Katz, Philip O; Le Moigne, Anne; Pollack, Charles
2017-05-01
These secondary analyses used data from 2 similarly designed studies in subjects experiencing frequent heartburn to evaluate the efficacy of esomeprazole 20 mg once daily for 2 weeks, which reflects the approved over-the-counter dosage and duration. Subjects without endoscopically identified erosive esophagitis who were experiencing heartburn for ≥6 months and ≥4 of 7 days prior to baseline (study 1, N = 368; study 2, N = 349) were randomly assigned to receive double-blind treatment with esomeprazole 40 or 20 mg (administered as esomeprazole magnesium trihydrate 44.5 and 22.3 mg, respectively) or placebo once daily for 4 weeks. Subjects recorded the severity of heartburn in a daily diary, and investigators assessed subjects at each study visit. Two-week assessments were the primary end points of interest in these analyses and included the percentage of subjects with complete heartburn resolution (no episodes during 7 consecutive days), time to sustained complete heartburn resolution (the first of 7 consecutive episode-free days), and heartburn relief (no episodes other than ≤1 mild episode during 7 consecutive days). At week 2, the percentages of subjects who experienced complete heartburn resolution were significantly greater with esomeprazole 40 mg (study 1, 26.1%; study 2, 35.3%) and 20 mg (study 1, 25.2%; study 2, 35.7%) compared with placebo (study 1, 9.0%; study 2, 3.4%) (all, P ≤ 0.001). Beginning on day 1, the percentages of subjects who experienced sustained heartburn resolution was significantly greater in the groups treated with esomeprazole 40 mg (study 1, 19%; study 2, 19%; P < 0.0001) and 20 mg (study 1, 10%; study 2, 15%; P < 0.05) compared with the group that received placebo (study 1, 2%; study 2, 1%). Additionally, at week 2, the percentages of subjects experiencing heartburn relief were significantly greater with esomeprazole 40 mg (study 1, 35.3%; study 2, 40.5%) and 20 mg (study 1, 34.5%; study 2, 46.4%) compared with placebo (study 1, 16.5%; study 2, 8.6%) (all, P ≤ 0.001). The results of this study demonstrate that once-daily treatment with esomeprazole 20 mg for 2 weeks effectively resolved subjects׳ heartburn compared with placebo, beginning on day 1. Studies precede FDA Act 801 clinical trial registration and results submission requirements. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.
Extra-skeletal Ewing sarcoma of the lumbosacral region in an adult pregnant patient: a case report.
Al Khawaja, Darweesh; Vescovi, Cristina; Dower, Ashraf; Thiruvilangam, Vallapan; Mahasneh, Tamadur
2017-03-01
Extra-skeletal Ewing sarcoma in pregnancy is rare. There is thus limited scientific evidence to guide clinicians in its complicated management, particularly within the context of early gestation. We therefore share our successful outcome in a 32-year-old pregnant patient, following a unique management strategy of complete aggressive surgical resection prior to neo-adjuvant therapy. The case involved a 2-month history of right-sided back and gluteal pain, with associated paraesthesia. Lumbosacral magnetic resonance imaging (MRI) revealed an approximate 40×50 mm indeterminate mass in the lower right paraspinal musculature. The mass extended into the first right sacral foramen and the central canal; and also impinged on the S2 exiting nerve. After considering the patients' rapid deterioration, pregnant status and other clinical factors, it was elected to proceed with complete surgical resection prior to any other therapeutic modality. Following surgery, the patient experienced immediate resolution of her pain and by 6 weeks was able to cease the use of all analgesics. At 32-weeks' gestation she underwent an uncomplicated vaginal delivery. At 9 months follow up, she remains disease free and has experienced complete resolution of her back pain and radiculopathy.
Extra-skeletal Ewing sarcoma of the lumbosacral region in an adult pregnant patient: a case report
Al Khawaja, Darweesh; Dower, Ashraf; Thiruvilangam, Vallapan; Mahasneh, Tamadur
2017-01-01
Extra-skeletal Ewing sarcoma in pregnancy is rare. There is thus limited scientific evidence to guide clinicians in its complicated management, particularly within the context of early gestation. We therefore share our successful outcome in a 32-year-old pregnant patient, following a unique management strategy of complete aggressive surgical resection prior to neo-adjuvant therapy. The case involved a 2-month history of right-sided back and gluteal pain, with associated paraesthesia. Lumbosacral magnetic resonance imaging (MRI) revealed an approximate 40×50 mm indeterminate mass in the lower right paraspinal musculature. The mass extended into the first right sacral foramen and the central canal; and also impinged on the S2 exiting nerve. After considering the patients’ rapid deterioration, pregnant status and other clinical factors, it was elected to proceed with complete surgical resection prior to any other therapeutic modality. Following surgery, the patient experienced immediate resolution of her pain and by 6 weeks was able to cease the use of all analgesics. At 32-weeks’ gestation she underwent an uncomplicated vaginal delivery. At 9 months follow up, she remains disease free and has experienced complete resolution of her back pain and radiculopathy. PMID:28435928
Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication.
Moshtaghi, Omid; Mahboubi, Hossein; Haidar, Yarah M; Sahyouni, Ronald; Lin, Harrison W; Djalilian, Hamid R
2017-12-01
To describe persistent post-stapedotomy vertigo (PSV) and its treatment using migraine prophylaxis. A retrospective review of all patients with persistent PSV spanning 10 years at a tertiary academic hospital was performed. Patients who experienced persistent vertigo for a minimum of 3 months after surgery were included. Those with possible perilymph fistula, long prosthesis, and benign paroxysmal positional vertigo were excluded. All patients received instructions on migraine dietary and lifestyle changes and Vitamin B2 and magnesium. In addition, prophylactic treatment with nortriptyline, verapamil, or a combination thereof was started. Changes in vertigo frequency was the main outcome variable. The secondary outcome variables included the time period and medications necessary to achieve symptomatic resolution. Four women and one man with an average age of 53 years were identified that met criteria for persistent PSV indicating an incidence of 0.9% at our institution. The onset of vertigo symptoms was on average 20 days postoperatively. All five patients had daily vertigo episodes and experienced complete resolution with no vertigo episodes after treatment. Symptomatic resolution was achieved over an average of 9 weeks after initiating treatments. Persistent PSV beyond 3 months is a rare occurrence and its treatment can be challenging when there is no evidence of an underlying pathology. This subset of patients may be suffering from migraine, which was triggered postoperatively. Treatment with migraine prophylaxis in this cohort of patients may result in resolution of vertigo.
Dall, Lawrence; Peterson, Sandford; Simmons, Tom; Dall, Amy
2005-03-01
There is some evidence to suggest that host inflammatory response has some effect on the clinical manifestations of cellulitis. The objective of this pilot study was to investigate whether the addition of oral nonsteroidal anti-inflammatory (NSAI) therapy to antibiotic treatment hastens resolution of cellulitis-related inflammation. Patients presenting in the emergency department with signs and symptoms of class II cellulitis were assigned to receive treatment with either antibiotic therapy alone (intravenous, supplemented with oral cephalexin or an equivalent) for 10 days (n = 33) or antibiotic therapy for 10 days plus an oral anti-inflammatory (ibuprofen 400 mg every 6 hours) for 5 days (n = 31). Patients were discharged as soon as possible to complete their therapy on an outpatient basis. The addition of an oral anti-inflammatory agent significantly (P < .05) shortened the time to regression of inflammation and complete resolution of cellulitis. Twenty-four of 29 evaluable patients (82.8%) who received supplemental anti-inflammatory treatment showed regression of inflammation within 1 to 2 days compared with only 3 of 33 patients (9.1%) treated without an anti-inflammatory in the same time frame. All patients receiving adjunctive anti-inflammatory treatment experienced complete resolution of cellulitis in 4 to 5 days or less, while 24.2% (8/33) of patients treated with antibiotic alone required 6 to 7 days, and 6.1% (2/33) required 7 days or more (P < .05). This small preliminary study provides some promising data, suggesting that the supplemental use of anti-inflammatory therapy may hasten the time to regression of inflammation and complete resolution of cellulitis.
Johnson, David A; Le Moigne, Anne; Li, Jing; Pollack, Charles; Nagy, Peter
2016-07-01
Sleep disturbances related to reflux symptoms have a significant impact on the daily lives of affected individuals. These analyses identified clinical factors related to resolution of reflux-related sleep disturbance in subjects treated with esomeprazole 20 mg for 14 days. Data from the first 14 days of 2 similar randomized, double-blind studies were pooled for subjects experiencing frequent heartburn and related sleep disturbances receiving esomeprazole 20 mg (n = 357) or placebo (n = 346). A stepwise logistic regression analysis was performed with pooled and individual study data to evaluate relationships between clinical factors [treatment (esomeprazole vs. placebo), run-in sleep disturbance frequency, occurrence (yes/no) of 24-h, daytime, and nighttime heartburn (yes: ≥1 episode in 14-day treatment period)] and complete sleep disturbance resolution (no disturbances for 7 consecutive days). Absence of daytime (p = 0.0018) or nighttime (p < 0.0001) heartburn during treatment was a significant predictor of complete sleep disturbance resolution at 14 days for the total population, while higher run-in sleep disturbance frequency (p < 0.0001) was associated with a lower likelihood of resolution. Esomeprazole treatment was an independent significant predictor of improvement across all endpoints (p < 0.0001). A significant treatment by run-in sleep disturbance interaction was observed for complete resolution (p = 0.0231), indicating greater therapeutic benefit with esomeprazole in subgroups with higher run-in symptom frequency. Lower run-in sleep disturbance frequency, no occurrence of daytime or nighttime heartburn during therapy, and esomeprazole treatment predicted complete reflux-related sleep disturbance resolution. The magnitude of therapeutic benefit for esomeprazole 20 mg over placebo increased with increasing baseline sleep disturbance.
