Science.gov

Sample records for early promising results

  1. Using Peer Assisted Strategies to Teach Early Writing: Results of a Pilot Study to Examine Feasibility and Promise

    ERIC Educational Resources Information Center

    Puranik, Cynthia S.; Patchan, Melissa M.; Lemons, Christopher J.; Al Otaiba, Stephanie

    2017-01-01

    Despite the poor outcomes for U.S. students on national writing tests, overall research on how to teach writing is sparse, and this scarcity is more pronounced in the early years of beginning to write. In this study 81,200 we present preliminary findings from Year 1 of a 3-year Institute of Education Sciences-funded Goal 2 project aimed at…

  2. Earthquake prediction; new studies yield promising results

    USGS Publications Warehouse

    Robinson, R.

    1974-01-01

    On Agust 3, 1973, a small earthquake (magnitude 2.5) occurred near Blue Mountain Lake in the Adirondack region of northern New York State. This seemingly unimportant event was of great significance, however, because it was predicted. Seismologsits at the Lamont-Doherty geologcal Observatory of Columbia University accurately foretold the time, place, and magnitude of the event. Their prediction was based on certain pre-earthquake processes that are best explained by a hypothesis known as "dilatancy," a concept that has injected new life and direction into the science of earthquake prediction. Although much mroe reserach must be accomplished before we can expect to predict potentially damaging earthquakes with any degree of consistency, results such as this indicate that we are on a promising road. 

  3. EARLY SCHOOL ADMISSIONS PROJECT, PROMISING PRACTICES.

    ERIC Educational Resources Information Center

    Baltimore City Public Schools, MD.

    THE EXPERIMENTAL PROJECT ATTEMPTS TO DETERMINE WHETHER EARLY ADMISSION TO SCHOOL CAN OVERCOME BARRIERS TO LEARNING WHICH ENVIRONMENTAL FACTORS SEEM TO IMPOSE. A DEPRIVED CHILD OFTEN DOES NOT RECEIVE ATTENTION, AFFECTION, OR GUIDANCE WITHIN HIS HOME. THE YOUNG CHILD SHOULD BE HELPED TO DEVELOP A WHOLESOME SELF-CONCEPT, TO ACQUIRE THE DRIVE TO…

  4. Early Childhood Interventions: Proven Results, Future Promise

    ERIC Educational Resources Information Center

    Karoly, Lynn A.; Kilburn, M. Rebecca; Cannon, Jill S.

    2005-01-01

    Parents, policymakers, business leaders, and the general public increasingly recognize the importance of the first few years in the life of a child for promoting healthy physical, emotional, social, and intellectual development. Whether the evidence comes from sophisticated research by brain scientists or the simple observation of the…

  5. Experimental Lung Cancer Drug Shows Early Promise | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer A first-of-its-kind drug is showing early promise in attacking certain lung cancers that are hard to treat because they build up resistance to conventional chemotherapy. The drug, CO-1686, performed well in a preclinical study involving xenograft and transgenic mice, as reported in the journal Cancer Discovery. It is now being evaluated for

  6. Experimental Lung Cancer Drug Shows Early Promise | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer A first-of-its-kind drug is showing early promise in attacking certain lung cancers that are hard to treat because they build up resistance to conventional chemotherapy. The drug, CO-1686, performed well in a preclinical study involving xenograft and transgenic mice, as reported in the journal Cancer Discovery. It is now being evaluated for safety and efficacy in Phase I and II clinical trials.

  7. Early physics results.

    PubMed

    Jenni, Peter

    2012-02-28

    For the past year, experiments at the Large Hadron Collider (LHC) have started exploring physics at the high-energy frontier. Thanks to the superb turn-on of the LHC, a rich harvest of initial physics results have already been obtained by the two general-purpose experiments A Toroidal LHC Apparatus (ATLAS) and the Compact Muon Solenoid (CMS), which are the subject of this report. The initial data have allowed a test, at the highest collision energies ever reached in a laboratory, of the Standard Model (SM) of elementary particles, and to make early searches Beyond the Standard Model (BSM). Significant results have already been obtained in the search for the Higgs boson, which would establish the postulated electro-weak symmetry breaking mechanism in the SM, as well as for BSM physics such as Supersymmetry (SUSY), heavy new particles, quark compositeness and others. The important, and successful, SM physics measurements are giving confidence that the experiments are in good shape for their journey into the uncharted territory of new physics anticipated at the LHC.

  8. Early Results from SOLIS

    NASA Astrophysics Data System (ADS)

    Harvey, J.; Giampapa, M.; Henney, C.; Keller, C.; Jones, H.

    2004-05-01

    SOLIS (Synoptic Optical Long-Term Investigations of the Sun) is a project that is replacing antiquated synoptic observing equipment at the National Solar Observatory. SOLIS consists of a suite of three instruments on an equatorial mount that will be installed on Kitt Peak in April 2004. The major SOLIS instrument is a vector spectromagnetograph (VSM) that maps magnetic fields across the full solar disk using a slit spectrograph and one arc sec pixels. Limited daily observations started at a temporary site in August, 2003 and include line-of-sight component magnetograms in the photosphere and chromosphere and, for the first time, full-disk vector magnetograms. At a medium scan speed ( ˜ 10 minutes for the full disk) noise is less than 1 Mx/cm2. This low noise, combined with negligible instrumental polarization and well resolved spectral line profiles, yields moderate resolution magnetograms of unprecedented quality. Observations show magnetic flux nearly everywhere in the photosphere from the disk center to the solar limb. Weak, intranetwork fields are now routinely observed and show a tendency to be of opposite polarity to the stronger surrounding fields. Diffuse fields surround decaying active regions and appear to be distinct from canopy fields. Vector magnetograms easily show the radial orientation of network fields, and the diffuse component surrounding decaying active regions. Near the disk center, the transverse magnetic fields of network elements change on a time scale of minutes. Detailed quantitative calibration of the observations is in progress. Good results have been obtained from the other SOLIS instruments: a full-disk filter imager at several narrow wavelengths and a double-pass grating spectrograph that provides high-accuracy line spectra of integrated sunlight. SOLIS data are freely available via the Internet and users are invited to submit observing time requests for special observations. The National Solar Observatory is operated by AURA, Inc

  9. Promising Directions for Research and Development in Early Childhood Education.

    ERIC Educational Resources Information Center

    Elliott, David L.

    A survey of research and development studies currently needed in early childhood education stresses child development and its relation to instruction. Topics which have been discussed are perception, oral language, concept formation, learning set, motivation, and the psychology of learning. Universities and public school systems working together…

  10. Metabolomics as a promising tool for early osteoarthritis diagnosis.

    PubMed

    de Sousa, E B; Dos Santos, G C; Duarte, M E L; Moura, V; Aguiar, D P

    2017-09-21

    Osteoarthritis (OA) is the main cause of disability worldwide, due to progressive articular cartilage loss and degeneration. According to recent research, OA is more than just a degenerative disease due to some metabolic components associated to its pathogenesis. However, no biomarker has been identified to detect this disease at early stages or to track its development. Metabolomics is an emerging field and has the potential to detect many metabolites in a single spectrum using high resolution nuclear magnetic resonance (NMR) techniques or mass spectrometry (MS). NMR is a reproducible and reliable non-destructive analytical method. On the other hand, MS has a lower detection limit and is more destructive, but it is more sensitive. NMR and MS are useful for biological fluids, such as urine, blood plasma, serum, or synovial fluid, and have been used for metabolic profiling in dogs, mice, sheep, and humans. Thus, many metabolites have been listed as possibly associated to OA pathogenesis. The goal of this review is to provide an overview of the studies in animal models and humans, regarding the use of metabolomics as a tool for early osteoarthritis diagnosis. The concept of osteoarthritis as a metabolic disease and the importance of detecting a biomarker for its early diagnosis are highlighted. Then, some studies in plasma and synovial tissues are shown, and finally the application of metabolomics in the evaluation of synovial fluid is described.

  11. Targeted Therapy Larotrectinib Shows Promise in Early Trials

    Cancer.gov

    The drug larotrectinib shrank tumors in patients with 13 different cancer types, results from three small clinical trials show. The drug, which targets tumors with TRK fusions, was effective in children and adults, this Cancer Currents post explains.

  12. Experimental Lung Cancer Drug Shows Early Promise | Frederick National Laboratory for Cancer Research

    Cancer.gov

    A first-of-its-kind drug is showing early promise in attacking certain lung cancers that are hard to treat because they build up resistance to conventional chemotherapy. The drug, CO-1686, performed well in a preclinical study involving xenograft and

  13. CALIPSO Overview and Early Results

    NASA Astrophysics Data System (ADS)

    McCormick, M. P.

    2008-05-01

    The CALIPSO spacecraft was co-manifested with the CloudSat spacecraft and launched by a Boeing Delta~II rocket from Vandenberg Air Force Base, California on April~28,~2006. CALIPSO is the acronym for Cloud Aerosol Lidar and Infrared Pathfinder Satellite Observations. CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) is a three-channel lidar on board that uses a Nd:YAG laser emitting pulses at 1064 and 532~nm. The receiver uses a 1-meter diameter telescope and photomultipliers in the two 532~nm channels; one for parallel-polarized backscatter, and the other for perpendicular-polarized backscatter. The 1064~nm channel uses an APD for measuring the total backscatter at this wavelength. CALIPSO is in a near-circular sunsynchronous polar 705-km orbit with a 1:30~PM ascending node, and is flying in formation with CloudSat, Aura, Aqua and PARASOL. CALIPSO and CloudSat are flying 15~seconds apart in the formation. This talk will present an overview of the CALIPSO mission and details of CALIOP and the rest of the payload. It will show typical results from measurements of clouds, details on cirrus cloud statistics for the first year of data, a characterization of Polar Stratospheric Clouds over the Artic and Antarctic during local winters and early springs, and some general atmospheric events like hurricanes and aerosols from minor volcanic eruptions, desert dust events, and smoke from fires and their transport. The presentation will end with a look toward the future of spaceborne lidars.

  14. Quality Ratings and Improvement Systems in Early Childhood Education: Promising Approaches for Pennsylvania. A PACER Policy Brief

    ERIC Educational Resources Information Center

    Jenkins, Della; Englander, Katie

    2016-01-01

    Policymakers are recognizing that Pennsylvania has fallen behind in providing equitable access to high quality early childhood education. Governor Tom Wolf ran on a campaign promise of universal pre-k access and proposed an unprecedented budget increase for early childhood programs in 2016. In Philadelphia, Mayor Jim Kenney has made pre-k a…

  15. Promising Metabolite Profiles in the Plasma and CSF of Early Clinical Parkinson's Disease

    PubMed Central

    Stoessel, Daniel; Schulte, Claudia; Teixeira dos Santos, Marcia C.; Scheller, Dieter; Rebollo-Mesa, Irene; Deuschle, Christian; Walther, Dirk; Schauer, Nicolas; Berg, Daniela; Nogueira da Costa, Andre; Maetzler, Walter

    2018-01-01

    Parkinson's disease (PD) shows high heterogeneity with regard to the underlying molecular pathogenesis involving multiple pathways and mechanisms. Diagnosis is still challenging and rests entirely on clinical features. Thus, there is an urgent need for robust diagnostic biofluid markers. Untargeted metabolomics allows establishing low-molecular compound biomarkers in a wide range of complex diseases by the measurement of various molecular classes in biofluids such as blood plasma, serum, and cerebrospinal fluid (CSF). Here, we applied untargeted high-resolution mass spectrometry to determine plasma and CSF metabolite profiles. We semiquantitatively determined small-molecule levels (≤1.5 kDa) in the plasma and CSF from early PD patients (disease duration 0–4 years; n = 80 and 40, respectively), and sex- and age-matched controls (n = 76 and 38, respectively). We performed statistical analyses utilizing partial least square and random forest analysis with a 70/30 training and testing split approach, leading to the identification of 20 promising plasma and 14 CSF metabolites. These metabolites differentiated the test set with an AUC of 0.8 (plasma) and 0.9 (CSF). Characteristics of the metabolites indicate perturbations in the glycerophospholipid, sphingolipid, and amino acid metabolism in PD, which underscores the high power of metabolomic approaches. Further studies will enable to develop a potential metabolite-based biomarker panel specific for PD. PMID:29556190

  16. Promising Fuel Cycle Options for R&D – Results, Insights, and Future Directions

    SciTech Connect

    Wigeland, Roald Arnold

    2015-05-01

    The Fuel Cycle Options (FCO) campaign in the U.S. DOE Fuel Cycle Research & Development Program conducted a detailed evaluation and screening of nuclear fuel cycles. The process for this study was described at the 2014 ICAPP meeting. This paper reports on detailed insights and questions from the results of the study. The comprehensive study identified continuous recycle in fast reactors as the most promising option, using either U/Pu or U/TRU recycle, and potentially in combination with thermal reactors, as reported at the ICAPP 2014 meeting. This paper describes the examination of the results in detail that indicated that theremore » was essentially no difference in benefit between U/Pu and U/TRU recycle, prompting questions about the desirability of pursuing the more complex U/TRU approach given that the estimated greater challenges for development and deployment. The results will be reported from the current effort that further explores what, if any, benefits of TRU recycle (minor actinides in addition to plutonium recycle) may be in order to inform decisions on future R&D directions. The study also identified continuous recycle using thorium-based fuel cycles as potentially promising, in either fast or thermal systems, but with lesser benefit. Detailed examination of these results indicated that the lesser benefit was confined to only a few of the evaluation metrics, identifying the conditions under which thorium-based fuel cycles would be promising to pursue. For the most promising fuel cycles, the FCO is also conducting analyses on the potential transition to such fuel cycles to identify the issues, challenges, and the timing for critical decisions that would need to be made to avoid unnecessary delay in deployment, including investigation of issues such as the effects of a temporary lack of plutonium fuel resources or supporting infrastructure. These studies are placed in the context of an overall analysis approach designed to provide comprehensive

  17. Results and Indicators for Children: An Analysis to Inform Discussions about Promise Neighborhoods

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Murphey, David; Emig, Carol; Hamilton, Kathleen; Hadley, Alena; Sidorowicz, Katie

    2009-01-01

    President Obama has proposed creation of up to 20 "Promise Neighborhoods" in communities experiencing poverty, crime, and low student achievement. Promise Neighborhoods would engage children and parents within a defined geographic area in a multifaceted strategy to meet several goals: good physical and mental health for every child, enrollment in…

  18. The Promise of Teacher Inquiry and Reflection: Early Childhood Teachers as Change Agents

    ERIC Educational Resources Information Center

    Escamilla, Isauro M.; Meier, Daniel

    2018-01-01

    In this article, a preschool teacher and an early childhood teacher educator describe and analyze their work co-creating and co-facilitating an early childhood inquiry group over seven years. The group consisted of veteran lead teachers, assistant teachers, instructional coaches, and an outside teacher educator at an urban, public preschool in San…

  19. In-house coordination project for organ and tissue procurement: social responsibility and promising results 1

    PubMed Central

    Silva, Vanessa Silva e; Moura, Luciana Carvalho; Martins, Luciana Ribeiro; dos Santos, Roberta Cristina Cardoso; Schirmer, Janine; Roza, Bartira de Aguiar

    2016-01-01

    Abstract Objectives: to report the results of evaluation regarding changes in the number of potential donor referrals, actual donors, and conversion rates after the implementation of an in-house organ and tissue donation for transplantation coordination project. Methods: epidemiological study, both retrospective and transversal, was performed with organ donation data from the Secretariat of Health for the State and the in-house organ donation coordination project of a beneficent hospital. The data was compared using nonparametric statistical Mann-Whitney test, and the Student's t-test, considering a significance level of 5% (p <0.05). Results: there were statistically significant differences (p < 0.05), before and after the implementation of the project on the number of potential donor notification/month (3.05 - 4.7 ), number of actual donor/month (0.78 to 1.60) and rate of conversion ( 24.7 to 34.8 %). The hospitals 1, 2, 7 and 8 had significant results in potential donor, actual donor or conversion rate. Conclusion: the presence of an in-house coordinator is promising and beneficial, the specialist is important to change the indicators of efficiency, which consequently reduces the waiting lists for organ transplants. PMID:27463111

  20. In-house coordination project for organ and tissue procurement: social responsibility and promising results.

    PubMed

    Silva, Vanessa Silva E; Moura, Luciana Carvalho; Martins, Luciana Ribeiro; Santos, Roberta Cristina Cardoso Dos; Schirmer, Janine; Roza, Bartira de Aguiar

    2016-01-01

    to report the results of evaluation regarding changes in the number of potential donor referrals, actual donors, and conversion rates after the implementation of an in-house organ and tissue donation for transplantation coordination project. epidemiological study, both retrospective and transversal, was performed with organ donation data from the Secretariat of Health for the State and the in-house organ donation coordination project of a beneficent hospital. The data was compared using nonparametric statistical Mann-Whitney test, and the Student's t-test, considering a significance level of 5% (p <0.05). there were statistically significant differences (p < 0.05), before and after the implementation of the project on the number of potential donor notification/month (3.05 - 4.7 ), number of actual donor/month (0.78 to 1.60) and rate of conversion ( 24.7 to 34.8 %). The hospitals 1, 2, 7 and 8 had significant results in potential donor, actual donor or conversion rate. the presence of an in-house coordinator is promising and beneficial, the specialist is important to change the indicators of efficiency, which consequently reduces the waiting lists for organ transplants.

  1. Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

    PubMed

    Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

    2017-08-01

    Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all P<0.001). Mean days between laboratory test date and evidence of completed action/treatment plan decreased by 19.4 days (P<0.001). Staff surveys showed modest but nonsignificant improvement for intervention practices relative to controls overall and for the 3 high-risk domains that were the focus of PROMISES. A consortium of stakeholders, quality improvement tools, coaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

  2. Results of an early hearing detection program.

    PubMed

    Borkoski Barreiro, Silvia A; Falcón González, Juan C; Bueno Yanes, Jorge; Pérez Bermúdez, José L; López Cano, Zoraida; Ramos Macías, Ángel

    2013-01-01

    Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Cold Atmospheric Plasma for Clinical Purposes: Promising Results in Patients and Future Applications

    NASA Astrophysics Data System (ADS)

    Isbary, Georg

    Infected chronic wounds are both socioeconomic and medical problem. Cold atmospheric plasma (CAP) has already proven its efficacy in killing bacteria on agar plates but also the first prospective randomized controlled trial in patients. As an add-on therapy CAPs proved a highly significant decrease in bacterial load in 5 min plasma-treated wounds (34%, p < 10-6, n = 291, 36 patients) in comparison with wounds that received only standard wound care. This reduction is found in all kinds of germs, even multiresistant ones. Two minutes of plasma treatment led to a significant reduction in bacterial load as well (40%, p < 0.016, n = 70, 14 patients). The treatment is very well tolerated and no side effects occurred until now (in total more than 2,000 treatments in over 220 patients). The results of this study revealed the potential of atmospheric argon plasma treatment as a new approach to kill bacteria in terms of mutiresistancy. With the same CAP device other dermatologic diseases were treated successfully, e.g. Hailey-Hailey disease. New plasma devices using surrounding ambient air have not only greater bactericidal but also virucidal properties. These devices may herald a new era in public, personal, pet, and food hygiene, same as in decontamination. Investigations of human compatibility are promising.

  4. Simple Reshaping of the Breast in Massive Weight Loss Patients: Promising Preliminary Results.

    PubMed

    Ikander, Peder; Gad, Dorte; Gunnarsson, Gudjon Leifur; Boljanovic, Slaven; Salzberg, Andrew; Sørensen, Jens Ahm; Thomsen, Jørn Bo

    2017-02-01

    The challenging breast reshaping after massive weight loss (MWL) has been increasingly performed as the number of bariatric surgery procedures increase worldwide. The breasts often appear wide, lateralized, and deflated, with significant ptosis. The aim of this article is to share our initial experience using the lower pole subglandular advancement mastoplasty (LOPOSAM) technique to reshape the breasts in MWL patients and to elaborate the technical details and simplicity of the method in the attached video. We performed 30 LOPOSAM procedures in 15 MWL women aged 24 to 63 years from February to September 2015. We used a wise pattern mark-up and a superior based pedicle for the relocation of the nipple areola complex. The key step for the autoaugmentation was an inferior and central mound based parabola-shaped flap, which was placed in a subglandular pocket to reshape the breast and lift the inframammary crease. The median operation time for the LOPOSAM procedure was 81 minutes (range, 35-160 minutes) by 2 surgeons. The median weight loss was 64 kg (range, 45-103) and 22 body mass index units (range, 16-33) per patient. The median follow-up was 240 days (range, 105 Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation to 345). The surgical goal was achieved in all cases. Four complications occurred in 3 patients, 1 major, a hematoma-requiring surgery and 3 minor wound dehiscence. The self-reported patient satisfaction was high, 13 were very satisfied with the result, 1 satisfied, and 1 less satisfied. The LOPOSAM technique is quick and simple to perform, and the preliminary results are promising. However, a longer follow-up is needed to confirm this.

  5. Less promising results with sclerosing ethoxysclerol injections for midportion achilles tendinopathy: a retrospective study.

    PubMed

    van Sterkenburg, Maayke N; de Jonge, Milko C; Sierevelt, Inger N; van Dijk, C Niek

    2010-11-01

    Local injections of the sclerosing substance polidocanol (Ethoxysclerol) have shown good clinical results in patients with chronic midportion Achilles tendinopathy. After training by the inventors of the technique, sclerosing Ethoxysclerol injections were applied on a group of patients in our center. Sclerosing Ethoxysclerol injections will yield good results in the majority of patients. Case series; Level of evidence, 4. In 113 patients (140 tendons) with Achilles tendinopathy, we identified 62 patients (70 tendons) showing neovascularization on color Doppler ultrasound. Fifty-three Achilles tendons (48 patients) were treated with sclerosing Ethoxysclerol injections, with intervals of 6 weeks and a maximum of 5 sessions. Treatment was completed when neovascularization or pain had disappeared, or when there was no positive treatment effect after 3 to 4 sessions. Forty-eight patients (20 women and 28 men) with a median age of 45 years, (range, 33-68 years) were treated. Median symptom duration was 23 months (range, 3-300 months). Fifty-three tendons were treated with a median of 3 sessions of Ethoxysclerol injections. Six weeks after the last injection, 35% of patients had no complaints, 9% had minimal symptoms, 42% were the same, and 14% had more complaints. Women were 3.8 times (95% confidence interval: 1.1-13.8) more likely to have unsatisfactory outcome than men. Pain correlated positively with neovessels on ultrasound (P < .01). At 2.7 to 5.1 year follow-up, 53% had received additional (surgical/conservative) treatment; 3 of these patients (7.5%) still had complaints of Achilles tendinopathy. In 6 patients, complaints that were still present 6 weeks after treatment had resolved spontaneously by final follow-up. Our study did not confirm the high beneficial value of sclerosing neovascularization in patients with midportion Achilles tendinopathy. Despite the retrospective design of our study, we consider it important to stress that injection of Ethoxysclerol may

  6. Our Children...Today's Investment, Tomorrow's Promise. Building an Early Childhood Development System for Nova Scotia.

    ERIC Educational Resources Information Center

    2001

    This report provides the framework for response to Nova Scotia's agreement with the government of Canada to invest in an early childhood development (ECD) strategy. The report begins with a list of guiding principles for child and family services. The major challenge for the ECD strategy is to identify the key areas of investment that will create…

  7. Tying Early Childhood Education More Closely to Schooling: Promise, Perils and Practical Problems

    ERIC Educational Resources Information Center

    Halpern, Robert

    2013-01-01

    Background: Over the past decade or so, the idea of joining early childhood education (ECE) and schooling has gained currency in the educational reform arena. Numerous education reform proposals and plans include ECE as a component. Scores of school districts around the country have added preschool classrooms to at least some of their elementary…

  8. Beacon of Hope: The Promise of Early Head Start for America's Youngest Children

    ERIC Educational Resources Information Center

    Lombardi, Joan, Ed.; Bogle, Mary M., Ed.

    2005-01-01

    Between 1995 and 2004, Early Head Start (EHS) grew from 68 to more than 700 programs nationwide, serving more than 62,000 children and securing the program's reputation as a beacon of hope for the nation's low-income families with infants and toddlers. According to a comprehensive 5-year national evaluation of EHS, children who participated in…

  9. From "At Risk" to "At Promise": An Evaluation of an Early Reading First Project

    ERIC Educational Resources Information Center

    Zoll, Susan Marie

    2012-01-01

    This study demonstrates the impact of an Early Reading First intervention on preschool children's language and literacy development using an ex post facto, causal-comparative research design. The project's professional development model was evaluated to produce a process and outcome evaluation to answer two overarching research questions: (1) What…

  10. Early Childhood: Years of Promise, Parts 1 & 2. Profiles in Education Series. [Videotape].

    ERIC Educational Resources Information Center

    1998

    Noting a Carnegie report pointing out changes in children's lives, including working mothers and poor quality care, this videotape provides educators, librarians, and parents information to help children grow to their fullest potential. The 45-minute video highlights a collaborative early childhood care model in place in Stamford, Connecticut to…

  11. Electronic Nose: A Promising Tool For Early Detection Of Alicyclobacillus spp In Soft Drinks

    NASA Astrophysics Data System (ADS)

    Concina, I.; Bornšek, M.; Baccelliere, S.; Falasconi, M.; Sberveglieri, G.

    2009-05-01

    In the present work we investigate the potential use of the Electronic Nose EOS835 (SACMI scarl, Italy) to early detect Alicyclobacillus spp in two flavoured soft drinks. These bacteria have been acknowledged by producer companies as a major quality control target microorganisms because of their ability to survive commercial pasteurization processes and produce taint compounds in final product. Electronic Nose was able to distinguish between uncontaminated and contaminated products before the taint metabolites were identifiable by an untrained panel. Classification tests showed an excellent rate of correct classification for both drinks (from 86% uo to 100%). High performance liquid chromatography analyses showed no presence of the main metabolite at a level of 200 ppb, thus confirming the skill of the Electronic Nose technology in performing an actual early diagnosis of contamination.

  12. Promising Results from Three NASA SBIR Solar Array Technology Development Programs

    NASA Technical Reports Server (NTRS)

    Eskenazi, Mike; White, Steve; Spence, Brian; Douglas, Mark; Glick, Mike; Pavlick, Ariel; Murphy, David; O'Neill, Mark; McDanal, A. J.; Piszczor, Michael

    2005-01-01

    Results from three NASA SBIR solar array technology programs are presented. The programs discussed are: 1) Thin Film Photovoltaic UltraFlex Solar Array; 2) Low Cost/Mass Electrostatically Clean Solar Array (ESCA); and 3) Stretched Lens Array SquareRigger (SLASR). The purpose of the Thin Film UltraFlex (TFUF) Program is to mature and validate the use of advanced flexible thin film photovoltaics blankets as the electrical subsystem element within an UltraFlex solar array structural system. In this program operational prototype flexible array segments, using United Solar amorphous silicon cells, are being manufactured and tested for the flight qualified UltraFlex structure. In addition, large size (e.g. 10 kW GEO) TFUF wing systems are being designed and analyzed. Thermal cycle and electrical test and analysis results from the TFUF program are presented. The purpose of the second program entitled, Low Cost/Mass Electrostatically Clean Solar Array (ESCA) System, is to develop an Electrostatically Clean Solar Array meeting NASA s design requirements and ready this technology for commercialization and use on the NASA MMS and GED missions. The ESCA designs developed use flight proven materials and processes to create a ESCA system that yields low cost, low mass, high reliability, high power density, and is adaptable to any cell type and coverglass thickness. All program objectives, which included developing specifications, creating ESCA concepts, concept analysis and trade studies, producing detailed designs of the most promising ESCA treatments, manufacturing ESCA demonstration panels, and LEO (2,000 cycles) and GEO (1,350 cycles) thermal cycling testing of the down-selected designs were successfully achieved. The purpose of the third program entitled, "High Power Platform for the Stretched Lens Array," is to develop an extremely lightweight, high efficiency, high power, high voltage, and low stowed volume solar array suitable for very high power (multi-kW to MW

  13. Early recombinant factor VIIa therapy in acute intracerebral hemorrhage: promising approach.

    PubMed

    Kumar, Sudhir; Badrinath, H R

    2006-03-01

    Intracerebral hemorrhage (ICH) is the most devastating form of stroke with a high morbidity and mortality. ICH constitutes about 20-30% of all strokes, with the prevalence being higher in Asian population. Treatment of ICH is predominantly conservative, which includes control of blood pressure, use of anti-cerebral edema measures such as mannitol and mechanical ventilation. The benefit of early surgery in ICH is debatable. Initial hematoma volume and subsequent growth in its size are important predictors of a poor outcome in ICH. This means that therapies aimed at preventing hematoma enlargement in the earliest possible window period could lead to a better outcome in ICH. Recombinant factor VIIa (rFVIIa) is one such agent, which has been shown to prevent hematoma expansion and improve outcome in acute ICH. The purpose of the current review is to focus on the evidence regarding the usefulness of rFVIIa in acute ICH.

  14. Atlas-based functional radiosurgery: Early results

    SciTech Connect

    Stancanello, J.; Romanelli, P.; Pantelis, E.

    2009-02-15

    Functional disorders of the brain, such as dystonia and neuropathic pain, may respond poorly to medical therapy. Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and the centromedian nucleus of the thalamus (CMN) may alleviate dystonia and neuropathic pain, respectively. A noninvasive alternative to DBS is radiosurgical ablation [internal pallidotomy (IP) and medial thalamotomy (MT)]. The main technical limitation of radiosurgery is that targets are selected only on the basis of MRI anatomy, without electrophysiological confirmation. This means that, to be feasible, image-based targeting must be highly accurate and reproducible. Here, we report on the feasibility ofmore » an atlas-based approach to targeting for functional radiosurgery. In this method, masks of the GPi, CMN, and medio-dorsal nucleus were nonrigidly registered to patients' T1-weighted MRI (T1w-MRI) and superimposed on patients' T2-weighted MRI (T2w-MRI). Radiosurgical targets were identified on the T2w-MRI registered to the planning CT by an expert functional neurosurgeon. To assess its feasibility, two patients were treated with the CyberKnife using this method of targeting; a patient with dystonia received an IP (120 Gy prescribed to the 65% isodose) and a patient with neuropathic pain received a MT (120 Gy to the 77% isodose). Six months after treatment, T2w-MRIs and contrast-enhanced T1w-MRIs showed edematous regions around the lesions; target placements were reevaluated by DW-MRIs. At 12 months post-treatment steroids for radiation-induced edema and medications for dystonia and neuropathic pain were suppressed. Both patients experienced significant relief from pain and dystonia-related problems. Fifteen months after treatment edema had disappeared. Thus, this work shows promising feasibility of atlas-based functional radiosurgery to improve patient condition. Further investigations are indicated for optimizing treatment dose.« less

  15. Key Performance Indicators: From Promise to Payoff. The Productivity for Results Series No. 2

    ERIC Educational Resources Information Center

    Casserly, Michael; Eugene, Michael

    2014-01-01

    This paper draws upon the expertise of two leading educators, Michael Casserly, director of the Council of the Great City Schools, and Michael Eugene, chief operating officer of the Orange County Public Schools in Florida. They outline a set of key performance indicators that some urban districts use to benchmark the results of their operating…

  16. Comb-Push Ultrasound Shear Elastography of Breast Masses: Initial Results Show Promise

    PubMed Central

    Song, Pengfei; Fazzio, Robert T.; Pruthi, Sandhya; Whaley, Dana H.; Chen, Shigao; Fatemi, Mostafa

    2015-01-01

    Purpose or Objective To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. Materials and Methods CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Results Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young’s modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). Conclusion CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses. PMID:25774978

  17. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    PubMed

    Denis, Max; Mehrmohammadi, Mohammad; Song, Pengfei; Meixner, Duane D; Fazzio, Robert T; Pruthi, Sandhya; Whaley, Dana H; Chen, Shigao; Fatemi, Mostafa; Alizad, Azra

    2015-01-01

    To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  18. An initial assessment of the consumer demand roundtable: Results and promise.

    PubMed

    Barker, Dianne C; Gutman, Marjorie A; Gordon, Sara R

    2010-03-01

    An initial assessment of the National Tobacco Cessation Collaborative's (NTCC) 2005-2007 Consumer Demand Roundtable (CDR) was conducted in 2008 to assess the results and products of CDR, and to offer recommendations to guide ongoing NTCC efforts to expand the demand, reach, and use of effective tobacco-cessation treatments. The evaluation was a small, retrospective, descriptive study, primarily using in-depth telephone interviews, supplemented by a review of CDR agendas, products, and web-based participant surveys. A sample of 30 tobacco-cessation leaders who had participated in at least one CDR meeting or conference was interviewed in May and June of 2008. Specific products implemented or influenced by CDR were identified, and organized by its six core strategies. Almost all respondents reported that the CDR was successful in its first goal to generate new ways of thinking about increasing demand for chronically underused evidence-based quit-smoking treatment, providing concrete examples of ways they had infused CDR concepts into the work of their organizations. The development of new products and communication messages suggested some progress in meeting the goal of identifying and catalyzing feasible innovations in treatment design, promotion, research, practice, and policy. Results suggest that the CDR, conceived as a "think tank" for the tobacco-cessation field, made sizable progress, especially in shifting the field to a new way of thinking. Continued leadership, funding, and proactive, sustained communication are needed to ensure these new innovations are further tested, implemented, and sustained. A longer-term follow-up evaluation to measure this impact is recommended. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Early Results from the Qweak Experiment

    NASA Astrophysics Data System (ADS)

    Androic, D.; Armstrong, D. S.; Asaturyan, A.; Averett, T.; Balewski, J.; Beaufait, J.; Beminiwattha, R. S.; Benesch, J.; Benmokhtar, F.; Birchall, J.; Carlini, R. D.; Cates, G. D.; Cornejo, J. C.; Covrig, S.; Dalton, M. M.; Davis, C. A.; Deconinck, W.; Diefenbach, J.; Dowd, J. F.; Dunne, J. A.; Dutta, D.; Duvall, W. S.; Elaasar, M.; Falk, W. R.; Finn, J. M.; Forest, T.; Gaskell, D.; Gericke, M. T. W.; Grames, J.; Gray, V. M.; Grimm, K.; Guo, F.; Hoskins, J. R.; Johnston, K.; Jones, D.; Jones, M.; Jones, R.; Kargiantoulakis, M.; King, P. M.; Korkmaz, E.; Kowalski, S.; Leacock, J.; Leckey, J.; Lee, A. R.; Lee, J. H.; Lee, L.; MacEwan, S.; Mack, D.; Magee, J. A.; Mahurin, R.; Mammei, J.; Martin, J.; McHugh, M. J.; Meekins, D.; Mei, J.; Michaels, R.; Micherdzinska, A.; Mkrtchyan, A.; Mkrtchyan, H.; Morgan, N.; Myers, K. E.; Narayan, A.; Ndukum, L. Z.; Nelyubin, V.; Nuruzzaman; van Oers, W. T. H.; Opper, A. K.; Page, S. A.; Pan, J.; Paschke, K.; Phillips, S. K.; Pitt, M. L.; Poelker, M.; Rajotte, J. F.; Ramsay, W. D.; Roche, J.; Sawatzky, B.; Seva, T.; Shabestari, M. H.; Silwal, R.; Simicevic, N.; Smith, G. R.; Solvignon, P.; Spayde, D. T.; Subedi, A.; Subedi, R.; Suleiman, R.; Tadevosyan, V.; Tobias, W. A.; Tvaskis, V.; Waidyawansa, B.; Wang, P.; Wells, S. P.; Wood, S. A.; Yang, S.; Young, R. D.; Zhamkochyan, S.

    2014-03-01

    A subset of results from the recently completed Jefferson Lab Qweak experiment are reported. This experiment, sensitive to physics beyond the Standard Model, exploits the small parity-violating asymmetry in elastic e{{p}} scattering to provide the first determination of the proton's weak charge Q_w^p. The experiment employed a 180 μA longitudinally polarized 1.16 GeV electron beam on a 35 cm long liquid hydrogen target. Scattered electrons in the angular range 6° < θ < 12° corresponding to Q2 = 0.025 GeV2 were detected in eight Cerenkov detectors arrayed symmetrically around the beam axis. The goals of the experiment were to provide a measure of e{{p}} to 4.2% (combined statisstatistical and systematic error), which implies a measure of sin2(θw) at the level of 0.3%, and to help constrain the vector weak quark charges C1u and C1d. The experimental method is described, with particular focus on the challenges associated with the world's highest power LH2 target. The new constraints on C1u and C1d provided by the subset of the experiment's data analyzed to date will also be shown, together with the extracted weak charge of the neutron.

  20. Landsat-7 Mission and Early Results

    NASA Technical Reports Server (NTRS)

    Dolan, S. Kenneth; Sabelhaus, Phillip A.; Williams, Darrel L.; Irons, James R.; Barker, John L.; Markham, Brian L.; Bolek, Joseph T.; Scott, Steven S.; Thompson, R. J.; Rapp, Jeffrey J.

    1999-01-01

    The Landsat-7 mission has the goal of acquiring annual data sets of reflective band digital imagery of the landmass of the Earth at a spatial resolution of 30 meters for a period of five years using the Enhanced Thematic Mapper Plus (ETM+) imager on the Landsat-7 satellite. The satellite was launched on April 15, 1999. The mission builds on the 27-year continuous archive of thematic images of the Earth from previous Landsat satellites. This paper will describe the ETM+ instrument, the spacecraft, and the ground processing system in place to accomplish the mission. Results from the first few months in orbit will be given, with emphasis on performance parameters that affect image quality, quantity, and availability. There will also be a discussion of the Landsat Data Policy and the user interface designed to make contents of the archive readily available, expedite ordering, and distribute the data quickly. Landsat-7, established by a Presidential Directive and a Public Law, is a joint program of the National Aeronautics and Space Administration (NASA) Earth Science Enterprise and the United States Geological Survey (USGS) Earth Resources Observing System (EROS) Data Center.

  1. Early Calibration Results of CYGNSS Mission

    NASA Astrophysics Data System (ADS)

    Balasubramaniam, R.; Ruf, C. S.; McKague, D. S.; Clarizia, M. P.; Gleason, S.

    2017-12-01

    The first of its kind, GNSS-R complete orbital mission, CYGNSS was successfully launched on Dec 15 2016. The goal of this mission is to accurately forecast the intensification of tropical cyclones by modelling its inner core. The 8 micro observatories of CYGNSS carry a passive instrument called Delay Doppler Mapping Instrument (DDMI). The DDMIs form a 2D representation called the Delay-Doppler Map (DDM) of the forward scattered power signal. Each DDMI outputs 4 DDMs per second which are compressed and sent to the ground resulting in a total of 32 sea-surface measurements produced by the CYGNSS constellation per second. These are subsequently used in the Level-2 wind retrieval algorithm to extract wind speed information. In this paper, we perform calibration and validation of CYGNSS measurements for accurate extraction of wind speed information. The calibration stage involves identification and correction for dependence of the CYGNSS observables namely Normalised Bistatic Radar Cross Section and Leading Edge Slope of the Integrated Delay Waveform over instrument parameters, geometry etc. The validation stage involves training of the Geophysical Model Function over a multitude of ground truth sources during the Atlantic hurricane season and also refined validation of high wind speed data products.

  2. Challenges and promises for nurse education curriculum development in Kosovo: results of an "accidental ethnography".

    PubMed

    Goepp, Julius G; Johnson, Tiesha D; Maddow, Charles L

    2008-05-01

    Kosovo's infrastructure was devastated by armed conflict through the 1990s; in 1999 a visiting inter-disciplinary team described healthcare services as being in "disarray". Several collaborative programs were initiated to enhance delivery of emergency medical (EM) services. Our inter-disciplinary team traveled to Kosovo in 2004 to evaluate EM physician education and training. A brief renewed outbreak of hostilities created a mass casualty incident. An "accidental ethnography" focused on nurse education was conducted by team members during and after the event. Results indicated low levels of professionalization of nurses as indicated by expressions of professional self-identity and self-esteem, autonomy, and submission to patriarchal attitudes. Undergraduate nurse education is restricted to a diploma program and one foreign training project, one graduate degree program exists abroad, and no national board examination exists. Nurses' social location is described as marginalized and disenfranchised, and retention of nurses is a persistent problem. Based on these observations we outline an inter-professional curriculum development program to foster professionalization of Kosovar nurses through a synthesis of participatory action research with elements of grounded theory and standard curriculum development methodologies. The collaborative, emancipatory, and empowering nature of PAR is described in the context of professionalizing nurse education programs.

  3. Sulbutiamine shows promising results in reducing fatigue in patients with multiple sclerosis.

    PubMed

    Sevim, Serhan; Kaleağası, Hakan; Taşdelen, Bahar

    2017-08-01

    Fatigue is the most frequent and often debilitating symptom for patients with multiple sclerosis (MS). There are no available effective therapies for fatigue associated with MS, and it is unclear whether a successful therapy of MS leads to clinical improvement. Sulbutiamine is a lipophilic compound that crosses the blood-brain barrier more readily than thiamine and increases the levels of thiamine and thiamine phosphate esters in the brain. Whereas several clinical trials have demonstrated the beneficial effects of sulbutiamine in patients with asthenia, there have been no reports on the effects of sulbutiamine on fatigue in patients with MS. Our study was designed to evaluate the short-term effects of sulbutiamine on fatigue in patients with MS. Patients were included if fatigue was one of their three predominant symptoms. They were required to have a total score on the Fatigue Impact Scale (FIS) of >20, and on the Beck Depression Inventory of <17, and no relapse in the last 3 months prior to onset of the study. Patients were advised to receive 400mg orally of sulbutiamine once daily for two months. The outcome of the study was in the changes of FIS. Twenty-six patients with MS (18 females and 8 males) were selected. The patients were 18-57 years of age (mean:37,2). The average score of Expanded Disability Status Scale (EDSS) of the patients was 2,71. A significant number of the subjects who were on some kind of disease modifying treatment (DMT) demonstrated obvious improvement in their total FIS scores, whereas none of the subjects who were not on any DMT improved (13/23 vs. 0/5). The average fatigue score was 77 (SD:30,5) at the baseline and 60,5 (SD:29,7) on Day 60, respectively. Sulbutiamine intake resulted in a significant reduction on the total score of FIS and on all three subscales assessing physical, cognitive, and psychosocial functioning (all p-values < 0,01). There were no serious adverse events. Sulbutiamin appears to be effective in treating fatigue

  4. Early Childhood Teacher Research: From Questions to Results

    ERIC Educational Resources Information Center

    Castle, Kathryn

    2011-01-01

    What is early childhood teacher research and why is it important? How does a teacher researcher formulate a research question and a plan for doing research? How do teachers apply research results to effect change? "Early Childhood Teacher Research" is an exciting new resource that will address the sorts of questions and concerns that pre- and…

  5. Early post-interventional sonographic evaluation of prostatic artery embolization. A promising role for contrast-enhanced ultrasonography (CEUS).

    PubMed

    Moschouris, Hippocrates; Stamatiou, Konstantinos; Kalokairinou Motogna, Mariana; Vrakas, Spyros; Kiltenis, Michail; Kladis-Kalentzis, Konstantinos; Tsavdaroglou, Avraam; Papadogeorgopoulos, Nikolaos; Marmaridou, Kyriaki; Malagari, Katerina

    2018-05-02

    To assess the feasibility, findings and potential value of early post-interventional, contrast-enhanced ultrasonographic (CEUS) study of prostate artery embolization (PAE). Fourteen patients treated with PAE for symptomatic benign prostatic hyperplasia were prospectively included in the study. Sonographic evaluation of the prostate included: 1) baseline transabdominal and transrectal CEUS (ta-CEUS and tr-CEUS, respectively) 1-3 days prior to PAE; 2) early post PAE CEUS, with ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE; and 3) follow-up with ta-CEUS and tr-CEUS 3 months post PAE. A brief unenhanced US study preceded each CEUS. Post-therapeutic changes in size, echogenicity and enhancement of the prostate were recorded and were correlated with clinical outcomes. PAE resulted in clinical success in 11/14 patients (78.5%). All sonographic studies were technically adequate, with the exception of ta-CEUS immediately post PAE in 2/14 (14.2%) patients. CEUS studies immediately post PAE and 3 days post PAE showed non-enhancing, welldefined infarctions of the prostate in 10/14 patients (71.4%). There was a strong correlation between ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE regarding the measurements of prostatic infarctions (r =0.98, p< 0.01). The presence of infarctions on early post PAE CEUS was associated with clinical success (p=0.01) and their extent correlated with the degree of prostate shrinkage on 3-month follow-up (r=0.84, p<0.05). The 3 cases of failed PAE showed no infarctions and no prostate shrinkage. Early post-interventional CEUS of PAE is feasible and may have clinical and prognostic value.

  6. Promising Opportunities for Black and Latino Young Men: Findings from the Early Implementation of the Expanded Success Initiative. Technical Appendices

    ERIC Educational Resources Information Center

    Villavicencio, Adriana; Klevan, Sarah; Guidry, Brandon; Wulach, Suzanne

    2014-01-01

    This appendix describes the data collection and analytic processes used to develop the findings in the report "Promising Opportunities for Black and Latino Young Men." A central challenge was creating an analytic framework that could be uniformly applied to all schools, despite the individualized nature of their Expanded Success…

  7. GP50 as a promising early diagnostic antigen for Taenia multiceps infection in goats by indirect ELISA.

    PubMed

    Huang, Xing; Xu, Jing; Wang, Yu; Guo, Cheng; Chen, Lin; Gu, Xiaobin; Lai, Weimin; Peng, Xuerong; Yang, Guangyou

    2016-12-01

    Coenurosis is caused by coenurus, the metacestode of Taenia multiceps, which mainly parasitizes the brain and spinal cord of cattle, sheep and goats. To date, no widely-approved methods are available to identify early coenurus infection. In this study, we identified a full-length cDNA that encodes GP50 (TmGP50) from the transcriptome of T. multiceps, and then cloned and expressed in E. coli. The native proteins in adult stage and coenurus were located via immunofluorescence assays, while the potential of recombinant TmGP50 protein (rTmGP50) for indirect ELISA-based serodiagnostics was assessed using native goat sera. In addition, we orally infected 20 goats with mature T. multiceps eggs. Praziquantel (10%) was given to 10 of the goats 45 days post-infection (p.i.). Blood samples were collected for 17 weeks p.i. from the 20 goats and anti-rTmGP50 antibodies were evaluated using the indirect ELISA established here. The TmGP50 contains an 897 bp open reading frame, in which signal sequence resides in 1 ~ 48 sites and mature polypeptide consists of 282 amino acid residues. Immunofluorescence staining showed that native TmGP50 was localized to the microthrix and parenchymatous zone of the adult parasite and coenurus, and the coenurus cystic wall. The indirect ELISA based on rTmGP50 exhibited a sensitivity of 95.0% and a specificity of 92.6% when detecting GP50 antibodies in sera of naturally infected goats and sheep. In goats experimentally infected with T. multiceps, anti-TmGP50 antibody was detectable from 2 to 17 weeks p.i. in the control group, while the antibody fell below the cut-off value about 3 weeks after praziquantel treatment. Our results indicate that recombinant TmGP50 is a suitable early diagnostic antigen for coenurus infection in goats.

  8. Early results from the ultra heavy cosmic ray experiment

    NASA Technical Reports Server (NTRS)

    Osullivan, D.; Thompson, A.; Bosch, J.; Keegan, R.; Wenzel, K.-P.; Jansen, F.; Domingo, C.

    1995-01-01

    Data extraction and analysis of the LDEF Ultra Heavy Cosmic Ray Experiment is continuing. Almost twice the pre LDEF world sample has been investigated and some details of the charge spectrum in the region from Z approximately 70 up to and including the actinides are presented. The early results indicate r process enhancement over solar system source abundances.

  9. Early meteorological results from the viking 2 lander.

    PubMed

    Hess, S L; Henry, R M; Leovy, C B; Mitchell, J L; Ryan, J A; Tillman, J E

    1976-12-11

    Early results from the meteorological instruments on the Viking 2 lander are presented. As on lander 1, the daily patterns of temperature, wind, and pressure have been highly repetitive during the early summer period. The average daily maximum temperature was 241 degrees K and the diurnal minimum was 191 degrees K. The wind has a vector mean of 0.7 meter per second from the southeast with a diurnal amplitude of 3 meters per second. Pressure exhibits both diurnal and semidiurnal oscillations, although of substantially smaller amplitude than those of lander 1. Departures from the repetitive diurnal patterns begin to appear on sol 37.

  10. Global Citizenship and the Role of the United Nations: The Promise of the Early Childhood Peace Consortium

    ERIC Educational Resources Information Center

    Salah, Rima

    2018-01-01

    Today millions of children are trapped in situations of war, conflict, violence and displacement. Science shows that violence has a detrimental effect on the development of young children. It, also, heralds in a new era, with opportunities to contribute to sustaining peace and prevention of violence, through investment in early childhood…

  11. A Conceptual Model for Youth-Led Programs as a Promising Approach to Early Childhood Care and Education

    ERIC Educational Resources Information Center

    Ponguta, Liliana Angelica; Rasheed, Muneera Abdul; Reyes, Chin Regina; Yousafzai, Aisha Khizar

    2018-01-01

    The international community has set forth global targets that include calls for universal access to high-quality early childhood care and education (ECCE), as indicated in the United Nations' Sustainable Development Goals. One major impediment to achieving this target is the lack of a skilled workforce. In this paper, we argue the case for…

  12. Impact cratering calculations. Part 1: Early time results

    NASA Technical Reports Server (NTRS)

    Thomsen, J. M.; Sauer, F. N.; Austin, M. G.; Ruhl, S. F.; Shultz, P. H.; Orphal, D. L.

    1979-01-01

    Early time two dimensional finite difference calculations of laboratory scale hypervelocity impact of 0.3 g spherical 2024 aluminum projectiles into homogeneous plasticene clay targets were performed. Analysis of resulting material motions showed that energy and momentum were coupled quickly from the aluminum projectile to the target material. In the process of coupling, some of the plasticene clay target was vaporized while the projectile become severely deformed. The velocity flow field developed within the target was shown to have features similar to those found in calculations of near surface explosion cratering. Specific application of Maxwell's analytic Z-Model showed that this model can be used to describe the early time flow fields resulting from the impact cratering calculations as well, provided the flow field centers are located beneath the target surface and most of the projectile momentum is dissipated before the model is applied.

  13. Results of Observations of Occultations of Stars by Main-Belt and Trojan Asteroids, and the Promise of Gaia

    NASA Astrophysics Data System (ADS)

    Dunham, David W.; Herald, David Russell; Preston, Steven; Loader, Brian; Bixby Dunham, Joan

    2016-10-01

    For 40 years, the sizes and shapes of scores of asteroids have been determined from observations of asteroidal occultations, and many hundreds of high-precision positions of the asteroids relative to stars have been measured. Earlier this year, the 3000th observation of an asteroidal occultation was documented. Some of the first evidence for satellites of asteroids was obtained from the early efforts; now, the orbits and sizes of some satellites discovered by other means have been refined from occultation observations. Also, several close binary stars have been discovered, and the angular diameters of some stars have been measured from analysis of these observations. The International Occultation Timing Association (IOTA) coordinates this activity worldwide, from predicting and publicizing the events, to accurately timing the occultations from as many stations as possible, and publishing and archiving the observations. The first observations were timed visually, but now nearly all observations are either video-recorded, or recorded with CCD drift scans, allowing small magnitude-drop events to be recorded, and resulting in more consistent results. Techniques have been developed allowing one or two observers to set up multiple stations with small telescopes, video cameras, and timers, thereby recording many chords, even across a whole asteroid; some examples will be shown.Later this year, the first release of Gaia data will allow us to greatly improve the vast star catalog that we use for both predicting and analyzing these events. Although the first asteroidal data will wait until the 4th Gaia release, before that, we can greatly improve the orbits of asteroids that have occulted 3 or more stars in the past so that we can start computing the paths of future occultations by them to few km accuracy. In a couple of years, we'll be able to realistically predict one to two orders of magnitude more events than we can now, allowing efforts to be concentrated on smaller

  14. Keeping Promises

    NASA Technical Reports Server (NTRS)

    Howell, Gregory A.

    2005-01-01

    Commitments are between people, not schedules. Project management as practiced today creates a "commitment-free zone," because it assumes that people will commit to centrally managed schedules without providing a mechanism to ensure their work can be done. So they give it their best, but something always seems to come up ..."I tried, but you know how it is." This form of project management does not provide a mechanism to ensure that what should be done, can in fact be done at the required moment. Too often, promises reliable promise. made in coordination meetings are conditional and unreliable. It has been my experience that at times trust can be low and hard to build in this environment. The absence of reliable promises explains why on well-run projects, people are often only completing 30-50 percent of the deliverables they d promised for the week. We all know what a promise is; we have plenty of experience making them and receiving them from others. So what s the problem? The sad fact is that the project environment-like many other work environments- is often so filled with systemic dishonesty, that we don t expect promises that are reliable. Project managers excel when they manage their projects as networks of commitments and help their people learn to elicit and make reliable promises.

  15. Is 1H NMR metabolomics becoming the promising early biomarker for neonatal sepsis and for monitoring the antibiotic toxicity?

    PubMed

    Noto, Antonio; Mussap, Michele; Fanos, Vassilios

    2014-06-01

    Metabolomics, the latest of omics disciplines, has been successfully used in various fields of basic research such as pharmacology and toxicology. Recently, this new science has gained an important role in the translational research of diagnostics. In this regard, the challenge for neonatologists and medical laboratories is to diagnose neonatal sepsis, a disease with high mortality and morbidity due to the difficulty in diagnosing it. Metabolomics, through its ability to identify perturbations caused by this condition, aims at recognizing metabolites that characterize neonatal sepsis with high specificity and sensitivity. The purpose of this review is to highlight the ability of metabolomics to find early biomarkers for this condition, as well as to predict the toxic effects caused by antibiotics.

  16. The Eole experiment - Early results and current objectives.

    NASA Technical Reports Server (NTRS)

    Morel, P.; Bandeen, W.

    1973-01-01

    The Eole experiment with 480 constant level balloons released in the Southern Hemisphere is described. Each balloon, floating freely at approximately the 200-mb level, is a precise tracer of the horizontal motion of air masses, the accuracy of which is limited only by the laminated structure of the stratospheric flow, within an rms uncertainty of 1.5 m/sec. The balloons were found after 2 months to distribute at random over the whole hemisphere outside the tropics, irrespective of their original launching site. Early results of Eulerian and Lagrangian averages of the Eole wind data are given for describing the mean 200-mb zonal and meridional circulations.

  17. Early Results from NICER Observations of Accreting Neutron Stars

    NASA Astrophysics Data System (ADS)

    Chakrabarty, Deepto; Ozel, Feryal; Arzoumanian, Zaven; Gendreau, Keith C.; Bult, Peter; Cackett, Ed; Chenevez, Jerome; Fabian, Andy; Guillot, Sebastien; Guver, Tolga; Homan, Jeroen; Keek, Laurens; Lamb, Frederick; Ludlam, Renee; Mahmoodifar, Simin; Markwardt, Craig B.; Miller, Jon M.; Psaltis, Dimitrios; Strohmayer, Tod E.; Wilson-Hodge, Colleen A.; Wolff, Michael T.

    2018-01-01

    The Neutron Star Interior Composition Explorer (NICER) offers significant new capabilities for the study of accreting neuton stars relative to previous X-ray missions including large effective area, low background, and greatly improved low-energy response. The NICER Burst and Accretion Working Group has designed a 2 Ms observation program to study a number of phenomena in accreting neutron stars including type-I X-ray bursts, superbursts, accretion-powered pulsations, quasi-periodic oscillations, and accretion disk reflection spectra. We present some early results from the first six months of the NICER mission.

  18. Early on-orbit calibration results from Aqua MODIS

    NASA Astrophysics Data System (ADS)

    Xiong, Xiaoxiong; Barnes, William L.

    2003-04-01

    Aqua MODIS, also known as the MODIS Flight Model 1 (FM1), was launched on May 4, 2002. It opened its nadir aperture door (NAD) on June 24, 2002, beginning its Earth observing mission. In this paper, we present early results from Aqua MODIS on-orbit calibration and characterization and assess the instrument's overall performance. MODIS has 36 spectral bands located on four focal plane assemblies (FPAs). Bands 1-19, and 26 with wavelengths from 0.412 to 2.1 microns are the reflective solar bands (RSB) that are calibrated on-orbit by a solar diffuser (SD). The degradation of the SD is tracked using a solar diffuser stability monitor (SDSM). The bands 20-25, and 27-36 with wavelengths from 3.75 to 14.5 microns are the thermal emissive bands (TEB) that are calibrated on-orbit by a blackbody (BB). Early results indicate that the on-orbit performance has been in good agreement with the predications determined from pre-launch measurements. Except for band 21, the low gain fire band, band 6, known to have some inoperable detectors from pre-launch characterization, and one noisy detector in band 36, all of the detectors' noise characterizations are within their specifications. Examples of the sensor's short-term and limited long-term responses in both TEB and RSB will be provided to illustrate the sensor's on-orbit stability. In addition, we will show some of the improvements that Aqua MODIS made over its predecessor, Terra MODIS (Protoflight Model - PFM), such as removal of the optical leak into the long-wave infrared (LWIR) photoconductive (PC) bands and reduction of electronic crosstalk and out-of-band (OOB) thermal leak into the short-wave infrared (SWIR) bands.

  19. Thirty years of use and improvement of remote sensing, applied to epidemiology: from early promises to lasting frustration.

    PubMed

    Herbreteau, Vincent; Salem, Gérard; Souris, Marc; Hugot, Jean-Pierre; Gonzalez, Jean-Paul

    2007-06-01

    Remote sensing, referring to the remote study of objects, was originally developed for Earth observation, through the use of sensors on board planes or satellites. Improvements in the use and accessibility of multi-temporal satellite-derived environmental data have, for 30 years, contributed to a growing use in epidemiology. Despite the potential of remote-sensed images and processing techniques for a better knowledge of disease dynamics, an exhaustive analysis of the bibliography shows a generalized use of pre-processed spatial data and low-cost images, resulting in a limited adaptability when addressing biological questions.

  20. Intention-based therapy for autism spectrum disorder: promising results of a wait-list control study in children.

    PubMed

    Weiner, Robert H; Greene, Roger L

    2014-01-01

    Autism is a complex neurodevelopmental disability that usually manifests during the first three years of life and typically lasts throughout a person's lifetime. The purpose of this study is to investigate the efficacy of NeuroModulation Technique (NMT), a form of intention-based therapy, in improving functioning in children diagnosed with autism. A total of 18 children who met the study criteria were selected to participate. All children completed baseline measures. The children in the experimental group (n = 9) received two sessions a week of NMT for six weeks. Then, children in the wait-list control group (n = 9) received two sessions a week of NMT for six weeks. Primary efficacy outcome measures included the Pervasive Developmental Disorder Behavioral Inventory Autism Composite Index, the Aberrant Behavior Checklist-Community Total Score, and the Autism Treatment Evaluation Checklist Total Score. Our hypotheses were that children in both groups would show significant improvement over their respective baseline scores following NMT treatment, which would reflect an improvement in adaptive behaviors as well as a decrease in maladaptive behaviors. Statistical analysis indicates a significant improvement in both the experimental and wait-list control group on all primary outcome measures following NMT treatment. The wait-list control group demonstrated no significant improvement on test measures over baseline scores during the wait period. No adverse reactions were reported. These findings suggest that NMT is a promising intervention for autism that has the potential to produce a significant reduction in maladaptive behaviors and a significant increase in adaptive behaviors within a relatively short period of time. © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  1. NOSE laparoscopic gastrectomies for early gastric cancer may reduce morbidity and hospital stay: early results from a prospective nonrandomized study.

    PubMed

    Hüscher, Cristiano G S; Lirici, Marco Maria; Ponzano, Cecilia

    2017-04-01

    Natural orifice specimen extraction - NOSE laparoscopy is a promising technique that avoids mini-laparotomy, possibly reducing postoperative pain, wound infections and hospital stay. Recent systematic reviews have shown that postoperative morbidity associated with laparoscopically assisted gastrectomies is similar to that after open gastrectomies. More specifically, there is no difference in wound infection rate. The study objective was to evaluate whether postoperative morbidity and hospital stay may be reduced by transoral specimen extraction after laparoscopically assisted gastrectomy for early gastric cancer (EGC). A prospective, nonrandomized study was carried out starting in August 2012. Data from all patients operated on during the first year, with minimum 18 months follow-up, were collected to assess feasibility, oncologic results, postoperative morbidity, hospital stay and functional results. Overall, 14 patients were included and followed-up. After gastric resection, a 3 cm opening was created on the gastric stump, and the specimen, divided into three segments stitched one to each other, was sutured to the gastric tube and retrieved through the mouth. Postoperative morbidity was 7.14% (1/14): one case of pneumonia. No wound infection occurred. The mean postoperative hospital stay was 4.7 ± 1.0 days. NOSE laparoscopic subtotal gastrectomy is feasible and safe, with similar oncologic results as LAG, but decreased morbidity and hospital stay.

  2. Downregulated Glia Interplay and Increased miRNA-155 as Promising Markers to Track ALS at an Early Stage.

    PubMed

    Cunha, Carolina; Santos, Catarina; Gomes, Cátia; Fernandes, Adelaide; Correia, Alexandra Marçal; Sebastião, Ana Maria; Vaz, Ana Rita; Brites, Dora

    2018-05-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease of unknown cause. Absence of specific targets and biomarkers compromise the development of new therapeutic strategies and of innovative tools to stratify patients and assess their responses to treatment. Here, we investigate changes in neuroprotective-neuroinflammatory actions in the spinal cord of SOD1 G93A mice, at presymptomatic and symptomatic stages to identify stage-specific biomarkers and potential targets. Results showed that in the presymptomatic stage, there are alterations in both astrocytes and microglia, which comprise decreased expression of GFAP and S100B and upregulation of GLT-1, as well as reduced expression of CD11b, M2-phenotype markers, and a set of inflammatory mediators. Reduced levels of Connexin-43, Pannexin-1, CCL21, and CX3CL1 further indicate the existence of a compromised intercellular communication. In contrast, in the symptomatic stage, increased markers of inflammation became evident, such as NF-κB/Nlrp3-inflammasome, Iba1, pro-inflammatory cytokines, and M1-polarizion markers, together with a decreased expression of M2-phenotypic markers. We also observed upregulation of the CX3CL1-CX3CR1 axis, Connexin-43, Pannexin-1, and of microRNAs (miR)-124, miR-125b, miR-146a and miR-21. Reduced motor neuron number and presence of reactive astrocytes with decreased GFAP, GLT-1, and GLAST further characterized this inflammatory stage. Interestingly, upregulation of miR-155 and downregulation of MFG-E8 appear as consistent biomarkers of both presymptomatic and symptomatic stages. We hypothesize that downregulated cellular interplay at the early stages may represent neuroprotective mechanisms against inflammation, SOD1 aggregation, and ALS onset. The present study identified a set of inflamma-miRNAs, NLRP3-inflammasome, HMGB1, CX3CL1-CX3CR1, Connexin-43, and Pannexin-1 as emerging candidates and promising pharmacological targets that may represent potential

  3. The EOLE experiment: Early results and current objectives

    NASA Technical Reports Server (NTRS)

    Morel, P.; Bandeen, W. R.

    1972-01-01

    The EOLE experiment with 480 constant level balloons released in the Southern Hemisphere is described. Each balloon floating freely at approximately the 200 mb level, is a precise tracer of the horizontal motion of air masses, the accuracy of which is limited only by the laminated structure of the stratospheric flow, within an RMS uncertainty of 1.5 m/sec. The balloons were found after 2 months to distribute at random over the whole hemisphere outside the tropics, irrespective of their original launching site. Early results of Eulerian and Lagrangian averages of the EOLE wind data are given for describing the mean 200 mb zonal and meridional circulations. The effect of the small scale eddies of two-dimensional turbulence has been studied with respect to the relative eddy diffusion of pairs of balloons and the relative dispersion of triangular clusters. New estimates of the RMS divergence of the 200 mb flow are given, together with their scale dependence which was found to be a logarithmic law.

  4. HST Observations of the Uranian Ring Plane Crossing: Early Results

    NASA Astrophysics Data System (ADS)

    Showalter, Mark R.; Lissauer, J. J.; French, R. G.; Hamilton, D. P.; Nicholson, P. D.; de Pater, I.

    2007-10-01

    Between early May and mid-August 2007, Earth was on the north side of the Uranian ring plane while the Sun was still shining on the rings’ southern face. This has provided an exceedingly rare opportunity to view the ring system via transmitted light. The ɛ ring, which typically out-shines every other component of the inner ring-moon system, has been rendered essentially invisible. We have been conducting regular imaging of the Uranian system throughout this period with the Wide Field/Planetary Camera on HST to address numerous scientific goals. (1) To search the inner Uranian system for the "shepherding” moons long believed to confine the narrow rings; (2) to study the packing density of the main rings via direct observations of their vertical thickness; (3) to search for the inner dust rings that appeared in a few Voyager images; (4) to determine the vertical thickness of the faint outer rings μ and ν (5) to obtain the most sensitive determinations of the outer rings’ colors and try to understand why ring ν is red but ring μ is blue; (6) to search for additional outer dust rings under optimal viewing geometry; and (7) to continue monitoring the seemingly chaotic orbital variations of the inner Uranian moons, particularly Mab. HST observations span mid-May to mid-September. We will present our initial results from this observing program.

  5. Early Results from the RAIDS Experiment on the ISS

    NASA Astrophysics Data System (ADS)

    Budzien, S. A.; Bishop, R. L.; Stephan, A. W.; Christensen, A. B.; Hecht, J. H.; Straus, P. R.

    2009-12-01

    The Remote Atmospheric and Ionospheric Detection System (RAIDS) is a suite of three photometers, three spectrometers, and two spectrographs which span the wavelength range 55-874 nm and remotely sense the thermosphere and ionosphere by scanning and imaging the limb. RAIDS was scheduled to fly to the Japanese Experiment Module—Exposed Facility (JEM-EF) aboard the International Space Station (ISS) in September 2009. RAIDS along with a companion hyperspectral imaging experiment will serve as the first US payload on the JEM-EF. The scientific objectives of the new RAIDS experiment are to study the temperature of the lower thermosphere (100-200 km), to measure composition and chemistry of the lower thermosphere and ionosphere, and to measure the initial source of OII 83.4 nm emission. RAIDS will provide valuable data useful for exploring tidal effects in the thermosphere and ionosphere system, validating dayside ionospheric remote sensing methods, and studying local time variations in important chemical and thermal processes. Early observational results from the RAIDS experiment will be presented. The RAIDS sensor suite performs multispectral limb scanning from the open end of the HICO-RAIDS Experiment Payload aboard the ISS.

  6. Is story-based blended learning a promising avenue for skin and sexual health education? Results from the PAEDIMED project.

    PubMed

    Apfelbacher, Christian J; Deimling, Erika; Wulfhorst, Britta; Adler, Frederic; Diepgen, Thomas L; Linder, Dennis; Blenk, Holger; Stosiek, Nikolaus; Reinmann, Gabi

    2010-03-01

    The PAEDIMED study group developed a learning and teaching scenario for school health education in the area of skin and sexual health in Italy, Romania and Germany, combining web-based and traditional learning ("blended learning"). A questionnaire-based needs assessment and context analysis were conducted, based on which an education scenario was designed. Particular emphasis was put on emotional and motivational aspects, using narrative components in the didactic concept. The design process occupied a central role in the project (design-based research). Evaluation was both formative and summative. Continuous feedback was obtained from relevant stakeholders. Following a prototypical implementation, the scenario was evaluated using questionnaires. The results revealed a high level of acceptance of the education scenario as well as an increase in students' knowledge concerning skin and sexual health. Evaluation also suggested that health education is highly influenced by cultural background and habits as well as diverse contextual and personal conditions.

  7. Activities of the Bloomberg Philanthropies Global Road Safety Programme (formerly RS10) in Russia: promising results from a sub-national project.

    PubMed

    Slyunkina, Ekaterina S; Kliavin, Vladimir E; Gritsenko, Elena A; Petruhin, Alexandr B; Zambon, Francesco; He, Huan; Hyder, Adnan A

    2013-12-01

    In Russia, the high Road Traffic Injuries (RTIs) rate has been attributed to two well-known risk factors - the low rates of seatbelt and child restraints use and speeding. Despite the importance of understanding both speeding and seatbelt use patterns for the purpose of direct interventions or monitoring road safety situation, no study has assessed the current status of speeding among all vehicles and seatbelt wearing rates among all vehicle occupants in Russia. We are aware that alcohol is a known risk factor for RTI in the country however the work focused on seat belts and speed. This research was conducted as part of the Bloomberg Philanthropies Global Road Safety Programme and focuses on observed speeding and seatbelt use in two Russian regions: Lipetskaya and Ivanovskaya Oblast. Data was collected through observational surveys on selected roads in the two interventions sites (Lipetskaya and Ivanovskaya Oblast) between October 2010 and March 2013. The percentage of seatbelt use by drivers and passengers and the percentage of speeding vehicles by speed limit and road types were calculated. Observational studies on speeding show signs that drivers are speeding less from the first survey held in July 2011 in Lipetskaya Oblast and March 2012 in Ivanovksya Oblast. Overall the observational studies showed a consistent reduction in the proportion of vehicles exceeding the speed limit: from 54.7% (2012) to 40.1% (2013) in Ivanovskaya Oblast and from 47.0% (2011) to 26.1% (2013) in Lipetskaya Oblast. Observational studies on seatbelt use demonstrate an increase in seatbelt wearing rates from the first survey held in October 2010 in Lipetskaya Oblast and April 2011 in Ivanovskaya Oblast. The overall prevalence of seatbelt use increased from 52.4% (2010) to 73.5% (2013) amongst all occupants in Lipetskaya Oblast and from 47.5% (2011) to 88.8% (2013) in Ivanovskaya Oblast. Preliminary results show some promising signs that speeding and seatbelt use are moving in the right

  8. Western gulf culture-density study-early results

    Treesearch

    Mohd S. Rahman; Michael G. Messina; Richard F. Fisher; Alan B. Wilson; Nick Chappell; Conner Fristoe; Larry Anderson

    2006-01-01

    The Western Gulf Culture-Density Study is a collaborative research effort between Texas A&M University and five forest products companies to examine the effects of early silvicultural treatment intensity and a wide range of both densities and soil types on performance of loblolly pine. The study tests 2 silvicultural intensities, 5 planting densities (200 to 1,200...

