established that SynCAM1 is a synaptic adhesion molecule, its contribution to hypothalamic function is unknown. Here we show that, in addition to the expected neuronal localization illustrated by its presence in GnRH neurons, SynCAM1 is expressed in hypothalamic astrocytes. Cell adhesion assays indicated that SynCAM is recognized by both GnRH neurons and astrocytes as an adhesive partner and promotes cell-cell adhesiveness via homophilic, extracellular domain-mediated interactions. Alternative splicing of the SynCAM1 primary mRNA transcript yields four mRNAs encoding membrane-spanning SynCAM1 isoforms. Variants 1 and 4 are predicted to be both N and O glycosylated. Hypothalamic astrocytes and GnRH-producing GT1-7 cells express mainly isoform 4 mRNA, and sequential N- and O-deglycosylation of proteins extracted from these cells yields progressively smaller SynCAM1 species, indicating that isoform 4 is the predominant SynCAM1 variant expressed in astrocytes and GT1-7 cells. Neither cell type expresses the products of two other SynCAM genes (SynCAM2 and SynCAM3), suggesting that SynCAM-mediated astrocyte-astrocyte and astrocyte-GnRH neuron adhesiveness is mostly mediated by SynCAM1 homophilic interactions. When erbB4 receptor function is disrupted in astrocytes, via transgenic expression of a dominant-negative erbB4 receptor form, SynCAM1-mediated adhesiveness is severely compromised. Conversely, SynCAM1 adhesive behavior is rapidly, but transiently, enhanced in astrocytes by ligand-dependent activation of erbB4 receptors, suggesting that erbB4-mediated events affecting SynCAM1 function contribute to regulate astrocyte adhesive communication. PMID:21486931

Features of complementary and alternative medicine use by patients with coronary artery disease in Beijing: a cross-sectional study

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) is commonly used in China for the management of coronary artery disease (CAD). However, few studies have been conducted to investigate the prevalence, perceived effectiveness, types, and reasons of CAM use in patients diagnosed with CAD. Methods A cross-sectional study design was adopted. Questionnaires were distributed at the outpatient cardiac clinics of four tertiary-level teaching general hospitals in Beijing. Quantitative data were analyzed using Student’s t-test. Categorical data were analyzed using chi-square test. Logistic regression was employed to explore factors associated with the use of CAM as well as CAM use features in Chinese medicine (CM) hospitals when significant differences were found upon comparisons. Results From May to July, 2009, a total of 600 questionnaires were distributed, and 546 patients with a diagnosis of CAD responded with valid values and were included in the present study. CAM was used by 69.1% of the patients with CAD; the majority (75.9%) of these CAM users believes that CAM is effective. “Few side effects” (49.6%) was the main reason of CAM use; whereas “doubt of effect” (61.5%) was the main reason for non-use. Patent herbal medicine (90.7%) was the most commonly used CAM type. Compared with non-CAM users, CAM users tended to be older (p < 0.01), have a longer disease duration (p = 0.02) and better current health status. In addition, CAM users had significant lower odds for emergency admission and hospitalization within the past one year. Patients with CAD from CM and WM hospitals differ in CAM use frequency, types, perceived effectiveness, as well as reasons for CAM use or non-CAM use. Conclusion The present study suggested a group of significant factors which could influence the use of CAM in patients with CAD. CAM use patterns differ in patients from CM and WM hospitals. PMID:24160843

The role of complementary and alternative medicine (CAM) in Germany - a focus group study of GPs.

PubMed

Joos, Stefanie; Musselmann, Berthold; Miksch, Antje; Rosemann, Thomas; Szecsenyi, Joachim

2008-06-12

There has been a marked increase in the use of complementary and alternative medicine (CAM) in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners), some general practitioners (GPs) provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of 'Heilpraktiker' as a competing CAM-provider. It seems to be a need for increased funding for research, better education and remuneration by the Statutory Health Insurance in order to improve access to 'Integrative medicine' in Germany.

Inflammatory bowel disease professionals’ attitudes to and experiences of complementary and alternative medicine

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) use in patients with IBD is on the increase. Patients report they use CAM when their condition is unresponsive to conventional medication or when they suffer from side-effects, negative stress and disease-related concerns. CAM use may improve patients’ well-being but it can also lead to side-effects and interactions with conventional medications. Research on attitudes to and experiences of CAM among healthcare professionals working with IBD patients is not well studied. Studies in this area could lead to enhanced awareness of and improved communication about CAM between care staff and IBD patients. The aim of this study was to explore IBD professionals’ attitudes to and experience of CAM. Methods Sixteen physicians and nurses, 26–70 years old, who had worked with IBD patients for 1–42 years, were recruited. Semi-structured qualitative interviews were conducted. Qualitative content analysis was performed. Results Participants stated patients used CAM to improve their well-being generally and there conditions specifically. Participants had a positive attitude towards CAM and respected their patients’ decision to use it, but reported a lack of CAM knowledge. They required education about CAM to be able to meet patients’ needs and provide adequate information. The result of this study indicates that there is a need for CAM education to be implemented in nursing and medical school. Conclusions All participants had experience of IBD patients who had used CAM in an attempt to achieve improvement and well-being. Attitudes to CAM were mainly positive, although a problematic aspect was lack of knowledge and evidence in relation to CAM. Implementing CAM education in nursing and medical school will allow healthcare professionals to gain an understanding of therapies widely used by patients with IBD. In clinical practice, using a standard questionnaire regarding CAM use allow healthcare professionals to better understand their patients’ wishes and current CAM use. PMID:24325595

Taiwanese adult cancer patients' reports of using complementary therapies.

PubMed

Lu, Jui-Hua; Tsay, Shiow-Luan; Sung, Su-Ching

2010-01-01

More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience.

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Optical Aptamer Probes of Fluorescent Imaging to Rapid Monitoring of Circulating Tumor Cell

PubMed Central

Hwang, Ji Yeon; Kim, Sang Tae; Han, Ho-Seong; Kim, Kyunggon; Han, Jin Soo

2016-01-01

Fluorescence detecting of exogenous EpCAM (epithelial cell adhesion molecule) or muc1 (mucin1) expression correlated to cancer metastasis using nanoparticles provides pivotal information on CTC (circulating tumor cell) occurrence in a noninvasive tool. In this study, we study a new skill to detect extracellular EpCAM/muc1 using quantum dot-based aptamer beacon (QD-EpCAM/muc1 ALB (aptamer linker beacon). The QD-EpCAM/muc1 ALB was designed using QDs (quantum dots) and probe. The EpCAM/muc1-targeting aptamer contains a Ep-CAM/muc1 binding sequence and BHQ1 (black hole quencher 1) or BHQ2 (black hole quencher2). In the absence of target EpCAM/muc1, the QD-EpCAM/muc1 ALB forms a partial duplex loop-like aptamer beacon and remained in quenched state because the BHQ1/2 quenches the fluorescence signal-on of the QD-EpCAM/muc1 ALB. The binding of EpCAM/muc1 of CTC to the EpCAM/muc1 binding aptamer sequence of the EpCAM/muc1-targeting oligonucleotide triggered the dissociation of the BHQ1/2 quencher and subsequent signal-on of a green/red fluorescence signal. Furthermore, acute inflammation was stimulated by trigger such as caerulein in vivo, which resulted in increased fluorescent signal of the cy5.5-EpCAM/muc1 ALB during cancer metastasis due to exogenous expression of EpCAM/muc1 in Panc02-implanted mouse model. PMID:27886058

A Simple, Low Overhead Data Compression Algorithm for Converting Lossy Compression Processes to Lossless

DTIC Science & Technology

1993-12-01

0~0 S* NAVAL POSTGRADUATE SCHOOL Monterey, California DTIC ELECTE THESIS S APR 11 1994DU A SIMPLE, LOW OVERHEAD DATA COMPRESSION ALGORITHM FOR...A SIMPLE. LOW OVERHEAD DATA COMPRESSION ALGORITHM FOR CONVERTING LOSSY COMPRESSION PROCESSES TO LOSSLESS. 6. AUTHOR(S) Abbott, Walter D., III 7...Approved for public release; distribution is unlimited. A Simple, Low Overhead Data Compression Algorithm for Converting Lossy Processes to Lossless by

A lightweight sensor network management system design

USGS Publications Warehouse

Yuan, F.; Song, W.-Z.; Peterson, N.; Peng, Y.; Wang, L.; Shirazi, B.; LaHusen, R.

2008-01-01

In this paper, we propose a lightweight and transparent management framework for TinyOS sensor networks, called L-SNMS, which minimizes the overhead of management functions, including memory usage overhead, network traffic overhead, and integration overhead. We accomplish this by making L-SNMS virtually transparent to other applications hence requiring minimal integration. The proposed L-SNMS framework has been successfully tested on various sensor node platforms, including TelosB, MICAz and IMote2. ?? 2008 IEEE.

Analyzing Double Delays at Newark Liberty International Airport

NASA Technical Reports Server (NTRS)

Evans, Antony D.; Lee, Paul

2016-01-01

When weather or congestion impacts the National Airspace System, multiple different Traffic Management Initiatives can be implemented, sometimes with unintended consequences. One particular inefficiency that is commonly identified is in the interaction between Ground Delay Programs (GDPs) and time based metering of internal departures, or TMA scheduling. Internal departures under TMA scheduling can take large GDP delays, followed by large TMA scheduling delays, because they cannot be easily fitted into the overhead stream. In this paper we examine the causes of these double delays through an analysis of arrival operations at Newark Liberty International Airport (EWR) from June to August 2010. Depending on how the double delay is defined between 0.3 percent and 0.8 percent of arrivals at EWR experienced double delays in this period. However, this represents between 21 percent and 62 percent of all internal departures in GDP and TMA scheduling. A deep dive into the data reveals that two causes of high internal departure scheduling delays are upstream flights making up time between their estimated departure clearance times (EDCTs) and entry into time based metering, which undermines the sequencing and spacing underlying the flight EDCTs, and high demand on TMA, when TMA airborne metering delays are high. Data mining methods (currently) including logistic regression, support vector machines and K-nearest neighbors are used to predict the occurrence of double delays and high internal departure scheduling delays with accuracies up to 0.68. So far, key indicators of double delay and high internal departure scheduling delay are TMA virtual runway queue size, and the degree to which estimated runway demand based on TMA estimated times of arrival has changed relative to the estimated runway demand based on EDCTs. However, more analysis is needed to confirm this.

What should students learn about complementary and alternative medicine?

PubMed

Gaster, Barak; Unterborn, John N; Scott, Richard B; Schneeweiss, Ronald

2007-10-01

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Complementary and alternative health care in Israel

PubMed Central

2012-01-01

The paper explores the patterns of coexistence of alternative/complementary health care (CAM) and conventional medicine in Israel in the cultural, political, and social contexts of the society. The data are drawn from over ten years of sociological research on CAM in Israel, which included observation, survey research, and over one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the major medical institutions. The analysis considers the reasons for CAM use, number of practitioners, the frequency of CAM use and some of its correlates, and how CAM is regulated. The structure of the relationship between the conventional health care system and CAM is discussed in the public sector, which provides two-thirds of CAM services, and in the private sector, which provides about one-third. The history of the development of these structures and some of the dilemmas of their operation are discussed. A number of policy issues are considered against this background: regulation and licensing, CAM in primary care, reimbursement for CAM treatment, and the inclusion of CAM in education and training for the health professions. PMID:22913721

Suckling induced activation pattern in the brain of rat pups.

PubMed

Barna, János; Renner, Eva; Arszovszki, Antónia; Cservenák, Melinda; Kovács, Zsolt; Palkovits, Miklós; Dobolyi, Arpád

2018-06-01

The aim of the study was to understand the effects of suckling on the brain of the pups by mapping their brain activation pattern in response to suckling. The c-fos method was applied to identify activated neurons. Fasted rat pups were returned to their mothers for suckling and sacrificed 2 hours later for Fos immunohistochemistry. Double labeling was also performed to characterize some of the activated neurons. For comparison, another group of fasted pups were given dry food before Fos mapping. After suckling, we found an increase in the number of Fos-immunoreactive neurons in the insular and somatosensory cortices, central amygdaloid nucleus (CAm), paraventricular (PVN) and supraoptic hypothalamic nuclei, lateral parabrachial nucleus (LPB), nucleus of the solitary tract (NTS), and the area postrema. Double labeling experiments demonstrated the activation of calcitonin gene-related peptide-ir (CGRP-ir) neurons in the LPB, corticotropin-releasing hormone-ir (CRH-ir) but not oxytocin-ir neurons in the PVN, and noradrenergic neurons in the NTS. In the CAm, Fos-ir neurons did not contain CRH but were apposed to CGRP-ir fiber terminals. Refeeding with dry food-induced Fos activation in all brain areas activated by suckling. The degree of activation was higher following dry food consumption than suckling in the insular cortex, and lower in the supraoptic nucleus and the NTS. Furthermore, the accumbens, arcuate, and dorsomedial hypothalamic nuclei, and the lateral hypothalamic area, which were not activated by suckling, showed activation by dry food. Neurons in a number of brain areas are activated during suckling, and may participate in the signaling of satiety, taste perception, reward, food, and salt balance regulation.

Dietary Soy Supplement on Fibromyalgia Symptoms: A Randomized, Double-Blind, Placebo-Controlled, Early Phase Trial

PubMed Central

Wahner-Roedler, Dietlind L.; Thompson, Jeffrey M.; Luedtke, Connie A.; King, Susan M.; Cha, Stephen S.; Elkin, Peter L.; Bruce, Barbara K.; Townsend, Cynthia O.; Bergeson, Jody R.; Eickhoff, Andrea L.; Loehrer, Laura L.; Sood, Amit; Bauer, Brent A.

2011-01-01

Most patients with fibromyalgia use complementary and alternative medicine (CAM). Properly designed controlled trials are necessary to assess the effectiveness of these practices. This study was a randomized, double-blind, placebo-controlled, early phase trial. Fifty patients seen at a fibromyalgia outpatient treatment program were randomly assigned to a daily soy or placebo (casein) shake. Outcome measures were scores of the Fibromyalgia Impact Questionnaire (FIQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and after 6 weeks of intervention. Analysis was with standard statistics based on the null hypothesis, and separation test for early phase CAM comparative trials. Twenty-eight patients completed the study. Use of standard statistics with intent-to-treat analysis showed that total FIQ scores decreased by 14% in the soy group (P = .02) and by 18% in the placebo group (P < .001). The difference in change in scores between the groups was not significant (P = .16). With the same analysis, CES-D scores decreased in the soy group by 16% (P = .004) and in the placebo group by 15% (P = .05). The change in scores was similar in the groups (P = .83). Results of statistical analysis using the separation test and intent-to-treat analysis revealed no benefit of soy compared with placebo. Shakes that contain soy and shakes that contain casein, when combined with a multidisciplinary fibromyalgia treatment program, provide a decrease in fibromyalgia symptoms. Separation between the effects of soy and casein (control) shakes did not favor the intervention. Therefore, large-sample studies using soy for patients with fibromyalgia are probably not indicated. PMID:18990724

Is prayer CAM?

PubMed

Tippens, Kim; Marsman, Kevin; Zwickey, Heather

2009-04-01

Alternative medicine researchers and policy makers have classified prayer as a mind-body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization-which have included prayer-depict increasing CAM use, particularly in specific racial and ethnic groups. This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization.

Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is widely used for the treatment of infertility. While the Middle East and North Africa region has been shown to house one of the fastest growing markets of CAM products in the world, research describing the use of CAM therapies among Middle-Eastern infertile patients is minimal. The aim of this study is to examine the prevalence, characteristics and determinants of CAM use among infertile patients in Lebanon. Methods A cross sectional survey design was used to carry out face-to-face interviews with 213 consecutive patients attending the Assisted Reproductive Unit at a major academic medical center in Beirut. The questionnaire comprised three sections: socio-demographic and lifestyle characteristics, infertility-related aspects and information on CAM use. The main outcome measure was the use of CAM modalities for infertility treatment. Determinants of CAM use were assessed through the logistic regression method. Results Overall, 41% of interviewed patients reported using a CAM modality at least once for their infertility. There was a differential by gender in the most commonly used CAM therapies; where males mostly used functional foods (e.g. honey & nuts) (82.9%) while females mostly relied on spiritual healing/prayer (56.5%). Factors associated with CAM use were higher household income (OR: 0.305, 95% CI: 0.132–0.703) and sex, with females using less CAM than males (OR: 0.12, 95% CI: 0.051–0.278). The older patients were diagnosed with infertility, the lower the odds of CAM use (p for trend <0.05). Almost half of the participants (48%) were advised on CAM use by their friends, and only 13% reported CAM use to their physician. Conclusions The considerably high use of CAM modalities among Lebanese infertile patients, added to a poor CAM use disclosure to physicians, underscore the need to integrate CAM into the education and training of health professionals, as well as enhance infertile patients' awareness on safe use of CAM products. PMID:22901284

Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

PubMed

Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

2014-09-25

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use during patient interviews, and by familiarizing themselves with the potential benefits and risks of commonly used CAM modalities.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world.

PubMed

Yang, Xiaohan; Cushman, John C; Borland, Anne M; Edwards, Erika J; Wullschleger, Stan D; Tuskan, Gerald A; Owen, Nick A; Griffiths, Howard; Smith, J Andrew C; De Paoli, Henrique C; Weston, David J; Cottingham, Robert; Hartwell, James; Davis, Sarah C; Silvera, Katia; Ming, Ray; Schlauch, Karen; Abraham, Paul; Stewart, J Ryan; Guo, Hao-Bo; Albion, Rebecca; Ha, Jungmin; Lim, Sung Don; Wone, Bernard W M; Yim, Won Cheol; Garcia, Travis; Mayer, Jesse A; Petereit, Juli; Nair, Sujithkumar S; Casey, Erin; Hettich, Robert L; Ceusters, Johan; Ranjan, Priya; Palla, Kaitlin J; Yin, Hengfu; Reyes-García, Casandra; Andrade, José Luis; Freschi, Luciano; Beltrán, Juan D; Dever, Louisa V; Boxall, Susanna F; Waller, Jade; Davies, Jack; Bupphada, Phaitun; Kadu, Nirja; Winter, Klaus; Sage, Rowan F; Aguilar, Cristobal N; Schmutz, Jeremy; Jenkins, Jerry; Holtum, Joseph A M

2015-08-01

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO2 uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAM crop species and to harness the WUE of CAM by engineering this pathway into existing food, feed, and bioenergy crops. An improved understanding of CAM has potential for high returns on research investment. To exploit the potential of CAM crops and CAM bioengineering, it will be necessary to elucidate the evolution, genomic features, and regulatory mechanisms of CAM. Field trials and predictive models will be required to assess the productivity of CAM crops, while new synthetic biology approaches need to be developed for CAM engineering. Infrastructure will be needed for CAM model systems, field trials, mutant collections, and data management. © 2015 ORNL/UT-Battelle New Phytologist © 2015 New Phytologist Trust.

Socioeconomic Factors and Women's Use of Complementary and Alternative Medicine in Four Racial/Ethnic Groups

PubMed Central

Chao, Maria T.; Wade, Christine M.

2014-01-01

Objective Higher socioeconomic status (SES) is associated with using complementary and alternative medicine (CAM) in national surveys. Less is known about how socioeconomic factors affect CAM use in US subpopulations. We examined whether the relationship between SES and CAM use differs by racial/ethnic groups. Methods Using national survey data, we assessed education and income effects on women's CAM use in four racial/ethnic groups (Whites, Blacks, Mexican Americans, and Chinese Americans), controlling for age, health status, and geographic region. CAM use was defined as using any of 11 domains in the prior year. Results Adjusted effects of SES on CAM use were similar among Mexican American and non-Hispanic White women—education had a distinct gradient effect, with each increasing level of education significantly more likely to use CAM; household income ≥$60,000 was associated with CAM use compared to income <$20,000. For Chinese American women, socioeconomic factors were not associated with CAM use when controlling for confounders. Although income was not associated with CAM use among African American women, college graduates were three times more likely to use CAM than those with less than a high school education, adjusting for confounders. Conclusion SES effects on CAM use are not uniform across racial/ethnic populations. Other factors, such as culture and social networks, may interact with SES to influence CAM use in minority populations. PMID:18447102

Oncologists' experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis.

PubMed

Corina, Güthlin; Christine, Holmberg; Klein, Gudrun

2016-09-01

The rising use of complementary and alternative medicine (CAM) means oncologists are increasingly asked by patients to discuss CAM treatment options. However, no formal training or established standards are available on the subject. The aim of this paper was to investigate real-world discussions of CAM treatments. In particular, we wanted to learn about the values, norms and defining features that characterise oncologist-patient discussions on CAM. Semi-standardised interviews with 17 oncologists were analysed using interpretation pattern analysis combined with thematic analysis. Advice on CAM is seen by oncologists as an important service they provide to their patients, even though their knowledge of the subject is often limited. Many interviewees mentioned an apparent lack of scientific proof, especially when their aim was to warn patients against the use of CAM. Discussions on CAM tend to reflect the idea that CAM belongs 'to another world', and judging by the interviews with oncologists, this notion appears to be shared by patients and oncologists alike. Oncologists require reliable information on CAM and would profit from training in the communication of CAM treatment options to patients. Knowing scientific data on CAM would also lower barriers stemming from the view that CAM belongs 'to another world'. Under- and postgraduate education programmes should include training on how to respond to requests addressing possible CAM options.

The impact of EpCAM expression on response to chemotherapy and clinical outcomes in patients with epithelial ovarian cancer.

PubMed

Tayama, Shingo; Motohara, Takeshi; Narantuya, Dashdemberel; Li, Chenyan; Fujimoto, Koichi; Sakaguchi, Isao; Tashiro, Hironori; Saya, Hideyuki; Nagano, Osamu; Katabuchi, Hidetaka

2017-07-04

Epithelial ovarian cancer is a highly lethal malignancy; moreover, overcoming chemoresistance is the major challenging in treating ovarian cancer patients. The cancer stem cell (CSC) hypothesis considers CSCs to be the main culprits in driving tumor initiation, metastasis, and resistance to conventional therapy. Although growing evidence suggest that CSCs are responsible for chemoresistance, the contribution of CSC marker EpCAM to resistance to chemotherapy remains unresolved.Here we have demonstrated that ovarian cancers containing high levels of EpCAM have a significantly much lower probability of achieving overall responsive rates after first-line chemotherapy. In addition, multivariate analysis revealed that EpCAM expression is an independent risk factor for chemoresistance, indicating that EpCAM expression is a predictive biomarker of chemotherapeutic response. Consistent with these clinical observations, in vitro assays, we found that the subpopulation of EpCAM-positive ovarian cancer cells shows a significantly higher viability compared with EpCAM-negative cells in response to cisplatin treatment by preventing chemotherapy-induced apoptosis, which is regulated by EpCAM-Bcl-2 axis. Furthermore, in an in vivo mouse model, platinum agents preferentially eliminated EpCAM-negative cells in comparison with EpCAM-positive cells, suggesting that the remaining subpopulation of EpCAM-positive cells contributes to tumor recurrence after chemotherapy. Finally, we also found that an increased expression of EpCAM is associated with poor prognosis in ovarian cancer patients.Our findings highlight the clinical significance of EpCAM in the resistance to chemotherapy and provide a rationale for EpCAM-targeted therapy to improve chemoresistance. Targeting EpCAM should be a promising approach to effectively extirpate the CSCs as the putative root of ovarian cancer.

Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

PubMed

Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

2011-08-01

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico.

PubMed

Brambila-Tapia, Aniel Jessica Leticia; Rios-Gonzalez, Blanca Estela; Lopez-Barragan, Liliana; Saldaña-Cruz, Ana Miriam; Rodriguez-Vazquez, Katya

2016-01-01

The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools. Copyright © 2016 Elsevier Inc. All rights reserved.

EpCAM expression in primary tumour tissues and metastases: an immunohistochemical analysis.

PubMed

Spizzo, Gilbert; Fong, Dominic; Wurm, Martin; Ensinger, Christian; Obrist, Peter; Hofer, Carina; Mazzoleni, Guido; Gastl, Guenther; Went, Philip

2011-05-01

Epithelial cell adhesion molecule (EpCAM) is a cell surface protein with oncogenic features that is expressed on healthy human epithelia and corresponding malignant tumours. EpCAM expression frequently correlates with more aggressive tumour behaviour and new EpCAM-specific therapeutic agents have recently been approved for clinical use in patients with cancer. However, no consensus exists on how and when to evaluate EpCAM expression in patients with cancer. EpCAM expression was assessed by a well-established immunohistochemical staining protocol in 2291 primary tumour tissues and in 108 metastases using the EpCAM-specific antibody clone VU1D9. A total immunostaining score was calculated as the product of a proportion score and an intensity score. Four expression subgroups (no, weak, moderate and intense) were defined. As described previously, the term 'EpCAM overexpression' was reserved for tissues showing a total immunostaining score >4. EpCAM was highly expressed in most tumours of gastrointestinal origin and in some carcinomas of the genitourinary tract. However, hepatocellular carcinomas, clear cell renal cell cancer, urothelial cancer and squamous cell cancers were frequently EpCAM negative. EpCAM expression in breast cancer depended on the histological subtype; lobular histology usually showed no or weak expression. Most metastases were EpCAM positive and they frequently reflected the expression phenotype of the primary tumour. EpCAM expression was detected on adenocarcinomas of various primary sites. If EpCAM-specific antibodies are intended to be used in patients with cancer, we recommend prior immunohistochemical evaluation of EpCAM expression, particularly in patients with renal cell cancer, hepatocellular carcinoma, urothelial carcinoma, breast cancer and squamous cell carcinomas.

The use of complementary and alternative medicine among people living with diabetes in Sydney

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. Methods A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Results Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Conclusions Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage. PMID:22240113

College Access Marketing

ERIC Educational Resources Information Center

Tremblay, Christopher W.

2011-01-01

College Access Marketing (CAM) is a relatively new phenomenon that seeks to positively influence the college-going rate. This report defines CAM, describes CAM examples, and discusses how CAM seeks to counter barriers to college. It explores four main elements of CAM: information, marketing, advocacy, and social mobilization. Further, it…

Complementary and alternative medicine in pulmonology.

PubMed

Mark, John D; Chung, Youngran

2015-06-01

To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children. The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders. This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.

Pattern and frequency of use of complementary and alternative medicine among patients with epilepsy in the midwestern United States.

PubMed

Liow, Kore; Ablah, Elizabeth; Nguyen, John C; Sadler, Toni; Wolfe, Deborah; Tran, Ky-Dieu; Guo, Lisa; Hoang, Tina

2007-06-01

Complementary and alternative medicine (CAM) is recognized to be commonly used by patients, yet there have been few studies regarding the scope of CAM use by patients with epilepsy. This study assessed usage and perceptions of CAM by patients with epilepsy in the midwest of the United States. A 25-item survey was administered to adult patients with epilepsy, and data were collected from 228 patients. The survey collected demographics, specific CAM usage, adverse effects of CAM therapy, and perceptions of the effectiveness of CAM. Thirty-nine percent reported using CAM; 25% reported using CAM specifically for their epilepsy. Prayer/spirituality was the most commonly used form of CAM (46%), followed by "mega" vitamins (25%), chiropractic care (24%), and stress management (16%). CAM use is common among midwestern patients with epilepsy, although the pattern of use may be slightly different than in other regions of the United States and elsewhere.

Is Prayer CAM?

PubMed Central

Marsman, Kevin; Zwickey, Heather

2009-01-01

Abstract Background Alternative medicine researchers and policy makers have classified prayer as a mind–body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization—which have included prayer—depict increasing CAM use, particularly in specific racial and ethnic groups. Objectives This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization. PMID:19388867

L1-CAM in cancerous tissues.

PubMed

Gavert, Nancy; Ben-Shmuel, Amir; Raveh, Shani; Ben-Ze'ev, Avri

2008-11-01

L1-cell adhesion molecule (L1-CAM) is a cell adhesion receptor of the immunoglobulin superfamily, known for its roles in nerve cell function. While originally believed to be present only in brain cells, in recent years L1-CAM has been detected in other tissues, and in a variety of cancer cells, including some common types of human cancer. We review the prevalence of L1-CAM in human cancer, the possible mechanisms involved in L1-CAM-mediated tumorigenesis, and cancer therapies based upon L1-CAM antibody treatment. In colon cancer cells, the L1-CAM gene was identified as a target of the Wnt/beta-catenin-TCF signaling pathway, and L1-CAM was exclusively detected at the invasive front of colon and ovarian cancer tissue. The expression of L1-CAM in normal and cancer cells enhanced tumorigenesis and conferred metastasis in colon cancer cells. Antibodies against the L1-CAM ectodomain severely inhibited the proliferation of a variety of cancer cells in culture and reduced tumor burden when injected into mice harboring cancer cells expressing L1-CAM. These results, in addition to the presence of L1-CAM on the cell surface and its restricted distribution in normal tissues, make it an ideal target for tumor therapy.

Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

PubMed

Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

2015-01-01

Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

Molecular cloning and expression of the calmodulin gene from guinea pig hearts.

PubMed

Feng, Rui; Liu, Yan; Sun, Xuefei; Wang, Yan; Hu, Huiyuan; Guo, Feng; Zhao, Jinsheng; Hao, Liying

2015-06-01

The aim of the present study was to isolate and characterize a complementary DNA (cDNA) clone encoding the calmodulin (CaM; GenBank accession no. FJ012165) gene from guinea pig hearts. The CaM gene was amplified from cDNA collected from guinea pig hearts and inserted into a pGEM®-T Easy vector. Subsequently, CaM nucleotide and protein sequence similarity analysis was conducted between guinea pigs and other species. In addition, reverse transcription-polymerase chain reaction (RT-PCR) was performed to investigate the CaM 3 expression patterns in different guinea pig tissues. Sequence analysis revealed that the CaM gene isolated from the guinea pig heart had ∼90% sequence identity with the CaM 3 genes in humans, mice and rats. Furthermore, the deduced peptide sequences of CaM 3 in the guinea pig showed 100% homology to the CaM proteins from other species. In addition, the RT-PCR results indicated that CaM 3 was widely and differentially expressed in guinea pigs. In conclusion, the current study provided valuable information with regard to the cloning and expression of CaM 3 in guinea pig hearts. These findings may be helpful for understanding the function of CaM3 and the possible role of CaM3 in cardiovascular diseases.

Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer.

PubMed

Mercurio, Reegan; Eliott, Jaklin Ardath

2011-01-01

Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer. This study is a content analysis featuring quantitative and qualitative techniques, the latter guided by 'media framing', of targeted newspaper articles. One hundred nineteen articles focused on CAM use for the treatment of cancer were identified. Quantitative analysis found that biologically based CAMs were most frequently described and breast cancer most mentioned. Two thirds of all articles described CAM use in the context of a cure, with approximately half of these opposing this reason for use. Potential benefits of CAM were discussed more frequently than potential risks, and information on costs and how to access CAM were uncommon. Recommendations included advice to use complementary, not alternative therapies, yet advice to discuss CAM with a medical doctor was rare. Qualitative analysis found six CAM cancer-related frames, four in support of CAM use for cancer treatment. The dominant frame constructed CAM as legitimate tools to assist biomedicine (even to cure), with others depicting CAM as normal and necessary or as addressing limitations of biomedicine. Negative frames depicted CAM as questionable and risky practices and the industry/practitioners as possessing malevolent intent. These findings have implications for biomedical practitioners attempting to determine, respect and assist patient choices about their treatment.

The shed ectodomain of Nr-CAM stimulates cell proliferation and motility, and confers cell transformation.

PubMed

Conacci-Sorrell, Maralice; Kaplan, Anna; Raveh, Shani; Gavert, Nancy; Sakurai, Takeshi; Ben-Ze'ev, Avri

2005-12-15

Nr-CAM, a cell-cell adhesion molecule of the immunoglobulin-like cell adhesion molecule family, known for its function in neuronal outgrowth and guidance, was recently identified as a target gene of beta-catenin signaling in human melanoma and colon carcinoma cells and tissue. Retrovirally mediated transduction of Nr-CAM into fibroblasts induces cell motility and tumorigenesis. We investigated the mechanisms by which Nr-CAM can confer properties related to tumor cell behavior and found that Nr-CAM expression in NIH3T3 cells protects cells from apoptosis in the absence of serum by constitutively activating the extracellular signal-regulated kinase and AKT signaling pathways. We detected a metalloprotease-mediated shedding of Nr-CAM into the culture medium of cells transfected with Nr-CAM, and of endogenous Nr-CAM in B16 melanoma cells. Conditioned medium and purified Nr-CAM-Fc fusion protein both enhanced cell motility, proliferation, and extracellular signal-regulated kinase and AKT activation. Moreover, Nr-CAM was found in complex with alpha4beta1 integrins in melanoma cells, indicating that it can mediate, in addition to homophilic cell-cell adhesion, heterophilic adhesion with extracellular matrix receptors. Suppression of Nr-CAM levels by small interfering RNA in B16 melanoma inhibited the adhesive and tumorigenic capacities of these cells. Stable expression of the Nr-CAM ectodomain in NIH3T3 cells conferred cell transformation and tumorigenesis in mice, suggesting that the metalloprotease-mediated shedding of Nr-CAM is a principal route for promoting oncogenesis by Nr-CAM.

The use of complementary and alternative medicines by patients with peripheral neuropathy.

PubMed

Brunelli, Brian; Gorson, Kenneth C

2004-03-15

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with chronic neurological disorders. The prevalence and characteristics of CAM use by patients with peripheral neuropathy is unknown. We performed a prospective, questionnaire-based study to determine the prevalence and patterns of use of CAM therapies in 180 consecutive outpatients with peripheral neuropathy. The use of CAM was reported by 77 patients (43%) with neuropathy. The most frequent were megavitamins (35%), magnets (30%), acupuncture (30%), herbal remedies (22%), and chiropractic manipulation (21%); 37 (48%) tried more than one form of alternative treatment. Seventeen respondents (27%) thought their neuropathy symptoms improved with these approaches. Those who used CAM were slightly younger (mean age 62 vs. 65 years, p = 0.05) and more often college educated (39% vs. 24%, p = 0.03) compared to CAM nonusers. They also more often reported burning neuropathic pain (62% vs. 44%, p = 0.01). Patients with diabetic neuropathy used CAM more frequently than others (p = 0.03). The most common reason for using CAM was inadequate pain control (32%). Almost half of patients did not consult a physician before starting CAM. We conclude that there is a high prevalence of CAM use in our patients with neuropathy, and one-quarter reported that their symptoms improved. CAM users were better educated than nonusers, but most did not discuss CAM treatments with their physician. Neuropathic pain was substantially more common in CAM users, and lack of pain control was the most common reason for CAM use.

The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): a qualitative investigation.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-05-01

Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.

Modeled hydraulic redistribution in tree-grass, CAM-grass, and tree-CAM associations: the implications of crassulacean acid metabolism (CAM).

PubMed

Yu, Kailiang; Foster, Adrianna

2016-04-01

Past studies have largely focused on hydraulic redistribution (HR) in trees, shrubs, and grasses, and recognized its role in interspecies interactions. HR in plants that conduct crassulacean acid metabolism (CAM), however, remains poorly investigated, as does the effect of HR on transpiration in different vegetation associations (i.e., tree-grass, CAM-grass, and tree-CAM associations). We have developed a mechanistic model to investigate the net direction and magnitude of HR at the patch scale for tree-grass, CAM-grass, and tree-CAM associations at the growing season to yearly timescale. The modeling results show that deep-rooted CAM plants in CAM-grass associations could perform hydraulic lift at a higher rate than trees in tree-grass associations in a relatively wet environment, as explained by a significant increase in grass transpiration rate in the shallow soil layer, balancing a lower transpiration rate by CAM plants. By comparison, trees in tree-CAM associations may perform hydraulic descent at a higher rate than those in tree-grass associations in a dry environment. Model simulations also show that hydraulic lift increases the transpiration of shallow-rooted plants, while hydraulic descent increases that of deep-rooted plants. CAM plants transpire during the night and thus perform HR during the day. Based on these model simulations, we suggest that the ability of CAM plants to perform HR at a higher rate may have different effects on the surrounding plant community than those of plants with C3 or C4 photosynthetic pathways (i.e., diurnal transpiration).

Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

PubMed

Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

2006-06-01

To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

Ion-source modeling and improved performance of the CAMS high-intensity Cs-sputter ion source

NASA Astrophysics Data System (ADS)

Brown, T. A.; Roberts, M. L.; Southon, J. R.

2000-10-01

The interior of the high-intensity Cs-sputter source used in routine operations at the Center for Accelerator Mass Spectrometry (CAMS) has been computer modeled using the program NEDLab, with the aim of improving negative ion output. Space charge effects on ion trajectories within the source were modeled through a successive iteration process involving the calculation of ion trajectories through Poisson-equation-determined electric fields, followed by calculation of modified electric fields incorporating the charge distribution from the previously calculated ion trajectories. The program has several additional features that are useful in ion source modeling: (1) averaging of space charge distributions over successive iterations to suppress instabilities, (2) Child's Law modeling of space charge limited ion emission from surfaces, and (3) emission of particular ion groups with a thermal energy distribution and at randomized angles. The results of the modeling effort indicated that significant modification of the interior geometry of the source would double Cs + ion production from our spherical ionizer and produce a significant increase in negative ion output from the source. The results of the implementation of the new geometry were found to be consistent with the model results.

18 CFR 367.52 - Overhead construction costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACT Service Company Property Instructions § 367.52 Overhead construction costs. (a) All overhead construction costs, such as engineering, supervision, general office salaries and expenses, construction... costs. 367.52 Section 367.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY...

18 CFR 367.52 - Overhead construction costs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACT Service Company Property Instructions § 367.52 Overhead construction costs. (a) All overhead construction costs, such as engineering, supervision, general office salaries and expenses, construction... costs. 367.52 Section 367.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY...

An evidence-based review of commonly used dietary supplements.

PubMed

Laird, John

2015-07-01

Use of complementary and alternative medicine (CAM) is increasing in the United States. Physician assistants need to know about the efficacy of CAM therapies if they practice integrative medicine (which combines CAM and traditional therapies), recommend a CAM therapy occasionally as part of their treatment plan, refer patients to CAM providers, or have patients who self-select CAM therapies. This article describes integrative medicine and reviews the most commonly used dietary supplements.

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

PubMed Central

Wallis, Marianne

2008-01-01

Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients.

PubMed

Farooqui, Maryam; Hassali, Mohamed Azmi; Abdul Shatar, Aishah Knight; Shafie, Asrul Akmal; Seang, Tan Boon; Farooqui, Muhammad Aslam

2012-05-01

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments. Copyright © 2011 Elsevier Ltd. All rights reserved.

L1-CAM and N-CAM: From Adhesion Proteins to Pharmacological Targets.

PubMed

Colombo, Federico; Meldolesi, Jacopo

2015-11-01

L1 cell adhesion molecule (L1-CAM) and neural cell adhesion molecule (N-CAM), key members of the immunoglobulin-like CAM (Ig-CAM) family, were first recognized to play critical roles in surface interactions of neurons, by binding with each other and with extracellular matrix (ECM) proteins. Subsequently, adhesion was recognized to include signaling due to both activation of β-integrin, with the generation of intracellular cascades, and integration with the surface cytoskeleton. The importance of the two Ig-CAMs was revealed by their activation of the tyrosine kinase receptors of fibroblast growth factor (FGF), epidermal growth factor (EGF), and nerve growth factor (NGF). Based on these complex signaling properties, L1-CAM and N-CAM have become of great potential pharmacological interest in neurons and cancers. Treatment of neurodegenerative disorders and cognitive deficits of neurons is aimed to increase the cell Ig-CAM tone, possibly provided by synthetic/mimetic peptides. In cancer cells, where Ig-CAMs are often overexpressed, the proteins are employed for prognosis. The approaches to therapy are based on protein downregulation, antibodies, and adoptive immunotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Arrhythmogenic Calmodulin Mutation D129G Dysregulates Cell Growth, Calmodulin-dependent Kinase II Activity, and Cardiac Function in Zebrafish*

PubMed Central

Zacharias, Triantafyllos; Kulej, Katarzyna; Wang, Kevin; Torggler, Raffaela; la Cour, Jonas M.

2016-01-01

Calmodulin (CaM) is a Ca2+ binding protein modulating multiple targets, several of which are associated with cardiac pathophysiology. Recently, CaM mutations were linked to heart arrhythmia. CaM is crucial for cell growth and viability, yet the effect of the arrhythmogenic CaM mutations on cell viability, as well as heart rhythm, remains unknown, and only a few targets with relevance for heart physiology have been analyzed for their response to mutant CaM. We show that the arrhythmia-associated CaM mutants support growth and viability of DT40 cells in the absence of WT CaM except for the long QT syndrome mutant CaM D129G. Of the six CaM mutants tested (N53I, F89L, D95V, N97S, D129G, and F141L), three showed a decreased activation of Ca2+/CaM-dependent kinase II, most prominently the D129G CaM mutation, which was incapable of stimulating Thr286 autophosphorylation. Furthermore, the CaM D129G mutation led to bradycardia in zebrafish and an arrhythmic phenotype in a subset of the analyzed zebrafish. PMID:27815504

[Complementary and alternative medicine in primary care in Switzerland].

PubMed

Déglon-Fischer, Agnès; Barth, Jürgen; Ausfeld-Hafter, Brigitte

2009-08-01

This study investigated the current supply of complementary and alternative medicine (CAM) in Swiss primary care. Information was collected on physicians' qualifications in CAM, frequency of patients' demand for CAM, physicians' supply and temporal resources for CAM as well as physicians' referrals to CAM. 750 (500 German-speaking and 250 French-speaking) randomly selected Swiss female and male primary care physicians were asked to complete a questionnaire (response rate 50.4%). Sociodemographic data on professional training, place of residence, and sex were used to calculate a weighting factor to correct the responders' data in the analysis accordingly. 14.2% of the physicians were qualified in at least one CAM discipline. Around 30% (95% confidence interval 25.4-34.6%) of the physicians were asked for CAM by their patients more than once a week. Homeopathy and phytotherapy were the most frequently offered therapies, followed by traditional Chinese medicine (TCM)/acupuncture. 62.5% (57.6-67.4%) of the physicians refer their patients to CAM. Most patients were referred to TCM/acupuncture. Of the 37.2% (32.6-42.4%) of the physicians who do not refer their patients to CAM, around 40% (35.1-44.9%) offer it themselves. About three quarters of the physicians offer CAM themselves or refer their patients to CAM treatments. CAM is very important in primary medical care in Switzerland. Clear regulations for CAM are required in order to ensure a high quality in care. Copyright 2009 S. Karger AG, Basel.