NASA Technical Reports Server (NTRS)
Rodionova, Olga; Sridhar, Banavar; Ng, Hok K.
2016-01-01
Air traffic in the North Atlantic oceanic airspace (NAT) experiences very strong winds caused by jet streams. Flying wind-optimal trajectories increases individual flight efficiency, which is advantageous when operating in the NAT. However, as the NAT is highly congested during peak hours, a large number of potential conflicts between flights are detected for the sets of wind-optimal trajectories. Conflict resolution performed at the strategic level of flight planning can significantly reduce the airspace congestion. However, being completed far in advance, strategic planning can only use predicted environmental conditions that may significantly differ from the real conditions experienced further by aircraft. The forecast uncertainties result in uncertainties in conflict prediction, and thus, conflict resolution becomes less efficient. This work considers wind uncertainties in order to improve the robustness of conflict resolution in the NAT. First, the influence of wind uncertainties on conflict prediction is investigated. Then, conflict resolution methods accounting for wind uncertainties are proposed.
Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies.
Sahyouni, Ronald; Moshtaghi, Omid; Haidar, Yarah M; Mahboubi, Hossein; Moshtaghi, Afsheen; Lin, Harrison W; Djalilian, Hamid R
2017-12-01
To report findings from a cohort of vestibular schwannoma (VS) patients presenting with vertigo from a secondary comorbid vestibular disorder; and to discuss management strategies for this subset of patients presenting with both episodic vertigo and VS. All VS patients who presented with vertigo as the primary symptom from 2012 to 2015 and endorsing no other major complaints were examined. Treatment with migraine lifestyle and prophylactic therapy, or Epley maneuver. Resolution of vertigo following medical treatment alone. Of the nine patients studied, seven (78%) suffered from vestibular migraine, and two (22%) experienced benign positional vertigo. All patients experienced complete resolution of symptoms after treatment. As a result of symptomatic improvement, seven patients (78%) avoided surgery in favor of observation, while two patients (22%) underwent radiosurgery due to continued tumor growth and other nonvertigo symptoms. VS patients can sometimes present with a history of recurrent episodic vertigo. The etiology of the vertigo could be due to the tumor itself or may be due to an underlying comorbidity such as vestibular migraine or benign positional vertigo. VS patients presenting with vertigo should undergo a standard vertigo history and examination to identify other potential causes of vertigo. Most VS patients in our cohort avoided intervention and had resolution of their vertigo.
Links, Paul S; Eynan, Rahel; Ball, Jeffrey S; Barr, Aiala; Rourke, Sean
2005-01-01
Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.
High-resolution three-dimensional partially coherent diffraction imaging.
Clark, J N; Huang, X; Harder, R; Robinson, I K
2012-01-01
The wave properties of light, particularly its coherence, are responsible for interference effects, which can be exploited in powerful imaging applications. Coherent diffractive imaging relies heavily on coherence and has recently experienced rapid growth. Coherent diffractive imaging recovers an object from its diffraction pattern by computational phasing with the potential of wavelength-limited resolution. Diminished coherence results in reconstructions that suffer from artefacts or fail completely. Here we demonstrate ab initio phasing of partially coherent diffraction patterns in three dimensions, while simultaneously determining the coherence properties of the illuminating wavefield. Both the dramatic improvements in image interpretability and the three-dimensional evaluation of the coherence will have broad implications for quantitative imaging of nanostructures and wavefield characterization with X-rays and electrons.
Gieger, Tracy; Siegel, Sheri; Rosen, Kari; Jackson, Dorothy; Ware, Kevin; Kiselow, Michael; Shiomitsu, Keijiro
2013-01-01
Data from 37 dogs with nasal carcinomas treated with two or more coarsely fractionated courses of radiation therapy (RT) were retrospectively reviewed. The median radiation dose for the first course of RT was 24 Gray (Gy). All dogs clinically responded, and 11 had complete resolution of signs for a median of 114 days. Dogs were retreated at relapse, with a median dose of 20 Gy, and 26 of 37 dogs (70%) had clinical responses. The second course of RT was initiated at a median of 150 days following completion of the first course. Side effects were mild: four dogs had chronic ocular conditions necessitating medication, one of which required enucleation. Median survival time (ST) from the first dose of RT was 453 days and 180 days from the first dose of the second course of RT. The following factors were examined but were not significant for survival: total RT dose, dose of the first course of RT, complete resolution of clinical signs, use of either chemotherapy or nonsteroidal anti-inflammatory drugs (NSAIDs), and stage (T1/T2 versus T3/T4). Dogs responded well to reirradiation with a subset experiencing chronic ocular side effects.
López López, Daniel; Vilar Fernández, Juan Manuel; Losa Iglesias, Marta Elena; Álvarez Castro, Carlos; Romero Morales, Carlos; García Sánchez, María Matilde; Becerro de Bengoa Vallejo, Ricardo
2016-07-01
The aim of our study was to evaluate the efficacy and safety of topical cantharidin-podophylotoxin-salicylic acid (CPS) treatment of recalcitrant plantar warts (RPW). This study was carried out in a health center in the city of A Coruña (Spain) between January and December 2013. A total of 75 patients completed all the stages of the research process. Information related to treatment with CPS and adverse effects was abstracted from medical records. Of 93 potential patients identified, 75 had at least one follow-up visit or telephone call after treatment and were included in this study. Patients experienced an average of 5.4 visits until complete resolution of their plantar wart occurred, although CPS was not applied at every visit. Fifty-four patients required one application to eliminate the wart and 21 patients required two applications/patient. Seventy-seven percent of patients experienced blistering - an expected therapeutic side effect. All patients experienced some form of an adverse event, the most common being pain (81.3%) and significant blistering (15%). Other side effects were rare (18.7%) and included pruritus, possible mild infection, significant irritation, and bleeding. All patients reported treatment, supporting our results that CPS is a safe and efficacious treatment modality for RPW and should be considered when symptomatic infection necessitates treatment. © 2016 Wiley Periodicals, Inc.
Akten, H Serpil; Kilic, Hatice; Celik, Bulent; Erbas, Gonca; Isikdogan, Zeynep; Turktas, Haluk; Kokturk, Nurdan
2018-04-25
This study aimed to evaluate the diagnostic yield of fiberoptic bronchoscopic (FOB) transbronchial biopsy and its relation with quantitative findings of high resolution computerized tomography (HRCT). A total of 83 patients, 19 males and 64 females with a mean age of 45.1 years diagnosed with sarcoidosis with complete records of high resolution computerized tomography were retrospectively recruited during the time period from Feb 2005 to Jan 2015. High resolution computerized tomography scans were retrospectively assessed in random order by an experienced observer without knowledge of the bronchoscopic results or lung function tests. According to the radiological staging with HRCT, 2.4% of the patients (n=2) were stage 0, 19.3% (n=16) were stage 1, 72.3% (n=60) were stage 2 and 6.0% (n=5) were stage 3. This study showed that transbronchial lung biopsy showed positive results in 39.7% of the stage I or II sarcoidosis patients who were diagnosed by bronchoscopy. Different high resolution computerized tomography patterns and different scores of involvement did make a difference in the diagnostic accuracy of transbronchial biopsy (p=0.007). Creative Commons Attribution License
Percutaneous Femoropopliteal Recanalization Using a Completely Transpedal/Transtibial Approach
DOE Office of Scientific and Technical Information (OSTI.GOV)
Clark, Timothy W.I., E-mail: timothy.clark@uphs.upenn.edu; Watts, Micah M.; Kwan, Tak W.
PurposeTo report preliminary experience with femoropopliteal revascularization using a completely transpedal/transtibial approach.Materials and MethodsThree patients with Rutherford 3–4 disease underwent revascularization of TASC C/D lesions using a pedal/tibial artery as the only site of arterial access.ResultsOne patient with a chronic superficial femoral artery occlusion had continuity achieved to the common femoral artery using a dedicated reentry device and stenting; in a second patient, an occluded popliteal artery stent was successfully revised with an endograft; and in a third patient with morbid obesity, a chronic SFA occlusion was successfully stented. All patients experienced complete resolution of presenting symptoms; no puncture sitemore » complications were seen.ConclusionsUse of a pedal/tibial approach as the sole site of arterial access may become an important access technique for femoropopliteal revascularization when patients have limited femoral access options.« less
Della Pepa, Roberta; Picardi, M; Sorà, F; Stamouli, M; Busca, A; Candoni, A; Delia, M; Fanci, R; Perriello, V; Zancanella, M; Nosari, A; Salutari, P; Marchesi, F; Pane, F; Pagano, L
2016-09-01
Chronic disseminated candidiasis (CDC) is a complication of Candida infection in immunocompromised patients, involving the liver and spleen, and rarely other organs. The aim of the study is to identify the best antifungal drug for hematologic immunocompromised patients with CDC. In this multicentric retrospective study, the charts of 20 patients with CDC following cytotoxic agent protocols for hematological malignancies, diagnosed from 2003 to 2013, were analyzed. The response to systemic antifungal therapy within 90 days from CDC diagnosis and the possible delay in chemotherapy plan, due to the infection, were evaluated. Six patients were treated with high-dose (HD; 5 mg/kg/daily) liposomal amphotericin B (L-AmB), whereas three received standard-dose (SD) L-AmB (3 mg/kg/daily). Azoles were given to six patients; the remaining five were treated with echinocandins. All patients treated with HD L-AmB (6/6-100 %) achieved complete resolution of CDC; one of them had to interrupt the chemotherapy program for the infection. In the SD L-AmB group, treatment failed in the 100 % of cases and one patient had to delay chemotherapy for the infection. Of the six patients who received azoles, two achieved complete resolution of the infection, four experienced treatment failure, and only three performed chemotherapy as planned. Echinocandins treatment resulted in complete resolution of the infection in 2/5 cases, partial response in 2/5 cases, and failure in one case. In this group, 3/5 patients completed chemotherapy as planned. This study shows that HD L-AmB was particularly effective against CDC in hematologic patients, allowing most patients to continue cytotoxic agent program.