  9. Migration characteristics and early clinical results of the NANOS® short-stem hip arthroplasty.

    PubMed

    Kaipel, Martin; Grabowiecki, Phillip; Sinz, Katrina; Farr, Sebastian; Sinz, Günter

    2015-05-01

    Femoral short stems promise essential advantages in total hip arthroplasty. Up to now, only short- and midterm clinical studies exist. Data on early stem migration that could predict later aseptic loosening at an early stage are rare. The purpose of this study was to assess migration patterns and clinical outcome 2 years after hip replacement by a metaphyseal anchored cementless short stem. Migration data and clinical results were prospectively assessed in 49 patients. Clinical outcome was measured using the Harris Hip Score (HHS). Migration analyses were performed using the computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) system. At 2 years after surgery, none of the implants needed revision, and HHS increased from 47.9 up to 98.1. Of 49 patients, 5 (10%) showed increased vertical stem migration (1.5 mm/2a) that might predict late aseptic loosening. Of 49 stems, 44 (90%) showed stable migration patterns indicating a beneficial long-term outcome. Results of this study confirm the excellent clinical data of previous works. Migration patterns strongly suggest that short-stem arthroplasty is not only an innovative but also a reliable strategy in total hip replacement.

  10. Early results from NASA's SnowEx campaign

    NASA Astrophysics Data System (ADS)

    Kim, Edward; Gatebe, Charles; Hall, Dorothy; Misakonis, Amy; Elder, Kelly; Marshall, Hans Peter; Hiemstra, Chris; Brucker, Ludovic; Crawford, Chris; Kang, Do Hyuk; De Marco, Eugenia; Beckley, Matt; Entin, Jared

    2017-04-01

    SnowEx is a multi-year airborne snow campaign with the primary goal of addressing the question: How much water is stored in Earth's terrestrial snow-covered regions? Year 1 (2016-17) focuses on the distribution of snow-water equivalent (SWE) and the snow energy balance in a forested environment. The year 1 primary site is Grand Mesa and the secondary site is the Senator Beck Basin, both in western, Colorado, USA. Ten core sensors on four core aircraft will make observations using a broad suite of airborne sensors including active and passive microwave, and active and passive optical/infrared sensing techniques to determine the sensitivity and accuracy of these potential satellite remote sensing techniques, along with models, to measure snow under a range of forest conditions. SnowEx also includes an extensive range of ground truth measurements—in-situ samples, snow pits, ground based remote sensing measurements, and sophisticated new techniques. A detailed description of the data collected will be given and some early results will be presented. Seasonal snow cover is the largest single component of the cryosphere in areal extent (covering an average of 46M km2 of Earth's surface (31 % of land areas) each year). This seasonal snow has major societal impacts in the areas of water resources, natural hazards (floods and droughts), water security, and weather and climate. The only practical way to estimate the quantity of snow on a consistent global basis is through satellites. Yet, current space-based techniques underestimate storage of snow water equivalent (SWE) by as much as 50%, and model-based estimates can differ greatly vs. estimates based on remotely-sensed observations. At peak coverage, as much as half of snow-covered terrestrial areas involve forested areas, so quantifying the challenge represented by forests is important to plan any future snow mission. Single-sensor approaches may work for certain snow types and certain conditions, but not for others

  11. Aquarius Radiometer Performance: Early On-Orbit Calibration and Results

    NASA Technical Reports Server (NTRS)

    Piepmeier, Jeffrey R.; LeVine, David M.; Yueh, Simon H.; Wentz, Frank; Ruf, Christopher

    2012-01-01

    The Aquarius/SAC-D observatory was launched into a 657-km altitude, 6-PM ascending node, sun-synchronous polar orbit from Vandenberg, California, USA on June 10, 2011. The Aquarius instrument was commissioned two months after launch and began operating in mission mode August 25. The Aquarius radiometer meets all engineering requirements, exhibited initial calibration biases within expected error bars, and continues to operate well. A review of the instrument design, discussion of early on-orbit performance and calibration assessment, and investigation of an on-going calibration drift are summarized in this abstract.

  12. Early surgical management for giant omphalocele: Results and prognostic factors.

    PubMed

    Roux, Nathalie; Jakubowicz, Déborah; Salomon, Laurent; Grangé, Gilles; Giuseppi, Agnès; Rousseau, Véronique; Khen-Dunlop, Naziha; Beaudoin, Sylvie

    2018-05-23

    Giant omphalocele often represents a major surgical challenge and is reported with high mortality and morbidity rates. The aim of this study was to assess the outcome of neonates with giant omphalocele managed with early operative surgical treatment, and subsequently to identify possible factors that could alter the prognosis. We reviewed the medical records of 29 consecutive newborns with prenatally diagnosed giant omphalocele. In these cases one of two procedures had been performed: either staged closure after silo, or immediate closure with a synthetic patch. The cases were separated into 2 groups: Isolated giant omphalocele (IO group) and giant omphalocele associated with malformation (NIO group). Infants in the IO group had a lower size of the omphalocele (p<0,001), a shorter hospital stay (95 days [45-915] vs. 41.5 days [10-110] p= 0, 02), and a shorter median ventilation length (10 days [1-33] vs. 27, 5 [6-65] p = 0, 05). In the NIO group, 5 cases displayed a significantly more difficult course than the others. They were compared to the remaining cases for prenatal and anatomic features. Four factors associated with greater morbidity were identified: CONCLUSIONS: Isolated omphalocele, even containing the whole liver, has a very good prognosis with early surgical treatment. Without associated anomalies, 95% of giant omphaloceles can be discharged with a median of 41.5 days in hospital. However, associated anomalies (especially cardiopathies) may burden the prognosis and should be both carefully assessed during pregnancy and taken into account in parental information. Retrospective Study LEVEL OF EVIDENCE: Level I. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Earthquake Early Warning in Japan - Result of recent two years -

    NASA Astrophysics Data System (ADS)

    Shimoyama, T.; Doi, K.; Kiyomoto, M.; Hoshiba, M.

    2009-12-01

    Japan Meteorological Agency(JMA) started to provide Earthquake Early Warning(EEW) to the general public in October 2007. It was followed by provision of EEW to a limited number of users who understand the technical limit of EEW and can utilize it for automatic control from August 2006. Earthquake Early Warning in Japan definitely means information of estimated amplitude and arrival time of a strong ground motion after fault rupture occurred. In other words, the EEW provided by JMA is defined as a forecast of a strong ground motion before the strong motion arrival. EEW of JMA is to enable advance countermeasures to disasters caused by strong ground motions with providing a warning message of anticipating strong ground motion before the S wave arrival. However, due to its very short available time period, there should need some measures and ideas to provide rapidly EEW and utilize it properly. - EEW is issued to general public when the maximum seismic intensity 5 lower (JMA scale) or greater is expected. - EEW message contains origin time, epicentral region name, and names of areas (unit is about 1/3 to 1/4 of one prefecture) where seismic intensity 4 or greater is expected. Expected arrival time is not included because it differs substantially even in one unit area. - EEW is to be broadcast through the broadcasting media(TV, radio and City Administrative Disaster Management Radio), and is delivered to cellular phones through cell broadcast system. For those who would like to know the more precise estimation and smaller earthquake information at their point of their properties, JMA allows designated private companies to provide forecast of strong ground motion, in which the estimation of a seismic intensity as well as arrival time of S-wave are contained, at arbitrary places under the JMA’s technical assurance. From October, 2007 to August, 2009, JMA issued 11 warnings to general public expecting seismic intensity “5 lower” or greater, including M=7.2 inland

  14. The WHAM Hα Magellanic Stream Survey: Progress and Early Results

    NASA Astrophysics Data System (ADS)

    Smart, Brianna; Haffner, L. Matthew; Barger, Kat; Krishnarao, Dhanesh

    2017-01-01

    We present early analysis of the Hα survey of the Magellanic Stream using the Wisconsin H-Alpha Mapper (WHAM). The neutral component of the Stream extends some 200° across the sky (Nidever et al. 2010). However, the full extent of the ionized gas has not been mapped in detail. Previous studies (e.g., Putman et al. 2003; Weiner & Williams 1996) suggest that ionized gas is likely to be found all along the length of the Stream, and may extend beyond the current neutral boundaries as traced by 21 cm. Barger et al. (2013) used WHAM to map ionized gas throughout the Magellanic Bridge between the Magellanic Clouds. Although ionized emission tracks the neutral emission for the most part, it often spans a few degrees away from the H I at slightly offset velocities. Additionally, Fox et al. (2014) find evidence in an absorption line study that the tidal debris in the Magellanic System contains twice as much ionized gas as neutral material and may extend 30° away from 21-cm sensitivity boundaries. We are now compiling the first comprehensive picture of the ionized component of the Magellanic Stream using WHAM's unprecedented sensitivity to trace diffuse emission (~tens of mR), its velocity resolution (12 km/s) to separate the Stream from the Milky Way, and its multiwavelength capabilities (e.g., [S II] and [N II]) to examine the physical conditions of the gas. Much of the data along the primary axis of the Stream has been collected for the first phase of this extensive study, a complete kinematic Hα survey of the Stream. We present survey progress, challenges in extracting Stream emission, and first-look kinematic maps at select positions along the Stream.

  15. FRONTIER FIELDS: HIGH-REDSHIFT PREDICTIONS AND EARLY RESULTS

    SciTech Connect

    Coe, Dan; Bradley, Larry; Zitrin, Adi, E-mail: DCoe@STScI.edu

    2015-02-20

    The Frontier Fields program is obtaining deep Hubble and Spitzer Space Telescope images of new ''blank'' fields and nearby fields gravitationally lensed by massive galaxy clusters. The Hubble images of the lensed fields are revealing nJy sources (AB mag > 31), the faintest galaxies yet observed. The full program will transform our understanding of galaxy evolution in the first 600 million years (z > 9). Previous programs have yielded a dozen or so z > 9 candidates, including perhaps fewer than expected in the Ultra Deep Field and more than expected in shallower Hubble images. In this paper, we present high-redshift (z >more » 6) number count predictions for the Frontier Fields and candidates in three of the first Hubble images. We show the full Frontier Fields program may yield up to ∼70 z > 9 candidates (∼6 per field). We base this estimate on an extrapolation of luminosity functions observed between 4 < z < 8 and gravitational lensing models submitted by the community. However, in the first two deep infrared Hubble images obtained to date, we find z ∼ 8 candidates but no strong candidates at z > 9. We defer quantitative analysis of the z > 9 deficit (including detection completeness estimates) to future work including additional data. At these redshifts, cosmic variance (field-to-field variation) is expected to be significant (greater than ±50%) and include clustering of early galaxies formed in overdensities. The full Frontier Fields program will significantly mitigate this uncertainty by observing six independent sightlines each with a lensing cluster and nearby blank field.« less

  16. Impact of a peer-counseling intervention on breastfeeding practices in different socioeconomic strata: results from the equity analysis of the PROMISE-EBF trial in Uganda.

    PubMed

    Eide, Kristiane Tislevoll; Fadnes, Lars Thore; Engebretsen, Ingunn Marie Stadskleiv; Onarheim, Kristine Husøy; Wamani, Henry; Tumwine, James K; Norheim, Ole Frithjof

    2016-01-01

    Undernutrition is highly prevalent among infants in Uganda. Optimal infant feeding practices may improve nutritional status, health, and survival among children. Our study evaluates the socioeconomic distribution of exclusive breastfeeding (EBF) and growth outcomes among infants included in a trial, which promoted EBF by peer counselors in Uganda. Twenty-four clusters comprising one to two communities in Uganda were randomized into intervention and control arms, including 765 mother-infant pairs (PROMISE-EBF trial, 200608, ClinicalTrials.gov no. NCT00397150). Intervention clusters received the promotion of EBF by peer counselors in addition to standard care. Breastfeeding and growth outcomes were compared according to wealth quintiles and intervention/control arms. Socioeconomic inequality in breastfeeding and growth outcomes were measured using the concentration index 12 and 24 weeks postpartum. We used the decomposition of the concentration index to identify factors contributing to growth inequality at 24 weeks. EBF was significantly concentrated among the poorest in the intervention group at 24 weeks postpartum, concentration index -0.060. The control group showed a concentration of breastfeeding among the richest part of the population, although not statistically significant. Stunting, wasting, and underweight were similarly significantly concentrated among the poorest in the intervention group and the total population at 24 weeks, but showing non-significant concentrations for the control group. This study shows that EBF can be successfully promoted among the poor. In addition, socioeconomic inequality in growth outcomes starts early in infancy, but the breastfeeding intervention was not strong enough to counteract this influence.

  17. Planck early results. XXV. Thermal dust in nearby molecular clouds

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Abergel, A.; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bock, J. J.; Bonaldi, A.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bucher, M.; Burigana, C.; Cabella, P.; Cardoso, J.-F.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chiang, L.-Y.; Chiang, C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Dobashi, K.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Frailis, M.; Franceschi, E.; Galeotta, S.; Ganga, K.; Giard, M.; Giardino, G.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Guillet, V.; Hansen, F. K.; Harrison, D.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Jaffe, A. H.; Jones, A.; Jones, W. C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leonardi, R.; Leroy, C.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; MacTavish, C. J.; Maffei, B.; Mandolesi, N.; Mann, R.; Maris, M.; Marshall, D. J.; Martin, P.; Martínez-González, E.; Masi, S.; Matarrese, S.; Matthai, F.; Mazzotta, P.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; Osborne, S.; Pajot, F.; Paladini, R.; Pasian, F.; Patanchon, G.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Reach, W. T.; Rebolo, R.; Reinecke, M.; Renault, C.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rubiño-Martín, J. A.; Rusholme, B.; Sandri, M.; Santos, D.; Savini, G.; Scott, D.; Seiffert, M. D.; Shellard, P.; Smoot, G. F.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Sudiwala, R.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Umana, G.; Valenziano, L.; Verstraete, L.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    Planck allows unbiased mapping of Galactic sub-millimetre and millimetre emission from the most diffuse regions to the densest parts of molecular clouds. We present an early analysis of the Taurus molecular complex, on line-of-sight-averaged data and without component separation. The emission spectrum measured by Planck and IRAS can be fitted pixel by pixel using a single modified blackbody. Some systematic residuals are detected at 353 GHz and 143 GHz, with amplitudes around -7% and +13%, respectively, indicating that the measured spectra are likely more complex than a simple modified blackbody. Significant positive residuals are also detected in the molecular regions and in the 217 GHz and 100 GHz bands, mainly caused by the contribution of the J = 2 → 1 and J = 1 → 0 12CO and 13CO emission lines. We derive maps of the dust temperature T, the dust spectral emissivity index β, and the dust optical depth at 250 μm τ250. The temperature map illustrates the cooling of the dust particles in thermal equilibrium with the incident radiation field, from 16 - 17 K in the diffuse regions to 13 - 14 K in the dense parts. The distribution of spectral indices is centred at 1.78, with a standard deviation of 0.08 and a systematic error of 0.07. We detect a significant T - β anti-correlation. The dust optical depth map reveals the spatial distribution of the column density of the molecular complex from the densest molecular regions to the faint diffuse regions. We use near-infrared extinction and Hi data at 21-cm to perform a quantitative analysis of the spatial variations of the measured dust optical depth at 250 μm per hydrogen atom τ250/NH. We report an increase of τ250/NH by a factor of about 2 between the atomic phase and the molecular phase, which has a strong impact on the equilibrium temperature of the dust particles. Corresponding author: A. Abergel, e-mail: alain.abergel@ias.u-psud.fr

  18. Early Science Results from the Williams College Eclipse Expedition

    NASA Astrophysics Data System (ADS)

    Pasachoff, Jay M.; Person, Michael J.; Dantowitz, Ron; Lockwood, Christian A.; Nagle-McNaughton, Tim; Meadors, Erin N.; Perez, Cielo C.; Marti, Connor J.; Yu, Ross; Rosseau, Brendan; Daly, Declan M.; Ide, Charles A.; Davis, Allen B.; Lu, Muzhou; Sliski, David; Seiradakis, John; Voulgaris, Aris; Rusin, Vojtech; Peñaloza-Murillo, Marcos A.; Roman, Michael; Seaton, Daniel B.; Steele, Amy; Lee, Duane M.; Freeman, Marcus J.

    2018-01-01

    We describe our first cut of data reduction on a wide variety of observations of the solar corona and of the effect of the penumbra and umbra on the terrestrial atmosphere, carried out from our eclipse site on the campus of Willamette University in Salem, Oregon. Our team of faculty, undergraduate students, graduate students, and other colleagues observed the eclipse, taking images and spectra with a variety of sensors and telescopes. Equipment included frame-transfer cameras observing at 3 Hz in 0.3 nm filters at the coronal green and red lines to measure the power spectrum of oscillations in coronal loops or elsewhere in the lower corona; 3 spectrographs; a variety of telescopes and telephotos for white-light imaging; a double Lyot system tuned at Fe XIV 530.3 nm (FWHM 0.4 nm) and Fe X 637.4 nm (FWHM 0.5 nm); and a weather station to record changes in the terrestrial atmosphere. We are comparing our observations with predictions based on the previous mapping of the photospheric magnetic field, and preparing wide-field complete coronal imaging incorporating NOAA/NASA GOES-16 SUVI and NRL/NASA/LASCO for the corona outside our own images (which extend, given the completely clear skies we had, at least 4 solar radii), and NASA SDO/AIA and NOAA/NASA GOES-16 SUVI for the solar disk. One of our early composites appeared as Astronomy Picture of the Day for September 27: https://apod.nasa.gov/apod/ap170927.htmlOur expedition was supported in large part by grants from the Committee for Research and Exploration of the National Geographic Society and from the Solar Terrestrial Program of the Atmospheric and Geospace Sciences Division of the National Science Foundation, with additional student support from the STP/AGS of NSF, the NASA Massachusetts Space Grant Consortium, the Sigma Xi honorary scientific society, the Clare Booth Luce Foundation studentship and the Freeman Foote Expeditionary Fund at Williams College, other Williams College funds, and U. Pennsylvania funds.

  19. Attitudes of the German General Population toward Early Diagnosis of Dementia – Results of a Representative Telephone Survey

    PubMed Central

    Luck, Tobias; Luppa, Melanie; Sieber, Jennifer; Schomerus, Georg; Werner, Perla; König, Hans-Helmut; Riedel-Heller, Steffi G.

    2012-01-01

    Background Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer’s dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. Methods A representative telephone survey of the German population aged 18+ years (n = 1,002) was conducted in 2011. Results The majority of respondents (69%) would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP) as the first source of professional help. More than half of the respondents (55%) stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. Conclusions Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs’ potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved. PMID:23209827

  20. Mathematical Rigor vs. Conceptual Change: Some Early Results

    NASA Astrophysics Data System (ADS)

    Alexander, W. R.

    2003-05-01

    Results from two different pedagogical approaches to teaching introductory astronomy at the college level will be presented. The first of these approaches is a descriptive, conceptually based approach that emphasizes conceptual change. This descriptive class is typically an elective for non-science majors. The other approach is a mathematically rigorous treatment that emphasizes problem solving and is designed to prepare students for further study in astronomy. The mathematically rigorous class is typically taken by science majors. It also fulfills an elective science requirement for these science majors. The Astronomy Diagnostic Test version 2 (ADT 2.0) was used as an assessment instrument since the validity and reliability have been investigated by previous researchers. The ADT 2.0 was administered as both a pre-test and post-test to both groups. Initial results show no significant difference between the two groups in the post-test. However, there is a slightly greater improvement for the descriptive class between the pre and post testing compared to the mathematically rigorous course. There was great care to account for variables. These variables included: selection of text, class format as well as instructor differences. Results indicate that the mathematically rigorous model, doesn't improve conceptual understanding any better than the conceptual change model. Additional results indicate that there is a similar gender bias in favor of males that has been measured by previous investigators. This research has been funded by the College of Science and Mathematics at James Madison University.

  1. Early Results and Spaceflight Implications of the SWAB Flight Experiment

    NASA Technical Reports Server (NTRS)

    Ott, C. Mark; Pierson, Duane L.

    2007-01-01

    Microbial monitoring of spacecraft environments provides key information in the assessment of infectious disease risk to the crew. Monitoring aboard the Mir space station and International Space Station (ISS) has provided a tremendous informational baseline to aid in determining the types and concentrations of microorganisms during a mission. Still, current microbial monitoring hardware utilizes culture-based methodology which may not detect many medically significant organisms, such as Legionella pneumophila. We hypothesize that evaluation of the ISS environment using non-culture-based technologies would reveal microorganisms not previously reported in spacecraft, allowing for a more complete health assessment. To achieve this goal, a spaceflight experiment, operationally designated as SWAB, was designed to evaluate the DNA from environmental samples collected from ISS and vehicles destined for ISS. Results from initial samples indicate that the sample collection and return procedures were successful. Analysis of these samples using denaturing gradient gel electrophoresis and targeted PCR primers for fungal contaminants is underway. The current results of SWAB and their implication for in-flight molecular analysis of environmental samples will be discussed.

  2. The Gravity Probe B experiment and early results

    NASA Astrophysics Data System (ADS)

    Conklin, John W.; Gravity Probe B Collaboration

    2008-11-01

    The NASA Gravity Probe B orbiting gyroscope test of General Relativity, launched from Vandenberg Air Force Base on 20 April, 2004 tests two consequences of Einstein's theory: 1) the predicted 6.6 arcs/yr geodetic effect due to the motion of the gyroscope through the curved space-time around the Earth; 2) the predicted 0.039 arcs/yr frame-dragging effect due to the rotating Earth. The mission required the development of many technologies that did not exist when experiment was conceived in 1960. Cryogenic gyroscopes with drift-rates 7 orders of magnitude better than the best inertial navigation gyroscopes, a < 1 marcs star tracking telescope, and other essential technologies were developed as a result of an intensive collaboration between Stanford physicists and engineers, NASA and industry. Gravity Probe B collected science data from August 27, 2004 through September 29, 2005. Analysis of the data began during the mission and is on-going. This paper describes the main features and challenges of the experiment and presents the preliminary results to date.

  3. Lidar In-space Technology Experiment: Overview and early results

    NASA Technical Reports Server (NTRS)

    McCormick, M. Patrick

    1995-01-01

    The September 1994 Shuttle flight of the Lidar In-space Technology Experiment (LITE) brought to fruition 10 years of effort at NASA's Langley Research Center where it was built. Being the first flight of a spaceborne lidar to measure atmospheric constituents and parameters and surface properties, it culminates the efforts of many worldwide over the last 20 years to usher in this new remote sensing technique from space. This paper will describe the LITE instrument, the in-orbit performance, and initial results. In addition, the global correlative measurements program will be outlined which involved 60 groups in 20 countries who made various simultaneous ground-based or aircraft measurements as LITE flew overhead.

  4. Early results from the Far Infrared Absolute Spectrophotometer (FIRAS)

    NASA Technical Reports Server (NTRS)

    Mather, J. C.; Cheng, E. S.; Shafer, R. A.; Eplee, R. E.; Isaacman, R. B.; Fixsen, D. J.; Read, S. M.; Meyer, S. S.; Weiss, R.; Wright, E. L.

    1991-01-01

    The Far Infrared Absolute Spectrophotometer (FIRAS) on the Cosmic Background Explorer (COBE) mapped 98 percent of the sky, 60 percent of it twice, before the liquid helium coolant was exhausted. The FIRAS covers the frequency region from 1 to 100/cm with a 7 deg angular resolution. The spectral resolution is 0.2/cm for frequencies less than 20/cm and 0.8/cm for higher frequencies. Preliminary results include: a limit on the deviations from a Planck curve of 1 percent of the peak brightness from 1 to 20/cm, a temperature of 2.735 +/- 0.06 K, a limit on the Comptonization parameter y of 0.001, on the chemical potential parameter mu of 0.01, a strong limit on the existence of a hot smooth intergalactic medium, and a confirmation that the dipole anisotropy spectrum is that of a Doppler shifted blackbody.

  5. Early Results from NASA's Assessment of Satellite Servicing

    NASA Technical Reports Server (NTRS)

    Thronson, Harley A.; Reed, Benjamin B.; Townsend, Jacqueline A.; Ahmed, Mansoor; Whipple, Arthur O.; Oegerle, William R.

    2010-01-01

    Following recommendations by the NRC, NASA's FY 2008 Authorization Act and the FY 2009 and 2010 Appropriations bills directed NASA to assess the use of the human spaceflight architecture to service existing/future observatory-class scientific spacecraft. This interest in satellite servicing, with astronauts and/or with robots, reflects the success that NASA achieved with the Shuttle program and HST on behalf of the astronomical community as well as the successful construction of ISS. This study, led by NASA GSFC, will last about a year, leading to a final report to NASA and Congress in autumn 2010. We will report on its status, results from our March satellite servicing workshop, and recent concepts for serviceable scientific missions.

  6. The Whole Heliosphere Interval: Campaign Summaries and Early Results

    NASA Technical Reports Server (NTRS)

    Thompson, Barbara J.; Gibson, Sarah E.; Kozyra, Janet U.

    2008-01-01

    The Whole Heliosphere Interval (WHI) is an internationally coordinated observing and modeling effort to characterize the 3-dimensional interconnected solar-heliospheric-planetary system - a.k.a. the "heliophysical" system. The heart of the WHI campaign is the study of the interconnected 3-D heliophysical domain, from the interior of the Sun, to the Earth, outer planets, and into interstellar space. WHI observing campaigns began with the 3-0 solar structure from solar Carrington Rotation 2068, which ran from March 20 - April 16, 2008. Observations and models of the outer heliosphere and planetary impacts extended beyond those dates as necessary; for example, the solar wind transit time to outer planets can take months. WHI occurs during solar minimum, which optimizes our ability to characterize the 3-D heliosphere and trace the structure to the outer limits of the heliosphere. A summary of some of the key results from the WHI first workshop in August 2008 will be given.

  7. LSNR Airborne LIDAR Mapping System Design and Early Results (Invited)

    NASA Astrophysics Data System (ADS)

    Shrestha, K.; Carter, W. E.; Slatton, K. C.

    2009-12-01

    Low signal-to-noise ratio (LSNR) detection techniques allow for implementation of airborne light detection and range (LIDAR) instrumentation aboard platforms with prohibitive power, size, and weight restrictions. The University of Florida has developed the Coastal Area Tactical-mapping System (CATS), a prototype LSNR LIDAR system capable of single photon laser ranging. CATS is designed to operate in a fixed-wing aircraft flying 600 m above ground level, producing 532 nm, 480 ps, 3 μJ output pulses at 8 kHz. To achieve continuous coverage of the terrain with 20 cm spatial resolution in a single pass, a 10x10 array of laser beamlets is scanned. A Risley prism scanner (two rotating V-coated optical wedges) allows the array of laser beamlets to be deflected in a variety of patterns, including conical, spiral, and lines at selected angles to the direction of flight. Backscattered laser photons are imaged onto a 100 channel (10x10 segmented-anode) photomultiplier tube (PMT) with a micro-channel plate (MCP) amplifier. Each channel of the PMT is connected to a multi-stop 2 GHz event timer. Here we report on tests in which ranges for known targets were accumulated for repeated laser shots and statistical analyses were applied to evaluate range accuracy, minimum separation distance, bathymetric mapping depth, and atmospheric scattering. Ground-based field test results have yielded 10 cm range accuracy and sub-meter feature identification at variable scan settings. These experiments also show that a secondary surface can be detected at a distance of 15 cm from the first. Range errors in secondary surface identification for six separate trials were within 7.5 cm, or within the timing resolution limit of the system. Operating at multi-photon sensitivity may have value for situations in which high ambient noise precludes single-photon sensitivity. Low reflectivity targets submerged in highly turbid waters can cause detection issues. CATS offers the capability to adjust the

  8. Early Science Results from SOFIA, the Worlds Largest Airborne Observatory

    NASA Astrophysics Data System (ADS)

    De Buizer, J.

    2012-09-01

    The Stratospheric Observatory for Infrared Astronomy, or SOFIA, is the largest flying observatory ever built, consisting of a 2.7-meter diameter telescope embedded in a modified Boeing 747-SP aircraft. SOFIA is a joint project between NASA and the German Aerospace Center Deutsches Zentrum fur Luft und-Raumfahrt. By flying at altitudes up to 45000 feet, the observatory gets above 99.9% of the infrared-absorbing water vapor in the Earth's atmosphere. This opens up an almost uninterrupted wavelength range from 0.3-1600 microns that is in large part obscured from ground based observatories. Since its 'Initial Science Flight' in December 2010, SOFIA has flown several dozen science flights, and has observed a wide array of objects from Solar System bodies, to stellar nurseries, to distant galaxies. This talk will review some of the exciting new science results from these first flights which were made by three instruments: the mid-infrared camera FORCAST, the far-infrared heterodyne spectrometer GREAT, and the optical occultation photometer HIPO.

  9. HUNTING THE COOLEST DWARFS: METHODS AND EARLY RESULTS

    SciTech Connect

    Schneider, A.; Song, Inseok; Melis, Carl

    2011-12-20

    We present the methods and first results of a survey of nearby high proper motion main-sequence stars to probe for cool companions with the Gemini camera at Lick Observatory. This survey uses a sample of old (age > 2 Gyr) stars as targets to probe for companions down to temperatures of 500 K. Multi-epoch observations allow us to discriminate comoving companions from background objects. So far, our survey has successfully rediscovered the wide T8.5 companion to GJ 1263 and has discovered a companion to the nearby M0V star GJ 660.1. The companion to GJ 660.1 (GJ 660.1B) is {approx}4 magmore » fainter than its host star in the J-band and is located at a projected separation of {approx}120 AU. Known trigonometric parallax and Two Micron All Sky Survey magnitudes for the GJ 660.1 system indicate a spectral type for the companion of M9 {+-} 2.« less

  10. The earth radiation budget experiment: Early validation results

    NASA Astrophysics Data System (ADS)

    Smith, G. Louis; Barkstrom, Bruce R.; Harrison, Edwin F.

    The Earth Radiation Budget Experiment (ERBE) consists of radiometers on a dedicated spacecraft in a 57° inclination orbit, which has a precessional period of 2 months, and on two NOAA operational meteorological spacecraft in near polar orbits. The radiometers include scanning narrow field-of-view (FOV) and nadir-looking wide and medium FOV radiometers covering the ranges 0.2 to 5 μm and 5 to 50 μm and a solar monitoring channel. This paper describes the validation procedures and preliminary results. Each of the radiometer channels underwent extensive ground calibration, and the instrument packages include in-flight calibration facilities which, to date, show negligible changes of the instruments in orbit, except for gradual degradation of the suprasil dome of the shortwave wide FOV (about 4% per year). Measurements of the solar constant by the solar monitors, wide FOV, and medium FOV radiometers of two spacecraft agree to a fraction of a percent. Intercomparisons of the wide and medium FOV radiometers with the scanning radiometers show agreement of 1 to 4%. The multiple ERBE satellites are acquiring the first global measurements of regional scale diurnal variations in the Earth's radiation budget. These diurnal variations are verified by comparison with high temporal resolution geostationary satellite data. Other principal investigators of the ERBE Science Team are: R. Cess, SUNY, Stoneybrook; J. Coakley, NCAR; C. Duncan, M. King and A Mecherikunnel, Goddard Space Flight Center, NASA; A. Gruber and A.J. Miller, NOAA; D. Hartmann, U. Washington; F.B. House, Drexel U.; F.O. Huck, Langley Research Center, NASA; G. Hunt, Imperial College, London U.; R. Kandel and A. Berroir, Laboratory of Dynamic Meteorology, Ecole Polytechique; V. Ramanathan, U. Chicago; E. Raschke, U. of Cologne; W.L. Smith, U. of Wisconsin and T.H. Vonder Haar, Colorado State U.

  11. Early Results from Swift AGN and Cluster Survey

    NASA Astrophysics Data System (ADS)

    Dai, Xinyu; Griffin, Rhiannon; Nugent, Jenna; Kochanek, Christopher S.; Bregman, Joel N.

    2016-04-01

    The Swift AGN and Cluster Survey (SACS) uses 125 deg^2 of Swift X-ray Telescope serendipitous fields with variable depths surrounding gamma-ray bursts to provide a medium depth (4 × 10^-15 erg cm^-2 s^-1) and area survey filling the gap between deep, narrow Chandra/XMM-Newton surveys and wide, shallow ROSAT surveys. Here, we present the first two papers in a series of publications for SACS. In the first paper, we introduce our method and catalog of 22,563 point sources and 442 extended sources. SACS provides excellent constraints on the AGN and cluster number counts at the bright end with negligible uncertainties due to cosmic variance, and these constraints are consistent with previous measurements. The depth and areal coverage of SACS is well suited for galaxy cluster surveys outside the local universe, reaching z > 1 for massive clusters. In the second paper, we use SDSS DR8 data to study the 203 extended SACS sources that are located within the SDSS footprint. We search for galaxy over-densities in 3-D space using SDSS galaxies and their photometric redshifts near the Swift galaxy cluster candidates. We find 103 Swift clusters with a > 3σ over-density. The remaining targets are potentially located at higher redshifts and require deeper optical follow-up observations for confirmations as galaxy clusters. We present a series of cluster properties including the redshift, BCG magnitude, BCG-to-X-ray center offset, optical richness, X-ray luminosity and red sequences. We compare the observed redshift distribution of the sample with a theoretical model, and find that our sample is complete for z ≤ 0.3 and 80% complete for z ≤ 0.4, consistent with the survey depth of SDSS. These analysis results suggest that our Swift cluster selection algorithm presented in our first paper has yielded a statistically well-defined cluster sample for further studying cluster evolution and cosmology. In the end, we will discuss our ongoing optical identification of z>0.5 cluster

  12. Launcher Roadmap for the CrVI Substitution of Surface Treatments. Screening of Trivalent-Chromium Conversion Solutions and First Promising Results for Repair Applications on Aluminium Alloys

    NASA Astrophysics Data System (ADS)

    Debout, Vincent; Pettier, Sophie

    2014-06-01

    Airbus Defence and Space, Space System is involved in a global roadmap for launchers in order to substitute hexavalent chromium (CrVI) and Cadmium in the current surface treatments on metallic structures.Within this framework, a screening of trivalent chromium (CrIII) conversion solutions for touch-up applications has been carried out since this step is crucial to perform local application or to repair minor damages on launcher structures but it leads to higher risks of exposure for the workers.Three commercial CrIII conversion solutions have been evaluated on high performance aluminum alloys such as AA2024 T3 and AA7175 T7351 that are often used as structural materials.This preliminary investigation highlights the effect of surface preparation, rinsing and conversion process on the final corrosion performance of conversion coatings (CCs). The results are also discussed in terms of visual aspect and adhesion with new Cr-free primers.Two operating sets of parameters are identified with promising results that represent the first steps towards the development of a new Cr-free touch-up process.

  13. Exclusive breastfeeding promotion and neuropsychological outcomes in 5-8 year old children from Uganda and Burkina Faso: Results from the PROMISE EBF cluster randomized trial.

    PubMed

    Tumwine, James K; Nankabirwa, Victoria; Diallo, Hama Abdoulaye; Engebretsen, Ingunn Marie Stadskleiv; Ndeezi, Grace; Bangirana, Paul; Sanou, Anselme Simeon; Kashala-Abotnes, Espérance; Boivin, Michael; Giordani, Bruno; Elgen, Irene Bircow; Holding, Penny; Kakooza-Mwesige, Angelina; Skylstad, Vilde; Nalugya, Joyce; Tylleskar, Thorkild; Meda, Nicolas

    2018-01-01

    The beneficial effects from exclusive breastfeeding (EBF) have been widely acknowledged. We assessed the effect of exclusive breastfeeding promotion by peer counsellors in Uganda and Burkina Faso, on cognitive abilities, social emotional development, school performance and linear growth among 5-8 years old children. Children in the PROMISE EBF trial (2006-2008) were re-enrolled in the follow-up PROMISE Saving Brains (SB) study (2013-2015). Caretaker interviews captured sociodemographic characteristics and social emotional development using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Overall cognition and working memory were assessed using the Kaufman Assessment Battery for Children, second edition (KABC2), cognitive flexibility was measured with the Child Category Test (CCT), and attention with the Test of Variables of Attention (T.O.V.A), while school performance was measured by a standardized test on arithmetic and reading. Country-pooled, age adjusted z-scores from each of the above outcomes were entered into a linear regression model controlling for confounders. The number of children re-enrolled in the intervention and control arms were: 274/396 (69.2%) and 256/369 (69.4%) in Uganda and 265/392 (67.6%) and 288/402 (71.6%) in Burkina Faso. Assessment of cognitive ability showed small and no significant differences, of which general cognition (z-scores, 95% CI) showed the largest mean difference: -0.17 (-0.40; 0.05). Social emotional symptoms were similar across arms. There were no differences in school performance or linear growth for age detected. Peer promotion for exclusive breastfeeding in Burkina Faso and Uganda was not associated with differences at 5-8 years of age in a range of measures of child development: cognitive abilities, emotion-behaviour-social symptoms or linear growth. This study from sub Saharan Africa did not reconfirm findings elsewhere that have shown an association between exclusive breastfeeding and

  14. Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

    PubMed

    Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

    2017-11-01

    To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (P<.001). Early diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

  15. Induction chemotherapy followed by alternating chemo-radiotherapy in non-endemic undifferentiated carcinoma of the nasopharynx: optimal compliance and promising 4-year results.

    PubMed

    Ponzanelli, Anna; Vigo, Viviana; Marcenaro, Michela; Bacigalupo, Almalina; Gatteschi, Beatrice; Ravetti, Jean-Luis; Corvò, Renzo; Benasso, Marco

    2008-08-01

    Concomitant chemo-radiotherapy is the standard treatment for advanced nasopharyngeal carcinoma (NPC). Induction chemotherapy may improve the results further by enhancing both loco-regional and distant control. Fifty patients with untreated, stage IV (UICC 1992) undifferentiated NPC were initially treated with three courses of epidoxorubicin, 90 mg/m(2), day 1 and cisplatin, 40 mg/m(2), days 1 and 2, every three weeks and then underwent three courses of cisplatin, 20 mg/m(2)/day, days 1-4 and fluorouracil, 200mg/m(2)/day, days 1-4 (weeks 1, 4, 7), alternated to three splits of radiation (week 2-3, 5-6, 8-9-10) up to 70 Gy. All patients but one received 3 cycles of induction chemotherapy. Toxicities from induction chemotherapy were grade III or IV mucositis (2%), grade III or IV nausea/vomiting (22%), grade III or IV hematological toxicity (6%). At the end of induction phase 12% of CRs, 84% of PRs were recorded. Toxicities from alternating chemo-radiotherapy were grade III or IV mucositis (30%), grade III or IV nausea/vomiting (8%), grade III or IV hematological toxicity (24%). Overall, 86% of CRs and 14% of PRs were observed. Four-year progression free survival and overall survival rates are 71% and 81%, respectively. In a small number of patients studied, no correlation between the level of EGFR overexpression and outcomes was detected. In locally advanced UNPC our combined program including induction chemotherapy followed by alternating chemo-radiotherapy is active and gives promising long-term outcomes with acceptable toxicity and optimal patients' compliance. This program merits to be tested in a phase III trial.

  16. Early Science Instruction and Academic Language Development Can Go Hand in Hand. The Promising Effects of a Low-Intensity Teacher-Focused Intervention

    ERIC Educational Resources Information Center

    Henrichs, Lotte F.; Leseman, Paul P. M.

    2014-01-01

    Early science instruction is important in order to lay a firm basis for learning scientific concepts and scientific thinking. In addition, young children enjoy science. However, science plays only a minor role in the kindergarten curriculum. It has been reported that teachers feel they need to prioritize language and literacy practices over…

  17. A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators.

    PubMed

    Angus, D C; Barnato, A E; Bell, D; Bellomo, R; Chong, C-R; Coats, T J; Davies, A; Delaney, A; Harrison, D A; Holdgate, A; Howe, B; Huang, D T; Iwashyna, T; Kellum, J A; Peake, S L; Pike, F; Reade, M C; Rowan, K M; Singer, M; Webb, S A R; Weissfeld, L A; Yealy, D M; Young, J D

    2015-09-01

    To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock. Using a search strategy of PubMed, EmBase and CENTRAL, we selected all relevant randomised clinical trials published from January 2000 to January 2015. We translated non-English papers and contacted authors as necessary. Our primary analysis generated a pooled odds ratio (OR) from a fixed-effect model. Sensitivity analyses explored the effect of including non-ED studies, adjusting for study quality, and conducting a random-effects model. Secondary outcomes included organ support and hospital and ICU length of stay. From 2395 initially eligible abstracts, five randomised clinical trials (n = 4735 patients) met all criteria and generally scored high for quality except for lack of blinding. There was no effect on the primary mortality outcome (EGDT: 23.2% [495/2134] versus control: 22.4% [582/2601]; pooled OR 1.01 [95% CI 0.88-1.16], P = 0.9, with heterogeneity [I(2) = 57%; P = 0.055]). The pooled estimate of 90-day mortality from the three recent multicentre studies (n = 4063) also showed no difference [pooled OR 0.99 (95% CI 0.86-1.15), P = 0.93] with no heterogeneity (I(2) = 0.0%; P = 0.97). EGDT increased vasopressor use (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and ICU admission [OR 2.19 (95% CI 1.82-2.65); P < 0.001]. Including six non-ED randomised trials increased heterogeneity (I(2) = 71%; P < 0.001) but did not change overall results [pooled OR 0.94 (95% CI 0.82 to 1.07); P = 0.33]. EGDT is not superior to usual care for ED patients with septic shock but is associated with increased utilisation of ICU resources.

  18. Early Results of Chimney Technique for Type B Aortic Dissections Extending to the Aortic Arch

    SciTech Connect

    Huang, Chen; Tang, Hanfei; Qiao, Tong

    ObjectiveTo summarize our early experience gained from the chimney technique for type B aortic dissection (TBAD) extending to the aortic arch and to evaluate the aortic remodeling in the follow-up period.MethodsFrom September 2011 to July 2014, 27 consecutive TBAD patients without adequate proximal landing zones were retrograde analyzed. Chimney stent-grafts were deployed parallel to the main endografts to reserve flow to branch vessels while extending the landing zones. In the follow-up period, aortic remodeling was observed with computed tomography angiography.ResultsThe technical success rate was 100 %, and endografts were deployed in zone 0 (n = 3, 11.1 %), zone 1 (n = 18, 66.7 %), and zonemore » 2 (n = 6, 22.2 %). Immediately, proximal endoleaks were detected in 5 patients (18.5 %). During a mean follow-up period of 17.6 months, computed tomography angiography showed all the aortic stent-grafts and chimney grafts to be patent. Favorable remodeling was observed at the level of maximum descending aorta and left subclavian artery with expansion of true lumen (from 18.4 ± 4.8 to 25 ± 0.86 mm, p < 0.001 and 27.1 ± 0.62 to 28.5 ± 0.37 mm, p < 0.001) and depressurization of false lumen (from 23.7 ± 2.7 to 8.7 ± 3.8 mm, p < 0.001, from 5.3 ± 1.2 to 2.1 ± 2.1 mm, p < 0.001). While at the level of maximum abdominal aorta, suboptimal remodeling of the total aorta (from 24.1 ± 0.4 to 23.6 ± 1.5 mm, p = 0.06) and true lumen (from 13.8 ± 0.6 to 14.5 ± 0.4 mm, p = 0.08) was observed.ConclusionBased on our limited experience, the chimney technique with thoracic endovascular repair is demonstrated to be promising for TBAD extending to the arch with favorable aortic remodeling.« less

  19. Early Science Instruction and Academic Language Development Can Go Hand in Hand. The Promising Effects of a Low-Intensity Teacher-Focused Intervention

    NASA Astrophysics Data System (ADS)

    Henrichs, Lotte F.; Leseman, Paul P. M.

    2014-11-01

    Early science instruction is important in order to lay a firm basis for learning scientific concepts and scientific thinking. In addition, young children enjoy science. However, science plays only a minor role in the kindergarten curriculum. It has been reported that teachers feel they need to prioritize language and literacy practices over science. In this paper, we investigate whether science lessons might be integrated with learning the language functional for school: academic language. The occurrence of scientific reasoning and sophisticated vocabulary in brief science lessons with 5-year-olds is evaluated. The aim of the study was twofold: first, to explore the nature of kindergarten science discourse without any researcher directions (pre-intervention observation). Second, in a randomized control trial, we evaluated the effect on science discourse of a brief teacher training session focused on academic language awareness. The science lessons focussed on air pressure and mirror reflection. Analyses showed that teachers from the intervention group increased their use of scientific reasoning and of domain-specific academic words in their science discourse, compared to the control group. For the use of general academic words and for lexical diversity, the effect was task-specific: these dependent measures only increased during the air pressure task. Implications of the study include the need to increase teachers' awareness of possibilities to combine early science instruction and academic language learning.

  20. Promises, promises for neuroscience and law.

    PubMed

    Buckholtz, Joshua W; Faigman, David L

    2014-09-22

    Stunning technical advances in the ability to image the human brain have provoked excited speculation about the application of neuroscience to other fields. The 'promise' of neuroscience for law has been touted with particular enthusiasm. Here, we contend that this promise elides fundamental conceptual issues that limit the usefulness of neuroscience for law. Recommendations for overcoming these challenges are offered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Final visual acuity results in the early treatment for retinopathy of prematurity study.

    PubMed

    Good, William V; Hardy, Robert J; Dobson, Velma; Palmer, Earl A; Phelps, Dale L; Tung, Betty; Redford, Maryann

    2010-06-01

    To compare visual acuity at 6 years of age in eyes that received early treatment for high-risk prethreshold retinopathy of prematurity (ROP) with conventionally managed eyes. Infants with symmetrical, high-risk prethreshold ROP (n = 317) had one eye randomized to earlier treatment at high-risk prethreshold disease and the other eye managed conventionally, treated if ROP progressed to threshold severity. For asymmetric cases (n = 84), the high-risk prethreshold eye was randomized to either early treatment or conventional management. The main outcome measure was ETDRS visual acuity measured at 6 years of age by masked testers. Retinal structure was assessed as a secondary outcome. Analysis of all subjects with high-risk prethreshold ROP showed no statistically significant benefit for early treatment (24.3% vs 28.6% [corrected] unfavorable outcome; P = .15). Analysis of 6-year visual acuity results according to the Type 1 and 2 clinical algorithm showed a benefit for Type 1 eyes (25.1% vs 32.8%; P = .02) treated early but not Type 2 eyes (23.6% vs 19.4%; P = .37). Early-treated eyes showed a significantly better structural outcome compared with conventionally managed eyes (8.9% vs 15.2% unfavorable outcome; P < .001), with no greater risk of ocular complications. Early treatment for Type 1 high-risk prethreshold eyes improved visual acuity outcomes at 6 years of age. Early treatment for Type 2 high-risk prethreshold eyes did not. Application to Clinical Practice Type 1 eyes, not Type 2 eyes, should be treated early. These results are particularly important considering that 52% of Type 2 high-risk prethreshold eyes underwent regression of ROP without requiring treatment. Trial Registration clinicaltrials.gov Identifier: NCT00027222.

  2. Early life exposure to PCB126 results in delayed mortality and growth impairment in the zebrafish larvae.

    PubMed

    Di Paolo, Carolina; Groh, Ksenia J; Zennegg, Markus; Vermeirssen, Etiënne L M; Murk, Albertinka J; Eggen, Rik I L; Hollert, Henner; Werner, Inge; Schirmer, Kristin

    2015-12-01

    The occurrence of chronic or delayed toxicity resulting from the exposure to sublethal chemical concentrations is an increasing concern in environmental risk assessment. The Fish Embryo Toxicity (FET) test with zebrafish provides a reliable prediction of acute toxicity in adult fish, but it cannot yet be applied to predict the occurrence of chronic or delayed toxicity. Identification of sublethal FET endpoints that can assist in predicting the occurrence of chronic or delayed toxicity would be advantageous. The present study characterized the occurrence of delayed toxicity in zebrafish larvae following early exposure to PCB126, previously described to cause delayed effects in the common sole. The first aim was to investigate the occurrence and temporal profiles of delayed toxicity during zebrafish larval development and compare them to those previously described for sole to evaluate the suitability of zebrafish as a model fish species for delayed toxicity assessment. The second aim was to examine the correlation between the sublethal endpoints assessed during embryonal and early larval development and the delayed effects observed during later larval development. After exposure to PCB126 (3-3000ng/L) until 5 days post fertilization (dpf), larvae were reared in clean water until 14 or 28 dpf. Mortality and sublethal morphological and behavioural endpoints were recorded daily, and growth was assessed at 28 dpf. Early life exposure to PCB126 caused delayed mortality (300 ng/L and 3000 ng/L) as well as growth impairment and delayed development (100 ng/L) during the clean water period. Effects on swim bladder inflation and cartilaginous tissues within 5 dpf were the most promising for predicting delayed mortality and sublethal effects, such as decreased standard length, delayed metamorphosis, reduced inflation of swim bladder and column malformations. The EC50 value for swim bladder inflation at 5 dpf (169 ng/L) was similar to the LC50 value at 8 dpf (188 and 202 ng/L in

  3. The promise and problems of non-physician practitioners in general surgery education: Results of a multi-center, mixed-methods study of faculty.

    PubMed

    Coverdill, James E; Shelton, Jeff Scott; Alseidi, Adnan; Borgstrom, David C; Dent, Daniel L; Dumire, Russell; Fryer, Jonathan; Hartranft, Thomas H; Holsten, Steven B; Nelson, M Timothy; Shabahang, Mohsen M; Sherman, Stanley R; Termuhlen, Paula M; Woods, Randy J; Mellinger, John D

    2018-02-01

    Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns. NPPs reduce faculty and resident workloads and teach residents. NPPs also reduce resident exposure to educationally valuable activities, and faculty sometimes round, make decisions, and operate with NPPs instead of residents. Interviews indicate that NPPs can overly reduce resident involvement in patient care, diminish resident responsibility and decision making, disrupt team dynamics, and compete for procedures. NPPs both enhance and hinder surgical education and highlight the need to more clearly articulate learning outcomes for residents and activities necessary to achieve those outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Early loosening of a press-fit cup with ceramic-on-ceramic articulation: our early results.

    PubMed

    Haverkamp, Daniël; Westerbos, Stijn; Campo, Martin M; Boonstra, Ritsert H; Rob Albers, G H; van der Vis, Harm M

    2013-12-01

    In this study, we present the short-term results of the Selexys TH+ cup with the Ceramys inlay which is a press-fit cup with a ceramic-on-ceramic articulation. (Mathys, Bettlach, Switzerland). We compared the results with a retrospective-matched control group with a Delta PF cup (Lima, Udine, Italy), which is also a press-fit cup with a ceramic-on-ceramic articulation. 257 elective hip arthroplasties with the Selexys TH+ cup in 250 patients placed in 2009 and 2010 were analyzed and compared with a control group retrospective analysis of the uncemented Delta PF cup (Lima, Udine, Italy) placed in 2007 and 2008 in 208 patients (222 hips). Surgical technique and surgeons were identical in both groups. During a follow-up period of 3-21 months, 19 aseptic loosenings (7.4 %) were found for the Selexys TH+ cup. The survival plotted by a Kaplan-Meier curve shows a 1-year survival of 87.4 %. The Lima Delta PF cup showed a 1-year survival of 99.5 %. Failure analysis showed no clear explanation for this early loosening. The Selexys TH+ cup combined with the Ceramys ceramic-on-ceramic inlay coupling show an unacceptable high early revision rate. Therefore, we advice against using this combination.

  5. Early Blindness Results in Developmental Plasticity for Auditory Motion Processing within Auditory and Occipital Cortex

    PubMed Central

    Jiang, Fang; Stecker, G. Christopher; Boynton, Geoffrey M.; Fine, Ione

    2016-01-01

    Early blind subjects exhibit superior abilities for processing auditory motion, which are accompanied by enhanced BOLD responses to auditory motion within hMT+ and reduced responses within right planum temporale (rPT). Here, by comparing BOLD responses to auditory motion in hMT+ and rPT within sighted controls, early blind, late blind, and sight-recovery individuals, we were able to separately examine the effects of developmental and adult visual deprivation on cortical plasticity within these two areas. We find that both the enhanced auditory motion responses in hMT+ and the reduced functionality in rPT are driven by the absence of visual experience early in life; neither loss nor recovery of vision later in life had a discernable influence on plasticity within these areas. Cortical plasticity as a result of blindness has generally be presumed to be mediated by competition across modalities within a given cortical region. The reduced functionality within rPT as a result of early visual loss implicates an additional mechanism for cross modal plasticity as a result of early blindness—competition across different cortical areas for functional role. PMID:27458357

  6. Results of paleomagnetic study of Early Proterozoic rocks in the Baikal Range of the Siberian craton

    NASA Astrophysics Data System (ADS)

    Vodovozov, V. Yu.; Didenko, A. N.; Gladkochub, D. P.; Mazukabzov, A. M.; Donskaya, T. V.

    2007-10-01

    This paper presents paleomagnetic results obtained from the study of Early Proterozoic rocks in the Baikal Range of the Siberian craton, namely, the 1850 1880-Ma volcanicalstic rocks of the Akitkanskian series of the North Baikal volcanic-plutonic belt) and 1674-Ma basic dikes of the Chaya complex within the massif. The data of this work are used to reconstruct the development of the Siberian craton structure in the Early Precambrian. The projections of the inferred paleomagnetic directions onto a sphere form S (southern) and W (western) groups of vectors of characteristic magnetization components. The S group consists of three clusters representing primary magnetization components belonging to different time levels of the end of the Early Proterozoic. The W group is represented by directions associated with a metachronous magnetization probably acquired during the Riphean. Four paleomagnetic poles are obtained. Two of them that can be regarded as key poles correspond to time levels of 1875 and 1670 Ma (the Early Proterozoic). The two other poles can be used for a detailed reconstruction of the Proterozoic segment of the Siberian apparent polar wander path. The data presented in the paper indicate that the formation of the southern Siberian craton structure was accomplished at the end of the Early Proterozoic, which resulted in a synchronous motion of different blocks composing the southern flank of the craton (in particular, the Sharyzhalgai and Baikal Ranges).

  7. Developing Mathematically Promising Students.

    ERIC Educational Resources Information Center

    Sheffield, Linda Jensen, Ed.

    This book, written on the recommendation of the Task Force on Mathematically Promising Students, investigates issues involving the development of promising mathematics students. Recommendations are made concerning topics such as the definition of promising students; the identification of such students; appropriate curriculum, instruction, and…

  8. Early results from Magsat. [studies of near-earth magnetic fields

    NASA Technical Reports Server (NTRS)

    Langel, R. A.; Estes, R. H.; Mayhew, M. A.

    1981-01-01

    Papers presented at the May 27, 1981 meeting of the American Geophysical Union concerning early results from the Magsat satellite program, which was designed to study the near-earth magnetic fields originating in the core and lithosphere, are discussed. The satellite was launched on October 30, 1979 into a sun-synchronous (twilight) orbit, and re-entered the atmosphere on June 11, 1980. Instruments carried included a cesium vapor magnetometer to measure field magnitudes, a fluxgate magnetometer to measure field components and an optical system to measure fluxgate magnetometer orientation. Early results concerned spherical harmonic models, fields due to ionospheric and magnetospheric currents, the identification and interpretation of fields from lithospheric sources. The preliminary results confirm the possibility of separating the measured field into core, crustal and external components, and represent significant developments in analytical techniques in main-field modelling and the physics of the field sources.

  9. POSNA Quality Safety Value Initiative: From Vision to Implementation to Early Results.

    PubMed

    Waters, Peter M; Flynn, John M

    2015-01-01

    The POSNA Quality, Safety and Value Initiative (QSVI) formally started with POSNA board approval in early 2011. The initial vision statement was: "To lead in defining our members' value based clinical care. To partner with hospital based and orthopedic organizational efforts to guarantee safe, high quality outcomes for our patients. To communicate our initiatives and results cooperatively with payer, credentialing, and compliance organizations to improve pediatric orthopedic care in North America."

  10. Results from conceptual design study of potential early commercial MHD/steam power plants

    NASA Technical Reports Server (NTRS)

    Hals, F.; Kessler, R.; Swallom, D.; Westra, L.; Zar, J.; Morgan, W.; Bozzuto, C.

    1981-01-01

    This paper presents conceptual design information for a potential early MHD power plant developed in the second phase of a joint study of such plants. Conceptual designs of plant components and equipment with performance, operational characteristics and costs are reported on. Plant economics and overall performance including full and part load operation are reviewed. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen oxides are reviewed. Results from reliability/availability analysis conducted are also included.

  11. The impact of osteoarthritis on early exit from work: results from a population-based study.

    PubMed

    Laires, Pedro A; Canhão, Helena; Rodrigues, Ana M; Eusébio, Mónica; Gouveia, Miguel; Branco, Jaime C

    2018-04-11

    Osteoarthritis (OA) is a leading cause of pain and disability, which may be a source of productivity losses. The objectives of this study were to describe the impact of OA, namely through pain and physical disability, on early exit from work and to calculate its economic burden. We analysed data from the national, cross-sectional, population-based EpiReumaPt study (Sep2011-Dec2013) in which 10,661 individuals were randomly surveyed in order to capture all cases of rheumatic diseases. We used all participants aged 50-64, near the official retirement age, who were clinically validated by experienced rheumatologists (n = 1286), including OA cases. A national database was used to calculate productivity values by gender, age and region, using the human capital approach. The impact of OA on the likelihood of early exit from work and the population attributable fractions used to calculate due economic burden (indirect costs) were obtained at the individual level by logistic regression. All results were based on weighted data. Almost one third of the Portuguese population aged 50-64 had OA (29.7%; men: 16.2% and women: 43.5%) and more than half were out of paid work (51.8%). Only knee OA is associated with early exit from work (OR: 2.25; 95%CI: 1.42-3.59; p = 0.001), whereas other OA locations did not reach any statistical difference. Furthermore, we observed an association between self-reported longstanding musculoskeletal pain (OR: 1.55; 95%CI: 1.07-2.23; p = 0.02) and pain interference (OR: 1.35; 95%CI: 1.13-1.62; p = 0.001) with early exit from work. We also detected a clear relationship between levels of disability, measured by the Health Assessment Questionnaire (HAQ), and the probability of work withdrawal. The estimated annual cost of early exit from work attributable to OA was €656 million (€384 per capita; €1294 per OA patient and €2095 per OA patient out-of-work). In this study, we observed an association between OA and early exit from

  12. Artificial Intelligence Applications for Education: Promise, ...Promises.

    ERIC Educational Resources Information Center

    Adams, Dennis M.; Hamm, Mary

    1988-01-01

    Surveys the current status of artificial intelligence (AI) technology. Discusses intelligent tutoring systems, robotics, and applications for educators. Likens the status of AI at present to that of aviation in the very early 1900s. States that educators need to be involved in future debates concerning AI. (CW)

  13. The Kalamazoo Promise Scholarship

    ERIC Educational Resources Information Center

    Bartik, Timothy J.; Lachowska, Marta

    2014-01-01

    This study takes advantage of the unexpected announcement of the Kalamazoo Promise to study its effects on student achievement and behavior in high school. The Kalamazoo Promise provides college scholarships to graduates of Kalamazoo Public Schools (KPS), a midsized urban school district in Michigan that is racially and economically diverse.…

  14. Keeping the Promise

    ERIC Educational Resources Information Center

    Whissemore, Tabitha

    2016-01-01

    Since its launch in September 2015, Heads Up America has collected information on nearly 125 promise programs across the country, many of which were instituted long before President Barack Obama announced the America's College Promise (ACP) plan in 2015. At least 27 new free community college programs have launched in states, communities, and at…

  15. Early Results from the NASA Orbiting Carbon Observatory-2 (OCO-2)

    NASA Astrophysics Data System (ADS)

    Crisp, David; Eldering, Annmarie

    2015-04-01

    The Orbiting Carbon Observatory-2 (OCO-2) is NASA's first satellite designed to collect the measurements needed to estimate the column-averaged carbon dioxide (CO2) dry air mole fraction, XCO2, with the sensitivity, accuracy, and resolution needed to characterize the CO2 sources and sinks on regional scales over the globe. OCO-2 was successfully launched from Vandenberg Air Force Base in California on July 2, 2014 and joined the 705-km Afternoon Constellation (A-Train) on August 3, 2014. The three-channel imaging grating spectrometer was then cooled to its operating temperatures and a comprehensive series of characterization and calibration activities were initiated. Since early October 2014, the observatory has been routinely collecting almost 1 million soundings over the sunlit hemisphere each day. Early cloud screening results indicate that 15-30% of these measurements may be sufficiently cloud free to yield precise estimates of XCO2. Initial deliveries of calibrated, geo-located OCO-2 spectra to the NASA Goddard Earth Science Data and Information Services Center (GES DISC) began on December 30, 2014. Preliminary estimates of XCO2 retrieved from these data are currently being validated against observations from the Total Carbon Column Observing Network (TCCON) and other standards. Routine deliveries XCO2 and other products, including surface pressure and chlorophyll fluorescence, to the GES DISC are expected to begin before the end of March, 2015. This presentation will summarize the status of the OCO-2 mission and the coverage, resolution, and accuracy of its early results.

  16. Simultaneous Multislice Echo Planar Imaging With Blipped Controlled Aliasing in Parallel Imaging Results in Higher Acceleration: A Promising Technique for Accelerated Diffusion Tensor Imaging of Skeletal Muscle.

    PubMed

    Filli, Lukas; Piccirelli, Marco; Kenkel, David; Guggenberger, Roman; Andreisek, Gustav; Beck, Thomas; Runge, Val M; Boss, Andreas

    2015-07-01

    The aim of this study was to investigate the feasibility of accelerated diffusion tensor imaging (DTI) of skeletal muscle using echo planar imaging (EPI) applying simultaneous multislice excitation with a blipped controlled aliasing in parallel imaging results in higher acceleration unaliasing technique. After federal ethics board approval, the lower leg muscles of 8 healthy volunteers (mean [SD] age, 29.4 [2.9] years) were examined in a clinical 3-T magnetic resonance scanner using a 15-channel knee coil. The EPI was performed at a b value of 500 s/mm2 without slice acceleration (conventional DTI) as well as with 2-fold and 3-fold acceleration. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in all 3 acquisitions. Fiber tracking performance was compared between the acquisitions regarding the number of tracks, average track length, and anatomical precision using multivariate analysis of variance and Mann-Whitney U tests. Acquisition time was 7:24 minutes for conventional DTI, 3:53 minutes for 2-fold acceleration, and 2:38 minutes for 3-fold acceleration. Overall FA and MD values ranged from 0.220 to 0.378 and 1.595 to 1.829 mm2/s, respectively. Two-fold acceleration yielded similar FA and MD values (P ≥ 0.901) and similar fiber tracking performance compared with conventional DTI. Three-fold acceleration resulted in comparable MD (P = 0.199) but higher FA values (P = 0.006) and significantly impaired fiber tracking in the soleus and tibialis anterior muscles (number of tracks, P < 0.001; anatomical precision, P ≤ 0.005). Simultaneous multislice EPI with blipped controlled aliasing in parallel imaging results in higher acceleration can remarkably reduce acquisition time in DTI of skeletal muscle with similar image quality and quantification accuracy of diffusion parameters. This may increase the clinical applicability of muscle anisotropy measurements.

  17. Novel flow cytometric method for the detection of podocalyxin-positive elements in urine of patients with glomerulonephritides - first promising results.

    PubMed

    Habara, P; Marečková, H; Malíčková, K; Potyšová, Z; Hrušková, Z; Zima, T; Tesař, V

    2012-01-01

    Glomerulonephritides together create a heterogenic group of supposedly immunologically mediated diseases of glomeruli. They still belong among the most frequent causes of chronic renal failure. Detection of podocytes in urine might serve as an important marker of glomerulonephritides activity. The aim of this study was to develop a novel flow cytometric method for the detection of podocyte fragments and podocytes in urine and assess its possible use in clinical practice. We placed emphasis on the improvement of pre-analytic phase. To suppress the autofluorescence of the background, blocking solutions and magnetic separation were used. An additional surface marker CD10 (nephrilysin) was used together with routinely used podocalyxin (PCX) in order to achieve better identification of podocytes. Based on the surface marker expression, three different element types were identified in the urine samples: PCX+/CD10+ elements (EL) (supposedly podocytes), PCX-/CD10+ EL (supposedly parietal epithelial cells) and PCX+ EL. We examined a total of 36 patients who underwent renal biopsy (non-glomerular nephropathy, MGN, FSGS, IgAN, AAV and MPGN) and 27 healthy controls. Negative results were found in non-glomerular nephropathy and in MGN. In patients with FSGS and IgAN, the levels of urine elements were slightly increased. The highest levels of all elements were found in AAV and MPGN. Our first results suggest that flow cytometric detection may distinguish between glomerular and nonglomerular diseases and that the levels of urine elements might correlate with the degree of glomerular destruction.

  18. Complete major amputation of the upper extremity: Early results and initial treatment algorithm.

    PubMed

    Märdian, Sven; Krapohl, Björn D; Roffeis, Jana; Disch, Alexander C; Schaser, Klaus-Dieter; Schwabe, Philipp

    2015-03-01

    Traumatic major amputations of the upper extremity are devastating injuries. These injuries have a profound impact on patient's quality of life and pose a burden on social economy. The aims of the current study were to report about the initial management of isolated traumatic major upper limb amputation from the time of admission to definitive soft tissue closure and to establish a distinct initial management algorithm. We recorded data concerning the initial management of the patient and the amputated body part in the emergency department (ED) (time from admission to the operation, Injury Severity Score [ISS], cold ischemia time from injury to ED, and total cold ischemia time). The duration, amount of surgical procedures, the time to definitive soft tissue coverage, and the choice of flap were part of the documentation. All intraoperative and postoperative complications were recorded. All patients were successfully replanted (time from injury to ED, 59 ± 4 minutes; ISS16; time from admission to operating room 57 ± 10 minutes; total cold ischemia time 203 ± 20 minutes; total number of procedures 7.3 ± 2.5); definitive soft tissue coverage could be achieved 23 ± 14 days after injury. Two thromboembolic complications occurred, which could be treated by embolectomy during revision surgery, and we saw one early infection, which could be successfully managed by serial debridements in our series. The management of complete major amputations of the upper extremity should be reserved for large trauma centers with enough resources concerning technical, structural, and personnel infrastructure to meet the demands of surgical reconstruction as well as the postoperative care. Following a distinct treatment algorithm is mandatory to increase the rate of successful major replantations, thus laying the foundation for promising secondary functional reconstructive efforts. Therapeutic study, level V.

  19. Study design and early result of a phase I study of SABR for early-stage glottic cancer.

    PubMed

    Yu, Tosol; Wee, Chan Woo; Choi, Noorie; Wu, Hong-Gyun; Kang, Hyun-Cheol; Park, Jong Min; Kim, Jung-In; Kim, Jin Ho; Kwon, Tack-Kyun; Chung, Eun-Jae

    2018-05-14

    Avoidance of organs at risk has become possible with advances in image-guided volumetric-modulated arc therapy (VMAT) techniques. This study was designed to evaluate the safety and feasibility of stereotactic ablative radiotherapy (SABR) for early stage glottic cancer. This report presents the preliminary result of the first and second dose level. Fraction size was increased from 3.5 gray (Gy) (total dose 59.5 Gy) to 9 Gy (total dose 45 Gy). Dose-limiting toxicities were defined as grade 3 or higher treatment-related toxicities. Voice outcome was assessed with electroglottography, and quality of life (QoL) was measured with the Head and Neck Cancer Inventory (HNCI). Seven patients received 59.5 Gy at 3.5 Gy per fraction as the first dose level, and five patients received 55 Gy at 5 Gy per fraction as the second dose level. None of the patients developed grade 3+ toxicity throughout a median follow-up of 17.5 months (range, 1.7-30.6 months). One patient in the second dose level recurred in the primary site at 4 months after radiotherapy (RT) and received total laryngectomy. The rest of participants were disease-free at locoregional and distant sites. Jitter, shimmer, mean phonation time, and noise-to-harmony ratio did not change significantly at 6 months after RT. HNCI scores between pretreatment and posttreatment were not significantly different (P = 0.221). This study revealed acceptable toxicity, voice outcome, and QoL in patients treated with hypofractionated VMAT of 3.5 Gy and 5 Gy per fraction. This phase I study is currently ongoing with a dose of 55 Gy in 11 fractions and 45 Gy in five fractions. 2b. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Rapamycin and Chloroquine: The In Vitro and In Vivo Effects of Autophagy-Modifying Drugs Show Promising Results in Valosin Containing Protein Multisystem Proteinopathy

    PubMed Central

    Nalbandian, Angèle; Llewellyn, Katrina J.; Nguyen, Christopher; Yazdi, Puya G.; Kimonis, Virginia E.

    2015-01-01

    Mutations in the valosin containing protein (VCP) gene cause hereditary Inclusion body myopathy (hIBM) associated with Paget disease of bone (PDB), frontotemporal dementia (FTD), more recently termed multisystem proteinopathy (MSP). Affected individuals exhibit scapular winging and die from progressive muscle weakness, and cardiac and respiratory failure, typically in their 40s to 50s. Histologically, patients show the presence of rimmed vacuoles and TAR DNA-binding protein 43 (TDP-43)-positive large ubiquitinated inclusion bodies in the muscles. We have generated a VCPR155H/+ mouse model which recapitulates the disease phenotype and impaired autophagy typically observed in patients with VCP disease. Autophagy-modifying agents, such as rapamycin and chloroquine, at pharmacological doses have previously shown to alter the autophagic flux. Herein, we report results of administration of rapamycin, a specific inhibitor of the mechanistic target of rapamycin (mTOR) signaling pathway, and chloroquine, a lysosomal inhibitor which reverses autophagy by accumulating in lysosomes, responsible for blocking autophagy in 20-month old VCPR155H/+ mice. Rapamycin-treated mice demonstrated significant improvement in muscle performance, quadriceps histological analysis, and rescue of ubiquitin, and TDP-43 pathology and defective autophagy as indicated by decreased protein expression levels of LC3-I/II, p62/SQSTM1, optineurin and inhibiting the mTORC1 substrates. Conversely, chloroquine-treated VCPR155H/+ mice revealed progressive muscle weakness, cytoplasmic accumulation of TDP-43, ubiquitin-positive inclusion bodies and increased LC3-I/II, p62/SQSTM1, and optineurin expression levels. Our in vitro patient myoblasts studies treated with rapamycin demonstrated an overall improvement in the autophagy markers. Targeting the mTOR pathway ameliorates an increasing list of disorders, and these findings suggest that VCP disease and related neurodegenerative multisystem proteinopathies can

  1. Reducing Human-Tsetse Contact Significantly Enhances the Efficacy of Sleeping Sickness Active Screening Campaigns: A Promising Result in the Context of Elimination.