Complementary and alternative medicine use in patients with hematological cancers in Malaysia.

PubMed

Gan, G G; Leong, Y C; Bee, P C; Chin, E; Teh, A K H

2015-08-01

Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country. This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale. A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage. In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients' Attitude towards CAM in a University-Based Oncology Center in Germany.

PubMed

Kessel, Kerstin A; Lettner, Sabrina; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herrschbach, Peter; Gschwend, Jürgen E; Meyer, Bernhard; Peschel, Christian; Schmid, Roland; Schwaiger, Markus; Wolff, Klaus-Dietrich; Combs, Stephanie E

2016-01-01

To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting. A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%). Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.

Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

PubMed Central

Inui, Hiroaki; Ninomiya, Hiroki; Tanaka, Hiroshi; Nobuhara, Katsuya

2017-01-01

Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases). In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus) tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms. PMID:28702502

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

Wu, Hao; Garzoglio, Gabriele; Ren, Shangping

FermiCloud is a private cloud developed in Fermi National Accelerator Laboratory to provide elastic and on-demand resources for different scientific research experiments. The design goal of the FermiCloud is to automatically allocate resources for different scientific applications so that the QoS required by these applications is met and the operational cost of the FermiCloud is minimized. Our earlier research shows that VM launching overhead has large variations. If such variations are not taken into consideration when making resource allocation decisions, it may lead to poor performance and resource waste. In this paper, we show how we may use an VMmore » launching overhead reference model to minimize VM launching overhead. In particular, we first present a training algorithm that automatically tunes a given refer- ence model to accurately reflect FermiCloud environment. Based on the tuned reference model for virtual machine launching overhead, we develop an overhead-aware-best-fit resource allocation algorithm that decides where and when to allocate resources so that the average virtual machine launching overhead is minimized. The experimental results indicate that the developed overhead-aware-best-fit resource allocation algorithm can significantly improved the VM launching time when large number of VMs are simultaneously launched.« less

78 FR 77027 - Overhead Clearance (Air-Draft) Accidents

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... No. USCG-2013-0466] Overhead Clearance (Air-Draft) Accidents AGENCY: Coast Guard, DHS. ACTION... clearance (air-draft) accidents. In its petition, which calls for vessel masters to be provided with accurate vertical air draft information, a maritime organization has described 16 overhead clearance...

Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice. The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy. A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM). We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users. Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden. Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review.

PubMed

Joyce, Paul; Wardle, Jon; Zaslawski, Chris

2016-12-01

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

Complementary and alternative medicine in breast cancer patients.

PubMed

Nahleh, Zeina; Tabbara, Imad A

2003-09-01

Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind-body approaches, and traditional Chinese medicine. We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes. Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind-body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products. CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.

Nitric Oxide Mediates the Hormonal Control of Crassulacean Acid Metabolism Expression in Young Pineapple Plants1[W][OA

PubMed Central

Freschi, Luciano; Rodrigues, Maria Aurineide; Domingues, Douglas Silva; Purgatto, Eduardo; Van Sluys, Marie-Anne; Magalhaes, Jose Ronaldo; Kaiser, Werner M.; Mercier, Helenice

2010-01-01

Genotypic, developmental, and environmental factors converge to determine the degree of Crassulacean acid metabolism (CAM) expression. To characterize the signaling events controlling CAM expression in young pineapple (Ananas comosus) plants, this photosynthetic pathway was modulated through manipulations in water availability. Rapid, intense, and completely reversible up-regulation in CAM expression was triggered by water deficit, as indicated by the rise in nocturnal malate accumulation and in the expression and activity of important CAM enzymes. During both up- and down-regulation of CAM, the degree of CAM expression was positively and negatively correlated with the endogenous levels of abscisic acid (ABA) and cytokinins, respectively. When exogenously applied, ABA stimulated and cytokinins repressed the expression of CAM. However, inhibition of water deficit-induced ABA accumulation did not block the up-regulation of CAM, suggesting that a parallel, non-ABA-dependent signaling route was also operating. Moreover, strong evidence revealed that nitric oxide (NO) may fulfill an important role during CAM signaling. Up-regulation of CAM was clearly observed in NO-treated plants, and a conspicuous temporal and spatial correlation was also evident between NO production and CAM expression. Removal of NO from the tissues either by adding NO scavenger or by inhibiting NO production significantly impaired ABA-induced up-regulation of CAM, indicating that NO likely acts as a key downstream component in the ABA-dependent signaling pathway. Finally, tungstate or glutamine inhibition of the NO-generating enzyme nitrate reductase completely blocked NO production during ABA-induced up-regulation of CAM, characterizing this enzyme as responsible for NO synthesis during CAM signaling in pineapple plants. PMID:20147491

Calcium triggers reversal of calmodulin on nested anti-parallel sites in the IQ motif of the neuronal voltage-dependent sodium channel NaV1.2.

PubMed

Hovey, Liam; Fowler, C Andrew; Mahling, Ryan; Lin, Zesen; Miller, Mark Stephen; Marx, Dagan C; Yoder, Jesse B; Kim, Elaine H; Tefft, Kristin M; Waite, Brett C; Feldkamp, Michael D; Yu, Liping; Shea, Madeline A

2017-05-01

Several members of the voltage-gated sodium channel family are regulated by calmodulin (CaM) and ionic calcium. The neuronal voltage-gated sodium channel Na V 1.2 contains binding sites for both apo (calcium-depleted) and calcium-saturated CaM. We have determined equilibrium dissociation constants for rat Na V 1.2 IQ motif [IQRAYRRYLLK] binding to apo CaM (~3nM) and (Ca 2+ ) 4 -CaM (~85nM), showing that apo CaM binding is favored by 30-fold. For both apo and (Ca 2+ ) 4 -CaM, NMR demonstrated that Na V 1.2 IQ motif peptide (Na V 1.2 IQp ) exclusively made contacts with C-domain residues of CaM (CaM C ). To understand how calcium triggers conformational change at the CaM-IQ interface, we determined a solution structure (2M5E.pdb) of (Ca 2+ ) 2 -CaM C bound to Na V 1.2 IQp . The polarity of (Ca 2+ ) 2 -CaM C relative to the IQ motif was opposite to that seen in apo CaM C -Na v 1.2 IQp (2KXW), revealing that CaM C recognizes nested, anti-parallel sites in Na v 1.2 IQp . Reversal of CaM may require transient release from the IQ motif during calcium binding, and facilitate a re-orientation of CaM N allowing interactions with non-IQ Na V 1.2 residues or auxiliary regulatory proteins interacting in the vicinity of the IQ motif. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrative medicine or infiltrative pseudoscience?

PubMed

Li, Ben; Forbes, Thomas L; Byrne, John

2018-01-02

Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS).

PubMed

Neiberg, Rebecca H; Aickin, Mikel; Grzywacz, Joseph G; Lang, Wei; Quandt, Sara A; Bell, Ronny A; Arcury, Thomas A

2011-04-01

There are widespread assumptions that a large proportion of American adults use a variety of complementary and alternative medicine (CAM) therapies. The goal of this study is to explore the clustering or linkages among CAM categories in the general population. Linkset analysis and data from the 2002 National Health Interview Survey (NHIS) were used to address two specific aims. First, the dominant linkages of CAM categories used by the same individual were delineated, and population estimates were generated of the percentage of American adults using different linksets of CAM categories. Second, it was determined whether dominant linkages of CAM modalities differ by age, gender, ethnicity, and education. Linkset analysis, a method of estimating co-occurrence beyond chance, was used on data from the 2002 NHIS (N = 29,862) to identify possible sets of CAM use. Most adults use CAM therapies from a single category. Approximately 20% of adults combined two CAM categories, with the combination of mind-body therapies and biologically based therapies estimated to be most common. Only 5% of adults use therapies representing three or more CAM categories. Combining therapies across multiple CAM categories was more common among those 46-64, women, whites, and those with a college education. The results of this study allow researchers to refine descriptions of CAM use in the adult population. Most adults do not use a wide assortment of CAM; most use therapies within a single CAM category. Sets of CAM use were found to differ by age, gender, ethnicity, and education in ways consistent with previous research.

Women's reasons for complementary and alternative medicine use: racial/ethnic differences.

PubMed

Chao, Maria T; Wade, Christine; Kronenberg, Fredi; Kalmuss, Debra; Cushman, Linda F

2006-10-01

Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments.

Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon

PubMed Central

Anouti, Bilal; Haibe, Yolla

2017-01-01

Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted. PMID:28912824

Complementary and alternative medicine in the undergraduate medical curriculum: a survey of Korean medical schools.

PubMed

Kim, Do Yeun; Park, Wan Beom; Kang, Hee Cheol; Kim, Mi Jung; Park, Kyu-Hyun; Min, Byung-Il; Suh, Duk-Joon; Lee, Hye Won; Jung, Seung Pil; Chun, Mison; Lee, Soon Nam

2012-09-01

The current status of complementary and alternative medicine (CAM) education in Korean medical schools is still largely unknown, despite a growing need for a CAM component in medical education. The prevalence, scope, and diversity of CAM courses in Korean medical school education were evaluated. Participants included academic or curriculum deans and faculty at each of the 41 Korean medical schools. A mail survey was conducted from 2007 to 2010. Replies were received from all 41 schools. CAM was officially taught at 35 schools (85.4%), and 32 schools (91.4%) provided academic credit for CAM courses. The most common courses were introduction to CAM or integrative medicine (88.6%), traditional Korean medicine (57.1%), homeopathy and naturopathy (31.4%), and acupuncture (28.6%). Educational formats included lectures by professors and lectures and/or demonstrations by practitioners. The value order of core competencies was attitude (40/41), knowledge (32/41), and skill (6/41). Reasons for not initiating a CAM curriculum were a non-evidence-based approach in assessing the efficacy of CAM, insufficiently reliable reference resources, and insufficient time to educate students in CAM. This survey reveals heterogeneity in the content, format, and requirements among CAM courses at Korean medical schools. Korean medical school students should be instructed in CAM with a more consistent educational approach to help patients who participate in or demand CAM.

Expression of L1-CAM and ADAM10 in human colon cancer cells induces metastasis.

PubMed

Gavert, Nancy; Sheffer, Michal; Raveh, Shani; Spaderna, Simone; Shtutman, Michael; Brabletz, Thomas; Barany, Francis; Paty, Phillip; Notterman, Daniel; Domany, Eytan; Ben-Ze'ev, Avri

2007-08-15

L1-CAM, a neuronal cell adhesion receptor, is also expressed in a variety of cancer cells. Recent studies identified L1-CAM as a target gene of beta-catenin-T-cell factor (TCF) signaling expressed at the invasive front of human colon cancer tissue. We found that L1-CAM expression in colon cancer cells lacking L1-CAM confers metastatic capacity, and mice injected in their spleen with such cells form liver metastases. We identified ADAM10, a metalloproteinase that cleaves the L1-CAM extracellular domain, as a novel target gene of beta-catenin-TCF signaling. ADAM10 overexpression in colon cancer cells displaying endogenous L1-CAM enhanced L1-CAM cleavage and induced liver metastasis, and ADAM10 also enhanced metastasis in colon cancer cells stably transfected with L1-CAM. DNA microarray analysis of genes induced by L1-CAM in colon cancer cells identified a cluster of genes also elevated in a large set of human colon carcinoma tissue samples. Expression of these genes in normal colon epithelium was low. These results indicate that there is a gene program induced by L1-CAM in colon cancer cells that is also present in colorectal cancer tissue and suggest that L1-CAM can serve as target for colon cancer therapy.

Women's Reasons for Complementary and Alternative Medicine Use: Racial/Ethnic Differences

PubMed Central

CHAO, MARIA T.; WADE, CHRISTINE; KRONENBERG, FREDI; KALMUSS, DEBRA; CUSHMAN, LINDA F.

2009-01-01

Objectives Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. Design A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Results Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Conclusions Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments. PMID:17034277

Complementary and alternative medicine use by Canadian university students.

PubMed

Teper, Amy M; Tsai, Ellen

2008-01-01

Studies investigating Complementary and Alternative Medicine (CAM) prevalence are outdated and are generalized across different demographic groups due to their national scope. Determining trends among specific populations is necessary to gain insight into the growing popularity of CAM. To determine the prevalence and factors associated with CAM use among Canadian university undergraduate students and to determine student views regarding CAM research, education and policy-making decisions. Two arbitrarily selected undergraduate student classes at Queen's University were surveyed for this cross-sectional descriptive study. Information was provided by 128 respondents via questionnaire (75% response rate) on key demographics, CAM use and satisfaction with mainstream Canadian healthcare. Upon completion of the survey, voluntary participation was requested for the interview portion resulting in 7 semi-structured qualitative interviews. Of the 128 participants, 90 (70%) claimed to be users of at least one CAM modality. Female gender was strongly associated with CAM use (p<0.001). Other characteristics that may be correlated include being enrolled in a health-related academic program, being dissatisfied with certain aspects of the healthcare system and having parents who use CAM. The majority of respondents desired more research and education on CAM and more collaboration between the two healthcare streams. Canadian university undergraduate students are active CAM users and interest in CAM is high among this population. Further investigation is required to ensure that students are using CAM safely and appropriately.

Field evaluation of unlighted overhead guide signs using older drivers : executive summary report.

DOT National Transportation Integrated Search

2003-08-01

Problem: In the preceding Unlighted Overhead Guide : Sign Feasibility Study, it was determined that : the lighting of overhead guide signs on : freeways could be eliminated if white : microprismatic Type VII or Type IX legends : were used on green be...

High-Redshift SNe with Subaru and HST

NASA Astrophysics Data System (ADS)

Rubin, David; Suzuki, Nao; Regnault, Nicolas; Aldering, Gregory; Amanullah, Rahman; Antilogus, Pierre; Astier, Pierre; Barbary, Kyle; Betoule, Marc; Boone, Kyle Robert; Currie, Miles; Deustua, Susana; Doi, Mamoru; Fruchter, Andrew; Goobar, Ariel; Hayden, Brian; Hazenberg, Francois; Hook, Isobel; Huang, Xiaosheng; Jiang, Jian; Kato, Takahiro; Kim, Alex; Kowalski, Marek; Lidman, Chris; Linder, Eric; Maeda, Keiichi; Morokuma, Tomoki; Nordin, Jakob; Pain, Reynald; Perlmutter, Saul; Ruiz-Lapuente, Pilar; Sako, Masao; Myers Saunders, Clare; Spadafora, Anthony L.; Tanaka, Masaomi; Tominaga, Nozomu; Yasuda, Naoki; Yoshida, Naoki

2018-01-01

High-redshift type Ia supernovae are crucial for constraining any time variation in dark energy. Here, we present the first discoveries and light curves from the SUbaru Supernovae with Hubble Infrared (SUSHI) program, which combines high-redshift SN discoveries from the Subaru Strategic Program (SSP, as well as other Subaru time) with HST WFC3 IR followup. This program efficiently uses the wide field and high collecting area of Subaru Hyper Suprime-Cam for optical light curves, but still obtains a precision NIR color. We are on track to double the number of well-measured SNe Ia at z > 1.1, triggering on 23 SNe Ia in our first season.

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, Francis J.

1985-01-01

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270.degree. around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass 74 of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions.

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, F.J.

1985-01-22

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270[degree] around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions. 7 figs.

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

PubMed Central

2014-01-01

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges. PMID:24499316

Use of complementary and alternative medicine (CAM) by parents in their children and adolescents with epilepsy - Prevelance, predictors and parents' assessment.

PubMed

Hartmann, Nicole; Neininger, Martina P; Bernhard, Matthias K; Syrbe, Steffen; Nickel, Petra; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid

2016-01-01

The use of complementary and alternative medicine (CAM) is popular. Parents of children suffering from epilepsy may also consider administering CAM to their children. Systematic data about frequency of and motivations for CAM use, however, are scarce. In a university hospital's neuropaediatric department parents of patients aged 0-18 years suffering from epilepsy were consecutively invited to take part in a structured interview during 4 months in 2014. Of the invited parents, 164/165 (99%) agreed to participate. From those, 21/164 (13%) stated that they used CAM in their child. The highest independent predictive value of CAM use was the occurrence of adverse drug events (ADE) of anticonvulsants as judged by parents. Patients affected by ADE had a 5.6 higher chance of receiving CAM compared to patients without ADE. Most commonly used were homeopathy (14/21, 67%) and osteopathy (12/21, 57%). The internet was the most frequently used source of information (14/21, 67%). Of the parents, 10/21 (48%) described positive effects of CAM on seizure frequency, 12/21 (57%) on general condition of their child, and 20/21 (95%) wished to continue CAM for epilepsy therapy. From the non-users of CAM, 91/143 (66%) expressed the desire to learn more about CAM for epilepsy therapy. Our study was performed in a university hospital in a large urban city in Eastern Germany. CAM user rates can differ in other parts of Germany and Europe, in other institutions and for chronic diseases other than epilepsy. The main reason for CAM use was the occurrence of ADE of anticonvulsants. More than half of the parents saw a benefit of CAM for their children. Almost all parents wished to continue CAM use, even those who did not see concrete positive effects. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

PubMed

Gok Metin, Zehra; Izgu, Nur; Karadas, Canan; Arikan Donmez, Ayse

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

Preventive Screening of Women Who Use Complementary and Alternative Medicine Providers

PubMed Central

Tyree, Patrick T.; Lafferty, William E.

2009-01-01

Abstract Background Many women use complementary and alternative medicine (CAM). Although CAM use has been associated with reductions in conventionally recommended pediatric preventive care (e.g., vaccination), little is known about associations between CAM use and receipt of recommended preventive screening in women. Methods Using Washington State insurance data from 2000 to 2003, the authors generated clustered logistic regression models, examining associations between provider-based CAM use and receipt of screening tests for Chlamydia trachomatis, breast cancer, and cervical cancer: (1) contrasting women who used CAM providers only (alternative use) and women who used both conventional and CAM providers (complementary use) with women who used conventional care only and (2) testing associations between screening and use of four specific CAM provider types—naturopathic physicians, chiropractors, massage therapists, and acupuncturists. Results Both alternative and complementary use was associated with reduced Chlamydia screening. Cancer screening increased with complementary use but decreased with alternative use of CAM. Use of naturopathy was associated with decreased mammography, whereas all four CAM therapies were positively associated with Papanicolaou testing. Conclusions When used in conjunction with conventional care, use of provider-based CAM may signal high interest in various types of health-promoting behavior, including cancer screening. Negative associations between CAM and Chlamydia screening and between naturopathy and mammography require additional study. Interventions with CAM providers and their patients, aimed at improving rates of conventionally recommended screening, might encourage greater focus on preventive care, an important task when CAM providers serve as women's only contact with the healthcare system. PMID:19630554

Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine.

PubMed

Ebel, Marie-Desirée; Rudolph, Ivonne; Keinki, Christian; Hoppe, Andrea; Muecke, Ralph; Micke, Oliver; Muenstedt, Karsten; Huebner, Jutta

2015-08-01

A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.

Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults.

PubMed

Van den Bulck, Jan; Custers, Kathleen

2010-04-01

The use of complementary and alternative medicine (CAM) is widespread, even among people who use conventional medicine. Positive beliefs about CAM are common among physicians and medical students. Little is known about the beliefs regarding CAM among the general public. Among science students, belief in CAM was predicted by belief in the paranormal. In a cross-sectional study, 712 randomly selected adults (>18 years old) responded to the CAM Health Belief Questionnaire (CHBQ) and a paranormal beliefs scale. CAM beliefs were very prevalent in this sample of adult Flemish men and women. Zero-order correlations indicated that belief in CAM was associated with age (r = 0.173 P < 0.001) level of education (r = -0.079 P = 0.039) social desirability (r = -0.119 P = 0.002) and paranormal belief (r = 0.365 P < 0.001). In a multivariate model, two variables predicted CAM beliefs. Support for CAM increased with age (regression coefficient: 0.01; 95% confidence interval (CI): 0.006 to 0.014), but the strongest relationship existed between support for CAM and beliefs in the paranormal. Paranormal beliefs accounted for 14% of the variance of the CAM beliefs (regression coefficient: 0.376; 95%: CI 0.30-0.44). The level of education (regression coefficient: 0.06; 95% CI: -0.014-0.129) and social desirability (regression coefficient: -0.023; 95% CI: -0.048-0.026) did not make a significant contribution to the explained variance (<0.1%, P = 0.867). Support of CAM was very prevalent in this Flemish adult population. CAM beliefs were strongly associated with paranormal beliefs.

A Temporal Credential-Based Mutual Authentication with Multiple-Password Scheme for Wireless Sensor Networks

PubMed Central

Zhang, Ruisheng; Liu, Qidong

2017-01-01

Wireless sensor networks (WSNs), which consist of a large number of sensor nodes, have become among the most important technologies in numerous fields, such as environmental monitoring, military surveillance, control systems in nuclear reactors, vehicle safety systems, and medical monitoring. The most serious drawback for the widespread application of WSNs is the lack of security. Given the resource limitation of WSNs, traditional security schemes are unsuitable. Approaches toward withstanding related attacks with small overhead have thus recently been studied by many researchers. Numerous studies have focused on the authentication scheme for WSNs, but most of these works cannot achieve the security performance and overhead perfectly. Nam et al. proposed a two-factor authentication scheme with lightweight sensor computation for WSNs. In this paper, we review this scheme, emphasize its drawbacks, and propose a temporal credential-based mutual authentication with a multiple-password scheme for WSNs. Our scheme uses multiple passwords to achieve three-factor security performance and generate a session key between user and sensor nodes. The security analysis phase shows that our scheme can withstand related attacks, including a lost password threat, and the comparison phase shows that our scheme involves a relatively small overhead. In the comparison of the overhead phase, the result indicates that more than 95% of the overhead is composed of communication and not computation overhead. Therefore, the result motivates us to pay further attention to communication overhead than computation overhead in future research. PMID:28135288

A Temporal Credential-Based Mutual Authentication with Multiple-Password Scheme for Wireless Sensor Networks.

PubMed

Liu, Xin; Zhang, Ruisheng; Liu, Qidong

2017-01-01

Wireless sensor networks (WSNs), which consist of a large number of sensor nodes, have become among the most important technologies in numerous fields, such as environmental monitoring, military surveillance, control systems in nuclear reactors, vehicle safety systems, and medical monitoring. The most serious drawback for the widespread application of WSNs is the lack of security. Given the resource limitation of WSNs, traditional security schemes are unsuitable. Approaches toward withstanding related attacks with small overhead have thus recently been studied by many researchers. Numerous studies have focused on the authentication scheme for WSNs, but most of these works cannot achieve the security performance and overhead perfectly. Nam et al. proposed a two-factor authentication scheme with lightweight sensor computation for WSNs. In this paper, we review this scheme, emphasize its drawbacks, and propose a temporal credential-based mutual authentication with a multiple-password scheme for WSNs. Our scheme uses multiple passwords to achieve three-factor security performance and generate a session key between user and sensor nodes. The security analysis phase shows that our scheme can withstand related attacks, including a lost password threat, and the comparison phase shows that our scheme involves a relatively small overhead. In the comparison of the overhead phase, the result indicates that more than 95% of the overhead is composed of communication and not computation overhead. Therefore, the result motivates us to pay further attention to communication overhead than computation overhead in future research.

Potential Role of Axonal Chemorepellent Slit2 in Modulating Adventitial Inflammation in a Rat Carotid Artery Balloon Injury Model

PubMed Central

Liu, Dong; Xiao, Yan; Subramanian, Romesh R.; Okamoto, Ei-ichi; Wilcox, Josiah N.; Anderson, Leonard; De Leon, Hector

2016-01-01

Leukocyte infiltration of adventitial and perivascular tissues is an early event in the development of vascular remodeling after injury. We investigated whether Slit/Robo—an axonal chemorepellent system in vertebrate and invertebrate development—is activated during the inflammatory phase that follows endothelial denudation. Using the rat carotid artery model of angioplasty, we conducted a time course analysis of mRNAs encoding Slit ligands (Slit2 and Slit3) and Robo receptors (Robo1, Robo2 and Robo4), as well as proinflammatory cell adhesion molecule (CAM) genes. Adventitial inflammatory cells were counted in immunostained arterial sections. E-selectin, vascular CAM-1 (VCAM-1), and intercellular CAM-1 (ICAM-1) were upregulated 2–3 hr after injury, followed by infiltration of neutrophils and monocytes as evidenced by real-time PCR, in situ hybridization, and immunohistochemistry. Slit2, Slit3, and Robo genes exhibited no expression changes at 3 hr; however, they were markedly upregulated 1 day after angioplasty. ICAM-1 expression was reduced by 50%, and the number of adventitial neutrophils decreased by >75% one day after angioplasty. Slit2 has been shown to be a potent chemorepelent of leukocytes, endothelial cells and smooth muscle cells. Thus, we decided to further investigate the localization of Slit2 in injured vessels. Immunohistochemical stainings revealed the presence of Slit2 within the vessel wall and in the perivascular vasa vasorum of naive and injured arteries. Double immunohistochemical analyses showed that infiltrating monocytes expressed Slit2 in the perivascular and adventitial tissues of injured arteries 1 and 3 days postangioplasty. In addition, recombinant full-length Slit2 and Slit2-N/1118, an N-terminal fragment of Slit2, inhibited stromal cell-derived factor 1 (SDF-1)-mediated migration of circulating rat peripheral blood mononuclear cells. In summary, adventitial activation of CAM genes and neutrophil infiltration preceded upregulation of Slit/Robo genes. Sli2 expression colocalized with infiltrating inflammatory cells in the adventitial layer. This temporospatial association suggests that leukocyte chemorepellent Slit2 may be involved in halting the adventitial accumulation of inflammatory cells in injured vessels. PMID:26841069

Phase II evaluation of anti-MAdCAM antibody PF-00547659 in the treatment of Crohn's disease: report of the OPERA study.

PubMed

Sandborn, William J; Lee, Scott D; Tarabar, Dino; Louis, Edouard; Klopocka, Maria; Klaus, Jochen; Reinisch, Walter; Hébuterne, Xavier; Park, Dong-Il; Schreiber, Stefan; Nayak, Satyaprakash; Ahmad, Alaa; Banerjee, Anindita; Brown, Lisa S; Cataldi, Fabio; Gorelick, Kenneth J; Cheng, John B; Hassan-Zahraee, Mina; Clare, Robert; D'Haens, Geert R

2017-10-05

This phase II, randomised, double-blind, placebo-controlled clinical trial was designed to evaluate the efficacy and safety of PF-00547659, a fully human monoclonal antibody that binds to human mucosal addressin cell adhesion molecule (MAdCAM) to selectively reduce lymphocyte homing to the intestinal tract, in patients with moderate-to-severe Crohn's disease (CD). Eligible adults were aged 18-75 years, with active moderate-to-severe CD (Crohn's Disease Activity Index (CDAI) 220-450), a history of failure or intolerance to antitumour necrosis factor and/or immunosuppressive agents, high-sensitivity C reactive protein >3.0 mg/L and ulcers on colonoscopy. Patients were randomised to PF-00547659 22.5 mg, 75 mg or 225 mg or placebo. The primary endpoint was CDAI 70-point decrease from baseline (CDAI-70) at week 8 or 12. In all, 265 patients were eligible for study entry. Although CDAI-70 response was not significantly different with placebo versus PF-00547659 treatment at weeks 8 or 12, remission rate was greater in patients with higher baseline C reactive protein (>5 mg/L vs >18.8 mg/L, respectively). Soluble MAdCAM decreased significantly from baseline to week 2 in a dose-related manner and remained low during the study in PF-00547659-treated patients. Circulating β 7 + CD4+ central memory T-lymphocytes increased at weeks 8 and 12 with PF-00547659 treatment. No safety signal was seen. Clinical endpoint differences between PF-00547659 and placebo did not reach statistical significance in patients with moderate-to-severe CD. PF-00547659 was pharmacologically active, as shown by a sustained dose-related decrease in soluble MAdCAM and a dose-related increase in circulating β 7 + central memory T cells. NCT01276509; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Use of Complementary and Alternative Medicine among Lebanese Adults: Results from a National Survey

PubMed Central

Naja, F.; Alameddine, M.; Itani, L.; Shoaib, H.; Hariri, D.; Talhouk, S.

2015-01-01

Objective. To examine the prevalence and correlates of Complementary and Alternative Medicine (CAM) use in Lebanon. Methods. A cross-sectional survey was conducted through face to face interviews on a nationally representative sample of 1,475 Lebanese adults. The survey questionnaire explored the sociodemographic and health related characteristics as well as the types and modes of CAM use. The main outcome in this study was the use of CAM during the last 12 months. Results. Prevalence of CAM use was 29.87% with “folk herbs” being the most commonly used (75%). Two out of five CAM users indicated using it as alternative to conventional therapies and only 28.4% of users disclosed the use of CAM to their physician. CAM use was significantly associated with higher income, presence of a chronic disease, and lack of access to needed health care. Lower odds of CAM use were observed among older adults and those with a higher education level. Conclusions. This study revealed a high prevalence of CAM use in Lebanon. Health policy and decision makers need to facilitate proper regulation and integration of CAM into mainstream medicine and educate health care providers and the public alike on the safe and effective use of CAM therapies. PMID:26106436

Negotiating complementary and alternative medicine use in primary care visits with older patients

PubMed Central

Koenig, Christopher J.; Ho, Evelyn Y.; Yadegar, Vivien; Tarn, Derjung M.

2013-01-01

Objective To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Methods Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Results Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician–patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Conclusion Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Practice implications Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. PMID:22483672

Complementary and alternative medicine use among adults in Enugu, Nigeria.

PubMed

Onyiapat, Jane-Lovena E; Okoronkwo, Ijeoma L; Ogbonnaya, Ngozi P

2011-03-04

Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted.

Temporal and spatial transcriptomic and microRNA dynamics of CAM photosynthesis in pineapple.

PubMed

Wai, Ching M; VanBuren, Robert; Zhang, Jisen; Huang, Lixian; Miao, Wenjing; Edger, Patrick P; Yim, Won C; Priest, Henry D; Meyers, Blake C; Mockler, Todd; Smith, J Andrew C; Cushman, John C; Ming, Ray

2017-10-01

The altered carbon assimilation pathway of crassulacean acid metabolism (CAM) photosynthesis results in an up to 80% higher water-use efficiency than C 3 photosynthesis in plants making it a potentially useful pathway for engineering crop plants with improved drought tolerance. Here we surveyed detailed temporal (diel time course) and spatial (across a leaf gradient) gene and microRNA (miRNA) expression patterns in the obligate CAM plant pineapple [Ananas comosus (L.) Merr.]. The high-resolution transcriptome atlas allowed us to distinguish between CAM-related and non-CAM gene copies. A differential gene co-expression network across green and white leaf diel datasets identified genes with circadian oscillation, CAM-related functions, and source-sink relations. Gene co-expression clusters containing CAM pathway genes are enriched with clock-associated cis-elements, suggesting circadian regulation of CAM. About 20% of pineapple microRNAs have diel expression patterns, with several that target key CAM-related genes. Expression and physiology data provide a model for CAM-specific carbohydrate flux and long-distance hexose transport. Together these resources provide a list of candidate genes for targeted engineering of CAM into C 3 photosynthesis crop species. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

Negotiating complementary and alternative medicine use in primary care visits with older patients.

PubMed

Koenig, Christopher J; Ho, Evelyn Y; Yadegar, Vivien; Tarn, Derjung M

2012-12-01

To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician-patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg.

PubMed

Dalla Libera, D; Colombo, B; Pavan, G; Comi, G

2014-05-01

The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p < 0.05). 73 % patients chose CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM therapies or to directly interact with CAM trained experts, in order to coordinate an integrative approach to health, as especially required in paediatric headache patients and their parents. Further studies are required to investigate safety and efficacy of CAM in pediatric headache, as a possible side-medicine to conventional pharmacological approach.

The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia.

PubMed

Abuelgasim, Khadega A; Alsharhan, Yousef; Alenzi, Tariq; Alhazzani, Abdulaziz; Ali, Yosra Z; Jazieh, Abdul Rahman

2018-03-12

A significant proportion of cancer patients use complementary and alternative medicine (CAM) along with conventional therapies (CT), whereas a smaller proportion delay or defer CT in favor of CAM. Previous studies exploring CAM use among cancer patients in the Middle East region have shown discrepant results. This study investigates the prevalence and pattern of CAM use by Saudi cancer patients. It also discusses the possible benefits and harm related to CAM use by cancer patients, and it explores the beliefs patients hold and their transparency with health care providers regarding their CAM use. A cross-sectional study was conducted in oncology wards and outpatient clinics by using face-to-face interviews with the participants. A total of 156 patients with a median age of 50 years (18-84) participated in the study. The prevalence of CAM use was 69.9%; the most prominent types of CAM were those of a religious nature, such as supplication (95.4%), Quran recitation (88.1%), consuming Zamzam water (84.4%), and water upon which the Quran has been read (63.3%). Drinking camel milk was reported by 24.1% of CAM users, whereas camel urine was consumed by 15.7%. A variety of reasons were given for CAM use: 75% reported that they were using CAM to treat cancer, enhance mood (18.3%),control pain (11.9%), enhance the immune system (11%),increase physical fitness (6.4%), and improve appetite (4.6%). Thirty percent of CAM users had discussed the issue with their doctors; only 7.7% had done so with their nurses. The use of CAM, including camel products, is highly prevalent among cancer patients in the Middle East, but these patients do not necessarily divulge their CAM use to their treating physicians and nurses. Although CAM use can be beneficial, some can be very harmful, especially for cancer patients. Association is known between camel products and brucellosis and Middle East respiratory syndrome coronavirus (MERS-CoV). Both can lead to tremendous morbidity in immune-compromised patients. Doctor-patient communication regarding CAM use is of paramount importance in cancer care.

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

PubMed

Dhanoa, Amreeta; Yong, Tze Lek; Yeap, Stephanie Jin Leng; Lee, Isaac Shi Zhung; Singh, Vivek Ajit

2014-10-17

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients. All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire. Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors. This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

Field evaluation of unlighted overhead guide signs using older drivers : research implementation plan.

DOT National Transportation Integrated Search

2006-04-01

STATEMENT OF NEED: In the preceding Unlighted Overhead Guide Sign Feasibility Study, it was determined that the lighting of overhead : guide signs on freeways could be eliminated if white micro-prismatic Type VII or Type IX legends were used on : gre...

GLANCE - calculatinG heaLth impActs of atmospheric pollutioN in a Changing climatE

NASA Astrophysics Data System (ADS)

Vogel, Leif; Faria, Sérgio; Markandya, Anil

2016-04-01

Current annual global estimates of premature deaths from poor air quality are estimated in the range of 2.6-4.4 million, and 2050 projections are expected to double against 2010 levels. In Europe, annual economic burdens are estimated at around 750 bn €. Climate change will further exacerbate air pollution burdens; therefore, a better understanding of the economic impacts on human societies has become an area of intense investigation. European research efforts are being carried out within the MACC project series, which started in 2005. The outcome of this work has been integrated into a European capacity for Earth Observation, the Copernicus Atmospheric Monitoring Service (CAMS). In MACC/CAMS, key pollutant concentrations are computed at the European scale and globally by employing chemically-driven advanced transport models. The project GLANCE (calculatinG heaLth impActs of atmospheric pollutioN in a Changing climatE) aims at developing an integrated assessment model for calculating the health impacts and damage costs of air pollution at different physical scales. It combines MACC/CAMS (assimilated Earth Observations, an ensemble of chemical transport models and state of the art ECWMF weather forecasting) with downscaling based on in-situ network measurements. The strengthening of modelled projections through integration with empirical evidence reduces errors and uncertainties in the health impact projections and subsequent economic cost assessment. In addition, GLANCE will yield improved data accuracy at different time resolutions. This project is a multidisciplinary approach which brings together expertise from natural sciences and socio economic fields. Here, its general approach will be presented together with first results for the years 2007 - 2012 on the European scale. The results on health impacts and economic burdens are compared to existing assessments.

Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration

PubMed Central

Wieland, L. Susan; Manheimer, Eric; Berman, Brian M.

2011-01-01

Over the past decade the Cochrane Collaboration has been an increasingly important source of information on complementary and alternative medicine (CAM) therapies. From 2007 to 2008 the Cochrane CAM Field developed a topics list that allowed us to categorize all 396 Cochrane reviews related to CAM (as of The Cochrane Library, Issue 4, 2009). This topics list is an advance in making Cochrane reviews on CAM topics accessible to the public. In this paper, we discuss challenges in developing the topics list, including developing an operational definition of CAM, deciding which reviews should be included within the CAM Field’s scope, developing the structured list of CAM Field-specific topics, and determining where in the topics list the reviews should be placed. Although aspects of our operational definition of CAM are open to revision, a standardized definition provides us with an objective, reproducible and systematic method for defining and classifying CAM therapies. PMID:21717826

Use and interest in complementary and alternative medicine among college students seeking healthcare at a university campus student health center.

PubMed

Nguyen, Jannett; Liu, Michael A; Patel, Rohini J; Tahara, Keli; Nguyen, Annie L

2016-08-01

There is growing data on complementary and alternative medicine (CAM) preferences among college students. While several studies have focused on undergraduate students, there is limited data on graduate students. Cross sectional analysis of undergraduate and graduate students seeking medical care at the University of California Irvine's Student Health Center (SHC). The survey assessed previous CAM use and preferences for future CAM use and education. The majority (67.0%) had used CAM within the last year, 27.0% would use CAM for their current health condition, and 51.9% would consider CAM for their current health condition if they were more knowledgeable. Most respondents desired more CAM education and indicated that they would try CAM modalities if covered under insurance. Most college students requested more knowledge to assist in their decisions to use CAM. These findings provide insight for health centers on the preferences of college student patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cam-Operated Pitch-Change Apparatus

NASA Technical Reports Server (NTRS)

Barnes, P. E. (Inventor)

1978-01-01

A pitch-change apparatus for a ducted thrust fan having a plurality of variable pitch blades employs a camming ring mounted coaxially at the hub at an axially fixed station along the hub axis for rotation about the hub axis both with the blades and relative to the blades. The ring has a generally spherical outer periphery and a plurality of helical camming grooves extending in a generally spherical plane on the periphery. Each of the variable pitch blades is connected to a pitch-change horn having a cam follower mounted on its outer end, and the camming ring and the horns are so arranged about the hub axis that the plurality of followers on the horns engage respectively the plurality of helical camming grooves. Rotary drive means rotates the camming ring relative to the blades to cause blade pitch to be changed through the cooperative operation of the camming grooves on the ring and the cam followers on the pitch-change horns.

Attitudes, Patterns of Recommendation, and Communication of Pediatric Providers About Complementary and Alternative Medicine in a Large Metropolitan Children’s Hospital

PubMed Central

Kundu, Anjana; Tassone, Rosalie F.; Jimenez, Nathalia; Seidel, Kristy; Valentine, Jessica K.; Pagel, Paul S.

2014-01-01

The authors conducted an Email survey of their medical staff to explore the attitudes, patterns of recommendation, and communication of pediatric providers about complementary and alternative medicine (CAM) in a large metropolitan children’s hospital. Two thirds of the respondents reported awareness about their patients’ CAM therapy use (65%) and recommended CAM therapy to their patients (67%). Providers who reported personal use of CAM (71%) were more likely to recommend CAM to their patients compared with those who do not (76% vs 45%; P < .05). One half of pediatric providers reported occasional consultation with their patient’s CAM provider, but bidirectional communication was rare (4%). Specific changes in care based on a CAM provider’s recommendations were also unusual (4%). Despite the positive attitudes about and willingness to recommend CAM by pediatric providers, communication between these clinicians and CAM providers may be less than ideal. PMID:21127080

Complementary and Alternative Medicine Use in Infertility: Cultural and Religious Influences in a Multicultural Canadian Setting

PubMed Central

Read, Suzanne C.; Carrier, Marie-Eve; Whitley, Rob; Gold, Ian; Tulandi, Togas

2014-01-01

Abstract Objectives: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use. Design: Qualitative semi-structured interviews using thematic analysis. Settings/location: Two infertility clinics in Montreal, Quebec, Canada. Participants: An ethnoculturally varied sample of 32 heterosexual infertile couples. Results: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. Participants' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility. Conclusions: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care. PMID:25127071

Effect of gel formation on the dissolution behavior of clarithromycin tablets.

PubMed

Inukai, Koki; Takiyama, Kei; Noguchi, Shuji; Iwao, Yasunori; Itai, Shigeru

2017-04-15

Clarithromycin (CAM) is a macrolide antibiotic that is widely used at clinical sites. We found that release of CAM is suppressed when tablets of CAM were exposed to an external solvent containing carboxylate buffers such as citrate. The suppressed release of CAM can be attributed to the formation of gels on the tablet surfaces, which inhibits penetration of the solvent into the tablet and thus disintegration of the tablets. Delayed disintegration of the tablets was also observed for commercial tablets. This suggests that taking CAM and carboxylates at the same time might be avoided. The crystal structure of CAM citrate reveals that molecular chains of CAM are cross-linked by hydrogen bond between citrate groups in the crystal. The crystal structure indicates that cross-linked CAM chains of the three-dimensional mesh structure might also be formed in high concentration CAM solutions in the presence of carboxylates, resulting in gel formation. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study

PubMed Central

2014-01-01

Background Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon. Objective To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM. Results A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time. PMID:24906634

Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study.