2009-01-01
A 25-year-old male military veteran presented with diagnoses of post concussion syndrome and post traumatic stress disorder three years after loss of consciousness from an explosion in combat. The patient underwent single photon emission computed tomography brain blood flow imaging before and after a block of thirty-nine 1.5 atmospheres absolute hyperbaric oxygen treatments. The patient experienced a permanent marked improvement in his post-concussive symptoms, physical exam findings, and brain blood flow. In addition, he experienced a complete resolution of post-traumatic stress disorder symptoms. After treatment he became and has remained employed for eight consecutive months. This case suggests a novel treatment for the combined diagnoses of blast-induced post-concussion syndrome and post-traumatic stress disorder. PMID:19829822
Oral ketamine for children with chronic pain: a pilot phase 1 study
Bredlau, Amy-Lee; McDermott, Michael P.; Adams, Heather; Dworkin, Robert H; Venuto, Charles; Fisher, Susan; Dolan, James G; Korones, David N
2013-01-01
Objective To assess whether oral ketamine aids is is safe at higher dosages for sedating children and whether it may be an option for control of chronic pain in children. Study design A prospective study was performed on 12 children with chronic pain to identify the maximum tolerated dosage of oral ketamine. Participants were given 14 days of oral ketamine, three times daily, at dosages ranging from 0.25–1.5 mg/kg/dose. Participants were assessed for toxicity and for pain severity at baseline and on day 14 of treatment. Results Two participants, both treated at 1.5 mg/kg/dose, experienced dose-limiting toxicities (sedation and anorexia). One participant, treated at 1 mg/kg/dose, opted to stop ketamine treatment due to new pain on treatment. Nine participants completed their course of ketamine treatment. Of these 12 children, 5 experienced improvement in their pain scores, two with complete resolution of pain, lasting for more than 4 weeks off ketamine treatment. Conclusion Oral ketamine at dosages of 0.25–1 mg/kg/dose appears to be safe when given for 14 days to children with chronic pain. PMID:23403253
Intranasal tissue necrosis associated with opioid abuse: Case report and systematic review.
Morrison, Danielle A; Wise, Sarah K; DelGaudio, John M; Chowdhury, Naweed I; Levy, Joshua M
2017-12-27
Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilized to identify English-language studies reporting intranasal mucosal injury associated with prescription opioid abuse. Primary outcomes included clinical presentation, treatment strategies, and outcomes. Systematic review identified 61 patients for qualitative analysis. Common clinical features include facial pain without a history of chronic sinusitis or known immunodeficiency. Diagnostic nasal endoscopy revealed superficial debris with underlying tissue necrosis, consistent with a preliminary diagnosis of IFRS. Characteristic pathologic findings include mucosal ulceration with an overlying acellular substrate, often with polarizable material. Fungal colonization is often reported, with several accounts of angiocentric invasion in immunocompetent patients. Complete symptom resolution is expected following surgical debridement with cessation of intranasal opioid inhalation, with 89% of identified patients experiencing a complete resolution of disease. Intranasal opioid abuse is a prevalent condition associated with chronic pain and tissue necrosis that is clinically concerning for invasive fungal disease. Whereas IFRS must be excluded, even in patients without known immunodeficiency, complete resolution of symptoms can be expected following surgical debridement with cessation of opioid abuse. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Complex task performance in Cyberspace. Surgical procedures in a telepresence environment.
Bowersox, J C; LaPorta, A J; Cordts, P R; Bhoyrul, S; Shah, A
1996-01-01
To assess the capabilities of our fully functional, prototype telepresence surgery system, experienced surgeons performed complete operative procedures on live, anesthetized pigs. Cholecystectomy, the prototypical procedure for evaluating the integration of surgical skills, was successfully performed in six animals. There were no aborted attempts or complications. Other procedures completed included gastrotomy and enterotomy closures, anastomosis of the small intestine, and nephrectomy. No specific training was required for using the telepresence surgery system, and the "feel" of the system was described as intuitive. Operative times were longer than required in conventional, open surgery, most likely the result of the four degrees of freedom available in the manipulators of the current-generation system. Force feedback and high-resolution, stereoscopic video input facilitated performance. Surgeons operating through a first-generation telepresence system can achieve technical results equivalent to those obtained in conventional surgery.
Church, Joseph T; Simha, Sidd; Wild, Laurie C; Teitelbaum, Daniel H; Ehrlich, Peter F
2017-05-01
Fecal incontinence is a socially debilitating problem for many children. We hypothesized that in selected patients with medically-refractory encopresis, placement of an appendicostomy or cecostomy tube for administration of antegrade continence enemas (ACE) would improve quality of life (QOL). We reviewed all patients with encopresis who underwent appendicostomy or cecostomy placement from 2003 to 2014 at our institution. We contacted subjects' parents by phone and administered 3 surveys: a survey reflecting current stooling habits, a disease-specific QOL survey, and the PedsQL™ QOL survey. QOL surveys were completed twice by parents, once reflecting pre-operative QOL, then again reflecting current QOL. Pre-procedure and post-procedure scores were compared by paired t-test. Ten patients underwent appendicostomy/cecostomy for encopresis. Eight completed phone surveys. All procedures were performed laparoscopically. All patients experienced fecal soiling pre-operatively, whereas 5/8 surveyed patients (63%) noted complete resolution of soiling post-procedure (p<0.01). General and disease-specific QOL improved from pre-procedure to post-procedure in the following domains: social habits, physical activity, ability to spend the night elsewhere, feeling, and overall QOL (p<0.05). PedsQL™ scores improved significantly in physical functioning, social functioning, and overall functioning (p<0.05). Antegrade continence enemas significantly improve quality of life in patients with medically-refractory encopresis, likely related to resolution of soiling. 4. Copyright © 2017. Published by Elsevier Inc.
Tactile Cueing for Target Acquisition and Identification
2005-09-01
method of coding tactile information, and the method of presenting elevation information were studied. Results: Subjects were divided into video game experienced...VGP) subjects and non- video game (NVGP) experienced subjects. VGPs showed a significantly lower’ target acquisition time with the 12...that video game players performed better with the highest level of tactile resolution, while non- video game players performed better with simpler pattern and a lower resolution display.
Kisler, Kassandra; Lazic, Divna; Sweeney, Melanie D; Plunkett, Shane; El Khatib, Mirna; Vinogradov, Sergei A; Boas, David A; Sakadži, Sava; Zlokovic, Berislav V
2018-06-01
Cerebrovascular dysfunction has an important role in the pathogenesis of multiple brain disorders. Measurement of hemodynamic responses in vivo can be challenging, particularly as techniques are often not described in sufficient detail and vary between laboratories. We present a set of standardized in vivo protocols that describe high-resolution two-photon microscopy and intrinsic optical signal (IOS) imaging to evaluate capillary and arteriolar responses to a stimulus, regional hemodynamic responses, and oxygen delivery to the brain. The protocol also describes how to measure intrinsic NADH fluorescence to understand how blood O 2 supply meets the metabolic demands of activated brain tissue, and to perform resting-state absolute oxygen partial pressure (pO 2 ) measurements of brain tissue. These methods can detect cerebrovascular changes at far higher resolution than MRI techniques, although the optical nature of these techniques limits their achievable imaging depths. Each individual procedure requires 1-2 h to complete, with two to three procedures typically performed per animal at a time. These protocols are broadly applicable in studies of cerebrovascular function in healthy and diseased brain in any of the existing mouse models of neurological and vascular disorders. All these procedures can be accomplished by a competent graduate student or experienced technician, except the two-photon measurement of absolute pO 2 level, which is better suited to a more experienced, postdoctoral-level researcher.
Topical sodium metabisulfite for the treatment of calcinosis cutis: a promising new therapy.
Del Barrio-Díaz, P; Moll-Manzur, C; Álvarez-Veliz, S; Vera-Kellet, C
2016-09-01
Calcinosis cutis is a chronic calcium-mediated disease that causes significant morbidity. Multiple treatments have been tried, with varying results; indeed, to date, no standard treatment has been generally accepted. Sodium metabisulfite is an inorganic compound that, when it reacts with oxygen, becomes sodium sulfate, a metabolite of sodium thiosulfate that has a similar ability to inhibit calcium oxalate agglomeration. Four women diagnosed with calcinosis cutis, secondary to dermatomyositis, systemic sclerosis and radiodermatitis after breast cancer, were evaluated for their response to topical 25% sodium metabisulfite. In all patients a decrease in lesion size, erythema and pain from injuries was shown, with complete resolution of the associated ulcers. One patient had a complete response. None experienced adverse effects. Topical sodium metabisulfite is a promising emerging therapy that should be considered as a valid alternative treatment in calcinosis cutis. Randomized prospective studies are required to evaluate its true efficacy. © 2016 British Association of Dermatologists.