    PubMed

    Courtin, Fabrice; Camara, Mamadou; Rayaisse, Jean-Baptiste; Kagbadouno, Moise; Dama, Emilie; Camara, Oumou; Traoré, Ibrahima S; Rouamba, Jérémi; Peylhard, Moana; Somda, Martin B; Leno, Mamadou; Lehane, Mike J; Torr, Steve J; Solano, Philippe; Jamonneau, Vincent; Bucheton, Bruno

    2015-01-01

    Control of gambiense sleeping sickness, a neglected tropical disease targeted for elimination by 2020, relies mainly on mass screening of populations at risk and treatment of cases. This strategy is however challenged by the existence of undetected reservoirs of parasites that contribute to the maintenance of transmission. In this study, performed in the Boffa disease focus of Guinea, we evaluated the value of adding vector control to medical surveys and measured its impact on disease burden. The focus was divided into two parts (screen and treat in the western part; screen and treat plus vector control in the eastern part) separated by the Rio Pongo river. Population census and baseline entomological data were collected from the entire focus at the beginning of the study and insecticide impregnated targets were deployed on the eastern bank only. Medical surveys were performed in both areas in 2012 and 2013. In the vector control area, there was an 80% decrease in tsetse density, resulting in a significant decrease of human tsetse contacts, and a decrease of disease prevalence (from 0.3% to 0.1%; p=0.01), and an almost nil incidence of new infections (<0.1%). In contrast, incidence was 10 times higher in the area without vector control (>1%, p<0.0001) with a disease prevalence increasing slightly (from 0.5 to 0.7%, p=0.34). Combining medical and vector control was decisive in reducing T. b. gambiense transmission and in speeding up progress towards elimination. Similar strategies could be applied in other foci.

  2. Early Flood Warning in Africa: Results of a Feasibility study in the JUBA, SHABELLE and ZAMBEZI

    NASA Astrophysics Data System (ADS)

    Pappenberger, F. P.; de Roo, A. D.; Buizza, Roberto; Bodis, Katalin; Thiemig, Vera

    2009-04-01

    Building on the experiences gained with the European Flood Alert System (EFAS), pilot studies are carried out in three river basins in Africa. The European Flood Alert System, pre-operational since 2003, provides early flood alerts for European rivers. At present, the experiences with the European EFAS system are used to evaluate the feasibility of flood early warning for Africa. Three case studies are carried in the Juba and Shabelle rivers (Somalia and Ethiopia), and in the Zambesi river (Southern Africa). Predictions in these data scarce regions are extremely difficult to make as records of observations are scarce and often unreliable. Meteorological and Discharge observations are used to calibrate and test the model, as well as soils, landuse and topographic data available within the JRC African Observatory. ECMWF ERA-40, ERA-Interim data and re-forecasts of flood events from January to March 1978, and in March 2001 are evaluated to examine the feasibility for early flood warning. First results will be presented.

  3. Grating visual acuity results in the early treatment for retinopathy of prematurity study.

    PubMed

    Dobson, Velma; Quinn, Graham E; Summers, C Gail; Hardy, Robert J; Tung, Betty; Good, William V

    2011-07-01

    To compare grating (resolution) visual acuity at 6 years of age in eyes that received early treatment (ET) for high-risk prethreshold retinopathy of prematurity (ROP) with that in eyes that underwent conventional management (CM). In a randomized clinical trial, infants with bilateral, high-risk prethreshold ROP (n = 317) had one eye undergo ET and the other eye undergo CM, with treatment only if ROP progressed to threshold severity. For asymmetric cases (n = 84), the high-risk prethreshold eye was randomized to ET or CM. Grating visual acuity measured at 6 years of age by masked testers using Teller acuity cards. Monocular grating acuity results were obtained from 317 of 370 surviving children (85.6%). Analysis of grating acuity results for all study participants with high-risk prethreshold ROP showed no statistically significant overall benefit of ET (18.1% vs 22.8% unfavorable outcomes; P = .08). When the 6-year grating acuity results were analyzed according to a clinical algorithm (high-risk types 1 and 2 prethreshold ROP), a benefit was seen in type 1 eyes (16.4% vs 25.2%; P = .004) undergoing ET, but not in type 2 eyes (21.3% vs 15.9%; P = .29). Early treatment of eyes with type 1 ROP improves grating acuity outcomes, but ET for eyes with type 2 ROP does not. APPLICATION TO CLINICAL MEDICINE: Type 1 eyes should be treated early; however, based on acuity results at 6 years of age, type 2 eyes should be cautiously monitored for progression to type 1 ROP. Trial Registration clinicaltrials.gov Identifier: NCT00027222.

  4. Assessment of renal perfusion with contrast-enhanced ultrasound: Preliminary results in early diabetic nephropathies.

    PubMed

    Dong, Yi; Wang, Wen-Ping; Lin, Pan; Fan, Peili; Mao, Feng

    2016-01-01

    We performed a prospective study to evaluate the value of contrast-enhanced ultrasound (CEUS) in quantitative evaluation of renal cortex perfusion in patients suspected of early diabetic nephropathies (DN), with the estimated GFR (MDRD equation) as the gold standard. The study protocol was approved by the hospital review board; each patient gave written informed consent. Our study included 46 cases (21 males and 25 females, mean age 55.6 ± 4.14 years) of clinical confirmed early DN patients. After intravenous bolus injection of 1 ml sulfur hexafluoride microbubbles of ultrasound contrast agent, real time CEUS of renal cortex was performed successively using a 2-5 MHz convex probe. Time-intensity curves (TICs) and quantitative indexes were created with Qlab software. Receiver operating characteristic (ROC) curves were used to predict the diagnostic criteria of CEUS quantitative indexes, and their diagnostic efficiencies were compared with resistance index (RI) and peak systolic velocity (PSV) of renal segmental arteries by chi square test. Our control group included forty-five healthy volunteers. Difference was considered statistically significant with P <  0.05. Changes of area under curve (AUC), derived peak intensity (DPI) were statistically significant (P <  0.05). DPI less than 12 and AUC greater than 1400 had high utility in DN, with 71.7% and 67.3% sensitivity, 77.8% and 80.0% specificity. These results were significantly better than those obtained with RI and PSV which had no significant difference in early stage of DN (P > 0.05). CEUS might be helpful to improve early diagnosis of DN by quantitative analyses. AUC and DPI might be valuable quantitative indexes.

  5. The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.

    PubMed

    Benninger, Michael S; Derakhshan, Adeeb; Milstein, Claudio F

    2015-07-01

    Retrospective chart review. To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis. The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis. Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations. The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23). The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important. © The Author(s) 2015.

  6. Effective treatment of haemorrhoids: early complication and late results after 150 consecutive stapled haemorrhoidectomies.

    PubMed

    Bove, Aldo; Bongarzoni, Giuseppe; Palone, Gino; Chiarini, Stella; Calisesi, Enrico Maria; Corbellini, Luciano

    2009-01-01

    Haemorrhoidectomy according to Longo potentially reduces post-operative pain and allows an early return to work. The aim of this study was to evaluate the efficacy of the technique, the early and especially late complications, and recurrences, in 150 patients. Between January 2005 and December 2006, we performed 150 consecutive haemorrhoidectomies with the Longo technique: 82 for third degree haemorrhoids and 68 for fourth degree haemorrhoids. The mean age of patients was 42 years. Every patient had a pre-operative proctoscopy and endoscopy KIT PPH01 (Ethicon Endo Surgery) was used. We evaluated the length of the operation, the post-operative pain, the early and late complications, and the recurrence of the disease. The mean follow up was 52 months (range 36-72). There was no mortality. The mean length of the operation was 25 minutes with a range of 15 to 45 minutes. Pain, evaluated using the V.A.S. scale, was very light in 114 patients (V.A.S. 2,1) and light in 36 (V.A.S. 3.2). Only 11 (7.5%) patients took painkillers, on demand, for a week after discharge from hospital and 2 patients (1,3%) for more than one month. Early complications (6.6%) were: 5 bleeding (2 after seven days), 4 acute urinary retentions, 1 external haemorrhoid thrombosis and 1 haematoma of the rectus wall. Mean Hospital stay was 2.1 days. Late complications (10%) were: 5 "faecal urgency" which disappeared after six months, 6 moderate asymptomatic strictures, and 4 persistent skin tags. There were 8 recurrences (5.1%), 2 for haemorrhoids of grade 3 e 6 for haemorrhoids of grade 4. All the recurrences appeared within the first 24 months. The stapled procedure according to Longo is an effective treatment for haemorrhoids. The results for postoperative pain and early return to work are very good. However, special care for haemostasis is essential in order to avoid bleeding. An effective surgical technique prevents late complications, but results after long term follow up show a not insignificant

  7. The characteristic black hole mass resulting from direct collapse in the early Universe

    NASA Astrophysics Data System (ADS)

    Latif, M. A.; Schleicher, D. R. G.; Schmidt, W.; Niemeyer, J. C.

    2013-12-01

    Black holes of a billion solar masses are observed in the infant Universe a few hundred million years after the big bang. The direct collapse of protogalactic gas clouds in primordial haloes with Tvir ≥ 104 K provides the most promising way to assemble massive black holes. In this study, we aim to determine the characteristic mass scale of seed black holes and the time evolution of the accretion rates resulting from the direct collapse model. We explore the formation of supermassive black holes via cosmological large eddy simulations (LES) by employing sink particles and following their evolution for 20 000 yr after the formation of the first sink. As the resulting protostars were shown to have cool atmospheres in the presence of strong accretion, we assume here that UV feedback is negligible during this calculation. We confirm this result in a comparison run without sinks. Our findings show that black hole seeds with characteristic mass of 105 M⊙ are formed in the presence of strong Lyman-Werner flux which leads to an isothermal collapse. The characteristic mass is about two times higher in LES compared to the implicit large eddy simulations. The accretion rates increase with time and reach a maximum value of 10 M⊙ yr-1 after 104 yr. Our results show that the direct collapse model is clearly feasible as it provides the expected mass of the seed black holes.

  8. Targeted deletion of p97 (VCP/CDC48) in mouse results in early embryonic lethality.

    PubMed

    Müller, J M M; Deinhardt, K; Rosewell, I; Warren, G; Shima, D T

    2007-03-09

    The highly conserved AAA ATPase p97 (VCP/CDC48) has well-established roles in cell cycle progression, proteasome degradation and membrane dynamics. Gene disruption in Saccromyces cerevisiae, Drosophila melanogaster and Trypanosoma brucei demonstrated that p97 is essential in unicellular and multicellular organisms. To explore the requirement for p97 in mammalian cell function and embryogenesis, we disrupted the p97 locus by gene targeting. Heterozygous p97+/- mice were indistinguishable from their wild-type littermates, whereas homozygous mutants did not survive to birth and died at a peri-implantation stage. These results show that p97 is an essential gene for early mouse development.

  9. The Aeronomy of Ice in the Mesosphere Mission: Overview and Early Results

    NASA Astrophysics Data System (ADS)

    Russell, J. M.; Bailey, S. M.; Thomas, G.; Rusch, D.; Gordley, L. L.; Hervig, M.; Horanyi, M.; Randall, C.; McClintock, W.; Siskind, D. E.; Stevens, M.; Englert, C.; Taylor, M.; Summeers, M.; Merkel, A.

    2007-12-01

    The Aeronomy of Ice in the Mesosphere (AIM) mission was launched from Vandenberg Air Force Base in California at 1:26:03 PDT on April 25, 2007 becoming the first satellite mission dedicated to the study of noctilucent clouds. A Pegasus XL rocket launched the satellite into a near perfect 600 km sun synchronous circular orbit. AIM carries three instruments - a nadir imager, a solar occultation instrument and in-situ cosmic dust detectors - that were specifically selected because of their ability to provide key measurements needed to address the six AIM science objectives. Brief descriptions of the science, instruments and observation scenario will be presented along with early science results.

  10. Early cessation of pressure garment therapy results in scar contraction and thickening

    PubMed Central

    DeBruler, Danielle M.; Zbinden, Jacob C.; Baumann, Molly E.; Blackstone, Britani N.; Malara, Megan M.; Bailey, J. Kevin

    2018-01-01

    Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1–2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements. PMID:29897933

  11. Early cessation of pressure garment therapy results in scar contraction and thickening.

    PubMed

    DeBruler, Danielle M; Zbinden, Jacob C; Baumann, Molly E; Blackstone, Britani N; Malara, Megan M; Bailey, J Kevin; Supp, Dorothy M; Powell, Heather M

    2018-01-01

    Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1-2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements.

  12. Early results of patellofemoral inlay resurfacing arthroplasty using the HemiCap Wave prosthesis.

    PubMed

    Patel, Akash; Haider, Zakir; Anand, Amarjit; Spicer, Dominic

    2017-01-01

    Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre. From 2010 to 2013, 16 consecutive patients underwent patellofemoral resurfacing procedures using HemiCap Wave (Arthrosurface Inc., Franklin, Massachusetts, USA) for anterior knee pain with confirmed radiologically and/or arthroscopically isolated severe patellofemoral arthrosis. Standardized surgical technique, as recommended by the implant manufacturer, was followed. Outcome measures included range of movement, functional knee scores (Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Short Form-36 (SF-36)), radiographic disease progression, revision rates and complications. Eight men and eight women underwent patellofemoral HemiCap Wave resurfacing, with an average age of 63 years (range: 46-83). Average follow-up was 24.1 months (6-34). Overall, post-operative scores were excellent. There was a statistically significant improvement in the post-operative OKS, KOOS and SF-36 scores ( p < 0.01). One patient had radiological disease progression. One patient underwent revision for deep infection. Two other minor complications were observed and treated conservatively. The HemiCap Wave patellofemoral resurfacing prosthesis has excellent early results in terms of functional outcomes, radiological outcomes and low complication rates. At the very least, early results show that the HemiCap Wave is comparable to more established onlay prostheses. The HemiCap Wave thus provides a safe and effective surgical option in the treatment

  13. Surgical management of anomalous pulmonary venous connection to the superior vena cava - early results

    PubMed Central

    Chandra, Dinesh; Gupta, Anubhav; Nath, Ranjit K.; kazmi, Aamir; Grover, Vijay; Gupta, Vijay K.

    2013-01-01

    Background The anatomical variability in patients with anomalous pulmonary venous connection to superior vena cava presents a surgical challenge. The problem is further compounded by the common occurrence of postoperative complications like arrhythmias and obstruction of the superior vena cava or pulmonary veins. We present our experience of managing this subset using the two patch and Warden's techniques. Patients and methods Between June 2011 and September 2012, 7 patients with APVC to the SVC were operated in our institute. After delineating the anatomy, five of them had a two patch repair and two were managed with Warden's technique. Results There was no in-hospital mortality or early mortality over a mean follow-up of 9.66 ± 3.88 months (range 6–15 months). All the patients on follow-up had unobstructed pulmonary venous and SVC drainage on echocardiography and all of them were in normal sinus rhythm. Conclusions Anomalous pulmonary venous connection to superior vena cava is a challenging subset of patients in whom the surgical management needs to be individualized. The detailed anatomy must be delineated using echocardiography with or without CT angiography before deciding the surgical plan. This entity can be repaired with excellent immediate and early results. However, these patients must be closely followed up for complications like systemic and pulmonary venous obstruction and sinus node dysfunction. PMID:24206880

  14. Early results of an in vivo trial of ESS in thyroid cancer

    NASA Astrophysics Data System (ADS)

    Rosen, Jennifer E.; Goukassian, Ilona D.; A'Amar, Ousama M.; Bigio, Irving J.; Lee, Stephanie L.

    2012-02-01

    Introduction: Thyroid cancer is the most common endocrine malignancy. The current gold standard for diagnosis, fine-needle aspiration (FNA) biopsy, yields 10-25% of indeterminate cytology results, leading to patients undergoing thyroidectomy for diagnosis. We assessed the technical potential of a miniaturized in vivo ESS (elastic light scattering spectroscopy) probe, built into an FNA needle assembly, to differentiate benign from malignant thyroid nodules. Methods: Under IRB approval, 15 patients in the endocrine clinic undergoing FNAB of a thyroid nodule had collection of ESS data using our novel miniaturized FNA probe. Using final surgical pathology as our gold standard, data post processing and visual inspection was completed. Results: 225 spectra were grouped and analyzed (120 benign, 30 malignant and 75 from indeterminate cytology). ESS probes demonstrated excellent reproducibility in use. Initial analysis of these preliminary data is promising, indicating distinction of spectral ESS features between malignant and benign conditions. Conclusion(s): An in vivo trial of an invasive miniaturized integrated ESS biopsy probe is acceptable to patients, and collection of ESS data is feasible and reliable. With development of a disease-specific algorithm, ESS could potentially be used as an in-situ real time intra-operative diagnostic tool or as a minimally invasive adjunct to conventional FNA cytology.

  15. Early allograft dysfunction in liver transplantation with donation after cardiac death donors results in inferior survival.

    PubMed

    Lee, David D; Singh, Amandeep; Burns, Justin M; Perry, Dana K; Nguyen, Justin H; Taner, C Burcin

    2014-12-01

    Donation after cardiac death (DCD) liver allografts have been associated with increased morbidity from primary nonfunction, biliary complications, early allograft failure, cost, and mortality. Early allograft dysfunction (EAD) after liver transplantation has been found to be associated with inferior patient and graft survival. In a cohort of 205 consecutive liver-only transplant patients with allografts from DCD donors at a single center, the incidence of EAD was found to be 39.5%. The patient survival rates for those with no EAD and those with EAD at 1, 3, and 5 years were 97% and 89%, 79% and 79%, and 61% and 54%, respectively (P = 0.009). Allograft survival rates for recipients with no EAD and those with EAD at 1, 3, and 5 years were 90% and 75%, 72% and 64%, and 53% and 43%, respectively (P = 0.003). A multivariate analysis demonstrated a significant association between the development of EAD and the cold ischemia time [odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.01-1.56, P = 0.037] and hepatocellular cancer as a secondary diagnosis in recipients (OR = 2.26, 95% CI = 1.11-4.58, P = 0.025). There was no correlation between EAD and the development of ischemic cholangiopathy. In conclusion, EAD results in inferior patient and graft survival in recipients of DCD liver allografts. Understanding the events that cause EAD and developing preventive or early therapeutic approaches should be the focus of future investigations. © 2014 American Association for the Study of Liver Diseases.

  16. Regression model estimation of early season crop proportions: North Dakota, some preliminary results

    NASA Technical Reports Server (NTRS)

    Lin, K. K. (Principal Investigator)

    1982-01-01

    To estimate crop proportions early in the season, an approach is proposed based on: use of a regression-based prediction equation to obtain an a priori estimate for specific major crop groups; modification of this estimate using current-year LANDSAT and weather data; and a breakdown of the major crop groups into specific crops by regression models. Results from the development and evaluation of appropriate regression models for the first portion of the proposed approach are presented. The results show that the model predicts 1980 crop proportions very well at both county and crop reporting district levels. In terms of planted acreage, the model underpredicted 9.1 percent of the 1980 published data on planted acreage at the county level. It predicted almost exactly the 1980 published data on planted acreage at the crop reporting district level and overpredicted the planted acreage by just 0.92 percent.

  17. Review of early clinical results and complications associated with oblique lumbar interbody fusion (OLIF).

    PubMed

    Phan, Kevin; Maharaj, Monish; Assem, Yusuf; Mobbs, Ralph J

    2016-09-01

    Lumbar interbody fusion represents an effective surgical intervention for patients with lumbar degenerative diseases, spondylolisthesis, disc herniation, pseudoarthrosis and spinal deformities. Traditionally, conventional open anterior lumbar interbody fusion and posterior/transforaminal lumbar interbody fusion techniques have been employed with excellent results, but each with their own advantages and caveats. Most recently, the antero-oblique trajectory has been introduced, providing yet another corridor to access the lumbar spine. Termed the oblique lumbar interbody fusion, this approach accesses the spine between the anterior vessels and psoas muscles, avoiding both sets of structures to allow efficient clearance of the disc space and application of a large interbody device to afford distraction for foraminal decompression and endplate preparation for rapid and thorough fusion. This review aims to summarize the early clinical results and complications of this new technique and discusses potential future directions of research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Arthroscopic coracoid transfer in the treatment of recurrent shoulder instability: a systematic review of early results.

    PubMed

    Butt, Usman; Charalambous, Charalambos P

    2013-04-01

    Systematic review of the literature to characterize safety profile and complication rates associated with arthroscopic coracoid transfer procedures. We conducted a combined search of Medline, EMBASE, and the CINAHL databases from 1985 to November 2012. Articles were selected and data extracted according to standard criteria. Only 3 studies met the inclusion criteria, and these originated from the pioneers of this technique. These studies described the results of 172 arthroscopic coracoid transfer procedures with an overall complication rate of 19.8% ± 5.6%. Conversion to open surgery was necessary in 6/172 (3.5%) patients. Repeated surgery was described in 5/172 (2.9% ± 2.5%) cases, all for screw removal. The overall rate of recurrent instability was 3/172 cases (1.7% ± 2%). Hardware-related complications occurred in 4/172 patients (2.3% ± 2.3%). Coracoid grafts failed to unite in 14/172 patients (8.1% ± 4.1%); graft osteolysis was seen in 7/172 patients (4.1% ± 2.6%). The coracoid graft fractured in 2/172 cases (1.2% ± 1.6%); one of these occurred intraoperatively and one occurred early postoperatively. There was one transient nerve palsy (0.6% ± 1.1%). Results of arthroscopic coracoid transfer surgery for anterior shoulder instability are sparse, with the available studies originating from the pioneers of this technique. Early results suggest that arthroscopic coracoid transfer is a technically feasible procedure that is able to restore shoulder stability. However, this technique seems to be associated with a high complication rate and a steep learning curve. Results from the wider orthopaedic shoulder arthroscopic community are awaited. Extensive cadaveric training and experience with the open technique is recommended before performing the arthroscopic procedure. Systematic review of Level IV studies. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Promising More Information

    NASA Technical Reports Server (NTRS)

    2003-01-01

    When NASA needed a real-time, online database system capable of tracking documentation changes in its propulsion test facilities, engineers at Stennis Space Center joined with ECT International, of Brookfield, Wisconsin, to create a solution. Through NASA's Dual-Use Program, ECT developed Exdata, a software program that works within the company's existing Promise software. Exdata not only satisfied NASA s requirements, but also expanded ECT s commercial product line. Promise, ECT s primary product, is an intelligent software program with specialized functions for designing and documenting electrical control systems. An addon to AutoCAD software, Promis e generates control system schematics, panel layouts, bills of material, wire lists, and terminal plans. The drawing functions include symbol libraries, macros, and automatic line breaking. Primary Promise customers include manufacturing companies, utilities, and other organizations with complex processes to control.

  20. Comparison of endoscopic and microscopic trans-sphenoidal pituitary surgery: early results in a single centre.

    PubMed

    Razak, Adam A; Horridge, Michelle; Connolly, Daniel J; Warren, Daniel J; Mirza, Showkat; Muraleedharan, Vakkat; Sinha, Saurabh

    2013-02-01

    Pituitary surgery has seen a recent shift from a microscopic to an endoscopic trans-sphenoidal approach. We present our early experience with endoscopic surgery and compare the outcome with our recent microscopic experience. From January 2008 until present time, 80 consecutive patients underwent trans-sphenoidal pituitary surgery in our institution. Until September 2009, all patients had a microscopic trans-septal approach. After this time, the patients underwent endoscopic trans-sphenoidal surgery. All patients underwent pre- and post-operative MRI and full endocrinological evaluation. Data was collected prospectively including tumour volume, endocrine function, visual function, length of stay and complications. There were 40 patients in each group. In the microscopic group, there were 26 non-functioning tumours and 14 functioning tumours. In the endoscopic group, there were 24 non-functioning and 16 functioning tumours. There were significantly better results in terms of tumour resection (p = 0.002) and remission (p = 0.018) in the endoscopic group. In this group there was also a lower incidence of CSF leaks and a shorter length of stay for secreting tumours (p = 0.005). 1 patient in the endoscopic group died at day 43 post-operatively, having initially presented in a poor clinical state with pituitary apoplexy. Microscopic trans-sphenoidal surgery remains the benchmark for future surgical techniques. Our early results suggest that endoscopic trans-sphenoidal surgery provides favourable results in both tumour resection and control of secreting tumours in comparison with microscopic surgery. Further longer-term evaluation is required to ensure the outcome of endoscopic surgery.

  1. Photodynamic therapy of early cancer in the upper aerodigestive tract and bronchi: instrumentation and clinical results

    NASA Astrophysics Data System (ADS)

    Wagnières, G.

    1990-01-01

    A complete instrumentation has been developed for photodynamic therapy (PDT) and combined PDT- hyperthermia in the upper aerodigestive tract and the bronchi. These instruments consist of several light distributors which permit optimal light dosage to "superficial" tumors, as well as an injector for laser beams into an optical fiber and a fiberoptic coupler for cw laser beam powers at least 100 Watts. PDT is carried out with HpD and Photofrin II at 630 nm, whereas occasional simultaneous hyperthermia is at 1.06 microns. PDT of 41 cases of "early" squamous cell carcinoma is reported with follow-up between 5 and 62 months. In the oesophagus and bronchi the results are good for cancers staged in situ or microinvasive at endoscopy (2 recurrences for 23 lesions treated). For more advanced cancers (submucosal in the oesopha- gus or invading the bronchial cartilage) the results are less satisfactory with 3 recurrences for 8 lesions treated. In the bronchi (1 case) and the oesophagus (1 case) the largest disease - free survival is now more than 5 years. We encountered 6 complications (3 cicatrical stenosis, 2 fistulae, 1 severe sunburn), most of them resulting from the lack of selectivity of PDT with these porphyrin mixtures at the applied conditions. These experiments show that PDT is efficient at destroying early squamous cell carcinomas in the pharynx, oesophagus and bronchi. Tumour selectivity of HpD and photofrin II is poor in the aerodigestive tract lined with squamous cell epithelium. The future lies in the synthesis of a more selective efficient photosensitizer.

  2. Early Scientific Results and Future Prospects for the Rejuvenated Hubble Space Telescope

    NASA Technical Reports Server (NTRS)

    Niedner, Malcolm B.

    2010-01-01

    Following the extraordinarily successful Servicing Mission 4 (SM4) of Hubble Space Telescope (HST) in May of 2009, the Observatory is now fully equipped with a broad array of powerful science instruments that put it at the pinnacle of its scientific power. Relevant to the subject matter of the Beyond 2010 Conference, HST will be well-placed over the next five-plus years to advance our knowledge of the formation of high-redshift galaxies and their growth with cosmic time; the emergence of structure in the early universe via Dark Matter-driven gravitational instability; and the universe's expansion history and any resulting implications for the temporal character of Dark Energy. These are fitting projects for the iconic facility now celebrating its 20th anniversary in orbit.

  3. Recondensation of chondritic material in the early solar system: Results of thermodynamic simulation

    NASA Technical Reports Server (NTRS)

    Dorofeyeva, V. A.; Makalkin, A. B.; Mironenko, M. V.; Vityazev, A. V.

    1993-01-01

    We have performed a thermodynamic simulation of the recondensation of evaporated meteoritic material. We suggest that evaporation and recondensation occurred in impact events during the intercollision of planetesimals during the early evolution of the solar system. The source materials adopted for our model are the chondrites CI Orgueil and H5 Richardton. These chondrites are representative examples of the two extremes regarding volatile content and oxidation state. We calculated equilibrium mineral compositions of the closed systems of the Orgueil's and Richardton's elemental composition at the P-T conditions characteristic of the explosion cloud formed at a planetesimal collision. The P-T conditions are as follows: 10(exp -4) bar, and 1500 and 2000 K. The results are presented.

  4. [Results after distraction arthroplasty according to Bufalini and Perugia in early stages of trapeziometacarpal osteoarthritis].

    PubMed

    Fatzer, Lukas; Soleman, E; Sanchez, T

    2015-02-01

    A distraction arthroplasty of the trapeziometacarpal joint was introduced by Bufalini and Perugia for the treatment of the early stages of carpometacarpal osteoarthritis. Our retrospective study presents the results of this technique. Thereby, a tendon graft anchored to the distal second metacarpal is fixed at the base of the first metacarpal, keeping it in distraction. 10 distraction arthroplasties were performed in 9 patients with carpometacarpal osteoarthritis stage I and II of the thumb after unsuccessful conservative therapy. In 2 cases, which were excluded from our study, trapeziectomy had to be performed because of persisting pain. Patient satisfaction, pain measurement, range of motion, and tip, key and grip strength were evaluated at a follow-up of 46.5 (29-63) months in the remaining 7 patients (8 operations overall). Strengh measurement was taken in an absolute value and compared to the opposite side. Thumb range of motion was measured with the combined flexion-opposition of the thumb with the Kapandij index and also the angle of abduction of the metacarpal I to metacarpal II. Assessment included a DASH score evaluation and an X-ray control. All of the 7 evaluated patients were satisfied with the operation results. Compared to the opposite side, patients achieved 80.1% (5.9 kg±1.1 kg) of key pinch strength, 86.3% (4.8 kg±0.9 kg) of oppositional tip pinch strength, and 86.1% (23.1 kg±4.8 kg) of grip strength. In combined flexion and opposition a Kapandij index of 8.5 (94.4%) compared to 9 on the opposite side was achieved. Thumb radial abduction was 48.2°±2.8°, compared to 51.0°±2.9° on the contralateral hand. At follow-up, the mean DASH score was 17.8 (±10.0). Radiological control showed no progression of carpometacarpal osteoarthritis of the thumb. The collected data after distraction arthroplasty according to Bufalini and Perugia confirm the efficacy of the technique in the early stage of carpometacarpal osteoarthritis of the

  5. Results of early thyroidectomy for medullary thyroid carcinoma in children with multiple endocrine neoplasia type 2.

    PubMed

    Telander, R L; Zimmerman, D; van Heerden, J A; Sizemore, G W

    1986-12-01

    Children with multiple endocrine neoplasia type 2 (MEN2) often develop medullary carcinoma of the thyroid (MCT) or its precursor, C-cell hyperplasia. Survival results are improved if malignancy is diagnosed early from the results of plasma immunoreactive calcitonin (iCT) measurement. The effect of early detection and thyroidectomy in children with MEN2 syndrome was determined by reviewing the experience between 1975 and 1985. Seventeen children with MEN2 who were 12 years old or younger underwent a total thyroidectomy for MCT or C-cell hyperplasia. iCT was measured in all patients preoperatively and postoperatively. Of the 17 children, 14 (82%) had MEN2a and 3 (18%) had MEN2b. There were 14 (82%) female and three (18%) male patients; their mean age was 6.97 years (range 1.5 to 12 years). In all patients, the diagnosis of MCT was made from initial elevated levels of iCT after stimulation with pentagastrin. Three patients had clinical evidence of disease preoperatively. All patients underwent a total thyroidectomy and lymph nodes were removed from the central zone; a neck dissection was performed in the three with clinically obvious disease. MCT with C-cell hyperplasia was found in 11 children and C-cell hyperplasia alone in six. Of the 11 with carcinoma, eight had bilateral disease and three unilateral. Six children had bilateral C-cell hyperplasia. All 17 children were alive and feeling well at the time of this report; however, three had evidence of metastatic disease according to iCT measurements. None of the children had recurrent nerve injuries; one had evidence of hypoparathyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. [Personalized cell therapy for early postoperative bullous keratopathy (experimental proof and clinical results)].

    PubMed

    Kasparov, A A; Kasparova, Evg A; Fadeeva, L L; Subbot, A M; Borodina, N V; Kasparova, E A; Kobzova, M V; Musaeva, G M; Pavliuk, A S

    2013-01-01

    The article presents the results of a long-term research on development and clinical application of personalized cell therapy (PCT) for treatment of early postoperative (manifesting within the first 3 months after surgery) bullous keratopathy (BK). The method of intracameral PCT implies in vitro incubation of the patient's blood sample with poly(A:U) stimulator, separation of the serum with activated leukocytes, and injection of the final cell preparation into the anterior chamber. The fundamental part of the research was aimed at a detailed description of the cell preparation and investigation of its possible mechanisms of action. Cytokine and growth factor level in the cell preparation suggested that its high clinical efficacy might be due to its ability to improve regeneration of damaged corneal endothelium. The clinical study was conducted on a group of 52 patients with early BK. A significant effect (smoothing of the Descement's membrane folds, complete resorption of corneal edema, improvement of corneal transparency, reduction of corneal thickness and increase of visual acuity by 0.49 +/- 0.27) was achieved in 44.2% of patients, while partial effect was seen in 21.1% of patients. There was no clinical effect in 34.6% of patients. In those patients who developed significant or partial clinical effect after the PCT, many endotheliocytes appeared to have multiple nuclei (2 and more). In some patients polyploid nuclei persisted for 3-5 years after the treatment. Polyploidy results from incomplete mitosis which might be due to regenerative processes in the endothelium stimulated by the PCT. Obviously, high efficacy and relative simplicity of the method should promote its further clinical introduction.

  7. The Trans-African Hydro-Meteorological Observatory: Early results from the crowd sourcing competition

    NASA Astrophysics Data System (ADS)

    van de Giesen, Nick; Hilkhuijsen, Tanja; Hut, Rolf; Andreini, Marc; Selker, John

    2013-04-01

    The Trans-African Hydro-Meteorological Observatory (www.tahmo.org) is an international initiative with the objective to develop, build, and operate 20,000 hydro-meteorological measurement stations in sub-Saharan Africa. TAHMO tries to integrate science with education. At the same time, we try to make the initiative financially sustainable by developing and rolling out viable business development. Estimated total costs for establishing the network will be in the order of US 20 million, whereas operational costs will be around US 2 million per year. The stations need to be designed in accordance to a set of rules that serves easy deployment and operation, such as absence of moving parts and cavities, self- and cross calibration of sensors, and low cost (€ 200-300 per station). There are some promising first results in this respect. The presentation will focus on recent activities, specifically concerning crowd sourcing activities at African universities. This competition (http://tahmo.info/sensor-design-competition) consists of two rounds. The first round is open to any academic or research group in Africa and asks for the design of an innovative robust sensor in line with the TAHMO design criteria. The top twenty teams with the best designs will receive a "Maker Package" that will allow them to build and test the sensors. The final top ten design teams will meet in Nairobi in August 2013 to tinker and collaborate for one week and to integrate the sensors into a standard weather station. The deadline for the first round is 1 March 2013 and the results from this round will be presented.

  8. Riociguat in patients with chronic thromboembolic pulmonary hypertension: results from an early access study.

    PubMed

    McLaughlin, Vallerie V; Jansa, Pavel; Nielsen-Kudsk, Jens E; Halank, Michael; Simonneau, Gérald; Grünig, Ekkehard; Ulrich, Silvia; Rosenkranz, Stephan; Gómez Sánchez, Miguel A; Pulido, Tomás; Pepke-Zaba, Joanna; Barberá, Joan Albert; Hoeper, Marius M; Vachiéry, Jean-Luc; Lang, Irene; Carvalho, Francine; Meier, Christian; Mueller, Katharina; Nikkho, Sylvia; D'Armini, Andrea M

    2017-12-28

    Following positive results from the Phase III CHEST-1 study in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), the Phase IIIb CTEPH early access study (EAS) was designed to assess the safety and tolerability of riociguat in real-world clinical practice, as well as to provide patients with early access to riociguat before launch. Riociguat is approved for the treatment of inoperable and persistent/recurrent CTEPH. We performed an open-label, uncontrolled, single-arm, early access study in which 300 adult patients with inoperable or persistent/recurrent CTEPH received riociguat adjusted from 1 mg three times daily (tid) to a maximum of 2.5 mg tid. Patients switching from unsatisfactory prior pulmonary arterial hypertension (PAH)-targeted therapy (n = 84) underwent a washout period of at least 3 days before initiating riociguat. The primary aim was to assess the safety and tolerability of riociguat, with World Health Organization functional class and 6-min walking distance (6MWD) as exploratory efficacy endpoints. In total, 262 patients (87%) completed study treatment and entered the safety follow-up (median treatment duration 47 weeks). Adverse events were reported in 273 patients (91%). The most frequently reported serious adverse events were syncope (6%), right ventricular failure (3%), and pneumonia (2%). There were five deaths, none of which was considered related to study medication. The safety and tolerability of riociguat was similar in patients switched from other PAH-targeted therapies and those who were treatment naïve. In patients with data available, mean ± standard deviation 6MWD had increased by 33 ± 42 m at Week 12 with no clinically relevant differences between the switched and treatment-naïve subgroups. Riociguat was well tolerated in patients with CTEPH who were treatment naïve, and in those who were switched from other PAH-targeted therapies. No new safety signals were

  9. Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.

    PubMed

    Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

    2017-06-01

    Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy. Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor. The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure. Therapeutic, IV.

  10. [Assessment of results in the early diagnosis of breast cancer program in Asturias Community].

    PubMed

    Natal, Carmen; Suárez, María Teresa; Serrano, Susana; Díaz, Concepción; González, Cristina; Menéndez, Primitiva; Castañón, Rubén; García, María Luisa; Blázquez, Elena

    2012-01-01

    To evaluate and disseminate the intermediate results of a breast cancer early detection program in the Asturias Community. We report the results of screening examinations performed between 2005 and 2009, using the indicators proposed in the European Guidelines on Quality Assurance in Mammography Screening. The information sources for breast cancer cases diagnosed were the pathology information system and the information on the characteristics of the tumour from the pathology report. The classification of the diagnostic features of the program was from its own information system. A total of 1,384 breast cancers were diagnosed in the program target population during the study period, of which 49% were diagnosed in the program, 13% were interval cancers, 17% were diagnosed in women who chose not to participate in the program, and 22% in women who for various reasons had not been invited to participate. The most advanced diagnoses were made in the group of interval cancers and the earliest diagnoses were made in the uninvited population. When the healthcare system is directed towards the asymptomatic population to provide a measure of prevention, it must ensure that there is a favourable balance. The results of this evaluation are consistent with accepted standards and with those found in other assessments. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  11. Media consumption and sleep quality in early childhood: results from the Ulm SPATZ Health Study.

    PubMed

    Genuneit, Jon; Brockmann, Pablo E; Schlarb, Angelika A; Rothenbacher, Dietrich

    2018-05-01

    Media use is increasingly becoming common in preschoolers and starting before the age of three years. While several studies have documented the effects of screen time on sleep duration in this age group, investigations including sleep quality are scarce and mainly cross-sectional. Moreover, they are limited by investigating sleep across broader age ranges or in older preschoolers, which may blur early effects and the ideal time for intervention. The current study analyzed data from the Ulm SPATZ Health Study, a birth cohort study in which 1006 live newborns were recruited from the general population shortly after delivery at the University Medical Center Ulm, Southern Germany, from April 2012 to May 2013. Longitudinal data on child sleep were parent reported on the Children's Sleep Habits Questionnaire (CSHQ) at ages two and three years. Child media consumption was assessed at three years of age with different questions on electronic media and books. Statistical analyses included Kruskal-Wallis tests and multivariable linear and logistic regression models. Electronic media consumption had a moderate prevalence and dose, and prevalence of never using books appeared to be high (39%). The preliminary results indicated strong statistically significant inverse cross-sectional associations between electronic media consumption and overall sleep quality and, using longitudinal data, with worsening indicators of bedtime resistance, sleep anxiety, and daytime sleepiness. This was the first larger-scale study to comprehensively investigate the effects of electronic media consumption and book reading on all CSHQ items in three-year-olds. Considering the risk of chronification, preventive efforts (eg, by effective sleep-oriented training programs) already seem necessary in early life. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The selection system of silviculture in spruce-fir stands - procedures, early results, and comparisons with unmanaged stands

    Treesearch

    Robert M. Frank; Barton M. Blum

    1978-01-01

    Early results after 20 years of record keeping indicate that spruce-fir stands will respond to the selection system of silviculture. Stand quality is improved, species composition can be altered, diameter-class distribution approaches a stated goal, stand density is controlled, and yields are increased. Selection silviculture in spruce-fir can now be compared to early...

  13. Youth PROMISE Act

    THOMAS, 113th Congress

    Rep. Scott, Robert C. "Bobby" [D-VA-3

    2013-03-21

    House - 04/23/2013 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Youth Promise Act

    THOMAS, 112th Congress

    Rep. Scott, Robert C. "Bobby" [D-VA-3

    2011-08-01

    House - 09/08/2011 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Feminizing genitoplasty in adult transsexuals: early and long-term surgical results.

    PubMed

    Goddard, Jonathan C; Vickery, Richard M; Qureshi, Assad; Summerton, Duncan J; Khoosal, Deenesh; Terry, Tim R

    2007-09-01

    To examine the early and late surgical outcomes of feminizing genitoplasty (FG) in adult transsexuals in a UK single surgeon practice over a 10-year period. Computerized and manual databases were searched over the period 1994-2004 to identify patients who had undergone male to female FG. Case-notes were retrieved and analysed to identify epidemiological data, the number and type of perioperative problems, early results at outpatient review, late occurring problems and patient satisfaction. A telephone questionnaire was then conducted targeting all FG patients in our series. The questions were directed at identifying surgical complications, outcome and patient satisfaction. In all, 233 case-notes were identified and 222 (95%) were retrieved. All patients had penectomy, urethroplasty and labiaplasty, 207 (93%) had formation of a neoclitoris, and 202 (91%) had a skin-lined neovagina. The median (range) age was 41 (19-76) years. The median hospital stay was 10 (6-21) days. A record of the first outpatient visit was available in 197 (84.5%) cases. The median time to follow up was 56 (8-351) days. Over all, 82.2% had an adequate vaginal depth, with a median depth of 13 (5-15) cm and 6.1% had developed vaginal stenosis. Three (1.7%) patients had had a vaginal prolapse, two (1.1%) had a degree of vaginal skin flap necrosis and one (0.6%) was troubled with vaginal hair growth. In 86.3% of the patients the neoclitorizes were sensitive. There was urethral stenosis in 18.3% of the patients and 5.6% complained of spraying of urine. Minor corrective urethral surgery was undertaken in 36 patients including 42 urethral dilatations, and eight meatotomies were performed. At the first clinic visit 174 (88.3%) patients were 'happy', 13 (6.6%) were 'unhappy' and 10 (5.1%) made no comment. Of the 233 patients, we successfully contacted 70 (30%). All had had penectomy and labioplasty, 64 (91%) had a clitoroplasty and 62 (89%) a neovagina. The median age was 43 (19-76) years and the

  16. Early life environmental and pharmacological stressors result in persistent dysregulations of the serotonergic system

    PubMed Central

    Wong, Peiyan; Sze, Ying; Gray, Laura Jane; Chang, Cecilia Chin Roei; Cai, Shiwei; Zhang, Xiaodong

    2015-01-01

    Dysregulations in the brain serotonergic system and exposure to environmental stressors have been implicated in the development of major depressive disorder. Here, we investigate the interactions between the stress and serotonergic systems by characterizing the behavioral and biochemical effects of chronic stress applied during early-life or adulthood in wild type (WT) mice and mice with deficient tryptophan hydroxylase 2 (TPH2) function. We showed that chronic mild stress applied in adulthood did not affect the behaviors and serotonin levels of WT and TPH2 knock-in (KI) mice. Whereas, maternal separation (MS) stress increased anxiety- and depressive-like behaviors of WT mice, with no detectable behavioral changes in TPH2 KI mice. Biochemically, we found that MS WT mice had reduced brain serotonin levels, which was attributed to increased expression of monoamine oxidase A (MAO A). The increased MAO A expression was detected in MS WT mice at 4 weeks old and adulthood. No change in TPH2 expression was detected. To determine whether a pharmacological stressor, dexamethasone (Dex), will result in similar biochemical results obtained from MS, we used an in vitro system, SH-SY5Y cells, and found that Dex treatment resulted in increased MAO A expression levels. We then treated WT mice with Dex for 5 days, either during postnatal days 7–11 or adulthood. Both groups of Dex treated WT mice had reduced basal corticosterone and glucocorticoid receptors expression levels. However, only Dex treatment during PND7–11 resulted in reduced serotonin levels and increased MAO A expression. Just as with MS WT mice, TPH2 expression in PND7–11 Dex-treated WT mice was unaffected. Taken together, our findings suggest that both environmental and pharmacological stressors affect the expression of MAO A, and not TPH2, when applied during the critical postnatal period. This leads to long-lasting perturbations in the serotonergic system, and results in anxiety- and depressive

  17. A new UKIDSS proper motion survey and key early results, including new benchmark systems

    NASA Astrophysics Data System (ADS)

    Smith, L.; Lucas, P.; Burningham, B.; Jones, H.; Pinfield, D.; Smart, R.; Andrei, A.

    We present a proper motion catalogue for the 1500 deg2 of 2 epoch J-band UKIDSS Large Area Survey (LAS) data, which includes 120,000 stellar sources with motions detected above the 5sigma level. Our upper limit on proper motion detection is 3\\farcs3 yr-1 and typical uncertainties are of order 10 mas yr-1 for bright sources from data with a modest 1.8-7.0 year epoch baseline. We developed a bespoke proper motion pipeline which applies a source-unique second order polynomial transformation to UKIDSS array coordinates to counter potential local non-uniformity in the focal plane. Our catalogue agrees well with the proper motion data supplied in the current WFCAM Science Archive (WSA) tenth data release (DR10) catalogue where there is overlap, and in various optical catalogues, but it benefits from some improvements, such as a larger matching radius and relative to absolute proper motion correction. We present proper motion results for 128 T dwarfs in the UKIDSS LAS and key early results of projects utilising our catalogue, in particular searches for brown dwarf benchmark systems through cross matches with existing proper motion catalogues. We report the discovery of two new T dwarf benchmark systems.

  18. Neuronal redox imbalance results in altered energy homeostasis and early postnatal lethality.

    PubMed

    Maity-Kumar, Gandhari; Thal, Dietmar R; Baumann, Bernd; Scharffetter-Kochanek, Karin; Wirth, Thomas

    2015-07-01

    Redox imbalance is believed to contribute to the development and progression of several neurodegenerative disorders. Our aim was to develop an animal model that exhibits neuron-specific oxidative stress in the CNS to study the consequences and eventually find clues regarding the pathomechanisms of oxidative insults in neuronal homeostasis. We therefore generated a novel neuron-specific superoxide dismutase 2 (SOD2)-deficient mouse by deleting exon 3 of the SOD2 gene using CamKIIα promoter-driven Cre expression. These neuron-specific SOD2 knockout (SOD2(nko)) mice, although born at normal frequencies, died at the age of 4 weeks with critical growth retardation, severe energy failure, and several neurologic phenotypes. In addition, SOD2(nko) mice exhibited severe neuronal alterations such as reactive astrogliosis, neuronal cell cycle inhibition, and induction of apoptosis. JNK activation and stabilization of p53, as a result of reactive oxygen species accumulation, are most likely the inducers of neuronal apoptosis in SOD2(nko) mice. It is remarkable that hypothalamic regulation of glucose metabolism was affected, which in turn induced necrotic brain lesions in SOD2(nko) mice. Taken together, our findings suggest that exclusive deficiency of SOD2 in neurons results in an impaired central regulation of energy homeostasis that leads to persistent hypoglycemia, hypoglycemia-related neuropathology, and an early lethality of the mutant mice. © FASEB.

  19. Early versus delayed loading of mandibular implant-supported overdentures: 5-year results.

    PubMed

    Turkyilmaz, Ilser; Tözüm, Tolga F; Tumer, Celal

    2010-05-01

    Because of poor retention of complete removable dentures for edentulous patients, implant-supported mandibular overdentures have lately become a popular alternative for them. The aims of this prospective study were to evaluate treatment outcomes of mandibular overdentures supported by two unsplinted early-loaded implants and compare these results with those for delayed-loaded implants. A total of 26 edentulous patients were treated with two unsplinted implants supporting a mandibular overdenture. All implants were placed in the canine regions of each mandible according to the one-stage surgical protocol. There were two groups: test group, in which the overdenture was connected 1 week after surgery, and control group, in which the overdenture was connected 3 months after surgery. Standardized clinical and radiographic parameters were recorded at surgery, and after 3, 6, 12, and 18 months, and 2, 3, 4, and 5 years. No implants were lost, and 0.93 +/- 0.3 mm marginal bone resorption was noted for all implants after 5 years. Clinical implant stability measurements, clinical peri-implant parameters, and marginal bone resorptions showed no statistically significant differences between the two groups over 5 years. The results of this prospective clinical study suggest that there is no significant difference in the clinical and radiographic state of patients treated with implant supported mandibular overdentures loaded either 1 week or 3 months after surgery.

  20. Ligation of intersphincteric fistula tract: early results of a pilot study.

    PubMed

    Abcarian, Ariane M; Estrada, Joaquin J; Park, John; Corning, Cybil; Chaudhry, Vivek; Cintron, Jose; Prasad, Leela; Abcarian, Herand

    2012-07-01

    needed to validate the early favorable results.

  1. Genomics-Driven Precision Medicine for Advanced Pancreatic Cancer: Early Results from the COMPASS Trial.

    PubMed

    Aung, Kyaw L; Fischer, Sandra E; Denroche, Robert E; Jang, Gun-Ho; Dodd, Anna; Creighton, Sean; Southwood, Bernadette; Liang, Sheng-Ben; Chadwick, Dianne; Zhang, Amy; O'Kane, Grainne M; Albaba, Hamzeh; Moura, Shari; Grant, Robert C; Miller, Jessica K; Mbabaali, Faridah; Pasternack, Danielle; Lungu, Ilinca M; Bartlett, John M S; Ghai, Sangeet; Lemire, Mathieu; Holter, Spring; Connor, Ashton A; Moffitt, Richard A; Yeh, Jen Jen; Timms, Lee; Krzyzanowski, Paul M; Dhani, Neesha; Hedley, David; Notta, Faiyaz; Wilson, Julie M; Moore, Malcolm J; Gallinger, Steven; Knox, Jennifer J

    2018-03-15

    Purpose: To perform real-time whole genome sequencing (WGS) and RNA sequencing (RNASeq) of advanced pancreatic ductal adenocarcinoma (PDAC) to identify predictive mutational and transcriptional features for better treatment selection. Experimental Design: Patients with advanced PDAC were prospectively recruited prior to first-line combination chemotherapy. Fresh tumor tissue was acquired by image-guided percutaneous core biopsy for WGS and RNASeq. Laser capture microdissection was performed for all cases. Primary endpoint was feasibility to report WGS results prior to first disease assessment CT scan at 8 weeks. The main secondary endpoint was discovery of patient subsets with predictive mutational and transcriptional signatures. Results: Sixty-three patients underwent a tumor biopsy between December 2015 and June 2017. WGS and RNASeq were successful in 62 (98%) and 60 (95%), respectively. Genomic results were reported at a median of 35 days (range, 19-52 days) from biopsy, meeting the primary feasibility endpoint. Objective responses to first-line chemotherapy were significantly better in patients with the classical PDAC RNA subtype compared with those with the basal-like subtype ( P = 0.004). The best progression-free survival was observed in those with classical subtype treated with m-FOLFIRINOX. GATA6 expression in tumor measured by RNA in situ hybridization was found to be a robust surrogate biomarker for differentiating classical and basal-like PDAC subtypes. Potentially actionable genetic alterations were found in 30% of patients. Conclusions: Prospective genomic profiling of advanced PDAC is feasible, and our early data indicate that chemotherapy response differs among patients with different genomic/transcriptomic subtypes. Clin Cancer Res; 24(6); 1344-54. ©2017 AACR . ©2017 American Association for Cancer Research.

  2. Management strategies, early results, benefits, and risk factors of laparoscopic repair of perforated peptic ulcer.

    PubMed

    Lunevicius, Raimundas; Morkevicius, Matas

    2005-10-01

    The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal was to emphasize the benefits of this operation, and the fourth goal was to clarify the possible risk factors associated with laparoscopic repair of the duodenal ulcer. The Medline/Pubmed database was used. Review was done after evaluation of 96 retrieved full-text articles. Thirteen prospective and twelve retrospective studies were selected, grouped, and summarized. The spectrum of the retrospective studies' results are as follows: median overall morbidity rate 10.5 %, median conversion rate 7%, median hospital stay 7 days, and median postoperative mortality rate 0%. The following is the spectrum of results of the prospective studies: median overall morbidity rate was slightly less (6%); the median conversion rate was higher (15%); the median hospital stay was shorter (5 days) and the postoperative mortality was higher (3%). The risk factors identified were the same. Shock, delayed presentation (> 24 hours), confounding medical condition, age > 70 years, poor laparoscopic expertise, ASA III-IV, and Boey score should be considered preoperative laparoscopic repair risk factors. Each of these factors independently should qualify as a criterion for open repair due to higher intraoperative risks as well as postoperative morbidity. Inadequate ulcer localization, large perforation size (defined by some as > 6 mm diameter, and by others as > 10 mm), and ulcers with friable edges are also considered as conversion risk factors.

  3. Early life exposure to allergen and ozone results in altered development in adolescent rhesus macaque lungs

    SciTech Connect

    Herring, M.J.; Putney, L.F.; St George, J.A.

    In rhesus macaques, previous studies have shown that episodic exposure to allergen alone or combined with ozone inhalation during the first 6 months of life results in a condition with many of the hallmarks of asthma. This exposure regimen results in altered development of the distal airways and parenchyma (Avdalovic et al., 2012). We hypothesized that the observed alterations in the lung parenchyma would be permanent following a long-term recovery in filtered air (FA) housing. Forty-eight infant rhesus macaques (30 days old) sensitized to house dust mite (HDM) were treated with two week cycles of FA, house dust mite allergenmore » (HDMA), ozone (O{sub 3}) or HDMA/ozone (HDMA + O{sub 3}) for five months. At the end of the five months, six animals from each group were necropsied. The other six animals in each group were allowed to recover in FA for 30 more months at which time they were necropsied. Design-based stereology was used to estimate volumes of lung components, number of alveoli, size of alveoli, distribution of alveolar volumes, interalveolar capillary density. After 30 months of recovery, monkeys exposed to HDMA, in either group, had significantly more alveoli than filtered air. These alveoli also had higher capillary densities as compared with FA controls. These results indicate that early life exposure to HDMA alone or HDMA + O{sub 3} alters the development process in the lung alveoli. - Highlights: • Abnormal lung development after postnatal exposure to ozone and allergen • This remodeling is shown as smaller, more numerous alveoli and narrower airways. • Allergen appears to have more of an effect than ozone during recovery. • These animals also have continued airway hyperresponsiveness (Moore et al. 2014)« less

  4. Planck early results. IV. First assessment of the High Frequency Instrument in-flight performance

    NASA Astrophysics Data System (ADS)

    Planck HFI Core Team; Ade, P. A. R.; Aghanim, N.; Ansari, R.; Arnaud, M.; Ashdown, M.; Aumont, J.; Banday, A. J.; Bartelmann, M.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bock, J. J.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bradshaw, T.; Bréelle, E.; Bucher, M.; Camus, P.; Cardoso, J.-F.; Catalano, A.; Challinor, A.; Chamballu, A.; Charra, J.; Charra, M.; Chary, R.-R.; Chiang, C.; Church, S.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Cressiot, C.; Crill, B. P.; Crook, M.; de Bernardis, P.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dolag, K.; Dole, H.; Doré, O.; Douspis, M.; Efstathiou, G.; Eng, P.; Filliard, C.; Forni, O.; Fosalba, P.; Fourmond, J.-J.; Ganga, K.; Giard, M.; Girard, D.; Giraud-Héraud, Y.; Gispert, R.; Górski, K. M.; Gratton, S.; Griffin, M.; Guyot, G.; Haissinski, J.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Hildebrandt, S. R.; Hills, R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Huffenberger, K. M.; Jaffe, A. H.; Jones, W. C.; Kaplan, J.; Kneissl, R.; Knox, L.; Lagache, G.; Lamarre, J.-M.; Lami, P.; Lange, A. E.; Lasenby, A.; Lavabre, A.; Lawrence, C. R.; Leriche, B.; Leroy, C.; Longval, Y.; Macías-Pérez, J. F.; Maciaszek, T.; MacTavish, C. J.; Maffei, B.; Mandolesi, N.; Mann, R.; Mansoux, B.; Masi, S.; Matsumura, T.; McGehee, P.; Melin, J.-B.; Mercier, C.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Mortlock, D.; Murphy, A.; Nati, F.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; North, C.; Noviello, F.; Novikov, D.; Osborne, S.; Paine, C.; Pajot, F.; Patanchon, G.; Peacocke, T.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Piacentini, F.; Piat, M.; Plaszczynski, S.; Pointecouteau, E.; Pons, R.; Ponthieu, N.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Reach, W. T.; Renault, C.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Roudier, G.; Rowan-Robinson, M.; Rusholme, B.; Santos, D.; Savini, G.; Schaefer, B. M.; Shellard, P.; Spencer, L.; Starck, J.-L.; Stassi, P.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sunyaev, R.; Sygnet, J.-F.; Tauber, J. A.; Thum, C.; Torre, J.-P.; Touze, F.; Tristram, M.; van Leeuwen, F.; Vibert, L.; Vibert, D.; Wade, L. A.; Wandelt, B. D.; White, S. D. M.; Wiesemeyer, H.; Woodcraft, A.; Yurchenko, V.; Yvon, D.; Zacchei, A.

    2011-12-01

    The Planck High Frequency Instrument (HFI) is designed to measure the temperature and polarization anisotropies of the cosmic microwave background and Galactic foregrounds in six ~30% bands centered at 100, 143, 217, 353, 545, and 857 GHz at an angular resolution of 10' (100 GHz), 7' (143 GHz), and 5' (217 GHz and higher). HFI has been operating flawlessly since launch on 14 May 2009, with the bolometers reaching 100 mK the first week of July. The settings of the readout electronics, including bolometer bias currents, that optimize HFI's noise performance on orbit are nearly the same as the ones chosen during ground testing. Observations of Mars, Jupiter, and Saturn have confirmed that the optical beams and the time responses of the detection chains are in good agreement with the predictions of physical optics modeling and pre-launch measurements. The Detectors suffer from a high flux of cosmic rays due to historically low levels of solar activity. As a result of the redundancy of Planck's observation strategy, theremoval of a few percent of data contaminated by glitches does not significantly affect the instrumental sensitivity. The cosmic ray flux represents a significant and variable heat load on the sub-Kelvin stage. Temporal variation and the inhomogeneous distribution of the flux results in thermal fluctuations that are a probable source of low frequency noise. The removal of systematic effects in the time ordered data provides a signal with an average noise equivalent power that is 70% of the goal in the 0.6-2.5 Hz range. This is slightly higher than was achieved during the pre-launch characterization but better than predicted in the early phases of the project. The improvement over the goal is a result of the low level of instrumental background loading achieved by the optical and thermal design of the HFI. Corresponding author: J.-M. Lamarre, jean-michel.lamarre@obspm.fr

  5. Migration characteristics and early clinical results of a novel-finned press-fit acetabular cup.

    PubMed

    Kaipel, Martin; Prenner, Anton; Bachl, Sebastian; Farr, Sebastian; Sinz, Günter

    2014-04-01

    Ana Nova® is a novel-finned press-fit acetabular cup which showed superior biomechanical characteristics in an experimental set-up. Using Einzel Bild Röntgen Analyse (EBRA) measurements should offer the opportunity to predict implant survival at an early stage. The purpose of this study was to assess migration and clinical outcome 2 years after total hip replacement by a novel-finned press-fit acetabular cup. In this study, migration and clinical results of the implant were prospectively assessed in 67 patients. Clinical outcome was assessed using the Harris hip score (HHS). Migration analyses were performed using the computer assisted EBRA system. Data were analyzed for normal distribution using the Kolmogorov-Smirnov test. Group comparisons were performed using the analysis of variance (ANOVA) test. P-values less than 0.05 were considered statistically significant. At 2 years after surgery, none of the implants needed revision and HHS increased from 39.7 up to 92.2. In contrast to the beneficial clinical outcome, 17 of 44 patients showed increased total migration ( 1 mm/2a). Adverse migration data in this study might predict aseptic loosening and decreased survival of the implant. According to previous studies, it is possible that this effect occurred because of limited accuracy of the EBRA system. In our opinion, migration analyses may not be recommended as a screening tool in a 2 year follow-up.

  6. Early Results from the First Year of Observations by the Atacama B-mode Search (ABS)

    NASA Astrophysics Data System (ADS)

    Simon, Sara M.; ABS Collaboration

    2013-06-01

    The Atacama B-mode Search (ABS) instrument, which began observation in February of 2012, is a crossed-Dragone telescope located at an elevation of 5100 m in the Atacama Desert in Chile. The primary scientific goal of ABS is to measure the B-mode polarization spectrum of the Cosmic Microwave Background (CMB) from multipole moments of about l=50 to l=500, a range that includes the primordial B-mode peak. Unlike most current polarization experiments, ABS features a cryogenic telescope and a warm half-wave plate used to modulate the polarization of the incoming light. The ABS focal plane array consists of 240 pixels designed for observation at 150 GHz by the TRUCE collaboration. Each pixel has its own individual, single-moded feedhorn and contains two transition-edge sensor (TES) bolometers sensitive to orthogonal polarizations. The detectors are read out using time domain multiplexing so that the thermal loading of the readout electronics does not heat the focal plane. I will present early results from the first year of ABS data.

  7. VCE early acoustic test results of General Electric's high-radius ratio coannular plug nozzle

    NASA Technical Reports Server (NTRS)

    Knott, P. R.; Brausch, J. F.; Bhutiani, P. K.; Majjigi, R. K.; Doyle, V. L.

    1980-01-01

    Results of variable cycle engine (VCE) early acoustic engine and model scale tests are presented. A summary of an extensive series of far field acoustic, advanced acoustic, and exhaust plume velocity measurements with a laser velocimeter of inverted velocity and temperature profile, high radius ratio coannular plug nozzles on a YJ101 VCE static engine test vehicle are reviewed. Select model scale simulated flight acoustic measurements for an unsuppressed and a mechanical suppressed coannular plug nozzle are also discussed. The engine acoustic nozzle tests verify previous model scale noise reduction measurements. The engine measurements show 4 to 6 PNdB aft quadrant jet noise reduction and up to 7 PNdB forward quadrant shock noise reduction relative to a fully mixed conical nozzle at the same specific thrust and mixed pressure ratio. The influences of outer nozzle radius ratio, inner stream velocity ratio, and area ratio are discussed. Also, laser velocimeter measurements of mean velocity and turbulent velocity of the YJ101 engine are illustrated. Select model scale static and simulated flight acoustic measurements are shown which corroborate that coannular suppression is maintained in forward speed.

  8. Adaptive multi-sensor biomimetics for unsupervised submarine hunt (AMBUSH): Early results

    NASA Astrophysics Data System (ADS)

    Blouin, Stéphane

    2014-10-01

    Underwater surveillance is inherently difficult because acoustic wave propagation and transmission are limited and unpredictable when targets and sensors move around in the communication-opaque undersea environment. Today's Navy underwater sensors enable the collection of a massive amount of data, often analyzed offtine. The Navy of tomorrow will dominate by making sense of that data in real-time. DRDC's AMBUSH project proposes a new undersea-surveillance network paradigm that will enable such a real-time operation. Nature abounds with examples of collaborative tasks taking place despite limited communication and computational capabilities. This publication describes a year's worth of research efforts finding inspiration in Nature's collaborative tasks such as wolves hunting in packs. This project proposes the utilization of a heterogeneous network combining both static and mobile network nodes. The military objective is to enable an unsupervised surveillance capability while maximizing target localization performance and endurance. The scientific objective is to develop the necessary technology to acoustically and passively localize a noise-source of interest in shallow waters. The project fulfills these objectives via distributed computing and adaptation to changing undersea conditions. Specific research interests discussed here relate to approaches for performing: (a) network self-discovery, (b) network connectivity self-assessment, (c) opportunistic network routing, (d) distributed data-aggregation, and (e) simulation of underwater acoustic propagation. We present early results then followed by a discussion about future work.

  9. The Aeronomy of Ice in the Mesosphere (AIM) mission: Overview and early science results

    NASA Astrophysics Data System (ADS)

    Russell, James M., III; Bailey, Scott M.; Gordley, Larry L.; Rusch, David W.; Horányi, Mihály; Hervig, Mark E.; Thomas, Gary E.; Randall, Cora E.; Siskind, David E.; Stevens, Michael H.; Summers, Michael E.; Taylor, Michael J.; Englert, Christoph R.; Espy, Patrick J.; McClintock, William E.; Merkel, Aimee W.

    2009-03-01

    The Aeronomy of Ice in the Mesosphere (AIM) mission was launched from Vandenberg Air Force Base in California at 1:26:03 PDT on April 25, 2007 becoming the first satellite mission dedicated to the study of polar mesospheric clouds. A Pegasus XL rocket launched the satellite into a near perfectly circular 600 km sun synchronous orbit. AIM carries three instruments selected because of their ability to provide key measurements needed to address the AIM goal which is to determine why these clouds form and vary. The instrument payload includes a nadir imager, a solar occultation instrument and an in-situ cosmic dust detector. Detailed descriptions of the science, instruments and observation scenario are presented. Early science results from the first northern and southern hemisphere seasons show a highly variable cloud morphology, clouds that are ten times brighter than measured by previous space-based instruments, and complex features that are reminiscent of tropospheric weather phenomena. The observations also confirm a previously theorized but never before directly observed population of small ice particles in the altitude region above the main Polar Mesospheric Cloud (PMC) layer that are widely believed to be the indirect cause of summertime radar echoes.

  10. Early results from the Northern Gulf of Mexico Ecosystem Change and Hazard Susceptibility Project

    USGS Publications Warehouse

    Brock, John C.; Lavoie, Dawn L.; Poore, Richard Z.

    2011-01-01

    The northern Gulf of Mexico coastal region and its diverse ecosystems are threatened by population and development pressure and by the impacts of rising sea level and severe storms such as the series of hurricanes that has impacted the northern Gulf in recent years. In response to the complex management issues facing the region, the U.S. Geological Survey (USGS) organized a multidisciplinary research program to coordinate the activities of USGS and other scientists working in the northern Gulf of Mexico region (fig. 1). The Northern Gulf of Mexico (NGOM) Ecosystem Change and Hazard Susceptibility Project aims to develop a thorough understanding of the dynamic coastal ecosystems on the northern Gulf coast, the impact of human activities on these ecosystems, and the vulnerability of ecosystems and human communities to more frequent and more intense hurricanes in the future. A special issue of Geo-Marine Letters published in December 2009 is devoted to early results of studies completed as part of this project. These studies, which have been conducted at sites throughout the northern Gulf region, from the Chandeleur Islands to Apalachicola Bay, have focused on three themes: (1) The underlying geologic framework that exerts controls over coastal processes (2) The impact of human activities on nearshore water quality (3) Hurricanes and associated effects

  11. Complications and early results after operative fixation of 68 pilon fractures of the distal tibia.

    PubMed

    Lomax, Adam; Singh, Anjani; N Jane, Madeley; C Senthil, Kumar

    2015-05-01

    In this cohort study, we present comprehensive injury specific and surgical outcome data from one of the largest reported series of pilon fractures of the distal tibia treated in a UK tertiary referral centre. A series of 68 closed pilon fractures were retrospectively reviewed from case notes, plain radiographs and computed tomography imaging. Patient demographics, injury and fracture patterns, methods and timing of fixation and clinical and radiological outcomes were assessed over a mean follow-up period of 7.7 months (1.5-30). Overall, deep infection occurred in 1.6% with superficial infection and wound breakdown occurring in 6.3% of cases. Rates of nonunion and malunion were 7.8%. Radiological posttraumatic arthritis was present in 26.6%, which was symptomatic and requiring orthopaedic management in 9.4%. Further surgery for all causes occurred in 26.6% of cases. Fixation of these complex fractures in subspecialist units can achieve overall low rates of wound complications, with definitive fixation of selected fractures within 48 h of initial presentation achieving comparable results to those fixed in a delayed fashion. However, this injury continues to have a significant overall complication rate with a high chance of developing early posttraumatic arthritis and of requiring further surgery. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Comparison of Early-period Results of Nasal Splint and Merocel Nasal Packs in Septoplasty

    PubMed Central

    Bingöl, Fatih; Budak, Ali; Şimşek, Eda; Kılıç, Korhan; Bingöl, Buket Özel

    2017-01-01

    Objective Several types of nasal packs are used postoperatively in septoplasty. In this study, we compared two commonly used nasal packing materials, the intranasal septal splint with airway and Merocel tampon, in terms of pain, bleeding, nasal obstruction, eating difficulties, discomfort in sleep, and pain and bleeding during removal of packing in the early period. Methods The study group included 60 patients undergoing septoplasty. Patients were divided into two groups (n=30 in each group). An intranasal splint with airway was used for the patients in the first group after septoplasty, while Merocel nasal packing was used for the second group. Patients were investigated in terms of seven different factors - pain, bleeding while the tampon was in place, nasal obstruction, eating difficulties, night sleep, pain during removal of the nasal packing, and bleeding after removal of packing. Results There was no statistically significant difference between the groups in terms of pain 24 hours after operation (p=0.05), while visual analog scale (VAS) scores for nasal obstruction, night sleep, eating difficulties, and pain during packing removal were lower in the nasal splint group with a statistically significant difference (p<0.05). There was no statistically significant difference between the groups in terms of postoperative bleeding (p=0.23). Significantly less bleeding occurred during removal of the packing in the nasal splint group (p<0.05). Conclusion Our study indicates that the nasal splint was more comfortable and effective in terms of causing lesser bleeding and pain during removal of packing. PMID:29392071

  13. Ocriplasmin for treatment of stage 2 macular holes: early clinical results.

    PubMed

    Miller, John B; Kim, Leo A; Wu, David M; Vavvas, Demetrios G; Eliott, Dean; Husain, Deeba

    2014-01-01

    To review clinical and structural outcomes of ocriplasmin for treatment of stage 2 macular holes. A retrospective review of the first patients with stage 2 macular holes to be treated with ocriplasmin at Massachusetts Eye and Ear Infirmary. All patients were imaged with spectral-domain optical coherence tomography (SD-OCT). Eight patients with stage 2 macular holes received a single injection of 125 μg of ocriplasmin. One patient (12.5%) demonstrated macular hole closure. The posterior hyaloid separated from the macula in six eyes (75%). All seven holes that remained open showed enlargement in hole diameters (narrowest, apical, and basal) at 1 week and 1 month. All seven were successfully closed with surgery. Ellipsoid zone disruptions were observed by OCT in four eyes (50%) and persisted throughout follow-up (more than 6 months on average). In early clinical results, the authors found a lower macular hole closure rate with ocriplasmin than previously reported. Enlargement was observed in all holes that failed to close with ocriplasmin. The authors found ellipsoid zone disruptions that persisted through 6 months of follow-up after ocriplasmin injection. Further work is needed to investigate the cause for these ellipsoid zone changes. Copyright 2014, SLACK Incorporated.