PubMed

Bahall, Mandreker

2017-06-30

Sophisticated conventional medicine (CM) has brought significant advances to cancer prevention, detection, and treatment. However, many cancer patients still turn to complementary and alternative medicine (CAM) treatment. This study explored the prevalence, patterns, and perceived value of CAM among cancer patients. This quantitative descriptive study was conducted between March 1, 2015, and July 31, 2015, among a cross-sectional, convenience sample of patients from the Oncology Department of San Fernando General Hospital in Trinidad and Tobago. Face-to-face interviews were conducted at the oncology clinic and treatment suite after obtaining informed consent. Data analysis included descriptive analysis, chi-square tests, and binary logistic regression analysis. The prevalence of CAM use among a sample of 350 cancer patients was 39.1% (39.6% for breast cancer, 44.4% for prostate cancer, 37% for ovarian cancer, and 38.7% for colon cancer patients). Herbs were the most common type of CAM used (93.4%), followed by spiritual therapy (73.7%). CAM use was more prevalent among females (68.6%), Indo-Trinidadians (63.5%), and patients aged 41-50 years (37.2%). The majority (70%-80%) rated CAM efficacy on perceived value. CAM was used mainly because of a desire to try anything that might help (67.6%), followed by it being congruent with the patients' beliefs (59.1%). Patients knew about CAM mainly through friends (69.3%) and family (69.3%). Most patients were generally satisfied (93.6%) and considered CAM helpful (89.8%), but the majority never informed their health care provider of CAM use (78.8%). Patients reported the simultaneous use of more than one type of CAM, without considering or knowing of possible side-effects. The perceived value of CAM included empowerment, control, cure, and improved quality of life. CAM use was associated with age, but no predictors of CAM use could be identified. Medicinal herbs and spiritual therapy are commonly used among cancer patients because of perceived benefits and satisfaction. CAM use is more prevalent among females, Indo-Trinidadians, and patients aged 41-50 years old. There are no useful predictors of CAM use. More than one type of CAM is commonly used simultaneously without disclosure to health care providers.

Knowledge of, Attitudes Toward, and Experience of Complementary and Alternative Medicine in Western Medicine– and Oriental Medicine–Trained Physicians in Korea

PubMed Central

Lee, Sang-Il; Khang, Young-Ho; Lee, Moo-Song; Kang, Weechang

2002-01-01

Objectives. We compared knowledge of, attitudes toward, and experience with complementary and alternative medicine (CAM) among Western medicine–trained doctors (WMDs) and Oriental medicine–trained doctors (OMDs). Methods. In Korea, 502 WMDs and 500 OMDs were interviewed with a structured questionnaire. Results. OMDs held more favorable attitudes toward CAM than did WMDs. OMDs possessed a deeper understanding of and greater experience with CAM. OMDs more readily endorsed health beliefs congruent with CAM. Conclusions. In the future, CAM can be more readily used by OMDs than by WMDs. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM in Korea. An education and training system for potential CAM providers remains to be developed. PMID:12453822

Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility.

PubMed

O'Reilly, Erin; Sevigny, Marika; Sabarre, Kelley-Anne; Phillips, Karen P

2014-10-14

Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility. Ten semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine. CAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described. Integrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM's holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.

Complementary and Alternative Medicine Use and Adherence to Asthma Medications among Latino and Non-Latino White Families

PubMed Central

McQuaid, Elizabeth L.; Fedele, David A.; Adams, Sue K.; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J.; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K.; Canino, Glorisa

2013-01-01

Objective The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and Non-Latino white (NLW) children with asthma, to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use, and to assess whether CAM use was associated with decreased adherence to controller medications. Methods Participants included 574 families of children with asthma from Non-Latino White, Puerto Rican, and Dominican backgrounds from RI and from Island Puerto Rico. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately one month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Results Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in Puerto Rican families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. Conclusions CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. PMID:24602583

Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

PubMed Central

Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies.

PubMed

Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.

Comparative study of RetCamRetCam II vs. binocular ophthalmoscopy in a screening program for retinopathy of prematurity.

PubMed

Tejada-Palacios, P; Zarratea, L; Moral, M; de la Cruz-Bértolo, J

2015-08-01

To determine the performance of RetCam vs. binocular ophthalmoscopy (BIO) in a screening program for retinopathy of prematurity (ROP). Observational comparative study with prospective data collection. Examinations with RetCam (n=169) were performed on 83 infants included in a screening program for ROP and stored for analysis at a later stage. An experienced ophthalmologist examined the ocular fundus with binocular indirect ophthalmoscopy (BIO). The RetCam images were assessed for the presence of ROP, zone, grade, and presence of plus disease. RetCam and BIO data were compared by visually to estimate sensitivity, specificity, positive (VPP) and negative (VPN) predictive values. ROP disease was detected in 108 eyes with BIO, and in 74 with RetCam. Out of 306 eyes examined with RetCam, false negative results were found in 34 eyes, with no false positives. Sensitivity of RetCam exam vs. BIO was 0.68, and specificity was 0.99. Positive predictive value was 0.93 and negative predictive value was 0.85. All 34 ROP cases not detected with RetCam were in zone III or outer zone II. They were all mild and regressed spontaneously. No threshold ROP was missed with RetCam. Binocular indirect ophthalmoscopy is the reference method for the diagnosis of ROP. RetCam may be used as an alternative for ROP screening. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients.

PubMed

Conrad, A C; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Huebner, J

2014-07-01

A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. The questionnaire collected data on attitude toward CAM and experiences. Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods.

49 CFR 214.515 - Overhead covers for existing on-track roadway maintenance machines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... previously equipped with overhead covers for the operator's position, defective covers shall be repaired, and missing covers shall be reinstalled, by March 28, 2005 and thereafter maintained in accordance with the... equipped with overhead covers for the operator's position, the employer shall evaluate the feasibility of...

1. EAST SIDE OF OVERHEAD BOMB TRANSPORT RACK, WITH BUILDING ...

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

1. EAST SIDE OF OVERHEAD BOMB TRANSPORT RACK, WITH BUILDING 343 AT LEFT AND BUILDING 328 AT RIGHT. VIEW TO WEST. - Rocky Mountain Arsenal, Overhead Bomb Transport Rack, 1580 feet South of December Seventh Avenue; 860 feet West of D Street, Commerce City, Adams County, CO

Surface code implementation of block code state distillation.

PubMed

Fowler, Austin G; Devitt, Simon J; Jones, Cody

2013-01-01

State distillation is the process of taking a number of imperfect copies of a particular quantum state and producing fewer better copies. Until recently, the lowest overhead method of distilling states produced a single improved [formula: see text] state given 15 input copies. New block code state distillation methods can produce k improved [formula: see text] states given 3k + 8 input copies, potentially significantly reducing the overhead associated with state distillation. We construct an explicit surface code implementation of block code state distillation and quantitatively compare the overhead of this approach to the old. We find that, using the best available techniques, for parameters of practical interest, block code state distillation does not always lead to lower overhead, and, when it does, the overhead reduction is typically less than a factor of three.

Surface code implementation of block code state distillation

PubMed Central

Fowler, Austin G.; Devitt, Simon J.; Jones, Cody

2013-01-01

State distillation is the process of taking a number of imperfect copies of a particular quantum state and producing fewer better copies. Until recently, the lowest overhead method of distilling states produced a single improved |A〉 state given 15 input copies. New block code state distillation methods can produce k improved |A〉 states given 3k + 8 input copies, potentially significantly reducing the overhead associated with state distillation. We construct an explicit surface code implementation of block code state distillation and quantitatively compare the overhead of this approach to the old. We find that, using the best available techniques, for parameters of practical interest, block code state distillation does not always lead to lower overhead, and, when it does, the overhead reduction is typically less than a factor of three. PMID:23736868

Implicit Block ACK Scheme for IEEE 802.11 WLANs

PubMed Central

Sthapit, Pranesh; Pyun, Jae-Young

2016-01-01

The throughput of IEEE 802.11 standard is significantly bounded by the associated Medium Access Control (MAC) overhead. Because of the overhead, an upper limit exists for throughput, which is bounded, including situations where data rates are extremely high. Therefore, an overhead reduction is necessary to achieve higher throughput. The IEEE 802.11e amendment introduced the block ACK mechanism, to reduce the number of control messages in MAC. Although the block ACK scheme greatly reduces overhead, further improvements are possible. In this letter, we propose an implicit block ACK method that further reduces the overhead associated with IEEE 802.11e’s block ACK scheme. The mathematical analysis results are presented for both the original protocol and the proposed scheme. A performance improvement of greater than 10% was achieved with the proposed implementation.

Laser Transformation Hardening of Firing Zone Cutout Cams.

DTIC Science & Technology

1981-06-01

bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...salt bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...Patterns ........ ................ 8 9 Laser Beam Step Pattern ...... .................. .. 10 10 Hardness Profile, 4340 Steel

Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology

PubMed Central

Furlow, Mandi L; Patel, Divya A; Sen, Ananda; Liu, J Rebecca

2008-01-01

Background In the U.S., complementary and alternative medicine (CAM) use is most prevalent among reproductive age, educated women. We sought to determine general attitudes and approaches to CAM among obstetric and gynecology patients and physicians. Methods Obstetrician-gynecologist members of the American Medical Association in the state of Michigan and obstetric-gynecology patients at the University of Michigan were surveyed. Physician and patient attitudes and practices regarding CAM were characterized. Results Surveys were obtained from 401 physicians and 483 patients. Physicians appeared to have a more positive attitude towards CAM as compared to patients, and most reported routinely endorsing, providing or referring patients for at least one CAM modality. The most commonly used CAM interventions by patients were divergent from those rated highest among physicians, and most patients did not consult with a health care provider prior to starting CAM. Conclusion Although obstetrics/gynecology physicians and patients have a positive attitude towards CAM, physician and patients' view of the most effective CAM therapies were incongruent. Obstetrician/gynecologists should routinely ask their patients about their use of CAM with the goal of providing responsible, evidence-based advice to optimize patient care. PMID:18582380

AUTONOMOUS AND NONAUTONOMOUS REGULATION OF WNT-MEDIATED NEURONAL POLARITY BY THE C. ELEGANS ROR KINASE CAM-1

PubMed Central

Chien, Shih-Chieh Jason; Gurling, Mark; Kim, Changsung; Craft, Teresa; Forrester, Wayne; Garriga, Gian

2015-01-01

Wnts are a conserved family of secreted glycoproteins that regulate various developmental processes in metazoans. Three of the five C. elegans Wnts, CWN-1, CWN-2 and EGL-20, and the sole Wnt receptor of the Ror kinase family, CAM-1, are known to regulate the anterior polarization of the mechanosensory neuron ALM. Here we show that CAM-1 and the Frizzled receptor MOM-5 act in parallel pathways to control ALM polarity. We also show that CAM-1 has two functions in this process: an autonomous signaling function that promotes anterior polarization and a nonautonomous Wnt-antagonistic function that inhibits anterior polarization. These antagonistic activities can account for the weak ALM phenotypes displayed by cam-1 mutants. Our observations suggest that CAM-1 could function as a Wnt receptor in many developmental processes, but the analysis of cam-1 mutants may fail to reveal CAM-1’s role as a receptor in these processes because of its Wnt-antagonistic activity. In this model, loss of CAM-1 results in increased levels of Wnts that act through other Wnt receptors, masking CAM-1’s autonomous role as a Wnt receptor. PMID:25917219

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

PubMed

Team, Victoria; Canaway, Rachel; Manderson, Lenore

2011-01-01

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population.

PubMed

Hamidah, Alias; Rustam, Zainudin A; Tamil, Azmi M; Zarina, Latiff A; Zulkifli, Zakaria S; Jamal, Rahman

2009-01-01

The purpose of the current study was to determine the prevalence of use of complementary and alternative medicine (CAM) by children with cancer and to compare the characteristics of CAM users and CAM nonusers. A cross-sectional study was performed at a pediatric oncology center in Kuala Lumpur, Malaysia. The parents of 97 children with cancer were interviewed using a structured questionnaire. Overall, 84.5% of the respondents had used CAM, and most of them believed that CAM provided a boost to the immune system, and used CAM with the intention to complement conventional treatment. The most frequently used CAM was water therapy (78%), followed by spirulina (33%), vitamin C (27%), multivitamin (23%), visit to traditional healers (22%), sea cucumber (Stichopus horrens) (15%), and Chinese traditional medicine (12%). The Malay (n = 67) were using more often (93%) CAM than non-Malay (n = 30, use 67%, P = 0.001). CAM use is common among Malaysian children with cancer. Understanding the sociocultural dimension of patients' health beliefs is important to a successful treatment, and pediatric oncologists should ask for the use of CAM.

Computer-assisted surgery in the lower jaw: double surgical guide for immediately loaded implants in postextractive sites-technical notes and a case report.

PubMed

De Santis, Daniele; Canton, Luciano Claudio; Cucchi, Alessandro; Zanotti, Guglielmo; Pistoia, Enrico; Nocini, Pier Francesco

2010-01-01

Computer-assisted surgery is based on computerized tomography (CT) scan technology to plan the placement of dental implants and a computer-aided design/computer-aided manufacturing (CAD-CAM) technology to create a custom surgical template. It provides guidance for insertion implants after analysis of existing alveolar bone and planning of implant position, which can be immediately loaded, therefore achieving esthetic and functional results in a surgical stage. The absence of guidelines to treat dentulous areas is often due to a lack of computer-assisted surgery. The authors have attempted to use this surgical methodology to replace residual teeth with an immediate implantoprosthetic restoration. The aim of this case report is to show the possibility of treating a dentulous patient by applying a computer-assisted surgical protocol associated with the use of a double surgical template: one before extraction and a second one after extraction of selected teeth.

Differential expression and functional analysis of three calmodulin isoforms in germinating pea (Pisum sativum L.) seeds.

PubMed

Duval, Frédéric D; Renard, Michelle; Jaquinod, Michel; Biou, Valérie; Montrichard, Françoise; Macherel, David

2002-11-01

Implication of the ubiquitous, highly conserved, Ca2+ sensor calmodulin (CaM) in pea seed germination has been investigated. Mass spectrometry analysis of purified CaM revealed the coexistence in seeds of three protein isoforms, diverging from each other by single amino acid substitution in the N-terminal alpha-helix. CaM was shown to be encoded by a small multigenic family, and full-length cDNAs of the three isoforms (PsCaM1, 2 and 3) were isolated to allow the design of specific primers in more divergent 5' and 3' untranslated regions. Expression studies, performed by semiquantitative RT-PCR, demonstrated differential expression patterns of the three transcripts during germination. PsCaM1 and 2 were detected at different levels in dry axes and cotyledons, and they accumulated during imbibition and prior to radicle protrusion. In contrast, PsCaM3 appeared only upon radicle protrusion, then gradually increased in both tissues. To characterise the biochemical properties of the CaM isoforms, functional analyses were conducted in vitro using recombinant Strep-tagged proteins (CaM1-ST, CaM2-ST and CaM3-ST) expressed in Escherichia coli. Gel mobility shift assays revealed that CaM1-ST exhibited a stoichiometric binding of a synthetic amphiphilic CaM kinase II peptide while CaM2-ST and CaM3-ST affinities for the same peptide were reduced. Affinity differences were also observed for CaM isoform binding to Trp-3, an idealised helical CaM-binding peptide. However, the three proteins activated in the same way the CaM-dependent pea NAD kinase. Finally, the significance of the single substitutions upon CaM interaction with its targets is discussed in a structural context.

The use of complementary and alternative medicines during breastfeeding: results from the Herbal supplements in Breastfeeding InvesTigation (HaBIT).

PubMed

Bettiol, Alessandra; Lombardi, Niccolò; Marconi, Ettore; Crescioli, Giada; Bonaiuti, Roberto; Maggini, Valentina; Gallo, Eugenia; Mugelli, Alessandro; Firenzuoli, Fabio; Ravaldi, Claudia; Vannacci, Alfredo

2018-05-16

Use of complementary and alternative medicines (CAMs) during breastfeeding is commonly increasing, mainly due to their presumed higher safety compared to conventional medications. Indeed, CAMs can cause serious adverse effects, and high-quality evidence supporting their use during lactation is limited. In Italy, specific investigations on the attitude of lactating women towards CAMs are lacking. The Herbal supplements in Breastfeeding InvesTigation (HaBIT) aimed to explore the attitudes and knowledge on CAMs among lactating women. A web-based survey was conducted over a six-year period among lactating women resident in Tuscany (Italy). Data on lactating behavior, CAMs use during pregnancy or breastfeeding, and women knowledge about CAMs' efficacy and safety were collected. 388 lactating women answered the questionnaire; the majority of them were primiparae with high education level. Two-hundred and four women declared to have been CAMs users during breastfeeding. Moreover, the 61 and 48% of subjects reported CAMs use also before and during pregnancy. A significant proportion of subjects were unable to correctly identify the type of CAMs they were using. The 73% of women were convinced that CAMs had higher or comparable safety than conventional medications; nevertheless, 65% of women admitted to have no scientific information about the potential risks of CAMs, and 14 CAMs users reported to have experienced side effects. These results claim the necessity that healthcare providers amplify their role to increase nursing women' awareness about CAMs. Further research is needed to support the evidence base of non-pharmaceutical approaches for symptom control during breastfeeding. This article is protected by copyright. All rights reserved.

Insights into molecular interactions between CaM and its inhibitors from molecular dynamics simulations and experimental data.

PubMed

González-Andrade, Martin; Rodríguez-Sotres, Rogelio; Madariaga-Mazón, Abraham; Rivera-Chávez, José; Mata, Rachel; Sosa-Peinado, Alejandro; Del Pozo-Yauner, Luis; Arias-Olguín, Imilla I

2016-01-01

In order to contribute to the structural basis for rational design of calmodulin (CaM) inhibitors, we analyzed the interaction of CaM with 14 classic antagonists and two compounds that do not affect CaM, using docking and molecular dynamics (MD) simulations, and the data were compared to available experimental data. The Ca(2+)-CaM-Ligands complexes were simulated 20 ns, with CaM starting in the "open" and "closed" conformations. The analysis of the MD simulations provided insight into the conformational changes undergone by CaM during its interaction with these ligands. These simulations were used to predict the binding free energies (ΔG) from contributions ΔH and ΔS, giving useful information about CaM ligand binding thermodynamics. The ΔG predicted for the CaM's inhibitors correlated well with available experimental data as the r(2) obtained was 0.76 and 0.82 for the group of xanthones. Additionally, valuable information is presented here: I) CaM has two preferred ligand binding sites in the open conformation known as site 1 and 4, II) CaM can bind ligands of diverse structural nature, III) the flexibility of CaM is reduced by the union of its ligands, leading to a reduction in the Ca(2+)-CaM entropy, IV) enthalpy dominates the molecular recognition process in the system Ca(2+)-CaM-Ligand, and V) the ligands making more extensive contact with the protein have higher affinity for Ca(2+)-CaM. Despite their limitations, docking and MD simulations in combination with experimental data continue to be excellent tools for research in pharmacology, toward a rational design of new drugs.

Gender Differences in the Use of Complementary and Alternative Medicine and Their Association With Moderate Mental Distress in U.S. Adults With Migraines/Severe Headaches.

PubMed

Rhee, Taeho Greg; Harris, Ila M

2017-01-01

We examined whether the prevalence of complementary and alternative medicine (CAM) use varies by gender, and assessed the interaction of gender and CAM use on moderate mental distress (MMD) in U.S. adults with migraines/severe headaches. We used data from the 2012 National Health Interview Survey, which represents non-institutionalized U.S. adults with migraines/severe headaches (n = 4645 unweighted). Using a cross-sectional design with survey sampling techniques, we conducted descriptive analyses for prevalence of CAM use by gender. Multivariate logistic regression analyses were run to investigate potential roles of migraines/severe headaches and CAM use on MMD by gender. The overall prevalence of past year CAM use was 44.4%. Women consistently used CAM more frequently than men (P = .004). The most commonly used CAM types included herbal supplements (22.2%), massage (14.2%), and chiropractic/osteopathic (13.9%). After controlling for covariates, the odds of MDD were increased by the presence of migraines/severe headaches (P < .001) and the use of any CAM (P < .001). The interaction effect of migraines/severe headaches and CAM use decreased the odds of MMD by 27% in women (P < .05), but not in men. Women used CAM more frequently than men among adults with migraines/severe headaches in the United States. In addition, the interaction of gender and CAM use exists; the CAM use was associated with decreased odds of MMD among women only, suggesting that women with migraines/severe headaches may have benefited from CAM for their mental distress. Future research is needed to explore why such patterns vary by gender. © 2016 American Headache Society.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor

PubMed Central

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Li, Xiang-dong

2016-01-01

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca2+-dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca2+-dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca2+-bound CaM (Ca2+-CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca2+-CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca2+-CaM structure, the N-lobe and the C-lobe of Ca2+-CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca2+-CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca2+ transition and that the binding of CaM to IQ1 increases Ca2+ affinity and substantially changes the kinetics of the Ca2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca2+ sensor responding to distinct calcium signals. PMID:27647889

Solution Structure of Calmodulin Bound to the Binding Domain of the HIV-1 Matrix Protein*

PubMed Central

Vlach, Jiri; Samal, Alexandra B.; Saad, Jamil S.

2014-01-01

Subcellular distribution of calmodulin (CaM) in human immunodeficiency virus type-1 (HIV-1)-infected cells is distinct from that observed in uninfected cells. CaM co-localizes and interacts with the HIV-1 Gag protein in the cytosol of infected cells. Although it has been shown that binding of Gag to CaM is mediated by the matrix (MA) domain, the structural details of this interaction are not known. We have recently shown that binding of CaM to MA induces a conformational change that triggers myristate exposure, and that the CaM-binding domain of MA is confined to a region spanning residues 8–43 (MA-(8–43)). Here, we present the NMR structure of CaM bound to MA-(8–43). Our data revealed that MA-(8–43), which contains a novel CaM-binding motif, binds to CaM in an antiparallel mode with the N-terminal helix (α1) anchored to the CaM C-terminal lobe, and the C-terminal helix (α2) of MA-(8–43) bound to the N-terminal lobe of CaM. The CaM protein preserves a semiextended conformation. Binding of MA-(8–43) to CaM is mediated by numerous hydrophobic interactions and stabilized by favorable electrostatic contacts. Our structural data are consistent with the findings that CaM induces unfolding of the MA protein to have access to helices α1 and α2. It is noteworthy that several MA residues involved in CaM binding have been previously implicated in membrane binding, envelope incorporation, and particle production. The present findings may ultimately help in identification of the functional role of CaM in HIV-1 replication. PMID:24500712

USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

PubMed

Nadareishvili, I; Lunze, K; Tabagari, N; Beraia, A; Pkhakadze, G

2017-11-01

In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.

Medical students' knowledge and attitude towards complementary and alternative medicine - A survey in Ghana.

PubMed

Ameade, Evans Paul Kwame; Amalba, Anthony; Helegbe, Gideon Kofi; Mohammed, Baba Sulemana

2016-07-01

Interest, use of and research into Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006). The best known CAM was herbal medicine (63.6%), with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1%) with majority (71.5%) favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%). Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0%) of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.

Overexpression of HepaCAM inhibits cell viability and motility through suppressing nucleus translocation of androgen receptor and ERK signaling in prostate cancer.

PubMed

Song, Xuedong; Wang, Yin; Du, Hongfei; Fan, Yanru; Yang, Xue; Wang, Xiaorong; Wu, Xiaohou; Luo, Chunli

2014-07-01

HepaCAM is suppressed in a variety of human cancers, and involved in cell adhesion, growth, migration, invasion, and survival. However, the expression and function of HepaCAM in prostate cancer are still unknown. HepaCAM expression has been detected by RT-PCR, Western blotting and immunohistochemistry staining in prostate cell lines RWPE-1, LNCap, DU145, PC3, and in 75 human prostate tissue specimens, respectively. Meanwhile, the cell proliferation ability was detected by WST-8 assay. The role of HepaCAM in prostate cancer cell migration and invasion was examined by wound healing and transwell assay. And flow cytometry was used to observe the apoptosis of prostate cancer cells. Then we detected changes of Androgen Receptor translocation and ERK signaling using immunofluorescence staining and western blot after overexpression of HepaCAM. The HepaCAM expression was significantly down-regulated in prostate cancer tissues and undetected in prostate cancer cells. However, the low HepaCAM expression was not statistically associated with clinicopathological characteristics of prostate cancer. Overexpression of HepaCAM in prostate cancer cells decreased the cell proliferation, migration and invasion, and induced the cell apoptosis. Meanwhile, HepaCAM prevented the androgen receptor translocation from the cytoplasm to the nucleus and down-regulated the MAPK/ERK signaling. Our results suggested that HepaCAM acted as a tumor suppressor in prostate cancer. HepaCAM inhibited cell viability and motility which might be through suppressing the nuclear translocation of Androgen Receptor and down-regulating the ERK signaling. Therefore, it was indicated that HepaCAM may be a potential therapeutic target for prostate cancer. © 2014 Wiley Periodicals, Inc.

Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

PubMed

Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

2016-01-29

In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Perception and use of complementary and alternative medicine for low back pain.

PubMed

Tsang, Vivian Hiu Man; Lo, Phoebe Hiu Wai; Lam, Fong Tao; Chung, Lulu Suet Wing; Tang, Tin Yan; Lui, Hoi Man; Lau, Jordan Tsz Gwan; Yee, Ho Fung; Lun, Yiu Kun; Chan, Hei Tung; Cheung, Jason Pui Yin

2017-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use in patients with low back pain (LBP) and to identify its correlation with demographic factors, clinical condition and psychosocial factors. A cross-sectional study was conducted with 278 LBP patients. Use of CAM, demographic parameters and disease duration were determined. Self-reported health status and self-rated scales assessed the effect of disease on quality of life and emotional well-being, respectively. Satisfaction with orthopaedic care and belief partiality towards CAM were assessed. In all, 72.3% patients sought CAM treatment. The most common choice of CAM was traditional Chinese medicine (TCM; n = 166), followed by massage therapy ( n = 114) and chiropractic treatment ( n = 45). Within TCM, acupuncture was the most popular treatment for LBP ( n = 127). Only 32.5% patients informed their doctors of their CAM use. In univariate analyses, factors positively associated with CAM use included duration of LBP (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.06-1.97), use of CAM in close social circles (OR = 1.98, 95% CI: 1.15-3.43) and summary score for belief partiality towards CAM (OR = 1.18, 95% CI: 1.13-1.23). Variables negatively and significantly associated with status of CAM use include age (OR = 0.97, 95% CI: 0.95-0.99) and summary score for satisfaction with orthopaedic care (OR = 0.93, 95% CI: 0.88-0.99). CAM use in patients with LBP is prevalent and largely unknown to their doctors. Personal beliefs and their satisfaction with conventional medical treatment both play a part in their decisions to use CAM. Future studies may aim at understanding the effect of CAM on patient adherence to conventional medical treatment and patients' perception of well-being and pain.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor.

PubMed

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Ye, Keqiong; Li, Xiang-Dong

2016-10-04

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca 2+ -dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca 2+ -dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca 2+ -bound CaM (Ca 2+ -CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca 2+ -CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca 2+ -CaM structure, the N-lobe and the C-lobe of Ca 2+ -CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca 2+ -CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca 2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca 2+ transition and that the binding of CaM to IQ1 increases Ca 2+ affinity and substantially changes the kinetics of the Ca 2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca 2+ sensor responding to distinct calcium signals.

The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review.

PubMed

Solomon, Daniela; Adams, Jon

2015-07-01

Depression has been identified as one of the most frequent indications for CAM use and is a strong predictor of CAM use. The present article provides a critical review of CAM use for depressive disorders including bipolar depression by addressing prevalence of CAM use and CAM users׳ characteristics, motivation, decision-making and communication with healthcare providers. A comprehensive search of 2003-2014 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and depressive disorders. A considerable level of CAM use was observed among both general and clinical populations of people suffering from depressive disorders, many of whom use CAM concurrently with their conventional medicine. In particular, high rates of CAM use were found among those with bipolar disorder, an illness known to cause substantial impairments in health-related quality of life. Concomitant prescription medication use ranged from 0.52% to as high as 100%. Study design such as the inclusion of bipolar and depression in the same diagnostic category hamper the differentiation and attribution of CAM usage for symptoms. Findings of our review show that enduring impairments in function and persistence of symptoms (as reflected by increased CAM use proportional to severity of illness and comorbidity) are the impetus for sufferers of depressive illness to seek out CAM. The psychosocial factors associated with CAM use in depressive illnesses and severe mental illness are yet to be established. Subsequent research amongst those with depressive disorders would be informative in clarifying the range of motivations associated with mental illness. Copyright © 2015 Elsevier B.V. All rights reserved.

Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey.

PubMed

Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell; Gardiner, Paula

2014-10-01

Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care.

Use of complementary and alternative medicine for children: a parents' perspective.

PubMed

Gad, Ashry; Al-Faris, Eiad; Al-Rowais, Noura; Al-Rukban, Mohamed

2013-10-01

The present study aims to detect the frequency and types of complementary and alternative medicine (CAM) therapies used for children and to explore parental motivating factors for using CAM for their children in Riyadh, Saudi Arabia. This is a cross-sectional study that involved 462 families selected through a multistage cluster-sampling technique covering Riyadh region, Saudi Arabia. The sample was selected from 40 clusters, distributed proportionally according to the size of the population in the catchment area of primary health care centres (PHCCs). A structured questionnaire that contains items fulfilling the research objectives was used to collect data by research assistants. The study included 926 parents, comprising 351 fathers and 575 mothers; 37.3% of them reported the use of CAM for their children including reciting the Quran, honey and Ferula asafoetida (26.1%, 21.5% and 18.8%, respectively). CAM was used six times higher for children of parents using CAM for themselves than children of parents who did not use CAM themselves (odds ratio (OR)=6.03, 3.9-9.37). Multivariate logistic regression showed that parental use of CAM (OR=3.0, 2.2-4.0), keeping CAM remedies at home (OR=2.3, 1.8-3.1), perceived success of CAM in practice (OR=1.8, 1.3-2.4) and preference of use of natural materials (OR=1.7, 1.2-2.5) were independent predictors of use of CAM for children. In this study, around one-third of the parents used CAM for their children. Quran (Muslims' holy book) was the most common CAM type used for children. Parents' use of CAM for themselves is the most important predictor of its use for children. An in-depth study to investigate CAM use for specific diseases in children is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-defined Delirium

PubMed Central

Marcantonio, Edward R.; Ngo, Long H.; O’Connor, Margaret; Jones, Richard N.; Crane, Paul K.; Metzger, Eran D.; Inouye, Sharon K.

2015-01-01

Background Delirium is common, morbid, and costly, yet remains often unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would represent a substantial advance for clinical care. Objective To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and to validate it against a clinical reference standard. Design Diagnostic test study Setting 4 general medicine units in an academic medical center Participants 201 inpatients aged ≥ 75 years old Measurements We identified 20 items that best operationalized the 4 CAM diagnostic features to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Independently, clinicians performed an extensive assessment that included patient interviews, family interviews, and review of the medical record. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). We compared the 3D-CAM delirium determination to the reference standard in all patients and in subgroups with and without dementia. Results The 201 participants in the prospective validation study had mean age (SD) of 84 (5.5) years, and 27% had dementia. The expert panel identified delirium in 21%. Median administration time for 3D-CAM was 3 minutes (inter-quartile range: 2–5 minutes). The sensitivity [95% CI] of 3D-CAM was 95% [84%, 99%] and the specificity was 94% [90%, 97%]. The 3D-CAM performed well in patients both with dementia (sensitivity=96% [82%, 100%], specificity=86% [67%, 96%]) and without dementia (sensitivity=93% [66%, 100%], specificity=96% [91%,99%]). Limitations Limited to single center, cross-sectional, and medicine patients only Conclusion The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PMID:25329203

Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community.

PubMed

Chen, Chunliang; Chong, Ying Jie; Hie, Szu Liang; Sultana, Rehena; Lee, Sze Huay Dorothy; Chan, Wei Shih Derrick; Chan, Sui Yung; Cheong, Han Hui

2016-07-01

Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs. Copyright © 2016 Elsevier Inc. All rights reserved.

The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.

PubMed

Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus

2015-01-01

There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.

Complementary and alternative medicine use by pediatric specialty outpatients.

PubMed

Adams, Denise; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Hervas-Malo, Marilou; Moher, David; Vohra, Sunita

2013-02-01

Complementary and alternative medicine (CAM) use is high among children and youth with chronic illnesses. The objective of this study was to assess the prevalence and patterns of CAM use in 10 subspecialty clinics in Canada and to compare CAM use between 2 geographically diverse locations. This survey was carried out at 1 Children's Hospital in western Canada (Edmonton) and 1 Children's Hospital in central Canada (Ottawa). Questionnaires were completed by parents in either French or English. Although demographic characteristics of the 2 populations were similar, CAM use at the western hospital was 71% (n = 704) compared with 42% (n = 222) at the central hospital (P < .0001). Most respondents agreed or strongly agreed that they feel comfortable discussing CAM in their clinic. The most common CAM products currently used were multivitamins/minerals, herbal products, and homeopathic remedies. The most common CAM practices currently used were massage, chiropractic, relaxation, and aromatherapy. Eighty adverse effects were reported, and 55 (68.8%) of these were self-assessed as minor. Results of this study indicate that CAM use is high among pediatric specialty clinic outpatients and is much greater in the western than in the central hospital. Most respondents felt that their CAM use was helpful with few or no harms associated. Many patients, using CAM alongside their conventional medicines, are still not discussing their CAM use with their physicians and are increasing the likelihood for potential interactions and preventable harms.

National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine.

PubMed

Yang, Geliang; Lee, Richard; Zhang, Huiqing; Gu, Wei; Yang, Peiying; Ling, Changquan

2017-02-21

It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists' knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.

Use of complementary and alternative medicine among midlife Arab women living in Qatar.

PubMed

Gerber, L M; Mamtani, R; Chiu, Y-L; Bener, A; Murphy, M; Cheema, S; Verjee, M

2014-10-12

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.

Complementary and alternative medicine - representations in popular magazines.

PubMed

Dunne, Alexandra; Phillips, Christine

2010-09-01

More than half the patients who use complementary and alternative medicine (CAM) in Australia do not discuss it with their doctors. Many consumers use popular media, especially women's magazines, to learn about CAM. To explore representations of CAM in popular Australian women's magazines. Content analysis of three Australian magazines: Australian Women's Weekly, Dolly and New Idea published from January to June 2008. Of 220 references to CAM (4-17 references per issue), most were to biologically based practices, particularly 'functional foods', which enhance health. Most representations of CAM were positive (81.3% positive, 16.4% neutral, 2.3% negative). Explanations of modes of action of CAM tended to be biological but relatively superficial. Australian magazines cast CAM as safe therapy which enhances patient engagement in healthcare, and works in ways analogous to orthodox medical treatments. General practitioners can use discussions with their patients about CAM to encourage health promoting practices.

[A research roadmap for complementary and alternative medicine - what we need to know by 2020].

PubMed

Fischer, Felix; Lewith, George; Witt, Claudia M; Linde, Klaus; von Ammon, Klaus; Cardini, Francesco; Falkenberg, Torkel; Fønnebø, Vinjar; Johannessen, Helle; Reiter, Bettina; Uehleke, Bernhard; Weidenhammer, Wolfgang; Brinkhaus, Benno

2014-01-01

The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and reliable information about its cost, safety and effectiveness in real-world settings. We need to consider the availability, accessibility and affordability of CAM. We need to engage in research excellence and utilise comparative effectiveness approaches and mixed methods to obtain this data. Our recommendations are both strategic and methodological. They are presented for the consideration of researchers and funders while being designed to answer the important and implicit questions posed by EU citizens currently using CAM in apparently increasing numbers. We propose that the EU actively supports an EU-wide strategic approach that facilitates the development of CAM research. This could be achieved in the first instance through funding a European CAM coordinating research office dedicated to foster systematic communication between EU governments, public, charitable and industry funders as well as researchers, citizens and other stakeholders. The aim of this office would be to coordinate research strategy developments and research funding opportunities, as well as to document and disseminate international research activities in this field. With the aim to develop sustainability as second step, a European Centre for CAM should be established that takes over the monitoring and further development of a coordinated research strategy for CAM, as well as it should have funds that can be awarded to foster high quality and robust independent research with a focus on citizens health needs and pan-European collaboration. We wish to establish a solid funding for CAM research to adequately inform health care and health creation decision-making throughout the EU. This centre would ensure that our vision of a common, strategic and scientifically rigorous approach to CAM research becomes our legacy and Europe’s reality. We are confident that our recommendations will serve these essential goals for EU citizens.

C-reactive protein as a predictor of chorioamnionitis.

PubMed

Smith, Erik J; Muller, Corinna L; Sartorius, Jennifer A; White, David R; Maslow, Arthur S

2012-10-01

Chorioamnionitis (CAM) affects many pregnancies complicated by preterm premature rupture of membranes (PPROM). Finding a serum factor that could accurately predict the presence of CAM could potentially lead to more efficient management of PPROM and improved neonatal outcomes. To determine if C-reactive protein (CRP) is an effective early marker of CAM in patients with PPROM. A retrospective evaluation of pregnant women with PPROM at Geisinger Medical Center in Danville, Pennsylvania, between January 2005 and January 2009. Nonparametric statistical tests (ie, Wilcoxon rank sum and Spearman rank correlation) were used to compare distributions that were skewed. Characteristics of the study population were compared using 2-sample t tests for continuous variables and Fisher exact tests for discrete variables. Logistic regression analysis was used to generate receiver operating characteristic curves and obtain area under the curve estimates in stepwise fashion for predicting histologic CAM. A secondary analysis compared the characteristics among patients with clinical CAM, histologic CAM, or non-CAM. The total population of 73 women was subdivided into patients with histologic CAM (n=26) and patients without histologic CAM (ie, no evidence of CAM on placental pathology; n=47). There was no difference between groups in CRP levels, days of pregnancy latency, white blood cell count, smoking status, antibiotic administration, or steroid benefit. The group with histologic CAM delivered at earlier gestational ages: mean (standard deviation) age was 29.5 (4.4) weeks vs 31.9 (3.5) weeks (P=.02). For our primary analysis, we found no difference in CRP levels (P=.32). Receiver operating characteristic curve plots of CRP levels, temperature at delivery, and white blood cell count resulted in an area under the curve estimate of 0.696, which was 70% predictive of histologic CAM. In the secondary analysis, after adjusting for gestational age, the estimated hazard ratio for CRP change was 1.05 (95% confidence interval, 1.02-1.08; P=.001). Therefore, increasing CRP levels from PPROM was statistically significant in predicting clinical CAM development over time. C-reactive protein levels were not effective independent predictors of clinical or histologic CAM, nor was sequential CRP testing statistically significant for the identification of clinical or histologic CAM in patients with PPROM.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

PubMed

Papadiochou, Sofia; Pissiotis, Argirios L

2018-04-01

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Attitudes and perceptions of Australian pharmacy students towards Complementary and Alternative Medicine – a pilot study

PubMed Central

Tiralongo, Evelin; Wallis, Marianne

2008-01-01

Background With the increased usage of CAM worldwide comes the demand for its integration into health professional education. However, the incorporation of CAM into health professional curricula is handled quite differently by different institutions and countries. Furthermore, the evaluation of CAM curricula is complicated because students' ability to learn about CAM may be influenced by factors such as student's prior knowledge and motivation, together with the perceptions and attitudes of clinical preceptors. The study aimed to describe the attitudes, perceptions and beliefs of second, third and fourth year pharmacy students towards complementary and alternative medicine (CAM) and to explore factors that might affect attitudes such as learning, preceptors and placements. Methods Pharmacy students from a University in South East Queensland, Australia participated in the study. The study consisted of a cross-sectional survey (n = 110) and semi-structured interviews (n = 9). Results The overall response rate for the survey was 75%, namely 50% (36/72) for second year, 77.3% (34/44) for third year and 97.6% (40/41) for fourth year students. Overall, 95.5% of pharmacy students believe that pharmacists should be able to advise patients about CAM and most (93.7%) have used CAM prior to course enrolment. Students' attitudes to CAM are influenced by the use of CAM by family, friends and self, CAM training, lecturers and to a lesser degree by preceptors. The majority of pharmacy students (89.2%) perceive education about CAM as a core and integral part of their professional degree and favour it over an additional postgraduate degree. However, they see a greater need for education in complementary medicines (such as herbal medicines, vitamins and minerals) than for education in complementary therapies (such as acupuncture, meditation and bio-magnetism). Knowledge and educational input rationalised rather than marginalised students' attitudes towards CAM. Conclusion Pharmacy students perceive education about CAM as a core and integral part of their professional degree. Students' attitudes towards CAM can be influenced by learning, lecturers, preceptors and practice experience. The content and focus of CAM education has to be further investigated and tailored to meet the professional needs of our future health professionals. PMID:18221569

Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries

PubMed Central

Skovgaard, L.; Nicolajsen, P. H.; Pedersen, E.; Kant, M.; Fredrikson, S.; Verhoef, M.; Meyrowitsch, D. W.

2012-01-01

Aims. The aim of the study was to describe and compare (1) the types and prevalence of complementary and alternative medicine (CAM) treatments used among individuals with multiple sclerosis (MS) in the Nordic countries; (2) the types of conventional treatments besides disease-modifying medicine for MS that were used in combination with CAM treatments; (3) the types of symptoms/health issues addressed by use of CAM treatments. Methods. An internet-based questionnaire was used to collect data from 6455 members of the five Nordic MS societies. The response rates varied from 50.9% in Norway to 61.5% in Iceland. Results. A large range of CAM treatments were reported to be in use in all five Nordic countries. Supplements of vitamins and minerals, supplements of oils, special diet, acupuncture, and herbal medicine were among the CAM treatment modalities most commonly used. The prevalence of the overall use of CAM treatments within the last twelve months varied from 46.0% in Sweden to 58.9% in Iceland. CAM treatments were most often used in combination with conventional treatments. The conventional treatments that were most often combined with CAM treatment were prescription medication, physical therapy, and over-the-counter (OTC) medications. The proportion of CAM users who reported exclusive use of CAM (defined as use of no conventional treatments besides disease-modifying medicine for MS) varied from 9.5% in Finland to 18.4% in Norway. In all five Nordic countries, CAM treatments were most commonly used for nonspecific/preventative purposes such as strengthening the body in general, improving the body's muscle strength, and improving well-being. CAM treatments were less often used for the purpose of improving specific symptoms such as body pain, problems with balance, and fatigue/lack of energy. Conclusions. A large range of CAM treatments were used by individuals with MS in all Nordic countries. The most commonly reported rationale for CAM treatment use focused on improving the general state of health. The overall pattern of CAM treatment use was similar across the five countries. PMID:23304461

Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: a cross-cultural study.