Swerlick, Robert A; Puar, Neha
2015-01-01
We retrospectively identified 17 patients with delayed pressure urticaria (DPU), diagnosed by history and confirmed with provocative pressure testing. The average age in the cohort was 42.6 years with 10 women and seven men. The mean duration of disease before diagnosis was 19.7 months (range, 1-60 months). The diagnosis of DPU was not included in the differential diagnosis of referring physicians and was not a diagnostic consideration in any of seven biopsies obtained. None of the patients responded adequately to treatment with antihistamines, but all 17 responded transiently when treated with either oral or intramuscular steroids. Eleven patients experienced complete or near complete resolution of DPU with treatment with sulfasalazine (SZ). Four patients had a partial response while two were unable to continue therapy because of drug intolerance. SZ appears to be a low cost and effective treatment for DPU. © 2015 Wiley Periodicals, Inc.
Environmental exposure effects on composite materials for commercial aircraft
NASA Technical Reports Server (NTRS)
Hoffman, D. J.
1978-01-01
Activities reported include completion of the program design tasks, resolution of a high fiber volume problem and resumption of specimen fabrication, fixture fabrication, and progress on the analysis methodology and definition of the typical aircraft environment. Program design activities including test specimens, specimen holding fixtures, flap-track fairing tailcones, and ground exposure racks were completed. The problem experienced in obtaining acceptable fiber volume fraction results on two of the selected graphite epoxy material systems was resolved with an alteration to the bagging procedure called out in BAC 5562. The revised bagging procedure, involving lower numbers of bleeder plies, produces acceptable results. All required laminates for the contract have now been laid up and cured. Progress in the area of analysis methodology has been centered about definition of the environment that a commercial transport aircraft undergoes. The selected methodology is analagous to fatigue life assessment.
Kip, Kevin E; D'Aoust, Rita F; Hernandez, Diego F; Girling, Sue Ann; Cuttino, Barrett; Long, Mary Kathryn; Rojas, Paola; Wittenberg, Trudy; Abhayakumar, Alisha; Rosenzweig, Laney
2016-01-01
Posttraumatic stress disorder (PTSD) is prevalent in both homeless and nonhomeless veterans. To examine unique characteristics of being homeless that may influence PTSD treatment completion and clinical success. Twenty-three veterans who were homeless and residing in a homeless shelter, along with 94 veterans from the community, were enrolled to receive one to five sessions of Accelerated Resolution Therapy (ART), an emerging trauma-focused therapy for symptoms of PTSD. Rates of treatment completion with ART and acute and 6-month change in symptoms of PTSD were compared in an observational (nonrandomized) manner by housing status. Compared to veterans recruited from the community, veterans residing in the homeless shelter were older and presented with more extensive psychopathology yet had less combat exposure while being more likely to have experienced sexual assault. Rates of treatment completion were 52.2% (12 of 23) among homeless veterans compared to 81.9% (77 of 94) among veterans from the community (p = .005). Among treatment completers, both groups received an average of four sessions of ART. Reduction of symptoms of PTSD was substantial and nonsignificantly greater among homeless veterans vs. those treated from the community (p = .14), as were comorbidity reductions in depression, anxiety, sleep quality, pain, and improved quality of life. Results at 6-month posttreatment follow-up were similar. Although limited by small sample size and a nonrandomized design, ART appears to be an effective, brief treatment for symptoms of PTSD among veterans residing in a homeless shelter. However, development of effective strategies to maximize treatment completion among homeless veterans is needed. Copyright © 2016 Elsevier Inc. All rights reserved.
Treatment of molluscum contagiosum with an East Indian sandalwood oil product.
Haque, Malika; Coury, Daniel L
2017-11-22
To evaluate the safety and efficacy of an East Indian sandalwood oil (EISO) product as a topical treatment for molluscum contagiosum. Ten subjects ranging in age from 22 months to 29 years were recruited. Subjects were instructed to apply an EISO product to the lesions twice daily. Subjects were monitored every two to three weeks during the study and were questioned regarding local or systemic side effects. Assessment of response was recorded by counting lesions and documented by photographs. Nine of ten subjects (90%) experienced complete resolution of molluscum lesions within the twelve week study period. Response was unrelated to lesion size or number, how long the molluscum rash had been present, or patient age or gender. There were no complaints of side effects, skin irritation, pain, or other adverse events reported in any subjects. In this pilot open label study, an EISO product proved to be an effective treatment for molluscum contagiosum lesions with resolution of lesions typically occurring within twelve weeks of therapy.
From good intentions to real life: introducing crisis resolution teams in Norway.
Karlsson, Bengt; Borg, Marit; Kim, Hesook Suzie
2008-09-01
In Norway, as in most western countries, the adult services for people experiencing mental health problems have gone through major changes over the last decades. A report submitted to the Norwegian Parliament in 1997 summarized several areas of improvement in the provision of mental health-care to its population, and led to the introduction of a national mental health programme in 1998 for its implementation to be completed by 2008. The most significant recent development in Norway is 'Crisis Resolution/Home Treatment' (CRHT) teams that provide an alternative to acute hospital care services. The major aim of this study is to explore an emerging form of community mental health-care, and present a framework for establishment and examination of CRHT teams applying the user perspectives. An illustration of user experiences in an already established CRHT team provides a background for understanding implications of this form of service in relation to service users' needs in acute crises.
EPA Alternative Dispute Resolution Contacts
The success of EPA's ADR efforts depends on a network of talented and experienced professionals in Headquarters offices and EPA Regions. For Agency-wide ADR information, please contact the Conflict Prevention and Resolution Center.
Patient's experience of treatment for sleep apnoea with a mandibular advancement splint.
Bhamrah, Gurprit; Dhir, Arti; Cash, Alex; Ahmad, Sofia; Winchester, Lindsay J
2015-10-01
Obstructive sleep apnoea (OSA) is a well recognised clinical disorder in which there is narrowing and repeated collapse of the upper airway during sleep resulting in the cessation of breathing. Patients with mild to moderate sleep apnoea are often provided with mandibular advancement splint (MAS) therapy as a form of first line or definitive treatment. The aims of this audit were to evaluate patient satisfaction and success of MAS therapy. 93 patients diagnosed with sleep apnoea and suitable for a splint were recruited prospectively at Queen Victoria Hospital, East Grinstead between January 2009 and October 2010. A patient satisfaction questionnaire was developed by health professionals involved in the care of patients with sleep apnoea and assessed for face and content validity and reliability. Participants completed the questionnaire six weeks after the splint was fitted. 44% who previously experienced snoring now reported no snoring and 47% reported less snoring since wearing the MAS appliance. 69% reported complete resolution of sleep apnoea symptoms. 37% experienced aching teeth and 33% experienced having a dry throat when wearing the appliance. 86% of sleeping partners felt that their quality of sleep was improved following their partners treatment. The standards set for each criteria in this audit were met. MAS treatment has a key role to play in the management of obstructive sleep apnoea with high rates of patient satisfaction and the majority of patients partners reporting a significant improvement in their own and their partners sleep quality. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
Enemchukwu, Ekene; Lai, Caroline; Reynolds, William Stuart; Kaufman, Melissa; Dmochowski, Roger
2015-06-01
To describe our experience with concomitant repair of urethral diverticula and stress urinary incontinence (SUI) with autologous pubovaginal sling (PVS). A retrospective chart review between January 2006 and 2013 identified 38 women undergoing concomitant diverticulectomy and rectus sheath PVS. Patient demographics, presenting symptoms, prior urethral surgery, concomitant procedures, postoperative outcomes, and complications were evaluated. The mean duration of symptoms was 56.7 months. Eleven patients presented with recurrent diverticula and 5 patients had prior SUI surgery (3 midurethral slings, 1 PVS, and 1 bulking agent). One patient had a prior urethrolysis. All other slings were cut or excised at the time of surgery. All women had demonstrable SUI on cough stress test or urodynamics. The mean follow-up was 12.7 months. All postoperative voiding cystourethrograms were negative for contrast extravasation. One patient required prolonged (>4 weeks) suprapubic tube drainage for urinary retention. Four others required an additional 1 week of suprapubic tube drainage. Eighteen patients (47%) reported mixed urinary symptoms. Of these, 9 had complete resolution, whereas 9 experienced significant improvement. Overall, 97.3% reported resolution of their dysuria, dyspareunia, and pain symptoms and 90% reported complete resolution of their SUI symptoms. There were 2 urethral diverticula recurrences and 2 SUI recurrences. Perioperative complications, including hemorrhage, sling erosion, or urethrovaginal fistulas, were not observed. Concomitant PVS placement is a safe and effective treatment option for SUI in patients undergoing urethral diverticulectomy. The risks and benefits should be weighed and management individualized. Copyright © 2015 Elsevier Inc. All rights reserved.
Bonache, Helena; Gonzalez-Mendez, Rosaura; Krahé, Barbara
2016-04-01
Although there is ample evidence linking insecure attachment styles and intimate partner violence (IPV), little is known about the psychological processes underlying this association, especially from the victim's perspective. The present study examined how attachment styles relate to the experience of sexual and psychological abuse, directly or indirectly through destructive conflict resolution strategies, both self-reported and attributed to their opposite-sex romantic partner. In an online survey, 216 Spanish undergraduates completed measures of adult attachment style, engagement and withdrawal conflict resolution styles shown by self and partner, and victimization by an intimate partner in the form of sexual coercion and psychological abuse. As predicted, anxious and avoidant attachment styles were directly related to both forms of victimization. Also, an indirect path from anxious attachment to IPV victimization was detected via destructive conflict resolution strategies. Specifically, anxiously attached participants reported a higher use of conflict engagement by themselves and by their partners. In addition, engagement reported by the self and perceived in the partner was linked to an increased probability of experiencing sexual coercion and psychological abuse. Avoidant attachment was linked to higher withdrawal in conflict situations, but the paths from withdrawal to perceived partner engagement, sexual coercion, and psychological abuse were non-significant. No gender differences in the associations were found. The discussion highlights the role of anxious attachment in understanding escalating patterns of destructive conflict resolution strategies, which may increase the vulnerability to IPV victimization. © The Author(s) 2016.