  14. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    SciTech Connect

    Pellerin, O., E-mail: olivier.pellerin@egp.aphp.f; Barral, F. G.; Lions, C.

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 {+-} 15 days (range, 6-722 days)more » through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.« less

  15. SPECTROSCOPIC ANALYSIS OF METAL-POOR STARS FROM LAMOST: EARLY RESULTS

    SciTech Connect

    Li, Hai-Ning; Zhao, Gang; Wang, Liang

    2015-01-10

    We report on early results from a pilot program searching for metal-poor stars with LAMOST and follow-up high-resolution observation acquired with the MIKE spectrograph attached to the Magellan II telescope. We performed detailed abundance analysis for eight objects with iron abundances [Fe/H] < -2.0, including five extremely metal-poor (EMP; [Fe/H] < -3.0) stars with two having [Fe/H] < -3.5. Among these objects, three are newly discovered EMP stars, one of which is confirmed for the first time with high-resolution spectral observations. Three program stars are regarded as carbon-enhanced metal-poor (CEMP) stars, including two stars with no enhancement in their neutron-capturemore » elements, which thus possibly belong to the class of CEMP-no stars; one of these objects also exhibits significant enhancement in nitrogen, and is thus a potential carbon and nitrogen-enhanced metal-poor star. The [X/Fe] ratios of the sample stars generally agree with those reported in the literature for other metal-poor stars in the same [Fe/H] range. We also compared the abundance patterns of individual program stars with the average abundance pattern of metal-poor stars and find only one chemically peculiar object with abundances of at least two elements (other than C and N) showing deviations larger than 0.5 dex. The distribution of [Sr/Ba] versus [Ba/H] agrees that an additional nucleosynthesis mechanism is needed aside from a single r-process. Two program stars with extremely low abundances of Sr and Ba support the prospect that both main and weak r-processes may have operated during the early phase of Galactic chemical evolution. The distribution of [C/N] shows that there are two groups of carbon-normal giants with different degrees of mixing. However, it is difficult to explain the observed behavior of the [C/N] of the nitrogen-enhanced unevolved stars based on current data.« less

  16. Protocolised Management In Sepsis (ProMISe): a multicentre randomised controlled trial of the clinical effectiveness and cost-effectiveness of early, goal-directed, protocolised resuscitation for emerging septic shock.

    PubMed

    Mouncey, Paul R; Osborn, Tiffany M; Power, G Sarah; Harrison, David A; Sadique, M Zia; Grieve, Richard D; Jahan, Rahi; Tan, Jermaine C K; Harvey, Sheila E; Bell, Derek; Bion, Julian F; Coats, Timothy J; Singer, Mervyn; Young, J Duncan; Rowan, Kathryn M

    2015-11-01

    cardiovascular support days in critical care for the EGDT group. At 1 year, the incremental net benefit for EGDT versus usual resuscitation was negative at -£725 (95% CI -£3000 to £1550). The probability that EGDT was more cost-effective than usual resuscitation was below 30%. There were no significant differences in any other secondary outcomes, including health-related quality of life, or adverse events. Recruitment was lower at weekends and out of hours. The intervention could not be blinded. There was no significant difference in all-cause mortality at 90 days for EGDT compared with usual resuscitation among adults identified with early septic shock presenting to EDs in England. On average, costs were higher in the EGDT group than in the usual-resuscitation group while quality-adjusted life-years were similar in both groups; the probability that it is cost-effective is < 30%. The ProMISe (Protocolised Management In Sepsis) trial completes the planned trio of evaluations of EGDT across the USA, Australasia and England; all have indicated that EGDT is not superior to usual resuscitation. Recognising that each of the three individual, large trials has limited power for evaluating potentially important subgroups, the harmonised approach adopted provides the opportunity to conduct an individual patient data meta-analysis, enhancing both knowledge and generalisability. Current Controlled Trials ISRCTN36307479. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 97. See the NIHR Journals Library website for further project information.

  17. Early Results of Endovascular Treatment of the Thoracic Aorta Using the Valiant Endograft

    SciTech Connect

    Thompson, Matt, E-mail: matt.thompson@stgeorges.nhs.uk; Ivaz, Stella; Cheshire, Nicholas

    Endovascular repair of the thoracic aorta has been adopted as the first-line therapy for much pathology. Initial results from the early-generation endografts have highlighted the potential of this technique. Newer-generation endografts have now been introduced into clinical practice and careful assessment of their performance should be mandatory. This study describes the initial experience with the Valiant endograft and makes comparisons with similar series documenting previous-generation endografts. Data were retrospectively collected on 180 patients treated with the Valiant endograft at seven European centers between March 2005 and October 2006. The patient cohort consisted of 66 patients with thoracic aneurysms, 22 withmore » thoracoabdominal aneurysms, 19 with an acute aortic syndrome, 52 with aneurysmal degeneration of a chronic dissection, and 21 patients with traumatic aortic transection. The overall 30-day mortality for the series was 7.2%, with a stroke rate of 3.8% and a paraplegia rate of 3.3%. Subgroup analysis demonstrated that mortality differed significantly between different indications; thoracic aneurysms (6.1%), thoracoabdominal aneurysms (27.3%), acute aortic syndrome (10.5%), chronic dissections (1.9%), and acute transections (0%). Adjunctive surgical procedures were required in 63 patients, and 51% of patients had grafts deployed proximal to the left subclavian artery. Comparison with a series of earlier-generation grafts demonstrated a significant increase in complexity of procedure as assessed by graft implantation site, number of grafts and patient comorbidity. The data demonstrate acceptable results for a new-generation endograft in series of patients with diverse thoracic aortic pathology. Comparison of clinical outcomes between different endografts poses considerable challenges due to differing case complexity.« less

  18. The JCMT Plane Survey: early results from the ℓ = 30° field

    NASA Astrophysics Data System (ADS)

    Moore, T. J. T.; Plume, R.; Thompson, M. A.; Parsons, H.; Urquhart, J. S.; Eden, D. J.; Dempsey, J. T.; Morgan, L. K.; Thomas, H. S.; Buckle, J.; Brunt, C. M.; Butner, H.; Carretero, D.; Chrysostomou, A.; deVilliers, H. M.; Fich, M.; Hoare, M. G.; Manser, G.; Mottram, J. C.; Natario, C.; Olguin, F.; Peretto, N.; Polychroni, D.; Redman, R. O.; Rigby, A. J.; Salji, C.; Summers, L. J.; Berry, D.; Currie, M. J.; Jenness, T.; Pestalozzi, M.; Traficante, A.; Bastien, P.; diFrancesco, J.; Davis, C. J.; Evans, A.; Friberg, P.; Fuller, G. A.; Gibb, A. G.; Gibson, S.; Hill, T.; Johnstone, D.; Joncas, G.; Longmore, S. N.; Lumsden, S. L.; Martin, P. G.; Nguyen Lu'o'ng, Q.; Pineda, J. E.; Purcell, C.; Richer, J. S.; Schieven, G. H.; Shipman, R.; Spaans, M.; Taylor, A. R.; Viti, S.; Weferling, B.; White, G. J.; Zhu, M.

    2015-11-01

    We present early results from the JCMT (James Clerk Maxwell Telescope) Plane Survey (JPS), which has surveyed the northern inner Galactic plane between longitudes ℓ = 7° and ℓ = 63° in the 850-μm continuum with SCUBA-2 (Submm Common-User Bolometer Array 2), as part of the JCMT Legacy Survey programme. Data from the ℓ = 30° survey region, which contains the massive-star-forming regions W43 and G29.96, are analysed after approximately 40 per cent of the observations had been completed. The pixel-to-pixel noise is found to be 19 mJy beam-1 after a smooth over the beam area, and the projected equivalent noise levels in the final survey are expected to be around 10 mJy beam-1. An initial extraction of compact sources was performed using the FELLWALKER method, resulting in the detection of 1029 sources above a 5σ surface-brightness threshold. The completeness limits in these data are estimated to be around 0.2 Jy beam-1 (peak flux density) and 0.8 Jy (integrated flux density) and are therefore probably already dominated by source confusion in this relatively crowded section of the survey. The flux densities of extracted compact sources are consistent with those of matching detections in the shallower APEX (Atacama Pathfinder Experiment) Telescope Large Area Survey of the Galaxy (ATLASGAL) survey. We analyse the virial and evolutionary state of the detected clumps in the W43 star-forming complex and find that they appear younger than the Galactic-plane average.

  19. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results

    PubMed Central

    Sabir, Mohammad

    2015-01-01

    Background The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. Materials and Methods A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. Results The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. Conclusion The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved. PMID:26266220

  20. Titan: Preliminary results on surface properties and photometry from VIMS observations of the early flybys

    USGS Publications Warehouse

    Buratti, B.J.; Sotin, Christophe; Brown, R.H.; Hicks, M.D.; Clark, R.N.; Mosher, J.A.; McCord, T.B.; Jaumann, R.; Baines, K.H.; Nicholson, P.D.; Momary, T.; Simonelli, D.P.; Sicardy, B.

    2006-01-01

    Cassini observations of the surface of Titan offer unprecedented views of its surface through atmospheric windows in the 1-5 ??m region. Images obtained in windows for which the haze opacity is low can be used to derive quantitative photometric parameters such as albedo and albedo distribution, and physical properties such as roughness and particle characteristics. Images from the early Titan flybys, particularly T0, Ta, and T5 have been analyzed to create albedo maps in the 2.01 and 2.73 ??m windows. We find the average normal reflectance at these two wavelengths to be 0.15??0.02 and 0.035??0.003, respectively. Titan's surface is bifurcated into two albedo regimes, particularly at 2.01 ??m. Analysis of these two regimes to understand the physical character of the surface was accomplished with a macroscopic roughness model. We find that the two types of surface have substantially different roughness, with the low-albedo surface exhibiting mean slope angles of ???18??, and the high-albedo terrain having a much more substantial roughness with a mean slope angle of ???34??. A single-scattering phase function approximated by a one-term Henyey-Greenstein equation was also fit to each unit. Titan's surface is back-scattering (g???0.3-0.4), and does not exhibit substantially different backscattering behavior between the two terrains. Our results suggest that two distinct geophysical domains exist on Titan: a bright region cut by deep drainage channels and a relatively smooth surface. The two terrains are covered by a film or a coating of particles perhaps precipitated from the satellite's haze layer and transported by eolian processes. Our results are preliminary: more accurate values for the surface albedo and physical parameters will be derived as more data is gathered by the Cassini spacecraft and as a more complete radiative transfer model is developed from both Cassini orbiter and Huygens Lander measurements. ?? 2006 Elsevier Ltd. All rights reserved.

  1. Early results of an endoscopic nipple-sparing mastectomy for breast cancer.

    PubMed

    Sakamoto, Naomi; Fukuma, Eisuke; Higa, Kuniki; Ozaki, Shinji; Sakamoto, Masaaki; Abe, Satoko; Kurihara, Terumasa; Tozaki, Mitsuhiro

    2009-12-01

    Endoscopic mastectomy has been reportedly associated with smaller scars and greater patient satisfaction; however, few reports on this topic have been made. The purpose of this retrospective study was to examine the early results of endoscopic nipple-sparing mastectomy (E-NSM) and to investigate the safety of this procedure. Between January 2002 and December 2005, a total of 87 patients with breast cancer but without skin and nipple involvement, including two cases of bilateral breast cancer, underwent E-NSM. In case of bloody nipple discharge and suspicious extension near the nipple as assessed by magnetic resonance imaging, the major ducts within the nipple were cored (nipple coring). In other cases, nipple coring was not performed. Of the 89 breasts in 87 patients, 42 had tumors of >2 cm and 80 were diagnosed as having invasive carcinoma. Lymph node involvement was observed in 36 procedures. The overall rate of nipple necrosis was 18% (16 of 89). The rate of nipple necrosis among the procedures with nipple coring was statistically higher than that among those without nipple coring (7 of 17, 41%, vs. 9 of 72, 13%) (P = .01). Nipple involvement was observed in 2.2% (2 of 89). After a median follow-up period of 52 months, distant metastasis was observed in nine cases; no local recurrences occurred in this series. E-NSM is an oncologically safe procedure and an acceptable method in selected patients requiring a mastectomy. The higher rate of nipple necrosis may have been the result of a technical problem, indicating the need for continued improvement in nipple coring procedures.

  2. Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

    SciTech Connect

    Beal, Kathryn; McCormick, Beryl; Zelefsky, Michael J.

    2007-09-01

    Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size {<=}2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterallymore » to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm{sup 3} (range, 20-97 cm{sup 3}). Patients with {<=}47 cm{sup 3} of treated tissue had better cosmetic outcomes than did the women who had >47 cm{sup 3} of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary.« less

  3. Confocal microendoscopy: Characterization of imaging bundles, fluorescent contrast agents, and early clinical results

    NASA Astrophysics Data System (ADS)

    Udovich, Joshua Anthony

    Ovarian cancer is the fifth leading cause of cancer related deaths among women. Early detection improves the chances of survival following diagnosis, and new imaging modalities have the potential to reduce deaths due to this disease. The confocal microendoscope (CME) is a non-destructive in-vivo imaging device for visualization of the ovaries that operates in real-time. Two components of the CME system are evaluated in this paper, and initial results from an ongoing clinical trial are presented. Fiber-optic imaging bundles are used in the CME imaging catheter to relay images over distances of up to 20 feet. When detecting fluorescent signals from investigated tissue, any fluorescence in the system can potentially reduce contrast in images. The emission and transmission properties of three commercially available fiber optic imaging bundles were evaluated. Emission maps of fluorescence from bundles were generated at multiple excitation wavelengths to determine the profile and amount of fluorescence present in bundles manufactured by Sumitomo, Fujikura, and Schott. Results are also presented that show the variation of transmittance as a function of illumination angle in these bundles. Users of high-resolution fiber-optic imaging bundles should be aware of these properties and take them into account during system design. Contrast is improved in images obtained with the CME through the application of topical dyes. Acridine orange (AO) and SYTO 16 are two fluorescent stains that are used to show the size, shape, and distribution of cell nuclei. Unfortunately, little is known about the effects of these dyes on living tissues. This study was undertaken to evaluate the effects of dye treatment on peritoneal tissues in mice. Seventy-five Balb/c mice were split into five groups of fifteen and given peritoneal injections of dye or saline. The proportions of negative outcomes for the control and test groups were compared using confidence intervals and the Fisher's exact test

  4. Radiographic and functional results in the treatment of early stages of Charcot neuroarthropathy with a walker boot and immediate weight bearing.

    PubMed

    Parisi, Maria Candida Ribeiro; Godoy-Santos, Alexandre Leme; Ortiz, Rafael Trevisan; Sposeto, Rafael Barban; Sakaki, Marcos Hideyo; Nery, Marcia; Fernandes, Tulio Diniz

    2013-01-01

    One of the most common gold standards for the treatment of Charcot neuroarthropathy (CN) in the early Eichenholtz stages I and II is immobilization with the total contact casting and lower limb offloading. However, the total amount of offloading is still debatable. This study evaluates the clinical and radiographic findings in the treatment of early stages of CN (Eichenholtz stages I and II) with a walker boot and immediate total weight-bearing status. Twenty-two patients with type 2 diabetes mellitus (DM) and CN of Eichenholtz stages I and II were selected for non-operative treatment. All patients were educated about their condition, and full weight bearing was allowed as tolerated. Patients were monitored on a fortnightly basis in the earlier stages, with clinical examination, temperature measurement, and standardized weight-bearing radiographs. Their American Orthopedic Foot and Ankle Society (AOFAS) scores were determined before and after the treatment protocol. No cutaneous ulcerations or infections were observed in the evaluated cases. The mean measured angles at the beginning and end of the study, although showing relative increase, did not present a statistically significant difference (p > 0.05). Mean AOFAS scores showed a statistically significant improvement by the end of the study (p < 0.005). The treatment of early stages of CN (Eichenholtz stages I and II) with emphasis on walker boot and immediate weight bearing has shown a good functional outcome, non-progressive deformity on radiographic assessment, and promising results as a safe treatment option.

  5. Aquaculture: Challenges and promise

    USDA-ARS?s Scientific Manuscript database

    Aquaculture is the culture of aquatic organisms, which includes fish, mollusks, crustaceans, algae and plants. People have been involved in different forms of aquaculture for thousands of years, with early documented evidence dating back as far as 500 BC in China (Ling 1977). Today, the practice of ...

  6. The Promise of Quantum Simulation.

    PubMed

    Muller, Richard P; Blume-Kohout, Robin

    2015-08-25

    Quantum simulations promise to be one of the primary applications of quantum computers, should one be constructed. This article briefly summarizes the history of quantum simulation in light of the recent result of Wang and co-workers, demonstrating calculation of the ground and excited states for a HeH(+) molecule, and concludes with a discussion of why this and other recent progress in the field suggest that quantum simulations of quantum chemistry have a bright future.

  7. The promise of quantum simulation

    DOE PAGES

    Muller, Richard P.; Blume-Kohout, Robin

    2015-07-21

    In this study, quantum simulations promise to be one of the primary applications of quantum computers, should one be constructed. This article briefly summarizes the history of quantum simulation in light of the recent result of Wang and co-workers, demonstrating calculation of the ground and excited states for a HeH + molecule, and concludes with a discussion of why this and other recent progress in the field suggest that quantum simulations of quantum chemistry have a bright future.

  8. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results.

    PubMed

    Sabir, Mohammad; Alam, Mohammad Nazish

    2015-06-01

    The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved.

  9. SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS

    PubMed Central

    GEBELLI, Jordi Pujol; de GORDEJUELA, Amador Garcia Ruiz; RAMOS, Almino Cardoso; NORA, Mario; PEREIRA, Ana Marta; CAMPOS, Josemberg Marins; RAMOS, Manoela Galvão; BASTOS, Eduardo Lemos de Souza; MARCHESINI, João Batista

    2016-01-01

    ABSTRACT Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. Aim: To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Methods: Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. Results: A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). Conclusions: SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. PMID:27683784

  10. [Cholecystectomy in the elderly: early results of open versus laparoscopic approach].

    PubMed

    Régo, Ronaldo Elias Carnut; de Campos, Tércio; de Moricz, André; Silva, Rodrigo Altenfelder; Pacheco Júnior, Adhemar Monteiro

    2003-01-01

    The rise of elderly population is due to the improvement of life expectancy. The biliary lithiasis is the most common condition requiring intra-abdominal surgery. Half of these patients sustain associated diseases and frequently develops acute and complicated forms of cholelithiasis. Therefore, cholecystectomy is indicated for patients with chronic symptomatic disease. During a long period open cholecystectomy has been practiced, with low complications and mortality rates. Videolaparoscopy has been recently proposed as an option in these cases, however, few studies compared its advantages over open cholecystectomy for elderly patients. To access the early results of the surgical treatment for cholelithiasis in the elderly submitted to an open or laparoscopic cholecystectomy. retrospective study with 246 patients > 65 years old, who underwent elective cholecystectomy through a subcostal incision (group I) or laparoscopic approach (group II). We employed Student's t test and Spearman's correlation for statistical analysis, considering p < 0,05 as significant. A hundred and twenty patients were arranged in group I and 126 in group II. Associated diseases were present in 155 cases (63). There were no differences between the groups regarding both the distribution of comorbid conditions. Conversion was evaluated in 10 patients (8.3%). The mean operative time was 133 minutes in group I and 112 minutes in group II (p=0.001). The mean hospital stay in group I was 3,3 days and in group II was 3.2 days p=0.698. Thirteen patients in each group developed complications: group I (10.8%) and group II (10.3%) p=0,896. There was no statistis significance in complication rate related to gender, age, associated diseases and ASA when the both groups were compared. There were two deaths, both in group II, although the mortality rate was not statiscally significant between the groups (p=0.158). Both open and laparoscopic cholecystectomy can be practiced in the elderly with low and

  11. Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System.

    PubMed

    Mallios, Alexandros; Jennings, William C; Boura, Benoit; Costanzo, Alessandro; Bourquelot, Pierre; Combes, Myriam

    2018-04-18

    We reviewed our initial experience creating a percutaneous arteriovenous fistula (pAVF) using a thermal resistance anastomosis device with proximal radial artery inflow. A retrospective review was conducted of all patients who underwent a pAVF creation procedure between May 2017 and October 2017. Primary end points of the study were technical success, patency by Doppler ultrasound examination or angiography, flow levels achieved, time to first use, and pAVF-related complications. A pAVF was attempted in 34 patients with technical success in 33 individuals (97%). Patency of the pAVF was 94%. Mean access flow was 946 mL/min (brachial artery measurement) at the latest follow-up visit (53-229 days; average, 141 days). At 6 weeks, all fistulas have been used or were ready for dialysis by clinical examination or ultrasound examination. Only one patient required superficialization of the upper arm cephalic vein by lipectomy. There were no adverse events related to the pAVF creation or use, nor was there need for further interventions. Successful pAVFs with proximal radial artery inflow were created with excellent initial results regarding technical success, patency, and safety. Advantages include avoidance of a surgical incision, short procedure times, good acceptance by patients, prompt access maturation, moderate flow, and low-pressure access, with possible reduction of risk for ischemic complications. Avoidance of vessel manipulation and side branch ligation might reduce risk of thrombosis and improve long-term patency and reduce need for further interventions. These early findings need to be confirmed in larger and longer follow-up studies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  12. The effect of gender on early and intermediate results of endovascular aneurysm repair.

    PubMed

    Nordness, Paul J; Carter, Glen; Tonnessen, Britt; Charles Sternbergh, W; Money, Samuel R

    2003-11-01

    Results of endovascular aneurysm repair (EVAR) may be gender dependent. Between September 1997 and September 2001, 118 AneuRx aortic grafts were placed for aneurysmal disease. During this period, 17 females and 101 males were treated with this device. A prospective database was maintained and supplemented with retrospectively gathered information to evaluate early and mid-term end points. A total of 113 devices were deployed in 118 attempts. Length of procedure was greater for females (3.3 +/- 1.75 vs. 2.3 +/- 0.8 hr, p = 0.05) and they were more likely to have significant arterial dissections (12% vs. 1%, p = 0.05). The mortality rates at 1 month were 12% for females and 0% for males ( p = 0.02); the complication rates at 1 month were 41% for females and 15% for males ( p = 0.02). Although technical success was not significantly different between the sexes, assisted primary technical success (requiring endovascular assistance) and assisted secondary technical success (requiring open surgical assistance) were significantly different (71% vs. 96%, p = 0.003; and 76% vs. 98%, p = 0.004, respectively). Clinical success at 1 month was 59% for females and 84% for males ( p = 0.02). This difference was also significant when assessing 1-month assisted primary clinical success (59% vs. 90%, p = 0.003) and assisted secondary clinical success as well (71% vs. 96%, p = 0.003). Clinical success and assisted primary clinical success were not different at 6- or 12-month intervals, however, assisted secondary clinical successes differed at both time intervals (56% vs. 83%, p = 0.02; and 56% vs. 81%, p = 0.05, respectively). As-yet undetermined factors appear to predispose females to complications and technical difficulties in the short term. Endovascular and open procedures required to achieve ongoing clinical success in the following months appear to favor males to a greater degree than females.

  13. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries

    PubMed Central

    2014-01-01

    Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to

  14. Credible threats and promises.

    PubMed Central

    McNamara, John M; Houston, Alasdair I

    2002-01-01

    We consider various implications of information about the other player in two-player evolutionary games. A simple model of desertion shows that information about the partner's behaviour can be disadvantageous, and highlights the idea of credible threats. We then discuss the general issue of whether the partner can convince the focal player that it will behave in a specific way, i.e. whether the focal player can make credible threats or promises. We show that when desertion decisions depend on reserves, a player can manipulate its reserves so as to create a credible threat of desertion. We then extend previous work on the evolution of trust and commitment, discussing conditions under which it is advantageous to assume that a partner will behave in a certain way even though it is not in its best interest. PMID:12495517

  15. Credible threats and promises.

    PubMed

    McNamara, John M; Houston, Alasdair I

    2002-11-29

    We consider various implications of information about the other player in two-player evolutionary games. A simple model of desertion shows that information about the partner's behaviour can be disadvantageous, and highlights the idea of credible threats. We then discuss the general issue of whether the partner can convince the focal player that it will behave in a specific way, i.e. whether the focal player can make credible threats or promises. We show that when desertion decisions depend on reserves, a player can manipulate its reserves so as to create a credible threat of desertion. We then extend previous work on the evolution of trust and commitment, discussing conditions under which it is advantageous to assume that a partner will behave in a certain way even though it is not in its best interest.

  16. Direct anterior versus miniposterior THA with the same advanced perioperative protocols: surprising early clinical results.

    PubMed

    Poehling-Monaghan, Kirsten L; Kamath, Atul F; Taunton, Michael J; Pagnano, Mark W

    2015-02-01

    Although some surgeons strongly advocate for one approach over the other, there are few data directly comparing the direct anterior approach with a miniposterior approach for total hip arthroplasty (THA). Using the same advanced pain and rapid rehabilitation protocols for both groups, we compared the direct anterior and miniposterior approaches with respect to (1) return to activities of daily living at 2 days, 2 weeks, or 2 months; (2) risk of intraoperative or early postoperative complications; and (3) component position. Over a 1-year period we identified all consecutive, primary direct anterior and miniposterior THAs performed by two surgeons at our institution, totaling 242 patients. Of those, 20 did not meet inclusion criteria as a result of prior trauma or surgery about the hip. A total of 222 patients, 126 direct anterior and 96 miniposterior, were retrospectively evaluated. All cases were done by one of two surgeons, one of whom performs THA exclusively through the direct anterior approach and the other who only uses the miniposterior approach. Groups did not differ demographically with mean±SD age 64±12 years, mean body mass index 30±5.7 kg/m2, and 50% female. The same rapid rehabilitation protocols were used with no postoperative hip positioning precautions. No differences were seen between the two groups in mean length of stay (2.2 days; range, 1-9 days), operative or in-hospital complications, intravenous breakthrough analgesia, stairs, maximum feet walked in-hospital, or percent discharged to home (80% [177 of 222]; all p>0.2). The direct anterior patients had longer mean operative times (114 minutes; range, 60-251 minutes) than the miniposterior patients (mean, 60 minutes; range, 41-113 minutes; p<0.001). The direct anterior group had a higher maximum visual analog scale pain score (5.3 direct anterior; ±2, versus 3.8 MP; ±2; p<0.0001). At 2 weeks, more direct anterior patients required gait aids (92% [116 of 126]) than miniposterior (68% [62 of

  17. An alternative treatment option for scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis: early results of a prospective study on the pyrocarbon adaptive proximal scaphoid implant (APSI).

    PubMed

    Daruwalla, Zubin J; Davies, Kirstenlee; Shafighian, Ali; Gillham, Nicholas R

    2013-06-01

    Scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis are difficult to treat. Options include proximal row carpectomy (PRC), four corner fusion (4CF) and wrist arthroplasty or arthrodesis. However, with inevitable disease progression, a significant proportion of patients undergo total wrist fusion. This reduces function by abolishing wrist movement. We review the preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients from our prospective study and challenge the assumption that there are no surgical alternatives. This study prospectively studied 12 consecutive pyrocarbon Interpositional arthroplasty day cases over 3 years. Patients were assessed using level of pain, ranges of motion, grip strength, key pinch, type of and time to return to work and the disabilities of the arm, shoulder and hand (DASH) score, both preoperatively and postoperatively. Radiographs were also taken and patient satisfaction recorded. All 12 patients could be contacted and were satisfied with their surgery. There were no immediate, early or late postoperative complications associated with the procedure. Promising results were noted in terms of pain, ranges of motion, grip strength, key pinch, type of and time to return to work, DASH scores, photographs and radiographs. The mean follow-up was 18 months, range between 11 months and 3 years. Our early results are encouraging, warrant further and longer studies and support the use of pyrocarbon implants as a primary procedure in what is a generally young and active subgroup of patients.

  18. Massage therapy decreases cancer-related fatigue: Results from a randomized early phase trial.

    PubMed

    Kinkead, Becky; Schettler, Pamela J; Larson, Erika R; Carroll, Dedric; Sharenko, Margaret; Nettles, James; Edwards, Sherry A; Miller, Andrew H; Torres, Mylin A; Dunlop, Boadie W; Rakofsky, Jeffrey J; Rapaport, Mark Hyman

    2018-02-01

    Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by cancer survivors, yet treatment options for CRF are limited. In this study, we evaluated the efficacy of weekly Swedish massage therapy (SMT) versus an active control condition (light touch [LT]) and waitlist control (WLC) on persistent CRF in breast cancer survivors. This early phase, randomized, single-masked, 6-week investigation of SMT, LT, and WLC enrolled 66 female stage 0-III breast cancer survivors (age range, 32-72 years) who had received surgery plus radiation and/or chemotherapy/chemoprevention with CRF (Brief Fatigue Inventory > 25). The primary outcome was the Multidimensional Fatigue Inventory (MFI), with the National Institutes of Health PROMIS Fatigue scale secondary. Mean baseline MFI scores for 57 evaluable subjects were 62.95 for SMT, 55.00 for LT, and 60.41 for WLC. SMT resulted in a mean (standard deviation) 6-week reduction in MFI total scores of -16.50 (6.37) (n = 20) versus -8.06 (6.50) for LT (n = 20) and an increase of 5.88 (6.48) points for WLC (n = 17) (treatment-by-time P < .0001). The mean baseline PROMIS Fatigue scores were SMT, 22.25; LT, 22.05; and WLC, 23.24. The mean (standard deviation) reduction in PROMIS Fatigue scores was -5.49 (2.53) points for SMT versus -3.24 (2.57) points for LT and -0.06 (1.88) points for WLC (treatment-by-time P = .0008). Higher credibility, expectancy, and preference for SMT than for LT did not account for these results. SMT produced clinically significant relief of CRF. This finding suggests that 6 weeks of a safe, widely accepted manual intervention causes a significant reduction in fatigue, a debilitating sequela for cancer survivors. Cancer 2018;124:546-54. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.

    PubMed

    Creswell, Jacob; Codlin, Andrew J; Andre, Emmanuel; Micek, Mark A; Bedru, Ahmed; Carter, E Jane; Yadav, Rajendra-Prasad; Mosneaga, Andrei; Rai, Bishwa; Banu, Sayera; Brouwer, Miranda; Blok, Lucie; Sahu, Suvanand; Ditiu, Lucica

    2014-01-02

    The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the

  20. Early and Long-Term Results of Subclavian Angioplasty in Aortoarteritis (Takayasu Disease): Comparison with Atherosclerosis

    SciTech Connect

    Tyagi, Sanjay; Verma, Puneet K.; Gambhir, Daljeet S.

    1998-05-15

    Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions. Results: PTA was successful in 52 (92.8%) stenotic lesions and 3more » (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4 {+-} 9.3 years vs 54.5 {+-} 10.5 years; p < 0.001), more often female (75% vs 17.4%; p < 0.001), gangrene was uncommon (0% vs 17.4%; p < 0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p < 0.001). The luminal diameter stenoses were similar before PTA (88.6 {+-} 9.7% vs 89.0 {+-} 9.1%; p= NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9 {+-} 4.6 ATM vs 5.5 {+-} 1.0 ATM; p < 0.001). This group had more residual stenosis (15.5 {+-} 12.4% vs 8.3 {+-} 9.4%; p < 0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3-120 months (mean 43.3 {+-} 28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty. Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that

  1. Early results after laparoscopic Roux-en-Y gastric bypass: effect of the learning curve

    PubMed Central

    Andrew, Christopher G.; Hanna, Wael; Look, Didier; McLean, Alexander P.H.; Christou, Nicolas V.

    2006-01-01

    Introduction This study was performed to evaluate the safety and short-term efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity and to describe the relation between learning curve and short-term outcomes. Methods We collected a prospective database on the first 201 consecutive patients who underwent LRYGB by a single university-based, experienced bariatric surgeon over 24 months. We divided patients into 3 consecutive groups of 67 patients for analysis (Group 1, Group 2 and Group 3). Results The mean patient age was 37 (standard deviation [SD] 9) years; mean body mass index (BMI) was 49.2 (SD 8.3) kg/m2. BMI was similar in Groups 1 and 2 (mean 47.1, SD 5.9 and mean 48.7, SD 8.9 kg/m2) but increased in Group 3 (mean 52, SD 9.7 kg/m2, p < 0.01). Operative time decreased from 145 (SD 30) minutes in Group 1 to 114 (SD 24) minutes in Group 2 (p < 0.01) and was maintained at 119 (SD 23) minutes in Group 3. Early and late complication rates were 14.9% and 12.4%, respectively. Leak rates decreased from 6.0% in the first group to 1.5% in Groups 2 and 3, but they did not reach statistical significance. Anastomotic stricture rates decreased from 11.9% in Group 1 to 3.0% in Group 2 (p < 0.01). Overall excess weight loss for the entire series was 31.5% (SD 11.9%), 54.5% (SD 14.1%), 77.1% (SD 18.5%) and 82.1% (SD 17.5%) at 3, 6, 12 and 18 months, respectively. Conclusion LRYGB can be performed with acceptable morbidity and short-term results during the learning curve. In our series, operative time and anastomotic stricture rates decreased with experience, despite an increase in mean BMI. PMID:17234071

  2. Long term results of early density management of a third growth redwood stand

    Treesearch

    Lynn A. Webb; John-Pascal Berrill; James L. Lindquist

    2017-01-01

    Precommercial or early thinning of regenerating redwood forests can support management objectives including maximizing yield, forest structure restoration, and promoting carbon sequestration. We present data collected over 30 years following a precommercial thinning (PCT) in a 19 year-old naturally regenerated and planted coast redwood (Sequoia sempervirens ...

  3. Intervention with African American Premature Infants: Four-Month Results of an Early Intervention Program

    ERIC Educational Resources Information Center

    Teti, Douglas M.; Black, Maureen M.; Viscardi, Rose; Glass, Penny; O'Connell, Melissa A.; Baker, Linda; Cusson, Regina; Reiner Hess, Christine

    2009-01-01

    This study evaluates the efficacy of an early intervention program targeting African American mothers and their premature, low birth weight infants at 3 to 4 months' corrected age from four neonatal intensive care units, 173 families are recruited (84 intervention, 89 control). The 8-session, 20-week intervention consists of a psychoeducational…

  4. Early generation selection results from a two year, six location study

    USDA-ARS?s Scientific Manuscript database

    In potato breeding programs, early generation selections are rarely evaluated in multiple environments because of limited seed quantities. By the time seed quantities are available, few clones remain from the original population. The purpose of this study was to allow multiple locations to select ...

  5. ECOLOGICAL RESEARCH IN THE LARGE-SCALE BIOSPHERE–ATMOSPHERE EXPERIMENT IN AMAZONIA: EARLY RESULTS.

    Treesearch

    M. Keller; A. Alencar; G. P. Asner; B. Braswell; M. Bustamente; E. Davidson; T. Feldpausch; E. Fern ndes; M. Goulden; P. Kabat; B. Kruijt; F. Luizao; S. Miller; D. Markewitz; A. D. Nobre; C. A. Nobre; N. Priante Filho; H. Rocha; P. Silva Dias; C von Randow; G. L. Vourlitis

    2004-01-01

    The Large-scale Biosphere–Atmosphere Experiment in Amazonia (LBA) is a multinational, interdisciplinary research program led by Brazil. Ecological studies in LBA focus on how tropical forest conversion, regrowth, and selective logging influence carbon storage, nutrient dynamics, trace gas fluxes, and the prospect for sustainable land use in the Amazon region. Early...

  6. The Employment Retention and Advancement Project Early Results from Four Sites

    ERIC Educational Resources Information Center

    Bloom, Dan; Hendra, Richard; Martinson, Karin; Scrivener, Susan

    2005-01-01

    Millions of welfare recipients have entered the labor force in the past decade, but surveys show that many remain in unstable, low-paying jobs that offer few opportunities for advancement. This report presents early evidence on the effectiveness of four diverse programs designed to help current or former welfare recipients work more steadily and…

  7. Effect of Formative and Ability Test Results on Early Learning of Students

    ERIC Educational Resources Information Center

    Kadir, Abdul; Ardi, Muhammad; Nurhayati, B.; Dirawan, Gufran Darma

    2016-01-01

    The objective of this study was to examine the relationship of formative tests to early learning ability of students in the science learning style. This research used an experimental method with a 2 x 2 factorial design. The participants comprised all the students in class VII of the Islamic Junior High School State of Kolaka, a total of 343…

  8. Exercise Effects on Fitness and Bone Mineral Density in Early Postmenopausal Women: 1-Year EFOPS Results.

    ERIC Educational Resources Information Center

    Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.

    2002-01-01

    Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…

  9. Project Early Kindergarten Evaluation: Results through 2009-10 of a Saint Paul Public Schools Initiative

    ERIC Educational Resources Information Center

    Maxfield, Jennifer; Gozali-Lee, Edith; Mueller, Dan

    2010-01-01

    Project Early Kindergarten (PEK) aims to improve the school-readiness of Saint Paul children and help close the achievement gap through offering high-quality educational experiences for preschool children. This report comes at the conclusion of the sixth year of PEK. Following an initial planning year (2004-05), PEK has served children through the…

  10. Tennessee Promise: A Response to Organizational Change

    ERIC Educational Resources Information Center

    Littlepage, Ben; Clark, Teresa; Wilson, Randal; Stout, Logan

    2018-01-01

    Community colleges in Tennessee, either directly or indirectly, experienced unprecedented change as a result of Tennessee Promise. The present study explored how student support service administrators at three community colleges responded to organizational change as a result of the Tennessee Promise legislation. Investigators selected community…

  11. [Factors associated with reported vaccination coverage in early infancy: results of a telephone survey].

    PubMed

    Nebot, M; Muñoz, E; Figueres, M; Rovira, G; Robert, M; Minguell, D

    2001-01-01

    Barcelona's Continuing Immunization Plan affords the possibility Of monitoring the immunization coverage of the population by means of the voluntary family postal notification system. Prior studies have revealed that some families fail to provide notification while being correctly vaccinated, which can lead to actual coverage being underestimated. The objectives of this study are to estimate the early childhood immunization coverage of the population and to ascertain the factors associated with failure to provide notification of immunization. A phone survey was conducted on a sample of 500 children regarding whom there was no record of any notification of the first three childhood vaccine doses (diphtheria, tetanus, whooping cough and oral polio), in addition to a sample of 500 children who were on record as having been immunized. To estimate the actual immunization coverage, all children were considered to have been properly immunized when their family members did provide notification. As regards those who failed to reply, it was considered in the worst of cases that these were cases of children who had not be immunized. In the best of cases scenario, a coverage similar to those of the responses was assumed. The response to the questionnaire was higher among those who had previously provided notification of immunization by way of the postal notification system (79.1%) than among those who had failed to provide notification of immunization (67%). The leading factors associated with failure to report immunization status were the size of the families, the use of private health care services and the place of birth of the parents. Solely six (6) cases of those who had failed to report immunization admitted to not having immunized their children, totaling 1.9% of the responses. The immunization coverage of the population in question would total 99.7% in the best of cases and 93.7% in the worst of cases scenario. Immunization coverage of the population in question is

  12. Parotid gland sparing in patients undergoing bilateral head and neck irradiation: techniques and early results.

    PubMed

    Eisbruch, A; Ship, J A; Martel, M K; Ten Haken, R K; Marsh, L H; Wolf, G T; Esclamado, R M; Bradford, C R; Terrell, J E; Gebarski, S S; Lichter, A S

    1996-09-01

    To minimize xerostomia in patients receiving bilateral head and neck irradiation (RT) by using conformal RT planning to spare a significant volume of one parotid gland from radiation. The study involved 15 patients with head and neck tumors in whom bilateral neck radiation was indicated. The major salivary glands and the targets (tumor, surgical bed, metastases to lymph nodes, and the locations of lymph nodes at risk for metastases) were outlined on axial computed tomography images. Beam's-eye view (BEV) displays were used to construct conformal beams that delivered the prescribed doses to the targets while sparing from direct radiation most of one parotid gland. The gland that was planned to be spared resided in the neck side that was judged in each patient to be at a lesser risk of metastatic disease. Major salivary gland flow rates and the responses to a subjective xerostomia questionnaire were assessed before, during, and after radiation. Radiation planning for patients with central oropharyngeal tumors required the generation of multiple axial nonopposed beams. The resulting isodoses encompassed the targets, including the retropharyngeal nodes and the jugular nodes up to the base of skull bilaterally, while limiting the dose to the oral cavity, spinal cord, and one parotid gland. For patients with lateralized tumors, the ipsilateral neck side was treated up to the base of the skull; in the contralateral neck side, the treatment included the subdigastric nodes but excluded the jugular nodes at the base of the skull and most of the parotid gland. This was accomplished by a moderate gantry angle that was chosen using the BEV displays. Three months following the completion of radiation, the spared parotid glands retained on average 50% of their unstimulated and stimulated flows. In contrast, no saliva flow was measured from the unspared glands in any of the patients. Subjective xerostomia was absent, mild, or not different from that reported before radiation in 10

  13. Enceladus-Mimas paradox: a result of different early evolutions of satellites?

    NASA Astrophysics Data System (ADS)

    Czechowski, Leszek; Witek, Piotr

    2015-04-01

    the coefficient of the heat conduction in the considered layer, i.e.: kconv =Nu k. This approach is used successfully in parameterized theory of convection for SSC in the Earth and other planets (e.g. [3], [4]). Parameterization of liquid state convection (LSC) is even simpler. Ra in molten region is very high (usually higher than 1016). The LSC could be very intensive resulting in almost adiabatic temperature gradient given by: dT-= gαmT-, dr cpm where αm and cpm are thermal expansion coefficient and specific heat in molten region, g is the local gravity. In Enceladus and Mimas the adiabatic gradient is low and therefore LSC region is almost isothermal. 2. Results: Comparison of thermal models of Mimas and Enceladus indicates that conditions favorable for starting tidal heating (interior hot enough) lasted for short time (~107yr) in Mimas and for ~108 yr in Enceladus. This could explain Mimas-Enceladus paradox. 3. Conclusions: The Mimas-Enceladus paradox is probably the result of short time when Mimas was hot enough to allow for substantial tidal heating. The Mimas-Tethys resonance formed later when Mimas was already cool. (see also [1, 4]) The full text of the paper will be published in Acta Geophysica [5]. Acknowledgements: The research is partly supported by National Science Centre (grant 2011/ 01/ B/ ST10/06653). References : [1] Czechowski, L. (2014) Some remarks on the early evolution of Enceladus. Planet. Sp. Sc. 104, 185-199. [2] Merk, R., Breuer, D., Spohn, T. (2002). Numerical modeling of 26Al induced radioactive melting of asteroids concerning accretion. Icarus 199, 183-191. [3] Sharpe, H.N., Peltier, W.R., (1978) Parameterized mantle convection and the Earth's thermal history. Geophys. Res. Lett. 5, 737-740. [4] Czechowski, L. (2006) Parameterized model of convection driven by tidal and radiogenic heating. Adv. Space Res. 38, 788-793. [5] Czechowski, L., Witek, P. (2015) Comparisons of early evolutions of Mimas and Enceladus. Submitted to Acta

  14. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Astrophysics Data System (ADS)

    Hals, F. A.

    1981-03-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  15. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Technical Reports Server (NTRS)

    Hals, F. A.

    1981-01-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  16. Results from a pediatric surgical centre justify early intervention in disorders of sex development.

    PubMed

    Crawford, Jennifer M; Warne, Garry; Grover, Sonia; Southwell, Bridget R; Hutson, John M

    2009-02-01

    Controversy persists surrounding early management of disorders of sex development. We assessed genital appearance, gender identity, and quality of life in prepubertal children who have had early surgical intervention. Children treated for disorders of sex development who were 5 to 10 years of age were eligible (n = 54). Children were scored (modified Creighton scale) for anatomical and cosmetic outcome, and both patients and parents completed PedsQL quality-of-life and gender identity questionnaires, with ethics approval. Of 54 patients, 41 presented for review. Treatment began at 13.2 (1.8-250.1) months (median; range) and were reviewed at 7.5 +/- 2.1 (mean +/- SD) years of age. Nineteen were raised as girls and 22 as boys. Girls had good (85%) or satisfactory (15%) anatomical/cosmetic outcome, whereas 52% boys had good, 38% satisfactory, and 10% poor cosmetic outcomes. On gender identity questionnaire, boys scored 3.9 +/- 0.4 (mean +/- SD) and girls 3.6 +/- 0.5; 1 of 19 boys and 3 of 19 girls had lower scores, suggesting risk of gender identity disorder. Quality-of-life scores were 80+ for physical and 65 to 80 for psychosocial scores. Early intervention is generally associated with positive outcomes for patients and parents. Girls had better anatomical outcomes than boys, and gender dysphoria risks were low in both sexes.

  17. Early results of a prospective study on the pyrolytic carbon (pyrocarbon) Amandys® for osteoarthritis of the wrist

    PubMed Central

    Daruwalla, ZJ; Davies, KL; Shafighian, A; Gillham, NR

    2012-01-01

    INTRODUCTION The preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients were reviewed. As it is currently only a limited release product, we describe to potential users early complications and negative outcomes. METHODS Patients were assessed using pain levels, ranges of motion, grip strength, type of and time to return to work as well as pre-operative and post-operative DASH (Disabilities of the Arm, Shoulder and Hand) scores. Radiographs were taken and patient satisfaction was recorded. RESULTS All six patients were contacted. One was not satisfied. Three had reduced motion. None experienced squeaking. There were no immediate or late post-operative complications. There was one early volar displacement of an implant. CONCLUSIONS Although our early results are somewhat encouraging, further and longer studies are warranted before supporting the use of this particular pyrocarbon implant as a primary procedure. PMID:23031769

  18. Widespread Magmatism as a Result of Impact Related Decompression Melting on Early Mars

    NASA Astrophysics Data System (ADS)

    Edwards, C. S.; Bandfield, J. L.; Christensen, P. R.; Rogers, D.

    2012-12-01

    Flat-floored craters on Mars have been observed since early spacecraft viewed the surface. Early work characterized these craters as infilled by sedimentary materials [e.g. Christensen, 1983] but later work using THEMIS thermal inertia determined these craters contain some of the rockiest materials on the planet and not sedimentary materials [Edwards et al., 2009]. Here we investigate the distribution, physical properties (morphology and thermal inertia), and composition of these craters over the entire planet. We find the majority of rocky crater floors identified (~3300) are concentrated in the low albedo (0.1-0.17), cratered southern highlands. These craters are associated with the highest thermal inertia values (e.g. > 500 to 2000 J m-2 K-1 s-1/2), some of the most mafic materials on the planet (enriched in olivine/pyroxene vs. high-Si phases/plagioclase, often with >10-15% olivine areal abundance), and formed ~3.5 billion years ago. Based on the properties of the crater fill materials described, three mechanisms are considered for the formation of flat-floored, high thermal inertia crater floors on Mars including: 1) the lithification/induration of sediments, 2) the ponding of crustal melt material related to the heat generated during the impact process, and 3) infilling by volcanic materials. We find the only likely scenario is volcanic infilling through fractures created in the impact event. Furthermore, we find the generation of the primitive magma would be directly sourced from the decompression melting of the martian mantle due to the removal of several kilometers of overlying crustal material by the impactor. As the ancient martian crust was likely thin and the geothermal gradients were significantly higher than present day [e.g. Zuber, 2001], the decompression melting of the mantle [Bertka and Holloway, 1994] would be more likely to occur on early Mars then under present day conditions. This is borne out by the ancient ages (~3-4Ga) of the crater floors

  19. Lipid raft disarrangement as a result of neuropathological progresses: a novel strategy for early diagnosis?

    PubMed

    Marin, R; Rojo, J A; Fabelo, N; Fernandez, C E; Diaz, M

    2013-08-15

    Lipid rafts are the preferential site of numerous membrane signaling proteins which are involved in neuronal functioning and survival. These proteins are organized in multiprotein complexes, or signalosomes, in close contact with lipid classes particularly represented in lipid rafts (i.e. cholesterol, sphingolipids and saturated fatty acids), which may contribute to physiological responses leading to neuroprotection. Increasing evidence indicates that alteration of lipid composition in raft structures as a consequence of neuropathologies, such as Alzheimer's disease (AD) and Parkinson's disease (PD), causes a dramatic increase in lipid raft order. These phenomena may correlate with perturbation of signalosome activities, likely contributing to neurodegenerative progression. Interestingly, significant disruption of stable raft microenvironments has been already observed in the first stages of either AD or PD, suggesting that these alterations may represent early events in the neuropathological development. In this regard, the search for biochemical markers, such as specific metabolic products altered in the brain at the first steps of the disease, presently represents an important challenge for early diagnostic strategies. Alterations of these biomarkers may be reflected in either plasma or cerebrospinal fluid, thus representing a potential strategy to predict an accurate diagnosis. We propose that pathologically-linked lipid raft markers may be interesting candidates to be explored at this level, although it has not been studied so far to what extent alteration of different signalosome components may be reflected in peripheral fluids. In this mini-review, we will discuss on relevant aspects of lipid rafts that contribute to the modulation of neuropathological events related to AD and PD. An interesting hypothesis is that anomalies on raft biomarkers measured at peripheral fluids might mirror the lipid raft pathology observed in early stages of AD and PD. Copyright

  20. Outpatient follow-up after treatment for early breast cancer: updated results after 5 years.

    PubMed

    Churn, M; Kelly, V

    2001-01-01

    The value of frequent outpatient follow-up in the first few years after primary treatment for early breast cancer is a controversial issue. Schedules involving 3-4 monthly visits in the first 2-3 years and 6-monthly from years 3-5 are still commonplace. In this study we audited such a policy from a single cancer centre, identifying a cohort of all 612 patients with early breast cancer (pT(1-3)pN(0-1)NxM0) referred for adjuvant therapy in 1993. The hospital records were reviewed to ascertain patient and tumour characteristics, the surgical and adjuvant treatment received, the timing and sequencing of recurrences and their mode of detection. Five hundred and five patients had breast conservation surgery. The actuarial local recurrence-free survival rate at 5 years in this group was 94.5%. Twenty-five of the 31 local recurrences that occurred were the first site of relapse. Eight (32%) of these were detected at routine clinic appointments, seven (28%) by routine mammography, and nine (36%) were interim referrals. Significant risk factors for local recurrence identified were lymph node status (P = 0.03) and tumour grade (P = 0.04). One hundred and four patients underwent mastectomy. The actuarial local recurrence-free survival at 5 years in this group was 85.4%. Nine of the 13 local recurrences were the first site of relapse. Six (66.7%) of these were detected at routine appointments. The significant risk factor for local recurrence identified was tumour grade (P = 0.03). Overall, 60.1% of metastases presented as interim referrals. Nodal status, tumour grade and tumour stage were confirmed as significant risk factors for metastasis (P < or = 0.001). Hazard rate analysis demonstrated a peak incidence of both local and metastatic recurrences in the second year, diminishing thereafter. This peak was largely confined to patients with tumours with poor prognostic features. We identified only eight patients out of a total of 612 followed up as outpatients for 5 years who had

  1. Early add-on lacosamide in a real-life setting: results of the REALLY study.

    PubMed

    Villanueva, Vicente; Garcés, Mercedes; López-Gomáriz, Elena; Serratosa, José María; González-Giráldez, Beatriz; Parra, Jaime; Rodríguez-Uranga, Juan; Toledo, Manuel; López González, Francisco Javier; Bermejo, Pedro; Giner, Pau; Castillo, Ascensión; Molins, Albert; Campos, Dulce; Mauri, José Ángel; Muñoz, Rosario; Bonet, Macarena; Serrano-Castro, Pedro; del Villar, Ana; Saiz-Díaz, Rosa Ana

    2015-02-01

    Many patients with epilepsy are treated with antiepileptic drug (AED) polytherapy. Several factors influence the choice of early add-on therapy, and deciding on the most appropriate drug can be difficult. This study aimed to assess the efficacy and tolerability of lacosamide as early add-on therapy in patients with partial-onset seizures. REALLY (REtrospective study of lAcosamide as earLy add-on aLong one Year) was a multicenter, retrospective, 1-year, real-life study. Patients included were aged older than 16 years, had partial-onset seizures, and were treated with lacosamide as add-on therapy after one or two prior AEDs. Data were collected retrospectively from clinical records. The primary study objective was to assess the efficacy of lacosamide over 12 months (seizure-free and responder rates), and the secondary objective was to assess the tolerability of lacosamide at 3, 6, and 12 months [adverse events (AEs) and discontinuation]. One hundred and ninety-nine patients were enrolled in the study; 89 patients (44.7 %) had tried one AED and 110 patients (55.3 %) had tried two AEDs before lacosamide. At 12 months, the proportion of patients who were seizure free was 44.9 %, and 76 % of patients were responders. The seizure-free rate at 12 months for patients who had previously received one or two AEDs was 58 and 34.3 %, and the responder rate at 12 months was 83.0 and 70.4 %, respectively. The AE rate was 21.5 % at 3 months, 27.1 % at 6 months, and 31.2 % at 12 months, with 7.0 % of patients discontinuing treatment because of an AE. The most common AE reported was dizziness (11.6 %). Cryptogenic epilepsy, a higher number of prior AEDs, and the use of a sodium channel blocker at onset were associated with a worse outcome. The number of concomitant AEDs decreased over 1 year (Z = 5.89; p < 0.001). Twenty-two patients were converted to lacosamide monotherapy with at least one evaluation ≥6 months from the beginning of monotherapy conversion

  2. Results of a prospective randomized controlled trial of early ambulation for patients with lower extremity autografts.

    PubMed

    Lorello, David John; Peck, Michael; Albrecht, Marlene; Richey, Karen J; Pressman, Melissa A

    2014-01-01

    It is common practice to keep those patients with lower extremity autografts immobile until post-operative day (POD) 5. There is however inherent risks associated with even short periods of immobility. As of now there are no randomized controlled trials looking at early ambulation of patients with lower extremity autografts in the burn community.The objective of this study was to show that patients who begin ambulation within 24 hours of lower extremity autografting will have no increased risk of graft failure than those patients who remain immobile until POD 5. Thirty-one subjects who received autografts to the lower extremity were randomized after surgery into either the early ambulation group (EAG;17 subjects) or the standard treatment group (STG;14 subjects). Those subjects randomized to the EAG began ambulating with physical therapy on POD 1. Subjects in the STG maintained bed rest until POD 5. There was no difference in the number of patients with graft loss in either the EAG or STG on POD 5, and during any of the follow-up visits. No subjects required regrafting. There was a significant difference in the mean minutes of ambulation, with the EAG ambulating longer than the STG (EAG 23.4 minutes [SD 12.03], STG 14.1 [SD 9.00], P=.0235) on POD 5. Burn patients with lower extremity autografts can safely ambulate on POD 1 without fear of graft failure compared with those patients that remain on bed rest for 5 days.

  3. Early Results of the PETTICOAT Technique for the Management of Acute Type A Aortic Dissection

    PubMed Central

    Kotha, Vamshi Krishna; Pozeg, Zlatko I.; Herget, Eric J.; Moon, Michael C.; Appoo, Jehangir J.

    2017-01-01

    Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia. In Type B dissection, the PETTICOAT (Provisional Extension To Induce Complete Attachment) technique, which entails stent graft coverage of the primary intimal tear followed by bare metal stent placement distally, may improve true lumen caliber and promote false lumen thrombosis without increasing the risk of spinal cord ischemia, as intercostal branches remain perfused through the bare metal stents. The technique of hybrid arch with surgical creation of a Dacron landing zone covering a stent graft in the proximal descending aorta and bare metal stents in the thoraco-abdominal aorta is a promising concept in the treatment of ATAAD. PMID:29657948

  4. Early Results of the PETTICOAT Technique for the Management of Acute Type A Aortic Dissection.

    PubMed

    Kotha, Vamshi Krishna; Pozeg, Zlatko I; Herget, Eric J; Moon, Michael C; Appoo, Jehangir J

    2017-08-01

    Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia. In Type B dissection, the PETTICOAT (Provisional Extension To Induce Complete Attachment) technique, which entails stent graft coverage of the primary intimal tear followed by bare metal stent placement distally, may improve true lumen caliber and promote false lumen thrombosis without increasing the risk of spinal cord ischemia, as intercostal branches remain perfused through the bare metal stents. The technique of hybrid arch with surgical creation of a Dacron landing zone covering a stent graft in the proximal descending aorta and bare metal stents in the thoraco-abdominal aorta is a promising concept in the treatment of ATAAD.

  5. Early predictors of occupational back reinjury: results from a prospective study of workers in Washington State.

    PubMed

    Keeney, Benjamin J; Turner, Judith A; Fulton-Kehoe, Deborah; Wickizer, Thomas M; Chan, Kwun Chuen Gary; Franklin, Gary M

    2013-01-15

    Prospective population-based cohort study. To identify early predictors of self-reported occupational back reinjury within 1 year after work-related back injury. Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have reinjuries after returning to work, yet there are few studies of risk factors for occupational back reinjuries. We aimed to identify the incidence and early (in the claim) predictors of self-reported back reinjury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers' Compensation Disability Risk Identification Study Cohort provided a large, population-based sample with information on variables in 7 domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (P < 0.10) of self-reported reinjury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back reinjury. A total of 290 (25.8%) of 1123 (70.0% response rate) workers who completed the 1-year follow-up interview and had returned to work reported having reinjured their back at work. Baseline variables significantly associated with reinjury (P < 0.05) in the multivariate model included male sex, constant whole-body vibration at work, previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of reinjury. No other employment-related or psychological variables were significant. One-fourth of the workers who received work disability compensation for a back injury self

  6. Rewarding Progress, Reducing Debt: Early Results from Ohio's Performance-Based Scholarship Demonstration for Low-Income Parents

    ERIC Educational Resources Information Center

    Cha, Paulette; Patel, Reshma

    2010-01-01

    This report presents early results from a rigorous evaluation of a performance-based scholarship program that was implemented at three community colleges in Ohio during the 2008-2009 academic year. The program in Ohio that is the subject of this report is part of MDRC's national Performance-Based Scholarship (PBS) Demonstration, which was launched…

  7. Enhancing Student Services at Lorain County Community College: Early Results from the Opening Doors Demonstration in Ohio

    ERIC Educational Resources Information Center

    Scrivener, Susan; Au, Jenny

    2007-01-01

    In 2003, MDRC and a consortium of funders launched the Opening Doors demonstration to test reforms in six community colleges aimed at helping students stay in school and earn credentials. This report presents early results from the Opening Doors program at Lorain County Community College in Elyria, Ohio. The program provided intensive advising and…

  8. Creative reminiscence as an early intervention for depression: results of a pilot project.

    PubMed

    Bohlmeijer, E; Valenkamp, M; Westerhof, G; Smit, F; Cuijpers, P

    2005-07-01

    Reminiscence may help in resolving conflicts from the past and making up the balance of one's life. Life-review may be further enhanced by the creative expression of memories in stories, poems or drawings. In this way people are encouraged to create and discover metaphors, images and stories that symbolically represent the subjective and inner meaning of their lives. In this article, a new intervention, which combines reminiscence and creative expression aimed at early treatment of depression, is described. A pilot project showed that the intervention Searching for the meaning in life may generate small-sized effects in reducing depression. Additionally, it appears to generate effects of medium size in enhancing mastery. Several possible ways to improve the effectiveness of the intervention are described.

  9. Early Results from the Wisconsin H-Alpha Mapper Southern Sky Survey

    NASA Astrophysics Data System (ADS)

    Haffner, L. Matthew; Reynolds, R. J.; Madsen, G. J.; Hill, A. S.; Barger, K. A.; Jaehnig, K. P.; Mierkiewicz, E. J.; Percival, J. W.

    2010-01-01

    After a successful eleven-year campaign at Kitt Peak, we moved the Wisconsin H-Alpha Mapper (WHAM) to Cerro Tololo in early 2009. Here we present some of the early data after the first nine months under southern skies. These maps begin to complete the first all-sky, kinematic survey of the diffuse Hα emission from the Milky Way. Much of this emission arises from the Warm Ionized Medium (WIM), a significant component of the ISM that extends a few kiloparsecs above the Galactic disk. The WHAM instrument consists of a 0.6 m primary lens housed in a steerable siderostat coupled to a 15 cm dual-etalon Fabry-Perot spectrometer. The optical configuration delivers a spatially integrated spectrum from a one-degree beam on the sky covering 200 km/s with 12 km/s spectral resolution. Short, 30-second exposures allow us to cover the observable sky in about two years at sensitivity levels of about 0.1 R (EM 0.2 pc cm-6). While this first look at the data focuses on the Hα survey, WHAM is also capable of observing many other optical emission lines, revealing fascinating trends in the temperature and ionization state of the WIM. Our ongoing studies of the physical conditions of diffuse ionized gas will continue in the south following the Hα survey. In addition, future observations using our survey mode will cover the full velocity range of the Magellanic Stream, Bridge, and Clouds to trace the ionized gas associated with these neighboring systems. WHAM is supported by NSF award AST-0607512 and has made this smooth relocation south due to the excellent staff at KPNO and CTIO.

  10. Results of a Coordinated Specialty Care Program for Early Psychosis and Predictors of Outcomes.

    PubMed

    Nossel, Ilana; Wall, Melanie M; Scodes, Jennifer; Marino, Leslie A; Zilkha, Sacha; Bello, Iruma; Malinovsky, Igor; Lee, Rufina; Radigan, Marleen; Smith, Thomas E; Sederer, Lloyd; Gu, Gyojeong; Dixon, Lisa

    2018-05-15

    This study prospectively evaluated outcomes of OnTrackNY, a statewide coordinated specialty care (CSC) program for treatment of early psychosis in community settings, as well as predictors of outcomes. The sample included 325 individuals ages 16-30 with recent-onset nonaffective psychosis who were enrolled in OnTrackNY and who had at least one three-month follow-up. Clinicians provided data at baseline and quarterly up to one year. Domains assessed included demographic and clinical characteristics, social and occupational functioning, medications, suicidality and violence, hospitalization, and time to intervention. Primary outcomes included the symptoms, occupational functioning, and social functioning scales of the Global Assessment of Functioning (GAF), as adapted by the U.S. Department of Veterans Affairs Mental Illness Research, Education and Clinical Center; education and employment status; and psychiatric hospitalization rate. Education and employment rates increased from 40% to 80% by six months, hospitalization rates decreased from 70% to 10% by three months, and improvement in GAF scores continued for 12 months. Female gender, non-Hispanic white race-ethnicity, and more education at baseline predicted better education and employment status at follow-up. Individuals with early psychosis receiving CSC achieved significant improvements in education and employment and experienced a decrease in hospitalization rate. Demographic variables and baseline education predicted education and employment outcomes. CSC teams should make particular effort to support the occupational goals of individuals at increased risk of not engaging in work or school, including male participants and participants from racial and ethnic minority groups.

  11. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial

    PubMed Central

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2013-01-01

    Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

  12. Planck Early Results. XV. Spectral Energy Distributions and Radio Continuum Spectra of Northern Extragalactic Radio Sources

    NASA Technical Reports Server (NTRS)

    Aatrokoski, J.; Ade, P. A. R.; Aghanim, N.; Aller, H. D.; Aller, M. F.; Angelakis, E.; Amaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; hide

    2011-01-01

    Spectral energy distributions (SEDs) and radio continuum spectra are presented for a northern sample of 104 extragalactic radio sources. based on the Planck Early Release Compact Source Catalogue (ERCSC) and simultaneous multi frequency data. The nine Planck frequencies, from 30 to 857 GHz, are complemented by a set of simultaneous observations ranging from radio to gamma-rays. This is the first extensive frequency coverage in the radio and millimetre domains for an essentially complete sample of extragalactic radio sources, and it shows how the individual shocks, each in their own phase of development, shape the radio spectra as they move in the relativistic jet. The SEDs presented in this paper were fitted with second and third degree polynomials to estimate the frequencies of the synchrotron and inverse Compton (IC) peaks, and the spectral indices of low and high frequency radio data, including the Planck ERCSC data, were calculated. SED modelling methods are discussed, with an emphasis on proper. physical modelling of the synchrotron bump using multiple components. Planck ERCSC data also suggest that the original accelerated electron energy spectrum could be much harder than commonly thought, with power-law index around 1.5 instead of the canonical 2.5. The implications of this are discussed for the acceleration mechanisms effective in blazar shock. Furthermore in many cases the Planck data indicate that gamma-ray emission must originate in the same shocks that produce the radio emission.

  13. Emergent categorical representation of natural, complex sounds resulting from the early post-natal sound environment

    PubMed Central

    Bao, Shaowen; Chang, Edward F.; Teng, Ching-Ling; Heiser, Marc A.; Merzenich, Michael M.

    2013-01-01

    Cortical sensory representations can be reorganized by sensory exposure in an epoch of early development. The adaptive role of this type of plasticity for natural sounds in sensory development is, however, unclear. We have reared rats in a naturalistic, complex acoustic environment and examined their auditory representations. We found that cortical neurons became more selective to spectrotemporal features in the experienced sounds. At the neuronal population level, more neurons were involved in representing the whole set of complex sounds, but fewer neurons actually responded to each individual sound, but with greater magnitudes. A comparison of population-temporal responses to the experienced complex sounds revealed that cortical responses to different renderings of the same song motif were more similar, indicating that the cortical neurons became less sensitive to natural acoustic variations associated with stimulus context and sound renderings. By contrast, cortical responses to sounds of different motifs became more distinctive, suggesting that cortical neurons were tuned to the defining features of the experienced sounds. These effects lead to emergent “categorical” representations of the experienced sounds, which presumably facilitate their recognition. PMID:23747304

  14. Linking parent perceptions of children's weight to early coronary risk factors: results from the CARDIAC Project.

    PubMed

    Stabler, M E; Cottrell, L; Lilly, C

    2014-01-01

    Obesity is a public health threat because of the increasing prevalence in childhood and its causal relationship to the leading cause of death in America, heart disease. Detecting early signs of cardiovascular disease (CVD) risk factors in children and appropriately intervening to reverse the unhealthy trajectory associated with childhood obesity is of great importance. The objective of this study is to observe parental perception of their child's body mass index (BMI) and find associations between inaccurately estimated children and CVD risk factors. This study analyzed the association between 147 rural fifth grade students' lipid profiles and parents' self-reported survey who participated in the 2008-2011 Coronary Artery Risk Detection in Appalachian Communities study. After controlling for covariates, underestimated children were more likely to have higher log-transformed triglyceride and systolic blood pressure values and overestimated children were more likely to have lower systolic blood pressure. Underestimating a child's BMI is associated with coronary risk-related factors, while overestimating a child's BMI is associate with a protective CVD marker. A follow-up study examining the development of CVD risk factors in children of parents who inaccurately estimate their BMI would help clarify this relationship. Knowledge of how parental perceptions directly influence higher lipid levels in children could have an impact on public health efforts in the fight against childhood obesity in rural environments.

  15. Controlled multicenter trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice herniorrhaphy. Early results.

    PubMed

    Tschudi, J; Wagner, M; Klaiber, C; Brugger, J; Frei, E; Krähenbühl, L; Inderbitzi, R; Hüsler, J; Hsu Schmitz, S

    1996-08-01

    In February 1993 a prospective randomized multicenter trial was initiated to compare laparoscopic transabdominal preperitoneal hernioplasty to Shouldice herniorrhaphy as performed by surgeons of nonspecialized clinics. Until January 1994, 87 patients with 108 hernias took part in the trial (43 Shouldice and 44 laparoscopic repairs). The laparoscopic procedure took significantly longer than did the open operation but caused less pain as measured by pain analogue score and consumption of paracetamol and narcotics. The postoperative complication rate was 26% in the open and 16% in the laparoscopic group. The patients in the laparoscopic group were discharged earlier and their convalescence was shorter than after open hernia repair. There has been one early recurrence in the laparoscopic and two in the open group to date with a mean follow-up of 201 days. Laparoscopic hernia repair causes less pain than the conventional operation and enables the patient to return to full work and usual activities earlier. The recurrence rate will not be known for 5 years.

  16. Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results.

    PubMed

    Kotoula, Aggeliki; Gardikis, Stefanos; Tsalkidis, Aggelos; Mantadakis, Elpis; Zissimopoulos, Athanassios; Kambouri, Katerina; Deftereos, Savvas; Tripsianis, Gregorios; Manolas, Konstantinos; Chatzimichael, Athanassios; Vaos, George

    2009-01-01

    In order to establish the most reliable marker for distinguishing urinary tract infections (UTI) with and without renal parenchymal involvement (RPI), we recorded the clinical features and admission leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum procalcitonin (PCT) in 57 children (including 43 girls) aged 2-108 months admitted with a first episode of UTI. RPI was evaluated by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy within 7 days of admission. To establish cut-off points for ESR, CRP, and PCT, we used receiver operating characteristics curves and compared the area under the curve for ESR, CRP, and PCT. Twenty-seven children were diagnosed as having RPI based on positive renal scintigraphy. A body temperature of >38 degrees C, a history of diarrhea, and poor oral intake were more common in patients with RPI. ESR, CRP, and PCT, but not leukocyte count, were significantly higher in patients with RPI (P < 0.001). PCT was more sensitive and specific for the diagnosis of upper versus lower UTI than ESR and CRP. Using a cut-off value of 0.85 ng/ml, PCT had the best performance, with sensitivity, specificity, and positive and negative predictive values of 89%, 97%, 96%, and 91% respectively. Serum PCT is a better marker than ESR, CRP, and leukocyte count for the early prediction of RPI in children with a first episode of UTI.