PubMed

Ben-Arye, Eran; Karkabi, Khaled; Karkabi, Sonia; Keshet, Yael; Haddad, Maria; Frenkel, Moshe

2009-01-01

The purpose of this cross-cultural study was to evaluate patient perspectives on complementary and alternative medicine (CAM) integration within primary care clinics. It is one of the first multiethnic studies to explore patients' perspectives on the best model for integrating CAM into the conventional care setting. We developed a 13-item questionnaire that addresses issues of CAM use, expectations from the primary care physicians concerning CAM, and attitudes toward CAM integration within a patient's primary care clinic. We constructed the questionnaire with cross-cultural sensitivity concerning the core concepts of CAM and traditional medicine in both the Arab and Jewish communities in northern Israel. Data for statistical analysis were obtained from 3840 patients attending seven primary care clinics. Of the 3713 respondents who were willing to identify their religion, 2184 defined themselves as Muslims, Christians, or Druze and 1529 as Jews. Respondents in the two groups were equally distributed by sex but differed significantly by age, education, self-rated religiosity, and self-reported chronic diseases in their medical background. Respondents in the two groups reported comparable overall CAM use during the previous year, but the Arab respondents reported more use of herbs and traditional medicine. Respondents in both groups stated that their primary expectation from a family physician concerning CAM was to refer them appropriately and safely to a CAM practitioner. Respondents in both groups greatly supported a theoretical scenario of CAM integration into primary medical care. However, Arab respondents were more supportive of the option that non-physician CAM practitioners would provide CAM rather than physicians.

Complementary and Alternative Medicine Use in Pediatric Hematology/Oncology Patients at the University of Mississippi Medical Center.

PubMed

Sanchez, Hanny C; Karlson, Cynthia W; Hsu, Johann H; Ostrenga, Andrew; Gordon, Catherine

2015-11-01

To examine the prevalence and modalities of complementary and alternative medicine (CAM) use in children with cancer and sickle cell disease; the reasons for use of CAM; and the use of CAM before, during, and after treatment in children with cancer. This single-center, observational study administered caregivers a written questionnaire regarding the use of CAM therapies. A total of 101 caregivers completed questionnaires. Including prayer, total CAM use in oncology and sickle cell disease was 64% and 63%, respectively. Non-prayer CAM use was 30% in oncology and 23% in sickle cell disease. Of respondents who reported using any CAM, the three most commonly used types were prayer (62.3% oncology; 60.0% sickle cell disease), vitamins/minerals (14.8% oncology; 10.0% sickle cell disease), and massage (9.8% oncology; 7.5% sickle cell disease). The primary reasons for using CAM were to provide hope, to improve quality of life, and to lessen adverse effects. In oncology patients, CAM use tended to increase during treatment compared with before and after treatment. The reported prevalence of non-prayer CAM use was lower (23%-30%) in this sample than has been reported in national samples or other geographic regions of the United States. Nonetheless, participants reported many positive reasons for using CAM, including to gain hope, improve quality of life, and control pain. Thus, CAM use appears to be an important aspect of medical care for many pediatric hematology/oncology families and should be a consideration when providers are discussing treatment and quality of care with families.

Patterns of utilization of complementary and alternative medicine in 2 pediatric gastroenterology clinics.

PubMed

Adams, Denise; Schiffgen, Miriam; Kundu, Anjana; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

2014-09-01

The aim of the present study was to assess the prevalence and patterns of complementary and alternative medicine (CAM) use among pediatric patients with gastrointestinal (GI) disorders at academic clinics in Canada. The survey was carried out at 2 hospital-based gastroenterology clinics: the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. CAM use at the Stollery was 83% compared with 36% at CHEO (P < 0.001). The most common reason for not using CAM was lack of knowledge about it. Most respondents felt comfortable discussing CAM in their clinic and wanted more information on CAM. The most common CAM products being taken were multivitamins (91%), calcium (35%), vitamin C (32%), probiotics (14%), and fish oil/omega-3 fatty acids (13%). The most common CAM practices being used were massage (43%), chiropractic (27%), faith healing (25%), and relaxation (18%). Most respondents believed that CAM was helpful, and most of the 23 reported adverse effects were minor. Seven were reported as moderate, and 3 were reported as severe. Many (42%) patients used CAM at the same time as prescription medicines, and of these patients, concurrent use was discussed with their physician (76%) or pharmacist (52%). CAM use is high among pediatric patients with GI disorders and is much greater among those in Edmonton than in Ottawa. Most respondents reported their CAM use as helpful, with little or no associated harm. Many patients fail to disclose their concurrent use of CAM and conventional medicines to their doctors, increasing the likelihood of interactions.

Complementary and alternative medicine use and adherence to asthma medications among Latino and non-Latino white families.

PubMed

McQuaid, Elizabeth L; Fedele, David A; Adams, Sue K; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K; Canino, Glorisa

2014-01-01

The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and non-Latino white (NLW) children with asthma to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use and to assess whether CAM use was associated with decreased adherence to controller medications. Participants included 574 families of children with asthma from NLW, Puerto Rican (PR), and Dominican backgrounds from Rhode Island (RI) and from Island PR. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately 1 month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in PR families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease.

PubMed

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-03-28

To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine.

PubMed

Sridhar, Sathvik Belagodu; Shariff, Atiqulla; Al Halabi, Nour; Sarmini, Rand; Harb, Lubab Arkan

2017-01-01

This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM.

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome.

PubMed

Lewith, G; Stuart, B; Chalder, T; McDermott, C; White, P D

2016-08-01

Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue, disability and a range of other symptoms. The PACE trial was randomised to compare four non-pharmacological treatments for patients with CFS in secondary care clinics. The aims of this sub study were to describe the use of complementary and alternative medicine (CAM) in the trial sample and to test whether CAM use correlated with an improved outcome. CAM use was recorded at baseline and 52weeks. Logistic and multiple regression models explored relationships between CAM use and both patient characteristics and trial outcomes. At baseline, 450/640 (70%) of participants used any sort of CAM; 199/640 (31%) participants were seeing a CAM practitioner and 410/640 (64%) were taking a CAM medication. At 52weeks, those using any CAM fell to 379/589 (64%). Independent predictors of CAM use at baseline were female gender, local ME group membership, prior duration of CFS and treatment preference. At 52weeks, the associated variables were being female, local ME group membership, and not being randomised to the preferred trial arm. There were no significant associations between any CAM use and fatigue at either baseline or 52weeks. CAM use at baseline was associated with a mean (CI) difference of 4.10 (1.28, 6.91; p=0.024) increased SF36 physical function score at 52weeks, which did not reach the threshold for a clinically important difference. CAM use is common in patients with CFS. It was not associated with any clinically important trial outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

PubMed Central

Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

2011-01-01

More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

Discrepant Views of Korean Medical Oncologists and Cancer Patients on Complementary and Alternative Medicine

PubMed Central

Kim, Bong-Seog; Lee, Kyung Hee; Lee, Myung Ah; Hong, Young Seon; Shin, Sang Won; Lee, Soon Nam

2008-01-01

Purpose This study was designed to evaluate the communication gap between Korean medical oncologists and cancer patients on complementary and alternative medicine (CAM). Materials and Methods Cross sectional studies utilized the responses of 59 medical oncologists and 211 patients. To understand the communication gap, perceived reasons and nondisclosure of CAM use, reactions of physicians to disclosure, and expectations for CAM were analyzed. Data were compared with use of the chi-squared test. Results Both medical oncologists and patients were in accord that CAM use would privde the patients with a feeling of hope. The medical oncologists believed more often than patients to attribute CAM use for control over medical care decisions, for the treatment of an incurable disease or as a nontoxic approach (p<0.05). Regarding reasons for nondisclosure, medical oncologists were more likely to think that physicians would not understand the use of CAM, discontinue treatment or disapprove of the use of CAM (p<0.0001). Patients attributed nondisclosure mainly to the lack of questioning about CAM. Medical oncologists were more likely to warn of the risks with CAM use and less likely to encourage the use of CAM than perceived by patients (p=0.01). Patients expected that CAM could cure disease, extend survival, relieve symptoms and improve the immune system or quality of life more often than medical oncologists (p<0.05). Conclusion Given the discrepant views of medical oncologists and patients on the use of CAM, medical oncologists should be aware of the discrepancies and attempt to resolve any differences. PMID:19688054

Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants.

PubMed

Kemppainen, Laura M; Kemppainen, Teemu T; Reippainen, Jutta A; Salmenniemi, Suvi T; Vuolanto, Pia H

2018-06-01

The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease

PubMed Central

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-01-01

AIM: To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. METHODS: A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. RESULTS: In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). CONCLUSION: In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions. PMID:25834335

Therapeutic uses of the WebCam in child psychiatry.

PubMed

Chlebowski, Susan; Fremont, Wanda

2011-01-01

The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Six cases illustrate the use of the WebCam in individual and family therapy. The WebCam, used during individual sessions, can facilitate the development of prosocial skills. Comparing individual WebCam video sessions can help to evaluate the effectiveness of medication and progress in therapy. The WebCam has proven to be useful in psycho-education, facilitating communication, and treating children and families. The applications of this technology may include cognitive-behavioral therapy, dialectical-behavioral, and group therapy.

77 FR 53914 - Horton Automatics, Inc., a Subsidiary of Overhead Door Corporation Including On-Site Leased...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

...., a Subsidiary of Overhead Door Corporation Including On-Site Leased Workers From Remedy Intelligent..., including on-site leased workers from Remedy Intelligent Staffing, Corpus Christi, Texas. The workers are... Automatics, Inc., a subsidiary of Overhead Door Corporation, including on-site leased workers from Remedy...

Overhead Projector Spectrum of Polymethine Dye: A Physical Chemistry Demonstration

NASA Astrophysics Data System (ADS)

Solomon, Sally; Hur, Chinhyu

1995-08-01

The position of the predominant peak of 1,1'-diethyl-4,4'-cyanine iodide is measured in class using an overhead projector spectrometer, then predicted using the model of a particle-in a one dimensional box. The calculated wavelength is in excellent agreement with the wavelength estimated from the overhead projector spectroscopy experiment.

Geography via the Overhead Projector: Do It This Way, 7.

ERIC Educational Resources Information Center

Best, Thomas D.

This booklet is designed to assist teachers in their use of overhead projectors when teaching geography. With the overhead technique, relationships among patterns can be suggested bit by bit on inexpensive, easily prepared overlays that are projected to sizes appropriate for a particular instructional situation. A general discussion of the…

Report on Analyses of WAC Samples of Evaporator Overheads - 2004

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

Oji, L

2005-03-18

In November and December of 2004, the Tank Farm submitted annual samples from 2F, 2H and 3H Evaporator Overhead streams for characterization to verify compliance with the new Effluent Treatment Facility (ETF) Waste Acceptance Criteria (WAC) and to look for organic species. With the exception of slightly high ammonia in the 2F evaporator overheads and high radiation control guide number for the 3H and 2F evaporator overhead samples, all the overheads samples were found to be in compliance with the Effluent Treatment Facility WAC. The ammonium concentration in the 2F-evaporator overhead, at 33 mg/L, was above the ETF waste watermore » collection tank (WWCT) limits of 28 mg/L. The RCG Number for the 3H and 2F evaporator samples at, respectively, 1.38E-02 and 8.24E-03 were higher than the WWCT limit of 7.69E-03. The analytical detection limits for americium-241 and radium-226 in the evaporator samples were not consistently met because of low WWCT detection limits and insufficient evaporator samples.« less

PreCam Survey Work at ANL

Science.gov Websites

- Astrophysics - DES - PreCam PreCam Work at ANL The Argonne/HEP Dark Energy Survey (DES) group, working on the Dark Energy Camera (DECam), built a mini-DECam camera called PreCam. This camera has provided valuable

Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project

PubMed Central

Okafor, Chukwuemeka N.; Harman, Jeffrey S.; Canidate, Shantrel S.; Cook, Christa L.; Cook, Robert L.

2016-01-01

Abstract Objective: The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida. Design: The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25. Results: CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40–49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind–body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58–1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39–0.92; p < 0.02). Conclusions: CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes. PMID:27631385

Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

PubMed

Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H

2008-02-22

While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

Content-addressable memory based enforcement of configurable policies

DOEpatents

Berg, Michael J

2014-05-06

A monitoring device for monitoring transactions on a bus includes content-addressable memory ("CAM") and a response policy unit. The CAM includes an input coupled to receive a bus transaction tag based on bus traffic on the bus. The CAM stores data tags associated with rules of a security policy to compare the bus transaction tag to the data tags. The CAM generates an output signal indicating whether one or more matches occurred. The response policy unit is coupled to the CAM to receive the output signal from the CAM and to execute a policy action in response to the output signal.

Complementary and alternative medicine (CAM) use by african american (AA) and caucasian american (CA) older adults in a rural setting: a descriptive, comparative study

PubMed Central

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-01-01

Background The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. Methods The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. Results The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Conclusions Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided. PMID:14622445

Complementary and alternative medicine (CAM) use by African American (AA) and Caucasian American (CA) older adults in a rural setting: a descriptive, comparative study.

PubMed

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-11-18

The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided.

A web-based course on complementary medicine for medical students and residents improves knowledge and changes attitudes.

PubMed

Cook, David A; Gelula, Mark H; Lee, Mark C; Bauer, Brent A; Dupras, Denise M; Schwartz, Alan

2007-01-01

There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. To develop and evaluate an introductory course in CAM for medical students and residents. We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. This brief course in CAM improved knowledge, changed attitudes, and was well received.

Use of complementary and alternative medicines among women with gestational trophoblastic diseases: a survey at the Philippine General Hospital.

PubMed

Cagayan, M Stephanie Fay S; Oras, Celestrell May W

2010-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use among women with gestational trophoblastic disease (GTD) at the University of the Philippines-Philippine General Hospital (UP-PGH). A survey on the use of CAM among women (N = 52) with GTD managed at the UP-PGH Gestational Trophoblastic Disease Center from June to August 2009 was done. The mean age of the participants was 32.3 years, and there were no significant differences in the proportion of CAM users as to educational attainment, diagnosis and treatment type received. Among the participants 96% used CAM, most commonly mental healing/prayer, fruit juices/vegetable diet, banaba/taheebo tea and multivitamins. Reasons for CAM use included safety, improvement of immune system, stress reduction and hope for their condition. Benefits included enhanced quality of life, stress reduction, immune system improvement and a healthier lifestyle. No untoward effect of CAM use was reported. Thirty-six percent of the participants disclosed CAM use to their physician. About 56% percent of the physicians were in favor of the CAM used. The main sources of information on CAM were relatives and friends. To better address patients' needs, physicians should routinely ask patients about their use of CAM and be able to discuss these therapies with them.

Bidirectional modulation of endogenous EpCAM expression to unravel its function in ovarian cancer

PubMed Central

van der Gun, B T F; Huisman, C; Stolzenburg, S; Kazemier, H G; Ruiters, M H J; Blancafort, P; Rots, M G

2013-01-01

Background: The epithelial cell adhesion molecule (EpCAM) is overexpressed on most carcinomas. Dependent on the tumour type, its overexpression is either associated with improved or worse patient survival. For ovarian cancer, however, the role of EpCAM remains unclear. Methods: Cell survival of ovarian cancer cell lines was studied after induction or repression of endogenous EpCAM expression using siRNA/cDNA or artificial transcription factors (ATF) consisting of engineered zinc-fingers fused to either a transcriptional activator or repressor domain. Results: Two ATFs were selected as the most potent down- and upregulator, showing at least a two-fold alteration of EpCAM protein expression compared with control. Downregulation of EpCAM expression resulted in growth inhibition in breast cancer, but showed no effect on cell growth in ovarian cancer. Induction or further upregulation of EpCAM expression decreased ovarian cancer cell survival. Conclusion: The bidirectional ATF-based approach is uniquely suited to study cell-type-specific biological effects of EpCAM expression. Using this approach, the oncogenic function of EpCAM in breast cancer was confirmed. Despite its value as a diagnostic marker and for immunotherapy, EpCAM does not seem to represent a therapeutic target for gene expression silencing in ovarian cancer. PMID:23403823

Vct system having closed loop control employing spool valve actuated by a stepper motor

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

Quin, S.B. Jr.; Siemon, E.C.

1993-06-15

An internal combustion engine is described comprising: a crankshaft, the crankshaft being rotable about an axis; a cam shaft, the cam shaft being rotatable about a second axis, the second axis being parallel to the axis, the cam shaft being subject to torque reversals during the rotation thereof; a vane, the vane having at least one lobe, the vane being attached to the cam shaft, being rotatable with the cam shaft and being non-oscillatable with respect to the cam shaft; a housing, the housing being rotatable with the cam shaft and being oscillatable with respect to the cam shaft, themore » housing having at least one recess, the recess receiving the lobe, the lobe being oscillatable within the recess; rotary movement transmitting means for transmitting rotary movement from the crankshaft to the housing; actuating means for varying the position of the housing relative to the cam shaft in reaction to torque reversals in the cam shaft, the actuating means comprising a stepper motor, a lead screw and a proportional spool valve, the position of the spool valve being controlled by the position of the lead screw driven by the stepper motor, the actuating means also delivering hydraulic fluid to the vane; and processing means for controlling the position of the actuating means.« less

Range of Hip Joint Motion Is Correlated With MRI-Verified Cam Deformity in Adolescent Elite Skiers

PubMed Central

Agnvall, Cecilia; Swärd Aminoff, Anna; Todd, Carl; Jonasson, Pall; Thoreson, Olof; Swärd, Leif; Karlsson, Jon; Baranto, Adad

2017-01-01

Background: Radiologically verified cam-type femoroacetabular impingement (FAI) has been shown to correlate with reduced internal rotation, reduced passive hip flexion, and a positive anterior impingement test. Purpose: To validate how a clinical examination of the hip joint correlates with magnetic resonance imaging (MRI)–verified cam deformity in adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The sample group consisted of 102 adolescents with the mean age 17.7 ± 1.4 years. The hip joints were examined using MRI for measurements of the presence of cam (α-angle ≥55°) and clinically for range of motion (ROM) in both supine and sitting positions. The participants were divided into a cam and a noncam group based on the results of the MRI examination. Passive hip flexion, internal rotation, anterior impingement, and the FABER (flexion, abduction, and external rotation) test were used to test both hips in the supine position. With the participant sitting, the internal/external rotation of the hip joint was measured in 3 different positions of the pelvis (neutral, maximum anteversion, and retroversion) and lumbar spine (neutral, maximum extension, and flexion). Results: Differences were found between the cam and noncam groups in terms of the anterior impingement test (right, P = .010; left, P = .006), passive supine hip flexion (right: mean, 5°; cam, 117°; noncam, 122° [P = .05]; and left: mean, 8.5°; cam, 116°; noncam, 124.5° [P = .001]), supine internal rotation (right: mean, 4.9°; cam, 24°; noncam, 29° [P = .022]; and left: mean, 4.8°; cam, 26°; noncam, 31° [P = .028]), sitting internal rotation with the pelvis and lumbar spine in neutral (right: mean, 7.95°; cam, 29°; noncam, 37° [P = .001]; and left: mean, 6.5°; cam, 31.5°; noncam, 38° [P = .006]), maximum anteversion of the pelvis and extension of the lumbar spine (right: mean, 5.2°; cam, 20°; noncam, 25° [P = .004]; and left: mean, 5.85°; cam, 20.5; noncam, 26.4° [P = .004]), and maximum retroversion of the pelvis and flexion of the spine (right: mean, 8.4°; cam, 32.5°; noncam, 41° [P = .001]; and left: mean, 6.2°; cam, 36°; noncam, 42.3° [P = .012]). The cam group had reduced ROM compared with the noncam group in all clinical ROM measures. Conclusion: The presence of cam deformity on MRI correlates with reduced internal rotation in the supine and sitting positions, passive supine hip flexion, and the impingement test in adolescents. PMID:28695136

An Evaluation of Marine Boundary Layer Cloud Property Simulations in the Community Atmosphere Model Using Satellite Observations: Conventional Subgrid Parameterization versus CLUBB

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

Song, Hua; Zhang, Zhibo; Ma, Po-Lun

This paper presents a two-step evaluation of the marine boundary layer (MBL) cloud properties from two Community Atmospheric Model (version 5.3, CAM5) simulations, one based on the CAM5 standard parameterization schemes (CAM5-Base), and the other on the Cloud Layers Unified By Binormals (CLUBB) scheme (CAM5-CLUBB). In the first step, we compare the cloud properties directly from model outputs between the two simulations. We find that the CAM5-CLUBB run produces more MBL clouds in the tropical and subtropical large-scale descending regions. Moreover, the stratocumulus (Sc) to cumulus (Cu) cloud regime transition is much smoother in CAM5-CLUBB than in CAM5-Base. In addition,more » in CAM5-Base we find some grid cells with very small low cloud fraction (<20%) to have very high in-cloud water content (mixing ratio up to 400mg/kg). We find no such grid cells in the CAM5-CLUBB run. However, we also note that both simulations, especially CAM5-CLUBB, produce a significant amount of “empty” low cloud cells with significant cloud fraction (up to 70%) and near-zero in-cloud water content. In the second step, we use satellite observations from CERES, MODIS and CloudSat to evaluate the simulated MBL cloud properties by employing the COSP satellite simulators. We note that a feature of the COSP-MODIS simulator to mimic the minimum detection threshold of MODIS cloud masking removes much more low clouds from CAM5-CLUBB than it does from CAM5-Base. This leads to a surprising result — in the large-scale descending regions CAM5-CLUBB has a smaller COSP-MODIS cloud fraction and weaker shortwave cloud radiative forcing than CAM5-Base. A sensitivity study suggests that this is because CAM5-CLUBB suffers more from the above-mentioned “empty” clouds issue than CAM5-Base. The COSP-MODIS cloud droplet effective radius in CAM5-CLUBB shows a spatial increase from coastal St toward Cu, which is in qualitative agreement with MODIS observations. In contrast, COSP-MODIS cloud droplet effective radius in CAM5-Base almost remains a constant. In comparison with CloudSat observations, the histogram of the radar reflectivity from modeled MBL clouds is too narrow without a distinct separation between cloud and drizzle modes. Moreover, the probability of drizzle in both simulations is almost twice as high as the observation. Future studies are needed to understand the causes of these differences and their potential connection with the “empty” cloud issues in the model.« less

Multitasking TORT under UNICOS: Parallel performance models and measurements

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

Barnett, A.; Azmy, Y.Y.

1999-09-27

The existing parallel algorithms in the TORT discrete ordinates code were updated to function in a UNICOS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead.

Multitasking TORT Under UNICOS: Parallel Performance Models and Measurements

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

Azmy, Y.Y.; Barnett, D.A.

1999-09-27

The existing parallel algorithms in the TORT discrete ordinates were updated to function in a UNI-COS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead.

Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

PubMed

Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon

2017-09-01

Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. © 2017 American Headache Society.

CAM Photosynthesis in Submerged Aquatic Plants

USGS Publications Warehouse

Keeley, J.E.

1998-01-01

Crassulacean acid metabolism (CAM) is a CO2-concentrating mechanism selected in response to aridity in terrestrial habitats, and, in aquatic environments, to ambient limitations of carbon. Evidence is reviewed for its presence in five genera of aquatic vascular plants, including Isoe??tes, Sagittaria, Vallisneria, Crassula, and Littorella. Initially, aquatic CAM was considered by some to be an oxymoron, but some aquatic species have been studied in sufficient detail to say definitively that they possess CAM photosynthesis. CO2-concentrating mechanisms in photosynthetic organs require a barrier to leakage; e.g., terrestrial C4 plants have suberized bundle sheath cells and terrestrial CAM plants high stomatal resistance. In aquatic CAM plants the primary barrier to CO2 leakage is the extremely high diffusional resistance of water. This, coupled with the sink provided by extensive intercellular gas space, generates daytime CO2(Pi) comparable to terrestrial CAM plants. CAM contributes to the carbon budget by both net carbon gain and carbon recycling, and the magnitude of each is environmentally influenced. Aquatic CAM plants inhabit sites where photosynthesis is potentially limited by carbon. Many occupy moderately fertile shallow temporary pools that experience extreme diel fluctuations in carbon availability. CAM plants are able to take advantage of elevated nighttime CO2 levels in these habitats. This gives them a competitive advantage over non-CAM species that are carbon starved during the day and an advantage over species that expend energy in membrane transport of bicarbonate. Some aquatic CAM plants are distributed in highly infertile lakes, where extreme carbon limitation and light are important selective factors. Compilation of reports on diel changes in titratable acidity and malate show 69 out of 180 species have significant overnight accumulation, although evidence is presented discounting CAM in some. It is concluded that similar proportions of the aquatic and terrestrial floras have evolved CAM photosynthesis. Aquatic Isoe??tes (Lycophyta) represent the oldest lineage of CAM plants and cladistic analysis supports an origin for CAM in seasonal wetlands, from which it has radiated into oligotrophic lakes and into terrestrial habitats. Temperate Zone terrestrial species share many characteristics with amphibious ancestors, which in their temporary terrestrial stage, produce functional stomata and switch from CAM to C3. Many lacustrine Isoe??tes have retained the phenotypic plasticity of amphibious species and can adapt to an aerial environment by development of stomata and switching to C3. However, in some neotropical alpine species, adaptations to the lacustrine environment are genetically fixed and these constitutive species fail to produce stomata or loose CAM when artificially maintained in an aerial environment. It is hypothesized that neotropical lacustrine species may be more ancient in origin and have given rise to terrestrial species, which have retained most of the characteristics of their aquatic ancestry, including astomatous leaves, CAM and sediment-based carbon nutrition.

Enrichment, Isolation and Molecular Characterization of EpCAM-Negative Circulating Tumor Cells.

PubMed

Lampignano, Rita; Schneck, Helen; Neumann, Martin; Fehm, Tanja; Neubauer, Hans

2017-01-01

The presence of EpCAM-positive circulating tumor cells (CTCs) in the peripheral blood is associated with poor clinical outcomes in breast, colorectal and prostate cancer, as well as the prognosis of other tumor types. In addition, recent studies have suggested that the presence of CTCs undergoing epithelial-to-mesenchymal transition and, as such, may exhibit reduced or no expression of epithelial proteins e.g. EpCAM, might be related to disease progression in metastatic breast cancer (MBC) patients. Analyzing the neoplastic nature of this EpCAM-low/negative (EpCAM-neg) subpopulation remains an open issue as the current standard detection methods for CTCs are not efficient at identifying this subpopulation of cells. The possible association of EpCAM-neg CTCs with EpCAM-positive (EpCAM-pos) CTCs and role in the clinicopathological features and prognosis of MBC patients has still to be demonstrated. Several technologies have been developed and are currently being tested for the identification and the downstream analyses of EpCAM-pos CTCs. These technologies can be adapted and implemented into workflows to isolate and investigate EpCAM-neg cells to understand their biology and clinical relevance. This chapter will endeavour to explain the rationale behind the identification and analyses of all CTC subgroups, as well as to review the current strategies employed to enrich, isolate and characterize EpCAM-negative CTCs. Finally, the latest findings in the field will briefly be discussed with regard to their clinical relevance.

Ethnic Differences in Complementary and Alternative Medicine Use among Patients with Diabetes

PubMed Central

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-01-01

Objective To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. Design and Settings A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacological (herbs and vitamins) and nonpharmacological CAM. (e.g., prayer, yoga, and acupuncture). Results The prevalence of pharmacological and non-pharmacological CAM among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/Other (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p = 0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Conclusions Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. PMID:21130360

Ethnic differences in complementary and alternative medicine use among patients with diabetes.

PubMed

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-12-01

To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacologic (herbs and vitamins) and nonpharmacologic CAMs (e.g., prayer, yoga, and acupuncture). The prevalence of pharmacologic and non-pharmacologic CAMs among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/others (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p=0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. Published by Elsevier Ltd.

A dynamic alpha-beta inter-subunit agonist signaling complex is a novel feedback mechanism for regulating L-type Ca2+ channel opening.

PubMed

Zhang, Rong; Dzhura, Igor; Grueter, Chad E; Thiel, William; Colbran, Roger J; Anderson, Mark E

2005-09-01

L-type Ca2+ channels are macromolecular protein complexes in neurons and myocytes that open in response to cell membrane depolarization to supply Ca2+ for regulating gene transcription and vesicle secretion and triggering cell contraction. L-type Ca2+ channels include a pore-forming alpha and an auxiliary beta subunit, and alpha subunit openings are regulated by cellular Ca2+ through a mechanism involving the Ca2+-sensing protein calmodulin (CaM) and CaM binding motifs in the alpha subunit cytoplasmic C terminus. Here we show that these CaM binding motifs are "auto-agonists" that increase alpha subunit openings by binding the beta subunit. The CaM binding domains are necessary and sufficient for the alpha subunit C terminus to bind the beta subunit in vitro, and excess CaM blocks this interaction. Addition of CaM binding domains to native cardiac L-type Ca2+ channels in excised cell membrane patches increases openings, and this agonist effect is prevented by excess CaM. Recombinant LTCC openings are also increased by exogenous CaM binding domains by a mechanism requiring the beta subunit, and excess CaM blocks this effect. Thus, the bifunctional ability of the alpha subunit CaM binding motifs to competitively associate with the beta subunit or CaM provides a novel paradigm for feedback control of cellular Ca2+ entry.

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia

PubMed Central

Fleming, Brandy M.; Schwab, Emiko L.; Nouer, Simonne S.; Wan, Jim Y.; LeDoux, Mark S.

2012-01-01

Background Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety, effectiveness and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. Methods This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of anatomical regions affected on botulinum toxin and CAM-I use and their perceived effectiveness. Results 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use – individuals with bachelor’ s degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for and CAM-I (28%, p<0.0001). Conclusions Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. PMID:22633698

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia.

PubMed

Fleming, Brandy M; Schwab, Emiko L; Nouer, Simonne S; Wan, Jim Y; LeDoux, Mark S

2012-09-01

Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety and effectiveness, and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of affected anatomical regions on botulinum toxin and CAM-I use and their perceived effectiveness. 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use - individuals with bachelor's degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for CAM-I (28%, p < 0.0001). Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

Expected and perceived efficacy of complementary and alternative medicine: A comparison views of patients with cancer and oncologists.

PubMed

Kim, Sang Hyuck; Shin, Dong Wook; Nam, You-Seon; Kim, So Young; Yang, Hyung-Kook; Cho, Be Long; Park, Keeho; Jo, Heui-Sug; Yim, Chang-Yeol; Kam, Sin; Park, Jong-Hyock

2016-10-01

This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use. Copyright © 2016. Published by Elsevier Ltd.

N-glycosylation at the SynCAM (synaptic cell adhesion molecule) immunoglobulin interface modulates synaptic adhesion.

PubMed

Fogel, Adam I; Li, Yue; Giza, Joanna; Wang, Qing; Lam, Tukiet T; Modis, Yorgo; Biederer, Thomas

2010-11-05

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn(60). Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn(70)/Asn(104) flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn(60) reduces adhesion, N-glycans at Asn(70)/Asn(104) of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion.

Collaborating with medicine? Perceptions of Australian naturopaths on integrating within the conventional medical system.

PubMed

Wardle, J; Steel, A; Lauche, R; Adams, J

2017-11-01

Complementary and alternative medicine (CAM) is an increasingly prevalent part of contemporary health care. Whilst there have been some attempts to understand the dynamics of CAM integration in the health care system from the perspective of conventional care providers and patients, little research has examined the view of CAM practitioners. This study aims to identify the experiences of integration within a conventional healthcare system as perceived by naturopaths. Qualitative semi-structured interviews were conducted using a purposeful sample of 20 practising naturopaths in South East Queensland, Australia to discuss their experiences and perceptions of integrating with conventional medical providers. Analysis of the interviews revealed five broad challenges for the integration of CAM according to naturopaths: competing paradigms between CAM and conventional medicine; co-option of CAM by conventional medical practitioners; the preservation of separate CAM and conventional medical worlds by patients and providers due to lack of formalised relations; negative feedback and biases created through selective or limited experience or information with CAM; and indifferent, reactive and one-sided interaction between CAM and conventional medical providers. Naturopaths support the integration of health services and attempt to provide safe and appropriate care to their patients through collaborative approaches to practice. The challenges identified by naturopaths associated with integration of CAM with conventional providers may impact the quality of care of patients who choose to integrate CAM and conventional approaches to health. Given the significant role of naturopaths in contemporary health-care systems, these challenges require further research and policy attention.

Impact of age, sex, socioeconomic status, and physical activity on associated movements and motor speed in preschool children.

PubMed

Kakebeeke, Tanja H; Zysset, Annina E; Messerli-Bürgy, Nadine; Chaouch, Aziz; Stülb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Arhab, Amar; Rousson, Valentin; Kriemler, Susi; Munsch, Simone; Puder, Jardena J; Jenni, Oskar G

2018-02-01

Young children generally show contralateral associated movements (CAMs) when they are making an effort to perform a unimanual task. CAM and motor speed are two relevant aspects of motor proficiency in young children. These CAMs decrease over age, while motor speed increases. As both CAM and motor speed are associated with age, we were interested in whether these two parameters are also linked with each other. In this study, three manual dexterity tasks with the dominant and nondominant hands (pegboard, repetitive hand, and repetitive finger tasks) were used to investigate the effect of covariates (age, sex, socioeconomic status, total physical activity) on both motor speed and CAMs in preschool children. There was a significant age effect for both motor speed and CAMs in all tasks when the dominant hand was used. When the nondominant hand was used, the decrease in the intensity of CAMs over age was not consistently significant. The influence of physical activity and socioeconomic status on motor proficiency was small. Furthermore, the correlation between motor speed and CAMs, although significant, was low. Motor speed improved with age over three fine motor tasks in preschool children. Decrease in CAMs was observed but it was not always significant when the nondominant hand was working. Motor speed and CAMs were only weakly associated. We conclude that the excitatory pathways responsible for motor speed and inhibitory pathways responsible for reducing CAMs occupy two different domains in the brain and therefore mostly behave independently of each other.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

PubMed

Davis, Margot T; Mulvaney-Day, Norah; Larson, Mary Jo; Hoover, Ronald; Mauch, Danna

2014-12-01

Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable.

L1CAM expression in endometrial carcinomas: an ENITEC collaboration study.

PubMed

van der Putten, Louis Jm; Visser, Nicole Cm; van de Vijver, Koen; Santacana, Maria; Bronsert, Peter; Bulten, Johan; Hirschfeld, Marc; Colas, Eva; Gil-Moreno, Antonio; Garcia, Angel; Mancebo, Gemma; Alameda, Fransesc; Trovik, Jone; Kopperud, Reidun K; Huvila, Jutta; Schrauwen, Stefanie; Koskas, Martin; Walker, Francine; Weinberger, Vit; Minar, Lubos; Jandakova, Eva; Snijders, Marc Plm; van den Berg-van Erp, Saskia; Matias-Guiu, Xavier; Salvesen, Helga B; Amant, Frederic; Massuger, Leon Fag; Pijnenborg, Johanna Ma

2016-09-06

Identification of aggressive endometrioid endometrial carcinomas (EECs) and non-endometrioid carcinomas (NEECs) is essential to improve outcome. L1 cell adhesion molecule (L1CAM) expression is a strong prognostic marker in stage I EECs, but less is known about L1CAM expression in advanced-stage EECs and NEECs. This study analyses L1CAM expression in a clinically representative cohort of endometrial carcinomas. The expression of L1CAM was immunohistochemically determined in 1199 endometrial carcinomas, treated at one of the European Network for Individualized Treatment of Endometrial Cancer (ENITEC) centres. Staining was considered positive when >10% of the tumour cells expressed L1CAM. The association between L1CAM expression and several clincopathological characteristics and disease outcome was calculated. In all, L1CAM was expressed in 10% of the 935 stage I EECs, 18% of the 160 advanced stage EECs, and 75% of the 104 NEECs. The expression of L1CAM was associated with advanced stage, nodal involvement, high tumour grade, non-endometrioid histology, lymphovascular space invasion, and distant recurrences in all cases, and with reduced survival in the EECs, but not in the NEECs. The expression of L1CAM is a strong predictor of poor outcome in EECs, but not NEECs. It is strongly associated with non-endometrioid histology and distant spread, and could improve the postoperative selection of high-risk endometrial carcinomas. The value of L1CAM expression in the preoperative selection of high-risk endometrial carcinomas should be studied.

'Thinking outside the box': complementary and alternative therapies use in paediatric oncology patients.

PubMed

Molassiotis, Alexander; Cubbin, Denise

2004-03-01

The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among children with cancer who had received or were receiving treatment at a large hospital in the UK, including the identification of the most commonly used therapies and parental motives for doing so. Using a cross-sectional survey design, questionnaires were sent to parents of paediatric patients diagnosed with cancer. Of the 49 respondents, 32.7% reported using some type of CAM. The most commonly used therapies included multivitamins, aromatherapy massage, diets and music as therapy. Most children had used more than one therapy. Many of the factors that motivated parents to use CAM were related to helping or supporting their child's medical treatment. The main benefits identified from using CAM included increased confidence, pain relief and relaxation. The longer the time since diagnosis the more children tended to use CAM. The reasons for parents not using CAM included the child doing well and therefore not seeing the need for CAM use; not being aware of CAM; CAM not being offered and lack of information available. Parents identified a need for more information to be available both at ward level and for information about CAM to be discussed by medical staff, particularly at the start of treatment. The results indicate that CAM is frequently used by children and young people with cancer and that their use plays a substantial role in helping children through their conventional cancer treatment.

N-Glycosylation at the SynCAM (Synaptic Cell Adhesion Molecule) Immunoglobulin Interface Modulates Synaptic Adhesion*

PubMed Central

Fogel, Adam I.; Li, Yue; Giza, Joanna; Wang, Qing; Lam, TuKiet T.; Modis, Yorgo; Biederer, Thomas

2010-01-01

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn60. Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn70/Asn104 flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn60 reduces adhesion, N-glycans at Asn70/Asn104 of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion. PMID:20739279

Marginal and internal fits of fixed dental prostheses zirconia retainers.

PubMed

Beuer, Florian; Aggstaller, Hans; Edelhoff, Daniel; Gernet, Wolfgang; Sorensen, John

2009-01-01

CAM (computer-aided manufacturing) and CAD (computer-aided design)/CAM systems facilitate the use of zirconia substructure materials for all-ceramic fixed partial dentures. This in vitro study compared the precision of fit of frameworks milled from semi-sintered zirconia blocks that were designed and machined with two CAD/CAM and one CAM system. Three-unit posterior fixed dental prostheses (FDP) (n=10) were fabricated for standardized dies by: a milling center CAD/CAM system (Etkon), a laboratory CAD/CAM system (Cerec InLab), and a laboratory CAM system (Cercon). After adaptation by a dental technician, the FDP were cemented on definitive dies, embedded and sectioned. The marginal and internal fits were measured under an optical microscope at 50x magnification. A one-way analysis of variance (ANOVA) was used to compare data (alpha=0.05). The mean (S.D.) for the marginal fit and internal fit adaptation were: 29.1 microm (14.0) and 62.7 microm (18.9) for the milling center system, 56.6 microm (19.6) and 73.5 microm (20.6) for the laboratory CAD/CAM system, and 81.4 microm (20.3) and 119.2 microm (37.5) for the laboratory CAM system. One-way ANOVA showed significant differences between systems for marginal fit (P<0.001) and internal fit (P<0.001). All systems showed marginal gaps below 120 microm and were therefore considered clinically acceptable. The CAD/CAM systems were more precise than the CAM system.

Computer-based mechanical design of overhead lines

NASA Astrophysics Data System (ADS)

Rusinaru, D.; Bratu, C.; Dinu, R. C.; Manescu, L. G.

2016-02-01

Beside the performance, the safety level according to the actual standards is a compulsory condition for distribution grids’ operation. Some of the measures leading to improvement of the overhead lines reliability ask for installations’ modernization. The constraints imposed to the new lines components refer to the technical aspects as thermal stress or voltage drop, and look for economic efficiency, too. The mechanical sizing of the overhead lines is after all an optimization problem. More precisely, the task in designing of the overhead line profile is to size poles, cross-arms and stays and locate poles along a line route so that the total costs of the line's structure to be minimized and the technical and safety constraints to be fulfilled.The authors present in this paper an application for the Computer-Based Mechanical Design of the Overhead Lines and the features of the corresponding Visual Basic program, adjusted to the distribution lines. The constraints of the optimization problem are adjusted to the existing weather and loading conditions of Romania. The outputs of the software application for mechanical design of overhead lines are: the list of components chosen for the line: poles, cross-arms, stays; the list of conductor tension and forces for each pole, cross-arm and stay for different weather conditions; the line profile drawings.The main features of the mechanical overhead lines design software are interactivity, local optimization function and high-level user-interface

SuperCam_MastUnit

NASA Astrophysics Data System (ADS)

Deleuze, M. D.; Bernardi, P. B.; Caïs, Ph. C.; Perez, R. P.; Rees, J. M. R.; Pares, L. P.; Dubois, B. D.; Parot, Y. P.; Quertier, B. Q.; Maurice, S. M.; Maccabe, K. M.; Wiens, R. W.; Rull, F. R.

2016-10-01

This paper will describe and give a development status of SuperCam's mast unit. SuperCam will be carried on the Mars 2020 rover, and consists in an enhanced version of the ChemCam LIBS which is still performing at the surface of Mars, on Curiosity.