Huynh, Lynn; Totev, Todor; Vekeman, Francis; Neary, Maureen P; Duh, Mei S; Benson, Al B
2017-09-01
To calculate the cost reduction associated with diarrhea/flushing symptom resolution/improvement following treatment with above-standard dose octreotide-LAR from the commercial payor's perspective. Diarrhea and flushing are two major carcinoid syndrome symptoms of neuroendocrine tumor (NET). Previously, a study of NET patients from three US tertiary oncology centers (NET 3-Center Study) demonstrated that dose escalation of octreotide LAR to above-standard dose resolved/improved diarrhea/flushing in 79% of the patients within 1 year. Time course of diarrhea/flushing symptom data were collected from the NET 3-Center Study. Daily healthcare costs were calculated from a commercial claims database analysis. For the patient cohort experiencing any diarrhea/flushing symptom resolution/improvement, their observation period was divided into days of symptom resolution/improvement or no improvement, which were then multiplied by the respective daily healthcare cost and summed over 1 year to yield the blended mean annual cost per patient. For patients who experienced no diarrhea/flushing symptom improvement, mean annual daily healthcare cost of diarrhea/flushing over a 1-year period was calculated. The economic model found that 108 NET patients who experienced diarrhea/flushing symptom resolution/improvement within 1 year had statistically significantly lower mean annual healthcare cost/patient than patients with no symptom improvement, by $14,766 (p = .03). For the sub-set of 85 patients experiencing resolution/improvement of diarrhea, their cost reduction was more pronounced, at $18,740 (p = .01), statistically significantly lower than those with no improvement; outpatient costs accounted for 56% of the cost reduction (p = .02); inpatient costs, emergency department costs, and pharmacy costs accounted for the remaining 44%. The economic model relied on two different sources of data, with some heterogeneity in the prior treatment and disease status of patients. Symptom resolution/improvement of diarrhea/flushing after treatment with an above-standard dose of octreotide-LAR in NET was associated with a statistically significant healthcare cost decrease compared to a scenario of no symptom improvement.
Efficacy of nutritional treatment in patients with psoriasis: A case report.
Wong, Ang Peng; Kalinovsky, Tatiana; Niedzwiecki, Aleksandra; Rath, Matthias
2015-09-01
Psoriasis is a chronic inflammatory skin disease characterized by thickened, silvery-scaled patches. There is currently no cure and treatments only attempt to reduce the severity of symptoms. This study reports the case of a 36-year-old female who presented to the clinic with severe psoriasis and had been treated with topical steroid cream for the past 14 years. After adherence to prescribed dietary changes for 6 months, including abundant intake of vegetables, minimal consumption of meat, and avoidance of junk food and sugar in food or drinks, as well as nutritional supplementation with Vitacor Plus, ProLysinC, VitaCforte and LysinC Drink mix, the patient experienced complete resolution of psoriatic patches on her body.
Large rotorcraft transmission technology development program
NASA Technical Reports Server (NTRS)
Mack, J. C.
1983-01-01
Testing of a U.S. Army XCH-62 HLH aft rotor transmission under NASA Contract NAS 3-22143 was successfully completed. This test establishes the feasibility of large, high power rotorcraft transmissions as well as demonstrating the resolution of deficiencies identified during the HLH advanced technology programs and reported by USAAMRDLTR-77-38. Over 100 hours of testing was conducted. At the 100% design power rating of 10,620 horsepower, the power transferred through a single spiral bevel gear mesh is more than twice that of current helicopter bevel gearing. In the original design of these gears, industry-wide design methods were employed and failures were experienced which identified problem areas unique to gear size. To remedy this technology shortfall, a program was developed to predict gear stresses using finite element analysis for complete and accurate representation of the gear tooth and supporting structure. To validate the finite element methodology gear strain data from the existing U.S. Army HLH aft transmission was acquired, and existing data from smaller gears were made available.
Rigorously defined hemicrania continua presenting bilaterally.
Southerland, Andrew M; Login, Ivan S
2011-10-01
Hemicrania continua (HC) is a headache syndrome characterized by continuous, unilateral head pain, autonomic features, and a complete therapeutic response to indomethacin. Although HC is classified as a unique entity among primary headache disorders, it clearly shares features with other primary headaches, including trigeminal autonomic cephalalgias, and chronic daily headaches, such as chronic migraine and chronic tension-type headache. In addition, the diagnosis is often delayed secondary to a relatively low incidence and the occurrence of some phenotypic variability as found in previous case series. A 62-year-old woman presented with 5 months of unremitting, bilateral headache with significant autonomic symptoms during exacerbations of pain. Neurological examination and imaging studies were normal. After failure to respond to numerous previous therapeutic medicines and interventions, she experienced complete resolution following administration of indomethacin and eventual remission on sustained treatment. This case demonstrates that hemicrania continua with requisite autonomic features can occur in a purely bilateral form. Although the definitive aspects of HC continue to evolve, a bilateral headache meeting the current criteria warrants a therapeutic trial of indomethacin.
Phase I Trial and Pharmacokinetic Study of Lexatumumab in Pediatric Patients With Solid Tumors
Merchant, Melinda S.; Geller, James I.; Baird, Kristin; Chou, Alexander J.; Galli, Susana; Charles, Ava; Amaoko, Martha; Rhee, Eunice H.; Price, Anita; Wexler, Leonard H.; Meyers, Paul A.; Widemann, Brigitte C.; Tsokos, Maria; Mackall, Crystal L.
2012-01-01
Purpose Lexatumumab is an agonistic, fully human monoclonal antibody against tumor necrosis factor–related apoptosis-inducing ligand receptor 2 with preclinical evidence of activity in pediatric solid tumors. Patients and Methods This phase I dose-escalation study examined the safety, tolerability, pharmacokinetics, and immunogenicity of lexatumumab at doses up to, but not exceeding, the adult maximum-tolerated dose (3, 5, 8, and 10 mg/kg), administered once every 2 weeks to patients age ≤ 21 years with recurrent or progressive solid tumors. Results Twenty-four patients received a total of 56 cycles of lexatumumab over all four planned dose levels. One patient had grade 2 pericarditis consistent with radiation recall, and one patient developed grade 3 pneumonia with hypoxia during the second cycle. Five patients experienced stable disease for three to 24 cycles. No patients experienced complete or partial response, but several showed evidence of antitumor activity, including one patient with recurrent progressive osteosarcoma who experienced resolution of clinical symptoms and positron emission tomography activity, ongoing more than 1 year off therapy. One patient with hepatoblastoma showed a dramatic biomarker response. Conclusion Pediatric patients tolerate 10 mg/kg of lexatumumab administered once every 14 days, the maximum-tolerated dose identified in adults. The drug seems to mediate some clinical activity in pediatric solid tumors and may work with radiation to enhance antitumor effects. PMID:23071222
NASA Astrophysics Data System (ADS)
King, C. H.; Wagenbrenner, J.; Fedora, M.; Watkins, D.; Watkins, M. K.; Huckins, C.
2017-12-01
The Great Lakes Region of North America has experienced more frequent extreme precipitation events in recent decades, resulting in a large number of stream crossing failures. While there are accepted methods for designing stream crossings to accommodate peak storm discharges, less attention has been paid to assessing the risk of failure. To evaluate failure risk and potential impacts, coarse-resolution stream crossing surveys were completed on 51 stream crossings and dams in the North Branch Paint River watershed in Michigan's Upper Peninsula. These inventories determined stream crossing dimensions along with stream and watershed characteristics. Eleven culverts were selected from the coarse surveys for high resolution hydraulic analysis to estimate discharge conditions expected at crossing failure. Watershed attributes upstream of the crossing, including area, slope, and storage, were acquired. Sediment discharge and the economic impact associated with a failure event were also estimated for each stream crossing. Impacts to stream connectivity and fish passability were assessed from the coarse-level surveys. Using information from both the coarse and high-resolution surveys, we also developed indicators to predict failure risk without the need for complex hydraulic modeling. These passability scores and failure risk indicators will help to prioritize infrastructure replacement and improve the overall connectivity of river systems throughout the upper Great Lakes Region.
Long-term efficacy of a tongue tie service in improving breast feeding rates: A prospective study.
Billington, Jennifer; Yardley, Iain; Upadhyaya, Manasvi
2018-02-01
Breast feeding rates in England at 3months of age are approximately 17% for exclusive breast-feeding and 55% for breast-feeds supplemented with formula. Tongue-tie (TT) in infants is cited as a significant cause of difficulty with maintaining breast-feeding. Early treatment and support can improve breast-feeding and allow infants to benefit from the many long-term benefits of breast-feeding. Our aim was to determine BF rates in infants 3months after attending our tongue-tie clinic (TTC). Institutional ethical approval and study approval were obtained. Patients attending the TTC from May to July 2016 were included. Telephone contact was made 3months postprocedure to establish current behaviour. Symptom resolution was recorded as complete resolution (CR), moderate resolution (MoR), or minimal resolution (MiR). Feeding pattern was either exclusively BF or combined breast and formula feeds or exclusively formula fed. 100 infants were included with complete follow-up data on 87 (87% response rate). Median age at release of TT was 17 (2-88) days without any recurrence. Status at 3months was CR (n=70, 80%); MoR (n=13, 15%), and MiR (n=4, 5%). 43 (49%) were exclusively BF, 36 (41%) were supplementing BF with some formula (2/3 by choice and 1/3 owing to insufficient milk production), and 8 (10%) were using only formula milk (7 by choice and 2 owing to ongoing feeding difficulties). Of the 17 mothers still experiencing symptoms, 5 were exclusively breast-feeding, and 8 were persisting with combined feeds. Infants attending our tongue-tie clinic achieved both higher exclusive breastfeeding and combined breast and bottle-feeding when compared to national breast-feeding data at 3months of age. This can facilitate the achievement of long-term breastfeeding, exposing infants and mothers to many of the associated benefits. 4. Copyright © 2017 Elsevier Inc. All rights reserved.