  17. Planck early results. XV. Spectral energy distributions and radio continuum spectra of northern extragalactic radio sources

    DOE PAGES

    Aatrokoski, J.

    2011-12-01

    Spectral energy distributions (SEDs) and radio continuum spectra are presented for a northern sample of 104 extragalactic radio sources, based on the Planck Early Release Compact Source Catalogue (ERCSC) and simultaneous multifrequency data. The nine Planck frequencies, from 30 to 857GHz, are complemented by a set of simultaneous observations ranging from radio to gamma-rays. This is the first extensive frequency coverage in the radio and millimetre domains for an essentially complete sample of extragalactic radio sources, and it shows how the individual shocks, each in their own phase of development, shape the radio spectra as they move in the relativisticmore » jet. The SEDs presented in this paper were fitted with second and third degree polynomials to estimate the frequencies of the synchrotron and inverse Compton (IC) peaks, and the spectral indices of low and high frequency radio data, including the Planck ERCSC data, were calculated. SED modelling methods are discussed, with an emphasis on proper, physical modelling of the synchrotron bump using multiple components. Planck ERCSC data also suggest that the original accelerated electron energy spectrum could be much harder than commonly thought, with power-law index around 1.5 instead of the canonical 2.5. The implications of this are discussed for the acceleration mechanisms effective in blazar shock. Furthermore in many cases the Planck data indicate that gamma-ray emission must originate in the same shocks that produce the radio emission.« less

  18. Disease management of early childhood caries: results of a pilot quality improvement project.

    PubMed

    Ng, Man Wai; Torresyap, Gay; White, Alex; Melvin, Patrice; Graham, Dionne; Kane, Daniel; Scoville, Richard; Ohiomoba, Henry

    2012-08-01

    The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). We tested a disease management (DM) approach in children younger than age 60 months with ECC. After 30 months, for the 403 and 234 DM patients at Children's Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.

  19. Early benefit assessment of new drugs in Germany - results from 2011 to 2012.

    PubMed

    Hörn, Helmut; Nink, Katrin; McGauran, Natalie; Wieseler, Beate

    2014-06-01

    Rising drug costs in Germany led to the Act on the Reform of the Market for Medicinal Products (AMNOG) in January 2011. For new drugs, pharmaceutical companies have to submit dossiers containing all available evidence to demonstrate an added benefit versus an appropriate comparator therapy. The Federal Joint Committee (G-BA), the main decision-making body of the statutory healthcare system, is responsible for the overall procedure of "early benefit assessment". The Institute for Quality and Efficiency in Health Care (IQWiG) largely conducts the dossier assessments, which inform decisions by the G-BA on added benefit and support price negotiations. Of the 25 dossiers (excluding orphan drugs) assessed until 31 December 2012, 14 contained sufficient data from randomized active-controlled trials investigating patient-relevant outcomes or at least acceptable surrogates; 11 contained insufficient data. The most common indications were oncology (6) and viral infections (4). For the 14 drugs assessed, the extent of added benefit was rated as minor, considerable, and non-quantifiable in 3, 8, and 2 cases; the remaining drug showed no added benefit. Despite some shortcomings, for the first time it has been possible in Germany to implement a systematic procedure for assessing new drugs at market entry, thus providing support for price negotiations and informed decision-making for patients, clinicians and policy makers. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Results and survival after photodynamic therapy in early-stage esophageal carcinoma

    NASA Astrophysics Data System (ADS)

    Spinelli, Pasquale; Mancini, Andrea; Dal Fante, Marco; Meroni, Emmanuele; Jasinskas, Algirdas

    1996-01-01

    From January 1985 to December 1994, 23 early stage carcinomas of the esophagus were treated by photodynamic therapy in 21 patients. The stage of the tumors was assessed by esophagoscopy with multiple biopsies, CT scan and, from June 1991, also by endoscopic ultrasonography: 7 lesions were classified as carcinoma in situ (Tis) and 16 as invasive (T1). The photosensitizers used for PDT were hematoporphyrin derivative 3 mg/kg in 4 patients and dihematoporphyrin ether 2 mg/kg in 17. Light irradiation was performed using an Argon-dye laser system at a wavelength of 630 nm with an average energy of 50 J/cm2 and 70 J/cm2 for the treatment of Tis and T1, respectively. A complete response was achieved in 17/23 (74%) tumors, 15/21 (71%) patients. In the follow-up period from 6 to 78 months (median 36 months) 3 recurrences occurred 6, 12, and 14 months after PDT, respectively. Seven patients died due to concomitant diseases, not related to tumor progression. The actuarial survival rate was 95%, 75% and 37% at 1, 3, and 5 years, respectively. Complications included 1 case of sunburn and 2 cases of esophageal stenosis at the treatment site, that gradually responded to endoscopic bougienage.

  1. Very early predictors of conduct problems and crime: results from a national cohort study.

    PubMed

    Murray, Joseph; Irving, Barrie; Farrington, David P; Colman, Ian; Bloxsom, Claire A J

    2010-11-01

      Longitudinal research has produced a wealth of knowledge about individual, family, and social predictors of crime. However, nearly all studies have started after children are age 5, and little is known about earlier risk factors. The 1970 British Cohort Study is a prospective population survey of more than 16,000 children born in 1970. Pregnancy, birth, child, parent, and socioeconomic characteristics were measured from medical records, parent interviews, and child assessments at birth and age 5. Conduct problems were reported by parents at age 10, and criminal convictions were self-reported by study members at ages 30-34.   Early (up to age 5) psychosocial risk factors were strong predictors of conduct problems and criminal conviction. Among pregnancy and birth measures, only prenatal maternal smoking was strongly predictive. Risk factors were similar for girls and boys. Additive risk scores predicted antisocial behaviour quite strongly.   Risk factors from pregnancy to age 5 are quite strong predictors of conduct problems and crime. New risk assessment tools could be developed to identify young children at high risk for later antisocial behaviour. © 2010 The Authors. Journal of Child Psychology and Psychiatry © 2010 Association for Child and Adolescent Mental Health.

  2. Breaking a Promise.

    ERIC Educational Resources Information Center

    Potter, Will

    2003-01-01

    States with programs to match private donations to colleges often find the demand for money far exceeds what they can afford to pay. This has resulted in some private benefactors getting frustrated and withdrawing their donations. Few of the proposals to reform matching grant programs have made much headway in state legislatures, and few colleges…

  3. New Promising Strategies in Oncofertility

    PubMed Central

    Hudson, Janella N.; Stanley, Nathanael B.; Nahata, Leena; Bowman-Curci, Meghan; Quinn, Gwendolyn P.

    2017-01-01

    Introduction Approximately 70,000 adolescent and young adults (AYA) are diagnosed with cancer each year. While advancements in treatment have led to improved prognosis and survival for patients, these same treatments can adversely affect AYA reproductive capacity. Localized treatments such as surgery and radiation therapy may affect fertility by removing or damaging reproductive organs, and systemic therapies such as chemotherapy can be toxic to gonads, (ovaries and testicles), thus affecting fertility and/or endocrine function. This can be traumatic for AYA with cancer as survivors often express desire to have genetic children and report feelings of regret or depression as a result of infertility caused by cancer treatments. Areas Covered Emerging technologies in the field of assisted reproductive technology offer new promise for preserving the reproductive capacity of AYA cancer patients prior to treatment as well as providing alternatives for survivors. The following review revisits contemporary approaches to fertility preservation as well newly developing technologies. Expert Commentary There are several advances in ART that hold promise for patients and survivors. However there are challenges that inhibit uptake including poor communication between providers and patients about risks and fertility preservation options; high costs; and lack of insurance coverage for fertility preservation services. PMID:28959743

  4. [Promising networks, fruitful inquiry].

    PubMed

    Frenk, Silvestre

    2014-01-01

    This supplement of the Revista Médica del Instituto Mexicano del Seguro Social includes 10 original contributions, and also six current themes, all of them related to childhood obesity. It is the result of an institutional program that it has been identified as Redes de Investigación Institucional, and it has been promoted and developed by the Coordinación de Investigación of the Instituto Mexicano del Seguro Social.

  5. Loss of transcription factor early growth response gene 1 results in impaired endochondral bone repair

    PubMed Central

    Reumann, Marie K.; Strachna, Olga; Yagerman, Sarah; Torrecilla, Daniel; Kim, Jihye; Doty, Steven B.; Lukashova, Lyudmila; Boskey, Adele L.; Mayer-Kuckuk, Philipp

    2011-01-01

    Transcription factors that play a role in ossification during development are expected to participate in postnatal fracture repair since the endochondral bone formation that occurs in embryos is recapitulated during fracture repair. However, inherent differences exist between bone development and fracture repair, including a sudden disruption of tissue integrity followed by an inflammatory response. This raises the possibility that repair-specific transcription factors participate in bone healing. Here, we assessed the consequence of loss of early growth response gene 1 (EGR-1) on endochondral bone healing because this transcription factor has been shown to modulate repair in vascularized tissues. Model fractures were created in ribs of wild type (wt) and EGR-1−/− mice. Differences in tissue morphology and composition between these two animal groups were followed over 28 post fracture days (PFDs). In wt mice, bone healing occurred in healing phases characteristic of endochondral bone repair. A similar healing sequence was observed in EGR-1−/− mice but was impaired by alterations. A persistent accumulation of fibrin between the disconnected bones was observed on PFD7 and remained pronounced in the callus on PFD14. Additionally, the PFD14 callus was abnormally enlarged and showed increased deposition of mineralized tissue. Cartilage ossification in the callus was associated with hyper-vascularity and -proliferation. Moreover, cell deposits located in proximity to the callus within skeletal muscle were detected on PFD14. Despite these impairments, repair in EGR-1−/− callus advanced on PFD28, suggesting EGR-1 is not essential for healing. Together, this study provides genetic evidence that EGR-1 is a pleiotropic regulator of endochondral fracture repair. PMID:21726677

  6. Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study.

    PubMed

    Murray, Anna; Bennett, Claire E; Perry, John R B; Weedon, Michael N; Jacobs, Patricia A; Morris, Danielle H; Orr, Nicholas; Schoemaker, Minouk J; Jones, Michael; Ashworth, Alan; Swerdlow, Anthony J

    2011-01-01

    Women become infertile approximately 10 years before menopause, and as more women delay childbirth into their 30s, the number of women who experience infertility is likely to increase. Tests that predict the timing of menopause would allow women to make informed reproductive decisions. Current predictors are only effective just prior to menopause, and there are no long-range indicators. Age at menopause and early menopause (EM) are highly heritable, suggesting a genetic aetiology. Recent genome-wide scans have identified four loci associated with variation in the age of normal menopause (40-60 years). We aimed to determine whether theses loci are also risk factors for EM. We tested the four menopause-associated genetic variants in a cohort of approximately 2000 women with menopause≤45 years from the Breakthrough Generations Study (BGS). All four variants significantly increased the odds of having EM. Comparing the 4.5% of individuals with the lowest number of risk alleles (two or three) with the 3.0% with the highest number (eight risk alleles), the odds ratio was 4.1 (95% CI 2.4-7.1, P=4.0×10(-7)). In combination, the four variants discriminated EM cases with a receiver operator characteristic area under the curve of 0.6. Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM in an independent cohort from the BGS. The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.

  7. [Results of applying a paediatric early warning score system as a healthcare quality improvement plan].

    PubMed

    Rivero-Martín, M J; Prieto-Martínez, S; García-Solano, M; Montilla-Pérez, M; Tena-Martín, E; Ballesteros-García, M M

    2016-06-01

    The aims of this study were to introduce a paediatric early warning score (PEWS) into our daily clinical practice, as well as to evaluate its ability to detect clinical deterioration in children admitted, and to train nursing staff to communicate the information and response effectively. An analysis was performed on the implementation of PEWS in the electronic health records of children (0-15 years) in our paediatric ward from February 2014 to September 2014. The maximum score was 6. Nursing staff reviewed scores >2, and if >3 medical and nursing staff reviewed it. Monitoring indicators: % of admissions with scoring; % of complete data capture; % of scores >3; % of scores >3 reviewed by medical staff, % of changes in treatment due to the warning system, and number of patients who needed Paediatric Intensive Care Unit (PICU) admission, or died without an increased warning score. The data were collected from all patients (931) admitted. The scale was measured 7,917 times, with 78.8% of them with complete data capture. Very few (1.9%) showed scores >3, and 14% of them with changes in clinical management (intensifying treatment or new diagnostic tests). One patient (scored 2) required PICU admission. There were no deaths. Parents or nursing staff concern was registered in 80% of cases. PEWS are useful to provide a standardised assessment of clinical status in the inpatient setting, using a unique scale and implementing data capture. Because of the lack of severe complications requiring PICU admission and deaths, we will have to use other data to evaluate these scales. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  8. Loss of transcription factor early growth response gene 1 results in impaired endochondral bone repair.

    PubMed

    Reumann, Marie K; Strachna, Olga; Yagerman, Sarah; Torrecilla, Daniel; Kim, Jihye; Doty, Stephen B; Lukashova, Lyudmila; Boskey, Adele L; Mayer-Kuckuk, Philipp

    2011-10-01

    Transcription factors that play a role in ossification during development are expected to participate in postnatal fracture repair since the endochondral bone formation that occurs in embryos is recapitulated during fracture repair. However, inherent differences exist between bone development and fracture repair, including a sudden disruption of tissue integrity followed by an inflammatory response. This raises the possibility that repair-specific transcription factors participate in bone healing. Here, we assessed the consequence of loss of early growth response gene 1 (EGR-1) on endochondral bone healing because this transcription factor has been shown to modulate repair in vascularized tissues. Model fractures were created in ribs of wild type (wt) and EGR-1(-/-) mice. Differences in tissue morphology and composition between these two animal groups were followed over 28 post fracture days (PFDs). In wt mice, bone healing occurred in healing phases characteristic of endochondral bone repair. A similar healing sequence was observed in EGR-1(-/-) mice but was impaired by alterations. A persistent accumulation of fibrin between the disconnected bones was observed on PFD7 and remained pronounced in the callus on PFD14. Additionally, the PFD14 callus was abnormally enlarged and showed increased deposition of mineralized tissue. Cartilage ossification in the callus was associated with hyper-vascularity and -proliferation. Moreover, cell deposits located in proximity to the callus within skeletal muscle were detected on PFD14. Despite these impairments, repair in EGR-1(-/-) callus advanced on PFD28, suggesting EGR-1 is not essential for healing. Together, this study provides genetic evidence that EGR-1 is a pleiotropic regulator of endochondral fracture repair. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Testing the Role of Impacts in Warming Early Mars: Comparisons Between 1-D and GCM Results

    NASA Astrophysics Data System (ADS)

    Steakley, K.; Kahre, M. A.; Murphy, J. R.; Haberle, R. M.; Kling, A.

    2017-12-01

    Comet and asteroid impacts have been explored as a potential mechanism for producing warmer and wetter conditions for early Mars and possibly contributing to valley network formation. However, criticisms have been made regarding the timing of large impacts compared to valley network activity and the ability of such impacts to induce long lasting climate changes and the appropriate amount of precipitation. We test the impact heating hypothesis for the late Noachian Mars atmosphere by revisiting the scenarios described in Segura et al. (2008, JGR Planets 113, E11007) with a 3D global climate model (GCM). Segura et al. (2008) showed with a 1-D model that impacts ranging 30-100 km in diameter could in certain cases induce months to years of above-freezing temperatures and tens of cm to meters of rainfall in atmospheres with 150-mbar, 1-bar, or 2-bar surface pressures. We impose the same initial conditions into the Ames Research Center Mars GCM with updated water cycle physics that includes bulk cloud formation, sedimentation, precipitation (liquid or snow), a Manabe moist convection scheme, and the radiative effects of both liquid and ice clouds. Initial conditions in the GCM match those described in Segura et al. (2008) as closely as possible and include a hot post-impact debris layer, a warm atmosphere, and water vapor profiles consistent with the water abundances mobilized by the impact. Scenarios with 30-, 50- and 100- km impactors in 150-mbar, 1-bar, and 2-bar surface pressure cases are explored both with and without radiatively active water clouds. Our goals are to determine how global rainfall totals and global surface temperatures from the GCM compare with the simpler 1-D Segura et al. (2008) model, to examine what rainfall patterns emerge in the GCM and how they compare to the observed valley network distribution, and to more carefully assess the role of cloud microphysics and radiative effects on the duration and intensity of post-impact climates.

  10. Early Results from the Global Precipitation Measurement (GPM) Mission in Japan

    NASA Astrophysics Data System (ADS)

    Kachi, Misako; Kubota, Takuji; Masaki, Takeshi; Kaneko, Yuki; Kanemaru, Kaya; Oki, Riko; Iguchi, Toshio; Nakamura, Kenji; Takayabu, Yukari N.

    2015-04-01

    of gauge-calibrated GSMaP algorithm (Ushio et al., 2013). In addition to those improvements in the algorithms number of passive microwave imagers and/or sounders used in the GPM-GSMaP was increased compared to the previous version. After the early calibration and validation of the products and evaluation that all products achieved the release criteria, all GPM standard products and the GPM-GSMaP product has been released to the public since September 2014. The GPM products can be downloaded via the internet through the JAXA G-Portal (https://www.gportal.jaxa.jp).

  11. Study of the mesosphere using wide-field twilight polarization measurements: Early results beyond the polar circle

    NASA Astrophysics Data System (ADS)

    Ugolnikov, O. S.; Kozelov, B. V.

    2016-07-01

    This paper discusses the results of early measurements of temperature and dust in the mesosphere on the basis of wide-field twilight sky polarimetry, which began in 2015 in Apatity (North of Russia, 67.6° N, 33.4° E) using the original entire-sky camera. These measurements have been performed for the first time beyond the Polar Circle in the winter and early spring period. The general polarization properties of the twilight sky and the procedure for identifying single scattering are described. The key results of the study include the Boltzmann temperature values at altitudes higher than 70 km and the conclusion on a weak effect of dust on scattering properties of the mesosphere during this period.

  12. Microgravity Effects on the Early Events of Biological Nitrogen Fixation in Medicago Truncatula: Results from the SyNRGE Experiment

    NASA Technical Reports Server (NTRS)

    Stutte, Gary W.; Roberts, Michael

    2012-01-01

    SyNRGE (Symbiotic Nodulation in a Reduced Gravity Environment) was a sortie mission on STS-135 in the Biological Research in Canisters (BRIC) hardware to study the effect of microgravity on a plant-microbe symbiosis resulting in biological nitrogen fixation. Medicago truncatula, a model species for th legume family, was inoculated with its bacterial symbiont, Sinorhizobium meliloti, to observe early biomolecular events associated with infection and nodulation in Petri Dish Fixation Units (PDFU's).

  13. Early Results from the Advanced Radiation Protection Thick GCR Shielding Project

    NASA Technical Reports Server (NTRS)

    Norman, Ryan B.; Clowdsley, Martha; Slaba, Tony; Heilbronn, Lawrence; Zeitlin, Cary; Kenny, Sean; Crespo, Luis; Giesy, Daniel; Warner, James; McGirl, Natalie; hide

    2017-01-01

    The Advanced Radiation Protection Thick Galactic Cosmic Ray (GCR) Shielding Project leverages experimental and modeling approaches to validate a predicted minimum in the radiation exposure versus shielding depth curve. Preliminary results of space radiation models indicate that a minimum in the dose equivalent versus aluminum shielding thickness may exist in the 20-30 g/cm2 region. For greater shield thickness, dose equivalent increases due to secondary neutron and light particle production. This result goes against the long held belief in the space radiation shielding community that increasing shielding thickness will decrease risk to crew health. A comprehensive modeling effort was undertaken to verify the preliminary modeling results using multiple Monte Carlo and deterministic space radiation transport codes. These results verified the preliminary findings of a minimum and helped drive the design of the experimental component of the project. In first-of-their-kind experiments performed at the NASA Space Radiation Laboratory, neutrons and light ions were measured between large thicknesses of aluminum shielding. Both an upstream and a downstream shield were incorporated into the experiment to represent the radiation environment inside a spacecraft. These measurements are used to validate the Monte Carlo codes and derive uncertainty distributions for exposure estimates behind thick shielding similar to that provided by spacecraft on a Mars mission. Preliminary results for all aspects of the project will be presented.

  14. Home Visiting: A Promising Early Intervention Strategy for At-Risk Families. Report to the Chairman, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, Committee on Appropriations, U.S. Senate.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    The report reviews home visiting as an early intervention strategy to provide health, social, education, or other services to improve maternal and child health and well-being. The report describes: (1) the nature and scope of existing home-visiting programs in the United States and Europe; (2) the effectiveness of home visiting; (3) strategies…

  15. Host resistance screening for balsam woolly adelgid: early results from 12 fir species

    Treesearch

    Leslie Newton; Fred Hain; John. Frampton

    2011-01-01

    Nearly all Fraser fir (Abies fraseri) Christmas trees produced in North Carolina need to be treated one or more times during their 5- to 10-year rotation to prevent or lessen damage caused by the exotic balsam woolly adelgid (BWA) (Adelges piceae Ratz.). These pesticide applications result in an annual cost to the industry...

  16. An early look at forest regeneration indicator results for the Midwest and Northeast United States

    Treesearch

    William H. McWilliams; James A. Westfall

    2015-01-01

    Interacting regeneration stressors create challenges for policy makers and managers who are tasked with making decisions for restoring forest following major disturbances, such as harvest or catastrophic mortality. Concern over an aging forest, dwindling young forest habitat, and restoration of native forests in the midwest and northeast United States has resulted in...

  17. Ponderosa pine seeding trials in west-side Sierra Nevada clearcuts: some early results

    Treesearch

    Robert L. Neal

    1975-01-01

    In direct-seeding trials on the Challenge Experimental Forest, Yuba County, California, 27 combinations of seeding rates, aspect, and site treatment were tested. The best results were obtained on northerly aspects on unburned mechanically disturbed seedbeds with a high proportion of exposed mineral soil when seed application rates were high. Sowing at least 1 pound of...

  18. Early results of a chestnut planting in eastern Kentucky illustrate reintroduction challenges

    Treesearch

    Cornelia C. Pinchot; Scott E. Schlarbaum; Jennifer A. Franklin; David S. Buckley; Stacy L. Clark; Callie J. Schweitzer; Arnold M. Saxton; Frederick V. Hebard

    2012-01-01

    This paper examines the first year results from a silvicultural study of American, hybrid (BC2F3) and Chinese chestnut seedlings (Castanea spp. Mill.) on the Daniel Boone National Forest in southeastern Kentucky. After one year, no significant differences in growth were found among the silvicultural...

  19. Competitive Employment for Youth with Autism Spectrum Disorders: Early Results from a Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Wehman, Paul H.; Schall, Carol M.; McDonough, Jennifer; Kregel, John; Brooke, Valerie; Molinelli, Alissa; Ham, Whitney; Graham, Carolyn W.; Riehle, J. Erin; Collins, Holly T.; Thiss, Weston

    2014-01-01

    For most youth with autism spectrum disorders (ASD), employment upon graduation from high school or college is elusive. Employment rates are reported in many studies to be very low despite many years of intensive special education services. This paper presented the preliminary results of a randomized clinical trial of Project SEARCH plus ASD…

  20. Managing Herbicide Drift and Early Results of Simulated Glyphosate Drift to Potato Study

    USDA-ARS?s Scientific Manuscript database

    The off target movement of herbicides can injure sensitive crops. Off target movement of spray droplets results from displacement by wind, poor application techniques, or improper settings or operation of application equipment. Applicators should be aware of wind speed and direction, use nozzles and...

  1. The national fire and fire surrogate study: early results and future challenges

    Treesearch

    Thomas A. Waldrop; James McIver

    2006-01-01

    Fire-adapted ecosystems today have dense plant cover and heavy fuel loads as a result of fire exclusion and other changes in land use practices. Mechanical fuel treatments and prescribed fire are powerful tools for reducing wildfire potential, but the ecological consequences of their use is unknown. The National Fire and Fire Surrogate Study examines the effects of...

  2. SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS.

    PubMed

    Gebelli, Jordi Pujol; Gordejuela, Amador Garcia Ruiz de; Ramos, Almino Cardoso; Nora, Mario; Pereira, Ana Marta; Campos, Josemberg Marins; Ramos, Manoela Galvão; Bastos, Eduardo Lemos de Souza; Marchesini, João Batista

    Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. Cerca de 500.000 cirurgias bariátricas são realizadas a cada ano em todo o mundo. As técnicas mais realizadas são o bypass gástrico em Y-de-Roux e a gastrectomia vertical. A derivação biliopancreática, com ou sem duodenal switch, é considerada técnica mais eficaz no tratamento cirúrgico do paciente obeso

  3. [Early results of proximal femoral fractures treated with FENIX modular hemiarthroplasty].

    PubMed

    Görski, Radosław; Górecki, Andrzej; Olszewski, Paweł; Biedrzycki, Jerzy; Skowronek, Paweł

    2010-01-01

    The article discusses preliminary clinical results in patients with proximal femoral fractures treated with hemiarthroplasty using a FENIX implant. The study group comprised 41 subjects aged 69 to 97 (median age 82.3 year). The follow-up study provided data on 26 subjects (63.4%), among which 15 attended the check-up, 5 subjects refused to visit at the Department and 6 subjects were reported as deceased. Median follow-up period amounted to 6.8 month (1 to 22 months). General hospitalization-related complications occurred in 8 patients (19.5%). During hospitalization no deaths occurred, in the deceased group 3 patients died within 12 months after surgery, while another 3 died after the twelve-month postoperative period (median of 13.3%). According to Merle d'Aubigne-Postel score favorable long-term results were observed in 9 patients (59.9%), 13 patients regained the level of motor function similar to the functional ability prior to fracture. The need to postpone the surgery due to general health status and impaired pre-operative motor function are significant negative prognostic factors. The results obtained were compared with previous efficacy studies on femoral fracture treatment using an Austin-Moore implant. Functional ability and self-reliance was higher in the FENIX group. FENIX arthroplasty effectively helps patients regain self-reliance and motor function thanks to its modular characteristics and anatmoical construction.

  4. Do promises matter? An exploration of the role of promises in psychological contract breach.

    PubMed

    Montes, Samantha D; Zweig, David

    2009-09-01

    Promises are positioned centrally in the study of psychological contract breach and are argued to distinguish psychological contracts from related constructs, such as employee expectations. However, because the effects of promises and delivered inducements are confounded in most research, the role of promises in perceptions of, and reactions to, breach remains unclear. If promises are not an important determinant of employee perceptions, emotions, and behavioral intentions, this would suggest that the psychological contract breach construct might lack utility. To assess the unique role of promises, the authors manipulated promises and delivered inducements separately in hypothetical scenarios in Studies 1 (558 undergraduates) and 2 (441 employees), and they measured them separately (longitudinally) in Study 3 (383 employees). The authors' results indicate that breach perceptions do not represent a discrepancy between what employees believe they were promised and were given. In fact, breach perceptions can exist in the absence of promises. Further, promises play a negligible role in predicting feelings of violation and behavioral intentions. Contrary to the extant literature, the authors' findings suggest that promises may matter little; employees are concerned primarily with what the organization delivers.

  5. Single-incision (with multi-input single-port) laparoscopic colorectal procedures: Early results

    PubMed Central

    Ertem, Metin; Gök, Hakan; Özveri, Emel

    2013-01-01

    Objective: Single incision laparoscopic surgery (SILS) is a “scar-less” new surgical technique which has been gaining popularity over recent years. In comparison to conventional multiport laparoscopic surgery, SILS is introduced as a less invasive method. This technique has also been applied to colorectal surgery. The aim of the presenting study is to investigate the applicability of SILS and report short term results. Material and Methods: We evaluated prospectively collected data of 24 patients who had been operated with “Single Incision Laparoscopic Colon Resection (SILCR)” in our clinic between June 2011–June 2013. Informed consent was obtained from all patients before surgery. Patient data such as ASA and BMI values, need for additional surgery, tumors, number of lymph nodes resected, length of hospital stay, length of surgery, timing of flatus, time to start oral feeding and complications were recorded. Results: SILCR was performed in 24 patients. In 13 patients, SILCR was performed for cancer treatment. There was no need for extra ports, conversion to open surgery and stoma creation was also not necessary. Drain was placed in 4 patients. Overall complication rate was 12.5%. The mean number of lymph nodes in 13 patients who underwent SILCR for tumor was found to be 23 (14–33). The mean operative time and length of hospital stay was 177 minutes (110–363) and 5.35 days (4–11) respectively. Anastomotic leakage was not seen in any of the patients. In one patient, urinoma formation due to ureteral leakage was seen which resulted from thermal injury. Conclusion: When we compare other series with almost the same number of patients’ reported SILS results in the literature, we believe that we could draw conclusions from our data. SILS appears to have comparable results to conventional multiport laparoscopic surgery in the hands of experienced surgeons. It seems advantegous as it can be done with conventional laparoscopic instruments in a

  6. Total enbloc spondylectomy for metastatic high grade spinal tumors: Early results

    PubMed Central

    Patil, Sanganagouda S; Nene, Abhay M

    2016-01-01

    Background: High grade metastatic spinal tumors are most common and are invasive. These patients can succumb to disease progression if not treated timely. Although considered as invasive and morbid, total enbloc spondylectomy (TES) in selected cases has better survival rates. The authors describe the results of TES for high grade metastatic spinal tumors. Materials and Methods: Five patients (four females and one male) underwent TES for solitary metastatic vertebral lesion between November 2012 and January 2014. These patients presented to us with spinal instability, unrelenting severe spinal pain and/or with severe progressive radiculopathy. Average age was 46.2 years (range 39–62 years). After complete investigations, computed tomography scan, magnetic resonance imaging scan and positron emission tomography (PET) scan, it was confirmed that these patients had high grade solitary vertebral metastatic tumor. Results: Average duration of followup was 18 months (range 16–20 months). The average preoperative visual analog scale score of 9.4 (range 9–10) improved to 2 (range 1–4) at last followup. Average blood loss was 1440 mL (range 1000–2000 mL). Average duration of surgery was 198 min (range 180–240 min). Significant pain relief was noticed in each patient in the immediate postoperative period and during followups. These patients attained complete functional activities of daily living with in a month. The imaging showed implants in situ, no recurrence of tumor, and no activity on PET scan at the final followup. Conclusion: The present series shows favorable short term results of TES for solitary, metastatic, high grade vertebral body tumors by a team approach. PMID:27512215

  7. The effect of gender on the early results of coronary artery bypass surgery in the younger patients' group

    PubMed Central

    Uncu, Hasan; Acipayam, Mehmet; Altinay, Levent; Doğan, Pinar; Davarcı, Isil; Özsöyler, İbrahim

    2014-01-01

    Introduction In this retrospective study, we aimed to determine the risk factors for coronary artery bypass surgery in patients under 45 years of age, and evaluate the early postoperative results and the effect of gender. Methods A total of 324 patients under 45 years of age who undergone on-pump coronary artery bypass surgery between April 12, 2004 and January 10, 2012 were included to the study. Patients divided into groups as follows: Group 1 consisted of 269 males (mean age 41.3), Group 2 consisted of 55 females (mean age 41.6). Preoperative risk factors, intraoperative and postoperative data and early mortality rates of the groups were compared. Results Smoking rate was significantly higher in Group 1. Diabetes mellitus incidence and body mass index were significantly higher in Group 2 (P values P=0.01; P=0.0001; P=0.04 respectively). The aortic cross-clamping and cardiopulmonary bypass time and number of grafts per patient were significantly higher in Group 1 (P values P=0.04; P=0.04; P=0.002 respectively). There were no deaths in either group. Conclusion We found that gender has no effect on early mortality rates of the coronary bypass surgery patients under 45 years. PMID:25714211

  8. Pilot evaluation of a media literacy program for tobacco prevention targeting early adolescents shows mixed results.

    PubMed

    Kaestle, Christine E; Chen, Yvonnes; Estabrooks, Paul A; Zoellner, Jamie; Bigby, Brandon

    2013-01-01

    The purpose of this pilot study was to assess the impact of media literacy for tobacco prevention for youth delivered through a community site. A randomized pretest-posttest evaluation design with matched-contact treatment and control conditions. The pilot study was delivered through the YMCA in a lower-income suburban and rural area of Southwest Virginia, a region long tied, both economically and culturally, to the tobacco industry. Children ages 8 to 14 (76% white, 58% female) participated in the study (n = 38). The intervention was an antismoking media literacy program (five 1-hour lessons) compared with a matched-contact creative writing control program. General media literacy, three domains of tobacco-specific media literacy ("authors and audiences," "messages and meanings," and "representation and reality"), tobacco attitudes, and future expectations were assessed. Multiple regression modeling assessed the impact of the intervention, controlling for pretest measures, age, and sex. General media literacy and tobacco-specific "authors and audiences" media literacy improved significantly for treatment compared with control (p < .05); results for other tobacco-specific media literacy measures and for tobacco attitudes were not significant. Future expectations of smoking increased significantly for treatment participants ages 10 and younger (p < .05). Mixed results indicated that improvements in media literacy are accompanied by an increase in future expectations to smoke for younger children.

  9. Hearing taboo words can result in early talker effects in word recognition for female listeners.

    PubMed

    Tuft, Samantha E; MᶜLennan, Conor T; Krestar, Maura L

    2018-02-01

    Previous spoken word recognition research using the long-term repetition-priming paradigm found performance costs for stimuli mismatching in talker identity. That is, when words were repeated across the two blocks, and the identity of the talker changed reaction times (RTs) were slower than when the repeated words were spoken by the same talker. Such performance costs, or talker effects, followed a time course, occurring only when processing was relatively slow. More recent research suggests that increased explicit and implicit attention towards the talkers can result in talker effects even during relatively fast processing. The purpose of the current study was to examine whether word meaning would influence the pattern of talker effects in an easy lexical decision task and, if so, whether results would differ depending on whether the presentation of neutral and taboo words was mixed or blocked. Regardless of presentation, participants responded to taboo words faster than neutral words. Furthermore, talker effects for the female talker emerged when participants heard both taboo and neutral words (consistent with an attention-based hypothesis), but not for participants that heard only taboo or only neutral words (consistent with the time-course hypothesis). These findings have important implications for theoretical models of spoken word recognition.

  10. Ciprofloxacin and furagin in acute cystitis: comparison of early immune and microbiological results.

    PubMed

    Dybowski, Bartosz; Jabłońska, Olga; Radziszewski, Piotr; Gromadzka-Ostrowska, Joanna; Borkowski, Andrzej

    2008-02-01

    Furagin (a nitrofurantoin analogue) has the same efficacy in treating acute cystitis as ciprofloxacin, however the duration of therapy is longer. We established a hypothesis that therapy with ciprofloxacin results in faster resolution of mucosal inflammation in comparison with furagin. Rates of urinary secretion of immunoglobulins class A, M and G and interleukin-8 (IL-8) were evaluated before and after initiation of therapy in adult women presenting with acute cystitis confirmed by urine culture. Women were randomised into two groups receiving either ciprofloxacin 250mg twice a day for 3 days (n=13) or furagin 100mg three times a day for 7 days (n=14). Median lengths of follow-up were 4 days and 5 days in the ciprofloxacin and furagin groups, respectively. Treatment with ciprofloxacin resulted in faster eradication of pathogens. No bacteria or nitrates were detected in the ciprofloxacin group, whilst leukocyte esterase was positive in only one case. In the furagin group there were four positive cultures, seven cases with positive nitrates and five cases with positive esterase. Secretion rates of all four substances dropped significantly, but the changes over time were similar in both groups.

  11. A summary of selected early results from the ERTS-1 menhaden experiment

    NASA Technical Reports Server (NTRS)

    Stevenson, W. H. (Principal Investigator); Kemmerer, A. J.; Benigno, J. A.; Reese, G. B.; Minkler, F. C.

    1973-01-01

    The author has identified the following significant results. Imagery from ERTS-1 satellite was used in conjunction with aerial photographically-sensed menhaden distribution information, sea truth oceanographic measurements, and commercial fishing information from a 8685 square kilometer study area in the north-central portion of the Gulf of Mexico to demonstrate relationships between selected oceanographic parameters and menhaden distribution, ERTS-1 imagery and menhaden distribution, and ERTS-1 imagery and oceanographic parameters. ERTS-1, MSS band 5 imagery density levels correlated with photographically detected menhaden distribution patterns and could be explained based on sea truth Secchi disc transparency and water depth measurements. These two parameters, together with surface salinity, Forel-Ule color, and chlorophyll-a also were found to correlate significantly with menhaden distribution. Eight empirical models were developed which provided menhaden distribution predictions for the study area on combinations of Secchi disc transparency, water depth, surface salinity, and Forel-Ule color measurements.

  12. Human amyloidogenic light chain proteins result in cardiac dysfunction, cell death, and early mortality in zebrafish.

    PubMed

    Mishra, Shikha; Guan, Jian; Plovie, Eva; Seldin, David C; Connors, Lawreen H; Merlini, Giampaolo; Falk, Rodney H; MacRae, Calum A; Liao, Ronglih

    2013-07-01

    Systemic amyloid light-chain (AL) amyloidosis is associated with rapidly progressive and fatal cardiomyopathy resulting from the direct cardiotoxic effects of circulating AL light chain (AL-LC) proteins and the indirect effects of AL fibril tissue infiltration. Cardiac amyloidosis is resistant to standard heart failure therapies, and, to date, there are limited treatment options for these patients. The mechanisms underlying the development of cardiac amyloidosis and AL-LC cardiotoxicity are largely unknown, and their study has been limited by the lack of a suitable in vivo model system. Here, we establish an in vivo zebrafish model of human AL-LC-induced cardiotoxicity. AL-LC isolated from AL cardiomyopathy patients or control nonamyloidogenic LC protein isolated from multiple myeloma patients (Con-LC) was directly injected into the circulation of zebrafish at 48 h postfertilization. AL-LC injection resulted in impaired cardiac function, pericardial edema, and increased cell death relative to Con-LC, culminating in compromised survival with 100% mortality within 2 wk, independent of AL fibril deposition. Prior work has implicated noncanonical p38 MAPK activation in the pathogenesis of AL-LC-induced cardiotoxicity, and p38 MAPK inhibition via SB-203580 rescued AL-LC-induced cardiac dysfunction and cell death and attenuated mortality in zebrafish. This in vivo zebrafish model of AL-LC cardiotoxicity demonstrates that antagonism of p38 MAPK within the AL-LC cardiotoxic signaling response may serve to improve cardiac function and mortality in AL cardiomyopathy. Furthermore, this in vivo model system will allow for further study of the molecular underpinnings of AL cardiotoxicity and identification of novel therapeutic strategies.

  13. Optimal Geoid Modelling to determine the Mean Ocean Circulation - Project Overview and early Results

    NASA Astrophysics Data System (ADS)

    Fecher, Thomas; Knudsen, Per; Bettadpur, Srinivas; Gruber, Thomas; Maximenko, Nikolai; Pie, Nadege; Siegismund, Frank; Stammer, Detlef

    2017-04-01

    The ESA project GOCE-OGMOC (Optimal Geoid Modelling based on GOCE and GRACE third-party mission data and merging with altimetric sea surface data to optimally determine Ocean Circulation) examines the influence of the satellite missions GRACE and in particular GOCE in ocean modelling applications. The project goal is an improved processing of satellite and ground data for the preparation and combination of gravity and altimetry data on the way to an optimal MDT solution. Explicitly, the two main objectives are (i) to enhance the GRACE error modelling and optimally combine GOCE and GRACE [and optionally terrestrial/altimetric data] and (ii) to integrate the optimal Earth gravity field model with MSS and drifter information to derive a state-of-the art MDT including an error assessment. The main work packages referring to (i) are the characterization of geoid model errors, the identification of GRACE error sources, the revision of GRACE error models, the optimization of weighting schemes for the participating data sets and finally the estimation of an optimally combined gravity field model. In this context, also the leakage of terrestrial data into coastal regions shall be investigated, as leakage is not only a problem for the gravity field model itself, but is also mirrored in a derived MDT solution. Related to (ii) the tasks are the revision of MSS error covariances, the assessment of the mean circulation using drifter data sets and the computation of an optimal geodetic MDT as well as a so called state-of-the-art MDT, which combines the geodetic MDT with drifter mean circulation data. This paper presents an overview over the project results with focus on the geodetic results part.

  14. Early and mid-term results of lung transplantation with donors 60 years and older.

    PubMed

    López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

    2015-01-01

    There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. [Early prediction of the neurological result at 12 months in newborns at neurological risk].

    PubMed

    Herbón, F; Garibotti, G; Moguilevsky, J

    2015-08-01

    The aim of this study was to evaluate the Amiel-Tison neurological examination (AT) and cranial ultrasound at term for predicting the neurological result at 12 months in newborns with neurological risk. The study included 89 newborns with high risk of neurological damage, who were discharged from the Neonatal Intensive Care of the Hospital Zonal Bariloche, Argentina. The assessment consisted of a neurological examination and cranial ultrasound at term, and neurological examination and evaluation of development at 12 months. The sensitivity, specificity, positive and negative predictor value was calculated. The relationship between perinatal factors and neurodevelopment at 12 month of age was also calculated using logistic regression models. Seventy children completed the follow-up. At 12 months of age, 14% had an abnormal neurological examination, and 17% abnormal development. The neurological examination and the cranial ultrasound at term had low sensitivity to predict abnormal neurodevelopment. At 12 months, 93% of newborns with normal AT showed normal neurological results, and 86% normal development. Among newborns with normal cranial ultrasound the percentages were 90 and 81%, respectively. Among children with three or more perinatal risk factors, the frequency of abnormalities in the neurological response was 5.4 times higher than among those with fewer risk factors, and abnormal development was 3.5 times more frequent. The neurological examination and cranial ultrasound at term had low sensitivity but high negative predictive value for the neurodevelopment at 12 months. Three or more perinatal risk factors were associated with neurodevelopment abnormalities at 12 months of age. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  16. New Early and Late Carboniferous paleomagnetic results from the Qaidam Block, NW China: Implications for the paleogeography of Central Asia

    NASA Astrophysics Data System (ADS)

    Cao, Yong; Sun, Zhiming; Li, Haibing; Pei, Junling; Xu, Wei; Pan, Jiawei; Zhang, Lei; Ye, Xiaozhou; Huang, Baochun; Wang, Zongxiu

    2017-10-01

    There is an ongoing debate regarding the paleogeographic evolution of the Qaidam Block (37.3 °N/96.4 °E) in northwest China during the late Paleozoic. To provide a reliable constraint on the paleogeographic reconstruction and to determine the relationship with the adjacent area, we performed a paleomagnetic investigation of Early and Late Carboniferous sediments from the Qaidam Block. Stepwise thermal demagnetization successfully isolated high unblocking-temperature characteristic directions from the samples. The tilt-corrected mean direction of the Early Carboniferous sediments is Ds/Is = 298.6°/- 46.4° with α95 = 4.7° and N = 15 sites, corresponding to a paleopole at - 3.2 °N, 147.5 °E with A95 = 4.8°. The Late Carboniferous paleomagnetic direction is Ds/Is = 320.1°/- 46.1° with α95 = 5.3° and N = 8 sites, corresponding to a paleopole at - 15.1 °N, 132.2 °E with A95 = 5.4°. A positive fold test for the Early Carboniferous paleomagnetic directions, and consistency with the Kiaman reversed superchron for the Late Carboniferous paleomagnetic directions, indicates the primary origin of the characteristic remanence of the studied section. The new paleomagnetic results suggest that the Qaidam Block was located at about 27 °N and did not undergo significant N-S movement during the Carboniferous. However, the Qaidam Block experienced a counter-clockwise rotation of about 21° during this period. Comparisons of the paleomagnetic results from the major blocks of Central Asia suggest that the Qaidam Block may have experienced a relatively rapid northward movement and collided with the Tarim Block after the Late Permian. Based on the paleomagnetic poles of the Qaidam Block and adjacent blocks, we present a tentative paleogeographic reconstruction for central Asia during the Early and Late Carboniferous.

  17. Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India.

    PubMed

    Gadgil, Anita; Sauvaget, Catherine; Roy, Nobhojit; Muwonge, Richard; Kantharia, Surita; Chakrabarty, Anuradha; Bantwal, Kanchan; Haldar, Indrani; Sankaranarayanan, Rengaswamy

    2017-02-01

    Indian women with breast cancer are usually diagnosed in advanced stages leading to poor survival. Improving breast awareness and increasing access to early diagnosis and adequate treatment has been advocated for breast cancer control. We implemented a program to increase awareness on breast cancer and access to its early detection in an occupational health care scheme in Mumbai, India. Breast awareness brochures were mailed annually between June 2013 and June 2016 to a cohort of 22,500 eligible women aged 30-69 years old receiving universal health care from an occupational health care scheme comprising of primary health centres and a referral secondary care hospital in Mumbai. Women with suspected breast cancers were provided with diagnostic investigations and treatment. Socio-demographic information and tumour characteristics were compared between the breast awareness pre-intervention period (Jan 2005-May 2013) and the breast awareness intervention period after four rounds of mailers (June 2013-June 2016). The proportion of women with early tumours and axillary lymph node negative cancers increased from 74% to 81% and 46% to 53% respectively, between the two periods. While the proportion of patients receiving breast conserving surgery increased from 39% to 51%, the proportion receiving chemotherapy decreased from 84% to 56%. Interim results following efforts to improve breast awareness and access to care in a cohort of women in an occupational health care scheme indicate early detection and more conservative treatment of breast cancers. Creating awareness and improving access to care may result in cancer down-staging. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Patient-centered feedback on the results of personality testing increases early engagement in residential substance use disorder treatment: a pilot randomized controlled trial.

    PubMed

    Blonigen, Daniel M; Timko, Christine; Jacob, Theodore; Moos, Rudolf H

    2015-03-14

    Patient-centered models of assessment have shown considerable promise for increasing patients' readiness for mental health treatment in general, but have not been used to facilitate patients' engagement in substance use disorder (SUD) treatment. We developed a brief patient-centered intervention using assessment and feedback of personality data and examined its acceptability and efficacy to increase early engagement in residential SUD treatment. Thirty patients entering a 90-day residential SUD treatment program were randomly assigned to a feedback (n = 17) or control (n = 13; assessment-only) condition. Normal-range personality was assessed with the NEO Personality Inventory-Revised (NEO PI-R). Patients were re-interviewed one month after treatment entry to obtain information on their satisfaction with the intervention, as well as their adjustment to the residential milieu. Electronic medical records were reviewed to obtain information on patients' length of stay in the program and discharge status. Univariate ANOVAs and chi-square tests were conducted to examine group differences on outcomes. Patients' ratings indicated strong satisfaction with the feedback intervention and expectations that it would have a positive impact on their treatment experiences. Among patients who had not previously been treated in the residential program, the feedback intervention was associated with more positive relationships with other residents in treatment and a stronger alliance with the treatment program one month after treatment entry. The feedback intervention was also associated with a longer length of stay in treatment, although this effect did not reach statistical significance. The findings highlight the clinical utility of providing SUD patients with patient-centered feedback based on the results of personality testing, and provide preliminary support for the acceptability and efficacy of this intervention to facilitate early engagement in residential SUD treatment.

  19. Early experience with stretch polytetrafluoroethylene grafts for haemodialysis access surgery: results of a prospective randomised study.

    PubMed

    Tordoir, J H; Hofstra, L; Leunissen, K M; Kitslaar, P J

    1995-04-01

    The purpose of this study was to evaluate the results and complications of standard ePTFE versus stretch ePTFE AV fistulas. Prospective randomised trial. University Hospital. During a 2-year period 37 patients received 17 stretch and 20 standard ePTFE graft AV fistulas. Patients were evaluated for the occurrence of complications and graft patency. Regular Duplex scans were performed to detect stenoses in the fistula circuit. Thrombotic events occurred in 40% of the standard ePTFE grafts, compared to 12% of the stretch ePTFE prostheses (p < 0.001). The incidence of puncture complications was similar in both groups. The cumulative primary patency rate in the stretch ePTFE group was significantly higher compared to the standard ePTFE group (1-year patency rates of 59% and 29%, respectively; p < 0.01). No differences in the duration of puncture site bleeding were observed. Duplex scanning showed a significantly greater number of stenoses in the standard ePTFE grafts. The new stretch ePTFE prosthesis has better primary patency rates and less stenoses due to intimal hyperplasia as compared to standard ePTFE grafts.

  20. Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players

    PubMed Central

    Swartz, Erik E.; Broglio, Steven P.; Cook, Summer B.; Cantu, Robert C.; Ferrara, Michael S.; Guskiewicz, Kevin M.; Myers, Jay L.

    2015-01-01

    Objective To test a helmetless-tackling behavioral intervention for reducing head impacts in National Collegiate Athletic Association Division I football players. Design Randomized controlled clinical trial. Setting Football field. Patients or Other Participants Fifty collegiate football players (intervention = 25, control = 25). Intervention(s) The intervention group participated in a 5-minute tackling drill without their helmets and shoulder pads twice per week in the preseason and once per week through the season. During this time, the control group performed noncontact football skills. Main Outcome Measure(s) Frequency of head impacts was recorded by an impact sensor for each athlete-exposure (AE). Data were tested with a 2 × 3 (group and time) repeated-measures analysis of variance. Significant interactions and main effects (P < .05) were followed with t tests. Results Head impacts/AE decreased for the intervention group compared with the control group by the end of the season (9.99 ± 6.10 versus 13.84 ± 7.27, respectively). The intervention group had 30% fewer impacts/AE than the control group by season's end (9.99 ± 6.10 versus 14.32 ± 8.45, respectively). Conclusion A helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season. PMID:26651278

  1. Oral citrulline as arginine precursor may be beneficial in sickle cell disease: early phase two results.

    PubMed Central

    Waugh, W. H.; Daeschner, C. W.; Files, B. A.; McConnell, M. E.; Strandjord, S. E.

    2001-01-01

    L-Arginine may be a conditionally essential amino acid in children and adolescents with sickle cell disease, particularly as required substrate in the arginine-nitric oxide pathway for endogenous nitrovasodilation and vasoprotection. Vasoprotection by arginine is mediated partly by nitric oxide-induced inhibition of endothelial damage and inhibition of adhesion and activation of leukocytes. Activated leukocytes may trigger many of the complications, including vasoocclusive events and intimal hyperplasias. High blood leukocyte counts during steady states in the absence of infection are significant laboratory risk factors for adverse complications. L-Citrulline as precursor amino acid was given orally twice daily in daily doses of approximately 0.1 g/kg in a pilot Phase II clinical trial during steady states in four homozygous sickle cell disease subjects and one sickle cell-hemoglobin C disease patient (ages 10-18). There soon resulted dramatic improvements in symptoms of well-being, raised plasma arginine levels, and reductions in high total leukocyte and high segmented neutrophil counts toward or to within normal limits. Continued L-citrulline supplementation in compliant subjects continued to lessen symptomatology, to maintain plasma arginine concentrations greater than control levels, and to maintain nearly normal total leukocyte and neutrophil counts. Side effects or toxicity from citrulline were not experienced. Oral L-citrulline may portend very useful for palliative therapy in sickle cell disease. Placebo-controlled, long-term trials are now indicated. PMID:11688916

  2. Oral citrulline as arginine precursor may be beneficial in sickle cell disease: early phase two results.

    PubMed

    Waugh, W H; Daeschner, C W; Files, B A; McConnell, M E; Strandjord, S E

    2001-10-01

    L-Arginine may be a conditionally essential amino acid in children and adolescents with sickle cell disease, particularly as required substrate in the arginine-nitric oxide pathway for endogenous nitrovasodilation and vasoprotection. Vasoprotection by arginine is mediated partly by nitric oxide-induced inhibition of endothelial damage and inhibition of adhesion and activation of leukocytes. Activated leukocytes may trigger many of the complications, including vasoocclusive events and intimal hyperplasias. High blood leukocyte counts during steady states in the absence of infection are significant laboratory risk factors for adverse complications. L-Citrulline as precursor amino acid was given orally twice daily in daily doses of approximately 0.1 g/kg in a pilot Phase II clinical trial during steady states in four homozygous sickle cell disease subjects and one sickle cell-hemoglobin C disease patient (ages 10-18). There soon resulted dramatic improvements in symptoms of well-being, raised plasma arginine levels, and reductions in high total leukocyte and high segmented neutrophil counts toward or to within normal limits. Continued L-citrulline supplementation in compliant subjects continued to lessen symptomatology, to maintain plasma arginine concentrations greater than control levels, and to maintain nearly normal total leukocyte and neutrophil counts. Side effects or toxicity from citrulline were not experienced. Oral L-citrulline may portend very useful for palliative therapy in sickle cell disease. Placebo-controlled, long-term trials are now indicated.

  3. Early results of sarcomeric gene screening from the Egyptian National BA-HCM Program.

    PubMed

    Kassem, Heba Sh; Azer, Remon S; Saber-Ayad, Maha; Ayad, Maha S; Moharem-Elgamal, Sarah; Magdy, Gehan; Elguindy, Ahmed; Cecchi, Franco; Olivotto, Iacopo; Yacoub, Magdi H

    2013-02-01

    The present study comprised sarcomeric genotyping of the three most commonly involved sarcomeric genes: MYBPC3, MYH7, and TNNT2 in 192 unrelated Egyptian hypertrophic cardiomyopathy (HCM) index patients. Mutations were detected in 40 % of cases. Presence of positive family history was significantly (p=0.002) associated with a higher genetic positive yield (49/78, 62.8 %). The majority of the detected mutations in the three sarcomeric genes were novel (40/62, 65 %) and mostly private (47/62, 77 %). Single nucleotide substitution was the most frequently detected mutation type (51/62, 82 %). Over three quarters of these substitutions (21/27, 78 %) involved CpG dinucleotide sites and resulted from C>T or G>A transition in the three analyzed genes, highlighting the significance of CpG high mutability within the sarcomeric genes examined. This study could aid in global comparative studies in different ethnic populations and constitutes an important step in the evolution of the integrated clinical, translational, and basic science HCM program.

  4. Initial Experience and Early Results of Mitral Valve Repair with Cardiocel Pericardial Patch.

    PubMed

    Tomšič, Anton; Bissessar, Daniella D; van Brakel, Thomas J; Marsan, Nina Ajmone; Klautz, Robert J M; Palmen, Meindert

    2018-06-07

    To assess the performance of a tissue engineering process-treated bovine pericardium patch (CardioCel) in the setting of reconstructive mitral valve surgery. Between 3/2014 and 4/2016, 30 patients (57.2±14.3 years, 27% female) underwent mitral valve leaflet repair with a CardioCel patch. Perioperative mortality was 7% (2 patients, non-graft-related). In 28 remaining patients, pre-discharge echocardiography demonstrated good repaired valve function. At a mean follow-up of 1.7±0.9 years, 3 additional deaths occurred (2 due to infective endocarditis, 1 non-cardiac related). On follow-up echocardiography [follow-up time 1.7±0.8 years, available for 26/28 (93%) hospital survivors], recurrent regurgitation was seen in 2 patients (both infective endocarditis) and 1 underwent reoperation (no infection at the level of patch repair was observed). In the remaining patients, the most recent echocardiogram demonstrated ≤mild regurgitation and stable gradients. The thickness and echodensity of the implanted patch on follow-up echocardiograms were comparable with postoperative echocardiograms. Initial results of the CardioCel patch in mitral valve repair surgery are satisfactory. The resistance to infection and late degeneration will need to be assessed in the future. Copyright © 2018. Published by Elsevier Inc.

  5. Biodegradable fixation of mandibular fractures in children: stability and early results.

    PubMed

    Yerit, Kaan C; Hainich, Sibylle; Enislidis, Georg; Turhani, Dritan; Klug, Clemens; Wittwer, Gert; Ockher, Michael; Undt, Gerhard; Kermer, Christian; Watzinger, Franz; Ewers, Rolf

    2005-07-01

    The aim of this study was to assess the safety and efficiency of biodegradable self-reinforced (SR-PLDLA) bone plates and screws in open reduction and internal fixation of mandible fractures in children. Thirteen patients (5 female, 8 male; mean age 12 years, range 5-16 years) were operated on various fractures of the mandible (2 symphyseal, 6 parasymphyseal, 4 body, 3 angle, 1 ramus, 2 condylar fractures). The mean follow-up time was 26.4 months (range 10.9-43.4 months). Intermaxillary fixation was applied in cases with concomitant condylar fractures up to 3 weeks. Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operations was not endangered. Adverse tissue reactions to the implants, malocclusion, and growth restrictions did not occur during the observation period. Pediatric patients benefit from the advantages of resorbable materials, especially from faster mobilization and the avoidance of secondary removal operations. Based on these preliminary results, self-reinforced fixation devices are safe and efficient in the treatment of pediatric mandible fractures. However, further clinical investigations are necessary to evaluate the long-term reliability.

  6. Deletion of Mecom in mouse results in early-onset spinal deformity and osteopenia.

    PubMed

    Juneja, Subhash C; Vonica, Alin; Zeiss, Caroline; Lezon-Geyda, Kimberly; Yatsula, Bogdan; Sell, David R; Monnier, Vincent M; Lin, Sharon; Ardito, Thomas; Eyre, David; Reynolds, David; Yao, Zhenqiang; Awad, Hani A; Yu, Hongbo; Wilson, Michael; Honnons, Sylvie; Boyce, Brendan F; Xing, Lianping; Zhang, Yi; Perkins, Archibald S

    2014-03-01

    Recent studies have indicated a role for a MECOM allele in susceptibility to osteoporotic fractures in humans. We have generated a mutation in Mecom in mouse (termed ME(m1)) via lacZ knock-in into the upstream transcription start site for the gene, resulting in disruption of Mds1 and Mds1-Evi1 transcripts, but not of Evi1 transcripts. We demonstrate that ME(m1/m1) mice have severe kyphoscoliosis that is reminiscent of human congenital or primary kyphoscoliosis. ME(m1/m1) mice appear normal at birth, but by 2weeks, they exhibit a slight lumbar lordosis and narrowed intervertebral space. This progresses to severe lordosis with disc collapse and synostosis, together with kyphoscoliosis. Bone formation and strength testing show that ME(m1/m1) mice have normal bone formation and composition but are osteopenic. While endochondral bone development is normal, it is markedly dysplastic in its organization. Electron micrographs of the 1week postnatal intervertebral discs reveals marked disarray of collagen fibers, consistent with an inherent weakness in the non-osseous connective tissue associated with the spine. These findings indicate that lack of ME leads to a complex defect in both osseous and non-osseous musculoskeletal tissues, including a marked vertebral osteopenia, degeneration of the IVD, and disarray of connective tissues, which is likely due to an inherent inability to establish and/or maintain components of these tissues. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Early results of one-stage correction for hip instability in cerebral palsy.

    PubMed

    Kim, Hui Taek; Jang, Jae Hoon; Ahn, Jae Min; Lee, Jong Seo; Kang, Dong Joon

    2012-06-01

    We evaluated the clinical and radiological results of one-stage correction for cerebral palsy patients. We reviewed clinical outcomes and radiologic indices of 32 dysplastic hips in 23 children with cerebral palsy (13 males, 10 females; mean age, 8.6 years). Ten hips had dislocation, while 22 had subluxation. Preoperative Gross Motor Function Classification System (GMFCS) scores of the patients were as follows; level V (13 patients), level IV (9), and level III (1). Acetabular deficiency was anterior in 5 hips, superolateral in 7, posterior in 11 and mixed in 9, according to 3 dimensional computed tomography. The combined surgery included open reduction of the femoral head, release of contracted muscles, femoral shortening varus derotation osteotomy and the modified Dega osteotomy. Hip range of motion, GMFCS level, acetabular index, center-edge angle and migration percentage were measured before and after surgery. The mean follow-up period was 28.1 months. Hip abduction (median, 40°), sitting comfort and GMFCS level were improved after surgery, and pain was decreased. There were two cases of femoral head avascular necrosis, but no infection, nonunion, resubluxation or redislocation. All radiologic indices showed improvement after surgery. A single event multilevel surgery including soft tissue, pelvic and femoral side correction is effective in treating spastic dislocation of the hip in cerebral palsy.

  8. Planck early results. XXIV. Dust in the diffuse interstellar medium and the Galactic halo

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Abergel, A.; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Blagrave, K.; Bock, J. J.; Bonaldi, A.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bucher, M.; Burigana, C.; Cabella, P.; Cantalupo, C. M.; Cardoso, J.-F.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chiang, L.-Y.; Chiang, C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Frailis, M.; Franceschi, E.; Galeotta, S.; Ganga, K.; Giard, M.; Giardino, G.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Hansen, F. K.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Jaffe, A. H.; Joncas, G.; Jones, A.; Jones, W. C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leonardi, R.; Leroy, C.; Linden-Vørnle, M.; Lockman, F. J.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; MacTavish, C. J.; Maffei, B.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Marshall, D. J.; Martin, P.; Martínez-González, E.; Masi, S.; Matarrese, S.; Matthai, F.; Mazzotta, P.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; O'Dwyer, I. J.; Osborne, S.; Pajot, F.; Paladini, R.; Pasian, F.; Patanchon, G.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Pinheiro Gonçalves, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Reinecke, M.; Renault, C.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Sandri, M.; Santos, D.; Savini, G.; Scott, D.; Seiffert, M. D.; Shellard, P.; Smoot, G. F.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Umana, G.; Valenziano, L.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    This paper presents the first results from a comparison of Planck dust maps at 353, 545 and 857GHz, along with IRAS data at 3000 (100 μm) and 5000GHz (60 μm), with Green Bank Telescope 21-cm observations of Hi in 14 fields covering more than 800 deg2 at high Galactic latitude. The main goal of this study is to estimate the far-infrared to sub-millimeter (submm) emissivity of dust in the diffuse local interstellar medium (ISM) and in the intermediate-velocity (IVC) and high-velocity clouds (HVC) of the Galactic halo. Galactic dust emission for fields with average Hi column density lower than 2 × 1020 cm-2 is well correlated with 21-cm emission because in such diffuse areas the hydrogen is predominantly in the neutral atomic phase. The residual emission in these fields, once the Hi-correlated emission is removed, is consistent with the expected statistical properties of the cosmic infrared background fluctuations. The brighter fields in our sample, with an average Hi column density greater than 2 × 1020 cm-2, show significant excess dust emission compared to the Hi column density. Regions of excess lie in organized structures that suggest the presence of hydrogen in molecular form, though they are not always correlated with CO emission. In the higher Hi column density fields the excess emission at 857 GHz is about 40% of that coming from the Hi, but over all the high latitude fields surveyed the molecular mass faction is about 10%. Dust emission from IVCs is detected with high significance by this correlation analysis. Its spectral properties are consistent with, compared to the local ISM values, significantly hotter dust (T ~ 20K), lower submm dust opacity normalized per H-atom, and a relative abundance of very small grains to large grains about four times higher. These results are compatible with expectations for clouds that are part of the Galactic fountain in which there is dust shattering and fragmentation. Correlated dust emission in HVCs is not detected

  9. Development and preliminary results of an in vivo Raman probe for early lung cancer detection

    NASA Astrophysics Data System (ADS)

    Short, Michael A.; Lam, Stephen; McWilliams, Annette; Zhao, Jianhua; Lui, Harvey; Zeng, Haishan

    2008-02-01

    Our previous results from Raman spectroscopy studies on ex vivo lung tissue showed the technique had great potential to differentiate between samples with different pathologies. In this work, a fast dispersive-type near-infrared (NIR) Raman spectroscopy system was developed to collect real-time, noninvasive, in vivo human lung spectra. The 785 nm excitation, and the collection of tissue emission were accomplished by using a reusable fiber optic catheter which passed down the instrument channel of a bronchoscope. Filters in two stages blocked laser emission other than 785 nm from reaching the tissue surface, and reduced fiber fluorescence and elastically scattered excitation light from being passed to the spectrometer. The spectrometer itself consisted of one of two holographic gratings with usable frequency ranges of: 700 to 2000 cm -1 and 1500 to 3400 cm -1. The dispersed light was detected by a cooled CCD array consisting of 400 by 1340 pixels. To increase the resolution of the system, while maximizing the throughput, a second fiber bundle, consisting of 54×100 μm diameter fibers connected the catheter to the spectrometer. The fibers in this second bundle were spread out to form a parabolic arc which replaced the conventional entrance slit. This geometry corrected for image aberrations, permitting complete CCD vertical binning, thereby yielding up to a 20-fold improvement in signal-to-noise ratio. The estimated spectral resolution of the system was 9 cm -1 for both gratings. So far we have measured spectra from 20 patients and have seen clear differences between spectra from tumor and normal tissue.

  10. Early cow's milk consumption among Brazilian children: results of a national survey.

    PubMed

    Bortolini, Gisele Ane; Vitolo, Márcia Regina; Gubert, Muriel Bauermann; Santos, Leonor Maria Pacheco

    2013-01-01

    to assess the intake, frequency, and type of milk consumed by Brazilian children younger than 60 months of age. this was a cross-sectional study, which used secondary data from the National Demographic and Health Survey of 2006-2007. Data from 4,817 children under the age of 60 months were used. All analyses were performed with expanded samples. The dietetic survey assessed the previous day's consumption, and estimates were made through univariate analysis, presented as a percentage. on the day prior to the survey, breast milk was consumed by 91% of the children younger than six months of age, by 61.5% of the children aged 6 to 12 months, and by 34.8% of the children aged 13 to 24 months. Among the children who had received other types of milk, cow's milk was consumed by 62.4% of the children younger than six months, by 74.6% of the children aged 6 to 12 months, and by approximately 80% of the children older than 12 months. Infant formulas were consumed by 23% of the children younger than six months of age, by 9.8% of the children aged 6 to 12 months, and by less than 1% of the older children. Soy milk consumption varied from 14.6% to 20% among the investigated ages. Non-breast milk consumption before the age of six months was more frequent in children living in the Northeastern and Southern regions. the results of the present study demonstrated that most children received cow's milk prematurely as a substitute for breast milk, highlighting the importance of the development of public policies to promote, protect, and support breastfeeding in all regions of Brazil, aiming at reversing the observed scenario. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  11. Early myocardial revascularization for postinfarction angina: results and long-term follow-up.

    PubMed

    Singh, A K; Rivera, R; Cooper, G N; Karlson, K E

    1985-11-01

    Within 30 days of acute myocardial infarction, 108 consecutive patients underwent urgent surgical myocardial revascularization for postinfarction angina between July 1976 and March 1983. There were 84 men and 24 women whose mean age was 59.6 +/- 9.5 years (range 34 to 80). Group I (15 patients, 14%) underwent surgery within 48 hours, Group II (47 patients, 43%) between 3 and 7 days and Group III (46 patients, 43%) within 30 days. Fifty-nine patients (55%) had transmural infarction. The ejection fraction was less than 40% in 21 patients (19%). Left ventricular end-diastolic pressure was 20 mm Hg or greater in 42 patients (39%). The incidence of single, double, triple vessel and 70% or greater left main coronary artery stenosis was 4, 20, 59 and 17%, respectively. There were two deaths (1.8%) within 30 days of operation. The incidence of intraaortic balloon pumping was higher in patients operated on earlier after myocardial infarction (53% of Group I versus 22% of Group III). Statistically, there were no differences in the use of inotropic agents or the occurrence of arrhythmias or postoperative myocardial infarction in the three groups. Late follow-up (mean 35 months, range 18 to 98) is complete for all patients (100%). There were four late myocardial infarctions and eight deaths. Actuarial survival was 87% at 5 years. Seventy-three percent of the 108 patients were free of angina and the condition of 14% improved. These results indicate that myocardial revascularization in the first 30 days after myocardial infarction can be accomplished with morbidity and mortality rates similar to those of an elective operation for chronic angina refractory to medical management.

  12. Endoscopic management of traumatic posterior urethral stricture: early results and followup.

    PubMed

    Goel, M C; Kumar, M; Kapoor, R

    1997-01-01

    We assessed the outcome of core through internal urethrotomy for traumatic posterior urethral stricture, and reviewed the followup results of these patients. During the last 4 years 13 patients with a stricture up to 2 cm. long underwent core through internal urethrotomy with C-arm fluoroscopy guidance and an orientation in 2 planes. Retrograde urethrotomy was performed and an 18F Foley catheter was left indwelling for 4 weeks, after which urethrotomy was repeated. All patients were advised to perform clean intermittent self-catheterization for urethral calibration and dilation. Outcome was defined as class 1-3 patients who required 2 or fewer urethrotomies with clean intermittent self-catheterization discontinued after the primary procedure, class 2-5 who required 2 or fewer urethrotomies with clean intermittent self-catheterization and class 3-5 who required 3 or more urethrotomies. Of the 13 patients 8 (61%) did well after a mean followup of 17.7 months. The 3 patients with a class 1 outcome did well, while 2 of 5 with a class 2 outcome required repeat urethrotomy during followup. Of the 5 patients (39%) with a class 3 outcome in whom core through internal urethrotomy failed 3 required open surgery and 2 were lost to followup. Recurrence rate was 69% at 3 months and 25% at 12 months after the initial procedure. No patient was incontinent at last followup. Two patients had significant hematuria postoperatively, which resolved with conservative treatment. Endoscopic treatment should be considered the first line procedure for all post-traumatic posterior urethral strictures. The morbidity of open surgery can be avoided in 61% of patients. Hospital stay, loss of work, morbidity and related complications are also markedly decreased with endoscopic therapy.