Buying CAM.

ERIC Educational Resources Information Center

Meloy, Jim; And Others

1990-01-01

The relationship between computer-aided design (CAD), computer-aided manufacturing (CAM), and computer numerical control (CNC) computer applications is described. Tips for helping educate the CAM buyer on what to look for and what to avoid when searching for the most appropriate instructional CAM package are provided. (KR)

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

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

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

DOE PAGES

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

2016-04-12

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

“We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

PubMed Central

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-01-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

Complementary and alternative medicine use by osteoporotic patients in Australia (CAMEO-A): a prospective study.

PubMed

Mak, Jenson C S; Faux, Steven

2010-05-01

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with osteoporosis in Australasia and worldwide. This study was done to determine the prevalence and patterns of use of CAM in an Australian osteoporosis clinic. This was a prospective, cross-sectional questionnaire-based study of 202 patients attending an academic osteoporosis clinic in Sydney, Australia. Subject had a mean age of 68.5 +/- 10.9 years, 79.7% were female, and 55.9% were born overseas. CAM use was reported by 104 patients (51.5%) using the standard and 62 patients (30.7%) using the stringent definition of CAM. The most frequent CAM were multivitamins (24.0%), acupuncture (19.2%), t'ai chi (14.4%), and yoga (12.5%). Seventy-three percent (73%) did not consult a physician before starting CAM and 23.1% stated that their treating specialists were unaware of CAM use. The most common reasons for using CAM were having a holistic approach (53.0%) and inadequate pain control (29.0%). CAM users were associated with Asian country of birth (23.1% versus 12.2%, p = 0.03), more frequent clinic visits over a 12-month period (1.8 versus 1.5 times, p = 0.03), and a trend for a worse lumbar spine T-score (-2.35 versus -2.20 SD, p = 0.05) and higher rates of university education (26.0% versus 14.3%, p = 0.05). It is estimated that $696 million is spent annually on CAM by patients with osteoporosis. Patients attending osteoporosis clinics frequently use CAM. Physicians may need to routinely inquire about a history of CAM use to ensure better screening for possible adverse clinical interactions.

"We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

PubMed

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-04-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

Ecophysiology of Crassulacean Acid Metabolism (CAM).

PubMed

Lüttge, Ulrich

2004-06-01

Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. Input is given by a network of environmental parameters. Six major ones, CO(2), H(2)O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level ('physiological aut-ecology'). Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain 'black boxes', and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. 'Physiological syn-ecology' reveals that phenotypic plasticity constitutes the ecophysiological advantage of CAM.

Complementary and alternative medicine: Do physicians believe they can meet the requirements of the Collège des médecins du Québec?

PubMed

Gaboury, Isabelle; Johnson, Noémie; Robin, Christine; Luc, Mireille; O'Connor, Daniel; Patenaude, Johane; Pélissier-Simard, Luce; Xhignesse, Marianne

2016-12-01

To determine whether medical training prepares FPs to meet the requirements of the Collège des médecins du Québec for their role in advising patients on the use of complementary and alternative medicine (CAM). Secondary analysis of survey results. Quebec. Family physicians and GPs in active practice. Perceptions of the role of the physician as an advisor on CAM; level of comfort responding to questions and advising patients on CAM; frequency with which patients ask their physicians about CAM; personal position on CAM; and desire for training on CAM. The response rate was 19.5% (195 respondents of 1000) and the sample appears to be representative of the target population. Most respondents (85.8%) reported being asked about CAM several times a month. A similar proportion (86.7%) believed it was their role to advise patients on CAM. However, of this group, only 33.1% reported being able to do so. There is an association between an urban practice and knowledge of the advisory role of physicians. More than three-quarters of respondents expressed interest in receiving additional training on CAM. There is a gap between the training that Quebec physicians receive on CAM and their need to meet legal and ethical obligations designed to protect the public where CAM products and therapies are concerned. One solution might be more thorough training on CAM to help physicians meet the Collège des médecins du Québec requirements. Copyright© the College of Family Physicians of Canada.

WADeG Cell Phone

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

2009-09-01

The on cell phone software captures the images from the CMOS camera periodically, stores the pictures, and periodically transmits those images over the cellular network to the server. The cell phone software consists of several modules: CamTest.cpp, CamStarter.cpp, StreamIOHandler .cpp, and covertSmartDevice.cpp. The camera application on the SmartPhone is CamStarter, which is "the" user interface for the camera system. The CamStarter user interface allows a user to start/stop the camera application and transfer files to the server. The CamStarter application interfaces to the CamTest application through registry settings. Both the CamStarter and CamTest applications must be separately deployed on themore » smartphone to run the camera system application. When a user selects the Start button in CamStarter, CamTest is created as a process. The smartphone begins taking small pictures (CAPTURE mode), analyzing those pictures for certain conditions, and saving those pictures on the smartphone. This process will terminate when the user selects the Stop button. The camtest code spins off an asynchronous thread, StreamIOHandler, to check for pictures taken by the camera. The received image is then tested by StreamIOHandler to see if it meets certain conditions. If those conditions are met, the CamTest program is notified through the setting of a registry key value and the image is saved in a designated directory in a custom BMP file which includes a header and the image data. When the user selects the Transfer button in the CamStarter user interface, the covertsmartdevice code is created as a process. Covertsmartdevice gets all of the files in a designated directory, opens a socket connection to the server, sends each file, and then terminates.« less

Cecropin A-melittin mutant with improved proteolytic stability and enhanced antimicrobial activity against bacteria and fungi associated with gastroenteritis in vitro.

PubMed

Ji, Shengyue; Li, Weili; Zhang, Lei; Zhang, Yue; Cao, Binyun

2014-09-05

Cecropin A-melittin (CAM), a chimeric antimicrobial peptide with potent antimicrobial activity, is threatened by some special extracellular proteases when used to deal with certain drug-resistant pathogenic microbes in the gastrointestinal tract. Thus, a four-tryptophan-substitution mutant (CAM-W) from CAM was developed via the replacement of special amino acid residues to enhance the antimicrobial potency and to improve the proteolytic stability of this agent. The pharmaceutical index of CAM-W was investigated, with a focus on biological potency, cytotoxicity, and proteolytic stability, as well as pH and thermal resistance. CAM-W exhibited potent antimicrobial activity and was approximately 3-12 times higher than that of CAM. CAM-W also exhibited a strong antifungal activity against a series of common pathogenic fungi, in a lower IC50 range between 2.1mg/L and 3.3mg/L than that of its reference CAM ranging from 9.8mg/L to 14.2mg/L. Besides, CAM-W showed moderate cytotoxicity (IC50>300mg/L) in erythrocyte lysis test. In addition, CAM-W overcame challenges under various conditions, including specific temperatures (20, 30, 40, 50, 60, 70, 80, and 90°C), pH values (2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, and 9.0), and proteases (trypsin, pepsin, human neutrophil elastase, Pseudomonas aeruginosa elastase, and Staphylococcus aureus V8 protease) that are commonly present in human gastrointestinal tract. These results suggest that the four-tryptophan-substitution can confer CAM-W with a high pharmaceutical index, which is important for CAM-W to become a potential alternative to conventional antibiotics against bacteria and fungi associated with gastroenteritis. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of electronic personal health records (PHRs) for complementary and alternative medicine (CAM) disclosure: Implications for integrative health care.

PubMed

Yeo, Younsook; Park, Jisung; Roh, Soonhee; Levkoff, Sue

2016-06-01

To test a hypothesis that patients' use of Internet-based personal health records (PHRs) will be positively related to their disclosure of their CAM use to medical doctors, controlling for covariates' effects (e.g., health, human capital, and demographics), and to examine the factors influencing patients' CAM use disclosures. Cross-sectional survey. We analyzed data in a subsample of CAM users who used both the internet and healthcare services (n=1457) from the Health Information National Trends Survey, a nationally representative study of U.S. adults (≥18), by using a multivariate logistic analysis. Among the subsample, 52.7% disclosed their use of CAM to their doctors and 19.3% used PHRs. Both the bivariate (64.1% vs. 35.9%, p<0.01) and multivariate (β=0.558, SE=0.220, OR=1.75, p<0.05) analyses revealed a positive relationship between PHR use and CAM use disclosure. Other significant factors for CAM use disclosure included being older, being a female, having insurance, and having regular source of care. Particularly, foreign-born adults had significantly lower odds of disclosing their CAM use than U.S.-born adults. We found that patients' PHR use facilitated their disclosure of CAM use to medical doctors. To ensure integrative healthcare and integrative medicine in the healthcare sector and optimum care for patients, education for CAM users regarding PHR adoption is encouraged. Next-generation PHR designs should consider incorporating domains for CAM data that allow patients to store CAM data and also incorporating 'intelligent' PHRs, whose contents can be converted into the patient's first language. Copyright © 2016 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria.

PubMed

Onyiapat, Jane-Lovena; Okafor, Chinyelu; Okoronkwo, Ijeoma; Anarado, Agnes; Chukwukelu, Ekene; Nwaneri, Ada; Okpala, Pat

2017-04-04

The use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women. The study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics. Majority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine. The use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: a questionnaire study.

PubMed

Münstedt, Karsten; Brenken, Anja; Kalder, Matthias

2009-09-01

Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's chi(2) test were used for statistical analysis. About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives' belief in the methods' effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners' perceptions of the methods' therapeutic effectiveness. CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.

Use of complementary and alternative medicine in children with recurrent acute otitis media in Italy.

PubMed

Marchisio, P; Bianchini, S; Galeone, C; Baggi, E; Rossi, E; Albertario, G; Torretta, S; Pignataro, L; Esposito, S; Principi, N

2011-01-01

Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p<0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.

How to locate and appraise qualitative research in complementary and alternative medicine

PubMed Central

2013-01-01

Background The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Methods Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. Results 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. Conclusions This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies. PMID:23731997

How to locate and appraise qualitative research in complementary and alternative medicine.

PubMed

Franzel, Brigitte; Schwiegershausen, Martina; Heusser, Peter; Berger, Bettina

2013-06-03

The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine

PubMed Central

Sridhar, Sathvik Belagodu; Shariff, Atiqulla; Al Halabi, Nour; Sarmini, Rand; Harb, Lubab Arkan

2017-01-01

Aims and Objectives: This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. Materials and Methods: This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. Results: A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Conclusion: Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM. PMID:28584493

Calmodulin and calcium differentially regulate the neuronal Nav1.1 voltage-dependent sodium channel

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

Gaudioso, Christelle; Carlier, Edmond; Youssouf, Fahamoe

2011-07-29

Highlights: {yields} Both Ca{sup ++}-Calmodulin (CaM) and Ca{sup ++}-free CaM bind to the C-terminal region of Nav1.1. {yields} Ca{sup ++} and CaM have both opposite and convergent effects on I{sub Nav1.1}. {yields} Ca{sup ++}-CaM modulates I{sub Nav1.1} amplitude. {yields} CaM hyperpolarizes the voltage-dependence of activation, and increases the inactivation rate. {yields} Ca{sup ++} alone antagonizes CaM for both effects, and depolarizes the voltage-dependence of inactivation. -- Abstract: Mutations in the neuronal Nav1.1 voltage-gated sodium channel are responsible for mild to severe epileptic syndromes. The ubiquitous calcium sensor calmodulin (CaM) bound to rat brain Nav1.1 and to the human Nav1.1 channelmore » expressed by a stably transfected HEK-293 cell line. The C-terminal region of the channel, as a fusion protein or in the yeast two-hybrid system, interacted with CaM via a consensus C-terminal motif, the IQ domain. Patch clamp experiments on HEK1.1 cells showed that CaM overexpression increased peak current in a calcium-dependent way. CaM had no effect on the voltage-dependence of fast inactivation, and accelerated the inactivation kinetics. Elevating Ca{sup ++} depolarized the voltage-dependence of fast inactivation and slowed down the fast inactivation kinetics, and for high concentrations this effect competed with the acceleration induced by CaM alone. Similarly, the depolarizing action of calcium antagonized the hyperpolarizing shift of the voltage-dependence of activation due to CaM overexpression. Fluorescence spectroscopy measurements suggested that Ca{sup ++} could bind the Nav1.1 C-terminal region with micromolar affinity.« less

Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO.

PubMed

van Tilburg, Miranda A L; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; Turner, Marsha J; Drossman, Douglas A; Whitehead, William E

2008-07-24

Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO

PubMed Central

van Tilburg, Miranda AL; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; Turner, Marsha J; Drossman, Douglas A; Whitehead, William E

2008-01-01

Background Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. Methods 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. Results CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. Conclusion CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate. PMID:18652682

75 FR 44288 - Overhead and Gantry Cranes; Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

...] Overhead and Gantry Cranes; Extension of the Office of Management and Budget's (OMB) Approval of... requirements specified in the Standard on Overhead and Gantry Cranes (29 CFR 1910.179). DATES: Comments must be... requirements for: Marking the rated load of cranes; preparing certification records to verify the inspection of...

How To Prepare Effective Overhead Projector Presentations: One Picture Is Worth a Thousand Words.

ERIC Educational Resources Information Center

National Audio-Visual Supply, East Rutherford, NJ.

Designed to help create effective presentations, this guide describes the basic techniques and provides hints for producing professional, attention-getting overhead transparencies in a step-by-step procedure format. Eight topics are addressed in the guide: (1) eight steps to a successful meeting presentation; (2) advantages of overhead projection;…

EpCAM overexpression prolongs proliferative capacity of primary human breast epithelial cells and supports hyperplastic growth

PubMed Central

2013-01-01

Introduction The Epithelial Cell Adhesion Molecule (EpCAM) has been shown to be strongly expressed in human breast cancer and cancer stem cells and its overexpression has been supposed to support tumor progression and metastasis. However, effects of EpCAM overexpression on normal breast epithelial cells have never been studied before. Therefore, we analyzed effects of transient adenoviral overexpression of EpCAM on proliferation, migration and differentiation of primary human mammary epithelial cells (HMECs). Methods HMECs were transfected by an adenoviral system for transient overexpression of EpCAM. Thereafter, changes in cell proliferation and migration were studied using a real time measurement system. Target gene expression was evaluated by transcriptome analysis in proliferating and polarized HMEC cultures. A Chicken Chorioallantoic Membrane (CAM) xenograft model was used to study effects on in vivo growth of HMECs. Results EpCAM overexpression in HMECs did not significantly alter gene expression profile of proliferating or growth arrested cells. Proliferating HMECs displayed predominantly glycosylated EpCAM isoforms and were inhibited in cell proliferation and migration by upregulation of p27KIP1 and p53. HMECs with overexpression of EpCAM showed a down regulation of E-cadherin. Moreover, cells were more resistant to TGF-β1 induced growth arrest and maintained longer capacities to proliferate in vitro. EpCAM overexpressing HMECs xenografts in chicken embryos showed hyperplastic growth, lack of lumen formation and increased infiltrates of the chicken leukocytes. Conclusions EpCAM revealed oncogenic features in normal human breast cells by inducing resistance to TGF-β1-mediated growth arrest and supporting a cell phenotype with longer proliferative capacities in vitro. EpCAM overexpression resulted in hyperplastic growth in vivo. Thus, we suggest that EpCAM acts as a prosurvival factor counteracting terminal differentiation processes in normal mammary glands. PMID:23758908

Medical students' knowledge, perceptions, and interest in complementary and alternative medicine.

PubMed

Loh, Kah Poh; Ghorab, Hatem; Clarke, Eric; Conroy, Ronan; Barlow, James

2013-04-01

Complementary and alternative medicine (CAM) is a growing industry in the health care system. In Ireland, to date there has not been a study that evaluates the knowledge of, interest in, and attitude of Irish medical students toward CAM. This research can serve as a pilot study to inform Irish medical schools on the need to introduce CAM into the medical curriculum. The survey instrument was a modified design based on previously published studies carried out in other geographical areas. All medical students within the undergraduate and graduate entry programs (GEP) at the Royal College of Surgeons in Ireland were invited to participate in the study. SPSS software was used to analyze the results of the questionnaires. The survey completion rate was 20.1%. A majority of students (78.4%) thought that CAM knowledge is important for their future career as physicians. Approximately 65% of students reported that they have not acquired sufficient knowledge about CAM from medical school, and 50.2% of students believe CAM should be incorporated into the medical curriculum. Preclinical years (49.4%) were suggested as the most appropriate time to learn about CAM. Knowledge of CAM modalities was generally rated as minimal or none by students. Among the 15 CAM modalities incorporated in the survey, massage, acupuncture, and meditation received the highest interest from students. Students who believe in a religion had a higher interest in CAM (p<0.05). In terms of their personal view, massage, spirituality, and acupuncture received the highest positive responses. Attitudes toward CAM were positive from students. Lower willingness to use CAM was seen in clinical students (p<0.05). It is important for the faculty of Irish medical schools to consider the possibility of integrating CAM education into the conventional medical curriculum in a systematic manner to better prepare students in their future career.

Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

PubMed

Jarman, Christopher N; Perron, Brian E; Kilbourne, Amy M; Teh, Carrie Farmer

2010-03-01

Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known, providers should conduct routine assessments of CAM use.

Parental perspectives on use, benefits, and physician knowledge of complementary and alternative medicine in children with autistic disorder and attention-deficit/hyperactivity disorder.

PubMed

Huang, Angela; Seshadri, Kapila; Matthews, Tara Anne; Ostfeld, Barbara M

2013-09-01

Complementary and alternative medicine (CAM) use appears to be increasing in children with developmental disorders. However, it is not clear whether parents perceive their healthcare providers as resources who are knowledgeable about CAM therapies and are interested in further developing their knowledge. (1) To establish and compare use of, and perceived satisfaction with, traditional medicine and CAM in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) and (2) to assess parental perceptions of physician knowledge of CAM and physician interest in continuing education about CAM for the two groups of parents. Families of children with a diagnosis of ADHD or ASD were surveyed regarding the frequency of use of traditional treatment and CAM, parental perceptions of the helpfulness of each therapy, parental perceptions regarding physicians' knowledge level about CAM, and physician interest in continuing education. Thirty-six percent (n=135) of 378 surveys were returned: 41 contained a diagnosis of ADHD and 22 of ASD. Traditional therapies were used by 98% of children with ADHD and 100% of those with ASD. Perceived helpfulness of medication was 92% for children with ADHD and 60% for children with ASD (p<0.05). CAM was used for 19.5% of children with ADHD and 82% of children with ASD. Perceived satisfaction for any form of CAM in the children with ADHD was at an individual patient level. Satisfaction for two of the most commonly used CAM treatments in children with ASD ranged from 50% to 78%. In children with ASD (the diagnostic group with the highest use of and satisfaction with CAM), physician's perceived knowledge of CAM was lower (14% versus 38%; p<0.05), as was perceptions of the physician's interest in learning more (p<0.05). CAM use is significant, especially in children with ASD. Physicians are not perceived as a knowledgeable resource.

Anti-TIF1-γ antibody and cancer-associated myositis: A clinicohistopathologic study.

PubMed

Hida, Ayumi; Yamashita, Takenari; Hosono, Yuji; Inoue, Manami; Kaida, Kenichi; Kadoya, Masato; Miwa, Yusuke; Yajima, Nobuyuki; Maezawa, Reika; Arai, Satoko; Kurasawa, Kazuhiro; Ito, Kazuhiro; Shimada, Hiroyuki; Iwanami, Tomoko; Sonoo, Masahiro; Hatanaka, Yuki; Murayama, Shigeo; Uchibori, Ayumi; Chiba, Atsuro; Aizawa, Hitoshi; Momoo, Takayuki; Nakae, Yoshiharu; Sakurai, Yasuhisa; Shiio, Yasushi; Hashida, Hideji; Yoshizawa, Toshihiro; Sakiyama, Yoshio; Oda, Aya; Inoue, Kiyoharu; Takeuchi, Sousuke; Iwata, Nobue K; Date, Hidetoshi; Masuda, Naoki; Mikata, Takashi; Motoyoshi, Yasufumi; Uesaka, Yoshikazu; Maeda, Meiko Hashimoto; Nakashima, Ran; Tsuji, Shoji; Kwak, Shin; Mimori, Tsuneyo; Shimizu, Jun

2016-07-19

We aimed to analyze the clinical and histopathologic features of cancer-associated myositis (CAM) in relation to anti-transcriptional intermediary factor 1 γ antibody (anti-TIF1-γ-Ab), a marker of cancer association. We retrospectively studied 349 patients with idiopathic inflammatory myopathies (IIMs), including 284 patients with pretreatment biopsy samples available. For the classification of IIMs, the European Neuromuscular Center criteria were applied. Patients with CAM with (anti-TIF1-γ-Ab[+] CAM) and without anti-TIF1-γ-Ab (anti-TIF1-γ-Ab[-] CAM) were compared with patients with IIM without cancers within and beyond 3 years of myositis diagnosis. Cancer was detected in 75 patients, of whom 36 (48%) were positive for anti-TIF1-γ-Ab. In anti-TIF1-γ-Ab(+) patients with CAM, cancers were detected within 1 year of myositis diagnosis in 35 (97%) and before 1 year of myositis diagnosis in 1. All the anti-TIF1-γ-Ab(+) patients with CAM satisfied the dermatomyositis (DM) criteria, including 2 possible DM sine dermatitis cases, and were characterized histologically by the presence of perifascicular atrophy, vacuolated fibers (VFs), and dense C5b-9 deposits on capillaries (dC5b-9). In contrast, 39 anti-TIF1-γ-Ab(-) patients with CAM were classified into various subgroups, and characterized by a higher frequency of necrotizing autoimmune myopathy (NAM). Notably, all 7 patients with CAM classified into the NAM subgroup were anti-TIF1-γ-Ab(-) and exhibited no dC5b-9 or VFs. CAM includes clinicohistopathologically heterogeneous disease entities. Among CAM entities, anti-TIF1-γ-Ab(+) CAM has characteristically shown a close temporal association with cancer detection and the histopathologic findings of dC5b-9 and VFs, and CAM with NAM is a subset of anti-TIF1-γ-Ab(-) CAM. © 2016 American Academy of Neurology.

Complementary and alternative medicines use in children with epilepsy in Ibadan, Nigeria.

PubMed

Lagunju, I A

2013-03-01

There is documented evidence that the use of complementary and alternative medicines (CAM) has been on the increase worldwide. A standardized questionnaire was administered to caregivers of children with epilepsy to evaluate the prevalence and pattern of CAM use. One hundred and seventy five caregivers of 175 children with epilepsy were studied. Ninety nine (56.6%) of the caregivers gave a history of CAM use. The forms of CAM used were herbal preparations (39.4%), spiritual/prayer healing (34.3%), scarifications (17.1%) and special vitamins (6.1%). Seventy (40%) of the 175 children had received CAM ever before seeking Western Medicine for the treatment of epilepsy. Of the 99 children with history of CAM use, 33 (33.3%) continued to use CAM in combination with the prescribed anti-epileptic drug (AED). Adverse effects were reported in 17 (17.1%) cases. There was no statistically significant relationship between the type of epilepsy and the use of CAM (p= 0.229, OR 1.655, 95% CI 0.608-4.508). There was a statistically significant inverse relationship between social class of the family (p = 0.043, OR 0.354, 95% CI 1.087-2.489) and mother's level of education (p = 0.013, OR 2.618, 95% CI 1.173-5.844) and the use of CAM. Only 30 (30.3%) of the 99 caregivers had spontaneously volunteered the history of the use of CAM to the attending physician and the leading reason for not giving the history was that the attending physician did not ask for the information. Children with epilepsy frequently use CAM and attending physicians often fail to ask about use of CAM in the routine evaluation of patients. There is a need to routinely ask caregivers and patients about the use of CAM in management of their disease.

Complementary and alternative medicine usage among cardiac patients: a descriptive study.

PubMed

Bahall, Mandreker

2015-03-31

The use of complementary and alternative medicine (CAM) persists, despite the availability of conventional medicine (CM), modernisation, globalisation, technological advancement, and limited scientific evidence supporting CAM. People with cardiovascular diseases often use CAM, despite possible major adverse effects and lack of evidence supporting CAM claims. This study explored CAM use among cardiac patients, the types of CAM used, reasons and factors that influence its use, and the association between patient demographics and CAM use. This cross-sectional quantitative study was conducted using quota sampling to survey 329 public clinic adult cardiac patients within the South-West Regional Health Authority (SWRHA) of Trinidad and Tobago. From 1 July 2012 to 31August 2012, each participant completed questionnaires, after consenting to participate. Data analysis included χ(2) tests and binary logistic regression. One hundred eighty-five (56.2%; standard error [SE] = 2.74%) patients used CAM. Herbal medicine was the most common CAM (85.9%; SE = 2.56%), followed by spiritual therapy/mind-body systems (61.6%; SE = 3.58%), physical therapy/body manipulation (13.5%; SE = 2.51%), alternative systems (8.1%; SE = 2.01%), and other methods (3.8%; SE = 1. 41%). The patients believed that CAM promotes health and wellness (79.5%; SE = 2.97%), assists in fighting illness (78.9%; SE = 3.00%), addresses the limitations of CM (69.2%; SE = 3.56%), alleviates symptoms (21.6%; SE = 6.51%), costs less than CM (21.6 %, SE = 3.03), and has fewer adverse/damaging effects than CM (29.7, SE =3.36), or they were disappointed with CM (12.4%, SE = 2.42). Ethnicity and religion were associated with CAM usage, but only ethnicity was a useful predictor of CAM use. Complementary and alternative medicine use was high among cardiac patients (56.2%, SE = 2.74%), and associated with ethnicity and religion. Friends, family, and perceived mode of action influenced a patient's use of CAM.

Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine.

PubMed

Zyoud, Sa'ed H; Al-Jabi, Samah W; Sweileh, Waleed M; Tabeeb, Ghada H; Ayaseh, Nora A; Sawafta, Mayas N; Khdeir, Razan L; Mezyed, Diana O; Daraghmeh, Dala N; Awang, Rahmat

2016-07-11

Complementary and alternative medicine (CAM), and herbal therapies, are accepted worldwide, and have been important from medical, sociological and economic perspectives, among haemodialysis (HD) patients. The primary aim of this study was to evaluate the use of CAM among patients with end-stage renal disease (ESRD) who are undergoing HD. Face-to-face interviews of patients with ESRD undergoing HD from ten outpatient renal departments at a national level in Palestine were conducted from June 2014 to January 2015. A survey questionnaire, which included questions on socio-demographic and clinical characteristics, and on the CAM therapies that were used, was administered. Out of 267 patients interviewed, 172 patients used at least one type of CAM in the last month prior to the interview, and thus the utilisation rate was 64.4 %. Forty one (15.4 %) patients reported using one type of CAMs, while 18.7 % used two different CAMs and 30.3 % used more than two types of CAMs for their health status. Of the patients who used CAM, herbal therapies were used most often (43.5 %), followed by honey (35.6 %), diet (22.8 %), and exorcism in Islam (16.9 %). The herbal therapies mentioned most often were Nigella sativa L. (18.7 %), followed by Salvia officinalis L. (16.9 %), and Pimpinella anisum L. (10.5 %). In conclusion, the prevalence of CAM is relatively high in the selected population. Most patients used biological therapies such as herbal remedies, thus highlighting a greater need for patient education regarding CAM therapies and possible herb-drug interactions. Health care providers must be aware of the potential benefits and risks related to CAM use. There is a need for more clinical research pertaining to CAM to reach stronger evidence regarding potential benefits and risks related to CAM use.

Use of complementary and alternative medicine among midlife Arab women living in Qatar

PubMed Central

Gerber, L.M.; Mamtani, R.; Chiu, Y-L.; Bener, A.; Murphy, M.; Cheema, S.; Verjee, M.

2015-01-01

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40–60 years (n = 814) were recruited at primary health-care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM. PMID:25343468

An active learning complementary and alternative medicine session in a self-care therapeutics class.

PubMed

Mattison, Melissa J; Nemec, Eric C

2014-09-15

To provide an interactive, non-supplement based complementary and alternative medicine (CAM) session in a self-care therapeutics class and to evaluate the effect of the session on pharmacy students' perceptions and knowledge of CAM. Second professional year pharmacy students enrolled in a required 3-credit course titled Self-Care Therapeutics participated in an active learning session on CAM. Students physically engaged in 5 separate active learning CAM sessions including massage therapy, Tai Chi, yoga, progressive muscle relaxation, and Reiki. Students were assessed on both knowledge and perception of CAM. Concept mastery was assessed using a written examination and individual readiness assurance tests (iRAT) and team readiness assurance tests (tRAT). Perception of CAM was measured using both a presession and a postsession survey. Participating in an intensive, active learning CAM session provided an opportunity to increase students' knowledge of CAM and an effective strategy for providing the learner with the experience to better envision incorporation into patient therapies.

Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients.

PubMed

Braun, Lesley; Harris, Jessica; Katris, Paul; Cain, Michael; Dhillon, Haryana; Koczwara, Bogda; Olver, Ian; Robotin, Monica

2014-12-01

Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy. © 2014 Wiley Publishing Asia Pty Ltd.

The Use of Complementary and Alternative Medicine in Scandinavia.

PubMed

Nilsson, Jonas; Källman, Mikael; Östlund, Ulrika; Holgersson, Georg; Bergqvist, Michael; Bergström, Stefan

2016-07-01

Complementary alternative medicine (CAM) is widely used among patients with cancer. This usage may have potentially harmful effects, especially when combined with anticancer drugs. However, some complementary methods may benefit patients. This review investigated the prevalence of CAM use among patients with cancer in Scandinavia and secondly studied the educational levels of CAM users compared to non-users. A systematic search of the PubMed library was carried out to locate articles published between January 2000 and October 2015 that investigated prevalence of CAM use among Scandinavian patients with cancer. Twenty-two articles were found, of which nine were included in the review. The prevalence of CAM use was 7.9% to 53%, with an average of 36.0% across all studies. Use of CAM is widespread among patients with cancer. Knowledge about CAM should be disseminated to both patients and staff in order to optimise discussions about CAM in clinical practice. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Prevalence and reasons for intentional use of complementary and alternative medicine as an adjunct to future visits to a medical doctor for chronic disease.

PubMed

Kristoffersen, Agnete E; Stub, Trine; Musial, Frauke; Fønnebø, Vinjar; Lillenes, Ola; Norheim, Arne Johan

2018-03-27

Intentional use of complementary and alternative medicine (CAM) has previously only been researched in small, possibly biased, samples. There seems to be a lack of scientific information regarding healthy individual's attitudes and presumed use of CAM. The aim of this study is to describe prevalence and characteristics of participants who intend to see a CAM provider compared to participants who intend to see a medical doctor (MD) only when suffering from a chronic, non- life-threatening disease and in the need of treatment. Further to describe differences between the groups regarding expected reasons for CAM use and expected skills of CAM providers. The survey was conducted in January 2016 as part of the "TNS Gallup Health policy Barometer". In total, 1728 individuals aged 16-92 years participated in the study, constituting an overall response rate of 47%. The survey included questions regarding opinions and attitudes towards health, health services and health politics in Norway. The majority of the participants (90.2%) would see a MD only if they were suffering from a chronic, non- life-threatening disease and were in the need of treatment. Men over the age of 60 with a university education tended to see a MD only. Only 9.8% of all respondents would in addition visit a CAM provider. Being an intentional user of a MD + CAM provider was associated with being a woman under the age of 60. The respondents believed that CAM providers have professional competence based on formal training in CAM. They also believed that individuals seeing a CAM provider have poor health and are driven by the hope of being cured. Further, that they have heard that others have good experience with such treatment. Intentional use of CAM is associated with positive attitudes, trustworthiness, and presumed positive experiences in the CAM-patient-setting. Intentional CAM users also have the impression that CAM providers have professional competence based on formal training in alternative therapies.

Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study

PubMed Central

2011-01-01

Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with respect to the regulation of CAM products in Lebanon is not conducive to public safety, nor does it support the integration of CAM products into the healthcare system. The Ministry of Health indeed plays a dominant role in the regulation of these products through a combination of mixed and compulsory policy instruments. Yet, the proper implementation of these regulations requires political resolve coupled with the cooperation of all CAM stakeholders. PMID:21871124

Overhead Crane Computer Model

NASA Astrophysics Data System (ADS)

Enin, S. S.; Omelchenko, E. Y.; Fomin, N. V.; Beliy, A. V.

2018-03-01

The paper has a description of a computer model of an overhead crane system. The designed overhead crane system consists of hoisting, trolley and crane mechanisms as well as a payload two-axis system. With the help of the differential equation of specified mechanisms movement derived through Lagrange equation of the II kind, it is possible to build an overhead crane computer model. The computer model was obtained using Matlab software. Transients of coordinate, linear speed and motor torque of trolley and crane mechanism systems were simulated. In addition, transients of payload swaying were obtained with respect to the vertical axis. A trajectory of the trolley mechanism with simultaneous operation with the crane mechanism is represented in the paper as well as a two-axis trajectory of payload. The designed computer model of an overhead crane is a great means for studying positioning control and anti-sway control systems.

New inner boundaries of the habitable zones around M dwarfs

NASA Astrophysics Data System (ADS)

Bin, Jiayu; Tian, Feng; Liu, Lei

2018-06-01

Two general circulation models CAM4 and CAM5 are used to study the climate of ocean planets around M dwarfs with different effective temperatures. The atmospheres in CAM5 simulations are warmer and contain more water vapor than those in CAM4 under identical model settings, a result likely caused by improved treatments of radiation and possibly clouds in CAM5. The inner boundary of the habitable zones of M dwarfs based on CAM5 simulations, expressed as a second order polynomial function, are farther away from the stars than what are suggested by previous works and the corresponding atmospheres are in the moist greenhouse state.

Overview of integrative medicine in child and adolescent psychiatry.

PubMed

Simkin, Deborah R; Popper, Charles W

2013-07-01

Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

Effects of antibacterial agents, levofloxacin and clarithromycin, on aquatic organisms.

PubMed

Yamashita, N; Yasojima, M; Nakada, N; Miyajima, K; Komori, K; Suzuki, Y; Tanaka, H

2006-01-01

Contamination of surface waters by pharmaceutical chemicals is an emerging environmental problem. This study evaluated the toxic effects of the antibacterial agents levofloxacin (LVFX) and clarithromycin (CAM), which are widely used in Japan, on aquatic organisms. Ecotoxicity tests using a bacterium, alga and crustacean were conducted. Microtox test using a marine fluorescent bacterium showed that LVFX and CAM have no acute toxicity to the bacterium. From the results of the Daphnia immobilisation test, LVFX and CAM did not show acute toxicity to the crustacean. Meanwhile, an algal growth inhibition test revealed that LVFX and CAM have high toxicity to the microalga. The phytotoxicity of CAM was about 100-fold higher than that of LVFX from a comparison of EC50 (median effective concentration) value. From the Daphnia reproduction test, LVFX and CAM also showed chronic toxicity to the crustacean. Concentrations of LVFX and CAM in the aquatic environment were compared with PNEC (predicted no effect concentration) to evaluate the ecological risk. As a result, the ecological risk of LVFX is considered to be low, but that of CAM is higher, suggesting that CAM discharged into an aquatic environment after therapeutic use may affect organisms in the aquatic environment.

L1CAM in the Early Enteric and Urogenital System

PubMed Central

Pechriggl, Elisabeth Judith; Concin, Nicole; Blumer, Michael J.; Bitsche, Mario; Zwierzina, Marit; Dudas, Jozsef; Koziel, Katarzyna; Altevogt, Peter; Zeimet, Alain-Gustave; Fritsch, Helga

2016-01-01

L1 cell adhesion molecule (L1CAM) is a transmembrane molecule belonging to the L1 protein family. It has shown to be a key player in axonal guidance in the course of neuronal development. Furthermore, L1CAM is also crucial for the establishment of the enteric and urogenital organs and is aberrantly expressed in cancer originating in these organs. Carcinogenesis and embryogenesis follow a lot of similar molecular pathways, but unfortunately, comprehensive data on L1CAM expression and localization in human developing organs are lacking so far. In the present study we, therefore, examined the spatiotemporal distribution of L1CAM in the early human fetal period (weeks 8–12 of gestation) by means of immunohistochemistry and in situ hybridization (ISH). In the epithelia of the gastrointestinal organs, L1CAM localization cannot be observed in the examined stages most likely due to their advanced polarization and differentiation. Despite these results, our ISH data indicate weak L1CAM expression, but only in few epithelial cells. The genital tracts, however, are distinctly L1CAM positive throughout the entire fetal period. We, therefore, conclude that in embryogenesis L1CAM is crucial for further differentiation of epithelia. PMID:28026654

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns.

PubMed

Kwon, Taek-Ka; Pak, Hyun-Soon; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

2013-05-01

All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. THE MEAN FRACTURE STRENGTHS WERE AS FOLLOWS: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.

Distributed Energy Resources Customer Adoption Model Plus (DER-CAM+), Version 1.0.0

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

Stadler, Michael; Cardorso, Goncalo; Mashayekh, Salman

DER-CAM+ v1.0.0 is internally referred to as DER-CAM v5.0.0. Due to fundamental changes from previous versions, a new name (DER-CAM+) will be used for DER-CAM version 5.0.0 and above. DER-CAM+ is a Decision Support Tool for Decentralized Energy Systems that has been tailored for microgrid applications, and now explicitly considers electrical and thermal networks within a microgrid, ancillary services, and operating reserve. DER-CAM was initially created as an exclusively economic energy model, able to find the cost minimizing combination and operation profile of a set of DER technologies that meet energy loads of a building or microgrid for a typicalmore » test year. The previous versions of DER-CAM were formulated without modeling the electrical/thermal networks within the microgrid, and hence, used aggregate single-node approaches. Furthermore, they were not able to consider operating reserve constraints, and microgrid revenue streams from participating in ancillary services markets. This new version DER-CAM+ considers these issues by including electrical power flow and thermal flow equations and constraints in the microgrid, revenues from various ancillary services markets, and operating reserve constraints.« less

Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey.

PubMed

James, Peter B; Bah, Abdulai J

2014-11-08

The widespread use of CAM around the world requires health professionals including pharmacists to have the required knowledge to better advise their patients. This has lead to an increased need for the inclusion of CAM instruction into the mainstream undergraduate Pharmacy education. This study was designed to describe pharmacy students awareness, use, attitude and perceived need for CAM education at COMAHS-USL and at the same time, determine how these descriptive outcomes are influenced by the socio-demographic variables considered in this study. A descriptive cross-sectional survey was conducted among undergraduate pharmacy students (n = 90) at the College of Medicine and Allied Health Sciences, University of Sierra Leone using a structured questionnaire. Chi square, fisher exact test, and general linear model univariate analysis were used to compare data between independent cohorts. All 90 (100%) of the students were aware and have used (except Ayurveda) at least one of the listed CAM modalities. Herbal/Botanical/Supplements followed by Spirituality/Prayer were the most commonly known and used CAM modalities. Almost two thirds of students considered the CAM modalities they have used to be effective and not harmful. Overall, pharmacy students had a positive attitude towards CAM (Mean attitudinal score = 34.9 ± 4. 5 (range 19-43)) with fourth and fifth year students showing a significantly less positive attitude as compared to the first, second and third year (B = -3.203 p = 0.001, 95% confidence interval -5.093 to -1.314). The media [53 (58.9%)] was the most frequent source of information about CAM. Nearly all students [89 (98.9%)] agreed that CAM knowledge is important to them as future pharmacist and that CAM should be included into the Pharmacy curriculum at COMAHS-USL [81 (90.0%)]. Pharmacy students in Sierra Leone are aware of and have used at least one of the CAM modalities and do show a positive attitude towards CAM. This was demonstrated by their overwhelming endorsement for CAM course to be part of the undergraduate pharmacy training at COMAHS-USL. This study among others will inform and guide the development and implementation of CAM instruction at COMAHS-USL.

High prevalence of complementary and alternative medicine use among patients with sickle cell disease in a tertiary hospital in Lagos, South West, Nigeria.

PubMed

Busari, A A; Mufutau, M A

2017-06-07

Attention and interest in the use of complementary and alternative medicine (CAM) has been reignited globally, most especially in patients with chronic diseases. Sickle cell disease (SCD) is one of such chronic diseases associated with devastating clinical and psychosocial consequences, thus leading those affected to seek alternative treatment apart from orthodox medicine. Hence, this study aimed to determine the prevalence, pattern and tolerability of the use of CAM in patients with SCD in the Lagos University Teaching Hospital (LUTH). This was a cross-sectional survey of 200 respondents with SCD attending the hematology clinics of the Lagos University Teaching Hospital over a period of 3 months. Data on socio-demographic characteristic, clinical profile, the types and sources of CAM used were collected using a well structured pretested questionnaire. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS®) version 17. Of the 200 patients who participated in the study, 113; 56.5% were males and 87; 43.5% were females. Majority of the SCD patients were 1-10 years old and their mean age was 18.8 ± 14.39 years. CAM was reportedly used by 88.5% of the respondents. Biological (herbal) products 156; 62.9% were the most commonly used CAM, followed by alternative medical systems 52; 20.9% and mind-body interventions 30; 12.1%. Relations, friends and neighbors influenced 85.2% of CAM users by recommending CAM to them. Tolerability of CAM was perceived to be excellent as only 33 (18.6%) of the respondents abandoned the use of CAM. Comparing CAM users and CAM non-users, there was no statistical significant difference in the proportion of those >18 years (45.76% vs 52.17%; p = 0.658), those who experienced two or more crises (51.41% vs 34.78%; p = 0.183), and those with stable haemoglobin concentration of >7 g/dL (15.81% vs 8.69%; p = 0.539) More patients among CAM non-users (91.30%) significantly spend over 3000 Naira (USD 15) per month on medicine than CAM users (4.51%) (p < 0.001). CAM use is highly prevalent among adults with sickle cell diseases in Nigeria. CAM is well tolerated and relatively affordable by these patients. Clinician awareness and understanding of the factors influencing the use of CAM and the potential herbal-orthodox medicine interaction are crucial during hospital treatment of these patients.