Proximal Rectus Femoris Avulsion: Ultrasonic Diagnosis and Nonoperative Management
Esser, Stephan; Jantz, David; Hurdle, Mark F.; Taylor, Walter
2015-01-01
Objective To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper. Background While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence. Differential Diagnosis Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear. Treatment Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result. Uniqueness Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery. Conclusions Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management. PMID:25978099
Molet, Jenny; Maras, Pamela M; Kinney-Lang, Eli; Harris, Neil G; Rashid, Faisal; Ivy, Autumn S; Solodkin, Ana; Obenaus, Andre; Baram, Tallie Z
2016-12-01
Memory and related cognitive functions are progressively impaired in a subgroup of individuals experiencing childhood adversity and stress. However, it is not possible to identify vulnerable individuals early, a crucial step for intervention. In this study, high-resolution magnetic resonance imaging (MRI) and intra-hippocampal diffusion tensor imaging (DTI) were employed to examine for structural signatures of cognitive adolescent vulnerabilities in a rodent model of early-life adversity. These methods were complemented by neuroanatomical and functional assessments of hippocampal network integrity during adolescence, adulthood and middle-age. The high-resolution MRI identified selective loss of dorsal hippocampal volume, and intra-hippocampal DTI uncovered disruption of dendritic structure, consistent with disrupted local connectivity, already during late adolescence in adversity-experiencing rats. Memory deteriorated over time, and stunting of hippocampal dendritic trees was apparent on neuroanatomical analyses. Thus, disrupted hippocampal neuronal structure and connectivity, associated with cognitive impairments, are detectable via non-invasive imaging modalities in rats experiencing early-life adversity. These high-resolution imaging approaches may constitute promising tools for prediction and assessment of at-risk individuals in the clinic. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
McGraw, Thomas
2016-01-01
AIM: To evaluate the efficacy and safety of polyethylene glycol (PEG) 3350 in subjects with self-reported occasional constipation. METHODS: Eligible subjects ≥ 17 years of age were randomized to receive either placebo or PEG 3350 17 g once daily in this multicenter, double-blind trial. Evaluations were conducted before (baseline) and after a 7-d treatment period. The primary efficacy variable was the proportion of subjects reporting complete resolution of straining and hard or lumpy stools. Secondary efficacy variables assessed the severity of the subjects’ daily bowel movement (BM) symptoms, and preference of laxatives based on diary entries, visual analog scale scores, and questionnaires. RESULTS: Of the 203 subjects enrolled in the study, 11 had major protocol violations. Complete resolution was noted by 36/98 (36.7%) subjects in the PEG 3350 group and 23/94 (24.5%) in the placebo group (P = 0.0595). The number of complete BMs without straining or lumpy stools was similar between both groups. Subjects receiving PEG 3350 experienced significant relief in straining and reduction in hardness of stools over a 7-d period (P < 0.0001). Subjects reported that PEG 3350 had a better effect on their daily lives, provided better control over a BM, better relief from constipation, cramping, and bloating, and was their preferred laxative. Adverse events (AEs) were balanced between the PEG 3350 and the placebo groups. No deaths, serious AEs, or discontinuations due to AEs were reported. This trial is registered at clinicaltrials.gov as NCT00770432. CONCLUSION: Oral administration of 17 g PEG 3350 once daily for a week is effective, safe, and well tolerated in subjects with occasional constipation. PMID:27158544
Vanderhoof, Melanie; Distler, Hayley; Lang, Megan W.; Alexander, Laurie C.
2018-01-01
The dependence of downstream waters on upstream ecosystems necessitates an improved understanding of watershed-scale hydrological interactions including connections between wetlands and streams. An evaluation of such connections is challenging when, (1) accurate and complete datasets of wetland and stream locations are often not available and (2) natural variability in surface-water extent influences the frequency and duration of wetland/stream connectivity. The Upper Choptank River watershed on the Delmarva Peninsula in eastern Maryland and Delaware is dominated by a high density of small, forested wetlands. In this analysis, wetland/stream surface water connections were quantified using multiple wetland and stream datasets, including headwater streams and depressions mapped from a lidar-derived digital elevation model. Surface-water extent was mapped across the watershed for spring 2015 using Landsat-8, Radarsat-2 and Worldview-3 imagery. The frequency of wetland/stream connections increased as a more complete and accurate stream dataset was used and surface-water extent was included, in particular when the spatial resolution of the imagery was finer (i.e., <10 m). Depending on the datasets used, 12–60% of wetlands by count (21–93% of wetlands by area) experienced surface-water interactions with streams during spring 2015. This translated into a range of 50–94% of the watershed contributing direct surface water runoff to streamflow. This finding suggests that our interpretation of the frequency and duration of wetland/stream connections will be influenced not only by the spatial and temporal characteristics of wetlands, streams and potential flowpaths, but also by the completeness, accuracy and resolution of input datasets.
McGraw, Thomas
2016-05-06
To evaluate the efficacy and safety of polyethylene glycol (PEG) 3350 in subjects with self-reported occasional constipation. Eligible subjects ≥ 17 years of age were randomized to receive either placebo or PEG 3350 17 g once daily in this multicenter, double-blind trial. Evaluations were conducted before (baseline) and after a 7-d treatment period. The primary efficacy variable was the proportion of subjects reporting complete resolution of straining and hard or lumpy stools. Secondary efficacy variables assessed the severity of the subjects' daily bowel movement (BM) symptoms, and preference of laxatives based on diary entries, visual analog scale scores, and questionnaires. Of the 203 subjects enrolled in the study, 11 had major protocol violations. Complete resolution was noted by 36/98 (36.7%) subjects in the PEG 3350 group and 23/94 (24.5%) in the placebo group (P = 0.0595). The number of complete BMs without straining or lumpy stools was similar between both groups. Subjects receiving PEG 3350 experienced significant relief in straining and reduction in hardness of stools over a 7-d period (P < 0.0001). Subjects reported that PEG 3350 had a better effect on their daily lives, provided better control over a BM, better relief from constipation, cramping, and bloating, and was their preferred laxative. Adverse events (AEs) were balanced between the PEG 3350 and the placebo groups. No deaths, serious AEs, or discontinuations due to AEs were reported. This trial is registered at clinicaltrials.gov as NCT00770432. Oral administration of 17 g PEG 3350 once daily for a week is effective, safe, and well tolerated in subjects with occasional constipation.
Increasing Advisor Effectiveness by Understanding Conflict and Conflict Resolution
ERIC Educational Resources Information Center
McClellan, Jeffrey
2005-01-01
On a daily basis, advisors encounter various types of interpersonal and intrapersonal conflict. Through this article, the reader will better understand conflict, its positive and negative impacts and the approaches of the actors experiencing conflict, and the means whereby conflicts arise, escalate, and come to resolution in advising situations.…
Hamilton, Kimberly; Iskandar, Bermans
2018-02-12
Endocrine abnormalities are well-recognized consequences of intracranial pathology such as pituitary tumours. Less commonly, hydrocephalus may lead to dysfunction of the endocrine system, presenting as amenorrhoea or precocious puberty. We present a case report and literature review of hydrocephalus causing endocrine abnormalities including reversible infertility. A 34 year-old female presented with amenorrhoea and infertility. MRI showed a third ventricular mass and hydrocephalus. The amenorrhoea resolved within weeks of endoscopic third ventriculostomy and tumour biopsy; pregnancy ensued within 6 months. Thirty-two cases of hydrocephalus-related amenorrhoea were reported between 1915 and 2007. All patients who underwent modern hydrocephalus treatment experienced partial or complete resolution of endocrine dysfunction. Successful pregnancy was reported in three patients, as in our case presentation. While mechanisms of dysfunction have not been completely elucidated, studies point toward loss of GnRH pulsatility due to compression of the medio-basal hypothalamic structures. Hydrocephalus can cause endocrine dysfunction, including amenorrhoea, which may reverse with CSF diversion. Therefore, cranial imaging is an important component in the evaluation of such endocrine abnormalities.