  13. Manchester iStent study: early results from a prospective UK case series.

    PubMed

    Patel, Ilesh; de Klerk, Timothy A; Au, Leon

    2013-01-01

    To evaluate the 6-month efficacy and safety of the iStent microtrabecular bypass stent in patients with open-angle glaucoma. A prospective, uncontrolled, interventional case series. Forty-four eyes with open-angle glaucoma were reported. All subjects underwent ab interno implantation of a single iStent together with (n = 40) or without (n = 4) cataract surgery. Patients were assessed at postoperative week 1, months 1 and 3, and quarterly, thereafter. Data collected included visual acuity, intraocular pressure measurement using Goldmann tonometry, number of glaucoma medications, and number and type of complications. The mean age of the sample was 76.8 years. The mean duration since glaucoma diagnosis was 5.3 years (standard deviation 2.9 years). The mean visual acuity was 0.53 logMAR at baseline that improved to 0.23 at 6 months postoperatively. The mean baseline intraocular pressure was 21.1 mmHg, and this decreased significantly to 16.7 mmHg at 6 months (P < 0.01). The mean number of drops prescribed preoperatively was 2.3, which decreased to 0.6 at 6 months (P < 0.01). Sixty-six per cent of patients were drop-free at 6 months. One patient developed an hyphaema following surgery; no other adverse events were recorded. The iStent proved to be a safe and effective treatment for patients with open-angle glaucoma over our 6-month follow up period. Insertion resulted in a significant decrease in intraocular pressure as well as the number of topical antiglaucoma medications required for adequate intraocular pressure control. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  14. The Design of a Remote Sensing Data Acquisition Campaign for Precision Agriculture and Some Early Results

    NASA Technical Reports Server (NTRS)

    Rickmanl, D.; Luvall, J. C.; Wersinger, J. M.; Mask, P.; Kissel, D. E.

    1999-01-01

    harvest! Soil images show significant within field variation in clay, soil brightness and emissivity. Light wind has been found to effect the reflectance and temperature of broad leaf crops, including soybeans, cotton and peanuts. Clearly, this work has already demonstrated some very important results. With continued development of the remote sensing technology there is good reason to believe this research will soon be able to help the individual farmer.

  15. Early perioperative results and surgical recurrence after strictureplasty and miniresection for complicated Crohn's disease.

    PubMed

    Sampietro, G M; Cristaldi, M; Porretta, T; Montecamozzo, G; Danelli, P; Taschieri, A M

    2000-01-01

    recurrence rate results support the efficacy and safety of SP and MR surgery in the treatment of complicated CD. Copyright 2000 S. Karger AG, Basel

  16. Early Spring in Europe: A Result of More Dominant North-Atlantic Southwesterlies?

    NASA Technical Reports Server (NTRS)

    Otterman, J.; Atlas, R.; Chase, T. N.; Chou, S.-H.; Jusem, J. C.; Pielke, R. A., Sr.; Rogers, J.; Russell, G. L.; Schubert, S. D.; Sud, Y. C.; hide

    2000-01-01

    Abstract A 1999 study reports an advancement of spring in Europe by 0.2 days per year in the 30 years since 1960. Our analysis indicates that this trend results directly from a change in the late-winter surface winds over the eastern North Atlantic: the southwesterly direction became more dominant, and the speed of these southwesterlies increased slightly. Splitting the 52-year NCEP reanalysis dataset into the First Half, FH (1948-1973)), and the Second Half, SH (1974-1999), we analyze the wind direction for the February mean at three sites at 45N: site A at 30W, site B at 20W, and site C at 10W. The incidence (number of years) of the southwesterlies in SH Vs. (FH) at these sites respectively increased in SH as follows: 24(18), 19(12), 14(l 1); whereas the incidence of northeasterlies decreased: 0(2), 1(2), and 1(6). When the February mean wind is southwesterly, the monthly mean sensible heat flux from the ocean at these sites takes zero or slightly negative values, that is, the surface air is warmer than the ocean. Analyzing the scenario in the warm late winter 1990, we observe that the sensible heat flux from the ocean surface in February 1990 shows a "tongue" of negative values extending southwest from southern England to 7N. This indicates that the source of the maritime air advected into Europe lies to the south of the "tongue." Streamline analysis suggests that the Southwestern or southcentral North Atlantic is the source. For February 1990, we find strong, ascending motions over Europe at 700 mb, up to -0.4 Pa/s as monthly averages. Associated with the unstable low-levels of the troposphere are positive rain and cloud anomalies. Thus, positive in situ feedback over land in late winter (when shortwave absorption is not significant) apparently further enhances the surface temperature through an increase in the greenhouse effect due to increased water vapor and cloudiness.

  17. The dementia and disability project in Thai elderly: rational, design, methodology and early results

    PubMed Central

    2013-01-01

    Background A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects

  18. The effects of patient and physician characteristics on early outpatient satisfaction with substance dependence care: results of the SUBUSQOL study

    PubMed Central

    Bourion-Bédès, Stéphanie; Schwan, Raymund; Di Patrizio, Paolo; Vlamynck, Guillaume; Viennet, Sarah; Schvartz, Maxime; Gaunard, Anne; Bédès, Alex; Clerc-Urmès, Isabelle; Baumann, Cédric

    2017-01-01

    Background Although patient perceptions of health care have increasingly been explored in the literature, little is known about care satisfaction among individuals with substance dependence. This exploratory study assessed the relationships between patient and physician characteristics and early outpatient satisfaction with care for alcohol and opioid dependence. Methods Satisfaction was assessed using a multidimensional, self-administered and validated questionnaire during the early care process among a prospective outpatient cohort. In addition to measuring satisfaction and obtaining sociodemographic and clinical data, this study collected data on the self-reported health status and physician characteristics at inclusion. Cross-sectional analysis with multiple linear regression was performed to identify the variables associated with satisfaction level. Results A total of 249 outpatients were included, and 63.8% completed the satisfaction questionnaire. Patients without a history of previous care for substance dependence were more satisfied with the appointment-making process (β=7.2; P=0.029) and with the doctor consultation (β=10.3; P=0.003) than those who had received care previously. Neither sociodemographic characteristics nor self-reported health status was associated with outpatient satisfaction. Conclusion The factors that affect patients’ ratings of early satisfaction with the care that they receive should be studied further because increased understanding of the factors that negatively affect these ratings might enable caregivers and outpatient management facilities to improve the patient experience during the early stages of care, which might in turn improve treatment adherence, continuity of care, and other health-related outcomes. PMID:28507432

  19. AMLCD cockpit: promise and payoffs

    NASA Astrophysics Data System (ADS)

    Snow, Michael P.; Jackson, Timothy W.; Meyer, Frederick M.; Reising, John M.; Hopper, Darrel G.

    1999-08-01

    The active matrix liquid crystal display (AMLCD) has become the preferred flight instrument technology in avionics multifunction display applications. Current bubble canopy fighter cockpit applications involve sizes up to 7.8 X 7.8 in. active display. Dual use avionics versions of AMLCD technology are now as large as 6.7 X 6.7 in. active display area in the ARINC D sized color multifunction display (MFD). This is the standard instrument in all new Boeing transport aircraft and is being retrofitted into the C-17A. A special design of the ARINC D instrument is used in the Space Shuttle cockpit upgrade. Larger sizes of AMLCD were desired when decisions were made in the early 1990s for the F-22. Commercial AMLCD technology has now produced monitors at 1280 X 1024 resolution (1.3 megapixels) in sizes of 16 to 21 in. diagonal. Each of these larger AMLCDs has more information carrying capacity than the entire F-22A cockpit instrument panel shipset, comprising six separate smaller AMLCDs (1.2 megapixels total). The larger AMLCDs are being integrated into airborne mission crewstations for use in dim ambient lighting conditions. It is now time to identify and address the technology challenges of upgrading these larger AMLCDs for sunlight readable application and of developing concepts for their integration into advanced bubble canopy fighter cockpits. The overall goals are to significantly increase the informational carrying capacity to bring both sensor and information fusion into the cockpit and, thereby, to enable a significant increase in warfighter situational awareness and effectiveness. A research cockpit was built using specialized versions of the IBM 16.1 in and two smaller 10 in. AMLCDs to examine human factors and display design issues associated with these next-generation AMLCD cockpit displays. This cockpit was later upgraded to allow greater reconfigurability and flexibility in the display hardware used to conduct part- task mission simulations. The objective

  20. Early Child Care and Adolescent Functioning at the End of High School: Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Vandell, Deborah Lowe; Burchinal, Margaret; Pierce, Kim M.

    2016-01-01

    Relations between early child care and adolescent functioning at the end of high school (EOHS; M age = 18.3 years) were examined in a prospective longitudinal study of 1,214 children. Controlling for extensive measures of family background, early child care was associated with academic standing and behavioral adjustment at the EOHS. More…

  1. Conventional early infant diagnosis in Lesotho from specimen collection to results usage to manage patients: Where are the bottlenecks?

    PubMed Central

    Hoffman, Heather J.; Isavwa, Anthony; Mokone, Mafusi; Foso, Matokelo; Safrit, Jeffrey T.; Mofenson, Lynne M.; Tylleskär, Thorkild

    2017-01-01

    Introduction Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade. Methods We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means (with 95% CI) were calculated and compared by region using linear mixed models. Results 1,187 individual infant records from 25 facilities were reviewed. Overall, early infant diagnosis turnaround time was 61.7 days (95%CI: 55.3–68.7). Mean time from specimen collection to district laboratory was 14 days (95%CI: 12.1–16.1); from district to central laboratory, 2 days (95%CI 0.8–5.2); results from central laboratory to district hospital, 23.3 days (95%CI: 18.7–29.0); from district hospital to health facility, 3.2 days (95%CI 1.9–5.5); and from health facility to caregiver, 10.4 days (95%CI, 7.9–13.5). Mean times from specimen transfer to the central laboratory and for result transfer from central laboratory to district hospital were significantly shorter in the Lowlands Region (0.9 and 16.2 days, respectively), compared to Highlands Region (6.0 [P = 0.030] and 34.3 days [P = 0.0099]. Turnaround time from blood draw to receipt of results was significantly shorter for HIV infected infants compared to HIV uninfected infants [p = 0.0036] at an average of 47.1 days (95%CI: 38.9–56.9) and 62 days (95%CI: 55.9–68.7) respectively. Of 47 HIV-infected infants, 36 were initiated on antiretroviral therapy at an average of 1.3 days (95%CI: 0.3, 5

  2. Nanotechnology: Its Promise and Challenges

    SciTech Connect

    Colvin, Vicki

    2009-05-14

    Vicki Colvin of Rice University talks about how nanotechnology-enabled systems, with dimensions on the scale of a billionth of a meter, offer great promise for solving difficult social problems and creating enormous possibilities.

  3. ICESat Laser Altimeter Pointing, Ranging and Timing Calibration from Integrated Residual Analysis: A Summary of Early Mission Results

    NASA Technical Reports Server (NTRS)

    Lutchke, Scott B.; Rowlands, David D.; Harding, David J.; Bufton, Jack L.; Carabajal, Claudia C.; Williams, Teresa A.

    2003-01-01

    On January 12, 2003 the Ice, Cloud and land Elevation Satellite (ICESat) was successfUlly placed into orbit. The ICESat mission carries the Geoscience Laser Altimeter System (GLAS), which consists of three near-infrared lasers that operate at 40 short pulses per second. The instrument has collected precise elevation measurements of the ice sheets, sea ice roughness and thickness, ocean and land surface elevations and surface reflectivity. The accurate geolocation of GLAS's surface returns, the spots from which the laser energy reflects on the Earth's surface, is a critical issue in the scientific application of these data Pointing, ranging, timing and orbit errors must be compensated to accurately geolocate the laser altimeter surface returns. Towards this end, the laser range observations can be fully exploited in an integrated residual analysis to accurately calibrate these geolocation/instrument parameters. Early mission ICESat data have been simultaneously processed as direct altimetry from ocean sweeps along with dynamic crossovers resulting in a preliminary calibration of laser pointing, ranging and timing. The calibration methodology and early mission analysis results are summarized in this paper along with future calibration activities

  4. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    SciTech Connect

    Nichols, Elizabeth, E-mail: Enichols1@umm.edu; Kesmodel, Susan B.; Bellavance, Emily

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures.more » A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.« less

  5. The Breast International Group 1-98 trial: big results for women with hormone-sensitive early breast cancer.

    PubMed

    Monnier, Alain M

    2007-05-01

    As there is a risk for relapse in early breast cancer, especially at 1-3 years post surgery, the need for adjuvant therapy is clear. In terms of disease-free survival, aromatase inhibitors have emerged as superior to tamoxifen for the adjuvant treatment of hormone-sensitive breast cancer in several Phase III clinical trials. Of these trials, the Breast International Group (BIG) 1-98 trial stands out as unique in design, as it is the only trial to address whether an aromatase inhibitor is more effective as initial adjuvant therapy or as sequential therapy with an aromatase inhibitor and tamoxifen in either order and in rigor of end points and safety evaluations. When compared with tamoxifen, letrozole has been shown to significantly reduce recurrence risk in the overall population by 19% and also significantly reduced recurrence risk in the patient subgroups at increased risk: node-positive and previously chemotherapy-treated patients. Letrozole is the only aromatase inhibitor to demonstrate a significant 27% reduction in the risk of distant metastases (p = 0.001) in the clinically relevant, hormone receptor-positive population in the initial adjuvant setting. Recent results also suggest that letrozole in particular reduces the risk of distant metastases early on after initial surgery for breast cancer. This is important, as early distant metastatic events compose the majority of early recurrences and are a well-recognized predictor of breast cancer death. Letrozole has been found to be well tolerated in the initial adjuvant treatment setting, and these data have been confirmed by long-term safety data from the monotherapy analysis in the BIG 1-98 study. Thus far, the results from the BIG 1-98 trial provide clear support for the use of letrozole in the initial adjuvant treatment of breast cancer. Future studies will provide the definitive answer to questions of which initial adjuvant therapy is superior (i.e., anastrozole or letrozole) and information as to the

  6. Lava heating and loading of ice sheets on early Mars: Predictions for meltwater generation, groundwater recharge, and resulting landforms

    NASA Astrophysics Data System (ADS)

    Cassanelli, James P.; Head, James W.

    2016-06-01

    Recent modeling studies of the early Mars climate predict a predominantly cold climate, characterized by the formation of regional ice sheets across the highland areas of Mars. Formation of the predicted "icy highlands" ice sheets is coincident with a peak in the volcanic flux of Mars involving the emplacement of the Late Noachian - Early Hesperian ridged plains unit. We explore the relationship between the predicted early Mars "icy highlands" ice sheets, and the extensive early flood volcanism to gain insight into the surface conditions prevalent during the Late Noachian to Early Hesperian transition period. Using Hesperia Planum as a type area, we develop an ice sheet lava heating and loading model. We quantitatively assess the thermal and melting processes involved in the lava heating and loading process following the chronological sequence of lava emplacement. We test a broad range of parameters to thoroughly constrain the lava heating and loading process and outline predictions for the formation of resulting geological features. We apply the theoretical model to a study area within the Hesperia Planum region and assess the observed geology against predictions derived from the ice sheet lava heating and loading model. Due to the highly cratered nature of the Noachian highlands terrain onto which the volcanic plains were emplaced, we predict highly asymmetrical lava loading conditions. Crater interiors are predicted to accumulate greater thicknesses of lava over more rapid timescales, while in the intercrater plains, lava accumulation occurs over longer timescales and does not reach great thicknesses. We find that top-down melting due to conductive heat transfer from supraglacial lava flows is generally limited when the emplaced lava flows are less than ∼10 m thick, but is very significant at lava flow thicknesses of ∼100 m or greater. We find that bottom-up cryosphere and ice sheet melting is most likely to occur within crater interiors where lavas

  7. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  8. Do Diagnosis Delays Impact Receipt of Test Results? Evidence from the HIV Early Infant Diagnosis Program in Uganda

    PubMed Central

    Mugambi, Melissa Latigo; Deo, Sarang; Kekitiinwa, Adeodata; Kiyaga, Charles; Singer, Mendel E.

    2013-01-01

    Background There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID) programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. Methods We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility). Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. Results Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70–0.98). Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40–2.33) and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37–0.81) compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25–0.93). Conclusion In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results. PMID:24282502

  9. Early Childhood Teachers' Perceived Competence during Transition from Teacher Education to Work: Results from a Longitudinal Study

    ERIC Educational Resources Information Center

    Mischo, Christoph

    2015-01-01

    The transition from education to work is a challenge for early childhood teachers. In this study, competence self-ratings of 348 German early childhood teachers were investigated one year before, at the end of and four months after early childhood teacher education at universities and vocational schools. Perceived competence was assessed by means…

  10. Changes in bacterioplankton community structure during early lake ontogeny resulting from the retreat of the Greenland Ice Sheet

    PubMed Central

    Peter, Hannes; Jeppesen, Erik; De Meester, Luc; Sommaruga, Ruben

    2018-01-01

    Retreating glaciers and ice sheets are among the clearest signs of global climate change. One consequence of glacier retreat is the formation of new meltwater-lakes in previously ice-covered terrain. These lakes provide unique opportunities to understand patterns in community organization during early lake ontogeny. Here, we analyzed the bacterial community structure and diversity in six lakes recently formed by the retreat of the Greenland Ice Sheet (GrIS). The lakes represented a turbidity gradient depending on their past and present connectivity to the GrIS meltwaters. Bulk (16S rRNA genes) and putatively active (16S rRNA) fractions of the bacterioplankton communities were structured by changes in environmental conditions associated to the turbidity gradient. Differences in community structure among lakes were attributed to both, rare and abundant community members. Further, positive co-occurrence relationships among phylogenetically closely related community members dominate in these lakes. Our results show that environmental conditions along the turbidity gradient structure bacterial community composition, which shifts during lake ontogeny. Rare taxa contribute to these shifts, suggesting that the rare biosphere has an important ecological role during early lakes ontogeny. Members of the rare biosphere may be adapted to the transient niches in these nutrient poor lakes. The directionality and phylogenetic structure of co-occurrence relationships indicate that competitive interactions among closely related taxa may be important in the most turbid lakes. PMID:29087379

  11. Risk and protective factors in early child development: Results from the All Our Babies (AOB) pregnancy cohort.

    PubMed

    McDonald, Sheila; Kehler, Heather; Bayrampour, Hamideh; Fraser-Lee, Nonie; Tough, Suzanne

    2016-11-01

    Understanding factors that protect against early developmental delay among children who are experiencing adversity can inform prevention and early intervention strategies. To identify risk factors for development delay at one year and protective factors for developmental delay in 'at risk' environments (poor maternal mental health and socio-demographic risk). Data was analyzed from 3360 mother-child dyads who participated in the All Our Babies (AOB) pregnancy cohort. Participants completed four questionnaires spanning pregnancy to one year postpartum and provided access to medical records. Risk factors for developmental delay at age one were identified using bivariate methods and multivariable modeling. Protective factors for child development in 'at risk' family environments were identified using bivariate analyses. At one year, 17% of children were developmentally delayed, defined as scoring in the monitoring zone on at least 2 of the 5 developmental domains of the Ages and Stages Questionnaire. Prenatal depression, preterm birth, low community engagement, and non-daily parent-child interaction increased the risk of delay. Protective factors for children in 'at risk' environments included relationship happiness, parenting self-efficacy, community engagement, higher social support, and daily parent-child interaction. The study results suggest that maternal and infant outcomes would be improved, even for vulnerable women, through identification and intervention to address poor mental health and through normalizing engagement with low cost, accessible community resources that can also support parent-child interaction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Blastomere biopsy influences epigenetic reprogramming during early embryo development, which impacts neural development and function in resulting mice.

    PubMed

    Wu, Yibo; Lv, Zhuo; Yang, Yang; Dong, Guoying; Yu, Yang; Cui, Yiqiang; Tong, Man; Wang, Liu; Zhou, Zuomin; Zhu, Hui; Zhou, Qi; Sha, Jiahao

    2014-05-01

    Blastomere biopsy is used in preimplantation genetic diagnosis; however, the long-term implications on the offspring are poorly characterized. We previously reported a high risk of memory defects in adult biopsied mice. Here, we assessed nervous function of aged biopsied mice and further investigated the mechanism of neural impairment after biopsy. We found that aged biopsied mice had poorer spatial learning ability, increased neuron degeneration, and altered expression of proteins involved in neural degeneration or dysfunction in the brain compared to aged control mice. Furthermore, the MeDIP assay indicated a genome-wide low methylation in the brains of adult biopsied mice when compared to the controls, and most of the genes containing differentially methylated loci in promoter regions were associated with neural disorders. When we further compared the genomic DNA methylation profiles of 7.5-days postconception (dpc) embryos between the biopsy and control group, we found the whole genome low methylation in the biopsied group, suggesting that blastomere biopsy was an obstacle to de novo methylation during early embryo development. Further analysis on mRNA profiles of 4.5-dpc embryos indicated that reduced expression of de novo methylation genes in biopsied embryos may impact de novo methylation. In conclusion, we demonstrate an abnormal neural development and function in mice generated after blastomere biopsy. The impaired epigenetic reprogramming during early embryo development may be the latent mechanism contributing to the impairment of the nervous system in the biopsied mice, which results in a hypomethylation status in their brains.

  13. Changes in bacterioplankton community structure during early lake ontogeny resulting from the retreat of the Greenland Ice Sheet.

    PubMed

    Peter, Hannes; Jeppesen, Erik; De Meester, Luc; Sommaruga, Ruben

    2017-10-31

    Retreating glaciers and ice sheets are among the clearest signs of global climate change. One consequence of glacier retreat is the formation of new meltwater-lakes in previously ice-covered terrain. These lakes provide unique opportunities to understand patterns in community organization during early lake ontogeny. Here, we analyzed the bacterial community structure and diversity in six lakes recently formed by the retreat of the Greenland Ice Sheet (GrIS). The lakes represented a turbidity gradient depending on their past and present connectivity to the GrIS meltwaters. Bulk (16S rRNA genes) and putatively active (16S rRNA) fractions of the bacterioplankton communities were structured by changes in environmental conditions associated to the turbidity gradient. Differences in community structure among lakes were attributed to both, rare and abundant community members. Further, positive co-occurrence relationships among phylogenetically closely related community members dominate in these lakes. Our results show that environmental conditions along the turbidity gradient structure bacterial community composition, which shifts during lake ontogeny. Rare taxa contribute to these shifts, suggesting that the rare biosphere has an important ecological role during early lakes ontogeny. Members of the rare biosphere may be adapted to the transient niches in these nutrient poor lakes. The directionality and phylogenetic structure of co-occurrence relationships indicate that competitive interactions among closely related taxa may be important in the most turbid lakes.The ISME Journal advance online publication, 31 October 2017; doi:10.1038/ismej.2017.191.

  14. A Multi-Institutional Study of Feasibility, Implementation, and Early Clinical Results With Noninvasive Breast Brachytherapy for Tumor Bed Boost

    SciTech Connect

    Hamid, Subarna, E-mail: shamid@tuftsmedicalcenter.org; Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI; Rocchio, Kathy

    2012-08-01

    Purpose: To evaluate the feasibility, implementation, and early results of noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT). Methods and Materials: NIBB is a commercially available (AccuBoost, Billerica, MA) mammography-based, brachytherapy system in which the treatment applicators are centered on the planning target volume (PTV) to direct {sup 192}Ir emissions along orthogonal axes. A privacy-encrypted online data registry collected information from 8 independent academic and community-based institutions. Data were from 146 consecutive women with early-stage breast cancer after lumpectomy and WBRT receiving boost with NIBB between July 2007 and March 2010. Toxicity and cosmesismore » were graded according to the Common Toxicity Criteria (v. 3.0) and the Harvard scale. Median follow-up was 6 months (1-39 months). Results: Grade 1-2 skin toxicity was observed in 64%, 48%, and 21% during the acute (1-3 weeks), intermediate (4-26 weeks), and late-intermediate (>26 weeks) periods. There was no Grade 4 toxicity. At 6 months, for the entire cohort, cosmesis was excellent/good in 62%/38%. The subset receiving NIBB before WBRT had cosmetic scores of 32% and 63%, whereas during WBRT, 58% and 37% were rated as excellent and good, respectively. Breast compression was scored as 'uncomfortable' in 12%, 29%, and 59% when NIBB was delivered before, during, or after WBRT. For each patient, the fraction-to-fraction variability in PTV was low. Skin flash was associated with a higher proportion of excellent cosmesis (58% vs. 42%) relative to having the applicator all within breast tissue. Conclusions: These data indicate that NIBB is feasible and can be consistently implemented in a broad array of practice settings. Preliminary evaluation suggests that NIBB is associated with acceptably mild normal tissue toxicity and favorable early cosmesis. The application of NIBB before WBRT may be associated with better patient tolerance at

  15. Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies.

    PubMed

    Doctor, Allan; Zimmerman, Jerry; Agus, Michael; Rajasekaran, Surender; Bubeck Wardenburg, Juliane; Fortenberry, James; Zajicek, Anne; Mairson, Emma; Typpo, Katri

    2017-03-01

    To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015). Literature review, research data, and expert opinion. Not applicable. Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities. Summary of presentations and discussion supported and supplemented by relevant literature. Among critically ill children, multiple organ dysfunction syndrome is relatively common and associated with significant morbidity and mortality. For outcomes to improve, effective therapies aimed at preventing and treating this condition must be discovered and rigorously evaluated. In this article, a number of potential opportunities to enhance current care are highlighted including the need for a better understanding of the pharmacokinetics and pharmacodynamics of medications, the effect of early and optimized nutrition, and the impact of effective glucose control in the setting of multiple organ dysfunction syndrome. Additionally, a handful of the promising therapies either currently being implemented or developed are described. These include extracorporeal therapies, anticytokine therapies, antitoxin treatments, antioxidant approaches, and multiple forms of exogenous steroids. For the field to advance, promising therapies and other therapies must be assessed in rigorous manner and implemented accordingly.

  16. Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

    PubMed Central

    Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

    2016-01-01

    Background: Early integration of palliative care in oncology practice (“simultaneous care”, SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. Patients and methods: A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Results: Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. Conclusion: SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field. PMID:27877212

  17. Prospective Single-Arm, Multi-Center Trial of a Patient-Specific Interpositional Knee Implant: Early Clinical Results

    PubMed Central

    Koeck, F.X; Luring, C; Goetz, J; Handel, M; Tingart, M; Grifka, J; Beckmann, J

    2011-01-01

    Background: The treatment of unicompartmental arthritis in younger patients is challenging. The aim of this study is to report final safety and efficacy analysis results for the iForma patient–specific interpositional device, which is designed for the treatment of isolated medial or lateral compartment arthritis of the knee. Methods: From June 2005 to June 2008 78 subjects (42 men, 36 women) received an iForma implant. The mean age was 53 years, the mean Body Mass Index 29.0. We surveyed the WOMAC scores, the visual analog pain scale and the Knee Society Scores. Results: The mean follow up was 16.4 months. The mean WOMAC knee scores increased from 48.3 before surgery to 71.3 after 24 months. A reduction in pain was achieved for all five pain measures using a standard visual analog scale (VAS). Knee Society Knee Score improved from 39.2 before to 61.9 24 month after surgery. The Knee Society Function Scores improved form preoperative 64.5 to 82.5 2 years postoperative. The preoperative range of motion could be restored. The overall revision rate was 24%. 15 implants were removed early, 4 knees were revised without implant removal. Conclusion: Within narrow indication of patients with unicompartmental disease, the iForma device can provide improvement in knee function and reduction in pain, however, with a significant higher risk of early revision compared to traditional arthroplasty. Respecting this limitation it may be an alternative option for arthritic patients with unicompartmental disease who have contraindications to High Tibial Osteotomy or are too young for knee replacement; the iForma device further has the distinct advantage of time and cost saving compared to those procedures. PMID:21552462

  18. Capturing Early Changes in the Marine Bacterial Community as a Result of Crude Oil Pollution in a Mesocosm Experiment

    PubMed Central

    Krolicka, Adriana; Boccadoro, Catherine; Nilsen, Mari Mæland; Baussant, Thierry

    2017-01-01

    The results of marine bacterial community succession from a short-term study of seawater incubations at 4°C to North Sea crude oil are presented herein. Oil was used alone (O) or in combination with a dispersant (OD). Marine bacterial communities resulting from these incubations were characterized by a fingerprinting analysis and pyrosequencing of the 16S rRNA gene with the aim of 1) revealing differences in bacterial communities between the control, O treatment, and OD treatment and 2) identifying the operational taxonomic units (OTUs) of early responders in order to define the bacterial gene markers of oil pollution for in situ monitoring. After an incubation for 1 d, the distribution of the individual ribotypes of bacterial communities in control and oil-treated (O and OD) tanks differed. Differences related to the structures of bacterial communities were observed at later stages of the incubation. Among the early responders identified (Pseudoalteromonas, Sulfitobacter, Vibrio, Pseudomonas, Glaciecola, Neptunomonas, Methylophaga, and Pseudofulvibacter), genera that utilize a disintegrated biomass or hydrocarbons as well as biosurfactant producers were detected. None of these genera included obligate hydrocarbonoclastic bacteria (OHCB). After an incubation for 1 d, the abundances of Glaciecola and Pseudofulvibacter were approximately 30-fold higher in the OD and O tanks than in the control tank. OTUs assigned to the Glaciecola genus were represented more in the OD tank, while those of Pseudofulvibacter were represented more in the O tank. We also found that 2 to 3% of the structural community shift originated from the bacterial community in the oil itself, with Polaribacter being a dominant bacterium. PMID:29187706

  19. Capturing Early Changes in the Marine Bacterial Community as a Result of Crude Oil Pollution in a Mesocosm Experiment.

    PubMed

    Krolicka, Adriana; Boccadoro, Catherine; Nilsen, Mari Mæland; Baussant, Thierry

    2017-12-27

    The results of marine bacterial community succession from a short-term study of seawater incubations at 4°C to North Sea crude oil are presented herein. Oil was used alone (O) or in combination with a dispersant (OD). Marine bacterial communities resulting from these incubations were characterized by a fingerprinting analysis and pyrosequencing of the 16S rRNA gene with the aim of 1) revealing differences in bacterial communities between the control, O treatment, and OD treatment and 2) identifying the operational taxonomic units (OTUs) of early responders in order to define the bacterial gene markers of oil pollution for in situ monitoring.After an incubation for 1 d, the distribution of the individual ribotypes of bacterial communities in control and oil-treated (O and OD) tanks differed. Differences related to the structures of bacterial communities were observed at later stages of the incubation. Among the early responders identified (Pseudoalteromonas, Sulfitobacter, Vibrio, Pseudomonas, Glaciecola, Neptunomonas, Methylophaga, and Pseudofulvibacter), genera that utilize a disintegrated biomass or hydrocarbons as well as biosurfactant producers were detected. None of these genera included obligate hydrocarbonoclastic bacteria (OHCB). After an incubation for 1 d, the abundances of Glaciecola and Pseudofulvibacter were approximately 30-fold higher in the OD and O tanks than in the control tank. OTUs assigned to the Glaciecola genus were represented more in the OD tank, while those of Pseudofulvibacter were represented more in the O tank. We also found that 2 to 3% of the structural community shift originated from the bacterial community in the oil itself, with Polaribacter being a dominant bacterium.

  20. Sleep Deprivation During Early-Adult Development Results in Long-Lasting Learning Deficits in Adult Drosophila

    PubMed Central

    Seugnet, Laurent; Suzuki, Yasuko; Donlea, Jeff M.; Gottschalk, Laura; Shaw, Paul J.

    2011-01-01

    Study Objectives: Multiple lines of evidence indicate that sleep is important for the developing brain, although little is known about which cellular and molecular pathways are affected. Thus, the aim of this study was to determine whether the early adult life of Drosophila, which is associated with high amounts of sleep and critical periods of brain plasticity, could be used as a model to identify developmental processes that require sleep. Subjects: Wild type Canton-S Drosophila melanogaster. Design; Intervention: Flies were sleep deprived on their first full day of adult life and allowed to recover undisturbed for at least 3 days. The animals were then tested for short-term memory and response-inhibition using aversive phototaxis suppression (APS). Components of dopamine signaling were further evaluated using mRNA profiling, immunohistochemistry, and pharmacological treatments. Measurements and Results: Flies exposed to acute sleep deprivation on their first day of life showed impairments in short-term memory and response inhibition that persisted for at least 6 days. These impairments in adult performance were reversed by dopamine agonists, suggesting that the deficits were a consequence of reduced dopamine signaling. However, sleep deprivation did not impact dopaminergic neurons as measured by their number or by the levels of dopamine, pale (tyrosine hydroxylase), dopadecarboxylase, and the Dopamine transporter. However, dopamine pathways were impacted as measured by increased transcript levels of the dopamine receptors D2R and dDA1. Importantly, blocking signaling through the dDA1 receptor in animals that were sleep deprived during their critical developmental window prevented subsequent adult learning impairments. Conclusions: These data indicate that sleep plays an important and phylogenetically conserved role in the developing brain. Citation: Seugnet L; Suzuki Y; Donlea JM; Gottschalk L; Shaw PJ. Sleep deprivation during early-adult development results in

  1. Promising Electric Aircraft Drive Systems

    NASA Technical Reports Server (NTRS)

    Dudley, Michael R.

    2010-01-01

    An overview of electric aircraft propulsion technology performance thresholds for key power system components is presented. A weight comparison of electric drive systems with equivalent total delivered energy is made to help identify component performance requirements, and promising research and development opportunities.

  2. Educating Homeless Students: Promising Practices.

    ERIC Educational Resources Information Center

    Stronge, James H., Ed.; Reed-Victor, Evelyn, Ed.

    This book is for educators who serve homeless students or students temporarily sharing houses with other families. It describes many promising strategies for working with these students. The chapters are: (1) "Educating Homeless Children and Youth: An Introduction" (James H. Stronge); (2) "Meeting the Developmental and Educational Needs of…

  3. Is the Prediction of Adolescent Outcomes from Early Child Care Moderated by Later Maternal Sensitivity? Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Burchinal, Margaret R.; Lowe Vandell, Deborah; Belsky, Jay

    2014-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during…

  4. "Big Bang" as a result result of the curvature-driven first-order phase transition in the early cold Universe

    NASA Astrophysics Data System (ADS)

    Pashitskii, E. A.; Pentegov, V. I.

    We suggest that the "Big Bang" may be a result of the first-order phase transition driven by changing scalar curvature of the 4D space-time in the expanding cold Universe, filled with nonlinear scalar field φ and neutral matter with equation of state p = vɛ (where p and ɛ are pressure and energy density of matter). We consider a Lagrangian for scalar field in curved space-time with nonlinearity φ, which along with the quadratic term -ΣR|φ|2 (where Σ is interaction constant and R is scalar curvature) contains a term ΣR(φ +φ+) linear in φ. Due to this term the condition for the extrema of the potential energy of the scalar field is given by a cubic equation. Provided v > 1/3 the scalar curvature R = [κ(3v-1)ɛ - 4Γ (where κ and Γ are Einstein's gravitational and cosmological constants) decreases along with decreasing " in the process of the Universe's expansion, and at some critical value Rc < 0 a first-order phase transition occurs, driven by an "external field" parameter proportional to R. Given certain conditions the critical radius of the early Universe at the point of the first-order phase transition may reach arbitrary large values, so this scenario of unrestricted "inflation" of the Universe may be called "hyperinflation". Beyond the point of phase transition the system is rolling down into the potential minimum releasing the potential energy of scalar field with subsequent powerful heating of the Universe playing the role of "Big Bang".

  5. Early Feasibility Study of a Transcatheter Tricuspid Valve Annuloplasty: SCOUT Trial 30-Day Results.

    PubMed

    Hahn, Rebecca T; Meduri, Christopher U; Davidson, Charles J; Lim, Scott; Nazif, Tamim M; Ricciardi, Mark J; Rajagopal, Vivek; Ailawadi, Gorav; Vannan, Mani A; Thomas, James D; Fowler, Dale; Rich, Stuart; Martin, Randy; Ong, Geraldine; Groothuis, Adam; Kodali, Susheel

    2017-04-11

    The SCOUT (Percutaneous Tricuspid Valve Annuloplasty System for Symptomatic Chronic Functional Tricuspid Regurgitation) trial is a prospective, single-arm, multicenter, early feasibility study of a novel transcatheter device to plicate the tricuspid annulus (TA) and reduce tricuspid regurgitation (TR). This study tested the feasibility and safety of a novel transcatheter device and assessed its early performance and functional outcomes. Between November 2015 and June 2016, 15 patients with New York Heart Association (NYHA) functional class ≥II and moderate or greater functional TR were enrolled. Primary performance and safety endpoint outcomes were technically successful at 30 days with no reintervention. Echocardiographic measurements (TA diameter, effective regurgitant orifice area [EROA], left ventricular stroke volume [LVSV]) and quality-of-life (QoL) measurements (NYHA functional class, Minnesota Living with Heart Failure Questionnaire [MLHFQ], and 6-min walk test [6MWT]) were performed at baseline and 30 days. All patients (mean 73.2 ± 6.9 years of age, 87% female) underwent successful device implantation with no deaths, strokes, bleeding, tamponade, or valve reintervention. Technical success rate at 30 days was 80%, with 3 single-pledget annular detachments without reintervention. In the remaining 12 patients, there were significant reductions in TA (12.3 ± 3.1 cm 2 to 11.3 ± 2.7 cm 2 , respectively; p = 0.019) and EROA (0.51 ± 0.18 cm 2 vs. 0.32 ± 0.18 cm 2 , respectively; p = 0.020), with significant increase in LVSV (63.6 ± 17.9 ml vs. 71.5 ± 25.7 ml, respectively; p = 0.021). In the intention-to-treat cohort, there were significant improvements in NYHA functional class (≥1 class, p = 0.001), MLHFQ (47.4 ± 17.6 to 20.9 ± 14.8; p < 0.001), and 6MWT (245.2 ± 110.1 to 298.0 m ± 107.6 m; p = 0.008). The 30-day results of the SCOUT trial confirmed the safety of the novel transcatheter device, which reduced TA and EROA, increased LVSV

  6. Early Predictors of Occupational Back Re-Injury: Results from a Prospective Study of Workers in Washington State

    PubMed Central

    Keeney, Benjamin J.; Turner, Judith A.; Fulton-Kehoe, Deborah; Wickizer, Thomas M.; Chan, Kwun Chuen Gary; Franklin, Gary M.

    2014-01-01

    Study Design Prospective population-based cohort study Objective To identify early predictors of self-reported occupational back re-injury within 1 year after work-related back injury Summary of Background Data Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have re-injuries after returning to work, yet there are few studies of risk factors for occupational back re-injuries. Methods We aimed to identify the incidence and early (in the claim) predictors of self-reported back re-injury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers’ Compensation Disability Risk Identification Study Cohort (D-RISC) provided a large, population-based sample with information on variables in seven domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (p-values < 0.10) of self-reported re-injury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back re-injury. Results 290 (25.8%) of 1,123 (70.0% response rate) workers who completed the one-year follow-up interview and had returned to work reported having re-injured their back at work. Baseline variables significantly associated with re-injury (p-value < 0.05) in the multivariate model included male gender, constant whole body vibration at work, a history of previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of re-injury. No other employment-related or psychological variables were

  7. Management of Symphysis and Parasymphysis Mandibular Fractures in Children Treated with MacLennan Splint: Stability and Early Results

    PubMed Central

    Bhat, Manohar; Sharma, Anupama; Sharma, Rajesh

    2015-01-01

    ABSTRACT Objective: The aim of this study was to assess the safety and efficiency of MacLennan splint in symphysis and parasymphysis mandibular fractures in children. Study design: Six patients (four boys and two girls, mean age 3 years, range between 2 and 5 years) were operated on parasymphysis fractures of children. The mean follow-up time was 12 months. MacLennan splint was applied in these case upto 3 weeks. Results: Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operation was not endangered. Adverse tissue reaction like infection, malocclusion, swelling and growth restrictions did not occur during observation period. Conclusion: MacLennan splint is having various advantages like faster mobilization and the avoidance of secondary removal operations. Based on this preliminary results MacLennan splints are safe and efficient in the treatment of pediatric mandible fracture. How to cite this article: Khairwa A, Bhat M, Sharma A, Sharma R. Management of Symphysis and Parasymphysis Mandibular Fractures in Children Treated with MacLennan Splint: Stability and Early Results. Int J Clin Pediatr Dent 2015;8(2):127-132. PMID:26379381

  8. Intraoperative radiotherapy given as a boost for early breast cancer: Long-term clinical and cosmetic results

    SciTech Connect

    Lemanski, Claire; Azria, David; Thezenas, Simon

    2006-04-01

    Purpose: The standard radiotherapy (RT) of breast cancer consists of 50 Gy external beam RT (EBRT) to the whole breast followed by an electron boost of 10-16 Gy to the tumor bed, but this has several cosmetic disadvantages. Intraoperative radiotherapy (IORT) could be an alternative to overcome these. Methods and Materials: We evaluated 50 women with early breast cancer operated on in a dedicated IORT facility. Median dose of 10 Gy was delivered using 9-MeV electron beams. All patients received postoperative EBRT (50 Gy in 2 Gy fractions). Late toxicity and cosmetic results were assessed independently by two physicians accordingmore » to the Common Terminology Criteria for Adverse Event v3.0 grading system and the European Organization for Research and Treatment of Cancer questionnaires. Results: After a median follow-up of 9.1 years (range, 5-15 years), two local recurrences were observed within the primary tumor bed. At the time of analysis, 45 patients are alive with (n = 1) or without disease. Among the 42 disease-free remaining patients, 6 experienced Grade 2 late subcutaneous fibrosis within the boost area. Overall, the scores indicated a very good quality of life and cosmesis was good to excellent in the evaluated patients. Conclusion: Our results confirm that IORT given as a boost after breast-conserving surgery is a reliable alternative to conventional postoperative fractionated boost radiation.« less

  9. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

    SciTech Connect

    Jiang, Ping, E-mail: ping.jiang@uksh.de; Baumann, René; Dunst, Juergen

    Purpose: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. Methods and Materials: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volumemore » covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection. Results: The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. Conclusions: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.« less

  10. Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey.

    PubMed

    Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

    2016-01-01

    Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

  11. Early results of Latitude primary total elbow replacement with a minimum follow-up of 2 years.

    PubMed

    Mehta, Saurabh S; Watts, Adam C; Talwalkar, Sumedh C; Birch, Ann; Nuttall, David; Trail, Ian A

    2017-10-01

    The aim of this study was to present outcomes of primary Latitude total elbow replacement (TER) with a minimum follow-up of 2 years. A retrospective cohort study was undertaken with prospective outcome data collection for the latest outcome. Included were 63 consecutive primary Latitude TERs in 58 patients performed during a period of 5 years at a specialist orthopedic hospital. The mean age of the patients was 62 years (33-85 years). Five primary TERs (4 patients) were lost to follow-up. The primary diagnosis was rheumatoid arthritis in 49, osteoarthritis in 8, and trauma in 6 elbows. The mean flexion-extension arc was 75° preoperatively and 97° postoperatively. Mean postoperative Elbex pain score was 19/100, and function score was 37/100. Mean postoperative scores were 42/100 for the Quick Disabilities of the Arm, Shoulder, and Hand and 38/50 for the elbow-specific American Shoulder and Elbow Surgeons assessment. Four patients died of unrelated causes, and 8 of 63 underwent further surgical intervention, including explantation and conversion from unlinked to linked implant. On radiographic review of 41 surviving TERs, aseptic radiologic loosening was observed of the humeral component in 4 elbows and of the ulnar component in 9. Seven elbows had no radial component, and of the remaining 34 elbows, 16 (47%) had signs of loosening of the radial implant. Complications included 1 heterotopic ossification, 1 olecranon fracture, and 3 further procedures for ulnar nerve entrapment. The results indicate that the early outcome of Latitude TER is comparable to that of other prostheses. There is concern about early radiologic loosening of the radial component. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  12. Clinical and MRI responses to etanercept in early non-radiographic axial spondyloarthritis: 48-week results from the EMBARK study

    PubMed Central

    Maksymowych, Walter P; Dougados, Maxime; Sieper, Joachim; Braun, Jürgen; Citera, Gustavo; Van den Bosch, Filip; Logeart, Isabelle; Wajdula, Joseph; Jones, Heather; Marshall, Lisa; Bonin, Randi; Pedersen, Ron; Vlahos, Bonnie; Kotak, Sameer; Bukowski, Jack F

    2016-01-01

    Objective To evaluate the efficacy and safety of etanercept (ETN) after 48 weeks in patients with early active non-radiographic axial spondyloarthritis (nr-axSpA). Methods Patients meeting Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA, but not modified New York radiographic criteria, received double-blind ETN 50 mg/week or placebo (PBO) for 12 weeks, then open-label ETN (ETN/ETN or PBO/ETN). Clinical, health, productivity, MRI and safety outcomes were assessed and the 48-week data are presented here. Results 208/225 patients (92%) entered the open-label phase at week 12 (ETN, n=102; PBO, n=106). The percentage of patients achieving ASAS40 increased from 33% to 52% between weeks 12 and 48 for ETN/ETN and from 15% to 53% for PBO/ETN (within-group p value <0.001 for both). For ETN/ETN and PBO/ETN, the EuroQol 5 Dimensions utility score improved by 0.14 and 0.08, respectively, between baseline and week 12 and by 0.23 and 0.22 between baseline and week 48. Between weeks 12 and 48, MRI Spondyloarthritis Research Consortium of Canada sacroiliac joint (SIJ) scores decreased by −1.1 for ETN/ETN and by −3.0 for PBO/ETN, p<0.001 for both. Decreases in MRI SIJ inflammation and C-reactive protein correlated with several clinical outcomes at weeks 12 and 48. Conclusions Patients with early active nr-axSpA demonstrated improvement from week 12 in clinical, health, productivity and MRI outcomes that was sustained to 48 weeks. Trial registration number NCT01258738. PMID:26269397

  13. Early application of an intermittent pneumatic compression device is safe and results in proximal arteriovenous fistula enlargement.

    PubMed

    Desai, Sanjay; Mitra, Amit; Arkans, Ed; Singh, Tej M

    2018-05-01

    Delays in arteriovenous fistula maturation can cause care delays and increased costs. Increased distention pressure and intermittent wall shear stress may dilate veins based on prior research. Early use of non-invasive devices may help assist clinical arteriovenous fistula dilation. This was an Institutional Review Board approved study. After arteriovenous fistula creation, a novel, intermittent pneumatic compression device (Fist Assist ® ) was applied 15 cm proximal to arteriovenous fistula enabling 60 mmHg of cyclic compression for 6 h daily for 30 days. Among the patients who completed 1 month follow-up, 30 (n = 30) arteriovenous fistula patients were in the study arm to test vein dilation with Fist Assist. Controls (n = 16) used a sham device. Vein size was measured and recorded at baseline and after 30 days by duplex measurement. Clinical results (percentage increase) were recorded and tested for significance. No patients experienced thrombosis or adverse effects. Patient compliance and satisfaction was high. After 1 month, the mean percentage increase in vein diameter in the Fist Assist treatment group was significantly larger (p = 0.026) than controls in the first 5 mm segment of the fistula after the anastomosis. All fistulas treated with Fist Assist are still functional with no reported thrombosis or extravasations. Early application of an intermittent pneumatic compression device may assist in arteriovenous fistula dilation and are safe. Non-invasive devices like Fist Assist may have clinical utility to help fistulae development and decrease costs as they may eventually assist maturation.

  14. Graduation Promise Act of 2011

    THOMAS, 112th Congress

    Rep. Hinojosa, Ruben [D-TX-15

    2011-02-17

    House - 03/04/2011 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Graduation Promise Act of 2009

    THOMAS, 111th Congress

    Rep. Hinojosa, Ruben [D-TX-15

    2009-12-02

    House - 01/04/2010 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Promise Neighborhoods Act of 2013

    THOMAS, 113th Congress

    Rep. Payne, Donald M., Jr. [D-NJ-10

    2013-05-23

    House - 07/08/2013 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Refining the Early and Middle Eocene Geomagnetic Polarity Time Scale: new results from ODP Leg 208 (Walvis Ridge)

    NASA Astrophysics Data System (ADS)

    Westerhold, T.; Roehl, U.; Frederichs, T.; Bohaty, S. M.; Florindo, F.; Zachos, J. C.; Raffi, I.; Agnini, C.

    2015-12-01

    Astronomical calibration of the Geomagnetic Polarity Time Scale (GPTS) for the Eocene (34-56 Ma) has advanced tremendously in recent years. Combining a cyclostratigraphic approach based on the recognition of the stable 405-kyr eccentricity cycle of Earth's orbit with high-resolution bio- and magnetostratigraphy from deep-sea sedimentary records (ODP Legs 171B, 189 and 207; IODP Exp. 320/321) resulted in a new calibration of the middle-to-late Eocene GPTS spanning Chrons C12r to C19n (30.9-41.3 Ma). A fully astronomically calibrated GPTS for the Eocene was established recently by integrating cyclo-bio-magnetostratigraphy from ODP Sites 702 and 1263 records spanning the middle Eocene with Site 1258 records covering the early Eocene. Comparison of this deep sea-derived GPTS with GTS2012 and GPTS calibration points from terrestrial successions show overall consistent results, but there are still major offsets for the duration of Chrons C20r, C22r and C23n.2n. Because of the relatively large uncertainty of the calibration point, a radioisotopic dated ash layer in DSDP 516F, at C21n.75 (46.24±0.5 Ma) the duration of C20r in GPTS2012 (2.292 myr) is uncertain. Offsets in durations of C22r and C23n.2n between GPTS2012 and the new astronomical GPTS (~400-kyr longer C22r; ~400-kyr shorter C23n.2n) could be due to uncertainties in the interpretation of Site 1258 magnetostratigraphic data. Here we present new results toward establishing a more accurate and complete bio-, magneto- and chemostratigraphy for South Atlantic Leg 208 sites encompassing magnetochrons C13 to C24 (33 to 56 Ma). Our study aims to integrate paleomagnetic records from multiple drilled sites with physical property data, stable isotope data and XRF core scanning data to construct an astronomically calibrated framework for refining GPTS age estimates. This effort will complete the Early-to-Middle Eocene GPTS and allow evaluation of the relative position of calcareous nannofossil events to magnetostratigraphy.

  18. Early Childhood Program Participation, Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-101

    ERIC Educational Resources Information Center

    Corcoran, Lisa; Steinley, Katrina

    2017-01-01

    This report presents findings from the Early Childhood Program Participation Survey of the National Household Education Surveys Program of 2016 (NHES:2016). The Early Childhood Program Participation Survey collected data on children's participation in relative care, nonrelative care, and center-based care arrangements. It also collected…

  19. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

  20. The Consequences of Early Childbearing: Research Summary. Results from the National Longitudinal Survey of Young Women (Parnes).

    ERIC Educational Resources Information Center

    Moore, Kristin A.; Hofferth, Sandra L.

    The effects of early childbearing on a woman's later social and economic status are examined in this paper. Previous research has documented an association of early motherhood with lower educational attainment, marital instability, higher subsequent fertility, and later economic poverty. However, these associations have not been tested in…

  1. Early results of urothelial carcinoma screening in a risk population of coke workers: urothelial carcinoma among coke workers.

    PubMed

    Giberti, C; Gallo, F; Schenone, M; Genova, A

    2010-08-01

    To present the protocol and the early results of a urothelial carcinoma (UC) screening analysis performed in a risk population of coke workers. Between June 2006 and October 2008, 171 male workers (mean age 43 years), employed in a Ligurian coke plant (Italiana Coke S.r.l) and exposed to polycyclic aromatic hydrocarbons (PAHs) for a median period of 16 years, underwent screening for UC. Urological evaluation included medical history, physical examination, routine laboratory tests, urine analysis, urinary cytology and uCyt+ assay. In the event of signs and symptoms suggestive of UC or positive urinary tests, the workers were also subjected to urinary ultrasonography and cystoscopy with biopsy of any suspicious lesions. Regarding the laboratory tests, 19/171 (11%) uCyt+ samples were considered inadequate and were excluded from the outcomes assessment. Overall, urine analysis, cytology and uCyt+ were positive in 18/152 (12%) subjects who showed no evidence of UC at the scheduled check-ups. No significant association was identified between marker positivity and occupational activity. Our results fail to show an increased risk of UC among the coke workers evaluated. However, they will need to be confirmed in the future by a larger enrollment and a longer follow-up in order to assess the definitive risk for UC after exposure to coke. Copyright © 2010 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  2. Microgravity Effects on the Early Events of Biological Nitrogen Fixation in Medicago Truncatula: Results from the SyNRGE Experiment

    NASA Astrophysics Data System (ADS)

    Stutte, Gary W.; Roberts, Michael S.

    2013-02-01

    SyNRGE (Symbiotic Nodulation in a Reduced Gravity Environment) was a sortie mission on STS-135 in the Biological Research in Canisters (BRIC) hardware to study the effect of μg on a plant-microbe symbiosis resulting in biological nitrogen fixation. Medicago truncatula, a model species for the legume family, was inoculated with its bacterial symbiont, Sinorhizobium meliloti, to observe early biomolecular events associated with infection and nodulation in Petri Dish Fixation Units (PDFU’s). Two sets of experiments were conducted in orbit and in 24-hour delayed ground controls. Experiments were designed to determine if S. meliloti would infect M. truncatula and initiate biomolecular changes associated with nodule formation and if the μg environment altered the host plant and/or bacteria to induce nodule formation upon return to 1g. Initial analysis results demonstrate that the legumes and bacteria cultivated in μg have potential to develop a symbiotic interaction, but suggest that μg alters their ability to form nodules upon return to 1g. (Research supported by NASA ESMD/ Advance Capabilities Division grant NNX10AR09A)

  3. Interocular suppression in strabismic amblyopia results in an attenuated and delayed hemodynamic response function in early visual cortex.

    PubMed

    Farivar, Reza; Thompson, Benjamin; Mansouri, Behzad; Hess, Robert F

    2011-12-20

    Factors such as strabismus or anisometropia during infancy can disrupt normal visual development and result in amblyopia, characterized by reduced visual function in an otherwise healthy eye and often associated with persistent suppression of inputs from the amblyopic eye by those from the dominant eye. It has become evident from fMRI studies that the cortical response to stimulation of the amblyopic eye is also affected. We were interested to compare the hemodynamic response function (HRF) of early visual cortex to amblyopic vs. dominant eye stimulation. In the first experiment, we found that stimulation of the amblyopic eye resulted in a signal that was both attenuated and delayed in its time to peak. We postulated that this delay may be due to suppressive effects of the dominant eye and, in our second experiment, measured the cortical response of amblyopic eye stimulation under two conditions--where the dominant eye was open and seeing a static pattern (high suppression) or where the dominant eye was patched and closed (low suppression). We found that the HRF in response to amblyopic eye stimulation depended on whether the dominant eye was open. This effect was manifested as both a delayed HRF under the suppressed condition and an amplitude reduction.

  4. Freedom: A Promise of Possibility.

    PubMed

    Bunkers, Sandra Schmidt

    2015-10-01

    The idea of freedom as a promise of possibility is explored in this column. The core concepts from a research study on considering tomorrow (Bunkers, 1998) coupled with humanbecoming community change processes (Parse, 2003) are used to illuminate this notion. The importance of intentionality in human freedom is discussed from both a human science and a natural science perspective. © The Author(s) 2015.

  5. The promise of cyborg intelligence.

    PubMed

    Brown, Michael F; Brown, Alexander A

    2017-03-01

    Yu et al. (2016) demonstrated that algorithms designed to find efficient routes in standard mazes can be integrated with the natural processes controlling rat navigation and spatial choices, and they pointed out the promise of such "cyborg intelligence" for biorobotic applications. Here, we briefly describe Yu et al.'s work, explore its relevance to the study of comparative cognition, and indicate how work involving cyborg intelligence would benefit from interdisciplinary collaboration between behavioral scientists and engineers.

  6. Early Results of Three-Year Monitoring of Red Wood Ants’ Behavioral Changes and Their Possible Correlation with Earthquake Events

    PubMed Central

    Berberich, Gabriele; Berberich, Martin; Grumpe, Arne; Wöhler, Christian; Schreiber, Ulrich

    2013-01-01

    Simple Summary For three years (2009–2012), two red wood ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), have been monitored 24/7 by high-resolution cameras. Early results show that ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants’ behavior hours before the earthquake: the nocturnal rest phase and daily activity are suppressed, and standard daily routine does not resume until the next day. At present, an automated image evaluation routine is being applied to the video streams. Based on this automated approach, a statistical analysis of the ant behavior will be carried out. Abstract Short-term earthquake predictions with an advance warning of several hours or days are currently not possible due to both incomplete understanding of the complex tectonic processes and inadequate observations. Abnormal animal behaviors before earthquakes have been reported previously, but create problems in monitoring and reliability. The situation is different with red wood ants (RWA; Formica rufa-group (Hymenoptera: Formicidae)). They have stationary mounds on tectonically active, gas-bearing fault systems. These faults may be potential earthquake areas. For three years (2009–2012), two red wood ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), have been monitored 24/7 by high-resolution cameras with both a color and an infrared sensor. Early results show that ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants’ behavior hours before the earthquake: the nocturnal rest phase and daily activity are suppressed, and standard daily routine does not resume until the next day. At present, an automated image evaluation routine is being applied to the more than 45,000 hours of video streams. Based on this automated approach, a statistical analysis of

  7. Factors associated with a bad functional prognosis in early inflammatory back pain: results from the DESIR cohort.

    PubMed

    Lukas, C; Dougados, M; Combe, B

    2016-01-01

    Spondyloarthritis (SpA) is a heterogeneous disease with hardly predictable potential courses. We aimed at determining prognostic factors of bad functional outcome at 2 years in patients with early inflammatory back pain (IBP). Data from patients included in the French multicentre devenir des spondylarthropathies indifférenciées récentes (DESIR) cohort, that is, suffering from IBP starting before 50 years of age and lasting for 3-36 months, were used. A bad functional outcome at 24 months was defined as an increase in bath ankylosing spondylitis functional index (BASFI), or BASFI at 2 years higher than the 75th centile in the cohort. Demographic, clinical, biological and radiological data collected at inclusion were compared in patients with bad functional outcome versus others, by χ(2) test, then by a multivariate logistic regression model with stepwise selection of relevant factors. 513 patients (54.4% females, 72.2% fulfilling ASAS criteria) were assessed. Of those, 130 (25.3%) fulfilled the aforementioned criteria of a bad functional outcome (BASFI increase ≥4 units or ≥36 at 2 years). Multivariate analysis revealed that not fulfilling ASAS criteria, female sex, age >33 years, lower educational level, active smoking status and high disease activity according to bath ankylosing spondylitis disease activity index (BASDAI) at baseline were independently associated with a bad functional outcome at 24 months. Sensitivity analyses restricted to patients fulfilling ASAS criteria for SpA resulted in similar results. We observed, in a large prospective cohort of patients with early IBP, formerly described bad prognostic factors, especially a low educational level, an older age and a high disease activity at onset, and revealed that active smoking status and female sex were also independently associated with a poor outcome. Fulfilment of ASAS criteria, on the other hand, was predictive of a better outcome, most likely due to the more consensual

  8. Past and recent abuse is associated with early cessation of breast feeding: results from a large prospective cohort in Norway

    PubMed Central

    Sørbø, Marie Flem; Brantsæter, Anne-Lise; Grimstad, Hilde

    2015-01-01

    Objective Breast feeding provides a wide range of health benefits for both infants and mothers. Few studies have examined the impact of past and recent abuse of women on breastfeeding behaviour. The aims of our study were to examine whether exposure to past and recent emotional, sexual or physical abuse was associated with early breastfeeding cessation, and to assess whether a potential association differed for known and unknown perpetrators. Design Prospective cohort study. Setting Norway, years 1999–2006. Participants 53 934 mothers participated in the Norwegian Mother and Child Cohort Study. We included mothers with singleton pregnancy who had responded to three questionnaires (weeks 18 and 30 in pregnancy, and 6 months postpartum) and had answered minimum one of the abuse questions in week 30. Main outcome measure ORs were estimated by binary logistic regression with cessation of any (all) breast feeding before 4 months as the outcome, and abuse including subcategories of abuse, as the exposure. Results Nearly all women initiated breast feeding, but 12.1% ceased any breast feeding before 4 months and 38.9% ceased full breast feeding before 4 months, but continued partial breast feeding. Overall, 19% of the women reported any adult abuse and 18% reported any child abuse. The highest risk of any breast feeding cessation before 4 months was seen in women exposed to three types of adult abuse (emotional, sexual or physical), with adjusted OR being 1.47 (95% CI 1.23 to 1.76) compared with no abuse. Recent abuse and exposure from known perpetrator resulted in nearly 40% and 30% increased risk, respectively. The OR of any breast feeding cessation for women exposed to any child abuse was 1.41 (95% CI 1.32 to 1.50) compared with no abuse in childhood. Conclusions Past and recent abuse of women is strongly associated with early cessation of breast feeding. Abused mothers comprise a key group to target for extra support and breastfeeding assistance. PMID

  9. A Glimpse at Late Mesozoic to Early Tertiary Offshore Stratigraphy from Wilkes Land, East Antarctica: Results of Strategic Dredging of the Mertz-Ninnis Trough

    NASA Astrophysics Data System (ADS)

    Schrum, H.; Domack, E.; Desantis, L.; Leventer, A.; McMullen, K.; Escutia, C.

    2004-12-01

    infilling a rifted basin of late Cretaceous age. Seaward dipping reflectors above the syn-rift strata represent post-rift deposits ranging from Paleogene to Quaternary. Included within this stratigraphy are lithified diamictites containing Mesozoic palynomorphs in addition to palynomorphs of Early Tertiary age (including dinoflagellates). Seaward dipping reflectors in the deep axis of the Mertz-Ninnis Trough were not sampled directly by our dredges, but are believed to be Lower Cretaceous siltstones by extrapolation to core DF-79-38, 100 km along strike to the southeast (Domack et al., 1980). Furthermore, the thermal maturity of the lignite samples recovered in our collections suggests that the coal is of Early Tertiary age, as are numerous organic-rich mudstones, which contain Paleogene palynomorphs. These results indicate that sedimentary strata in this portion of the Wilkes Land Margin contain significantly thick (greater than 2.7 km) post-rift (drift phase) marine sequences of both pre- and synglacial character. Strategic dredging is a promising methodology by which to sample stratigraphic succession in a cost effective manner along the East Antarctic margin in the absence of, or preparation for, International Ocean Drilling Projects on the shelf. Domack, E. W., Fairchild, W. W., and Anderson, J. B. (1980) Lower Cretaceous sediment from the East Antarctic continental shelf, Nature, 287, 625-626.

  10. Clinical significance of early smoking withdrawal effects and their relationships with nicotine metabolism: preliminary results from a pilot study.

    PubMed

    Hendricks, Peter S; Delucchi, Kevin L; Benowitz, Neal L; Hall, Sharon M

    2014-05-01

    Although the early time course of smoking withdrawal effects has been characterized, the clinical significance of early withdrawal symptoms and their predictors are unknown. This study evaluated the relationships of early smoking withdrawal effects with quit attempt outcomes and the rate of nicotine metabolism. Eleven treatment-seeking smokers abstained from smoking for 4 hr in the laboratory before a quit attempt. Withdrawal measures included heart rate, sustained attention, and self-report. Following baseline assessment, withdrawal measures were administered every 30 min. At the conclusion of the 4-hr early withdrawal session, participants received a brief smoking cessation intervention and then returned 1 week and 12 weeks later for outcome assessments that included biochemically confirmed smoking abstinence, cigarettes smoked in the past 24hr, and self-reported withdrawal symptoms. The rate of nicotine metabolism was estimated at intake with the nicotine metabolite ratio (trans-3'-hydroxycotinine/cotinine) measured in saliva. Greater self-reported negative affect and concentration difficulty during early withdrawal, most notably anxiety, were related with poorer quit attempt outcomes. There was some indication that although a faster increase in craving and greater hunger during early withdrawal were associated with more favorable outcomes, a greater decrease in heart rate during this time was associated with poorer outcomes. Faster nicotine metabolism was related to a faster increase in anxiety but a slower increase in craving during early withdrawal. These findings lend support to the clinical significance of early smoking withdrawal effects. The rate of nicotine metabolism may be a useful predictor of early withdrawal symptoms.

  11. Intersphincteric proctectomy with end-colostomy for anorectal Crohn's disease results in early and severe proximal colonic recurrence.

    PubMed

    de Buck van Overstraeten, Anthony; Wolthuis, Albert M; Vermeire, Séverine; Van Assche, Gert; Rutgeerts, Paul; Penninckx, Freddy; D'Hoore, André

    2013-07-01

    Perianal Crohn's disease (CD) represents a more aggressive phenotype of inflammatory bowel disease and often coincides with proctocolitis. This study aims to assess the outcome of patients undergoing proctectomy with end-colostomy. A retrospective outcome analysis of 10 consecutive patients who underwent intersphincteric proctectomy with end-colostomy between February 2007 and May 2011 was performed. All patients suffered from refractory distal and perianal CD. The proximal colon was normal at endoscopy. All data were extracted from a prospectively maintained database. The main outcome parameter was disease recurrence and need for completion colectomy. Severe and early endoscopic recurrence in the proximal colon occurred in 9/10 patients at a median time interval of 9.5 months (range: 1.9-23.6 months). Despite protracted medical treatment, completion colectomy was necessary in 5 patients. One patient, who underwent a second segmental colectomy with a new end-colostomy, showed again endoscopic recurrence and is currently treated with anti-TNF agents. Intersphincteric proctectomy with colostomy seems to be an ineffective surgery for perianal CD with coexisting proctitis and results in a high risk of recurrence of the disease in the remaining colon. Therefore, despite a normal appearance of the proximal colon, a proctocolectomy with end-ileostomy seems to be the surgical approach of choice in these patients. Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  12. Novel percutaneous suture-mediated patent foramen ovale closure technique. Early results of the NobleStitch EL Italian Registry.

    PubMed

    Gaspardone, Achille; De Marco, Federico; Sgueglia, Gregory A; De Santis, Antonella; Iamele, Maria; D'Ascoli, Emanuela; Tusa, Maurizio; Corciu, Anca; Mullen, Michael; Nobles, Anthony; Carminati, Mario; Bedogni, Francesco

    2018-04-03

    To assess the efficacy of a novel percutaneous "device-less" suture mediated patent foramen ovale (PFO) closure system. Between June 2016 and October 2017, a prospective registry aimed at assessing the safety and efficacy of the NobleStitch EL (HeartStitch, Fountain Valley, CA) suture-based PFO closure system was carried out at 12 sites in Italy. Among 200 consecutive evaluated patients, 192 were considered suitable for suture-mediated PFO closure (44±13 years, 114 women). Suture of the septum with the NobleStitch EL system was carried out successfully in 186 (96%) patients. Median fluoroscopy time was 16.1 (13.0-22.5) minutes and contrast volume 200 (150-270) ml. At 206±130 days follow-up, microbubbles transthoracic echocardiography with Valsalva maneuver revealed no RLS (grade 0) in 139 (75%) patients and RLS grade ≤1 in 166 (89%) patients. Significant RLS was present in 20 (11%) patients (grade 2 and 3 in 11 and 9 patients, respectively). There were no device-related complications. The early results of this first Italian Registry indicates that the suture mediated "deviceless" closure of PFO is feasible in the majority of septal anatomies, provides an effective closure of PFO comparable to traditional devices with an excellent safety profile at medium term follow-up.

  13. Early experience and results of bone graft enriched with autologous platelet gel for recalcitrant nonunions of lower extremity.

    PubMed

    Chiang, Chao-Ching; Su, Chen-Yao; Huang, Ching-Kuei; Chen, Wei-Ming; Chen, Tain-Hsiung; Tzeng, Yun-Hsuan

    2007-09-01

    Refractory nonunions of the tibia or femur are physically and mentally devastating conditions for the patients, and the treatment is challenging for orthopedic surgeons. The goal of this study was to assess the feasibility and outcome of surgical treatment in recalcitrant nonunions of a lower extremity with bone graft enriched with autologous platelet gel (APG). Twelve patients with four femoral and eight tibial atrophic nonunions after multiple prior procedures were included. All of them were treated with the bone grafting procedures with autograft complex enriched with APG. They were evaluated with radiographs, bone mineral density for bony healing process, and the Short-Form 36 Health Survey for functional outcome. Of the 12 patients, 11 healed at an average of 19.7 weeks after the first attempt and 1 healed after the second attempt at 21 weeks. The bone mineral density continued to increase steadily from early healing to the remodeling phase. Functional status was greatly improved at an average follow-up of 32.4 months. The results of this preliminary study implied the possible potential of bone graft enriched with APG in the treatment of recalcitrant nonunions of the lower extremity. More research is necessary to clarify its role in augmentation of bone graft to enhance healing of nonunion.

  14. Does otitis media in early childhood affect later behavioural development? Results from the Western Australian Pregnancy Cohort (Raine) Study.

    PubMed

    Da Costa, C; Eikelboom, R H; Jacques, A; Swanepoel, D W; Whitehouse, A J O; Jamieson, S E; Brennan-Jones, C G

    2018-03-01

    To examine the relationship between early life episodes of otitis media and later behavioural development with adjustment for confounders. Longitudinal cohort study. The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnant women from King Edward Memorial Hospital (KEMH) in Perth, Western Australia, between 1989 and 1991. Data from the children born were collected at both the Year 3 and Year 5 follow-up. At Year 3, n = 611 were diagnosed with recurrent otitis media through parent-report and clinical examination. At Year 5, n = 299 were considered exposed to otitis media based upon tympanometry results. Performance in the Child Behaviour Checklist (CBCL), a questionnaire completed by the primary caregiver at Year 10. Significant associations were found between recurrent otitis media at Year 3 and internalising behaviours (P = .011), and the somatic (P = .011), withdrawn (P = .014), attention (P = .003) and thought problems domains (P = .021), and the total CBCL score (P = .010). A significant association was also found between exposure to otitis media at Year 5 and externalising behaviours (P = .026). A modest association was seen between recurrent otitis media at Year 3 and exposure to otitis media at Year 5 and a number of behaviour domains at Year 10. © 2018 John Wiley & Sons Ltd.