Rutger's CAM2000 chip architecture

NASA Technical Reports Server (NTRS)

Smith, Donald E.; Hall, J. Storrs; Miyake, Keith

1993-01-01

This report describes the architecture and instruction set of the Rutgers CAM2000 memory chip. The CAM2000 combines features of Associative Processing (AP), Content Addressable Memory (CAM), and Dynamic Random Access Memory (DRAM) in a single chip package that is not only DRAM compatible but capable of applying simple massively parallel operations to memory. This document reflects the current status of the CAM2000 architecture and is continually updated to reflect the current state of the architecture and instruction set.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world

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

Yang, Xiaohan; Cushman, John C.; Borland, Anne M.

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO₂ uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAMmore » crop species and to harness the WUE of CAM by engineering this pathway into existing food and bioenergy crops. An improved understanding of CAM gained through intensive and expanded research efforts has potential for high returns on research investment in the foreseeable future. To help realize the potential of sustainable dryland agricultural systems, it is necessary to address scientific questions related to the genomic features, regulatory mechanisms, and evolution of CAM; CAM-into-C3 engineering; and the production of CAM crops. Answering these questions requires collaborative efforts to build infrastructure for CAM model systems, field trials, mutant collections, and data management.« less

Impact of physical parameterizations on idealized tropical cyclones in the Community Atmosphere Model

NASA Astrophysics Data System (ADS)

Reed, K. A.; Jablonowski, C.

2011-02-01

This paper explores the impact of the physical parameterization suite on the evolution of an idealized tropical cyclone within the National Center for Atmospheric Research's (NCAR) Community Atmosphere Model (CAM). The CAM versions 3.1 and 4 are used to study the development of an initially weak vortex in an idealized environment over a 10-day simulation period within an aqua-planet setup. The main distinction between CAM 3.1 and CAM 4 lies within the physical parameterization of deep convection. CAM 4 now includes a dilute plume Convective Available Potential Energy (CAPE) calculation and Convective Momentum Transport (CMT). The finite-volume dynamical core with 26 vertical levels in aqua-planet mode is used at horizontal grid spacings of 1.0°, 0.5° and 0.25°. It is revealed that CAM 4 produces stronger and larger tropical cyclones by day 10 at all resolutions, with a much earlier onset of intensification when compared to CAM 3.1. At the highest resolution CAM 4 also accounts for changes in the storm's vertical structure, such as an increased outward slope of the wind contours with height, when compared to CAM 3.1. An investigation concludes that the new dilute CAPE calculation in CAM 4 is largely responsible for the changes observed in the development, strength and structure of the tropical cyclone.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world

DOE PAGES

Yang, Xiaohan; Cushman, John C.; Borland, Anne M.; ...

2015-07-07

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO₂ uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAMmore » crop species and to harness the WUE of CAM by engineering this pathway into existing food and bioenergy crops. An improved understanding of CAM gained through intensive and expanded research efforts has potential for high returns on research investment in the foreseeable future. To help realize the potential of sustainable dryland agricultural systems, it is necessary to address scientific questions related to the genomic features, regulatory mechanisms, and evolution of CAM; CAM-into-C3 engineering; and the production of CAM crops. Answering these questions requires collaborative efforts to build infrastructure for CAM model systems, field trials, mutant collections, and data management.« less

Model of human recurrent respiratory papilloma on chicken embryo chorioallantoic membrane for tumor angiogenesis research.

PubMed

Uloza, Virgilijus; Kuzminienė, Alina; Palubinskienė, Jolita; Balnytė, Ingrida; Ulozienė, Ingrida; Valančiūtė, Angelija

2017-07-01

We aimed to develop a chick embryo chorioallantoic membrane (CAM) model of recurrent respiratory papilloma (RPP) and to evaluate its morphological and morphometric characteristics, together with angiogenic features. Fresh RRP tissue samples obtained from 13 patients were implanted in 174 chick embryo CAMs. Morphological, morphometric, and angiogenic changes in the CAM and chorionic epithelium were evaluated up until 7 days after the implantation. Immunohistochemical analysis (34βE12, Ki-67, MMP-9, PCNA, and Sambucus nigra staining) was performed to detect cytokeratins and endothelial cells and to evaluate proliferative capacity of the RRP before and after implantation on the CAM. The implanted RRP tissue samples survived on CAM in 73% of cases while retaining their essential morphologic characteristics and proliferative capacity of the original tumor. Implants induced thickening of both the CAM (241-560%, p=0.001) and the chorionic epithelium (107-151%, p=0.001), while the number of blood vessels (37-85%, p=0.001) in the CAM increased. The results of the present study confirmed that chick embryo CAM is a relevant host for serving as a medium for RRP fresh tissue implantation. The CAM assay demonstrated the specific RRP tumor growth pattern after implantation and provided the first morphological and morphometric characterization of the RRP CAM model that opens new horizons in studying this disease.

Pivoting between calmodulin lobes triggered by calcium in the Kv7.2/calmodulin complex.

PubMed

Alaimo, Alessandro; Alberdi, Araitz; Gomis-Perez, Carolina; Fernández-Orth, Juncal; Bernardo-Seisdedos, Ganeko; Malo, Covadonga; Millet, Oscar; Areso, Pilar; Villarroel, Alvaro

2014-01-01

Kv7.2 (KCNQ2) is the principal molecular component of the slow voltage gated M-channel, which strongly influences neuronal excitability. Calmodulin (CaM) binds to two intracellular C-terminal segments of Kv7.2 channels, helices A and B, and it is required for exit from the endoplasmic reticulum. However, the molecular mechanisms by which CaM controls channel trafficking are currently unknown. Here we used two complementary approaches to explore the molecular events underlying the association between CaM and Kv7.2 and their regulation by Ca(2+). First, we performed a fluorometric assay using dansylated calmodulin (D-CaM) to characterize the interaction of its individual lobes to the Kv7.2 CaM binding site (Q2AB). Second, we explored the association of Q2AB with CaM by NMR spectroscopy, using (15)N-labeled CaM as a reporter. The combined data highlight the interdependency of the N- and C-lobes of CaM in the interaction with Q2AB, suggesting that when CaM binds Ca(2+) the binding interface pivots between the N-lobe whose interactions are dominated by helix B and the C-lobe where the predominant interaction is with helix A. In addition, Ca(2+) makes CaM binding to Q2AB more difficult and, reciprocally, the channel weakens the association of CaM with Ca(2+).

Mind the gap! Lay and medical perceptions of risks associated with the use of alternative treatment and conventional medicine.

PubMed

Salamonsen, Anita

2015-01-01

Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine. In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors. The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option. For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems. © 2015 S. Karger GmbH, Freiburg.

Expression of calmodulin mRNA in rat olfactory neuroepithelium.

PubMed

Biffo, S; Goren, T; Khew-Goodall, Y S; Miara, J; Margolis, F L

1991-04-01

A calmodulin (CaM) cDNA was isolated by differential hybridization screening of a lambda gt10 library prepared from rat olfactory mucosa. This cDNA fragment, containing most of the open reading frame of the rat CaMI gene, was subcloned and used to characterize steady-state expression of CaM mRNA in rat olfactory neuroepithelium and bulb. Within the bulb mitral cells are the primary neuronal population expressing CaM mRNA. The major CaM mRNA expressed in the olfactory mucosa is 1.7 kb with smaller contributions from mRNAs of 4.0 and 1.4 kb. CaM mRNA was primarily associated with the olfactory neurons and, despite the cellular complexity of the tissue and the known involvement of CaM in diverse cellular processes, was only minimally evident in sustentacular cells, gland cells or respiratory epithelium. Following bulbectomy CaM mRNA declines in the olfactory neuroepithelium as does olfactory marker protein (OMP) mRNA. In contrast to the latter, CaM mRNA makes a partial recovery by one month after surgery. These results, coupled with those from in situ hybridization, indicate that CaM mRNA is expressed in both mature and immature olfactory neurons. The program regulating CaM gene expression in olfactory neurons is distinct from those controlling expression of B50/GAP43 in immature, or OMP in mature, neurons respectively.

Transcriptional repression of epithelial cell adhesion molecule (EpCAM) contributes to p53 control of breast cancer invasion

PubMed Central

Sankpal, NV; Willman, MW; Fleming, TP; Mayfield, J; Gillanders, WE

2014-01-01

p53 is a tumor suppressor gene with well-characterized roles in cell cycle regulation, apoptosis and the maintenance of genome stability. Recent evidence suggests that p53 may also contribute to the regulation of migration and invasion. Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein that is overexpressed in the majority of human epithelial carcinomas, including breast and colorectal carcinomas. We demonstrate by chromatin immunoprecipitation assays that p53 interacts with a candidate p53 binding site within the EpCAM gene. p53-mediated transcriptional repression of EpCAM was confirmed in gain-of-function, and loss-of-function experimental systems. Induction of wildtype p53 was associated with a significant dose-dependent decrease in EpCAM expression; conversely, specific ablation of p53 was associated with a significant increase in EpCAM expression. At the functional level, specific ablation of p53 expression is associated with increased breast cancer invasion, and this effect is abrogated by concomitant specific ablation of EpCAM expression. Taken together, these biochemical and functional data are the first demonstration that (1) wildtype p53 protein binds to a response element within the EpCAM gene and negatively regulates EpCAM expression, and (2) transcriptional repression of EpCAM contributes to p53 control of breast cancer invasion. PMID:19141643

The sL1CAM in sera of patients with endometrial and ovarian cancers.

PubMed

Wojciechowski, Michał; Głowacka, Ewa; Wilczyński, Miłosz; Pękala-Wojciechowska, Anna; Malinowski, Andrzej

2017-01-01

L1CAM is a cell adhesion molecule suspected to play an important role in carcinogenesis. The objective of the study was to evaluate the level of soluble L1CAM in the sera of patients with endometrial and ovarian carcinomas and verify the feasibility of the sL1CAM as a marker of these carcinomas. 35 endometrial and 18 ovarian cancer patients were enrolled in the study. 43 patients with benign gynecological conditions constituted a control group. The sL1CAM serum level was measured with ELISA test in each patient and it was referred to the data from the surgical staging of the cancers. The sL1CAM serum level was significantly lower in patients with endometrial cancer than in healthy women and slightly lower in the ovarian cancer group than in the control group. In the endometrial cancer group there was no correlation between sL1CAM concentration and cancer histopathology, stage or grade. sL1CAM concentration positively correlated with ovarian cancer stage and (not significantly) with grade. Despite the increasing data about the possible role of L1CAM as a strong prognostic factor of poor outcome in many cancers, we did not find evidence supporting the use of sL1CAM as a marker of endometrial or ovarian cancers.

Influence of Different CAM Strategies on the Fit of Partial Crown Restorations: A Digital Three-dimensional Evaluation.

PubMed

Zimmermann, M; Valcanaia, A; Neiva, G; Mehl, A; Fasbinder, D

2018-04-09

CAM fabrication is an important step within the CAD/CAM process. The internal fit of restorations is influenced by the accuracy of the subtractive CAM procedure. Little is known about how CAM strategies might influence the fit of CAD/CAM fabricated restorations. The aim of this study was to three-dimensionally evaluate the fit of CAD/CAM fabricated zirconia-reinforced lithium silicate ceramic partial crowns fabricated with three different CAM strategies. The null hypothesis was that different CAM strategies did not influence the fitting accuracy of CAD/CAM fabricated zirconia-reinforced lithium silicate ceramic partial crowns. Preparation for a partial crown was performed on a maxillary right first molar on a typodont. A chairside CAD/CAM system with the intraoral scanning device CEREC Omnicam (Dentsply Sirona, York, PA, USA) and the 3+1 axis milling unit CEREC MCXL was used. There were three groups with different CAM strategies: step bur 12 (12), step bur 12S (12S), and two step-mode (12TWO). The zirconia-reinforced lithium silicate ceramic Celtra Duo (Dentsply Sirona) was used as the CAD/CAM material. A new 3D method for evaluating the fit was applied, consisting of the quadrant scan with the intraoral scanning device CEREC Omnicam. The scan of the PVS material adherent to the preparation and the preparation scan were matched, and the difference analysis was performed with special software OraCheck (Cyfex AG, Zurich, Switzerland). Three areas were selected for analysis: margin (MA), axial (AX), and occlusal (OC). Statistical analysis was performed using 80% percentile, one-way ANOVA, and the post hoc Scheffé test with α=0.05. Statistically significant differences were found both within and between the test groups. The aspect axial fit results varied from 90.5 ± 20.1 μm for the two-step milling mode (12TWO_AX) to 122.8 ± 12.2 μm for the milling with step bur 12S (12S_AX). The worst result in all groups was found for the aspect occlusal fit with the highest value for group 12S of 222.8 ± 35.6 μm. Group two-step milling mode (12TWO) performed statistically significantly better from groups 12 and 12S for the occlusal fit ( p<0.05). Deviation patterns were visually analyzed with a color-coded scheme for each restoration. CAM strategy influenced the internal adaptation of zirconia-reinforced lithium silicate partial crowns fabricated with a chairside CAD/CAM system. Sensible selection of specific areas of internal adaptation and fit is an important factor for evaluating the CAM accuracy of CAD/CAM systems.

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism.

PubMed

Hartwell, James; Dever, Louisa V; Boxall, Susanna F

2016-06-01

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete gene set for CAM. We highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

L1CAM in human cancer.

PubMed

Altevogt, Peter; Doberstein, Kai; Fogel, Mina

2016-04-01

L1 cell adhesion molecule (L1CAM) is one of the first neural adhesion molecules described with important functions in the development of the nervous system. Subsequent work discovered that L1CAM is expressed in many human cancers and is often associated with bad prognosis. This is most likely due to the motility and invasion promoting function of L1CAM. Here, we describe the path L1CAM has taken from a neural adhesion molecule to a recognized tumor antigen. We summarize the literature on L1CAM expression in cancers and pre-cancerous lesions. We focus on the genetic elements required for its re-expression and highlight preclinical studies for targeted therapy. The data suggest that L1CAM is a valuable diagnostic/prognostic marker and an attractive target for the therapy of several human cancers. © 2015 UICC.

Impact of capturing rainfall scavenging intermittency using cloud superparameterization on simulated continental scale wildfire smoke transport

NASA Astrophysics Data System (ADS)

Pritchard, M. S.; Kooperman, G. J.; Zhao, Z.; Wang, M.; Russell, L. M.; Somerville, R. C.; Ghan, S. J.

2011-12-01

Evaluating the fidelity of new aerosol physics in climate models is confounded by uncertainties in source emissions, systematic error in cloud parameterizations, and inadequate sampling of long-range plume concentrations. To explore the degree to which cloud parameterizations distort aerosol processing and scavenging, the Pacific Northwest National Laboratory (PNNL) Aerosol-Enabled Multi-Scale Modeling Framework (AE-MMF), a superparameterized branch of the Community Atmosphere Model Version 5 (CAM5), is applied to represent the unusually active and well sampled North American wildfire season in 2004. In the AE-MMF approach, the evolution of double moment aerosols in the exterior global resolved scale is linked explicitly to convective statistics harvested from an interior cloud resolving scale. The model is configured in retroactive nudged mode to observationally constrain synoptic meteorology, and Arctic wildfire activity is prescribed at high space/time resolution using data from the Global Fire Emissions Database. Comparisons against standard CAM5 bracket the effect of superparameterization to isolate the role of capturing rainfall intermittency on the bulk characteristics of 2004 Arctic plume transport. Ground based lidar and in situ aircraft wildfire plume constraints from the International Consortium for Atmospheric Research on Transport and Transformation field campaign are used as a baseline for model evaluation.

Complementary and alternative medicine use among US Navy and Marine Corps personnel

PubMed Central

Smith, Tyler C; Ryan, Margaret AK; Smith, Besa; Reed, Robert J; Riddle, James R; Gumbs, Gia R; Gray, Gregory C

2007-01-01

Background Recently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown. Methods To investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population. Results and discussion Of 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use. Conclusion These data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data. PMID:17506899

The varied contribution of significant others to Complementary and Alternative Medicine (CAM) uptake by men with cancer: a qualitative analysis.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-06-01

To explore how men's Significant Others (SOs), including family members and close friends, contribute to the uptake and maintenance of specific CAM therapies. This study was the second, qualitative phase of a mixed-methods project investigating the use of CAM in an Australian male cancer population. Male participants were purposefully selected from a pool of 403 patients who answered a survey in the first quantitative phase (94% response rate and 86% consent rate for follow-up interview). Then semi-structured interviews among 26 men with a variety of cancers and 24 SOs were conducted. All 43 interviews were recorded, transcribed, and analysed thematically. Men used CAM/Natural products to cope with physical concerns, and this was actively supported by men's SOs who contributed to the uptake and maintenance of these CAMs. The shared CAM preparation and consumption functioned to strengthen the bond between men and their SOs, and also helped men's SOs to cope with uncertainty and regain control. In contrast, men practiced CAM/Mind-body medicine to receive emotional benefits, and only rarely shared this practice with their SOs, indicating a need for coping with emotions in a private way. Men's CAM use is a multifaceted process that can be better understood by considering CAM categories separately. CAM/Natural products help men to cope with physical concerns, while CAM/Mind-body medicine assist men to cope with their emotions in a private way. Oncology professionals can use this information to better promote and implement integrative cancer care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine use for constipation: a critical review focusing upon prevalence, type, cost, and users' profile, perception and motivations.

PubMed

Peng, W; Liang, H; Sibbritt, D; Adams, J

2016-09-01

Complementary and alternative medicine (CAM) is increasingly used by those suffering from constipation. This paper reports the first critical integrative review of CAM use for people with constipation focusing upon the prevalence, type and cost of CAM use, as well as CAM users' profile, perception and motivations. A comprehensive search of international literature was conducted in MEDLINE, Academic Search Complete (EBSCO), and Allied and Complementary Medicine Database (AMED). The search was limited to original research peer-reviewed English language articles concerning CAM use for constipation published with an abstract and full text between 2005 and 2015. A total of 35 papers met the inclusion criteria and were included in the review. The review shows approximately one in every three people suffering from constipation use CAM with herbal medicine the most commonly used CAM treatment for constipation and a large proportion of CAM use occurring concurrent with or in addition to conventional medical treatments. While early investigation suggests the cost of herbal medicine use in constipation care may be lower than that associated with the use other CAM modalities and conventional medications, this issue requires further research. Although a high percentage of people with constipation using CAM consider these treatments effective, there remains a need for further in-depth examination of both patient and provider perspectives as well as communication and decision-making around CAM use for constipation to inform safe, effective and coordinated care for patients with constipation. © 2016 John Wiley & Sons Ltd.

The use of complementary and alternative medicine in the general population: results from a longitudinal community study.

PubMed

Rössler, Wulf; Lauber, Christoph; Angst, Jules; Haker, Helene; Gamma, Alex; Eich, Dominique; Kessler, Ronald C; Ajdacic-Gross, Vladeta

2007-01-01

Many patients with psychological or physical problems are interested in non-medical approaches. The reasons for the growing popularity of complementary and alternative medicine (CAM) are not well understood considering that evidence of the effectiveness of conventional therapies is greater than ever before. We have examined data from the Zurich Study to determine trends and predictors of CAM use in Switzerland. The Zurich Study is a longitudinal community study that was started in 1979 with a sample of 591 participants born in 1958 and 1959. In 1999, the last of six interview waves with face-to-face interviews was conducted. CAM use was analyzed with data from interviews in 1993 and 1999. Polytomous logistic regression analysis focused on the personal, demographic and sociocultural background of CAM users. CAM use in the last 12 months was reported by 21.9% of the participants in 1993 and by 29.5% in 1999. CAM use among those exhibiting either physical or psychological problems was in the ratio of two to one. There was a trend from alternative variants of CAM (homeopathy) to complementary ones (massage, osteopathy, acupuncture). The vast majority of CAM use was in addition to conventional therapies. Predictors of CAM use were, among others, attribution of physical complaints to stress and other psychological variables, very low education level in parents, and lacking political interest. Besides the sociocultural background, characteristics such as the psychological attribution style play an important role in CAM use. CAM use in Switzerland is mainly of a complementary rather than an alternative nature.

CAM use in pediatric neurology: an exploration of concurrent use with conventional medicine.

PubMed

Galicia-Connolly, Elaine; Adams, Denise; Bateman, Justin; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

2014-01-01

Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. A survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. Overall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician. CAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies.

CAM Use in Pediatric Neurology: An Exploration of Concurrent Use with Conventional Medicine

PubMed Central

Galicia-Connolly, Elaine; Adams, Denise; Bateman, Justin; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W. James; Vohra, Sunita

2014-01-01

Background Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). Objective To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. Methods A survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. Results Overall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician. Conclusion CAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies. PMID:24736474

Healthcare professional views and experiences of complementary and alternative therapies in obstetric practice in North East Scotland: a prospective questionnaire survey.

PubMed

Stewart, D; Pallivalappila, A R; Shetty, A; Pande, B; McLay, J S

2014-07-01

The aim of this study was to investigate the use of complementary and alternative medicines (CAMs) therapy by UK healthcare professionals involved in the care of pregnant women, and to identify key predictors of use. A prospective survey. Maternity services in Grampian, North East Scotland. All healthcare professionals (135) involved in the care of pregnant women (midwives, obstetricians, anaesthetists). Questionnaire development, piloting, and distribution. Descriptive and inferential statistical analysis. A response rate of 87% was achieved. A third of respondents (32.5%) had recommended (prescribed, referred, or advised) the use of CAMs to pregnant women. The most frequently recommended CAMs modalities were: vitamins and minerals (excluding folic acid) (55%); massage (53%); homeopathy (50%); acupuncture (32%); yoga (32%); reflexology (26%); aromatherapy (24%); and herbal medicine (21%). Although univariate analysis identified that those who recommended CAMs were significantly more likely to be midwives who had been in post for more than 5 years, had received training in CAMs, were interested in CAMs, and were themselves users of CAMs, the only variable retained in bivariate logistic regression was 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09-22.05; P < 0.001). Despite the lack of safety or efficacy data, a wide variety of CAM therapies are recommended to pregnant women by approximately a third of healthcare professionals, with those recommending the use of CAMs being eight times more likely to be personal CAM users. © 2014 Royal College of Obstetricians and Gynaecologists.

Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center.

PubMed

Judson, Patricia L; Abdallah, Reem; Xiong, Yin; Ebbert, Judith; Lancaster, Johnathan M

2017-03-01

To define the use of complementary and alternative medicine (CAM) in individuals presenting for care at a comprehensive cancer center. A total of 17 639 individuals presenting to an NCI-designated Comprehensive Cancer Center (and consortium sites) completed a questionnaire regarding CAM use. Data were analyzed using the univariate χ 2 test to assess CAM use associated with a number of variables, including cancer status, age, gender, marital status, ethnicity, race, employment, and education level. Eighty-seven percent of individuals who completed the CAM survey acknowledged CAM therapy use within the previous 12 months. Of the 5 broad categories of CAM, the most commonly used were biologically based approaches (14 759/17 639 [83.67%]), mind-body interventions (4624/17 485 [26.45%]), manipulative and body-based therapies (3957/17 537 [22.56%]), alternative medical systems (429/15 952 [2.69%]), and energy therapies (270/15 872 [1.7%]). CAM use was more prevalent among women, non-Hispanics, Caucasians, patients 60 to 69 years of age, and those who are married, have a higher level of education, and are employed ( P < .005). This is the largest report of CAM use in individuals presenting for care at a comprehensive cancer center. Our analysis revealed that a very high percentage of patients utilize CAM. Because many of these CAM interventions are not studied in oncology patients, additional research on safety, efficacy, and mechanisms of action are essential. Furthermore, it is important that oncologists understand CAM modalities and counsel their patients about their use.

L1CAM expression in endometrial carcinomas: an ENITEC collaboration study

PubMed Central

van der Putten, Louis JM; Visser, Nicole CM; van de Vijver, Koen; Santacana, Maria; Bronsert, Peter; Bulten, Johan; Hirschfeld, Marc; Colas, Eva; Gil-Moreno, Antonio; Garcia, Angel; Mancebo, Gemma; Alameda, Fransesc; Trovik, Jone; Kopperud, Reidun K; Huvila, Jutta; Schrauwen, Stefanie; Koskas, Martin; Walker, Francine; Weinberger, Vit; Minar, Lubos; Jandakova, Eva; Snijders, Marc PLM; van den Berg-van Erp, Saskia; Matias-Guiu, Xavier; Salvesen, Helga B; Amant, Frederic; Massuger, Leon FAG; Pijnenborg, Johanna MA

2016-01-01

Background: Identification of aggressive endometrioid endometrial carcinomas (EECs) and non-endometrioid carcinomas (NEECs) is essential to improve outcome. L1 cell adhesion molecule (L1CAM) expression is a strong prognostic marker in stage I EECs, but less is known about L1CAM expression in advanced-stage EECs and NEECs. This study analyses L1CAM expression in a clinically representative cohort of endometrial carcinomas. Methods: The expression of L1CAM was immunohistochemically determined in 1199 endometrial carcinomas, treated at one of the European Network for Individualized Treatment of Endometrial Cancer (ENITEC) centres. Staining was considered positive when >10% of the tumour cells expressed L1CAM. The association between L1CAM expression and several clincopathological characteristics and disease outcome was calculated. Results: In all, L1CAM was expressed in 10% of the 935 stage I EECs, 18% of the 160 advanced stage EECs, and 75% of the 104 NEECs. The expression of L1CAM was associated with advanced stage, nodal involvement, high tumour grade, non-endometrioid histology, lymphovascular space invasion, and distant recurrences in all cases, and with reduced survival in the EECs, but not in the NEECs. Conclusions: The expression of L1CAM is a strong predictor of poor outcome in EECs, but not NEECs. It is strongly associated with non-endometrioid histology and distant spread, and could improve the postoperative selection of high-risk endometrial carcinomas. The value of L1CAM expression in the preoperative selection of high-risk endometrial carcinomas should be studied. PMID:27505134

Gas exchange and leaf anatomy of a C3-CAM hybrid, Yucca gloriosa (Asparagaceae).

PubMed

Heyduk, Karolina; Burrell, Nia; Lalani, Falak; Leebens-Mack, Jim

2016-03-01

While the majority of plants use the typical C3 carbon metabolic pathway, ~6% of angiosperms have adapted to carbon limitation as a result of water stress by employing a modified form of photosynthesis known as Crassulacean acid metabolism (CAM). CAM plants concentrate carbon in the cells by temporally separating atmospheric carbon acquisition from fixation into carbohydrates. CAM has been studied for decades, but the evolutionary progression from C3 to CAM remains obscure. In order to better understand the morphological and physiological characteristics associated with CAM photosynthesis, phenotypic variation was assessed in Yucca aloifolia, a CAM species, Yucca filamentosa, a C3 species, and Yucca gloriosa, a hybrid species derived from these two yuccas exhibiting intermediate C3-CAM characteristics. Gas exchange, titratable leaf acidity, and leaf anatomical traits of all three species were assayed in a common garden under well-watered and drought-stressed conditions. Yucca gloriosa showed intermediate phenotypes for nearly all traits measured, including the ability to acquire carbon at night. Using the variation found among individuals of all three species, correlations between traits were assessed to better understand how leaf anatomy and CAM physiology are related. Yucca gloriosa may be constrained by a number of traits which prevent it from using CAM to as high a degree as Y. aloifolia. The intermediate nature of Y. gloriosa makes it a promising system in which to study the evolution of CAM. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

Multiprogramming performance degradation - Case study on a shared memory multiprocessor

NASA Technical Reports Server (NTRS)

Dimpsey, R. T.; Iyer, R. K.

1989-01-01

The performance degradation due to multiprogramming overhead is quantified for a parallel-processing machine. Measurements of real workloads were taken, and it was found that there is a moderate correlation between the completion time of a program and the amount of system overhead measured during program execution. Experiments in controlled environments were then conducted to calculate a lower bound on the performance degradation of parallel jobs caused by multiprogramming overhead. The results show that the multiprogramming overhead of parallel jobs consumes at least 4 percent of the processor time. When two or more serial jobs are introduced into the system, this amount increases to 5.3 percent

Effects of overhead work involving different heights and distances on neck and shoulder muscle activity.

PubMed

Shin, Seung-Je; Yoo, Won-Gyu

2015-06-05

Although overhead work is closely related to musculoskeletal disorders, it is difficult to avoid these postures in daily working conditions. In industrial tasks that require elevated arm postures above shoulder height, flexibility in the location of the task is necessary. This study investigated the sternocleidomastoid, upper trapezius, lower trapezius, and anterior deltoid, serratus anterior muscle activities during overhead work involving four different height and distance locations performed by healthy adult participants. Eighteen young male right-hand-dominant workers were recruited. The right upper trapezius, lower trapezius, serratus anterior, anterior deltoid, and sternocleidomastoid muscle activities were measured under for overhead work condition (Location 1: overhead work with a height of 10 cm above the head of each subject and distance of 15 cm, Location 2: overhead work with a height of 10 cm above the head of each subject and distance of 30 cm, Location 3: overhead work with a height of 20 cm above the head of each subject and distance of 15 cm, Location 4: overhead work with a height of 20 cm above the head of each subject and distance of 30 cm). In Location 3, there was significantly higher neck extension range of motion compared to Location 1, Location 2 and Location 4. In Location 1, the activities of the upper trapezius, lower trapezius, serratus anterior, anterior deltoid, and sternocleidomastoid muscles were significantly lower than those in Location 3 (p<0.05). In Location 2, the activities of the upper trapezius, lower trapezius, serratus anterior, anterior deltoid, and sternocleidomastoid muscles were significantly lower than those in Location 4 (p<0.05). In Location 1, there were significantly lower upper trapezius, lower trapezius, serratus anterior, and anterior deltoid muscle activities than in Location 2 (p<0.05). In Location 3, there were significantly lower upper trapezius, lower trapezius, serratus anterior, and anterior deltoid muscle activities than in Location 4 (p<0.05). In Location 1, there was significantly higher sternocleidomastoid muscle activity than in Location 2 (p<0.05). Finally, In Location 3, there was significantly higher sternocleidomastoid muscle activity than in Location 4 (p<0.05). Overhead workers should engage in work that involves a low height and near distance. Height appears to be a stronger risk factor than distance in overhead work.

Nucleic acid encoding DS-CAM proteins and products related thereto

DOEpatents

Korenberg, Julie R.

2005-11-01

In accordance with the present invention, there are provided Down Syndrome-Cell Adhesion Molecule (DS-CAM) proteins. Nucleic acid sequences encoding such proteins and assays employing same are also disclosed. The invention DS-CAM proteins can be employed in a variety of ways, for example, for the production of anti-DS-CAM antibodies thereto, in therapeutic compositions and methods employing such proteins and/or antibodies. DS-CAM proteins are also useful in bioassays to identify agonists and antagonists thereto.

Crassulacean acid metabolism in submerged aquatic plants

USGS Publications Warehouse

Keeley, Jon E.; Sybesme, C.

1984-01-01

CO2-fixation in the dark is known to occur in various organs of many plants. However, only in species possessing crassulacean acid metabolism (CAM) does dark CO2-fixation contribute substantially to the carbon economy of the plant. Until very recently CAM was known only from terrestrial species, largely drought adapted succulents. The discovery of CAM in the submerged aquatic fern ally Isoetes howellii (Isoetaceae)(Keeley 1981) adds a new dimension to our understanding of crassulacean acid metabolism. In this paper I will summarize 1) the evidence of CAM in Isoetes howellii, 2) the data on the distribution of CAM in aquatic species, and 3) the work to date on the functional significance of CAM in aquatic species.

The Challenge of Complementary and Alternative Medicine After Austerity: A Response to Recent Commentaries.

PubMed

Tavares, Aida Isabel

2015-10-26

Complementary and Alternative Medicine (CAM) is frequently used in Portugal and it contributes to the improvement of people's health. CAM and Western Medicine (WM) are taken as complements both in the diagnosis and the treatment stage. The Portuguese health system is able to generate certified CAM professionals but the provision of CAM care and services is not included in the national health system. In times of austerity, this is not expected to change and access to CAM care continues to be out-of-pocket health expenditure. But the future for health in Portugal may well involve including CAM therapies in an integrated health system. © 2016 by Kerman University of Medical Sciences.

The Challenge of Complementary and Alternative Medicine After Austerity: A Response to Recent Commentaries

PubMed Central

Tavares, Aida Isabel

2016-01-01

Complementary and Alternative Medicine (CAM) is frequently used in Portugal and it contributes to the improvement of people’s health. CAM and Western Medicine (WM) are taken as complements both in the diagnosis and the treatment stage. The Portuguese health system is able to generate certified CAM professionals but the provision of CAM care and services is not included in the national health system. In times of austerity, this is not expected to change and access to CAM care continues to be out-of-pocket health expenditure. But the future for health in Portugal may well involve including CAM therapies in an integrated health system. PMID:26673657

The Mars NetLander panoramic camera

NASA Astrophysics Data System (ADS)

Jaumann, Ralf; Langevin, Yves; Hauber, Ernst; Oberst, Jürgen; Grothues, Hans-Georg; Hoffmann, Harald; Soufflot, Alain; Bertaux, Jean-Loup; Dimarellis, Emmanuel; Mottola, Stefano; Bibring, Jean-Pierre; Neukum, Gerhard; Albertz, Jörg; Masson, Philippe; Pinet, Patrick; Lamy, Philippe; Formisano, Vittorio

2000-10-01

The panoramic camera (PanCam) imaging experiment is designed to obtain high-resolution multispectral stereoscopic panoramic images from each of the four Mars NetLander 2005 sites. The main scientific objectives to be addressed by the PanCam experiment are (1) to locate the landing sites and support the NetLander network sciences, (2) to geologically investigate and map the landing sites, and (3) to study the properties of the atmosphere and of variable phenomena. To place in situ measurements at a landing site into a proper regional context, it is necessary to determine the lander orientation on ground and to exactly locate the position of the landing site with respect to the available cartographic database. This is not possible by tracking alone due to the lack of on-ground orientation and the so-called map-tie problem. Images as provided by the PanCam allow to determine accurate tilt and north directions for each lander and to identify the lander locations based on landmarks, which can also be recognized in appropriate orbiter imagery. With this information, it will be further possible to improve the Mars-wide geodetic control point network and the resulting geometric precision of global map products. The major geoscientific objectives of the PanCam lander images are the recognition of surface features like ripples, ridges and troughs, and the identification and characterization of different rock and surface units based on their morphology, distribution, spectral characteristics, and physical properties. The analysis of the PanCam imagery will finally result in the generation of precise map products for each of the landing sites. So far comparative geologic studies of the Martian surface are restricted to the timely separated Mars Pathfinder and the two Viking Lander Missions. Further lander missions are in preparation (Beagle-2, Mars Surveyor 03). NetLander provides the unique opportunity to nearly double the number of accessible landing site data by providing simultaneous and long-term observations at four different surface locations which becomes especially important for studies of variable surface features as well as properties and phenomena of the atmosphere. Major changes on the surface that can be detected by PanCam are caused by eolian activities and condensation processes, which directly reflect variations in the prevailing near-surface wind regime and the diurnal and seasonal volatile and dust cycles. Atmospheric studies will concentrate on the detection of clouds, measurements of the aerosol contents and the water vapor absorption at 936 nm. In order to meet these objectives, the proposed PanCam instrument is a highly miniaturized, dedicated stereo and multispectral imaging device. The camera consists of two identical camera cubes, which are arranged in a common housing at a fixed stereo base length of 11 cm. Each camera cube is equipped with a CCD frame transfer detector with 1024×1024 active pixels and optics with a focal length of 13 mm yielding a field-of-view of 53°×53° and an instantaneous filed of view of 1.1 mrad. A filter swivel with six positions provides different color band passes in the wavelength range of 400-950 nm. The camera head is mounted on top of a deployable scissors boom and can be rotated by 360° to obtain a full panorama, which is already covered by eight images. The boom raises the camera head to a final altitude of 90 cm above the surface. Most camera activities will take place within the first week and the first month of the mission. During the remainder of the mission, the camera will operate with a reduced data rate to monitor time-dependent variations on a daily basis. PanCam is a joint German/French project with contributions from DLR, Institute of Space Sensor Technology and Planetary Exploration, Berlin, Institut d'Astrophysique Spatiale, CNRS, Orsay, and Service d'Aéronomie, CNRS, Verrières-le-Buisson.

Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.

PubMed

Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P

2015-01-01

As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology.

Cam-controlled boring bar

DOEpatents

Glatthorn, Raymond H.

1986-01-01

A cam-controlled boring bar system (100) includes a first housing (152) which is rotatable about its longitudinal axis (154), and a second housing in the form of a cam-controlled slide (158) which is also rotatable about the axis (154) as well as being translatable therealong. A tool-holder (180) is mounted within the slide (158) for holding a single point cutting tool. Slide (158) has a rectangular configuration and is disposed within a rectangularly configured portion of the first housing (152). Arcuate cam slots (192) are defined within a side plate (172) of the housing (152), while cam followers (194) are mounted upon the cam slide (158) for cooperative engagement with the cam slots (192). In this manner, as the housing (152) and slide (158) rotate, and as the slide (158) also translates, a through-bore (14) having an hourglass configuration will be formed within a workpiece (16) which may be, for example, a nuclear reactor steam generator tube support plate.

Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study.

PubMed

Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman

2014-01-01

The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia.

Using Digital Time-Lapse Videos to Teach Geomorphic Processes to Undergraduates

NASA Astrophysics Data System (ADS)

Clark, D. H.; Linneman, S. R.; Fuller, J.

2004-12-01

We demonstrate the use of relatively low-cost, computer-based digital imagery to create time-lapse videos of two distinct geomorphic processes in order to help students grasp the significance of the rates, styles, and temporal dependence of geologic phenomena. Student interviews indicate that such videos help them to understand the relationship between processes and landform development. Time-lapse videos have been used extensively in some sciences (e.g., biology - http://sbcf.iu.edu/goodpract/hangarter.html, meteorology - http://www.apple.com/education/hed/aua0101s/meteor/, chemistry - http://www.chem.yorku.ca/profs/hempsted/chemed/home.html) to demonstrate gradual processes that are difficult for many students to visualize. Most geologic processes are slower still, and are consequently even more difficult for students to grasp, yet time-lapse videos are rarely used in earth science classrooms. The advent of inexpensive web-cams and computers provides a new means to explore the temporal dimension of earth surface processes. To test the use of time-lapse videos in geoscience education, we are developing time-lapse movies that record the evolution of two landforms: a stream-table delta and a large, natural, active landslide. The former involves well-known processes in a controlled, repeatable laboratory experiment, whereas the latter tracks the developing dynamics of an otherwise poorly understood slope failure. The stream-table delta is small and grows in ca. 2 days; we capture a frame on an overhead web-cam every 3 minutes. Before seeing the video, students are asked to hypothesize how the delta will grow through time. The final time-lapse video, ca. 20-80 MB, elegantly shows channel migration, progradation rates, and formation of major geomorphic elements (topset, foreset, bottomset beds). The web-cam can also be "zoomed-in" to show smaller-scale processes, such as bedload transfer, and foreset slumping. Post-lab tests and interviews with students indicate that these time-lapse videos significantly improve student interest in the material, and comprehension of the processes. In contrast, the natural landslide is relatively unconstrained, and its processes of movement, both gradual and catastrophic, are essentially impossible to observe directly without the aid of time-lapse imagery. We are constructing a remote digital camera, mounted in a tree, which will capture 1-2 photos/day of the toe. The toe is extremely active geomorphically, and the time-lapse movie should help us (and the students) to constrain the style, frequency, and rates of movement, surface slumping, and debris-flow generation. Because we have also installed a remote weather station on the landslide, we will be able to test the links between these processes and local climate conditions.

Education and Training Packages for CAD/CAM.

ERIC Educational Resources Information Center

Wright, I. C.

1986-01-01

Discusses educational efforts in the fields of Computer Assisted Design and Manufacturing (CAD/CAM). Describes two educational training initiatives underway in the United Kingdom, one of which is a resource materials package for teachers of CAD/CAM at the undergraduate level, and the other a training course for managers of CAD/CAM systems. (TW)

21 CFR 872.3661 - Optical Impression Systems for CAD/CAM.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Optical Impression Systems for CAD/CAM. 872.3661... (CAD/CAM) is a device used to record the topographical characteristics of teeth, dental impressions, or... Design and Manufacturing (CAD/CAM) of Dental Restorations; Guidance for Industry and FDA.” For the...

21 CFR 872.3661 - Optical Impression Systems for CAD/CAM.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Optical Impression Systems for CAD/CAM. 872.3661... (CAD/CAM) is a device used to record the topographical characteristics of teeth, dental impressions, or... Design and Manufacturing (CAD/CAM) of Dental Restorations; Guidance for Industry and FDA.” For the...

21 CFR 872.3661 - Optical Impression Systems for CAD/CAM.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Optical Impression Systems for CAD/CAM. 872.3661... (CAD/CAM) is a device used to record the topographical characteristics of teeth, dental impressions, or... Design and Manufacturing (CAD/CAM) of Dental Restorations; Guidance for Industry and FDA.” For the...

CAD/CAM. High-Technology Training Module.

ERIC Educational Resources Information Center

Zuleger, Robert

This high technology training module is an advanced course on computer-assisted design/computer-assisted manufacturing (CAD/CAM) for grades 11 and 12. This unit, to be used with students in advanced drafting courses, introduces the concept of CAD/CAM. The content outline includes the following seven sections: (1) CAD/CAM software; (2) computer…

Reasons for and perceived benefits of utilizing complementary and alternative medicine in U.S. adults with migraines/severe headaches.