3DIANA: 3D Domain Interaction Analysis: A Toolbox for Quaternary Structure Modeling
Segura, Joan; Sanchez-Garcia, Ruben; Tabas-Madrid, Daniel; Cuenca-Alba, Jesus; Sorzano, Carlos Oscar S.; Carazo, Jose Maria
2016-01-01
Electron microscopy (EM) is experiencing a revolution with the advent of a new generation of Direct Electron Detectors, enabling a broad range of large and flexible structures to be resolved well below 1 nm resolution. Although EM techniques are evolving to the point of directly obtaining structural data at near-atomic resolution, for many molecules the attainable resolution might not be enough to propose high-resolution structural models. However, accessing information on atomic coordinates is a necessary step toward a deeper understanding of the molecular mechanisms that allow proteins to perform specific tasks. For that reason, methods for the integration of EM three-dimensional maps with x-ray and NMR structural data are being developed, a modeling task that is normally referred to as fitting, resulting in the so called hybrid models. In this work, we present a novel application—3DIANA—specially targeted to those cases in which the EM map resolution is medium or low and additional experimental structural information is scarce or even lacking. In this way, 3DIANA statistically evaluates proposed/potential contacts between protein domains, presents a complete catalog of both structurally resolved and predicted interacting regions involving these domains and, finally, suggests structural templates to model the interaction between them. The evaluation of the proposed interactions is computed with DIMERO, a new method that scores physical binding sites based on the topology of protein interaction networks, which has recently shown the capability to increase by 200% the number of domain-domain interactions predicted in interactomes as compared to previous approaches. The new application displays the information at a sequence and structural level and is accessible through a web browser or as a Chimera plugin at http://3diana.cnb.csic.es. PMID:26772592
Elevation-dependent warming in global climate model simulations at high spatial resolution
NASA Astrophysics Data System (ADS)
Palazzi, Elisa; Mortarini, Luca; Terzago, Silvia; von Hardenberg, Jost
2018-06-01
The enhancement of warming rates with elevation, so-called elevation-dependent warming (EDW), is one of the regional, still not completely understood, expressions of global warming. Sentinels of climate and environmental changes, mountains have experienced more rapid and intense warming trends in the recent decades, leading to serious impacts on mountain ecosystems and downstream. In this paper we use a state-of-the-art Global Climate Model (EC-Earth) to investigate the impact of model spatial resolution on the representation of this phenomenon and to highlight possible differences in EDW and its causes in different mountain regions of the Northern Hemisphere. To this end we use EC-Earth climate simulations at five different spatial resolutions, from ˜ 125 to ˜ 16 km, to explore the existence and the driving mechanisms of EDW in the Colorado Rocky Mountains, the Greater Alpine Region and the Tibetan Plateau-Himalayas. Our results show that the more frequent EDW drivers in all regions and seasons are the changes in albedo and in downward thermal radiation and this is reflected in both daytime and nighttime warming. In the Tibetan Plateau-Himalayas and in the Greater Alpine Region, an additional driver is the change in specific humidity. We also find that, while generally the model shows no clear resolution dependence in its ability to simulate the existence of EDW in the different regions, specific EDW characteristics such as its intensity and the relative role of different driving mechanisms may be different in simulations performed at different spatial resolutions. Moreover, we find that the role of internal climate variability can be significant in modulating the EDW signal, as suggested by the spread found in the multi-member ensemble of the EC-Earth experiments which we use.
Fires and Heavy Smoke in Alaska
NASA Technical Reports Server (NTRS)
2002-01-01
On May 28, 2002, the Moderate Resolution Imaging Spectroradiometer (MODIS) captured this image of fires that continue to burn in central Alaska. Alaska is very dry and warm for this time of year, and has experienced over 230 wildfires so far this season. Please note that the high-resolution scene provided here is 500 meters per pixel. For a copy of the scene at the sensor's fullest resolution, visit the MODIS Rapid Response Image Gallery.
Does Milk Cause Constipation? A Crossover Dietary Trial
Crowley, Elesa T.; Williams, Lauren T.; Roberts, Tim K.; Dunstan, Richard H.; Jones, Peter D.
2013-01-01
The aims of this study were to: (1) determine whether replacement of cow’s milk protein with soy resolves Chronic Functional Constipation (CFC); and (2) investigate the effects of cow’s milk β casein A1 and cow’s milk β casein A2 on CFC. Children diagnosed with CFC were recruited to one of two crossover trials: Trial 1 compared the effects of cow’s milk and soy milk; Trial 2 compared the effects of cow’s milk β casein A1 and cow’s milk β casein A2. Resolution of constipation was defined as greater than eight bowel motions during a two week intervention. Thirteen children (18 to 144 months) participated in Trial 1 (6 boys, 7 girls). Nine participants who completed the soy epoch all experienced resolution (p < 0.05). Thirty-nine children (21 to 144 months) participated in Trial 2 (25 boys, 14 girls). Resolution of constipation was highest during the washout epoch, 81%; followed by cow’s milk β casein A2, 79%; and cow’s milk β casein A1, 57%; however, the proportions did not differ statistically. The results of Trial 1 demonstrate an association between CFC and cow’s milk consumption but Trial 2 failed to show an effect from type of casein. Some other component in cow’s milk common to both A1 and A2 milk may be causing a problem in these susceptible children. PMID:23340316
Yoshikawa, Ichiro; Honda, Hidekazu; Nagata, Kaori; Kanda, Kikuo; Yamasaki, Takuji; Kume, Keiichiro; Tabaru, Akinari; Otsuki, Makoto
2002-12-01
Application of a new variable stiffness colonoscope (VSC) is expected to control loop formation and to lessen patient discomfort. The aim of this prospective study was to compare the efficacy of VSC with a conventional colonoscope (CC) in unsedated colonoscopy, based on the experience of examiners. Four-hundred sixty-seven patients were randomly assigned to undergo colonoscopy with either VSC or CC by an endoscopist, including experienced and less-experienced examiners. The percentages of completed procedure and time to cecal intubation were recorded. Patients were asked to rate pain on a 5-point pain score. The percentages of completed procedure with VSC and CC were 98% and 95%, respectively, by less-experienced hands, and 99% and 98%, respectively, by experienced hands. Time for cecal intubation with VSC and CC was 15.7 and 18.5 min, respectively, by less-experienced hands, and 9.8 and 10.6 min, respectively, by experienced hands. A significantly lower mean pain score was noted in VSC patients compared with CC patients, irrespective of experience of the examiner. The percent of patients rating the procedure as moderately or severely painful was significantly lower with VSC than with CC, both in less-experienced (19% vs 40%; p < 0.01) and experienced hands (15% vs 26%; p < 0.05). Our results indicated that VSC allows favorable examination compared with CC regarding completeness, time to cecal intubation, and comfort of patients undergoing unsedated colonoscopy, irrespective of the examiner's experience. These features suggest VSC as the preferred colonoscope for patients undergoing unsedated colonoscopy.
Eradicating Medical Student Mistreatment: A Longitudinal Study of One Institution’s Efforts
Fried, Joyce M.; Vermillion, Michelle; Parker, Neil H.; Uijtdehaage, Sebastian
2015-01-01
Purpose Since 1995, the David Geffen School of Medicine at UCLA (DGSOM) has created policies to prevent medical student mistreatment, instituted safe mechanisms for reporting mistreatment, provided resources for discussion and resolution, and educated faculty and residents. In this study, the authors examined the incidence, severity, and sources of perceived mistreatment over the 13-year period during which these measures were implemented. Method From 1996 to 2008, medical students at DGSOM completed an anonymous survey after their third-year clerkships and reported how often they experienced physical, verbal, sexual harassment, ethnic, and power mistreatment, and who committed it. The authors analyzed these data using descriptive statistics and the students’ descriptions of these incidents qualitatively, categorizing them as “mild,” “moderate,” or “severe.” They compared the data across four periods, delineated by milestone institutional measures to eradicate mistreatment. Results Of 2,151 eligible students, 1,946 (90%) completed the survey. More than half (1,166/1,946) experienced some form of mistreatment. Verbal and power mistreatment were most common, but 5% of students (104/1,930) reported physical mistreatment. The pattern of incidents categorized as “mild,” “moderate,” or “severe” remained across the four study periods. Students most frequently identified residents and clinical faculty as the sources of mistreatment. Conclusions Despite a multipronged approach at DGSOM across a 13-year period to eradicate medical student mistreatment, it persists. Aspects of the hidden curriculum may be undermining these efforts. Thus, eliminating mistreatment requires an aggressive approach both locally at the institution level and nationally across institutions. PMID:22836847
Ponsky, Todd A; Bobanga, Iuliana D; Schwachter, Marc; Stathos, Theodore H; Rosen, Michael; Parry, Robert; Nalugo, Margaret; Rothenberg, Steven S
2014-12-01
To evaluate different technologies that can facilitate telementoring in a variety of pediatric surgical procedures. Two different telementoring technologies were used to provide two-way audio and visual communication between experienced pediatric surgeon mentors located in another city and less experienced trainees performing a surgical procedure. The first technology consisted of store-bought equipment that connected the operating room laparoscope to a Skype™ (Microsoft, Redmond, WA) connection (used in 1 case), whereas the second was a proprietary telementoring robot, Karl Storz Endoscopy-America, Inc. VisitOR1(®) (Karl Storz GmbH & Co. KG, Tuttlingen, Germany) (used in 5 cases). The procedures included a video-assisted thoracic surgery lower lobectomy, a temporary and two permanent gastric stimulator placements, and two laparoscopic inguinal hernia repairs and were performed by pediatric surgeons (3 cases), a pediatric gastroenterologist (1 case), and a general surgeon (2 cases) under the guidance of pediatric surgeon mentors. All procedures were completed successfully in a time-efficient manner, without loss of transmission and without complications. Although the Skype technology was less costly, it lacked telestrator capacity and was not adequately secure. The VisitOR1 telementoring robot enabled high-resolution video communication, had telestrator capacity, and allowed pointing during the procedure. The mentors assisted with trocar placement, modifying the surgical technique, identifying planes of dissection, and indicating locations of device and suture placement. Telementoring is a useful adjunct in the field of pediatric surgery that can aid in the transfer of surgical skills remotely and shorten the time to implementation of new surgical techniques into practice. Optimal telementoring technology should have a secure wireless connection, high video resolution, and minimal bandwidth latency.
Perception of Scenes in Different Sensory Modalities: A Result of Modal Completion.