  15. The Complete Local-Volume Groups Sample (CLoGS): Early results from X-ray and radio observations

    NASA Astrophysics Data System (ADS)

    Vrtilek, Jan M.; O'Sullivan, Ewan; David, Laurence P.; Giacintucci, Simona; Kolokythas, Konstantinos

    2017-08-01

    Although the group environment is the dominant locus of galaxy evolution (in contrast to rich clusters, which contain only a few percent of galaxies), there has been a lack of reliable, representative group samples in the local Universe. In particular, X-ray selected samples are strongly biased in favor of the X-ray bright, centrally-concentrated cool-core systems. In response, we have designed the Complete Local-Volume Groups Sample (CLoGS), an optically-selected statistically-complete sample of 53 groups within 80 Mpc which is intended to overcome the limitations of X-ray selected samples and serve as a representative survey of groups in the local Universe. We have supplemented X-ray data from Chandra and XMM (70% complete to date, using both archival and new observations, with a 26-group high richness subsample 100% complete) with GMRT radio continuum observations (at 235 and 610 MHz, complete for the entire sample). CLoGS includes groups with a wide variety of properties in terms of galaxy population, hot gas content, and AGN power. We here describe early results from the survey, including the range of AGN activity observed in the dominant galaxies, the relative fraction of cool-core and non-cool-core groups in our sample, and the degree of disturbance observed in the IGM.

  16. Sea surface temperature measurements by the along-track scanning radiometer on the ERS 1 satellite: Early results

    NASA Astrophysics Data System (ADS)

    Mutlow, C. T.; ZáVody, A. M.; Barton, I. J.; Llewellyn-Jones, D. T.

    1994-11-01

    The along-track scanning radiometer (ATSR) was launched in July 1991 on the European Space Agency's first remote sensing satellite, ERS 1. An initial analysis of ATSR data demonstrates that the sea surface temperature (SST) can be measured from space with very high accuracy. Comparison of simultaneous measurements of SST made from ATSR and from a ship-borne radiometer show that they agree to within 0.3°C. To assess data consistency, a complementary analysis of SST data from ATSR was also carried out. The ATSR global SST field was compared on a daily basis with daily SST analysis of the United Kingdom Meteorological Office (UKMO). The ATSR global field is consistently within 1.0°C of the UKMO analysis. Also, to demonstrate the benefits of along-track scanning SST determination, the ATSR SST data were compared with high-quality bulk temperature observations from drifting buoys. The likely causes of the differences between ATSR and the bulk temperature data are briefly discussed. These results provide early confidence in the quantitative benefit of ATSR's two-angle view of the Earth and its high radiometric performance and show a significant advance on the data obtained from other spaceborne sensors. It should be noted that these measurements were made at a time when the atmosphere was severely contaminated with volcanic aerosol particles, which degrade infrared measurements of the Earth's surface made from space.

  17. Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

    PubMed

    Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

    2016-02-01

    In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Juvenile Traumatic Brain Injury Results in Cognitive Deficits Associated with Impaired Endoplasmic Reticulum Stress and Early Tauopathy.

    PubMed

    Hylin, Michael J; Holden, Ryan C; Smith, Aidan C; Logsdon, Aric F; Qaiser, Rabia; Lucke-Wold, Brandon P

    2018-05-22

    The leading cause of death in the juvenile population is trauma, and in particular neurotrauma. The juvenile brain response to neurotrauma is not completely understood. Endoplasmic reticulum (ER) stress has been shown to contribute to injury expansion and behavioral deficits in adult rodents and furthermore has been seen in adult postmortem human brains diagnosed with chronic traumatic encephalopathy. Whether endoplasmic reticulum stress is increased in juveniles with traumatic brain injury (TBI) is poorly delineated. We investigated this important topic using a juvenile rat controlled cortical impact (CCI) model. We proposed that ER stress would be significantly increased in juvenile rats following TBI and that this would correlate with behavioral deficits using a juvenile rat model. A juvenile rat (postnatal day 28) CCI model was used. Binding immunoglobulin protein (BiP) and C/EBP homologous protein (CHOP) were measured at 4 h in the ipsilateral pericontusion cortex. Hypoxia-inducible factor (HIF)-1α was measured at 48 h and tau kinase measured at 1 week and 30 days. At 4 h following injury, BiP and CHOP (markers of ER stress) were significantly elevated in rats exposed to TBI. We also found that HIF-1α was significantly upregulated 48 h following TBI showing delayed hypoxia. The early ER stress activation was additionally asso-ciated with the activation of a known tau kinase, glycogen synthase kinase-3β (GSK-3β), by 1 week. Tau oligomers measured by R23 were significantly increased by 30 days following TBI. The biochemical changes following TBI were associated with increased impulsive-like or anti-anxiety behavior measured with the elevated plus maze, deficits in short-term memory measured with novel object recognition, and deficits in spatial memory measured with the Morris water maze in juvenile rats exposed to TBI. These results show that ER stress was increased early in juvenile rats exposed to TBI, that these rats developed tau oligomers over the

  19. Past and recent abuse is associated with early cessation of breast feeding: results from a large prospective cohort in Norway.

    PubMed

    Sørbø, Marie Flem; Lukasse, Mirjam; Brantsæter, Anne-Lise; Grimstad, Hilde

    2015-12-18

    Breast feeding provides a wide range of health benefits for both infants and mothers. Few studies have examined the impact of past and recent abuse of women on breastfeeding behaviour. The aims of our study were to examine whether exposure to past and recent emotional, sexual or physical abuse was associated with early breastfeeding cessation, and to assess whether a potential association differed for known and unknown perpetrators. Prospective cohort study. Norway, years 1999-2006. 53,934 mothers participated in the Norwegian Mother and Child Cohort Study. We included mothers with singleton pregnancy who had responded to three questionnaires (weeks 18 and 30 in pregnancy, and 6 months postpartum) and had answered minimum one of the abuse questions in week 30. ORs were estimated by binary logistic regression with cessation of any (all) breast feeding before 4 months as the outcome, and abuse including subcategories of abuse, as the exposure. Nearly all women initiated breast feeding, but 12.1% ceased any breast feeding before 4 months and 38.9% ceased full breast feeding before 4 months, but continued partial breast feeding. Overall, 19% of the women reported any adult abuse and 18% reported any child abuse. The highest risk of any breast feeding cessation before 4 months was seen in women exposed to three types of adult abuse (emotional, sexual or physical), with adjusted OR being 1.47 (95% CI 1.23 to 1.76) compared with no abuse. Recent abuse and exposure from known perpetrator resulted in nearly 40% and 30% increased risk, respectively. The OR of any breast feeding cessation for women exposed to any child abuse was 1.41 (95% CI 1.32 to 1.50) compared with no abuse in childhood. Past and recent abuse of women is strongly associated with early cessation of breast feeding. Abused mothers comprise a key group to target for extra support and breastfeeding assistance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

  20. Computerized detection of vertebral compression fractures on lateral chest radiographs: Preliminary results with a tool for early detection of osteoporosis

    SciTech Connect

    Kasai, Satoshi; Li Feng; Shiraishi, Junji

    Vertebral fracture (or vertebral deformity) is a very common outcome of osteoporosis, which is one of the major public health concerns in the world. Early detection of vertebral fractures is important because timely pharmacologic intervention can reduce the risk of subsequent additional fractures. Chest radiographs are used routinely for detection of lung and heart diseases, and vertebral fractures can be visible on lateral chest radiographs. However, investigators noted that about 50% of vertebral fractures visible on lateral chest radiographs were underdiagnosed or under-reported, even when the fractures were severe. Therefore, our goal was to develop a computerized method for detectionmore » of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation and thus allow the early diagnosis of osteoporosis. The cases used in this study were 20 patients with severe vertebral fractures and 118 patients without fractures, as confirmed by the consensus of two radiologists. Radiologists identified the locations of fractured vertebrae, and they provided morphometric data on the vertebral shape for evaluation of the accuracy of detecting vertebral end plates by computer. In our computerized method, a curved search area, which included a number of vertebral end plates, was first extracted automatically, and was straightened so that vertebral end plates became oriented horizontally. Edge candidates were enhanced by use of a horizontal line-enhancement filter in the straightened image, and a multiple thresholding technique, followed by feature analysis, was used for identification of the vertebral end plates. The height of each vertebra was determined from locations of identified vertebral end plates, and fractured vertebrae were detected by comparison of the measured vertebral height with the expected height. The sensitivity of our computerized method for detection of fracture cases was 95% (19/20), with 1.03 (139/135) false

  1. Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State

    PubMed Central

    Keeney, Benjamin J.; Fulton-Kehoe, Deborah; Turner, Judith A.; Wickizer, Thomas M.; Chan, Kwun Chuen Gary; Franklin, Gary M.

    2014-01-01

    Study Design Prospective population-based cohort study Objective To identify early predictors of lumbar spine surgery within 3 years after occupational back injury Summary of Background Data Back injuries are the most prevalent occupational injury in the United States. Little is known about predictors of lumbar spine surgery following occupational back injury. Methods Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers with new worker’s compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The model’s area under the receiver operating characteristic curve (AUC) was used to determine the model’s ability to identify correctly workers who underwent surgery. Results In the D-RISC sample of 1,885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those under age 35, women, Hispanics, and those whose first provider was a chiropractor. 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The multivariate model’s AUC was 0.93 (95% CI 0.92–0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery. Conclusion Baseline variables in multiple domains predicted lumbar spine surgery. There was a very

  2. Is the Prediction of Adolescent Outcomes From Early Child Care Moderated by Later Maternal Sensitivity? Results From the NICHD Study of Early Child Care and Youth Development

    PubMed Central

    Burchinal, Margaret R.; Vandell, Deborah Lowe; Belsky, Jay

    2016-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during adolescence accentuated the association between child care quality and adolescent academic-cognitive skills at age 15 years when maternal sensitivity during adolescence was high. This interaction was obtained in analyses with maternal sensitivity as both a categorical and continuous variable. Relations between early child care hours and adolescent behavioral outcomes also were moderated by maternal sensitivity, with longer child care hours predicting more impulsivity and externalizing at age 15 when maternal sensitivity during middle childhood, scored as a categorical variable, was low to moderate and when maternal sensitivity during adolescence, scored as a continuous variable, was lower. These findings suggest that some child care effects are moderated by subsequent parenting and that this moderation may take both linear and nonlinear forms. PMID:23937381

  3. Early Commitment Financial Aid Programs: Promises, Practices, and Policies

    ERIC Educational Resources Information Center

    Blanco, Cheryl D.

    2005-01-01

    Student financial assistance has long been a means to promote access to postsecondary education and attainment of college degrees. Numerous types of financial aid programs have proliferated over the years, including a relatively new concept that specifically targets high-risk, low-income students, focusing not just on getting them to go to college…

  4. Early Childhood Classrooms and Computers: Programs with Promise.

    ERIC Educational Resources Information Center

    Hoot, James L.; Kimler, Michele

    Word processing and the LOGO programing language are two microcomputer applications that are beginning to show benefits as learning tools in elementary school classrooms. Word processing packages are especially useful with beginning writers, whose lack of motor coordination often slows down their acquisition of competence in written communication.…

  5. Results of Surgery for Low-Grade Brain Arteriovenous Malformation Resection by Early Career Neurosurgeons: An Observational Study.

    PubMed

    Patel, Nirav J; Bervini, David; Eftekhar, Behzad; Davidson, Andrew Stewart; Walsh, Daniel C; Assaad, Nazih N; Morgan, Michael Kerin

    2018-03-28

    For sustainability of arteriovenous malformation (AVM) surgery, results from early career cerebrovascular neurosurgeons (ECCNs) must be acceptably safe. To determine whether ECCNs performance of Spetzler-Ponce Class A AVM (SPC A) resection can be acceptably safe. ECCNs completing a cerebrovascular fellowship (2004-2015) with the last author were included. Inclusion of the ECCN cases occurred if they: had a prospective database of all AVM cases since commencing independent practice; were the primary surgeon on SPC A; and had made the significant management decisions. All SPC A surgical cases from the beginning of the ECCN's independent surgical practice to a maximum of 8 yr were included. An adverse outcome was considered a complication of surgery leading to a new permanent neurological deficit with a last modified Rankin Scale score >1. A cumulative summation (Cusum) plot examined the performance of each surgery. The highest acceptable level of adverse outcomes for the Cusum was 3.3%, derived from the upper 95% confidence interval of the last author's reported series. Six ECCNs contributed 110 cases for analysis. The median number of SPC A cases operated by each ECCN was 16.5 (range 4-40). Preoperative embolization was performed in 5 (4.5%). The incidence of adverse outcomes was 1.8% (95% confidence interval: <0.01%-6.8%). At no point during the accumulated series did the combined cohort become unacceptable by the Cusum plot. ECCNs with appropriate training appointed to large-volume cerebrovascular centers can achieve results for surgery for SPC A that are not appreciably worse than those published from high-volume neurosurgeons.

  6. Migrant Background and Weight Gain in Early Infancy: Results from the German Study Sample of the IDEFICS Study

    PubMed Central

    Reeske, Anna; Spallek, Jacob; Bammann, Karin; Eiben, Gabriele; De Henauw, Stefaan; Kourides, Yiannis; Nagy, Peter; Ahrens, Wolfgang

    2013-01-01

    Objective To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. Methods We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Results Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (ß = 0.35; 95% CI 0.14–0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (ß = 0.77; 95% CI 0.40–1.14) and infants of parents from Eastern European countries with high SES (ß = 0.72; 95% CI 0.13–1.32). Conclusions Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy. PMID:23593270

  7. Low prevalence of work disability in early inflammatory arthritis (EIA) and early rheumatoid arthritis at enrollment into a multi-site registry: results from the catch cohort.

    PubMed

    Mussen, Lauren; Boyd, Tristan; Bykerk, Vivian; de Leon, Faye; Li, Lihua; Boire, Gilles; Hitchon, Carol; Haraoui, Boulos; Thorne, J Carter; Pope, Janet

    2013-02-01

    We determined the prevalence of work disability in early rheumatoid arthritis (ERA) and undifferentiated early inflammatory arthritis (EIA) patients at first enrollment into the Canadian Early Arthritis Cohort (CATCH) who met the 2010 ACR criteria versus those not meeting criteria, to determine the impact of meeting new criteria on work disability status. Data at first visit into the cohort were analyzed. Descriptive statistics and logistic regression analyses were performed to investigate the association of other variables in our database with work disability. 1,487 patients were enrolled in the CATCH study, a multi-site observational, prospective cohort of patients with EIA. 934 patients were excluded (505 based on missing criteria for ACR 2010 classification, as anti-CCP was absent, and 429 were not working for other reasons). Of the 553 patients included, 71 % were female with mean disease duration of 6.4 months. 524 (94.8 %) were employed while 29 (5.2 %) reported work disability at first visit. There were no differences between those meeting 2010 ACR criteria versus those who did not. Baseline characteristics associated with work disability were male gender, age, education, income, HAQ, and positive RF status. The mean HAQ score in work disabled patients was 1.4 versus 0.9 in those who were working (p < 0.001). Disease activity score (DAS28) was not associated with work disability (p = 0.069), nor was tender joint count, swollen joint count, anti-CCP, patient global assessment, or SF-12v2. In the regression model, work disability was associated with lower income levels (p = 0.01) and worse HAQ scores (OR 2.33; p = 0.001), but not significantly associated with male gender (p = 0.08), older age (>50 years; p = 0.3), lower education (p = 0.3) or RF positivity (p = 0.6). We found rates of work disability to be low at entry into this EIA cohort compared to previous studies. There may be potential for intervention in ERA to prevent the development of work

  8. Solar Energy: Progress and Promise.

    ERIC Educational Resources Information Center

    Council on Environmental Quality, Washington, DC.

    This report discusses many of the economic and policy questions related to the widespread introduction of solar power, presents recent progress in developing solar technologies and advancing their economic feasibility, and reviews some recommendations that have been made for achieving the early introduction and sustained application of solar…

  9. Interactive Multimedia: Practice and Promise.

    ERIC Educational Resources Information Center

    Latchem, Colin, Ed.; And Others

    This book describes developments in interactive multimedia (IMM) in the early 1990s. Its aim is to provide educators, students, trainers, librarians, managers, and practitioners with an overview, not only of the directions and uses of the technology, but also of the research foundations and educational and contextual issues that need to be…

  10. Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies

    PubMed Central

    Doctor, Allan; Zimmerman, Jerry; Agus, Michael; Rajasekaran, Surender; Wardenburg, Juliane Bubeck; Fortenberry, James; Zajicek, Anne; Typpo, Katri

    2016-01-01

    Objective To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome (MODS) presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015). Data Sources Literature review, research data, and expert opinion. Study Selection Not applicable. Data Extraction Moderated by an expert from the field, issues relevant to the association of MODS with a variety of conditions were presented, discussed and debated with a focus on identifying knowledge gaps and research priorities. Data Synthesis Summary of presentations and discussion supported and supplemented by relevant literature. Conclusions Among critically ill children, MODS is relatively common and associated with significant morbidity and mortality. For outcomes to improve, effective therapies aimed at preventing and treating this condition must be discovered and rigorously evaluated. In this manuscript, a number of potential opportunities to enhance current care are highlighted including the need for a better understanding of the pharmacokinetics and pharmacodynamics of medications, the effect of early and optimized nutrition, and the impact of effective glucose control in the setting of MODS. Additionally, a handful of the promising therapies either currently being implemented or developed are described. These include extracorporeal therapies, anti-cytokine therapies, anti-toxin treatments, anti-oxidant approaches and multiple forms of exogenous steroids. For the field to advance, these and other therapies must be assessed in rigorous manner and implemented accordingly. PMID:28248836

  11. Promising treatments in development for food allergies.

    PubMed

    Rancé, Fabienne

    2004-11-01

    Up to 6% of young children and 2% of adults suffer from food allergy. Among them many have IgE-mediated food allergy, a condition with potentially fatal allergic reactions. The only proven treatment is avoidance of the offending food, which can be identified using standardised allergic tests. However, several studies have addressed possible definite treatment options for food allergy. Immunotherapy, administered orally or by systemic injections, shows promising preliminary results, but these therapeutics are based on studies with insufficient scientific support, or are associated with a high risk of severe side effects. At present, no studies can support pharmacotherapy. However, promising results were recently published with anti-IgE antibodies in a human trial, and various approaches in a mouse model of food allergy (chinese herbal medicine, specific modulation of the T-cell response). Rapidly evolving findings might provide hope for a cure for food allergy in the near future.

  12. Elevated Early Callose Deposition Results in Complete Penetration Resistance to Powdery Mildew in Arabidopsis1[C][W][OA

    PubMed Central

    Ellinger, Dorothea; Naumann, Marcel; Falter, Christian; Zwikowics, Claudia; Jamrow, Torsten; Manisseri, Chithra; Somerville, Shauna C.; Voigt, Christian A.

    2013-01-01

    A common response by plants to fungal attack is deposition of callose, a (1,3)-β-glucan polymer, in the form of cell wall thickenings called papillae, at site of wall penetration. While it has been generally believed that the papillae provide a structural barrier to slow fungal penetration, this idea has been challenged in recent studies of Arabidopsis (Arabidopsis thaliana), where fungal resistance was found to be independent of callose deposition. To the contrary, we show that callose can strongly support penetration resistance when deposited in elevated amounts at early time points of infection. We generated transgenic Arabidopsis lines that express POWDERY MILDEW RESISTANT4 (PMR4), which encodes a stress-induced callose synthase, under the control of the constitutive 35S promoter. In these lines, we detected callose synthase activity that was four times higher than that in wild-type plants 6 h post inoculation with the virulent powdery mildew Golovinomyces cichoracearum. The callose synthase activity was correlated with enlarged callose deposits and the focal accumulation of green fluorescent protein-tagged PMR4 at sites of attempted fungal penetration. We observed similar results from infection studies with the nonadapted powdery mildew Blumeria graminis f. sp. hordei. Haustoria formation was prevented in resistant transgenic lines during both types of powdery mildew infection, and neither the salicylic acid-dependent nor jasmonate-dependent pathways were induced. We present a schematic model that highlights the differences in callose deposition between the resistant transgenic lines and the susceptible wild-type plants during compatible and incompatible interactions between Arabidopsis and powdery mildew. PMID:23335625

  13. Early Detection of Alzheimer's Disease Based on the Patient's Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method.

    PubMed

    Heymann, Petra; Gienger, Regine; Hett, Andreas; Müller, Stephan; Laske, Christoph; Robens, Sibylle; Ostermann, Thomas; Elbing, Ulrich

    2018-01-01

    Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

  14. Cardioband, a transcatheter surgical-like direct mitral valve annuloplasty system: early results of the feasibility trial.

    PubMed

    Maisano, Francesco; Taramasso, Maurizio; Nickenig, Georg; Hammerstingl, Christoph; Vahanian, Alec; Messika-Zeitoun, David; Baldus, Stephan; Huntgeburth, Michael; Alfieri, Ottavio; Colombo, Antonio; La Canna, Giovanni; Agricola, Eustachio; Zuber, Michel; Tanner, Felix C; Topilsky, Yan; Kreidel, Felix; Kuck, Karl-Heinz

    2016-03-07

    Cardioband system is a direct annuloplasty adjustable device that is implanted in the beating heart on the posterior annulus under fluoroscopic and transoesophageal echocardiographic (TEE) guidance. We report the early (1 month) outcomes of the first-in-man pre-CE-mark feasibility and safety trial. The study enrolled high-risk adult individuals at five institutions in Europe with symptomatic secondary mitral regurgitation (MR) despite optimal medical therapy. The primary efficacy endpoints included the technical success rate of implantation, feasibility of the Cardioband adjustment (technical performance), and ability to reduce the annular septolateral dimension and MR grade at hospital discharge and at 30 days. The study group included 31 consecutively enrolled high-risk patients with moderate-to-severe or severe secondary MR with at least 1 month of follow-up (mean age 71.8 ± 6.9 years). All patients received the full implant of a Cardioband. Adjustment of the Cardioband resulted in a significant reduction in the septolateral dimension in all but two patients (septolateral dimension from 36.8 ± 4.8 to 29 ± 5.5 mm after the procedure, P < 0.01). Following Cardioband adjustment (29 of 31 patients) MR was none or trace in 6 (21%), mild in 21 (72%), and moderate in 2 (7%). No patient had severe MR after adjustment. Procedural mortality was zero and in-hospital mortality was 6.5% (2 of 31 patients, neither procedure- nor device-related). At 30 days, 22 of the 25 patients (88%) had MR ≤2+. This study demonstrates the feasibility and safety of percutaneous direct mitral annuloplasty with the Cardioband device in high-risk patients with MR. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  15. Risk factors influencing the early outcome results after laparoscopic repair of perforated duodenal ulcer and their predictive value.

    PubMed

    Lunevicius, Raimundas; Morkevicius, Matas

    2005-09-01

    Clear patient selection criteria and indications for laparoscopic repair of perforated duodenal ulcers are necessary. The aims of our study are to report the early outcome results after operation and to define the predictive values of risk factors influencing conversion rate and genesis of suture leakage. Sixty nonrandomly selected patients operated on laparoscopically in a tertiary care academic center between October 1996 and May 2004 for perforated duodenal ulcers were retrospectively analyzed. The primary outcome measures included the duration of symptoms, shock, underlying medical illness, ulcer size, age, Boey score, and the collective predictive value of these variables for conversion and suture leakage rates. Laparoscopic repair was completed in 46 patients (76.7%). Fourteen patients (23.3%) underwent conversion to open repair. Eight patients (13.3%) had postoperative complications. Suture leakage was confirmed in four patients (6.7%). Hospital stay was 7.8+/-5.3 days. There was no mortality. Patients with an ulcer perforation size of >8 mm had a significantly increased risk for conversion to open repair (p<0.05): positive predictive value (PPV) 75%, sensitivity 27%, specificity 98%, and negative predictive value (NPV) 85%. The significance of ulcer perforation size was confirmed by a stepwise logistic regression test (p=0.0201). All patients who developed suture leakage had acute symptoms for >9 h preoperatively (p<0.001): PPV 31%, specificity 84%, sensitivity 100%, and NPV 100%. Conversions happened with surgeons whose previous experience involved 1.8+/-2.3 cases compared to 3.9+/-2.9 cases in successful laparoscopic repair (p=0.039, t test). Ulcer perforation size of >8 mm is a significant risk factor influencing the conversion rate. An increase in the suture leakage rate is predicted by delayed presentation of >9 h.

  16. Early results of prostate cancer radiation therapy: an analysis with emphasis on research strategies to improve treatment delivery and outcomes

    PubMed Central

    2013-01-01

    Background There is scant data regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT). Methods A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy, Ghana from 2003 to 2009. Data were collected regarding patient-and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score (GS), clinical stage (T), and use of androgen deprivation therapy (ADT). For patients who received EBRT, freedom from biochemical failure (FFbF) was evaluated using the Kaplan-Meier method. Results Of 379 patients referred for treatment 69.6% had initial PSA (iPSA) > 20 ng/ml, and median iPSA was 39.0 ng/ml. A total of 128 men, representing 33.8% of the overall cohort, were diagnosed with metastatic disease at time of referral. Among patients with at least 2 years of follow-up after EBRT treatment (n=52; median follow-up time: 38.9 months), 3- and 5-year actuarial FFbF was 73.8% and 65.1% respectively. There was significant association between higher iPSA and GS (8–10 vs. ≤7, p < 0.001), and T stage (T3/4 vs. T1/2, p < 0.001). Conclusions This is the largest series reporting on outcomes after prostate cancer treatment in West Africa. That one-third of patients presented with metastatic disease suggests potential need for earlier detection to permit curative-intent therapy. Data from this study will aid in the strategic development of prostate cancer research roadmap in Ghana. PMID:23324165

  17. Melanoma Vaccines: Mixed Past, Promising Future

    PubMed Central

    Ozao-Choy, Junko; Lee, Delphine J.; Faries, Mark B.

    2014-01-01

    Synopsis Cancer vaccines were one of the earliest forms of immunotherapy to be investigated. Past attempts to vaccinate against cancer, including melanoma, have mixed results, revealing the complexity of what was thought to be a simple concept. However, several recent successes and the combination of improved knowledge of tumor immunology and the advent of new immunomodulators make vaccination a promising strategy for the future. PMID:25245965

  18. Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

    PubMed

    Siegrist, Johannes; Wahrendorf, Morten; von dem Knesebeck, Olaf; Jürges, Hendrik; Börsch-Supan, Axel

    2007-02-01

    Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

  19. SU-F-T-195: Systematic Constraining of Contralateral Parotid Gland Led to Improved Dosimetric Outcomes for Multi-Field Optimization with Scanning Beam Proton Therapy: Promising Results From a Pilot Study in Patients with Base of Tongue Carcinoma

    SciTech Connect

    Wu, R; Liu, A; Poenisch, F

    Purpose: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning. Methods: Twenty-four (24) consecutive patients previously treated for base of tongue carcinoma were retrospectively selected. The doses were 70Gy, 63Gy and 57Gy (SIB in 33more » fractions) for high-, intermediate-, and standard-risk clinical target volumes (CTV), respectively; the treatment included bilateral neck. Scanning beams using MFO with standardized bilateral anterior oblique and PA fields were applied. New plans where then developed and optimized by employing additional contralateral parotid constraints at multiple defined dose levels. Using a step-wise iterative process, the volume-based constraints at each level were then further reduced until known target coverages were compromised. The newly developed plans were then compared to the original clinically approved plans using paired student t-testing. Results: All 24 newly optimized treatment plans maintained initial plan quality as compared to the approved plans, and the 98% prescription dose coverage to the CTV’s were not compromised. Representative DVH comparison is shown in FIGURE 1. The contralateral parotid doses were reduced at all levels of interest when systematic constraints were applied to V10, V20, V30 and V40Gy (All P<0.0001; TABLE 1). Overall, the mean contralateral parotid doses were reduced by 2.26 Gy on average, a ∼13% relative improvement. Conclusion: Applying systematic and volume-based contralateral parotid constraints for IMPT planning significantly reduced the dose at all

  20. Co-occurring development of early childhood communication and motor skills: results from a population-based longitudinal study.

    PubMed

    Wang, M V; Lekhal, R; Aarø, L E; Schjølberg, S

    2014-01-01

    Communicative and motor development is frequently found to be associated. In the current study we investigate to what extent communication and motor skills at 1½ years predict skills in the same domains at 3 years of age. This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Heath. Data stem from 62,944 children and their mothers. Mothers completed questionnaires on their child's communication and motor skills at ages 1½ and 3. Associations between communication and motor skills were estimated in a cross-lagged model with latent variables. Early communication skills were correlated with early motor skills (0.72). Stability was high (0.81) across time points for motor skills and somewhat lower (0.40) for communication skills. Early motor skills predicted later communication skills (0.38) whereas early communication skills negatively predicted later motor skills (-0.14). Our findings provide support for the hypothesis that these two difficulties are not symptoms of separate disorders, but might rather be different manifestations of a common underlying neurodevelopmental weakness. However, there also seem to be specific developmental pathways for each domain. Besides theoretical interest, more knowledge about the relationship between these early skills might shed light upon early intervention strategies and preventive efforts commonly used with children with problems in these areas. Our findings suggest that the relationship between language and motor skills is not likely to be simple and directional but rather to be complex and multifaceted. © 2012 John Wiley & Sons Ltd.

  1. Results of level-II oncoplasty in breast cancer patients: an early experience from a tertiary care hospital in Pakistan.

    PubMed

    Qureshi, Sajida; Ghazanfar, Shahriyar; Iqbal, Sumera; Bhatti, Abu Bakar Hafeez; Quraishy, Mohammad Saeed

    2014-03-01

    To assess the oncologic and cosmetic outcomes for breast cancer patients who underwent breast conservation therapy using Level II oncoplasty techniques. The prospective, non-randomised and descriptive study was conducted at the Department of Surgery, Unit IV of Civil Hospital, Karachi, from December 2009 to November 2011 in which 21 consecutive women with breast carcinoma who underwent wide local excision with remodeling mammoplasty were enrolled. All patients were reviewed by the surgeon and medical oncologist every 3 months for the first year. A grading system of 5-1 (excellent to poor) was employed and those with 3 or more were considered to have acceptable results. The mean patient age was 45.38 +/- 10.09 years (range: 26-70); 11 (52.3%) were premenopausal and 10 (47.7%) were postmenopausal; and 5 (27.8%) had family history of breast cancer. The mean size of the tumour determined by histology was 59.9 +/- 3.18 mm (range: 25-150). Eight (30%) patients received preoperative chemotherapy to downsize the tumour. Three (14.2%) patients received preoperative radiotherapy. Mean operative time was 1.59 +/- 0.52 hours (range: 1-2.5 hours). Mean volume of breast tissue excised from the breast containing the tumour was 545.27 +/- 412.06 cm3 (range: 43.70-1456). Assessment of excision margins showed no tumour at the margins of 19 (90.4%) patients. Two (9.5%) patients had close but negative margins. The mean hospital stay was 7.10 +/- 3.30 days (range: 4-15). There were early complications in 4 (19%) patients. One (4.76%) patient had late complications. Two (9.5%) patients developed tumour recurrence; both had an ipsilateral tumour recurrence. None of the patients developed metastases and one died of cardiac problem. Twenty (95.2%) patients had an acceptable post-surgical cosmetic result. Level II oncoplasty was a safe option in breast conservation allowing large-sized and difficult-location tumour excision with good cosmetic outcome in the study group. There is a need to

  2. Cultural Neuroscience: Progress and Promise

    PubMed Central

    Chiao, Joan Y.; Cheon, Bobby K.; Pornpattanangkul, Narun; Mrazek, Alissa J.; Blizinsky, Katherine D.

    2013-01-01

    The nature and origin of human diversity has been a source of intellectual curiosity since the beginning of human history. Contemporary advances in cultural and biological sciences provide unique opportunities for the emerging field of cultural neuroscience. Research in cultural neuroscience examines how cultural and genetic diversity shape the human mind, brain and behavior across multiple time scales: situation, ontogeny and phylogeny. Recent progress in cultural neuroscience provides novel theoretical frameworks for understanding the complex interaction of environmental, cultural and genetic factors in the production of adaptive human behavior. Here, we provide a brief history of cultural neuroscience, theoretical and methodological advances, as well as empirical evidence of the promise of and progress in the field. Implications of this research for population health disparities and public policy are discussed. PMID:23914126

  3. Promises to Practice: Learning a PROactive Approach to Ethical Dilemmas

    ERIC Educational Resources Information Center

    Ambery, Mary Elizabeth; Steinbrunner, Ruth K.

    2007-01-01

    Learning to be PROactive, as the title of this article suggests, means Pooling one's knowledge, Reflecting respect, and Opening oneself to action. It recognizes early childhood educators' promises to their field of practice, based on widely held beliefs and principles. Educators can apply professional ethics to everyday problem solving and their…

  4. The Renewed Promise of Medical Informatics

    PubMed Central

    2016-01-01

    Summary The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field. PMID:27199195

  5. The Renewed Promise of Medical Informatics.

    PubMed

    van Bemmel, J H; McCray, A T

    2016-05-20

    The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field.

  6. Silvicultural options for early-successional stands in Maine: 6-year results of the Silvicultural Intensity and Species Composition Experiment

    Treesearch

    Andrew S. Nelson; Robert G. Wagner; Mike R. Saunders

    2014-01-01

    The Silvicultural Intensity and Species Composition (SIComp) experiment was installed in 2003 on a recently clearcut mixedwood site within the Penobscot Experimental Forest in east-central Maine. This study was initiated because the response of early-successional stands to various intensities of silviculture was poorly understood in the region. The goal of SIComp is to...

  7. Survey Results for Training and Resource Needs Cited by Early Intervention Professionals in the Field of Visual Impairment

    ERIC Educational Resources Information Center

    Ely, Mindy S.; Ostrosky, Michaelene M.

    2017-01-01

    Introduction: Professionals working with infants and toddlers with visual impairments (that is, those who are blind or have low vision) were surveyed regarding their preservice training and their awareness and use of 29 resources related to young children who are visually impaired. Methods: Early intervention visual impairment professionals (n =…

  8. Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort.

    PubMed

    Kronisch, Caroline; McLernon, David J; Dale, James; Paterson, Caron; Ralston, Stuart H; Reid, David M; Tierney, Ann; Harvie, John; McKay, Neil; Wilson, Hilary E; Munro, Robin; Saunders, Sarah; Richmond, Ruth; Baxter, Derek; McMahon, Mike; Kumar, Vinod; McLaren, John; Siebert, Stefan; McInnes, Iain B; Porter, Duncan; Macfarlane, Gary J; Basu, Neil

    2016-07-01

    To identify baseline prognostic indicators of disability at 1 year within a contemporary early inflammatory arthritis inception cohort and then develop a clinically useful tool to support early patient education and decision-making. The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis. SERA data were analyzed to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at 1 year. Clinical and psychosocial baseline exposures were entered into a forward stepwise logistic regression model. The model was externally validated using newly accrued SERA data and subsequently converted into a prediction tool. Of the 578 participants (64.5% female), 36.7% (n = 212) reported functional disability at 1 year. Functional disability was independently predicted by baseline disability (odds ratio [OR] 2.67 [95% confidence interval (95% CI) 1.98, 3.59]), depression (OR 2.52 [95% CI 1.18, 5.37]), anxiety (OR 2.37 [95% CI 1.33, 4.21]), being in paid employment with absenteeism during the last week (OR 1.19 [95% CI 0.63, 2.23]), not being in paid employment (OR 2.36 [95% CI 1.38, 4.03]), and being overweight (OR 1.61 [95% CI 1.04, 2.50]). External validation (using 113 newly acquired patients) evidenced good discriminative performance with a C statistic of 0.74, and the calibration slope showed no evidence of model overfit (P = 0.31). In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at 1 year appear to be dominated by psychosocial rather than more traditional clinical measures. This indicates the potential benefit of early access to nonpharmacologic interventions targeting key psychosocial factors, such as mental health and work disability. © 2016, American College of Rheumatology.

  9. Slow Gait Speed Is an Independent Predictor of Early Death in Older Cancer Outpatients: Results from a Prospective Cohort Study.

    PubMed

    Pamoukdjian, F; Lévy, V; Sebbane, G; Boubaya, M; Landre, T; Bloch-Queyrat, C; Paillaud, E; Zelek, L

    2017-01-01

    To assess the predictive value of gait speed for early death in older outpatients with cancer. Prospective bicentric observational cohort study. The Physical Frailty in Elder Cancer patients (PF-EC) study (France). One hundred and ninety outpatients with cancer during the first 6 months of follow up in the PF-EC study. The association between usual gait speed over 4 m alone (GS) or included in the short physical performance battery (SPPB) and overall survival within 6 months following a comprehensive geriatric assessment (CGA). A Cox proportional-hazard regression model was performed in non-survivors for clinical factors from the CGA, along with c reactive protein (CRP). Two models were created to assess GS alone and from inclusion in the SPPB. The mean age was 80.6 years, and 50.5% of the participants were men. Death occurred in 11% (n=22) of the participants within the 6 month follow up period. Of these participants, 98% had solid cancers, and 33% had a metastatic disease. A GS < 0.8 m/s (HR=5.6, 95%CI=1.6-19.7, p=0.007), a SPPB < 9 (HR=5.8, 95%CI=1.6-20.9, p=0.007) and a CRP of 50 mg/l or greater (p<0.0001) were significantly associated with early death in the two multivariate analyses. Cancer site and extension were not significantly associated with early death. Walking tests are associated with early death within the 6 month follow up period after a CGA independent of cancer site and cancer extension. GS alone < 0.8 m/s is at least as efficacious as the SPPB in predicting this outcome. GS alone could be used routinely as a marker of early death to adapt oncologic therapeutics. Further studies are needed to validate these preliminary data.

  10. CpG Methylation Signature Predicts Recurrence in Early-Stage Hepatocellular Carcinoma: Results From a Multicenter Study.

    PubMed

    Qiu, Jiliang; Peng, Baogang; Tang, Yunqiang; Qian, Yeben; Guo, Pi; Li, Mengfeng; Luo, Junhang; Chen, Bin; Tang, Hui; Lu, Canliang; Cai, Muyan; Ke, Zunfu; He, Wei; Zheng, Yun; Xie, Dan; Li, Binkui; Yuan, Yunfei

    2017-03-01

    Purpose Early-stage hepatocellular carcinoma (E-HCC) is being diagnosed increasingly, and in one half of diagnosed patients, recurrence will develop. Thus, it is urgent to identify recurrence-related markers. We investigated the effectiveness of CpG methylation in predicting recurrence for patients with E-HCCs. Patients and Methods In total, 576 patients with E-HCC from four independent centers were sorted by three phases. In the discovery phase, 66 tumor samples were analyzed using the Illumina Methylation 450k Beadchip. Two algorithms, Least Absolute Shrinkage and Selector Operation and Support Vector Machine-Recursive Feature Elimination, were used to select significant CpGs. In the training phase, penalized Cox regression was used to further narrow CpGs into 140 samples. In the validation phase, candidate CpGs were validated using an internal cohort (n = 141) and two external cohorts (n = 191 and n =104). Results After combining the 46 CpGs selected by the Least Absolute Shrinkage and Selector Operation and the Support Vector Machine-Recursive Feature Elimination algorithms, three CpGs corresponding to SCAN domain containing 3, Src homology 3-domain growth factor receptor-bound 2-like interacting protein 1, and peptidase inhibitor 3 were highlighted as candidate predictors in the training phase. On the basis of the three CpGs, a methylation signature for E-HCC (MSEH) was developed to classify patients into high- and low-risk recurrence groups in the training cohort ( P < .001). The performance of MSEH was validated in the internal cohort ( P < .001) and in the two external cohorts ( P < .001; P = .002). Furthermore, a nomogram comprising MSEH, tumor differentiation, cirrhosis, hepatitis B virus surface antigen, and antivirus therapy was generated to predict the 5-year recurrence-free survival in the training cohort, and it performed well in the three validation cohorts (concordance index: 0.725, 0.697, and 0.693, respectively). Conclusion MSEH, a three

  11. The Saharan Aerosol Long-range Transport and Aerosol-Cloud-Interaction Experiment SALTRACE 2013 - Overview and Early Results (Invited)

    NASA Astrophysics Data System (ADS)

    Weinzierl, B.; Ansmann, A.; Reitebuch, O.; Freudenthaler, V.; Müller, T.; Kandler, K.; Althausen, D.; Busen, R.; Dollner, M.; Dörnbrack, A.; Farrell, D. A.; Gross, S.; Heimerl, K.; Klepel, A.; Kristensen, T. B.; Mayol-Bracero, O. L.; Minikin, A.; Prescod, D.; Prospero, J. M.; Rahm, S.; Rapp, M.; Sauer, D. N.; Schaefler, A.; Toledano, C.; Vaughan, M.; Wiegner, M.

    2013-12-01

    Chantal in the dusty environment. We give an overview of the SALTRACE measurements and show early results covering profiles of dust size distributions, dust optical properties and the investigation of the impact of dust aging processes between the Cape Verde region and Florida.

  12. Children of Low Socioeconomic Status Show Accelerated Linear Growth in Early Childhood; Results from the Generation R Study

    PubMed Central

    Silva, Lindsay M.; van Rossem, Lenie; Jansen, Pauline W.; Hokken-Koelega, Anita C. S.; Moll, Henriëtte A.; Hofman, Albert; Mackenbach, Johan P.; Jaddoe, Vincent W. V.; Raat, Hein

    2012-01-01

    Objectives People of low socioeconomic status are shorter than those of high socioeconomic status. The first two years of life being critical for height development, we hypothesized that a low socioeconomic status is associated with a slower linear growth in early childhood. We studied maternal educational level (high, mid-high, mid-low, and low) as a measure of socioeconomic status and its association with repeatedly measured height in children aged 0–2 years, and also examined to what extent known determinants of postnatal growth contribute to this association. Methods This study was based on data from 2972 mothers with a Dutch ethnicity, and their children participating in The Generation R Study, a population-based cohort study in Rotterdam, the Netherlands (participation rate 61%). All children were born between April 2002 and January 2006. Height was measured at 2 months (mid-90% range 1.0–3.9), 6 months (mid-90% range 5.6–11.4), 14 months (mid-90% range 13.7–17.9) and 25 months of age (mid-90% range 23.6–29.6). Results At 2 months, children in the lowest educational subgroup were shorter than those in the highest (difference: −0.87 cm; 95% CI: −1.16, −0.58). Between 1 and 18 months, they grew faster than their counterparts. By 14 months, children in the lowest educational subgroup were taller than those in the highest (difference at 14 months: 0.40 cm; 95% CI: 0.08,0.72). Adjustment for other determinants of postnatal growth did not explain the taller height. On the contrary, the differences became even larger (difference at 14 months: 0.61 cm; 95% CI: 0.26,0.95; and at 25 months: 1.00 cm; 95% CI: 0.57,1.43) Conclusions Compared with children of high socioeconomic status, those of low socioeconomic status show an accelerated linear growth until the18th month of life, leading to an overcompensation of their initial height deficit. The long-term consequences of these findings remain unclear and require further study. PMID:22649522

  13. Early and mid-term results of off-pump endarterectomy of the left anterior descending artery

    PubMed Central

    Takahashi, Mitsuko; Gohil, Sunir; Tong, Bonnie; Lento, Patrick; Filsoufi, Farzan; Reddy, Ramachandra C.

    2013-01-01

    OBJECTIVES Many patients referred for coronary artery bypass surgery (CABG) today have diffusely diseased coronary vessels, and some of them may require coronary endarterectomy to provide adequate revascularization. Most reports of coronary endarterectomy describe an on-pump procedure. As off-pump coronary artery bypass graft has become safer and more routine, there is renewed interest in off-pump coronary endarterectomy. We report on our series of patients who underwent off-pump coronary endarterectomy of the left anterior descending (LAD) artery using an open endarterectomy technique. METHODS All patients undergoing open heart surgery at The Mount Sinai Medical Center are entered into a state-mandated, audited database. A retrospective review of this database revealed 12 patients between January 2008 and June 2012 who underwent off-pump endarterectomy of the LAD as part of their coronary revascularization. Additional data were collected from a review of the patients' charts. RESULTS There were a total of 12 patients, with a mean age of 72 ± 4 years. Nine (75%) were male and 3 (25%) were female. Comorbidities included hypertension in 11 (92%) patients, dyslipidaemia in 10 (83%), diabetes in 8 (67%), renal failure in 6 (50%) and stroke in 1 (8%). The mean number of diseased coronary territories was 3 ± 0.4 (range 2–3), and the mean number of coronary bypass grafts performed was 4 ± 0.8 (range 2–5). Eight patients required transfusion with packed red blood cells (67%). One (8%) patient was converted from off-pump to on-pump. The mean intensive care unit stay was 3 ± 2.8 (range 1–8 days), and the mean hospital length of stay was 15 ± 13 (range 4–54 days). Postoperative follow-up (mean 24 ± 19 months, range 1–53) is complete, and no ischaemic events have occurred in the early and mid-term follow-up period. CONCLUSIONS We conclude that off-pump endarterectomy of the LAD is a viable option for patients with diffuse LAD disease. PMID:23190620

  14. Progress and Promise: Results from the Boston Pilot Schools

    ERIC Educational Resources Information Center

    Tung, Rosann; Ouimette, Monique; Rugen, Leah

    2006-01-01

    New research conducted by Boston's Center for Collaborative Education documents significant achievement by students who attend the city's Pilot Schools. Pilot School students are performing better than the district averages across every indicator of student engagement and performance, including the statewide standardized assessment (MCAS). In…

  15. Promising results in treating lymphoma in young people

    Cancer.gov

    Patients with a type of cancer known as primary mediastinal B-cell lymphoma who received infusions of chemotherapy, but who did not have radiation therapy to an area of the thorax known as the mediastinum, had excellent outcomes, according to clinical tri

  16. Realizing the promises of marine biotechnology.

    PubMed

    Luiten, Esther E M; Akkerman, Ida; Koulman, Albert; Kamermans, Pauline; Reith, Hans; Barbosa, Maria J; Sipkema, Detmer; Wijffels, René H

    2003-07-01

    High-quality research in the field of marine biotechnology is one of the key-factors for successful innovation in exploiting the vast diversity of marine life. However, fascinating scientific research with promising results and claims on promising potential applications (e.g. for pharmaceuticals, nutritional supplements, (feed-)products for aquaculture and bioremediation solutions) is not the only factor to realise the commercial applications of marine biotechnology. What else is needed to exploit the promising potential of marine biotechnology and to create new industrial possibilities? In the study project 'Ocean Farming-Sustainable exploitation of marine organisms', we explore the possibilities of marine organisms to fulfill needs, such as safe and healthy food, industrial (raw) materials and renewable energy in a sustainable way. One of the three design groups is envisioning the future of strong land-based 'marine' market chains. Marine biotechnology is one of the foci of attention in this design group. This article provides a model of future-oriented thinking in which a variety of experts actively participate.

  17. Application of regional physically-based landslide early warning model: tuning of the input parameters and validation of the results

    NASA Astrophysics Data System (ADS)

    D'Ambrosio, Michele; Tofani, Veronica; Rossi, Guglielmo; Salvatici, Teresa; Tacconi Stefanelli, Carlo; Rosi, Ascanio; Benedetta Masi, Elena; Pazzi, Veronica; Vannocci, Pietro; Catani, Filippo; Casagli, Nicola

    2017-04-01

    runs in real-time by assimilating weather data and uses Monte Carlo simulation techniques to manage the geotechnical and hydrological input parameters. In this context, an assessment of the factors controlling the geotechnical and hydrological features is crucial in order to understand the occurrence of slope instability mechanisms and to provide reliable forecasting of the hydrogeological hazard occurrence, especially in relation to weather events. In particular, the model and the soil characterization were applied in back analysis, in order to assess the reliability of the model through validation of the results with landslide events that occurred during the period. The validation was performed on four past events of intense rainfall that have affected Valle d'Aosta region between 2008 and 2010 years triggering fast shallows landslides. The simulations show substantial improvement of the reliability of the results compared to the use of literature parameters. A statistical analysis of the HIRESSS outputs in terms of failure probability has been carried out in order to define reliable alert levels for regional landslide early warning systems.

  18. [Efficiency of early diagnosis and prevention of chronic obstructive pulmonary disease in industrial workers (prospective observation results)].

    PubMed

    Bobrov, S V; Shpagina, L A; Kuznetsova, G V; Burganova, M R

    2011-01-01

    Examination of workers engaged into major industrial enterprises of Novosibirsk demonstrated high prevalence of bronchial obstruction in individuals contacting industrial aerosol. The workers with long length of service proved high level of tobacco addiction and marked psychologic dependence on smoking. Based on the data obtained, the authors specified a program for early diagnosis and prevention of occupational bronchitis among the workers of major industrial enterprises.

  19. A Novel Mechanism for the Pathogenesis of Nonmelanoma Skin Cancer Resulting from Early Exposure to Ultraviolet Light

    DTIC Science & Technology

    2015-11-01

    follow through next year, as the poor breeding of transgenic mice thwarted our efforts for a timely conclusion of this project. KEY RESEARCH...the epidermis during the early stages of skin tumor promotion. 7) We demonstrated using our K14mTmG transgenic mice that a low but significant...together with the use of two transgenic mice that are already available including two UV experiments, and a skin grafting experiment. The rationale

  20. The promises of qualitative inquiry.

    PubMed

    Gergen, Kenneth J; Josselson, Ruthellen; Freeman, Mark

    2015-01-01

    We address the significance and implications of the formal entry of qualitative inquiry into the American Psychological Association. In our view, the discipline is enriched in new and important ways. Most prominently, the qualitative movement brings with it a pluralist orientation to knowledge and to practices of inquiry. Adding to the traditional view of knowledge as empirically supported theory are research practices congenial with varying accounts of knowledge, including, for example, knowledge as hermeneutic understanding, social construction, and practice-based experience. Added to the goal of prediction are investments in increasing cultural understanding, challenging cultural conventions, and directly fostering social change. The qualitative movement also enriches the discipline as a whole through the special ways in which it inspires new ranges of theory, fosters minority inclusion, and invites interdisciplinary collaboration. Finally, the movement holds promise in terms of the discipline's contribution to society at large. Here we focus on the advantages of knowing with others in addition to about them, and on ways in which qualitative work enhances communication with the society and the world. Realizing these potentials will depend on developments in responsible research and reporting, academic and journal policies, along with the discipline's capacities for appreciating a more comprehensive orientation to inquiry. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  1. Telepsychiatry: Promise, potential, and challenges

    PubMed Central

    Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita

    2013-01-01

    Despite the high prevalence and potentially disabling consequences of mental disorders, specialized mental health services are extremely deficient, leading to the so-called ‘Mental Health Gap’. Moreover, the services are concentrated in the urban areas, further worsening the rural-urban and tertiary primary care divide. Strengthening of and expanding the existing human resources and infrastructure, and integrating mental health into primary care appear to be the two major solutions. However, both the strategies are riddled with logistic difficulties and have a long gestation period. In such a scenario, telepsychiatry or e-mental health, defined as the use of information and communication technology to provide or support psychiatric services across distances, appears to be a promising answer. Due to its enormous potential, a review of the existing literature becomes imperative. An extensive search of literature was carried out and has been presented to delineate the modes of communication, acceptability and satisfaction, reliability, outcomes, cost-effectiveness, and legal and ethical challenges related to telepsychiatry. Telepsychiatry has been applied for direct patient care (diagnosis and management), consultation, and training, education, and research purposes. Both real-time, live interaction (synchronous) and store–forward (asynchronous) types of technologies have been used for these purposes. A growing amount of literature shows that training, supervision, and consultation by specialists to primary care physicians through telepsychiatry has several advantages. In this background, we have further focused on the models of telepsychiatry best suited for India, considering that mental health care can be integrated into primary care and taken to the doorstep of patients in the community. PMID:23441027

  2. Early pregnancy exposure to antihistamines and risk of congenital heart defects: results of two case-control studies.

    PubMed

    Smedts, Huberdina P M; de Jonge, Linda; Bandola, Sarah J G; Baardman, Marlies E; Bakker, Marian K; Stricker, Bruno H C; Steegers-Theunissen, Régine P M

    2014-09-01

    We aimed to study the association between use of antihistamines in early pregnancy and congenital heart defects (CHD) in the offspring. Two case-control studies. HAVEN study, Erasmus MC, University Medical Centre, Rotterdam, and Eurocat Northern Netherlands (NNL), University Medical Center Groningen, Groningen, the Netherlands. We studied 361 children with CHD and 410 controls without congenital malformations from the HAVEN study and replicated the analyses in 445 children with CHD and 530 controls from the Eurocat NNL registry. Information about antihistamine use in early pregnancy and potential confounders was obtained from questionnaires postpartum. We calculated the association between antihistamines and CHD risk by multivariable logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI). In the HAVEN study, 25 of 771 mothers used antihistamines that were associated with an increased CHD risk (OR 3.0, 95% CI 1.2-7.3), particularly atrioventricular septal defects (AVSD) (OR 5.1, 95 % CI 1.3-20.5) and perimembranous ventricular septal defects (pVSD) (OR 5.1, 95% CI 1.8-14.4). Mothers with severe nausea who did not use antihistamines had a reduced risk (OR 0.7, 95% CI 0.5-0.98), whereas nauseous mothers using antihistamines showed an almost fivefold increased risk of pVSD (OR 4.8, 95% CI 1.1-21.8). The association between antihistamines and AVSD was confirmed in the Eurocat cohort (OR 3.5, 95% CI 1.4-8.7), but we could not replicate the association with overall CHD risk. We found a positive association between antihistamine use in early pregnancy and CHD risk, particularly AVSD, which seemed to be independent of nausea/vomiting.

  3. Preliminary numerical simulations of the 27 February 2010 Chile tsunami: first results and hints in a tsunami early warning perspective

    NASA Astrophysics Data System (ADS)

    Tinti, S.; Tonini, R.; Armigliato, A.; Zaniboni, F.; Pagnoni, G.; Gallazzi, Sara; Bressan, Lidia

    2010-05-01

    The tsunamigenic earthquake (M 8.8) that occurred offshore central Chile on 27 February 2010 can be classified as a typical subduction-zone earthquake. The effects of the ensuing tsunami have been devastating along the Chile coasts, and especially between the cities of Valparaiso and Talcahuano, and in the Juan Fernandez islands. The tsunami propagated across the entire Pacific Ocean, hitting with variable intensity almost all the coasts facing the basin. While the far-field propagation was quite well tracked almost in real-time by the warning centres and reasonably well reproduced by the forecast models, the toll of lives and the severity of the damage caused by the tsunami in the near-field occurred with no local alert nor warning and sadly confirms that the protection of the communities placed close to the tsunami sources is still an unresolved problem in the tsunami early warning field. The purpose of this study is two-fold. On one side we perform numerical simulations of the tsunami starting from different earthquake models which we built on the basis of the preliminary seismic parameters (location, magnitude and focal mechanism) made available by the seismological agencies immediately after the event, or retrieved from more detailed and refined studies published online in the following days and weeks. The comparison with the available records of both offshore DART buoys and coastal tide-gauges is used to put some preliminary constraints on the best-fitting fault model. The numerical simulations are performed by means of the finite-difference code UBO-TSUFD, developed and maintained by the Tsunami Research Team of the University of Bologna, Italy, which can solve both the linear and non-linear versions of the shallow-water equations on nested grids. The second purpose of this study is to use the conclusions drawn in the previous part in a tsunami early warning perspective. In the framework of the EU-funded project DEWS (Distant Early Warning System), we will

  4. Feasibility and acceptability of an early childhood obesity prevention intervention: results from the healthy homes, healthy families pilot study.

    PubMed

    Keita, Akilah Dulin; Risica, Patricia M; Drenner, Kelli L; Adams, Ingrid; Gorham, Gemma; Gans, Kim M

    2014-01-01

    This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children's health behaviors. We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years) to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up. 39 (78%) parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, P = 0.001) and ounces of fruit juice decreased at follow-up (11.9 ounces at 4 months compared to 16.0 ounces at baseline, P = 0.036). Sedentary behaviors also improved. Children significantly decreased time spent watching TV on weekdays (P < 0.01) and also reduced weekend TV time. In addition, the number of homes with TV sets in the child's bedroom also decreased (P < 0.0013). The findings indicate that a home-based early childhood obesity prevention intervention is feasible, acceptable and demonstrates short-term effects on dietary and sedentary behaviors of low-income racially/ethnically diverse children.

  5. Promises of advanced technology realized at Martin

    SciTech Connect

    Swanekamp, R.

    1996-09-01

    The 2,488-MW Martin station is a gas/oil-fired facility that embodies today`s demand for flexible operations, technological advances, and reduced production costs. Martin station first rose up from the Everglades in the early 1980s, with the construction of two 814-MW oil-fired steam plants, Units 1 and 2. Natural-gas-firing capability was added to the balanced-draft, natural-circulation boilers in 1986, increasing the station`s fuel flexibility. Martin then leaped into the headlines in the early 1990s when it added combined-cycle (CC) Units 3 and 4. With this 860-MW expansion, FP and L boldly became the fleet leader for the advanced, 2350F-class 7FA gas turbines.more » Further pushing he technology envelope, the CC includes a three-pressure reheat steam system that raises net plant efficiency for Units 3 and 4 to 54%, on a lower-heating-value (LHV) basis. Incorporating the reheat cycle required significant redesign of the gas-turbine/heat-recovery steam generator (HRSG) train, in order to maintain a rapid startup capability without exceeding metallurgical limits. Perhaps even more important than the technological achievements, Martin stands out from the crowd for its people power, which ensured that the promises of advanced technology actually came to fruition. This station`s aggressive, empowered O and M team shows that you can pioneer technology, reduce operating costs, and deliver high availability--all at the same time.« less

  6. BioSense/SR-BioSpectra demonstrations of wide area/early warning for bioaerosol threats: program description and early test and evaluation results

    NASA Astrophysics Data System (ADS)

    Simard, Jean-Robert; Buteau, Sylvie; Lahaie, Pierre; Mathieu, Pierre; Roy, Gilles; Nadeau, Denis; McFee, John; Ho, Jim; Rowsell, Susan; Ho, Nicolas; Babin, François; Cantin, Daniel; Healey, Dave; Robinson, Jennifer; Wood, Scott; Hsu, Jack

    2011-11-01

    Threats associated with bioaerosol weapons have been around for several decades and have been mostly associated with terrorist activities or rogue nations. Up to the turn of the millennium, defence concepts against such menaces relied mainly on point or in-situ detection technologies. Over the last 10 years, significant efforts have been deployed by multiple countries to supplement the limited spatial coverage of a network of one or more point bio-detectors using lidar technology. The addition of such technology makes it possible to detect within seconds suspect aerosol clouds over area of several tens of square kilometers and track their trajectories. These additional capabilities are paramount in directing presumptive ID missions, mapping hazardous areas, establishing efficient counter-measures and supporting subsequent forensic investigations. In order to develop such capabilities, Defence Research and Development Canada (DRDC) and the Chemical, Biological, Radiological-Nuclear, and Explosives Research and Technology Initiative (CRTI) have supported two major demonstrations based on spectrally resolved Laser Induced Fluorescence (LIF) lidar: BioSense, aimed at defence military missions in wide open spaces, and SR-BioSpectra, aimed at surveillance of enclosed or semienclosed wide spaces common to defence and public security missions. This article first reviews briefly the modeling behind these demonstration concepts. Second, the lidar-adapted and the benchtop bioaerosol LIF chambers (BSL1), developed to challenge the constructed detection systems and to accelerate the population of the library of spectral LIF properties of bioaerosols and interferents of interest, will be described. Next, the most recent test and evaluation (T&E) results obtained with SR-BioSpectra and BioSense are reported. Finally, a brief discussion stating the way ahead for a complete defence suite is provided.

  7. Uncorrected Hyperopia and Preschool Early Literacy: Results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study.

    PubMed

    Kulp, Marjean Taylor; Ciner, Elise; Maguire, Maureen; Moore, Bruce; Pentimonti, Jill; Pistilli, Maxwell; Cyert, Lynn; Candy, T Rowan; Quinn, Graham; Ying, Gui-Shuang

    2016-04-01

    To compare early literacy of 4- and 5-year-old uncorrected hyperopic children with that of emmetropic children. Cross-sectional. Children attending preschool or kindergarten who had not previously worn refractive correction. Cycloplegic refraction was used to identify hyperopia (≥3.0 to ≤6.0 diopters [D] in most hyperopic meridian of at least 1 eye, astigmatism ≤1.5 D, anisometropia ≤1.0 D) or emmetropia (hyperopia ≤1.0 D; astigmatism, anisometropia, and myopia <1.0 D). Threshold visual acuity (VA) and cover testing ruled out amblyopia or strabismus. Accommodative response, binocular near VA, and near stereoacuity were measured. Trained examiners administered the Test of Preschool Early Literacy (TOPEL), composed of Print Knowledge, Definitional Vocabulary, and Phonological Awareness subtests. A total of 492 children (244 hyperopes and 248 emmetropes) participated (mean age, 58 months; mean ± standard deviation of the most hyperopic meridian, +3.78±0.81 D in hyperopes and +0.51±0.48 D in emmetropes). After adjustment for age, race/ethnicity, and parent/caregiver's education, the mean difference between hyperopes and emmetropes was -4.3 (P = 0.01) for TOPEL overall, -2.4 (P = 0.007) for Print Knowledge, -1.6 (P = 0.07) for Definitional Vocabulary, and -0.3 (P = 0.39) for Phonological Awareness. Greater deficits in TOPEL scores were observed in hyperopic children with ≥4.0 D than in emmetropes (-6.8, P = 0.01 for total score; -4.0, P = 0.003 for Print Knowledge). The largest deficits in TOPEL scores were observed in hyperopic children with binocular near VA of 20/40 or worse (-8.5, P = 0.002 for total score; -4.5, P = 0.001 for Print Knowledge; -3.1, P = 0.04 for Definitional Vocabulary) or near stereoacuity of 240 seconds of arc or worse (-8.6, P < 0.001 for total score; -5.3, P < 0.001 for Print Knowledge) compared with emmetropic children. Uncorrected hyperopia ≥4.0 D or hyperopia ≥3.0 to ≤6.0 D associated with reduced binocular near VA (20

  8. Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry.

    PubMed

    Vermeer, Marloes; Kievit, Wietske; Kuper, Hillechiena H; Braakman-Jansen, Louise M A; Bernelot Moens, Hein J; Zijlstra, Theo R; den Broeder, Alfons A; van Riel, Piet L C M; Fransen, Jaap; van de Laar, Mart A F J

    2013-12-13

    Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the cost-effectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA). We used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) < 2.6). The UC cohort was treated without DAS28-guided treatment decisions. EuroQol-5D utility scores were estimated from the Health Assessment Questionnaire. A health care perspective was adopted and direct medical costs were collected. The incremental cost effectiveness ratio (ICER) per patient in remission and incremental cost utility ratio (ICUR) per quality-adjusted life year (QALY) gained were calculated over two and three years of follow-up. Two year data were available for 261 T2T patients and 213 UC patients; an extended follow-up of three years was available for 127 and 180 patients, respectively. T2T produced higher remission percentages and a larger gain in QALYs than UC. The ICER was € 3,591 per patient in remission after two years and T2T was dominant after three years. The ICUR was € 19,410 per QALY after two years and T2T was dominant after three years. We can conclude that treating to the target of remission in early RA is cost-effective compared with UC. The data suggest that in the third year, T2T becomes cost-saving.

  9. Early predictors of lumbar spine surgery after occupational back injury: results from a prospective study of workers in Washington State.

    PubMed

    Keeney, Benjamin J; Fulton-Kehoe, Deborah; Turner, Judith A; Wickizer, Thomas M; Chan, Kwun Chuen Gary; Franklin, Gary M

    2013-05-15

    Prospective population-based cohort study. To identify early predictors of lumbar spine surgery within 3 years after occupational back injury. Back injuries are the most prevalent occupational injury in the United States. Few prospective studies have examined early predictors of spine surgery after work-related back injury. Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers, with new workers compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The area under the receiver operating characteristic curve of the model was used to determine the model's ability to identify correctly workers who underwent surgery. In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The area under the receiver operating characteristic curve of the multivariate model was 0.93 (95% confidence interval, 0.92-0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery. Baseline variables in multiple domains predicted lumbar spine

  10. LANDSAT-4 Science Characterization Early Results. Volume 4: Applications. [agriculture, soils land use, geology, hydrology, wetlands, water quality, biomass identification, and snow mapping

    NASA Technical Reports Server (NTRS)

    Barker, J. L. (Editor)

    1985-01-01

    The excellent quality of TM data allows researchers to proceed directly with applications analyses, without spending a significant amount of time applying various corrections to the data. The early results derived of TM data are discussed for the following applications: agriculture, land cover/land use, soils, geology, hydrology, wetlands biomass, water quality, and snow.

  11. Brief Report: HIV Drug Resistance in Adults Failing Early Antiretroviral Treatment: Results From the HIV Prevention Trials Network 052 Trial.

    PubMed

    Fogel, Jessica M; Hudelson, Sarah E; Ou, San-San; Hart, Stephen; Wallis, Carole; Morgado, Mariza G; Saravanan, Shanmugam; Tripathy, Srikanth; Hovind, Laura; Piwowar-Manning, Estelle; Sabin, Devin; McCauley, Marybeth; Gamble, Theresa; Zhang, Xinyi C; Eron, Joseph J; Gallant, Joel E; Kumwenda, Johnstone; Makhema, Joseph; Kumarasamy, Nagalingeswaran; Chariyalertsak, Suwat; Hakim, James; Badal-Faesen, Sharlaa; Akelo, Victor; Hosseinipour, Mina C; Santos, Breno R; Godbole, Sheela V; Pilotto, Jose H; Grinsztejn, Beatriz; Panchia, Ravindre; Mayer, Kenneth H; Chen, Ying Q; Cohen, Myron S; Eshleman, Susan H

    2016-07-01

    Early initiation of antiretroviral treatment (ART) reduces HIV transmission and has health benefits. HIV drug resistance can limit treatment options and compromise use of ART for HIV prevention. We evaluated drug resistance in 85 participants in the HIV Prevention Trials Network 052 trial who started ART at CD4 counts of 350-550 cells per cubic millimeter and failed ART by May 2011; 8.2% had baseline resistance and 35.3% had resistance at ART failure. High baseline viral load and less education were associated with emergence of resistance at ART failure. Resistance at ART failure was observed in 7 of 8 (87.5%) participants who started ART at lower CD4 cell counts.

  12. Riftogenic magmatism of western part of the Early Mesozoic Mongolian-Transbaikalian igneous province: Results of geochronological studies

    NASA Astrophysics Data System (ADS)

    Yarmolyuk, V. V.; Kozlovsky, A. M.; Salnikova, E. B.; Travin, A. V.; Kudryashova, E. A.

    2017-08-01

    Geochronological studies of rocks from a bimodal high-alkali volcanic-plutonic complex collected in the area of Kharkhorin zone of the Early Mesozoic Mongolian-Transbaikalian igneous province (MTIP) are made. The age of alkali granites from Olziit sum is 211 ± 1 Ma (U-Pb ID-TIMS on zircon) to 209 ± 2 and 217 ± 4 Ma (40Ar/39Ar on alkali amphibole); the age of alkali granite-porphyries from the area of Sant sum is 206 ± 1 Ma (U-Pb ID-TIMS on zircon). These rock series formed syncronously to the analogous magmatism episode in the Northern Gobi and Western Transbaikalian rift zones of the MTIP. The similarity of the age and composition of igneous associations of the MTIP suggests a common mechanism of its formation related to the effect of a mantle plume on the continental lithosphere at the base of the entire igneous zone having a zonal structure.

  13. Documenting the conversion from traditional to Studio Physics formats at the Colorado School of Mines: Process and early results

    NASA Astrophysics Data System (ADS)

    Kohl, Patrick B.; Kuo, H. Vincent; Ruskell, Todd G.

    2008-10-01

    The Colorado School of Mines (CSM) has taught its first-semester introductory physics course using a hybrid lecture/Studio Physics format for several years. Over the past year we have converted the second semester of our calculus-based introductory physics course (Physics II) to a Studio Physics format, starting from a traditional lecture-based format. In this paper, we document the early stages of this conversion in order to better understand which features succeed and which do not, and in order to develop a model for switching to Studio that keeps the time and resource investment manageable. We describe the recent history of the Physics II course and of Studio at Mines, discuss the PER-based improvements that we are implementing, and characterize our progress via several metrics, including pre/post Conceptual Survey of Electricity and Magnetism (CSEM) scores, Colorado Learning About Science Survey scores (CLASS), solicited student comments, failure rates, and exam scores.

  14. A late eocene-early Oligocene transgressive event in the Golfo San Jorge basin: Palynological results and stratigraphic implications

    NASA Astrophysics Data System (ADS)

    Paredes, José M.; Foix, Nicolás; Guerstein, G. Raquel; Guler, María V.; Irigoyen, Martín; Moscoso, Pablo; Giordano, Sergio

    2015-11-01

    A new Cenozoic dataset in the subsurface of the South Flank of the Golfo San Jorge Basin (Santa Cruz province) allowed to identify a non-previously recognized transgressive event of late Eocene to early Oligocene age. Below of a marine succession containing a dinoflagellate cyst assemblage that characterizes the C/G palynological zone of the Chenque Formation (early Miocene), a 80-110 m thick marine succession contains a palynological assemblage integrated by Gelatia inflata, Diphyes colligerum and Reticulatosphaera actinocoronata supporting the occurrence of a marine incursion in the basin during the Eocene-Oligocene transition (EOT). The new lithostratigraphic unit - here defined as El Huemul Formation - covers in sharp contact to the Sarmiento Formation, and become thinner from East to West; the unit has been identified in about 1800 well logs covering up to 3500 km2, and its subsurface distribution exceed the boundaries of the study area. The El Huemul Formation consists of a thin lag of glauconitic sandstones with fining-upward log motif, followed by a mudstone-dominated succession that coarsening-upward to sandstones, evidencing a full T-R cycle. Preservation of the El Huemul Formation in the subsurface of the South Flank has been favored by the reactivation of WNW-ESE late Cretaceous normal faults, and by the generation of N-S striking normal faults of Paleocene-Eocene age. Flexural loading associated to igneous intrusions of Paleocene?- middle Eocene age also promoted the increase of subsidence in the South Flank of the basin prior to the transgression.

  15. Clinical and MRI responses to etanercept in early non-radiographic axial spondyloarthritis: 48-week results from the EMBARK study.