PubMed

Rhee, Taeho Greg; Harris, Ila M

2018-02-01

We estimated prevalence rates of complementary and alternative medicine (CAM) use by reason for use (treatment, wellness, or both), and examined perceived benefits of using CAM among U.S. adults with migraines/severe headaches. The 2012 National Health Interview Survey, which represents non-institutionalized adults with migraines/severe headaches (n = 4447 unweighted), were used. Of the study sample, 41.3% used some form of CAM in the past year. Nearly a third of them (29.6%) used CAM for wellness only and 59% used CAM for both wellness and treatment. In given six self-reported perceived benefits, those who used CAM for wellness only and for a combination of both treatment and wellness had higher likelihoods of reporting benefits for all categories (p < 0.05), except for better sleep, when compared to those who used CAM for treatment only. CAM use was associated with an improvement in several health-related quality of life outcomes in U.S. adults with migraines/severe headaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies

PubMed Central

Nahin, Richard L.; Calabrese, Carlo; Folkman, Susan; Kimbrough, Elizabeth; Shoham, Jacob; Haramati, Aviad

2010-01-01

Abstract In October 2007, a National Center for Complementary and Alternative Medicine (NCCAM)–sponsored workshop, entitled “Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies,” was held at Georgetown University in Washington, DC. Over a 2-day period, the workshop engaged a small group of experts from the fields of complementary and alternative medicine (CAM) research and complexity science to discuss and examine ways in which complexity science can be applied to CAM research. After didactic presentations and small-group discussions, a number of salient themes and ideas emerged. This paper article describes the workshop program and summarizes these emergent ideas, which are divided into five broad categories: (1) introduction to complexity; (2) challenges to CAM research; (3) applications of complexity science to CAM; (4) CAM as a model of complexity applied to medicine; and (5) future directions. This discusses possible benefits and challenges associated with applying complexity science to CAM research. By providing an introductory framework for this collaboration and exchange, it is hoped that this article may stimulate further inquiry into this largely unexplored area of research. PMID:20715978

The γ Class of Carbonic Anhydrases

PubMed Central

Ferry, James G.

2009-01-01

Homologs of the γ class of carbonic anhydrases, one of five independently evolved classes, are found in the genomic sequences of diverse species from all three domains of life. The archetype (Cam) from the Archaea domain is a homotrimer of which the crystal structure reveals monomers with a distinctive left-handed parallel β-helix fold. Histidines from adjacent monomers ligate the three active site metals surrounded by residues in a hydrogen bond network essential for activity. Cam is most active with iron, the physiologically relevant metal. Although the active site residues bear little resemblance to the other classes, kinetic analyses indicate a two-step mechanism analogous to all carbonic anhydrases investigated. Phylogenetic analyses of Cam homologs derived from the databases show that Cam is representative of a minor subclass with the great majority belonging to a subclass (CamH) with significant differences in active site residues and apparent mechanism from Cam. A physiological function for any of the Cam and CamH homologs is unknown, although roles in transport of carbon dioxide and bicarbonate across membranes has been proposed. PMID:19747990

A Readout Integrated Circuit (ROIC) employing self-adaptive background current compensation technique for Infrared Focal Plane Array (IRFPA)

NASA Astrophysics Data System (ADS)

Zhou, Tong; Zhao, Jian; He, Yong; Jiang, Bo; Su, Yan

2018-05-01

A novel self-adaptive background current compensation circuit applied to infrared focal plane array is proposed in this paper, which can compensate the background current generated in different conditions. Designed double-threshold detection strategy is to estimate and eliminate the background currents, which could significantly reduce the hardware overhead and improve the uniformity among different pixels. In addition, the circuit is well compatible to various categories of infrared thermo-sensitive materials. The testing results of a 4 × 4 experimental chip showed that the proposed circuit achieves high precision, wide application and high intelligence. Tape-out of the 320 × 240 readout circuit, as well as the bonding, encapsulation and imaging verification of uncooled infrared focal plane array, have also been completed.

A study to examine the attitudes, knowledge, and utilization of CAM by primary care professional in West Texas.

PubMed

Zhang, Yan; Peck, Kim; Spalding, Mary; Xu, Tom; Ragain, Mike

2010-12-01

This study examined the attitudes, knowledge, and utilization of CAM among primary care providers at two campuses of the Texas Tech University Health Sciences Center (TTUHSC). A cross-sectional study design and a convenient sampling method were used. This study employed the questionnaire adapted from the Wahner-Roedler's study to survey participants in TTUHSC. Primary survey collection was conducted at the two campuses where all Family Medicine healthcare professionals were recruited. We measured participants' knowledge of, their familiarity and experience with, their attitudes towards and utilization of CAM. Of the 69 respondents, more than half (56.5%) were female and younger than 36 years. Overall, our study revealed a positive attitude towards CAM. More than 60% of the providers would like to refer a patient to a CAM practitioner and about 75% of them believed that incorporation of CAM therapies into the practice would have a positive impact. Providers were most familiar with and felt most comfortable counseling their patients about massage therapy and St. John's Wort among all CAM modalities. About 70% of the participants believed that the institution should offer proven CAM therapies to patients. This study provides some preliminary findings that may lead to further exploration of healthcare professional's attitudes towards CAM. Published by Elsevier Ltd.

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

PubMed Central

Kwon, Taek-Ka; Pak, Hyun-Soon; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun

2013-01-01

PURPOSE All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS The mean fracture strengths were as follows: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain. PMID:23755332

Are modern health worries, environmental concerns, or paranormal beliefs associated with perceptions of the effectiveness of complementary and alternative medicine?

PubMed

Jeswani, Mamta; Furnham, Adrian

2010-09-01

To investigate to what extent paranormal beliefs, modern health worries (MHWs), and environmental concerns were related to beliefs about, and behaviour associated with complementary and alternative medicine (CAM). Of the participants, 150 completed a four-part questionnaire measuring use and perception of CAM, MHWs, paranormal beliefs, and environmental concerns. A factor analysis on the CAM questions revealed three clear components, labelled efficacy of CAM, attitudes to CAM, and safety of CAM. Age, total MHWs, paranormal beliefs, and environmental concerns were used as predictor variables in regression analyses with efficacy as criterion variable. Age was found to be a significantly related to efficacy of CAM. When total MHW score, paranormal belief score, and environmental concern score were added to the model, the r(2) increased by 29%. Environmental concern did not significantly relate to efficacy but spiritualism beliefs did. A factor analysis of the MHW scale items revealed nine factors. Out of these, radiation, doctors playing God, disasters, and epidemics, as well as harmful rays and air contaminants significantly predict belief in the efficacy of CAM. Overall, older people, with more MHWs, and who believe in the paranormal are more likely to believe that CAM works, possibly because of a more intuitive, 'holistic', thinking style. Limitations of the study are considered.

The Collaborative Assessment and Management of Suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk.

PubMed

Jobes, David A

2012-12-01

The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based clinical intervention that has significantly evolved over 25 years of clinical research. CAMS is best understood as a therapeutic framework that emphasizes a unique collaborative assessment and treatment planning process between the suicidal patient and clinician. This process is designed to enhance the therapeutic alliance and increase treatment motivation in the suicidal patient. Central to the CAMS approach is the use of the Suicide Status Form (SSF), which is a multipurpose clinical assessment, treatment planning, tracking, and outcome tool. The original development of CAMS was largely rooted in SSF-based quantitative and qualitative assessment of suicidal risk. As this line of research progressed, CAMS emerged as a problem-focused clinical intervention that is designed to target and treat suicidal "drivers" and ultimately eliminate suicidal coping. To date, CAMS (and the clinical use of the SSF) has been supported by six published correlational studies and one randomized clinical trial (RCT). Currently, two well-powered RCTs are under way, and various new CAMS-related projects are also being pursued. The clinical and empirical evolution of CAMS-how it was developed and what are the next steps for this clinical approach-are described here. © 2012 The American Association of Suicidology.

Understanding cancer survivors' information needs and information-seeking behaviors for complementary and alternative medicine from short- to long-term survival: a mixed-methods study.

PubMed

Scarton, Lou Ann; Del Fiol, Guilherme; Oakley-Girvan, Ingrid; Gibson, Bryan; Logan, Robert; Workman, T Elizabeth

2018-01-01

The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. A mixed-methods approach was used with cancer survivors from the "Assessment of Patients' Experience with Cancer Care" 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT). Seventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families' and friends' provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM. Patients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients.

Depression, anxiety and quality of life through the use of complementary and alternative medicine among breast cancer patients in Turkey.

PubMed

Kalender, Mehmet Emin; Buyukhatipoglu, Hakan; Balakan, Ozan; Suner, Ali; Dirier, Ahmet; Sevinc, Alper; Bulbul, Feridun; Tatli, Ali Murat; Ulas, Turgay; Camci, Celaletdin

2014-01-01

Breast cancer is the most common type of cancer amongst women today. The aim of this study was to examine the association between complementary and alternative medicine (CAM) and the quality of life (QoL), anxiety and depression and demographic characteristics of women with breast cancer. QoL was measured by the European Organization for Treatment and Research of Cancer quality of life core questionnaire (QLQ-C30, version 3.0) and anxiety and depression was measured by the hospital anxiety and depression scale. In total, 122 patients with breast cancer were enrolled in the study and 50% (n=61) of them reported that they were using CAM. The most commonly used CAM methods were stinging nettle (57%) and prayer and spiritual healing (49%). No relationship was found between the use of CAM and the patient's age, time to diagnosis, cancer stage, chemotherapy use, smoking and residence. However, the analyses showed a positive association between CAM and role functioning (P=0.014) and financial difficulties (P=0.011); and a negative association between CAM and emotional functioning (P=0.033). Based on the previous studies, 20-83.3% of breast cancer patients among different countries and cultures used CAM. Our results suggested that the use of CAM among women is quite popular, but they showed no correlation between CAM usage and anxiety and depression. In addition, CAM usage was more common in breast cancer patients with a poor emotional and financial status.

Complementary and alternative medicine (CAM) in obstetrics and gynaecology: a survey of office-based obstetricians and gynaecologists regarding attitudes towards CAM, its provision and cooperation with other CAM providers in the state of Hesse, Germany.

PubMed

Münstedt, K; Maisch, M; Tinneberg, H R; Hübner, J

2014-12-01

Whereas we have some information on complementary medicine in the field of oncology, little is known about complementary medicine in the field of obstetrics and gynaecology especially outside of hospitals. All office-based obstetricians and gynaecologists in the state of Hesse, Germany, were contacted and asked to fill in an assessment form regarding cooperation in the field of complementary and alternative medicine (CAM), as well as the perceived efficacy of various CAM methods for a number of pathological conditions in the field of obstetrics and gynaecology. It was found that more than half of Hessian office-based obstetricians and gynaecologists had existing cooperation regarding CAM, especially with colleagues, but also midwives, pharmacists, physiotherapists, and health practitioners. The probability of cooperation was significantly inversely associated with age. It was found that the probability for advising CAM differed between various health problems. The following CAM methods were considered reasonable for the treatment of different conditions: phytotherapy for climacteric complaints and premenstrual syndrome; homoeopathy for puerperal problems; acupuncture and traditional Chinese medicine for complaints during pregnancy; and dietary supplements for the side effects of cancer therapy. The analysis shows that there is much cooperation in the field of CAM. Comparison between physicians' perceived efficacy of CAM methods and objective findings shows that there is a need for the provision of valid information in the field.

Understanding cancer survivors’ information needs and information-seeking behaviors for complementary and alternative medicine from short- to long-term survival: a mixed-methods study

PubMed Central

Scarton, Lou Ann; Del Fiol, Guilherme; Oakley-Girvan, Ingrid; Gibson, Bryan; Logan, Robert; Workman, T. Elizabeth

2018-01-01

Objective The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. Methods A mixed-methods approach was used with cancer survivors from the “Assessment of Patients’ Experience with Cancer Care” 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT). Results Seventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families’ and friends’ provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM. Conclusion Patients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients. PMID:29339938

An open CAM system for dentistry on the basis of China-made 5-axis simultaneous contouring CNC machine tool and industrial CAM software.

PubMed

Lu, Li; Liu, Shusheng; Shi, Shenggen; Yang, Jianzhong

2011-10-01

China-made 5-axis simultaneous contouring CNC machine tool and domestically developed industrial computer-aided manufacture (CAM) technology were used for full crown fabrication and measurement of crown accuracy, with an attempt to establish an open CAM system for dental processing and to promote the introduction of domestic dental computer-aided design (CAD)/CAM system. Commercially available scanning equipment was used to make a basic digital tooth model after preparation of crown, and CAD software that comes with the scanning device was employed to design the crown by using domestic industrial CAM software to process the crown data in order to generate a solid model for machining purpose, and then China-made 5-axis simultaneous contouring CNC machine tool was used to complete machining of the whole crown and the internal accuracy of the crown internal was measured by using 3D-MicroCT. The results showed that China-made 5-axis simultaneous contouring CNC machine tool in combination with domestic industrial CAM technology can be used for crown making and the crown was well positioned in die. The internal accuracy was successfully measured by using 3D-MicroCT. It is concluded that an open CAM system for dentistry on the basis of China-made 5-axis simultaneous contouring CNC machine tool and domestic industrial CAM software has been established, and development of the system will promote the introduction of domestically-produced dental CAD/CAM system.

Complementary and alternative medicine use during early pregnancy.

PubMed

Pallivalappila, Abdul Rouf; Stewart, Derek; Shetty, Ashalatha; Pande, Binita; Singh, Rajvir; Mclay, James S

2014-10-01

To determine the prevalence and explore predictors of Complementary and Alternative Medicine (CAM) use during early pregnancy. A questionnaire survey of pregnant women (500) attending for mid trimester scan at the maternity services in Grampian, North-East Scotland. Outcome measures included; CAM used; vitamins and minerals used; independent predictors of use; views and experiences. Descriptive and inferential statistical analysis. The response rate was 66%. Two thirds of respondents (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. Respondents reported using a total of 28 different CAM modalities, of which oral herbal products were the most common (37% of respondents, 25 different products). The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3-7.3, p<0.001); ethnicity (non-white British) (OR 3.4, 95% CI 1.8-6.8, p<0.001); and use prior to pregnancy (OR 2.4, 95% CI 1.2-4.8, p=0.014). In comparison to prescribed medicines, most users were uncertain if CAM were safer (63%), more effective (66%), free from possible adverse effects (46%) or drug-CAM interactions (50%). Despite the majority of respondents being uncertain about their safety and effectiveness, CAM modalities and CAM products are widely used during the early stages of pregnancy in this study population. The role of family and friends rather than health professionals in the decision to use CAM may be of concern and requires further investigation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Open-MRI measures of cam intrusion for hips in an anterior impingement position relate to acetabular contact force.

PubMed

Buchan, Lawrence L; Zhang, Honglin; Konan, Sujith; Heaslip, Ingrid; Ratzlaff, Charles R; Wilson, David R

2016-02-01

Open MRI in functional positions has potential to directly and non-invasively assess cam femoroacetabular impingement (FAI). Our objective was to investigate whether open MRI can depict intrusion of the cam deformity into the intra-articular joint space, and whether intrusion is associated with elevated acetabular contact force. Cadaver hips (9 cam; 3 controls) were positioned in an anterior impingement posture and imaged using open MRI with multi-planar reformatting. The β-angle (describing clearance between the femoral neck and acetabulum) was measured around the entire circumference of the femoral neck. We defined a binary "MRI cam-intrusion sign" (positive if β < 0°). We then instrumented each hip with a piezoresistive sensor and conducted six repeated positioning trials, measuring acetabular contact force (F). We defined a binary "contact-force sign" (positive if F > 20N). Cam hips were more likely than controls to have both a positive MRI cam-intrusion sign (p = 0.0182, Fisher's exact test) and positive contact-force sign (p = 0.0083), which represents direct experimental evidence for cam intrusion. There was also a relationship between the MRI cam-intrusion sign and contact-force sign (p = 0.033), representing a link between imaging and mechanics. Our findings indicate that open MRI has significant potential for in vivo investigation of the cam FAI mechanism. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Examining CAM use disclosure using the Behavioral Model of Health Services Use.

PubMed

Faith, Jennifer; Thorburn, Sheryl; Tippens, Kimberly M

2013-10-01

To improve understanding of factors that may influence disclosure of complementary and alternative medicine (CAM) use in the U.S. Cross-sectional survey. Data are from the 2001 Health Care Quality Survey (HCQS), a nationally representative study of adults aged 18 and older living in the continental United States. Using the Behavioral Model of Health Services Use, we conducted multivariate logistic regressions to identify factors associated with disclosing CAM use among the sub-sample of recent CAM users (n=1995). Disclosure of CAM use. Most CAM users (71.0%) disclosed their use of CAM to their doctors. Contextual, individual, and health behavior factors were associated with CAM use disclosure. Of particular interest, disclosure was significantly more likely among those who perceived high quality relationships with their providers (AOR=1.59, CI: 1.01, 2.49) and among those who had a regular source of medical care (AOR=1.54, CI: 1.03, 2.29). The odds of disclosure were also higher among those who used practitioner-provided CAM, with (AOR=2.02, CI: 1.34, 3.06) or without (AOR=1.52, CI: 1.05, 2.20) concurrent herbal medicine use, compared to those who used herbal medicines only. The Behavioral Model of Health Services Use is a useful framework for examining factors that may influence disclosure of CAM use. Further research should examine these relationships using more comprehensive measures. Copyright © 2013 Elsevier Ltd. All rights reserved.

The House of Lords report on complementary medicine: a summary.

PubMed

Mills, S Y

2001-03-01

The House of Lords Science and Technology Committee reviewed a large amount of oral and written evidence from a wide variety of sources in order to scrutinize CAM. In their published report, they propose that CAM be subdivided into three groups for operational purposes. They note that public satisfaction with CAM is high and use of CAM is increasing. Evidence is required that CAM has an effect above and beyond placebo, and once this is provided the public should have access to it and its potential benefits. Public interest is not protected by the current lack of regulation of CAM, which should be organized in an appropriate way by and for each therapy. Acupuncture and herbal medicine should be subject to statutory regulation, and possibly non-medical homeopathy. The regulatory status of herbal medicines is particularly unsatisfactory, and should be clarified and enforced in law. Training for CAM professionals should be standardized and independently accredited and, for many, should include basic biomedical science. Registered conventional health professionals should become more familiar with CAM. Research into CAM requires the same rigour as is required of conventional medicine, and recommendations are made as to how research could be encouraged, including pump-priming by the National Health Service and Medical Research Council. The provision of information to the public and health professionals is inadequate and recommendations are made on how this should be improved. Those working in the best regulated CAM professions should work towards integration with conventional medicine.

Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care.

PubMed

Ben-Arye, Eran; Ali-Shtayeh, Mohammed Saleem; Nejmi, Mati; Schiff, Elad; Hassan, Esmat; Mutafoglu, Kamer; Afifi, Fatma U; Jamous, Rana Majed; Lev, Efraim; Silbermman, Michael

2012-03-01

Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East. A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author's affiliation with an academic or clinical institution in the Middle East. We identified 143 articles on CAM and cancer care that had been published in 12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor-patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind-body medicine, shiatsu, therapeutic touch, and yoga. CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.

Critical review of complementary and alternative medicine use in menopause: focus on prevalence, motivation, decision-making, and communication.

PubMed

Peng, Wenbo; Adams, Jon; Sibbritt, David W; Frawley, Jane E

2014-05-01

This study aims to undertake the first critical review of complementary and alternative medicine (CAM) use among menopausal women (a term here used to include premenopausal, perimenopausal and postmenopausal women) by focusing on the prevalence of CAM use and CAM users' characteristics, motivation, decision-making, and communication with healthcare providers. A comprehensive search of 2002-2012 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and menopause. A considerable level of CAM use was observed among women in menopause. Many menopausal women use CAM concurrently with their conventional medicine. However, communication regarding CAM between menopausal women and healthcare providers seems less than optimal, with a demand for further information on the safety and efficacy of medicines. Existing literature is of variable methodological rigor, often presenting small sample sizes and low-quality data collection. Further rigorous research on this topic-including quantitative and qualitative methods using large national samples, where relevant-is required. The findings of this critical review provide insights for those practicing and managing health care in this area of women's health. Healthcare providers should prepare to inform menopausal women about all treatment options, including CAM, and should be aware of the possible adverse effects of CAM and potential interactions between CAM and conventional medicine among women in menopause who are under their care.

L1CAM Expression is Related to Non-Endometrioid Histology, and Prognostic for Poor Outcome in Endometrioid Endometrial Carcinoma.

PubMed

Geels, Yvette P; Pijnenborg, Johanna M A; Gordon, Bart B M; Fogel, Mina; Altevogt, Peter; Masadah, Rina; Bulten, Johan; van Kempen, Léon C; Massuger, Leon F A G

2016-10-01

The majority of endometrial carcinomas are classified as Type I endometrioid endometrial carcinomas (EECs) and have a good prognosis. Type II non-endometrioid endometrial carcinomas (NEECs) have a significant worse outcome. Yet, 20 % of the EECs are associated with an unexplained poor outcome. The aim of this study was to determine if L1CAM expression, a recently reported biomarker for aggressive tumor behavior in endometrial carcinoma, was associated with clinicopathological features of EECs. A total of 103 patients diagnosed as EEC at the Radboud University Medical Centre, based on the pathology report were selected. L1CAM status of these tumors was determined, and histologic slides were reviewed by two expert pathologists. L1CAM-positivity was observed in 17 % (18/103). Review of the diagnostic slides revealed that 11 out of these 18 L1CAM-positive tumors (61 %) contained a serous- or mixed carcinoma component that was not initially mentioned in the pathology report. L1CAM-expression was associated with advanced age, poor tumor grade, and lymphovascular space invasion. A worse five year progression free survival rate was observed for patients with L1CAM-positive tumors (55.6 % for the L1CAM-positive group, compared to 83.3 % for the L1CAM-negative group P = 0.01). L1CAM expression carries prognostic value for histologically classified EEC and supports the identification of tumors with a NEEC component.

Overhead Costs and Rates in the U.S. Defense Industrial Base. Volume 1

DTIC Science & Technology

1980-10-01

Manager rather than to establish rigidly defined cost accounting structures. The conclusions to be own from the analysis were that overhead costs have...specific costs which make up tho overhead account ; whether management is controlling them; whether these costs are "reasonable" and the external factors... cost accounting structures, . ..... ....... .... ... ............................... , , ,’" ’ .. -17- and since there is no one accounting definition of

75 FR 31803 - Notice of Issuance of Final Determination Concerning a Lift Unit for an Overhead Patient Lift System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... Determination Concerning a Lift Unit for an Overhead Patient Lift System AGENCY: U.S. Customs and Border... concerning the country of origin of a lift unit for an overhead patient lift system. Based upon the facts presented, CBP has concluded in the final determination that Sweden is the country of origin of the lift...

16. THE INSTALLATION OF CONVEYORS AND OVERHEAD RAILS ELIMINATED THE ...

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

16. THE INSTALLATION OF CONVEYORS AND OVERHEAD RAILS ELIMINATED THE NEED TO LAY MOLDS OUT ON FLOORS AND HAND-POUR THEM. INSTEAD, WORKERS PULLED LARGE LADLES ALONG OVERHEAD RAILS AND FILLED CONVEYOR-DRIVEN MOLDS WHILE THEY STOOD ON A MOVING PLATFORM THAT TRAVELED AT THE SAME SPEED AS THE MOLD CONVEYOR, CA. 1950. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

The Use of Probability Theory as a Basis for Planning and Controlling Overhead Costs in Education and Industry. Final Report.

ERIC Educational Resources Information Center

Vinson, R. B.

In this report, the author suggests changes in the treatment of overhead costs by hypothesizing that "the effectiveness of standard costing in planning and controlling overhead costs can be increased through the use of probability theory and associated statistical techniques." To test the hypothesis, the author (1) presents an overview of the…

Use of complementary therapy by adolescents with asthma.

PubMed

Reznik, Marina; Ozuah, Philip O; Franco, Karen; Cohen, Robyn; Motlow, Ferrell

2002-10-01

About 40% of adult Americans use complementary or alternative medicine (CAM) for health problems. To determine the prevalence of reported use of CAM in a population of urban adolescents with asthma. We used a multistaged, stratified sample approach at an inner-city high school. An asthma screening survey was administered to 3800 registered students, aged 13 to 18 years. We identified a subset of 200 respondents who answered yes to each of the following questions: (1) Does your physician think that you have asthma? (2) Do your parents think that you have asthma? (3) Do you think that you have asthma? A self-completion questionnaire was administered to a sample drawn from this cohort. Differences in proportion were tested by chi( 2) analyses. Of the 160 participants, 63% were female, 68% were Hispanic, 26% were African American, 33% had weekly symptoms, and 14% had daily symptoms. Overall, 80% of participants reported using CAM for asthma. The most commonly reported CAM included rubs (74%), herbal teas (39%), prayer (37%), massage (36%), and Jarabe 7 syrup (24%). Subjects with daily or weekly symptoms were more likely to use CAM for each episode of asthma (72% vs 51%; P =.005). The 61% of subjects who had a family member who used CAM were more likely to use CAM again (84% vs 39%; P<.001). Of the respondents, 59% reported that CAM was effective. Subjects who perceived CAM to be effective were more likely to use it again (96% vs 22%; P<.001). Most adolescents with asthma in this study used CAM. The prevalence of CAM use in this study population was twice the national average for adults.

KSA Antigen Ep-CAM Mediates Cell–Cell Adhesion of Pancreatic Epithelial Cells: Morphoregulatory Roles in Pancreatic Islet Development

PubMed Central

Cirulli, V.; Crisa, L.; Beattie, G.M.; Mally, M.I.; Lopez, A.D.; Fannon, A.; Ptasznik, A.; Inverardi, L.; Ricordi, C.; Deerinck, T.; Ellisman, M.; Reisfeld, R.A.; Hayek, A.

1998-01-01

Cell adhesion molecules (CAMs) are important mediators of cell–cell interactions and regulate cell fate determination by influencing growth, differentiation, and organization within tissues. The human pancarcinoma antigen KSA is a glycoprotein of 40 kD originally identified as a marker of rapidly proliferating tumors of epithelial origin. Interestingly, most normal epithelia also express this antigen, although at lower levels, suggesting that a dynamic regulation of KSA may occur during cell growth and differentiation. Recently, evidence has been provided that this glycoprotein may function as an epithelial cell adhesion molecule (Ep-CAM). Here, we report that Ep-CAM exhibits the features of a morphoregulatory molecule involved in the development of human pancreatic islets. We demonstrate that Ep-CAM expression is targeted to the lateral domain of epithelial cells of the human fetal pancreas, and that it mediates calcium-independent cell–cell adhesion. Quantitative confocal immunofluorescence in fetal pancreata identified the highest levels of Ep-CAM expression in developing islet-like cell clusters budding from the ductal epithelium, a cell compartment thought to comprise endocrine progenitors. A surprisingly reversed pattern was observed in the human adult pancreas, displaying low levels of Ep-CAM in islet cells and high levels in ducts. We further demonstrate that culture conditions promoting epithelial cell growth induce upregulation of Ep-CAM, whereas endocrine differentiation of fetal pancreatic epithelial cells, transplanted in nude mice, is associated with a downregulation of Ep-CAM expression. In addition, a blockade of Ep-CAM function by KS1/4 mAb induced insulin and glucagon gene transcription and translation in fetal pancreatic cell clusters. These results indicate that developmentally regulated expression and function of Ep-CAM play a morphoregulatory role in pancreatic islet ontogeny. PMID:9508783

Opposing intermolecular tuning of Ca2+ affinity for Calmodulin by its target peptides

NASA Astrophysics Data System (ADS)

Cheung, Margaret

We investigated the impact of bound calmodulin (CaM)-target compound structure on the affinity of calcium (Ca2+) by integrating coarse-grained models and all-atomistic simulations with non-equilibrium physics. We focused on binding between CaM and two specific targets, Ca2+/CaM-dependent protein kinase II (CaMKII) and neurogranin (Ng), as they both regulate CaM-dependent Ca2+ signaling pathways in neurons. It was shown experimentally that Ca2+/CaM binds to the CaMKII peptide with higher affinity than the Ng peptide. The binding of CaMKII peptide to CaM in return increases the Ca2+ affinity for CaM. However, this reciprocal relation was not observed in the Ng peptide, which binds to Ca2+-free CaM or Ca2+/CaM with similar binding affinity. Unlike CaM-CaMKII peptide that allowed structure determination by crystallography, the structural description of CaM-Ng peptide is unknown due to low binding affinity, therefore, we computationally generated an ensemble of CaM-Ng peptide structures by matching the changes in the chemical shifts of CaM upon Ng peptide binding from nuclear magnetic resonance experiments. We computed the changes in Ca2+ affinity for CaM with and without binding targets in atomistic models using Jarzynski's equality. We discovered the molecular underpinnings of lowered affinity of Ca2+ for CaM in the presence of Ng by showing that the N-terminal acidic region of Ng peptide pries open the β-sheet structure between the Ca2+ binding loops particularly at C-domain of CaM, enabling Ca2+release. In contrast, CaMKII increases Ca2+ affinity for the C-domain of CaM by stabilizing the two Ca2+ binding loops.

A critical review of complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort: a focus upon prevalence, patterns and applications of use and users' motivations, information seeking and self-perceived efficacy.

PubMed

Fisher, Carole; Sibbritt, David; Hickman, Louise; Adams, Jon

2016-08-01

Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment. An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women. CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM. This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Use of complementary and alternative medicine in children with cancer: effect on survival.

PubMed

Karalı, Yasin; Demirkaya, Metin; Sevinir, Betül

2012-05-01

The objective of the present study was to determine the type, frequency, the reason why complementary and alternative medicine (CAM) treatments are used, the factors related with their use, and the effects of CAM usage on long-term survival. Families of a total of 120 children with cancer between 0-18 years of age, including 50 (41.7%) girls and 70 (58.3%) boys, participated in our study. The authors found that 88 patients (73.3%) used at least one CAM method, the most common (95.5%) of which was biologically based therapies. Most frequently used biologically based therapies were dietary supplements and herbal products. The most commonly used dietary supplement or herbal product was honey (43.2%) or stinging nettle (43.2%), respectively. We found that patients used such CAM methods as complementary to, but not instead of, conventional therapy. Sixty-nine out of 88 patient families (78.4%) shared the CAM method they used with their physicians. No statistically significant relation was found between socioeconomic, sociodemographic, or other factors or items and CAM use. The mean follow-up period of the CAM users and nonusers groups was 79.4 ± 36.7 (21.3-217.9) and 90.9 ± 50.3 (27.4-193.7) months, respectively. Five-year survival rates for CAM users and nonusers were found as 81.5% and 86.5%, respectively (P > .05). In conclusion, families of children with cancer use complementary and alternative treatment frequently. They do not attempt to replace conventional treatment with CAM. Higher rates of CAM use was found in families with higher educational level. CAM usage did not affect the long-term survival.

Trends in complementary/alternative medicine use by breast cancer survivors: Comparing survey data from 1998 and 2005

PubMed Central

Boon, Heather S; Olatunde, Folashade; Zick, Suzanna M

2007-01-01

Background Use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief. The purpose of this paper is to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer. Methods Surveys were mailed to women randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 (n = 557) and again in the spring of 2005(n = 877). Results The response rates were 76.3% in 1998 and 63% in 2005. In 1998, 66.7% of women reported using either a CAM product/therapy or seeing a CAM therapist at some time in their lives as compared with 81.9% in 2005 (p = 0.0002). Increases were seen in both use of CAM products/therapies (62% in 1998 vs. 70.6% in 2005) and visits to CAM practitioners (39.4% of respondents in 1998 vs 57.4% of respondents in 2005). Women in 2005 reported that 41% used CAM for treating their breast cancer. The most commonly used products and practitioners for treating breast cancer as reported in 2005 were green tea, vitamin E, flaxseed, vitamin C, massage therapists and dietitians/nutritionists. Conclusion CAM use (both self-medication with products and visits to CAM practitioners) increased significantly from 1998 to 2005. Now that more than 80% of all women with breast cancer report using CAM (41% in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an "alternative" or unusual approach to managing breast cancer. PMID:17397542

Backbone and side-chain resonance assignments of (Ca2+)4-calmodulin bound to beta calcineurin A CaMBD peptide.

PubMed

Fowler, C Andrew; Núñez Hernandez, Maria F; O'Donnell, Susan E; Yu, Liping; Shea, Madeline A

2017-10-01

Calcineurin (CaN) is a heterodimeric and highly conserved serine/threonine phosphatase (PP2B) that plays a critical role in coupling calcium signals to physiological processes including embryonic cardiac development, NF-AT-regulated gene expression in immune responses, and apoptosis. The catalytic subunit (CaN A ) has three isoforms (α, β, and γ,) in humans and seven isoforms in Paramecium. In all eukaryotes, the EF-hand protein calmodulin (CaM) regulates CaN activity in a calcium-dependent manner. The N- and C-domains of CaM (CaM N and CaM C ) recognize a CaM-binding domain (CaMBD) within an intrinsically disordered region of CaN A that precedes the auto-inhibitory domain (AID) of CaN A . Here we present nearly complete 1 H, 13 C, and 15 N resonance assignments of (Ca 2+ ) 4 -CaM bound to a peptide containing the CaMBD sequence in the beta isoform of CaN A (βCaN A -CaMBDp). Its secondary structure elements predicted from the assigned chemical shifts were in good agreement with those observed in the high-resolution structures of (Ca 2+ ) 4 -CaM bound to CaMBDs of multiple enzymes. Based on the reported literature, the CaMBD of the α isoform of CaN A can bind to CaM in two opposing orientations which may influence the regulatory function of CaM. Because a high resolution structure of (Ca 2+ ) 4 -CaM bound to βCaN A -CaMBDp has not been reported, our studies serve as a starting point for determining the solution structure of this complex. This will demonstrate the preferred orientation of (Ca 2+ ) 4 -CaM on the CaMBD as well as the orientations of CaM N and CaM C relative to each other and to the AID of βCaN A .

Calmodulin Methyltransferase Is Required for Growth, Muscle Strength, Somatosensory Development and Brain Function

PubMed Central

Haziza, Sitvanit; Magnani, Roberta; Lan, Dima; Keinan, Omer; Saada, Ann; Hershkovitz, Eli; Yanay, Nurit; Cohen, Yoram; Nevo, Yoram; Houtz, Robert L.; Sheffield, Val C.; Golan, Hava; Parvari, Ruti

2015-01-01

Calmodulin lysine methyl transferase (CaM KMT) is ubiquitously expressed and highly conserved from plants to vertebrates. CaM is frequently trimethylated at Lys-115, however, the role of CaM methylation in vertebrates has not been studied. CaM KMT was found to be homozygously deleted in the 2P21 deletion syndrome that includes 4 genes. These patients present with cystinuria, severe intellectual disabilities, hypotonia, mitochondrial disease and facial dysmorphism. Two siblings with deletion of three of the genes included in the 2P21 deletion syndrome presented with cystinuria, hypotonia, a mild/moderate mental retardation and a respiratory chain complex IV deficiency. To be able to attribute the functional significance of the methylation of CaM in the mouse and the contribution of CaM KMT to the clinical presentation of the 2p21deletion patients, we produced a mouse model lacking only CaM KMT with deletion borders as in the human 2p21deletion syndrome. No compensatory activity for CaM methylation was found. Impairment of complexes I and IV, and less significantly III, of the mitochondrial respiratory chain was more pronounced in the brain than in muscle. CaM KMT is essential for normal body growth and somatosensory development, as well as for the proper functioning of the adult mouse brain. Developmental delay was demonstrated for somatosensory function and for complex behavior, which involved both basal motor function and motivation. The mutant mice also had deficits in motor learning, complex coordination and learning of aversive stimuli. The mouse model contributes to the evaluation of the role of methylated CaM. CaM methylation appears to have a role in growth, muscle strength, somatosensory development and brain function. The current study has clinical implications for human patients. Patients presenting slow growth and muscle weakness that could result from a mitochondrial impairment and mental retardation should be considered for sequence analysis of the CaM KMT gene. PMID:26247364

Effect of Ca2+ on the promiscuous target-protein binding of calmodulin

PubMed Central

Westerlund, Annie M.

2018-01-01

Calmodulin (CaM) is a calcium sensing protein that regulates the function of a large number of proteins, thus playing a crucial part in many cell signaling pathways. CaM has the ability to bind more than 300 different target peptides in a Ca2+-dependent manner, mainly through the exposure of hydrophobic residues. How CaM can bind a large number of targets while retaining some selectivity is a fascinating open question. Here, we explore the mechanism of CaM selective promiscuity for selected target proteins. Analyzing enhanced sampling molecular dynamics simulations of Ca2+-bound and Ca2+-free CaM via spectral clustering has allowed us to identify distinct conformational states, characterized by interhelical angles, secondary structure determinants and the solvent exposure of specific residues. We searched for indicators of conformational selection by mapping solvent exposure of residues in these conformational states to contacts in structures of CaM/target peptide complexes. We thereby identified CaM states involved in various binding classes arranged along a depth binding gradient. Binding Ca2+ modifies the accessible hydrophobic surface of the two lobes and allows for deeper binding. Apo CaM indeed shows shallow binding involving predominantly polar and charged residues. Furthermore, binding to the C-terminal lobe of CaM appears selective and involves specific conformational states that can facilitate deep binding to target proteins, while binding to the N-terminal lobe appears to happen through a more flexible mechanism. Thus the long-ranged electrostatic interactions of the charged residues of the N-terminal lobe of CaM may initiate binding, while the short-ranged interactions of hydrophobic residues in the C-terminal lobe of CaM may account for selectivity. This work furthers our understanding of the mechanism of CaM binding and selectivity to different target proteins and paves the way towards a comprehensive model of CaM selectivity. PMID:29614072

Use of complementary and alternative medicine for weight control in the United States.

PubMed

Sharpe, Patricia A; Blanck, Heidi M; Williams, Joel E; Ainsworth, Barbara E; Conway, Joan M

2007-03-01

The purpose was to assess the prevalence and correlates of complementary and alternative medicine use for weight control. A list-assisted random-digit-dialed telephone survey of adults was conducted in the fall of 2002 (n = 11,211). The focus of the study was complementary and alternative medicine (CAM) use, other than dietary supplements, in the previous 12 months. The sample of respondents was drawn from the total noninstitutionalized U.S. adult population residing in telephone-equipped locations. The sampling procedures were designed to obtain adequate representation of Hispanic and non-Hispanic black respondents. Data from the total sample of 11,211 were weighted to achieve an estimate of the U.S. population. Analyses focused on 372 people who had used CAM within the previous 12 months. Of the total, 3.3% (n = 372) had used a CAM therapy in the previous 12 months. Higher adjusted odds ratios for CAM use were found among respondents who were exercising for weight control; using a lower carbohydrate, higher protein diet; using a nonprescription weight-loss product(s); overweight; physically active; and not satisfied with one's body (adjusted for age, race, gender, education, and city size). The most often used therapies were yoga (57.4%), meditation (8.2%), acupuncture (7.7%), massage (7.5%), and Eastern martial arts (5.9%). CAM users used CAM therapies on their own (62.6%), in a group setting (26.8%) or with a CAM practitioner (10.6%). The use of CAM therapies other than dietary supplements for weight loss was relatively low. The most popular therapy was yoga, and the majority of CAM users used CAM therapies on their own. Persons who had used other weight loss methods had greater odds for using CAM in the previous 12 months, suggesting that CAM use is often added to other weight-loss strategies.

Ecophysiology of Crassulacean Acid Metabolism (CAM)

PubMed Central

LÜTTGE, ULRICH

2004-01-01

• Background and Scope Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. • Input Input is given by a network of environmental parameters. Six major ones, CO2, H2O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level (‘physiological aut‐ecology’). • Receivers Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain ‘black boxes’, and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. • Output Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. • Conclusions While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. ‘Physiological syn‐ecology’ reveals that phenotypic plasticity constitutes the ecophysiological advantage of CAM. PMID:15150072

Calmodulin Methyltransferase Is Required for Growth, Muscle Strength, Somatosensory Development and Brain Function.

PubMed

Haziza, Sitvanit; Magnani, Roberta; Lan, Dima; Keinan, Omer; Saada, Ann; Hershkovitz, Eli; Yanay, Nurit; Cohen, Yoram; Nevo, Yoram; Houtz, Robert L; Sheffield, Val C; Golan, Hava; Parvari, Ruti

2015-08-01

Calmodulin lysine methyl transferase (CaM KMT) is ubiquitously expressed and highly conserved from plants to vertebrates. CaM is frequently trimethylated at Lys-115, however, the role of CaM methylation in vertebrates has not been studied. CaM KMT was found to be homozygously deleted in the 2P21 deletion syndrome that includes 4 genes. These patients present with cystinuria, severe intellectual disabilities, hypotonia, mitochondrial disease and facial dysmorphism. Two siblings with deletion of three of the genes included in the 2P21 deletion syndrome presented with cystinuria, hypotonia, a mild/moderate mental retardation and a respiratory chain complex IV deficiency. To be able to attribute the functional significance of the methylation of CaM in the mouse and the contribution of CaM KMT to the clinical presentation of the 2p21deletion patients, we produced a mouse model lacking only CaM KMT with deletion borders as in the human 2p21deletion syndrome. No compensatory activity for CaM methylation was found. Impairment of complexes I and IV, and less significantly III, of the mitochondrial respiratory chain was more pronounced in the brain than in muscle. CaM KMT is essential for normal body growth and somatosensory development, as well as for the proper functioning of the adult mouse brain. Developmental delay was demonstrated for somatosensory function and for complex behavior, which involved both basal motor function and motivation. The mutant mice also had deficits in motor learning, complex coordination and learning of aversive stimuli. The mouse model contributes to the evaluation of the role of methylated CaM. CaM methylation appears to have a role in growth, muscle strength, somatosensory development and brain function. The current study has clinical implications for human patients. Patients presenting slow growth and muscle weakness that could result from a mitochondrial impairment and mental retardation should be considered for sequence analysis of the CaM KMT gene.

Behaviors of providers of traditional korean medicine therapy and complementary and alternative medicine therapy for the treatment of cancer patients.

PubMed

Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young

2015-03-01

In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Adequate management and quality control of CAM providers is thought to involve both education and legislation.

Effect of Ca2+ on the promiscuous target-protein binding of calmodulin.

PubMed

Westerlund, Annie M; Delemotte, Lucie

2018-04-01

Calmodulin (CaM) is a calcium sensing protein that regulates the function of a large number of proteins, thus playing a crucial part in many cell signaling pathways. CaM has the ability to bind more than 300 different target peptides in a Ca2+-dependent manner, mainly through the exposure of hydrophobic residues. How CaM can bind a large number of targets while retaining some selectivity is a fascinating open question. Here, we explore the mechanism of CaM selective promiscuity for selected target proteins. Analyzing enhanced sampling molecular dynamics simulations of Ca2+-bound and Ca2+-free CaM via spectral clustering has allowed us to identify distinct conformational states, characterized by interhelical angles, secondary structure determinants and the solvent exposure of specific residues. We searched for indicators of conformational selection by mapping solvent exposure of residues in these conformational states to contacts in structures of CaM/target peptide complexes. We thereby identified CaM states involved in various binding classes arranged along a depth binding gradient. Binding Ca2+ modifies the accessible hydrophobic surface of the two lobes and allows for deeper binding. Apo CaM indeed shows shallow binding involving predominantly polar and charged residues. Furthermore, binding to the C-terminal lobe of CaM appears selective and involves specific conformational states that can facilitate deep binding to target proteins, while binding to the N-terminal lobe appears to happen through a more flexible mechanism. Thus the long-ranged electrostatic interactions of the charged residues of the N-terminal lobe of CaM may initiate binding, while the short-ranged interactions of hydrophobic residues in the C-terminal lobe of CaM may account for selectivity. This work furthers our understanding of the mechanism of CaM binding and selectivity to different target proteins and paves the way towards a comprehensive model of CaM selectivity.

Biofuel crops with CAM photosynthesis: Economic potential on moisture-limited lands

NASA Astrophysics Data System (ADS)

Bartlett, Mark; Hartzell, Samantha; Porporato, Amilcare

2017-04-01

As the demand for food and renewable energy increases, the intelligent utilization of marginal lands is becoming increasingly critical. In marginal lands classified by limited rainfall or soil salinity, the cultivation of traditional C3 and C4 photosynthesis crops often is economically infeasible. However, in such lands, nontraditional crops with crassulacean acid metabolism (CAM) photosynthesis show great economic potential for cultivation. CAM crops including Opuntia (prickly pear) and Ananas (pineapple) achieve a water use efficiency which is three fold higher than C4 crops such as corn and 6-fold higher than C3 crops such as wheat, leading to a comparable annual productivity with only 20% of the water demand. This feature, combined with a shallow rooting depth and a high water storage capacity, allows CAM plants to take advantage of small, infrequent rainfall amounts in shallow, quickly draining soils. Furthermore, CAM plants typically have properties (e.g., high content of non-structural carbohydrates) that are favorable for biofuel production. Here, for marginal lands characterized by low soil moisture availability and/or high salinity, we assess the potential productivity and economic benefits of CAM plants. CAM productivity is estimated using a recently developed model which simulates CAM photosynthesis under a range of soil and climate conditions. From these results, we compare the energy and water resource inputs required by CAM plants to those required by more traditional C3 and C4 crops (corn, wheat, sorghum), and we evaluate the economic potential of CAM crops as sources of food, fodder, or biofuel in marginal soils. As precipitation events become more intense and infrequent, we show that even though marginal land area may increase, CAM crop cultivation shows great promise for maintaining high productivity with minimal water inputs. Our analysis indicates that on marginal lands, widespread cultivation of CAM crops as biofuel feedstock may help alleviate existing tensions between food and fuel production.

Isolation and characterization of a novel calmodulin-binding protein from potato

NASA Technical Reports Server (NTRS)

Reddy, Anireddy S N.; Day, Irene S.; Narasimhulu, S. B.; Safadi, Farida; Reddy, Vaka S.; Golovkin, Maxim; Harnly, Melissa J.

2002-01-01

Tuberization in potato is controlled by hormonal and environmental signals. Ca(2+), an important intracellular messenger, and calmodulin (CaM), one of the primary Ca(2+) sensors, have been implicated in controlling diverse cellular processes in plants including tuberization. The regulation of cellular processes by CaM involves its interaction with other proteins. To understand the role of Ca(2+)/CaM in tuberization, we have screened an expression library prepared from developing tubers with biotinylated CaM. This screening resulted in isolation of a cDNA encoding a novel CaM-binding protein (potato calmodulin-binding protein (PCBP)). Ca(2+)-dependent binding of the cDNA-encoded protein to CaM is confirmed by (35)S-labeled CaM. The full-length cDNA is 5 kb long and encodes a protein of 1309 amino acids. The deduced amino acid sequence showed significant similarity with a hypothetical protein from another plant, Arabidopsis. However, no homologs of PCBP are found in nonplant systems, suggesting that it is likely to be specific to plants. Using truncated versions of the protein and a synthetic peptide in CaM binding assays we mapped the CaM-binding region to a 20-amino acid stretch (residues 1216-1237). The bacterially expressed protein containing the CaM-binding domain interacted with three CaM isoforms (CaM2, CaM4, and CaM6). PCBP is encoded by a single gene and is expressed differentially in the tissues tested. The expression of CaM, PCBP, and another CaM-binding protein is similar in different tissues and organs. The predicted protein contained seven putative nuclear localization signals and several strong PEST motifs. Fusion of the N-terminal region of the protein containing six of the seven nuclear localization signals to the reporter gene beta-glucuronidase targeted the reporter gene to the nucleus, suggesting a nuclear role for PCBP.

L1CAM in early-stage type I endometrial cancer: results of a large multicenter evaluation.

PubMed

Zeimet, Alain G; Reimer, Daniel; Huszar, Monica; Winterhoff, Boris; Puistola, Ulla; Azim, Samira Abdel; Müller-Holzner, Elisabeth; Ben-Arie, Alon; van Kempen, Léon C; Petru, Edgar; Jahn, Stephan; Geels, Yvette P; Massuger, Leon F; Amant, Frédéric; Polterauer, Stephan; Lappi-Blanco, Elisa; Bulten, Johan; Meuter, Alexandra; Tanouye, Staci; Oppelt, Peter; Stroh-Weigert, Monika; Reinthaller, Alexander; Mariani, Andrea; Hackl, Werner; Netzer, Michael; Schirmer, Uwe; Vergote, Ignace; Altevogt, Peter; Marth, Christian; Fogel, Mina

2013-08-07

Despite the excellent prognosis of Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage I, type I endometrial cancers, a substantial number of patients experience recurrence and die from this disease. We analyzed the value of immunohistochemical L1CAM determination to predict clinical outcome. We conducted a retrospective multicenter cohort study to determine expression of L1CAM by immunohistochemistry in 1021 endometrial cancer specimens. The Kaplan-Meier method and Cox proportional hazard model were applied for survival and multivariable analyses. A machine-learning approach was used to validate variables for predicting recurrence and death. Of 1021 included cancers, 17.7% were rated L1CAM-positive. Of these L1CAM-positive cancers, 51.4% recurred during follow-up compared with 2.9% L1CAM-negative cancers. Patients bearing L1CAM-positive cancers had poorer disease-free and overall survival (two-sided Log-rank P < .001). Multivariable analyses revealed an increase in the likelihood of recurrence (hazard ratio [HR] = 16.33; 95% confidence interval [CI] = 10.55 to 25.28) and death (HR = 15.01; 95% CI = 9.28 to 24.26). In the L1CAM-negative cancers FIGO stage I subdivision, grading and risk assessment were irrelevant for predicting disease-free and overall survival. The prognostic relevance of these parameters was related strictly to L1CAM positivity. A classification and regression decision tree (CRT)identified L1CAM as the best variable for predicting recurrence (sensitivity = 0.74; specificity = 0.91) and death (sensitivity = 0.77; specificity = 0.89). To our knowledge, L1CAM has been shown to be the best-ever published prognostic factor in FIGO stage I, type I endometrial cancers and shows clear superiority over the standardly used multifactor risk score. L1CAM expression in type I cancers indicates the need for adjuvant treatment. This adhesion molecule might serve as a treatment target for the fully humanized anti-L1CAM antibody currently under development for clinical use.

Reasons, perceived efficacy, and factors associated with complementary and alternative medicine use among Malaysian patients with HIV/AIDS.

PubMed

Hasan, Syed Shahzad; See, Choon Keong; Choong, Christopher Lee Kwok; Ahmed, Syed Imran; Ahmadi, Keivan; Anwar, Mudassir

2010-11-01

The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use. This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers. Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded. Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p = 0.021, r(s) = 0.148), monthly income (p = 0.001, r(s) = 0.260), and family history of CAM use (p = 0.001, r(s) = 0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use. This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS.

Comparing Complementary and Alternative Medicine Use with or without Including Prayer as a Modality in a Local and Diverse United States Jurisdiction.

PubMed

Robles, Brenda; Upchurch, Dawn M; Kuo, Tony

2017-01-01

Few studies to date have examined the utilization of complementary and alternative medicine (CAM) in a local, ethnically diverse population in the United States (U.S.). Fewer have addressed the differences in their use based on inclusion or exclusion of prayer as a modality. Variable definitions of CAM are known to affect public health surveillance (i.e., continuous, systematic data collection, analysis, and interpretation) or benchmarking (i.e., identifying and comparing key indicators of health to inform community planning) related to this non-mainstream collection of health and wellness therapies. The present study sought to better understand how including or excluding prayer could affect reporting of CAM use among residents of a large, urban U.S. jurisdiction. Using population-weighted data from a cross-sectional Internet panel survey collected as part of a larger countywide population health survey, the study compared use of CAM based on whether prayer or no prayer was included in its definition. Patterns of CAM use by socio-demographic characteristics were described for the two operationalized definitions. Multivariable binomial regression analyses were performed to control for gender, age, race/ethnicity, education, employment, income, and health insurance status. One of the analyses explored the associations between CAM use and racial/ethnic characteristics in the study sample. Los Angeles County, California. A socio-demographically diverse sample of Los Angeles County residents. CAM use (with prayer) and CAM use (excluding prayer). Blacks were among the highest users of CAM when compared to Whites, especially when prayer was included as a CAM modality. Regardless of prayer inclusion, being a woman predicted higher use of CAM. How CAM is defined matters in gauging the utilization of this non-mainstream collection of therapies. Given that surveillance and/or benchmarking data are often used to inform resource allocation and planning decisions, results from the present study suggest that when prayer is included as part of the CAM definition, utilization/volume estimates of its use increased correspondingly, especially among non-White residents of the region.

Complementary and alternative therapies in dentistry and characteristics of dentists who recommend them.

PubMed

Baatsch, Beatrice; Zimmer, Stefan; Rodrigues Recchia, Daniela; Büssing, Arndt

2017-12-01

The aims of this study were to analyse whether dentists offer or recommend complementary and alternative medicine (CAM) remedies in their clinical routine, and how effective these are rated by proponents and opponents. A second aim of this study was to give a profile of the dentists endorsing CAM. A prospective, explorative, anonymised cross-sectional survey was spread among practicing dentists in Germany via congresses, dental periodicals and online (n=250, 55% male, 45% female; mean age 49.1±11.4years). Of a set of 31 predefined CAM modalities, the dentists integrated plant extracts from Arnica montana (64%), chamomile (64%), clove (63%), Salvia officinalis (54%), but also relaxation therapies (62%), homeopathy (57%), osteopathic medicine (50%) and dietetics (50%). The effectiveness of specific treatments was rated significantly higher (p<0.0001) by CAM proponents than opponents. However also CAM opponents classified some CAM remedies as highly effective, namely ear acupuncture, osteopathic medicine and clove. For ear acupuncture these scores did not significantly differ between both groups. With respect to the characteristic of the proponents, the majority of CAM endorsing dentists were women. The mean age (50.4±0.9 vs 47.0±0.9years) and number of years of professional experience (24.2±1.0 vs 20.0±1.0years) were significantly higher for CAM proponents than the means for opponents (p<0.0001 respectively). CAM proponents worked significantly less (p<0.0001) and their perceived workload was significantly lower (p=0.008). Their self-efficacy expectation (SEE) and work engagement (Utrecht work engagement, UWE) were significantly higher (p≤0.01 and p<0.0001) compared to dentists who abandoned these treatment options. The logistic regression model showed (exploratively) an increased association from CAM proponents with the UWES subscale dedication, with years of experience, and that men are less likely to be CAM proponents than women. Various CAM treatments are recommended by German dentists and requested by their patients, but the scientific evidence for these treatments are often low or at least unclear. CAM proponents are often female, have higher SE and work engagement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Does complementary and alternative medicine (CAM) use reduce negative life impact of headaches for chronic migraineurs? A national survey.

PubMed

Lee, Jieun; Bhowmick, Amrita; Wachholtz, Amy

2016-01-01

Chronic migraine is a disabling condition that impacts multiple aspects of migraineurs' lives. Although pharmacological treatments can help to treat the pain associated with migraine headache, chronic migraineurs often experience side-effects of pharmacological treatments. Those experiences may contribute to the observed growth in complementary and alternative medicine (CAM) use among migraineurs. Relatively little is known about the patterns of CAM treatment and the characteristics of chronic migraineurs. Therefore, the purpose of the present study is to investigate the characteristics of chronic migraineurs who use CAM treatment and the relationship among satisfaction with current CAM use, negative life impact, migraine outcomes, and psychiatric comorbidities among chronic migraineurs. 2907 participants were recruited from a well-known online migraine headache resource. All participants were US adults aged 18 years or older. Migraineurs are referred to this website through various routes (e.g., referral from healthcare providers, internet search, obtaining information from research papers, personal invitation from other users, and information shared on social media etc.). Participants completed a 30-min self-report-survey in the spring of 2014. Almost half of the participants reported that they are currently using more than three different CAM treatments even though the majority of the participants reported neutral or dissatisfied with their current CAM treatment. Chronic migraineurs who use CAM treatments were more likely to experience prolonged or frequent migraine headaches (p = .018, η(2) = .0021), and experience greater negative life impact from their headaches (p = .000, η(2) = .0172) compared to non-CAM users. CAM treatment satisfaction was inversely related to the number of psychiatric comorbidities, frequency of migraines, and number of migraine symptoms (p's < .05). However, CAM treatment satisfaction was more strongly correlated with migraine outcomes than psychiatric comorbidities. Chronic migraineurs often pursue multiple CAM treatments in spite of low levels of satisfaction with those treatments. Patients who experience relief from traditional treatments are less likely to seek the out additional CAM treatments. Thus it is often the sicker migraine patients who use CAM. More attention is needed to consider migraine treatment resistance, and psychological factors in planning the treatment of chronic migraineurs as those factors may play an important role in treatment choices by patients.

Therapeutic Uses of the WebCam in Child Psychiatry

ERIC Educational Resources Information Center

Chlebowski, Susan; Fremont, Wanda

2011-01-01

Objective: The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Method: Six cases illustrate the use of the WebCam in individual…

Comprehensive Achievement Monitoring in the Sequoia Union High School District. Symposium, California Mathematics Council Northern Section.

ERIC Educational Resources Information Center

Easter, John; And Others

A description is provided of comprehensive Achievement Monitoring (CAM), a tool which enables classroom teachers to function as researchers and evaluators. Part I reviews the CAM philosophy and the section following discusses computerized feedback in CAM operations. The final two portions of the report describes the use of CAM in mathematics…

Collaborative Project. A Flexible Atmospheric Modeling Framework for the Community Earth System Model (CESM)

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

Gettelman, Andrew

2015-10-01

In this project we have been upgrading the Multiscale Modeling Framework (MMF) in the Community Atmosphere Model (CAM), also known as Super-Parameterized CAM (SP-CAM). This has included a major effort to update the coding standards and interface with CAM so that it can be placed on the main development trunk. It has also included development of a new software structure for CAM to be able to handle sub-grid column information. These efforts have formed the major thrust of the work.

Assessing local market and organizational readiness for the integration of complementary and alternative medicine into ambulatory care centers.

PubMed

Makowski, Suzana K E

2004-01-01

Complementary and alternative medicine (CAM) is one of the fastest growing segments of the health care industry today, with studies suggesting that between 30% and 50% of the adult population in the United States uses some form of CAM. Many ambulatory care centers are considering integrating CAM into their clinical services. This article will review some of the national trends and present a framework for assessing local market demand for CAM in order to help prioritize an organization's CAM integration strategy.

Characterization of monocarboxylate transporter 1 (MCT1) binding affinity for Basigin gene products and L1cam.

PubMed

Howard, John; Finch, Nicole A; Ochrietor, Judith D

2010-07-01

The purpose of this study was to determine the binding affinities of Basigin gene products and neural cell adhesion molecule L1cam for monocarboxylate transporter-1 (MCT1). ELISA binding assays were performed in which recombinant proteins of the transmembrane domains of Basigin gene products and L1cam were incubated with MCT1 captured from mouse brain. It was determined that Basigin gene products bind MCT1 with moderate affinity, but L1cam does not bind MCT1. Despite a high degree of sequence conservation between Basigin gene products and L1cam, the sequences are different enough to prevent L1cam from interacting with MCT1.

A computer program to perform dynamic thermal analysis for bare overhead conductors during short-time overload conditions

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

Shrestha, P.; Pham, K.

1995-12-31

Under emergency conditions, a bare overhead conductor can carry an increased amount of current that is well in excess of its normal rating. When there is this increase in current flow on a bare overhead conductor, the temperature does not rise instantaneously. but increases along a curve determined by the current, the conductor properties and the ambient conditions. The conductor temperature at the end of a short-time overload period must be restricted to its maximum design value. This paper presents a simplified approach in analyzing the dynamic performance for bare overhead conductors during short-time overload condition. A computer program wasmore » developed to calculate the short-time ratings for bare overhead conductors. The following parameters: current induced heating. solar load, convective/conductive cooling, radiative cooling, altitude, wind velocity and ampacity of the bare conductor were considered. Several sample graphical output lots are included with the paper.« less

Ergonomic evaluation of a wearable assistive device for overhead work.

PubMed

Rashedi, Ehsan; Kim, Sunwook; Nussbaum, Maury A; Agnew, Michael J

2014-01-01

Overhead work is an important risk factor for upper extremity (UE) musculoskeletal disorders. We examined the potential of a mechanical arm and an exoskeletal vest as a wearable assistive device (WADE) for overhead work. Twelve participants completed 10 minutes of simulated, intermittent overhead work, using each of three payloads (1.1, 3.4 and 8.1 kg) and with/without the WADE. Ratings of perceived discomfort (RPDs) and electromyography (EMG) were obtained for the upper arms, shoulders and low back. Using the WADE, UE RPDs decreased by ∼50% with the heavier payloads, whereas smaller (∼25%) and non-significant increases in low-back RPDs were found and were relatively independent of payload. Changes in RPDs with WADE use were consistent with physical demands indicated by EMG, though EMG-based differences in fatigue were less apparent. Participants generally preferred using the WADE, particularly with heavier payloads. These results supported the potential utility of a WADE as an intervention for overhead work.

Environmental Assessment for QSEU116038 - Lower Pattern Altitude at Moody Air Force Base, Georgia

DTIC Science & Technology

2012-04-01

flight rules ( IFR ) overhead flight patterns. The 2,000-foot AGL VFR overhead flight pattern is associated with the previous Moody AFB training mission...EA Environmental Assessment EIS environmental impact statement IFR instrument flight rules Lmax maximum sound level NEPA National Environmental...airspace only (airspace immediately surrounding the Moody AFB airfield) and would not affect instrument flight rules ( IFR ) overhead flight patterns

Calculation of induced voltages on overhead lines caused by inclined lightning strokes

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

Sakakibara, A.

1989-01-01

Equations to calculate the inducing scalar and vector potentials produced by inclined return strokes are shown. Equations are also shown for calculating the induced voltages on overhead lines where horizontal components of inducing vector potential exist. The adequacy of the calculation method is demonstrated by field experiments. Using these equations, induced voltages on overhead lines are calculated for a variety of directions of return strokes.

Overhead drilling: Comparing three bases for aligning a drilling jig to vertical

PubMed Central

Rempel, David; Star, Demetra; Barr, Alan; Janowitz, Ira

2010-01-01

Problem Drilling overhead into concrete or metal ceilings is a strenuous task done by construction workers to hang ductwork, piping, and electrical equipment. The task is associated with upper body pain and musculoskeletal disorders. Previously, we described a field usability evaluation of a foot lever and inverted drill press intervention devices that were compared to the usual method for overhead drilling. Both interventions were rated as inferior to the usual method based on poor setup time and mobility. Method Three new interventions, which differed on the design used for aligning the drilling column to vertical, were compared to the usual method for overhead drilling by commercial construction workers (n=16). Results The usual method was associated with the highest levels of regional body fatigue and the poorest usability ratings when compared to the three interventions. Conclusion Overall, the ‘Collar Base’ intervention design received the best usability ratings. Impact on Industry Intervention designs developed for overhead drilling may reduce shoulder fatigue and prevent subsequent musculoskeletal disorders. These designs may also be useful for other overhead work such as lifting and supporting materials (e.g., piping, ducts) that are installed near the ceiling. Workplace health and safety interventions may require multiple rounds of field-testing prior to achieving acceptable usability ratings by the end users. PMID:20630276

Caregiver-reported religious beliefs and complementary and alternative medicine use among children admitted to an epilepsy monitoring unit.

PubMed

Beattie, Julia Fleming; Thompson, Matthew D; Parks, Pamela H; Jacobs, Ruth Q; Goyal, Monisha

2017-04-01

Complementary and alternative medicine (CAM) includes a wide range of practices and products that are generally outside the use of conventional medicine as practiced in Western cultures. Use of CAM in persons with epilepsy is high, even compared to individuals with other chronic health conditions. In this study, we surveyed caregivers of children admitted to a regional epilepsy monitoring unit (EMU) in the southeast United States to assess CAM use among patients (N=225). Thirteen percent of respondents indicated current use of CAM by their child, 16% reported past use, and 43% reported interest in future use, most commonly in marijuana as a potential treatment (23%). Over 25% of respondents expressed interest in CAM use related to side effects of anti-epileptic medications. Regarding prayer as a form of CAM, a large majority of respondents in this sample identified as Christian and actively prayed for their child's illness, revealing a high prevalence of spiritual practices in this population. Eighty-one percent of respondents reported that they had not discussed CAM use with their doctor. Discussing CAM use with a health care provider was significantly related to past CAM use (p<.02), but not current use or willingness to try CAM in the future (p>.05). These results have important implications for future practice and support increased communication and patient education, as many anti-epileptic medications interact with certain herbs and supplements, posing a potential health risk and treatment barrier in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

Use of complementary and alternative medicine within Norwegian hospitals.

PubMed

Jacobsen, R; Fønnebø, V M; Foss, N; Kristoffersen, A E

2015-08-13

Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008. In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specific CAM therapies were offered in the hospital. Fifty-nine (73.8%) hospitals responded and form the basis for the analyses. CAM was offered in 64.4% of the responding hospitals. No major differences were found between public and private, or between somatic and psychiatric, hospitals. Acupuncture was the most frequent CAM method offered, followed by art- and expression therapy and massage. The proportion of hospitals offering CAM has increased from 50.5% in 2008 to 64.4% in 2013 (p = 0.089). The largest increase was found in psychiatric hospitals where 76.5% of hospitals offered CAM in 2013 compared to 28.6% in 2008 (p = 0.003). A small decrease was found in the proportion of hospitals offering acupuncture between 2008 (41.4%) and 2013 (37.3%). A majority of Norwegian hospitals offer some sort of CAM. The largest increase since 2008 was found in psychiatric hospitals. Psychiatric hospitals seem to have established a practice of offering CAM to their patients similar to the practice in somatic hospitals. This could indicate a shift in the attitude with regard to CAM in psychiatric hospitals.

Doctor-patient communication and cancer patients' choice of alternative therapies as supplement or alternative to conventional care.

PubMed

Salamonsen, Anita

2013-03-01

Cancer patients' use of complementary and alternative medicine (CAM) is widespread, despite the fact that clinical studies validating the efficacy of CAM remain sparse in the Nordic countries. The purpose of this study was to explore possible connections between cancer patients' communication experiences with doctors and the decision to use CAM as either supplement or alternative to conventional treatment (CT). The Regional Committee for Medical and Health Research Ethics and the Norwegian Data Inspectorate approved the study. From a group of 52 cancer patients with self-reported positive experiences from use of CAM, 13 were selected for qualitative interviews. Six used CAM as supplement, and seven as alternative to CT, periodically or permanently. Communication experiences with 46 doctors were described. The analysis revealed three connections between doctor-patient communication and patients' treatment decisions: (i) negative communication experiences because of the use of CAM; (ii) negative communication experiences resulted in the decision to use CAM, and in some cases to decline CT; and (iii) positive communication experiences led to the decision to use CAM as supplement, not alternative to CT. The patients, including the decliners of CT, wanted to discuss treatment decisions in well-functioning interpersonal processes with supportive doctors. In doctors' practices and education of doctors, a greater awareness of potential positive and negative outcomes of doctor-patient communication that concern CAM issues could be of importance. More research is needed to safeguard CAM users' treatment decisions and their relationship to conventional health care. © 2012 The Author. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Patterns of complementary and alternative medicine (CAM) use in children: a systematic review.

PubMed

Italia, Salvatore; Wolfenstetter, Silke Britta; Teuner, Christina Maria

2014-11-01

Utilization of complementary and alternative medicine (CAM) among children/adolescents is popular. This review summarizes the international findings for prevalence and predictors of CAM use among children/adolescents. We therefore systematically searched four electronic databases (PubMed, Embase, PsycINFO, AMED; last update in 07/2013) and reference lists of existing reviews and all included studies. Publications without language restriction reporting patterns of CAM utilization among children/adolescents without chronic conditions were selected for inclusion. The prevalence rates for overall CAM use, homeopathy, and herbal drug use were extracted with a focus on country and recall period (lifetime, 1 year, current use). As predictors, we extracted socioeconomic factors, child's age, and gender. The database search and citation tracking yielded 58 eligible studies from 19 countries. There was strong variation regarding study quality. Prevalence rates for overall CAM use ranged from 10.9-87.6 % for lifetime use and from 8-48.5 % for current use. The respective percentages for homeopathy (highest in Germany, United Kingdom, and Canada) ranged from 0.8-39 % (lifetime) and from 1-14.3 % (current). Herbal drug use (highest in Germany, Turkey, and Brazil) was reported for 0.8-85.5 % (lifetime) and 2.2-8.9 % (current) of the children/adolescents. Studies provided a relatively uniform picture of the predictors of overall CAM use (higher parental income and education, older children), but only a few studies analyzed predictors for single CAM modalities. CAM use is widespread among children/adolescents. Prevalence rates vary widely regarding CAM modality, country, and reported recall period.

EU FP7 project 'CAMbrella' to build European research network for complementary and alternative medicine.

PubMed

Weidenhammer, Wolfgang; Lewith, George; Falkenberg, Torkel; Fønnebø, Vinjar; Johannessen, Helle; Reiter, Bettina; Uehleke, Bernhard; von Ammon, Klaus; Baumhöfener, Franziska; Brinkhaus, Benno

2011-01-01

The status of complementary and alternative medicine (CAM) within the EU needs clarification. The definition and terminology of CAM is heterogeneous. The therapies, legal status, regulations and approaches used vary from country to country but there is widespread use by EU citizens. A coordination project funded by the EU has been launched to improve the knowledge about CAM in Europe. The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to establish an EU network involving centres of research excellence for collaborative projects, to develop consensus-based terminology to describe CAM interventions, to create a knowledge base that facilitates the understanding of patient demand for CAM and its prevalence, to review the current legal status and policies governing CAM provision, and to explore the needs and attitudes of EU citizens with respect to CAM. Based on this information a roadmap will be created that will enable sustainable and prioritised future European research in CAM. CAMbrella encompasses 16 academic research groups from 12 European countries and will run for 36 months starting from January 2010. The project will be delivered in 9 work packages coordinated by a Management Board and directed by a Scientific Steering Committee with support of an Advisory Board. The outcomes generated will be disseminated through the project's website, peer review open access publications and a final conference, with emphasis on current and future EU policies, addressing different target audiences. Copyright © 2011 S. Karger AG, Basel.

Current Understandings of the Research-Practice Gap From the Viewpoint of Complementary Medicine Academics: A Mixed-Method Investigation.

PubMed

Leach, Matthew J; Tucker, Basil

Research plays an important role in advancing health and healthcare. However, much research evidence is not reflected in contemporary complementary and alternative medicine (CAM) practice. Understanding and addressing the reasons for this research-practice gap may have positive implications for quality of care. To shed light on the gap between research and CAM practice. Descriptive cross-sectional, mixed-method study. A total of 126 senior CAM academics across Australasia, Europe, UK, and North America. Participants completed a 30-item online survey and a semi-structured interview; both of which explored the research-practice gap in CAM. A total of 43 (34%) academics completed the survey, with 29 (67%) respondents undergoing an interview. There was general agreement among respondents that CAM research should be informed by practice, and practice informed by research; however, most agreed that this did not reflect the current situation. Translational issues were perceived to be the primary reason for the research-practice gap in CAM. Suggested strategies for closing the gap focussed mostly around improving CAM student/practitioner education and training, and researcher-practitioner engagement and collaboration. Study findings point toward the presence of a research-practice gap in CAM, with several factors likely to be instrumental in sustaining this gap. Attention now needs to focus on understanding the views of CAM clinicians on this issue. Insights gained from this research will help inform the development of a multi-modal strategy that will effectively target the barriers to change in order to bring CAM research and practice closer together. Copyright © 2017 Elsevier Inc. All rights reserved.

The Confusion Assessment Method (CAM): A Systematic Review of Current Usage

PubMed Central

Wei, Leslie A.; Fearing, Michael A.; Sternberg, Eliezer J.; Inouye, Sharon K.

2008-01-01

Objectives To examine the psychometric properties, adaptations, translations, and applications of the Confusion Assessment Method (CAM), a widely-used instrument and diagnostic algorithm for identification of delirium. Design Systematic literature review Setting NA Measurements Electronic searches of PubMED, EMBASE, PsychINFO, CINAHL, Ageline, and Google Scholar, augmented by reviews of reference listings, were conducted to identify original English-language articles utilizing the CAM from January 1, 1991 to December 31, 2006. Two reviewers independently abstracted key information from each article. Participants NA Results Of 239 original articles, 10 (4%) were categorized as validation studies, 16 (7%) as adaptations; 12 (5%) as translations, and 222 (93%) as applications. Validation studies evaluated performance of the CAM against a reference standard. Results were combined across 7 high quality studies (n=1071), demonstrating an overall sensitivity of 94% (95% confidence interval, CI, 91–97%), and specificity of 89% (95% CI, 85–94%). CAM has been adapted for use in ICU, emergency, and institutional settings, and for scoring severity and subsyndromal delirium. CAM has been translated into 10 languages where published articles are available. In application studies, CAM-rated delirium is most commonly used as a risk factor or outcome, but also as an intervention or reference standard. Conclusions The CAM has helped to improve identification of delirium in clinical and research settings. To optimize performance, the CAM should be scored based on observations made during formal cognitive testing, and training is recommended. Future action is needed to optimize use of the CAM and to improve the recognition and management of delirium. PMID:18384586

Comparison of Swiss basic health insurance costs of complementary and conventional medicine.

PubMed

Studer, Hans-Peter; Busato, André

2011-01-01

From 1999 to 2005, 5 methods of complementary and alternative medicine (CAM) applied by physicians were provisionally included into mandatory Swiss basic health insurance. Between 2012 and 2017, this will be the case again. Within this process, an evaluation of cost-effectiveness is required. The goal of this study is to compare practice costs of physicians applying CAM with those of physicians applying solely conventional medicine (COM). The study was designed as a cross-sectional investigation of claims data of mandatory health insurance. For the years 2002 and 2003, practice costs of 562 primary care physicians with and without a certificate for CAM were analyzed and compared with patient-reported outcomes. Linear models were used to obtain estimates of practice costs controlling for different patient populations and structural characteristics of practices across CAM and COM. Statistical procedures show similar total practice costs for CAM and COM, with the exception of homeopathy with 15.4% lower costs than COM. Furthermore, there were significant differences between CAM and COM in cost structure especially for the ratio between costs for consultations and costs for medication at the expense of basic health insurance. Patients reported better quality of the patient-physician relationship and fewer adverse side effects in CAM; higher cost-effectiveness for CAM can be deduced from this perspective. This study uses a health system perspective and demonstrates at least equal or better cost-effectiveness of CAM in the setting of Swiss ambulatory care. CAM can therefore be seen as a valid complement to COM within Swiss health care. Copyright © 2011 S. Karger AG, Basel.

Host specificity of Enterocytozoon bieneusi genotypes in Bactrian camels (Camelus bactrianus) in China.

PubMed

Qi, Meng; Li, Junqiang; Zhao, Aiyun; Cui, Zhaohui; Wei, Zilin; Jing, Bo; Zhang, Longxian

2018-04-02

Enterocytozoon bieneusi is an obligate, intracellular fungus and is commonly reported in humans and animals. To date, there have been no reports of E. bieneusi infections in Bactrian camels (Camelus bactrianus). The present study was conducted to understand the occurrence and molecular characteristics of E. bieneusi in Bactrian camels in China. Of 407 individual Bactrian camel fecal specimens, 30.0% (122) were E. bieneusi-positive by nested polymerase chain reaction (PCR) based on internal transcriber spacer (ITS) sequence analysis. A total of 14 distinct E. bieneusi ITS genotypes were obtained: eight known genotypes (genotype EbpC, EbpA, Henan-IV, BEB6, CM8, CHG16, O and WL17), and six novel genotypes (named CAM1 to CAM6). Genotype CAM1 (59.0%, 72/122) was the most predominant genotype in Bactrian camels in Xinjiang, and genotype EbpC (18.9%, 23/122) was the second-most predominant genotype. Phylogenetic analysis revealed that six known genotypes (EbpC, EbpA, WL17, Henan-IV, CM8 and O) and three novel genotypes (CAM3, CAM5 and CAM6) fell into the human-pathogenic group 1. Two known genotypes (CHG16 and BEB6) fell into the cattle host-specific group 2. The novel genotypes CAM1, CAM 2 and CAM4 cluster into group 8. To our knowledge, this is the first report of E. bieneusi in Bactrian camels. The host-specific genotype CAM1 was the predominant genotype, which plays a negligible role in the zoonotic transmission of E. bieneusi. However, the second-most predominant genotype, EbpC, has greater zoonotic potential.

Addressing holistic healthcare needs of oncology patients: Implementation and evaluation of a complementary and alternative medicine (CAM) course within an elective module designed for healthcare professionals.

PubMed

Klafke, Nadja; Homberg, Angelika; Glassen, Katharina; Mahler, Cornelia

2016-12-01

Patients, and especially oncology patients, increasingly demand information and application of complementary therapies to supplement their conventional medical treatment and follow-up care. Due to the widespread interest in holistic treatment opportunities in oncology populations, healthcare professionals need to be prepared in differentiating evidence-based methods of the complementary and alternative medicine (CAM) spectrum and how to consult with patients about it. This paper reports on the implementation and evaluation of a newly designed module "Complementary and Alternative Medicine in oncological healthcare" in the bachelor degree program Interprofessional Health Care (B.Sc.). The study applied a developed evaluation questionnaire to capture students' perspectives on the CAM contents. This assessment instrument was administered pre and post the CAM teaching unit. Interprofessional medical education, University Hospital Heidelberg, Germany. The integration of the CAM elective module was possible and was met by positive response. Students' interest was reflected in an increase of their self-reported knowledge gain and positive CAM attitude. Comparison of pre and post evaluation data demonstrate that, particularly, students' expectations on developing their own opinion about CAM, and getting an overview of the evidence-base of different CAM methods have been met. Evaluation results indicate that the module content was in line with the students' expectations and may have positively impacted on their general CAM attitude. The results support us in continuing to offer this CAM course within the elective module to prepare today's healthcare professionals for patient-oriented healthcare delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Broadening our perspectives on complementary and alternative medicine for menopause: A narrative review.

PubMed

Tonob, Dunia; Melby, Melissa K

2017-05-01

Complementary and alternative medicine (CAM) is widely used for menopause, although not all women disclose use to their healthcare providers. This narrative review aims to expand providers' understanding of cross-cultural approaches to treating and managing menopause by providing an overarching framework and perspective on CAM treatments. Increased provider understanding and awareness may improve not only provider-patient communication but also effectiveness of treatments. The distinction between illness (what patients suffer) and disease (what physicians treat) highlights the gap between what patients seek and doctors provide, and may help clarify why many women seek CAM at menopause. For example, CAM is often sought by women for whom biomedicine has been unsuccessful or inaccessible. We review the relevance to menopause of three CAM categories: natural products, mind-body practices including meditation, and other complementary health approaches including traditional Chinese medicine (TCM) and Japanese Kampo. Assessing the effectiveness of CAM is challenging because of the individualized nature of illness patterns and associated treatments, which complicate the design of randomized controlled trials. Because many women seek CAM due to inefficacy of biomedical treatments, or cultural or economic marginalization, biomedical practitioners who make an effort to learn about CAM and ask patients about their CAM use or interest may dramatically improve the patient-provider relationship and rapport, as well as harnessing the 'meaning response' (Moerman, 2002) imbued in the clinical encounter. By working with women to integrate their CAM-related health-seeking behaviors and treatments, providers may also boost the efficacy of their own biomedical treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

Plasticity of crassulacean acid metabolism at subtropical latitudes: a pineapple case study.

PubMed

Rainha, Nuno; Medeiros, Violante P; Câmara, Mariana; Faustino, Hélder; Leite, João P; Barreto, Maria do Carmo; Cruz, Cristina; Pacheco, Carlos A; Ponte, Duarte; Bernardes da Silva, Anabela

2016-01-01

Plants with the crassulacean acid metabolism (CAM) express high-metabolic plasticity, to adjust to environmental stresses. This article hypothesizes that irradiance and nocturnal temperatures are the major limitations for CAM at higher latitudes such as the Azores (37°45'N). Circadian CAM expression in Ananas comosus L. Merr. (pineapple) was assessed by the diurnal pattern of leaf carbon fixation into l-malate at the solstices and equinoxes, and confirmed by determining maximal phosphoenolpyruvate carboxylase (PEPC) activity in plant material. Metabolic adjustments to environmental conditions were confirmed by gas exchange measurements, and integrated with environmental data to determine CAM's limiting factors: light and temperature. CAM plasticity was observed at the equinoxes, under similar photoperiods, but different environmental conditions. In spring, CAM expression was similar between vegetative and flowering plants, while in autumn, flowering (before anthesis) and fructifying (with fully developed fruit before ripening) plants accumulated more l-malate. Below 100 µmol m(-2) s(-1) , CAM phase I was extended, reducing CAM phase III during the day. Carbon fixation inhibition may occur by two major pathways: nocturnal temperature (<15°C) inhibiting PEPC activity and l-malate accumulation; and low irradiance influencing the interplay between CAM phase I and III, affecting carboxylation and decarboxylation. Both have important consequences for plant development in autumn and winter. Observations were confirmed by flowering time prediction using environmental data, emphasizing that CAM expression had a strong seasonal regulation due to a complex network response to light and temperature, allowing pineapple to survive in environments not suitable for high productivity. © 2015 Scandinavian Plant Physiology Society.

A lecture program on complementary and alternative medicine for cancer patients--evaluation of the pilot phase.

PubMed

Huebner, J; Ebel, M; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Hoppe, A

2015-06-01

About half of all patients with cancer use complementary or alternative medicine (CAM). In 2013, we started a lecture program for patients, followed by evidence-based recommendations on counseling on CAM. These recommendations have been published before by this working group. The aim of the program is to provide scientific facts on the most often used CAM methods in standardized presentations which help patients discuss the topic with their oncologists and support shared decision making. The article presents the evaluation of the pilot phase. Participants received a standardized questionnaire before the start of the lecture. The questionnaire comprises four parts: demographic data, data concerning experience with CAM, satisfaction with the lecture, and needs for further information on CAM. In 2013, seven lectures on CAM were given in cooperation with regional branches of the German Cancer Society in several German states. Four hundred sixty patients and relatives took part (75% females and 16% males). Forty-eight percent formerly had used CAM. Most often named sources of information on CAM were print media (48%) and the Internet (37%). Most participants rated additional written information valuable. About one third would like to have an individual consultation concerning CAM. A standardized presentation of evidence on CAM methods most often used, together with recommendations on the self-management of symptoms, is highly appreciated. The concept of a highly interactive lecture comprising is feasible and if presented in lay terminology, adequate. In order to give additional support on the topic, written information should be provided as the first step.

Multiple C-terminal tail Ca2+/CaMs regulate CaV1.2 function but do not mediate channel dimerization

PubMed Central

Kim, Eun Young; Rumpf, Christine H; Van Petegem, Filip; Arant, Ryan J; Findeisen, Felix; Cooley, Elizabeth S; Isacoff, Ehud Y; Minor, Daniel L

2010-01-01

Interactions between voltage-gated calcium channels (CaVs) and calmodulin (CaM) modulate CaV function. In this study, we report the structure of a Ca2+/CaM CaV1.2 C-terminal tail complex that contains two PreIQ helices bridged by two Ca2+/CaMs and two Ca2+/CaM–IQ domain complexes. Sedimentation equilibrium experiments establish that the complex has a 2:1 Ca2+/CaM:C-terminal tail stoichiometry and does not form higher order assemblies. Moreover, subunit-counting experiments demonstrate that in live cell membranes CaV1.2s are monomers. Thus, contrary to previous proposals, the crystallographic dimer lacks physiological relevance. Isothermal titration calorimetry and biochemical experiments show that the two Ca2+/CaMs in the complex have different properties. Ca2+/CaM bound to the PreIQ C-region is labile, whereas Ca2+/CaM bound to the IQ domain is not. Furthermore, neither of lobes of apo-CaM interacts strongly with the PreIQ domain. Electrophysiological studies indicate that the PreIQ C-region has a role in calcium-dependent facilitation. Together, the data show that two Ca2+/CaMs can bind the CaV1.2 tail simultaneously and indicate a functional role for Ca2+/CaM at the C-region site. PMID:20953164