    PubMed

    Maksymowych, Walter P; Dougados, Maxime; van der Heijde, Désirée; Sieper, Joachim; Braun, Jürgen; Citera, Gustavo; Van den Bosch, Filip; Logeart, Isabelle; Wajdula, Joseph; Jones, Heather; Marshall, Lisa; Bonin, Randi; Pedersen, Ron; Vlahos, Bonnie; Kotak, Sameer; Bukowski, Jack F

    2016-07-01

    To evaluate the efficacy and safety of etanercept (ETN) after 48 weeks in patients with early active non-radiographic axial spondyloarthritis (nr-axSpA). Patients meeting Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA, but not modified New York radiographic criteria, received double-blind ETN 50 mg/week or placebo (PBO) for 12 weeks, then open-label ETN (ETN/ETN or PBO/ETN). Clinical, health, productivity, MRI and safety outcomes were assessed and the 48-week data are presented here. 208/225 patients (92%) entered the open-label phase at week 12 (ETN, n=102; PBO, n=106). The percentage of patients achieving ASAS40 increased from 33% to 52% between weeks 12 and 48 for ETN/ETN and from 15% to 53% for PBO/ETN (within-group p value <0.001 for both). For ETN/ETN and PBO/ETN, the EuroQol 5 Dimensions utility score improved by 0.14 and 0.08, respectively, between baseline and week 12 and by 0.23 and 0.22 between baseline and week 48. Between weeks 12 and 48, MRI Spondyloarthritis Research Consortium of Canada sacroiliac joint (SIJ) scores decreased by -1.1 for ETN/ETN and by -3.0 for PBO/ETN, p<0.001 for both. Decreases in MRI SIJ inflammation and C-reactive protein correlated with several clinical outcomes at weeks 12 and 48. Patients with early active nr-axSpA demonstrated improvement from week 12 in clinical, health, productivity and MRI outcomes that was sustained to 48 weeks. NCT01258738. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Natural history of allergic sensitization in infants with early-onset atopic dermatitis: results from ORCA Study.

    PubMed

    Just, Jocelyne; Deslandes-Boutmy, Emmanuelle; Amat, Flore; Desseaux, Kristell; Nemni, Ariane; Bourrat, Emmanuelle; Sahraoui, Fatia; Pansé, Isabelle; Bagot, Martine; Fouéré, Sébastien

    2014-11-01

    Early-onset atopic dermatitis (AD) is a particular phenotype that may convey a risk of developing multiple sensitizations to allergens but little is known about the pathway of sensitization. The aims of this study were to describe the natural history of sensitization to allergens for this phenotype and to identify the most predictive marker associated with the risk of developing sensitization to inhaled allergens in a well-selected cohort of infants with AD. Infants with active AD were enrolled and prospectively explored for biological markers of atopy every year until the age of 6 yr. Allergic sensitization was defined as the presence of positive specific IgEs to allergens and multiple sensitizations as being sensitized to ≥2 allergens. Elevated blood eosinophilia was defined as an eosinophil blood count ≥470 eosinophils/mm(3) and elevated total IgE as a serum IgE level ≥45 kU/l. Two hundred and twenty-nine infants were included. Elevated blood eosinophilia was observed at baseline in 60 children (26.2%) and elevated total IgE in 85 (37.1%). When elevated at baseline, eosinophilia and IgE levels remained significantly higher during the follow-up period. Sensitization to food allergens decreased from 58% to 34%, whereas sensitization to inhaled allergens increased over time from 17% to 67%. Initial multiple sensitizations to food allergens were the most predictive factor for the risk of developing sensitization to inhaled allergens at 6 yr (OR 3.72 [1.68-8.30] p < 0.001). In the early-onset AD phenotype, multiple sensitization to food allergens conveys a higher risk of sensitization to inhaled allergens than single sensitization. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. An early oral health care program starting during pregnancy: results of a prospective clinical long-term study.

    PubMed

    Meyer, Karen; Geurtsen, Werner; Günay, Hüsamettin

    2010-06-01

    This study covers phase IV of a prospective clinical long-term study. Objective of this clinical investigation was to analyze the effects of a long-term prevention program on dental and oral health of teenagers at the age of 13 to 14 years. The entire study was subdivided into four phases. Phase I comprised an individual preventive care during pregnancy ("primary-primary prevention"); phase II assessed mothers and their young children until the age of 3 years ("primary prevention"); and in phase III, mothers and children at the age of 6 years were investigated. In phase IV of the study, the oral health of 13- to 14-year-old teenagers was examined (13.4 +/- 0.5 years; n = 29). All phases consisted of an examination, education about oral health care, and treatment based on the concept of an early oral health care promotion. The control group consisted of randomly selected adolescents at the same age (n = 30). The following clinical parameters were assessed: decayed/missing/filled teeth (DMF-T)/decayed, missing, and filled surface teeth index, hygiene index, papilla bleeding index, Periodontal Screening Index, and Streptococcus mutans/Lactobacillus concentration in saliva. The teenagers of the "prevention" group of phase IV of our prospective study revealed a share of 89.7% caries-free dentitions (65.5% sound; 24.2% caries-free with fillings). Mean DMF-T was 0.55 +/- 1.0. The control group showed a significantly higher mean DMF-T of 1.5 +/- 1.5 (p < 0.05) and revealed 56.7% of caries-free dentitions (30% sound, 26.7% caries-free with restorations). Our data clearly document that an early oral health care promotion starting during pregnancy may cause a sustained and long-term improvement of the oral health of children.

  18. Behavior problems in adolescence and subsequent mental health in early adulthood: results from the World Trade Center Health Registry Cohort.

    PubMed

    Gargano, Lisa M; Locke, Sean; Li, Jiehui; Farfel, Mark R

    2018-06-15

    The present study examined the association between 9/11-related adolescent behavioral problems on mental health outcomes in early adulthood. Data from enrollees of the World Trade Center Health Registry, who completed at least one adolescent (2006-2007 or 2011-2012) and adult survey (2011-2012 or 2015-2016), were analyzed. Adolescent behavioral difficulties were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Adult mental health outcomes included binge drinking, smoking status history, 9/11-related post-traumatic stress disorder (PTSD), depression, and the self-reported number of physician mental health diagnoses. Multivariable regression was used to estimate associations of SDQ scores with mental health outcomes. Of the 297 enrollees, 16.8% (n = 50) had abnormal/borderline SDQ scores as an adolescent. Binge drinking was not associated with adolescent SDQ scores. Enrollees with abnormal/borderline SDQ scores as an adolescent were more likely to be a consistent smoker (odds ratio (OR): 5.6, 95% confidence interval (CI): 1.2-25.2), have probable PTSD (OR: 3.5, 95% CI: 1.3-9.8), depression (OR: 6.2, 95% CI: 2.7-13.9), and to have two or more self-reported physician-diagnosed mental health conditions as an adult (OR 5.6, 95% CI: 2.0-12.5). The findings of this study underscore the need to intervene early with children exposed to traumatic events so as to avert later adolescent and adult problem behaviors.

  19. A population-based screening program for early detection of common cancers among women in India - methodology and interim results.

    PubMed

    Mishra, G A; Dhivar, H D; Gupta, S D; Kulkarni, S V; Shastri, S S

    2015-01-01

    Cancers of the uterine cervix, breast, and oral cavity accounted for 134,420, 115,251, and 24,375 cases, respectively, and were responsible for 52.8% of the total cancers among women in India in 2008. The major objectives were to create awareness regarding common cancers among women, to detect pre-cancers of the uterine cervix and oral cavity, and early cancers of the breast, uterine cervix, and oral cavity, by conducting screening with simple, low-cost technology, within the community, and to facilitate confirmation of diagnosis among the screen positives and treatment and follow-up among the diagnosed cases. This is a community-based screening program for early detection of breast, uterine cervix, and oral cancers, being implemented among the socioeconomically disadvantaged women in Mumbai, India. The process involves selection of clusters, household surveys, health education, and screening the eligible women for breast, uterine cervix, and oral cancers, by primary healthcare workers, at a temporarily set-up clinic within the community. The program is planned to cover a 125,000 disadvantaged population in five years. Twenty-one thousand and fifteen people, with 4009 eligible women, have been covered to date. The compliance for screening for breast, cervix, and oral cavity has been 85, 70, and 88% and the screen positivity rates are 3.9, 14.9, and 3.9%, respectively. Twenty-seven oral pre-cancers, 25 cervix pre-cancers, one invasive cancer of the breast, two of the cervix, and one oral cavity cancer have been diagnosed among the screened women and all of them have complied with the treatment. The program is raising awareness about the common cancers and harms of tobacco among the disadvantaged women population in Mumbai. It is also helping in detecting pre-cancers and cancers among asymptomatic women and is assisting them in receiving treatment.

  20. Results of a prospective trial of mantle irradiation alone for selected patients with early-stage Hodgkin's disease.

    PubMed

    Backstrand, K H; Ng, A K; Takvorian, R W; Jones, E L; Fisher, D C; Molnar-Griffin, B J; Silver, B; Tarbell, N J; Mauch, P M

    2001-02-01

    To determine the efficacy of mantle radiation therapy alone in selected patients with early-stage Hodgkin's disease. Between October 1988 and June 2000, 87 selected patients with pathologic stage (PS) IA to IIA or clinical stage (CS) IA Hodgkin's disease were entered onto a single-arm prospective trial of treatment with mantle irradiation alone. Eighty-three of 87 patients had > or = 1 year of follow-up after completion of mantle irradiation and were included for analysis in this study. Thirty-seven patients had PS IA, 40 had PS IIA, and six had CS IA disease. Histologic distribution was as follows: nodular sclerosis (n = 64), lymphocyte predominant (n = 15), mixed cellularity (n = 3), and unclassified (n = 1). Median follow-up time was 61 months. The 5-year actuarial rates of freedom from treatment failure (FFTF) and overall survival were 86% and 100%, respectively. Eleven of 83 patients relapsed at a median time of 27 months. Nine of the 11 relapses contained at least a component below the diaphragm. All 11 patients who developed recurrent disease were alive without evidence of Hodgkin's disease at the time of last follow-up. The 5-year FFTF in the 43 stage I patients was 92% compared with 78% in the 40 stage II patients (P =.04). Significant differences in FFTF were not seen by histology (P =.26) or by European Organization for Research and Treatment of Cancer H-5F eligibility (P =.25). Mantle irradiation alone in selected patients with early-stage Hodgkin's disease is associated with disease control rates comparable to those seen with extended field irradiation. The FFTF is especially favorable among stage I patients.

  1. Percutaneous device closure of atrial septal defect results in very early and sustained changes of right and left heart function.

    PubMed

    Monfredi, Oliver; Luckie, Matthew; Mirjafari, Hoda; Willard, Terence; Buckley, Helen; Griffiths, Linda; Clarke, Bernard; Mahadevan, Vaikom S

    2013-08-20

    To investigate the echocardiographic effects of percutaneous closure of secundum atrial septal defect (ASD) in adults and assess which pre-closure parameters predict good response to closure. ASD is a common congenital heart disease often undiscovered until adulthood. ASD closure has been revolutionized by the use of percutaneous devices. The effects of these procedures on echocardiographic parameters are not well characterized. Patients undergoing percutaneous device closure of ASD between June 2007 and June 2009 had 3 sequential echocardiograms reviewed: pre-procedure, immediate post-procedure (24 hours) and 6-8 weeks post-procedure. Significant changes from baseline were investigated using paired t-test/1-way ANOVA. Pearson correlation (2-tailed) tests were used to categorize patients as 'good responders' to closure in terms of selected parameters. 129 echocardiograms in 43 consecutive patients were included. Remodeling of both ventricles occurred immediately following ASD closure and was sustained. Right ventricular (RV) diameter in diastole decreased by 13.5% and 19.3% compared to baseline at 24 hours and 6-8 weeks post-closure, respectively (p<0.05); Left ventricular (LV) diameter in diastole increased by 8.5% and 15.6%, respectively (p<0.05). Functional parameters of the RV also demonstrated early and sustained decreases (TAPSE decreased by 8.3% and 17% compared to baseline at 24 hours and 6-8 weeks post-closure, respectively (p<0.05)). Smaller RV baseline diameter appeared to predict good response to closure. Percutaneous ASD closure has immediate, sustained benefits on multiple echocardiographic parameters. Good responders have smaller RV at baseline, suggesting early closure is preferable. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. A Promising Development: "Promise" Scholarships Targeting Individual Communities Reduce Barriers to College Access--and Completion

    ERIC Educational Resources Information Center

    Pierce, Dennis

    2015-01-01

    This article discusses Promise Scholarships in community colleges and sources of funding. The following community colleges and their scholarships are mentioned in this article: (1) Oregon Promise, Oregon; (2) Ventura College Promise, California; (3) Kalamazoo Promise, Michigan; (4) Pittsburgh Promise, Pennsylvania; (5) SEED Scholarship, Delaware;…

  3. Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications.

    PubMed

    Riboh, Jonathan C; Saltzman, Bryan M; Yanke, Adam B; Cole, Brian J

    2016-09-01

    Amniotic membrane (AM)-derived products have been successfully used in ophthalmology, plastic surgery, and wound care, but little is known about their potential applications in orthopaedic sports medicine. To provide an updated review of the basic science and preclinical and clinical data supporting the use of AM-derived products and to review their current applications in sports medicine. Systematic review. A systematic search of the literature was conducted using the Medline, EMBASE, and Cochrane databases. The search term amniotic membrane was used alone and in conjunction with stem cell, orthopaedic, tissue engineering, scaffold, and sports medicine. The search identified 6870 articles, 80 of which, after screening of the titles and abstracts, were considered relevant to this study. Fifty-five articles described the anatomy, basic science, and nonorthopaedic applications of AM-derived products. Twenty-five articles described preclinical and clinical trials of AM-derived products for orthopaedic sports medicine. Because the level of evidence obtained from this search was not adequate for systematic review or meta-analysis, a current concepts review on the anatomy, physiology, and clinical uses of AM-derived products is presented. Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint. The current body of evidence in sports medicine is heavily biased toward in vitro and animal studies, with little to no human clinical data. Nonetheless, 14 companies or distributors offer commercial AM products. The preparation and formulation of these products alter their biological and mechanical properties, and a thorough understanding of these

  4. Cannabidiol: a promising drug for neurodegenerative disorders?

    PubMed

    Iuvone, Teresa; Esposito, Giuseppe; De Filippis, Daniele; Scuderi, Caterina; Steardo, Luca

    2009-01-01

    Neurodegenerative diseases represent, nowadays, one of the main causes of death in the industrialized country. They are characterized by a loss of neurons in particular regions of the nervous system. It is believed that this nerve cell loss underlies the subsequent decline in cognitive and motor function that patients experience in these diseases. A range of mutant genes and environmental toxins have been implicated in the cause of neurodegenerative disorders but the mechanism remains largely unknown. At present, inflammation, a common denominator among the diverse list of neurodegenerative diseases, has been implicated as a critical mechanism that is responsible for the progressive nature of neurodegeneration. Since, at present, there are few therapies for the wide range of neurodegenerative diseases, scientists are still in search of new therapeutic approaches to the problem. An early contribution of neuroprotective and antiinflammatory strategies for these disorders seems particularly desirable because isolated treatments cannot be effective. In this contest, marijuana derivatives have attracted special interest, although these compounds have always raised several practical and ethical problems for their potential abuse. Nevertheless, among Cannabis compounds, cannabidiol (CBD), which lacks any unwanted psychotropic effect, may represent a very promising agent with the highest prospect for therapeutic use.

  5. Early life exposure to environmental tobacco smoke alters immune response to asbestos via a shift in inflammatory phenotype resulting in increased disease development

    PubMed Central

    Brown, Traci A.; Holian, Andrij; Pinkerton, Kent E.; Lee, Joong Won; Cho, Yoon Hee

    2016-01-01

    Asbestos in combination with tobacco smoke exposure reportedly leads to more severe physiological consequences than asbestos alone; limited data also show an increased disease risk due to environmental tobacco smoke (ETS) exposure. Environmental influences during gestation and early lung development can result in physiological changes that alter risk for disease development throughout an individual’s lifetime. Therefore, maternal lifestyle may impact the ability of offspring to subsequently respond to environmental insults and alter overall disease susceptibility. In this study, we examined the effects of exposure to ETS in utero and during early postnatal development on asbestos-related inflammation and disease in adulthood. ETS exposure in utero appeared to shift inflammation towards a Th2 phenotype, via suppression of Th1 inflammatory cytokine production. This effect was further pronounced in mice exposed to ETS in utero and during early postnatal development. In utero ETS exposure led to increased collagen deposition, a marker of fibrotic disease, when the offspring was later exposed to asbestos, which was further increased with additional ETS exposure during early postnatal development. These data suggest that ETS exposure in utero alters the immune responses and leads to greater disease development after asbestos exposure, which is further exacerbated when exposure to ETS continues during early postnatal development. PMID:27138493

  6. Early life exposure to environmental tobacco smoke alters immune response to asbestos via a shift in inflammatory phenotype resulting in increased disease development.

    PubMed

    Brown, Traci Ann; Holian, Andrij; Pinkerton, Kent E; Lee, Joong Won; Cho, Yoon Hee

    2016-07-01

    Asbestos in combination with tobacco smoke exposure reportedly leads to more severe physiological consequences than asbestos alone; limited data also show an increased disease risk due to environmental tobacco smoke (ETS) exposure. Environmental influences during gestation and early lung development can result in physiological changes that alter risk for disease development throughout an individual's lifetime. Therefore, maternal lifestyle may impact the ability of offspring to subsequently respond to environmental insults and alter overall disease susceptibility. In this study, we examined the effects of exposure to ETS in utero and during early postnatal development on asbestos-related inflammation and disease in adulthood. ETS exposure in utero appeared to shift inflammation towards a Th2 phenotype, via suppression of Th1 inflammatory cytokine production. This effect was further pronounced in mice exposed to ETS in utero and during early postnatal development. In utero ETS exposure led to increased collagen deposition, a marker of fibrotic disease, when the offspring was later exposed to asbestos, which was further increased with additional ETS exposure during early postnatal development. These data suggest that ETS exposure in utero alters the immune responses and leads to greater disease development after asbestos exposure, which is further exacerbated when exposure to ETS continues during early postnatal development.

  7. Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

    PubMed Central

    Bui, Quyen Thi-Tu; Lee, Hwa-Young; Le, Anh Thi-Kim; Van Dung, Do; Vu, Lan Thi-Hoang

    2016-01-01

    Background There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. Objective This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Design Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes – early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Results Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02–1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88–1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02–1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Conclusions Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF

  8. Quantifying Neonatal Sucking Performance: Promise of New Methods

    PubMed Central

    Capilouto, Gilson J.; Cunningham, Tommy J.; Mullineaux, David R.; Tamilia, Eleonora; Papadelis, Christos; Giannone, Peter J.

    2017-01-01

    Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neonatal sucking performance that hold significant clinical and research promise. We present early results from an ongoing study investigating neonatal sucking as a marker of risk for adverse neurodevelopmental outcomes. We include quantitative measures of sucking performance to better understand how movement variability evolves during skill acquisition. Results showed the coefficient of variation of suck duration was significantly different between preterm neonates at high risk for developmental concerns (HRPT) and preterm neonates at low risk for developmental concerns (LRPT). For HRPT, results indicated the coefficient of variation of suck smoothness increased from initial feeding to discharge and remained significantly greater than healthy full-term newborns (FT) at discharge. There was no significant difference in our measures between FT and LRPT at discharge. Our findings highlight the need to include neonatal sucking assessment as part of routine clinical care in order to capture the relative risk of adverse neurodevelopmental outcomes at discharge. PMID:28324904

  9. Quantifying Neonatal Sucking Performance: Promise of New Methods.

    PubMed

    Capilouto, Gilson J; Cunningham, Tommy J; Mullineaux, David R; Tamilia, Eleonora; Papadelis, Christos; Giannone, Peter J

    2017-04-01

    Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neonatal sucking performance that hold significant clinical and research promise. We present early results from an ongoing study investigating neonatal sucking as a marker of risk for adverse neurodevelopmental outcomes. We include quantitative measures of sucking performance to better understand how movement variability evolves during skill acquisition. Results showed the coefficient of variation of suck duration was significantly different between preterm neonates at high risk for developmental concerns (HRPT) and preterm neonates at low risk for developmental concerns (LRPT). For HRPT, results indicated the coefficient of variation of suck smoothness increased from initial feeding to discharge and remained significantly greater than healthy full-term newborns (FT) at discharge. There was no significant difference in our measures between FT and LRPT at discharge. Our findings highlight the need to include neonatal sucking assessment as part of routine clinical care in order to capture the relative risk of adverse neurodevelopmental outcomes at discharge. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Long-term follow-up results of stepwise radical endoscopic resection for Barrett's esophagus with early neoplasia.

    PubMed

    Belghazi, Kamar; van Vilsteren, Frederike G I; Weusten, Bas L A M; Meijer, Sybren L; Bergman, Jacques J G H M; Pouw, Roos E

    2018-01-01

    Stepwise radical endoscopic resection (SRER) has shown to be effective in eradicating Barrett's esophagus (BE) and its associated dysplasia. The aim of this study was to assess the long-term durability after successful SRER for early Barrett's neoplasia. Patients treated with SRER for BE ≤5 cm with high-grade dysplasia (HGD) or early cancer (EC) and who had reached complete eradication of intestinal metaplasia (CE-IM) and neoplasia (CE-neo) were included. Primary outcomes were recurrence of neoplasia (HGD/EC), recurrence of dysplasia (indefinite for dysplasia included), and recurrence of endoscopically visible BE. Secondary outcomes were buried Barrett's glands, IM in biopsy specimens obtained distal to a normal-appearing neo-squamocolumnar junction (neo-SCJ), need for retreatment, and sustained CE-IM and CE-neo at the last follow-up endoscopy. Seventy-three patients were included (64 men; mean age, 66 years; median BE, C2M3). Median follow-up was 76 months. Recurrence of neoplasia was observed in 1 patient (T1bN0M0) after 129 months of follow-up and was treated with curative surgery (annual incidence of .22% per patient-year of follow-up). In 4 patients, recurrence of dysplasia was found (.87% per patient-year of follow-up). Twelve patients had recurrent endoscopically visible BE after a median follow-up of 22 months (2.6% per patient-year of follow-up), mostly small islands or tongues. Five patients had a single finding of buried Barrett's glands (1.1% per patient-year of follow-up), and 27 patients (5.9% per patient-year of follow-up) showed IM in biopsy specimens just distal to the neo-SCJ, which was not reproduced in 56%. Retreatment was performed in 9 patients. CE-IM and CE-neo (excluding IM in the neo-SCJ) at the last follow-up endoscopy was seen in 95% and 97% of patients, respectively. This study presents the longest published follow-up data on SRER to date. The 6-year outcomes show that successful SRER is a durable treatment for BE ≤5 cm with HGD

  11. Attraction, recruitment and distribution of health professionals in rural and remote Australia: early results of the Rural Health Professionals Program.

    PubMed

    Morell, Anna L; Kiem, Sandra; Millsteed, Melanie A; Pollice, Almerinda

    2014-03-06

    Australians living in rural and remote communities experience relatively poor health status in comparison to the wider Australian population (Med J Aust 185:37-38, 2006). This can be attributed in part to issues of access to health services arising from difficulties in recruiting and retaining health professionals in these areas. The Rural Health Professionals Program is an initiative designed to increase the number of allied health and nursing professionals in rural and remote Australia by providing case managed recruitment and retention support services. This paper reports on early analysis of available programme data to build knowledge of factors related to the recruitment and distribution of health professionals in rural and remote Australia. Administrative programme data were collected monthly from 349 health professionals over the first 13 months of programme operation. These data were collated and quantitative analysis was conducted using SPSS software. Sixty-nine percent of recruits were women, and recruits had a mean age of 32.85 (SD = 10.92). Sixty percent of recruits were domestically trained, and the top two professions recruited were nurses (29%) and physiotherapists (21%). Eighty-seven percent were recruited to regional areas, with the remaining 13% recruited to remote areas. Among reasons for interest in the programme, financial support factors were most commonly cited by recruits (51%). Recruitment to a remote location was associated with being domestically trained, having previously lived in a rural or remote location, being a nurse (as opposed to an allied health professional) and older age. The findings provide early support for a case managed recruitment programme to improve distribution of health professionals, and some directions for future marketing and promotion of the programme. It is recommended that an outcome evaluation be conducted to determine the impact of the programme on recruitment and distribution outcomes. The findings herein

  12. The role of early magnetic resonance imaging in predicting survival on bevacizumab for recurrent glioblastoma: Results from a prospective clinical trial (CABARET).

    PubMed

    Field, Kathryn M; Phal, Pramit M; Fitt, Greg; Goh, Christine; Nowak, Anna K; Rosenthal, Mark A; Simes, John; Barnes, Elizabeth H; Sawkins, Kate; Cher, Lawrence M; Hovey, Elizabeth J; Wheeler, Helen

    2017-09-15

    Bevacizumab has been associated with prolonged progression-free survival for patients with recurrent glioblastoma; however, not all derive a benefit. An early indicator of efficacy or futility may allow early discontinuation for nonresponders. This study prospectively assessed the role of early magnetic resonance imaging (eMRI) and its correlation with subsequent routine magnetic resonance imaging (MRI) results and survival. Patients were part of a randomized phase 2 clinical trial (CABARET) comparing bevacizumab with bevacizumab plus carboplatin for recurrent glioblastoma. eMRI was conducted after 4 weeks in the trial (after 2 treatments with bevacizumab [10 mg/kg every 2 weeks]). The results were compared with the results of the subsequent 8-week MRI standard. For 119 of 122 patients, eMRI was available, and 111 had subsequent MRI for comparison. Thirty-six (30%) had an early radiological response, and 17 (14%) had progressive disease. The concordance between eMRI and 8-week MRI was moderate (κ = 0.56), with most providing the same result (n = 79 [71%]). There was strong evidence that progression-free survival and overall survival were predicted by the eMRI response (both P values < .001). The median survival was 8.6 months for an eMRI response, 6.6 months for stable disease, and 3.7 months for progressive disease; the hazard ratio (progressive disease vs stable disease) was 3.4 (95% confidence interval, 1.9-6.0). Landmark analyses showed that eMRI progression was a strong predictor of mortality independent of other potential baseline predictors. In this study, early progression on MRI appears to be a robust marker of a poor prognosis for patients on bevacizumab. Cancer 2017;123:3576-82. © 2017 American Cancer Society. © 2017 American Cancer Society.

  13. HIV pre-exposure prophylaxis and early antiretroviral treatment among female sex workers in South Africa: Results from a prospective observational demonstration project

    PubMed Central

    Naicker, Niven; Bothma, Rutendo; Mbogua, Judie; Cabrera Escobar, Maria A.; Moorhouse, Michelle; Venter, W. D. Francois

    2017-01-01

    in both study groups. There were no seroconversions on PrEP and 7 virological failures on early ART among women remaining in the study. Reported adherence to PrEP varied over time between 70% and 85%, whereas over 90% of participants reported taking pills daily while on early ART. Data on provider-side costs were also collected and analysed. The total cost of service delivery was approximately US$126 for PrEP and US$406 for early ART per person-year. The main limitations of this study include the lack of a control group, which was not included due to ethical considerations; clinical study requirements imposed when PrEP was not approved through the regulatory system, which could have affected uptake; and the timing of the implementation of a national sex worker HIV programme, which could have also affected uptake and retention. Conclusions PrEP and early ART services can be implemented within FSW routine services in high prevalence, urban settings. We observed good uptake for both PrEP and early ART; however, retention rates for PrEP were low. Retention rates for early ART were similar to retention rates for the current standard of care. While the cost of the interventions was higher than previously published, there is potential for cost reduction at scale. The TAPS Demonstration Project results provided the basis for the first government PrEP and early ART guidelines and the rollout of the national sex worker HIV programme in South Africa. PMID:29161256

  14. HIV pre-exposure prophylaxis and early antiretroviral treatment among female sex workers in South Africa: Results from a prospective observational demonstration project.

    PubMed

    Eakle, Robyn; Gomez, Gabriela B; Naicker, Niven; Bothma, Rutendo; Mbogua, Judie; Cabrera Escobar, Maria A; Saayman, Elaine; Moorhouse, Michelle; Venter, W D Francois; Rees, Helen

    2017-11-01

    were no seroconversions on PrEP and 7 virological failures on early ART among women remaining in the study. Reported adherence to PrEP varied over time between 70% and 85%, whereas over 90% of participants reported taking pills daily while on early ART. Data on provider-side costs were also collected and analysed. The total cost of service delivery was approximately US$126 for PrEP and US$406 for early ART per person-year. The main limitations of this study include the lack of a control group, which was not included due to ethical considerations; clinical study requirements imposed when PrEP was not approved through the regulatory system, which could have affected uptake; and the timing of the implementation of a national sex worker HIV programme, which could have also affected uptake and retention. PrEP and early ART services can be implemented within FSW routine services in high prevalence, urban settings. We observed good uptake for both PrEP and early ART; however, retention rates for PrEP were low. Retention rates for early ART were similar to retention rates for the current standard of care. While the cost of the interventions was higher than previously published, there is potential for cost reduction at scale. The TAPS Demonstration Project results provided the basis for the first government PrEP and early ART guidelines and the rollout of the national sex worker HIV programme in South Africa.

  15. Does a minimally invasive approach affect positioning of components in unicompartmental knee arthroplasty? Early results with survivorship analysis.

    PubMed

    Cool, Steve; Victor, Jan; De Baets, Thierry

    2006-12-01

    Fifty unicompartmental knee arthroplasties (UKAs) were performed through a minimally invasive approach and were reviewed with an average follow-up of 3.7 years. This technique leads to reduced access to surgical landmarks. The purpose of this study was to evaluate whether correct component positioning is possible through this less invasive approach. Component positioning, femorotibial alignment and early outcomes were evaluated. We observed perfect tibial component position, but femoral component position was less consistent, especially in the sagittal plane. Femorotibial alignment in the coronal plane was within 2.5 degrees of the desired axis for 80% of the cases. Femoral component position in the sagittal plane was within a 10 degrees range of the ideal for 70% of the cases. The mean IKS Knee Function Score and Knee Score were 89/100 and 91/100 respectively. We observed two polyethylene dislocations, and one revision was performed for progressive patellofemoral arthrosis. According to our data, minimally invasive UKA does not conflict with component positioning although a learning curve needs to be respected, with femoral component positioning as the major obstacle.

  16. Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study.

    PubMed

    Sadra, Saba; Fleischer, Adam; Klein, Erin; Grewal, Gurtej S; Knight, Jessica; Weil, Lowell Scott; Weil, Lowell; Najafi, Bijan

    2013-01-01

    Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance. Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors. Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049). This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted.

  17. Early Rivaroxaban Use After Cardioembolic Stroke May Not Result in Hemorrhagic Transformation: A Prospective Magnetic Resonance Imaging Study.

    PubMed

    Gioia, Laura C; Kate, Mahesh; Sivakumar, Leka; Hussain, Dulara; Kalashyan, Hayrapet; Buck, Brian; Bussiere, Miguel; Jeerakathil, Thomas; Shuaib, Ashfaq; Emery, Derek; Butcher, Ken

    2016-07-01

    Early anticoagulation after cardioembolic stroke remains controversial because of the potential for hemorrhagic transformation (HT). We tested the safety and feasibility of initiating rivaroxaban ≤14 days after cardioembolic stroke/transient ischemic attack. A prospective, open-label study of patients with atrial fibrillation treated with rivaroxaban ≤14 days of transient ischemic attack or ischemic stroke (National Institute of Health Stroke Scale <9). All patients underwent magnetic resonance imaging <24 hours of rivaroxaban initiation and day 7. The primary end point was symptomatic HT at day 7. Sixty patients (mean±SD age 71±19 years, 82% stroke/18% transient ischemic attack) were enrolled. Median (interquartile range) time from onset to rivaroxaban was 3 (5) days. At treatment initiation, median National Institute of Health Stroke Scale was 2 (4), and median diffusion-weighted imaging volume was 7.9 (13.7) mL. At baseline, HT was present in 25 (42%) patients (hemorrhagic infarct [HI]1=19, HI2=6). On follow-up magnetic resonance imaging, no patients developed symptomatic HT. New asymptomatic HI1 developed in 3 patients, and asymptomatic progression from HI1 to HI2 occurred in 5 patients; otherwise, HT remained unchanged at day 7. These data support the safety of rivaroxaban initiation ≤14 days of mild-moderate cardioembolic stroke/transient ischemic attack. Magnetic resonance imaging evidence of petechial HT, which is common, does not appear to increase the risk of symptomatic HT. © 2016 American Heart Association, Inc.

  18. Baltimore Community Schools: Promise & Progress

    ERIC Educational Resources Information Center

    Durham, Rachel E.; Connolly, Faith

    2016-01-01

    This report documents the interim progress of the Baltimore Community School (CommSch) strategy by examining outcomes for the 2014-15 school year. Results show that CommSch parents more often reported being connected with community resources by school staff compared to parents at other schools. They also were more likely to report that school…

  19. Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000-2011.

    PubMed

    Bui, Quyen Thi-Tu; Lee, Hwa-Young; Le, Anh Thi-Kim; Van Dung, Do; Vu, Lan Thi-Hoang

    2016-01-01

    There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes - early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02-1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88-1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02-1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices.

  20. Impact of Early Life Adversity on Reward Processing in Young Adults: EEG-fMRI Results from a Prospective Study over 25 Years

    PubMed Central

    Boecker, Regina; Holz, Nathalie E.; Buchmann, Arlette F.; Blomeyer, Dorothea; Plichta, Michael M.; Wolf, Isabella; Baumeister, Sarah; Meyer-Lindenberg, Andreas; Banaschewski, Tobias

    2014-01-01

    Several lines of evidence have implicated the mesolimbic dopamine reward pathway in altered brain function resulting from exposure to early adversity. The present study examined the impact of early life adversity on different stages of neuronal reward processing later in life and their association with a related behavioral phenotype, i.e. attention deficit/hyperactivity disorder (ADHD). 162 healthy young adults (mean age = 24.4 years; 58% female) from an epidemiological cohort study followed since birth participated in a simultaneous EEG-fMRI study using a monetary incentive delay task. Early life adversity according to an early family adversity index (EFA) and lifetime ADHD symptoms were assessed using standardized parent interviews conducted at the offspring's age of 3 months and between 2 and 15 years, respectively. fMRI region-of-interest analysis revealed a significant effect of EFA during reward anticipation in reward-related areas (i.e. ventral striatum, putamen, thalamus), indicating decreased activation when EFA increased. EEG analysis demonstrated a similar effect for the contingent negative variation (CNV), with the CNV decreasing with the level of EFA. In contrast, during reward delivery, activation of the bilateral insula, right pallidum and bilateral putamen increased with EFA. There was a significant association of lifetime ADHD symptoms with lower activation in the left ventral striatum during reward anticipation and higher activation in the right insula during reward delivery. The present findings indicate a differential long-term impact of early life adversity on reward processing, implicating hyporesponsiveness during reward anticipation and hyperresponsiveness when receiving a reward. Moreover, a similar activation pattern related to lifetime ADHD suggests that the impact of early life stress on ADHD may possibly be mediated by a dysfunctional reward pathway. PMID:25118701

  1. Transient and permanent hypocalcemia after total thyroidectomy: Early predictive factors and long-term follow-up results.

    PubMed

    Seo, Sung Tae; Chang, Jae Won; Jin, Jun; Lim, Young Chang; Rha, Ki-Sang; Koo, Bon Seok

    2015-12-01

    Post-thyroidectomy hypocalcemia is among the most common complications of total thyroidectomy. The purpose of this study was to evaluate early predictive factors and long-term changes in intact parathyroid hormone (iPTH) levels in patients with transient and permanent hypocalcemia after total thyroidectomy. A total of 349 consecutive patients who underwent total thyroidectomy with or without neck dissection between 2009 and 2011 were reviewed. PTH, total calcium (Ca), and ionized Ca (iCa) levels were evaluated at 1 hour, and 1, 3, 5, and 7 days, and 1, 3, 6, and 12 months postoperatively. Biochemical profiles at 1 hour after total thyroidectomy in patients with transient and permanent hypocalcemia were compared. Patients with postoperative hypocalcemia were followed for 12 months. Lesser preoperative serum levels of Ca and more extensive surgery were significantly associated with postoperative hypocalcemia (P < .05). The absolute level and relative decline (%) in iPTH at 1 hour were the most reliable predictors of postoperative hypocalcemia according to the receiver operating characteristics curve, with a threshold of 10.42 pg/mL and 70%. Sensitivity and specificity of the predictors were 83.4% (95% CI, 76.4-89.1), 100% (95% CI, 84.6-100.0), 84.1 (95% CI, 77.2-89.7), and 95.5% (95% CI, 77.2-99.9), respectively. Parathyroid function recovered in the first month after total thyroidectomy in 78 of 99 patients (79%) with transient hypocalcemia. However, 46 of 61 patients (74%) with a subnormal iPTH level at 3 months after surgery had permanent hypocalcemia. Mean postoperative PTH level and the mean relative decline in PTH measured 1 hour postoperatively were the most reliable predictors of postoperative or permanent hypocalcemia. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Peri-operative morbidity and early results of a randomised trial comparing TVT and TVT-O.

    PubMed

    Meschia, Michele; Bertozzi, Rosanna; Pifarotti, Paola; Baccichet, Roberto; Bernasconi, Francesco; Guercio, Elso; Magatti, Fabio; Minini, Gianfranco

    2007-11-01

    The aim of this study was to compare the morbidity and short-term efficacy of retro-pubic (TVT) and inside-out trans-obturator (TVT-O) sub-urethral sling in the treatment of stress urinary incontinence. This was a prospective multi-centre randomised trial; 231 women with primary stress urinary incontinence were randomised to TVT (114) or TVT-O (117). The International Consultation on Incontinence-Short Form (ICIQ-SF), Women Irritative Prostate Symptoms Score (W-IPSS) and Patient Global Impression of Severity (PGI-S) questionnaires were used to evaluate the impact of incontinence and voiding dysfunction on QoL and to measure the patient's perception of incontinence severity. The primary and secondary outcome measures were rates of success and complications. The SPSS software was used for data analysis. The TVT-O procedure was associated with significantly shorter operation time and with a more extensive use of general anaesthesia when compared with TVT. There were 5 (4%) bladder perforations in the TVT group compared with none in the TVT-O group. Rates of early post-operative urinary retention and voiding difficulty were similar for both groups and no difference was found in the average hospital stay. Six patients (5%) in the TVT-O group complained of thigh pain in the post-operative course. The median follow-up time was 6 months. Two hundred eighteen patients were available for the analysis of outcomes. Subjective and objective cure rates were 92% and 92% in the TVT group and 87% and 89% in the TVT-O group. The ICIQ-SF questionnaire symptoms score showed a highly statistical decrease in both groups, the W-IPSS on the contrary was unchanged. Our data show that both procedures were equally effective in the short-term for the treatment of stress urinary incontinence with a highly significant improvement in incontinence-related QoL.

  3. Improved survival of baby boomer women with early-stage uterine cancer: A Surveillance, Epidemiology and End Results (SEER) Study.

    PubMed

    Elshaikh, Mohamed A; Ruterbusch, Julie; Cote, Michele L; Cattaneo, Richard; Munkarah, Adnan R

    2013-11-01

    To study the prognostic impact of baby boomer (BB) generation on survival end-points of patients with early-stage endometrial carcinoma (EC). Data were obtained from the SEER registry between 1988-2009. Inclusion criteria included women who underwent hysterectomy for stage I-II EC. Patients were divided into two birth cohorts: BB (women born between 1946 and 1964) and pre-boomers (PB) (born between 1926 and 1945). A total of 30,956 patients were analyzed. Considering that women in the PB group were older than those of the BB generation, the statistical analysis was limited to women 50-59 years of age at the time of diagnosis (n=11,473). Baby boomers had a significantly higher percentage of endometrioid histology (p<0.0001), higher percentage of African American women (p<0.0001), lower tumor grade (p<0.0001), higher number of dissected lymph nodes (LN) (p<0.0001), and less utilization of adjuvant radiation therapy (p=0.0003). Overall survival was improved in women in the BB generation compared to the PB generation (p=0.0003) with a trend for improved uterine cancer-specific survival (p=0.0752). On multivariate analysis, birth cohort (BB vs. PB) was not a significant predictor of survival end-points. Factors predictive of survival included: tumor grade, FIGO stage, African-American race, and increased number of dissected LN. Our study suggests that the survival of BB women between 50-60 years of age is better compared to women in the PB generation. As more BB patients are diagnosed with EC, further research is warranted.

  4. Predictors of anxiety in early-stage Parkinson's disease - Results from the first two years of a prospective cohort study.

    PubMed

    Rutten, Sonja; van der Ven, Peter M; Weintraub, Daniel; Pontone, Gregory M; Leentjens, Albert F G; Berendse, Henk W; van der Werf, Ysbrand D; van den Heuvel, Odile A

    2017-10-01

    Anxiety has a negative impact on daily functioning and quality of life in patients with Parkinson's disease (PD). This study aims at assessing which sociodemographic and clinical characteristics predict the course of anxiety in early PD. The participants of this two-year prospective cohort study were recently diagnosed PD patients not receiving psychiatric medications or dopamine replacement therapy at baseline. Assessments were performed annually after baseline. The primary outcome measure was anxiety, as measured with the State-Trait Anxiety Inventory (STAI). Covariates were age, gender, family history, striatal dopamine transporter binding ratios, and severity of motor and non-motor features of PD at baseline. Data were analyzed using a mixed model analysis. Inclusion criteria were met by 306 subjects. An increase in STAI total score was predicted by older age, lower score on the Montreal Cognitive Assessment, and the presence of a probable REM-sleep behavior disorder (RBD) at baseline. A decrease in STAI total score over time was predicted by a higher baseline score on the 15-item Geriatric Depression Scale, compulsive behavior at baseline and a family history of PD. More severe baseline anxiety was associated with compulsive behavior and depressive symptoms. These symptoms had a parallel course, showing a decrease over time. An increase in anxiety was predicted by older age, worse cognitive functioning and the presence of RBD. Our findings, when replicated in a sample of PD patients in a more advanced disease stage, could provide starting points for prevention of anxiety in PD patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Properties of compact HII regions and their host clumps in the inner vs outer Galaxy - early results from SASSy

    NASA Astrophysics Data System (ADS)

    Djordjevic, Julie; Thompson, Mark; Urquhart, James S.

    2017-01-01

    We present a catalog of compact and ultracompact HII regions for all Galactocentric radii. Previous catalogs focus on the inner Galaxy (Rgal ≤ 8 kpc) but the recent SASSy 870 µm survey allows us to identify regions out to ~20 kpc. Early samples are also filled with false classifications leading to uncertainty when deriving star formation efficiencies in Galactic models. These objects have similar mid-IR colours to HII regions. Urquhart et al. (2013) found that they could use mid-IR, submm, and radio data to identify the genuine compact HII regions, avoiding confusion. They used this method on a small portion of the Galaxy (10 < l < 60), identifying 213 HII regions embedded in 170 clumps. We use ATLASGAL and SASSy, crossmatched with RMS, to sample the remaining galactic longitudes out to Rgal = 20 kpc. We derive the properties of the identified compact HII regions and their host clumps while addressing the implications for recent massive star formation in the outer Galaxy. Observations towards nearby galaxies are biased towards massive stars, affecting simulations and overestimating models for galactic evolution and star formation rates. The Milky Way provides the ideal template for studying factors affecting massive star formation rates and efficiencies at high resolution, thus fine-tuning those models. We find that there is no significant change in the rate of massive star formation in the outer vs inner Galaxy. Despite some peaks in known complexes and possible correlation with spiral arms, the outer Galaxy appears to produce massive stars as efficiently as the inner regions. However, many of the potential star forming SASSy clumps have no available radio counterpart to confirm the presence of an HII region or other star formation tracer. Follow-up observations will be required to verify this conclusion and are currently in progress.

  6. Results of concurrent radio-chemotherapy for the treatment of head and neck squamous cell carcinoma in everyday clinical practice with special reference to early mortality

    PubMed Central

    2013-01-01

    Background Randomized controlled trials have established concurrent chemo-radiotherapy as the preferred treatment option for inoperable local-regionally advanced head and neck squamous cell carcinomas (HNSCCs). Because many patients have multiple co-morbidities and would not fulfill the eligibility criteria of clinical trials, the results need to be re-evaluated in daily clinical practice with special reference to early mortality. Methods 167 consecutive patients with HNSCC who received concurrent chemo-radiotherapy at the Basel University Hospital between 1988 and 2006 were analyzed retrospectively with a special focus on early deaths and risk factors for an unfavorable outcome. Results In our cohort, the 3- and 5-year overall survival rates were 54% and 47%, respectively. The therapy was associated with relevant toxicity and an early mortality rate of 5.4%. Patients dying early were analyzed individually for the cause of death. Patients with elevated white blood cell counts (HR: 2.66 p = 0,016) and vascular co-morbidities (HR: 5.3, p = 0,047) showed significantly worse survival rates. The same factors were associated with a trend toward increased treatment-related mortality. The 3-year survival rate improved from approximately 43% for patients treated before the year 2000 to 65% for patients treated after the year 2000 (Fisher’s exact test p = 0.01). Conclusions Although many patients who received concurrent chemo-radiotherapy would not have qualified for clinical trials, the outcome was favorable and has significantly improved in recent years. However the early mortality was slightly worse than what is described in the literature. PMID:24373220

  7. Association Between Early Caffeine Citrate Administration and Risk of Acute Kidney Injury in Preterm Neonates: Results From the AWAKEN Study.

    PubMed

    Harer, Matthew W; Askenazi, David J; Boohaker, Louis J; Carmody, J Bryan; Griffin, Russell L; Guillet, Ronnie; Selewski, David T; Swanson, Jonathan R; Charlton, Jennifer R

    2018-06-04

    caffeine remained associated with reduced odds of developing AKI (adjusted odds ratio, 0.20; 95% CI, 0.11-0.34), indicating that for every 4.3 neonates exposed to caffeine one case of AKI was prevented. Among neonates with early AKI, those receiving caffeine were less likely to develop stage 2 or 3 AKI (adjusted odds ratio, 0.20; 95% CI, 0.12-0.34). Caffeine administration in preterm neonates is associated with reduced incidence and severity of AKI. Further studies should focus on the timing and dosage of caffeine to optimize the prevention of AKI.

  8. Surgical results for active endocarditis with prosthetic valve replacement: impact of culture-negative endocarditis on early and late outcomes.

    PubMed

    Murashita, Toshifumi; Sugiki, Hiroshi; Kamikubo, Yasuhiro; Yasuda, Keishu

    2004-12-01

    Surgical treatment of active infective endocarditis requires not only hemodynamic repair, but also special emphasis on the eradication of the infectious focus to prevent recurrence. This goal can be achieved by the combination of aggressive debridement of infective tissue and appropriate and adequate antibiotic treatment. We reviewed our experience with active endocarditis and identified factors determining early and late outcomes, particularly focusing on the factor of culture-negative endocarditis. Sixty seven patients with clinical evidence of active endocarditis who underwent operation between 1991 and 2001 were evaluated. The aortic valve was infected in 28 (42%), the mitral valve in 23 (34%), and multiple valves in 16 (24%). Native valve endocarditis was present in 58 (87%) and prosthetic valve endocarditis in 9 (13%). Mean follow-up was 5.7 years (range, 0.2-11.5 years). Microorganisms were detected in 46 (69%): Staphylococcus aureus in 9 (13%), other staphylococci in 9 (13%), streptococcus species in 19 (28%), and others in 9 (28%), whereas 21 (31%) patients had culture-negative endocarditis. Operative mortality was 17.8% (12 patients). Reoperation was required in 8 (12%), while 3 late deaths (5.5% of hospital survivors) occurred. All events, including death, reoperation, periprosthetic leak, and recurrence of infection, occurred within 2 years after operation. Actuarial freedom from reoperation, late survival, and events at 5 years were 81.6, 76.4, and 68.6%, respectively. On multivariate analysis, no independent adverse predictor was detected for hospital death, whereas the following independent adverse predictors were identified: preoperative heart failure (P=0.0375), prosthetic valve endocarditis (P=0.0391) and culture-negative endocarditis (P=0.0354) for poor late survival; culture-negative endocarditis (P=0.0354) and annular abscess (P=0066) for poor event-free survival. Freedom from events was similar between patients with Staphylococcus aureus

  9. Prevalence of suspected developmental delays in early infancy: results from a regional population-based longitudinal study.

    PubMed

    Valla, Lisbeth; Wentzel-Larsen, Tore; Hofoss, Dag; Slinning, Kari

    2015-12-17

    Prevalence estimates on suspected developmental delays (SDD) in young infants are scarce and a necessary first step for planning an early intervention. We investigated the prevalence of SDD at 4, 6 and 12 months, in addition to associations of SDD with gender, prematurity and maternal education. This study is based on a Norwegian longitudinal sample of 1555 infants and their parents attending well-baby clinics for regular health check-ups. Moreover, parents completed the Norwegian translation of the Ages and Stages Questionnaires (ASQ) prior to the check-up, with a corrected gestational age being used to determine the time of administration for preterm infants. Scores ≤ the established cut-offs in one or more of the five development areas: communication, gross motor, fine motor, problem solving and personal-social, which defined SDD for an infant were reported. Chi-square tests were performed for associations between the selected factors and SDD. According to established Norwegian cut-off points, the overall prevalence of SDD in one or more areas was 7.0 % (10.3 % US cut-off) at 4 months, 5.7 % (12.3 % US cut-off) at 6 months and 6.1 % (10.3 % US cut-off) at 12 months. The highest prevalence of SDD was in the gross motor area at all three time points. A gestational age of < 37 weeks revealed a significant association with the communication SDD at 4 months, and with the fine motor and personal social SDD at 6 months. Gender was significantly associated with the fine motor and problem solving SDD at 4 months and personal- social SDD at 6 months: as more boys than girls were delayed. No significant associations were found between maternal education and the five developmental areas of the ASQ. Our findings indicate prevalence rates of SDD between 5.7 and 7.0 % in Norwegian infants between 4 and 12 months of age based on the Norwegian ASQ cut-off points (10.3-12.3 %, US cut-off points). During the first year of life, delay is most frequent

  10. Early results in transplantation of initially rejected donor lungs after ex vivo lung perfusion: a case-control study.

    PubMed

    Wallinder, Andreas; Ricksten, Sven-Erik; Silverborn, Martin; Hansson, Christoffer; Riise, Gerdt C; Liden, Hans; Jeppsson, Anders; Dellgren, Göran

    2014-01-01

    An increasing number of studies have shown that ex vivo lung perfusion (EVLP) is safe and that rejected donor lungs can be resuscitated and used for lung transplantation (LTx). Early clinical outcomes in patients transplanted with reconditioned lungs at our centre were reviewed and compared with those of contemporary non-EVLP controls. During 18 months starting January 2011, 11 pairs of donor lungs initially deemed unsuitable for transplantation underwent EVLP. Haemodynamic (pulmonary flow, vascular resistance and artery pressure) and respiratory (peak airway pressure and compliance) parameters were analysed during evaluation. Lungs that improved (n = 11) to meet International Society of Heart and Lung Transplantation criteria were transplanted and compared with patients transplanted with non-EVLP lungs (n = 47) during the same time period. Donor lungs were initially rejected due to either inferior PaO2/FiO2 ratio (n = 9), bilateral infiltrate on chest X-ray (n = 1) or ongoing extra corporeal membrane oxygenation (n = 1). The donor lungs improved from a mean PaO2/FiO2 ratio of 27.9 kPa in the donor to a mean of 59.6 kPa at the end of the EVLP (median improvement 28.4 kPa, range 21.0-50.7 kPa). Two single lungs were deemed unsuitable and not used for LTx. Eleven recipients from the regular waiting list underwent either single (n = 3) LTx or double (n = 8) LTx with EVLP-treated lungs. The median time to extubation (12 (range, 3-912) vs 6 (range, 2-1296) h) and median intensive care unit (ICU) stay (152 (range, 40-625) vs 48 (range, 22-1632) h) were longer in the EVLP group (P = 0.05 and P = 0.01, respectively). There were no differences in length of hospital stay (median 28 (range 25-93) vs 28 (18-209), P = 0.21). Two patients in the EVLP group and 6 in the control group had primary graft dysfunction >Grade 1 at 72 h postoperatively. Three patients in the control group died before discharge. All recipients of EVLP lungs were discharged alive from hospital. The use of

  11. Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study.

    PubMed

    Shalev, Arieh Y; Ankri, Yael; Israeli-Shalev, Yossi; Peleg, Tamar; Adessky, Rhonda; Freedman, Sara

    2012-02-01

    Preventing posttraumatic stress disorder (PTSD) is a pressing public health need. To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD. Equipoise-stratified randomized controlled study. Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment. Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE). Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS. At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9

  12. Economic impact of early intervention in psychosis services: results from a longitudinal retrospective controlled study in England.

    PubMed

    Tsiachristas, Apostolos; Thomas, Tony; Leal, Jose; Lennox, Belinda R

    2016-10-20

    To demonstrate the costs, outcomes and economic impact of early intervention in psychosis (EIP) services. Longitudinal retrospective observational study of service usage and outcome data from mental health and acute care services for all those with a diagnosis of psychosis in contact with mental health services over a 3-year period (April 2010-March 2013). Thames Valley and South Midlands region in England (region covered by Oxford Academic Health Science Network). 3674 people with psychosis, aged 16-35 years. EIP team or other community mental health teams. Change in housing status, change in employment status and improvement on each of the four domains of the Health of the Nation Outcome Scale (HONOS) questionnaire. Costs of mental and acute health inpatient, outpatient and community service use were also included in the study. Patients in EIP services were 116% more likely (95% CI 1.263 to 3.708) to gain employment, 52% more likely to become accommodated in a mainstream house (95% CI 0.988 to 2.326) and 17% more likely to have an improvement in the emotional well-being domain of the HONOS questionnaire (95% CI 1.067 to 1.285), as compared to those in non-EIP services. Annual National Health Service (NHS) costs were also significantly lower for patients using EIP services compared to non-users. The mean annual NHS cost savings associated with EIP were £4031 (95% CI £1281 to £6780). These mostly came from lower mental health inpatient costs (£4075, 95% CI £1164 to £6986), lower acute hospital outpatient costs (£59, 95% CI £9 to £109), lower accident and emergency costs (£31, 95% CI £12 to £51), and higher mental health community costs (£648, 95% CI £122 to £1175). If all people with a first-episode psychosis across England were to be treated by EIP services, the savings in societal costs would be an estimated £63.3 million per year, of which £33.5 million would be in NHS costs. Treatment within an EIP service is associated with better health and

  13. Racial differences in kidney function among individuals with obesity and metabolic syndrome: results from the Kidney Early Evaluation Program (KEEP).

    PubMed

    Bomback, Andrew S; Kshirsagar, Abhijit V; Whaley-Connell, Adam T; Chen, Shu-Cheng; Li, Suying; Klemmer, Philip J; McCullough, Peter A; Bakris, George L

    2010-03-01

    Obesity and metabolic syndrome may differ by race. For participants in the National Kidney Foundation's Kidney Early Evaluation Program (KEEP), we examined whether African American and white participants with obesity and metabolic syndrome differ regarding albuminuria, estimated glomerular filtration rate (eGFR), anemia, and bone/mineral metabolism derangements in chronic kidney disease (CKD). 3 study cohorts were assembled: (1) eligible African American and white KEEP participants with body mass index > or = 30 kg/m(2), (2) a subgroup meeting criteria for metabolic syndrome, and (3) a subgroup with eGFR < 60 mL/min/1.73 m(2) and laboratory measurements for hemoglobin, parathyroid hormone, calcium, and phosphorus. Patient characteristics and kidney function assessments were compared and tested using chi(2) (categorical variables) and t test (continuous variables). Univariate and multivariate logistic regression analyses were performed to evaluate associations of race with kidney disease measures. Of 37,107 obese participants, 48% were African American and 52% were white. Whites were more likely to have metabolic syndrome components (hypertension, 87.1% vs 84.8%; dyslipidemia, 81.6% vs 66.7%; diabetes, 42.7% vs 34.9%) and more profoundly decreased eGFR than African Americans (CKD stages 3-5 prevalence, 23.6% vs 13.0%; P < 0.001). African Americans were more likely to have abnormal urinary albumin excretion (microalbuminuria, 12.5% vs 10.2%; OR, 1.60 [95% CI, 1.45-1.76]; macroalbuminuria, 1.3% vs 1.2%; OR, 1.61 [95% CI, 1.23-2.12]) and CKD stages 1-2 (10.3% vs 7.1%; OR, 1.54 [95% CI, 1.38-1.72]). For participants with CKD stages 3-5, anemia prevalence was 32.4% in African Americans and 14.1% in whites; corresponding values for secondary hyperparathyroidism were 66.2% and 46.6%, respectively. Obesity and metabolic syndrome may be heterogeneous disease states in African Americans and whites, possibly explaining differences in long-term kidney and cardiovascular

  14. Efficacy of abbreviated Stanford V chemotherapy and involved-field radiotherapy in early-stage Hodgkin lymphoma: mature results of the G4 trial.

    PubMed

    Advani, R H; Hoppe, R T; Baer, D; Mason, J; Warnke, R; Allen, J; Daadi, S; Rosenberg, S A; Horning, S J

    2013-04-01

    To assess the efficacy of an abbreviated Stanford V regimen in patients with early-stage Hodgkin lymphoma (HL). PATIENTS AND METHODS PATIENTS: with untreated nonbulky stage I-IIA supradiaphragmatic HL were eligible for the G4 study. Stanford V chemotherapy was administered for 8 weeks followed by radiation therapy (RT) 30 Gy to involved fields (IF). Freedom from progression (FFP), disease-specific survival (DSS) and overall survival (OS) were estimated. All 87 enrolled patients completed the abbreviated regimen. At a median follow-up of 10 years, FFP, DSS and OS are 94%, 99% and 94%, respectively. Therapy was well tolerated with no treatment-related deaths. Mature results of the abbreviated Stanford V regimen in nonbulky early-stage HL are excellent and comparable to the results from other contemporary therapies.

  15. A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients.

    PubMed

    Myers, Ronald E; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C; Waldman, Scott A

    2016-10-03

    We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption. We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results. Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using the new prognostic test. Multivariable analyses showed that physicians in academic medical centers were significantly more receptive to molecular test use than those in non-academic settings. Forty-one percent of respondents were ready to act on abnormal molecular test results. Physicians who viewed current staging methods as inaccurate and were confident in their capacity to incorporate molecular testing in practice were more likely to say they would act on abnormal test results. Physician receptivity to molecular diagnostic testing for early-stage colon cancer patients is likely to be influenced by practice setting and perceptions related to delivering quality care to patients. ClinicalTrials.gov Identifier: NCT01972737.

  16. A promising new thermoelectric material - Ruthenium silicide

    NASA Technical Reports Server (NTRS)

    Vining, Cronin B.; Mccormack, Joseph A.; Zoltan, Andrew; Zoltan, Leslie D.

    1991-01-01

    Experimental and theoretical efforts directed toward increasing thermoelectric figure of merit values by a factor of 2 or 3 have been encouraging in several respects. An accurate and detailed theoretical model developed for n-type silicon-germanium (SiGe) indicates that ZT values several times higher than currently available are expected under certain conditions. These new, high ZT materials are expected to be significantly different from SiGe, but not unreasonably so. Several promising candidate materials have been identified which may meet the conditions required by theory. One such candidate, ruthenium silicide, currently under development at JPL, has been estimated to have the potential to exhibit figure of merit values 4 times higher than conventional SiGe materials. Recent results are summarized.

  17. Penn State's Comprehensive Bilingual Early Childhood Teacher Training Project. Results of Three Project Years, 1987-1990. Volume 1.

    ERIC Educational Resources Information Center

    Soto, Lourdes Diaz; Negron, Lillian

    The results of a bilingual teacher training project developed to serve the needs of young limited-English-proficient children are presented. The report contains a program description, a rationale for program implementation, and program goals. Particular attention is focused on the following: demographic information, goal setting, course work,…

  18. Effect of food on early drug exposure from extended-release stimulants: results from the Concerta, Adderall XR Food Evaluation (CAFE) Study.

    PubMed

    Auiler, J F; Liu, K; Lynch, J M; Gelotte, C K

    2002-01-01

    Stimulant therapy is the mainstay of treatment for children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Once-daily, extended-release oral formulations offer long acting control of symptoms by modifying drug delivery and absorption. In particular, consistency in early drug exposure is important for symptom control during school or work hours. Because these once-daily formulations are usually taken in the morning, the timing of the doses with breakfast is important. This study compared the effect of a high-fat breakfast on early drug exposure from a morning dose of two extended-release stimulant formulations: the osmotic-controlled OROS tablet of methylphenidate HCI (CONCERTA) and the capsule containing extended-release beads of mixed amphetamine salts (ADDERALL XR). The study had a single-dose, open-label, randomised, four-treatment, crossover design in which healthy subjects received either 36 mg CONCERTA or 20 mg ADDERALL XR in the morning after an overnight fast or a high-fat breakfast. Serial blood samples were collected over 28h to determine plasma concentrations of methylphenidate and amphetamine. The food effect on early drug exposure and the pharmacokinetic profiles up to 8 h after dosing of the two extended-release stimulants were directly compared using partial area (AUC(p4h), AUC(p6h) and AUC(p8h)) fed/fasted ratios. Amphetamine concentrations were markedly lower when the subjects had eaten breakfast, resulting in lower early drug exposures (p < 0.0001). By contrast, methylphenidate concentrations over the same 8 h were unaffected by breakfast, providing consistent levels of early drug exposure. Therefore, as a child's or adult's eating pattern varies, methylphenidate exposure over the first 8 h would be expected to have less day-to-day variation compared with amphetamine exposure. The osmotic-controlled OROS tablet provides a reliable and consistent delivery of methylphenidate HCI, independent of food, for patients with

  19. Neuroimaging in psychiatric pharmacogenetics research: the promise and pitfalls.

    PubMed

    Falcone, Mary; Smith, Ryan M; Chenoweth, Meghan J; Bhattacharjee, Abesh Kumar; Kelsoe, John R; Tyndale, Rachel F; Lerman, Caryn

    2013-11-01

    The integration of research on neuroimaging and pharmacogenetics holds promise for improving treatment for neuropsychiatric conditions. Neuroimaging may provide a more sensitive early measure of treatment response in genetically defined patient groups, and could facilitate development of novel therapies based on an improved understanding of pathogenic mechanisms underlying pharmacogenetic associations. This review summarizes progress in efforts to incorporate neuroimaging into genetics and treatment research on major psychiatric disorders, such as schizophrenia, major depressive disorder, bipolar disorder, attention-deficit/hyperactivity disorder, and addiction. Methodological challenges include: performing genetic analyses in small study populations used in imaging studies; inclusion of patients with psychiatric comorbidities; and the extensive variability across studies in neuroimaging protocols, neurobehavioral task probes, and analytic strategies. Moreover, few studies use pharmacogenetic designs that permit testing of genotype × drug effects. As a result of these limitations, few findings have been fully replicated. Future studies that pre-screen participants for genetic variants selected a priori based on drug metabolism and targets have the greatest potential to advance the science and practice of psychiatric treatment.

  20. Visualizing Chemistry: The Progess and Promise of Advanced Chemical Imaging

    SciTech Connect

    Committee on Revealing Chemistry Through Advanced Chemical Imaging

    2006-09-01

    The field of chemical imaging can provide detailed structural, functional, and applicable information about chemistry and chemical engineering phenomena that have enormous impacts on medicine, materials, and technology. In recognizing the potential for more research development in the field of chemical imaging, the National Academies was asked by the National Science Foundation, Department of Energy, U.S. Army, and National Cancer Institute to complete a study that would review the current state of molecular imaging technology, point to promising future developments and their applications, and suggest a research and educational agenda to enable breakthrough improvements in the ability to image molecularmore » processes simultaneously in multiple physical dimensions as well as time. The study resulted in a consensus report that provides guidance for a focused research and development program in chemical imaging and identifies research needs and possible applications of imaging technologies that can provide the breakthrough knowledge in chemistry, materials science, biology, and engineering for which we should strive. Public release of this report is expected in early October.« less

  1. Early and long-term results after reconstructive surgery in 42 children and two young adults with renovascular hypertension due to fibromuscular dysplasia and middle aortic syndrome.

    PubMed

    Sandmann, W; Dueppers, P; Pourhassan, S; Voiculescu, A; Klee, D; Balzer, K M

    2014-05-01

    This retrospective study presents the early and late results of pediatric patients who underwent reconstructive surgery for renovascular hypertension (RVH) between 1979 and 2009. From 1979 to 2009 44 patients (male 22; mean age 13±5.2 years, range 1-19 years; early childhood 7 [1-6 years], middle childhood 5 [7-10 years]; adolescents 32 [11-19 years]) with renovascular hypertension underwent surgery for abdominal aortic stenoses (n=6), renal artery stenosis (RAS) (n=25) or for combined lesions (n=13). Nineteen aortic stenoses (bypass/interposition 10/5, patch dilatation/thromboendarterectomy 2/2), 51 renal arteries (interposition 36, resection+reimplantation 13, patch dilatation/aneurysmorraphy 1 each), and 10 visceral arteries (resection+reimplantation 6, interposition 3, patch dilatation 1) were reconstructed. Each patient underwent duplex studies and if required intra-arterial digital subtraction angiography. Reoperations within 30 postoperative days were required in four (9%) of the patients for occlusion of four arteries (6%), achieving a combined technical success rate of 94%. After 114±81 months 36 patients were re-examined by duplex and magnetic resonance angiography (2 not surgery-related deaths 7/12 years postoperatively, 8 patients lived abroad). Twelve patients had required a second and three a third procedure. Hypertension was cured early/late postoperatively in 27%/56%, improved in 41%/44%, and remained unchanged in 32%/0%. Best late results were obtained in patients with isolated aortic disease and at the age of middle childhood. Reconstructive surgery for pediatric RVH yields good results at every age and every type of lesion. However, these children should be followed up closely and to avoid early cardiovascular disease and death in later life, surgery should not be delayed. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  2. The Martian Soil as a Geochemical Sink for Hydrothermally Altered Crustal Rocks and Mobile Elements: Implications of Early MER Results

    NASA Technical Reports Server (NTRS)

    Newsom, H. E.; Nelson, M. J.; Shearer, C. K.; Draper, D. S.

    2005-01-01

    Hydrothermal and aqueous alteration can explain some of the exciting results from the MER team s analyses of the martian soil, including the major elements, mobile elements, and the nickel enrichment. Published results from the five lander missions lead to the following conclusions: 1) The soil appears to be globally mixed and basaltic with only small local variations in chemistry. Relative to martian basaltic meteorites and Gusev rocks the soils are depleted in the fluid-mobile element calcium, but only slightly enriched to somewhat depleted in iron oxide. 2) The presence of olivine in the soils based on M ssbauer data argues that the soil is only partly weathered and is more akin to a lunar regolith than a terrestrial soil. 3) The presence of bromine along with sulfur and chlorine in the soils is consistent with addition of a mobile element component to the soil.

  3. Early detection of Angelman syndrome resulting from de novo paternal isodisomic 15q UPD and review of comparable cases

    PubMed Central

    2013-01-01

    Background Angelman syndrome is a rare neurogenetic disorder that results in intellectual and developmental disturbances, seizures, jerky movements and frequent smiling. Angelman syndrome is caused by two genetic disturbances: either genes on the maternally inherited chromosome 15 are deleted or inactivated or two paternal copies of the corresponding genes are inherited (paternal uniparental disomy). A 16-month-old child was referred with minor facial anomalies, neurodevelopmental delay and speech impairment. The clinical symptoms suggested angelman syndrome. The aim of our study was to elucidate the genetic background of this case. Results This study reports the earliest diagnosed angelman syndrome in a 16-month-old Hungarian child. Cytogenetic results suggested a de novo Robertsonian-like translocation involving both q arms of chromosome 15: 45,XY,der(15;15)(q10;q10). Molecular genetic studies with polymorphic short tandem repeat markers of the fibrillin-1 gene, located in the 15q21.1, revealed that both arms of the translocated chromosome were derived from a single paternal chromosome 15 (isodisomy) and led to the diagnosis of angelman syndrome caused by paternal uniparental disomy. Conclusions AS resulting from paternal uniparental disomy caused by de novo balanced translocation t(15q;15q) of a single paternal chromosome has been reported by other groups. This paper reviews 19 previously published comparable cases of the literature. Our paper contributes to the deeper understanding of the phenotype-genotype correlation in angelman syndrome for non-deletion subclasses and suggests that patients with uniparental disomy have milder symptoms and higher BMI than the ones with other underlying genetic abnormalities. PMID:24011290

  4. Prenatal and early postnatal intoxication by inorganic mercury resulting from the maternal use of mercury containing soap.

    PubMed

    Lauwerys, R; Bonnier, C; Evrard, P; Gennart, J P; Bernard, A

    1987-05-01

    A case of slight renal tubular dysfunction associated with cataract and anaemia was diagnosed in a 3-month-old black boy in whom high levels of mercury were found in blood and urine. Several arguments suggest that the renal, ocular and haematological defects may have resulted from exposure to mercury during foetal life and the 1-month lactation period due to the extensive use of inorganic mercury containing cosmetics by the mother.

  5. Impact of real-time notification of Clostridium difficile test results and early initiation of effective antimicrobial therapy.

    PubMed

    Polen, Christian B; Judd, William R; Ratliff, Patrick D; King, Gregory S

    2018-05-01

    Clostridium difficile is a prominent nosocomial pathogen and is the most common causative organism of health care-associated diarrhea. To our knowledge, no studies have investigated the impact of real-time notification of culture results with rapid antimicrobial stewardship program (ASP) intervention in the setting of C difficile infection (CDI). The purpose of this study was to assess the impact of real-time notification of detection of toxigenic C difficile by DNA amplification results in patients with confirmed CDI. This is a single-center, retrospective cohort study at a 433-bed tertiary medical center in central Kentucky. The study consisted of 2 arms: patients treated for CDI prior to implementation of real-time provider notification and patients postimplementation. The primary outcome was time to initiation of effective antimicrobial therapy. The median time to initiation of effective antimicrobial therapy decreased from 5.75 hours in the preimplementation cohort to 2.05 hours in the postimplementation cohort (P = .001). ASP intervention also resulted in a shorter t