Gruber, Ronald R; Block, Richard A
2017-01-01
Dynamic perception includes amodal and modal completion, along with apparent movement. It fills temporal gaps for single objects. In 2 experiments, using 6 stimulus presentation conditions involving 3 sensory modalities, participants experienced 8-10 sequential stimuli (200 ms each) with interstimulus intervals (ISIs) of 0.25-7.0 s. Experiments focused on spatiotemporal completion (walking), featural completion (object changing), auditory, completion (falling bomb), and haptic changes (insect crawling). After each trial, participants judged whether they experienced the process of "happening " or whether they simply knew that the process must have occurred. The phenomenon was frequency independent, being reported at short ISIs but not at long ISIs. The phenomenon involves dynamic modal completion and possibly also conceptual processes.
Nonomura, Yumi; Otsuka, Atsushi; Endo, Yuichiro; Fujisawa, Akihiro; Tanioka, Miki; Kabashima, Kenji; Miyachi, Yoshiki
2012-05-01
Extramammary Paget's disease is a rare cutaneous malignant neoplasm. Previous studies indicated the efficacy of docetaxel in advanced cases. The common side effects of docetaxel are usually tolerable and seldom life-threatening. We experienced a case of severe pseudomembranous colitis and neutropenic fever that developed just after the first cycle of docetaxel chemotherapy. To the best of our knowledge, there are few reports of pseudomembranous colitis associated with docetaxel administration for skin cancers. The patient showed complete resolution of her symptoms within 2 weeks with an oral metronidazole therapy. During the second and third cycles, the patient received docetaxel safely with lower doses. The present case indicated that pseudomembranous colitis should be included in the differential diagnosis when assessing patients who develop severe diarrhea during systemic chemotherapy with docetaxel.
Research on three-dimensional visualization based on virtual reality and Internet
NASA Astrophysics Data System (ADS)
Wang, Zongmin; Yang, Haibo; Zhao, Hongling; Li, Jiren; Zhu, Qiang; Zhang, Xiaohong; Sun, Kai
2007-06-01
To disclose and display water information, a three-dimensional visualization system based on Virtual Reality (VR) and Internet is researched for demonstrating "digital water conservancy" application and also for routine management of reservoir. To explore and mine in-depth information, after completion of modeling high resolution DEM with reliable quality, topographical analysis, visibility analysis and reservoir volume computation are studied. And also, some parameters including slope, water level and NDVI are selected to classify easy-landslide zone in water-level-fluctuating zone of reservoir area. To establish virtual reservoir scene, two kinds of methods are used respectively for experiencing immersion, interaction and imagination (3I). First virtual scene contains more detailed textures to increase reality on graphical workstation with virtual reality engine Open Scene Graph (OSG). Second virtual scene is for internet users with fewer details for assuring fluent speed.
Almeida, Diogo F; Ruben, Rui B; Folgado, João; Fernandes, Paulo R; Audenaert, Emmanuel; Verhegghe, Benedict; De Beule, Matthieu
2016-12-01
Femur segmentation can be an important tool in orthopedic surgical planning. However, in order to overcome the need of an experienced user with extensive knowledge on the techniques, segmentation should be fully automatic. In this paper a new fully automatic femur segmentation method for CT images is presented. This method is also able to define automatically the medullary canal and performs well even in low resolution CT scans. Fully automatic femoral segmentation was performed adapting a template mesh of the femoral volume to medical images. In order to achieve this, an adaptation of the active shape model (ASM) technique based on the statistical shape model (SSM) and local appearance model (LAM) of the femur with a novel initialization method was used, to drive the template mesh deformation in order to fit the in-image femoral shape in a time effective approach. With the proposed method a 98% convergence rate was achieved. For high resolution CT images group the average error is less than 1mm. For the low resolution image group the results are also accurate and the average error is less than 1.5mm. The proposed segmentation pipeline is accurate, robust and completely user free. The method is robust to patient orientation, image artifacts and poorly defined edges. The results excelled even in CT images with a significant slice thickness, i.e., above 5mm. Medullary canal segmentation increases the geometric information that can be used in orthopedic surgical planning or in finite element analysis. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
The natural history of skin-limited Langerhans cell histiocytosis: a single-institution experience.
Ehrhardt, Matthew J; Humphrey, Stephen R; Kelly, Michael E; Chiu, Yvonne E; Galbraith, Sheila S
2014-11-01
Prior reports of Langerhans cell histiocytosis (LCH) suggest that isolated skin involvement is rare and often progresses to systemic disease. More rapid access to pediatric subspecialty care has likely led to more frequent representation of this condition. The purpose of this study is to characterize the natural history of skin-limited LCH in an era of increased access to pediatric subspecialty care. A retrospective chart review was performed on all patients newly diagnosed with LCH between 2001 and 2012 at the Children's Hospital of Wisconsin. Extensive review of laboratory, physical examination, and imaging reports was performed and data collected for patients with biopsy-proven skin LCH. Sixteen individuals with skin-limited LCH were identified. The median age at onset of skin eruption was birth (range, birth to 6 mo), and median duration of follow-up was 19.5 months (range, 2 wk to 10 y) from diagnosis. One patient (6%) developed pituitary disease and 1 patient (6%) had refractory skin involvement. All others experienced complete resolution. For patients without progressive or refractory disease, resolution of skin findings occurred within 7 months from onset. Progression of skin-limited to multisystem LCH likely may be less frequent than previously described.
Optic neuritis occurring with anti‐tumour necrosis factor α therapy
Simsek, Ismail; Erdem, Hakan; Pay, Salih; Sobaci, Gungor; Dinc, Ayhan
2007-01-01
Objective Various demyelinating disorders have been reported in association with anti‐tumour necrosis factor α (TNFα) agents. The objective of this study was to review the occurrence, clinical features and outcome of optic neuritis (ON) during treatment with anti‐TNFα agents. Methods A PubMed search was conducted to identify literature addressing the potential association between anti‐TNFα agents and ON, following our experience with a patient having rheumatoid arthritis in whom ON developed while being treated with infliximab. Results 15 patients including the case presented here with ON in whom the symptoms developed following TNFα antagonist therapy were evaluated. Eight of these patients had received infliximab, five had received etanercept and two patients had received adalimumab. Among them, nine patients experienced complete resolution, and two patients had partial resolution, while four patients continued to have symptoms. Discussion Patients being treated with a TNFα antagonist should be closely monitored for the development of ophthalmological or neurological signs and symptoms. Furthermore, consideration should be given to avoiding such therapies in patients with a history of demyelinating disease. If clinical evaluation leads to the diagnosis of ON, discontinuation of the medication and institution of steroid treatment should be a priority. PMID:17456525
Identifying Pregnant Women Experiencing Domestic Violence in an Urban Emergency Department
ERIC Educational Resources Information Center
Datner, Elizabeth M.; Wiebe, Douglas J.; Brensinger, Colleen M.; Nelson, Deborah B.
2007-01-01
The article describes characteristics of pregnant women presenting to the Emergency Department (ED) who are experiencing current violence and presented a screening tool to identify pregnant women experiencing violence. Women completed an in-person interview regarding violence, sociodemo-graphic factors, health status, and drug use. Fifteen percent…
Barriers to Specialty Care and Specialty Referral Completion in the Community Health Center Setting
Zuckerman, Katharine E.; Perrin, James M.; Hobrecker, Karin; Donelan, Karen
2013-01-01
Objective To assess the frequency of barriers to specialty care and to assess which barriers are associated with an incomplete specialty referral (not attending a specialty visit when referred by a primary care provider) among children seen in community health centers. Study design Two months after their child’s specialty referral, 341 parents completed telephone surveys assessing whether a specialty visit was completed and whether they experienced any of 10 barriers to care. Family/community barriers included difficulty leaving work, obtaining childcare, obtaining transportation, and inadequate insurance. Health care system barriers included getting appointments quickly, understanding doctors and nurses, communicating with doctors’ offices, locating offices, accessing interpreters, and inconvenient office hours. We calculated barrier frequency and total barriers experienced. Using logistic regression, we assessed which barriers were associated with incomplete referral, and whether experiencing ≥4 barriers was associated with incomplete referral. Results A total of 22.9% of families experienced incomplete referral. 42.0% of families encountered 1 or more barriers. The most frequent barriers were difficulty leaving work, obtaining childcare, and obtaining transportation. On multivariate analysis, difficulty getting appointments quickly, difficulty finding doctors’ offices, and inconvenient office hours were associated with incomplete referral. Families experiencing ≥4 barriers were more likely than those experiencing ≤3 barriers to have incomplete referral. Conclusion Barriers to specialty care were common and associated with incomplete referral. Families experiencing many barriers had greater risk of incomplete referral. Improving family/community factors may increase satisfaction with specialty care; however, improving health system factors may be the best way to reduce incomplete referrals. PMID:22929162
Conflict Resolution in Parent-Adolescent Relationships and Adolescent Delinquency
ERIC Educational Resources Information Center
Van Doorn, Muriel D.; Branje, Susan J. T.; Meeus, Wim H. J.
2008-01-01
This study examines the relation between conflict resolution styles in parent-adolescent relationships and adolescent delinquency. Questionnaires about conflict resolution styles were completed by 284 early adolescents (mean age 13.3) and their parents. Adolescents also completed a questionnaire on delinquency. Hierarchical regression analyses…
Lavallee, Christina F; Persinger, Michael A
2010-12-01
Previous studies exploring mental time travel paradigms with functional neuroimaging techniques have uncovered both common and distinct neural correlates of re-experiencing past events or pre-experiencing future events. A gap in the mental time travel literature exists, as paradigms have not explored the affective component of re-experiencing past episodic events; this study explored this sparsely researched area. The present study employed standardized low resolution electromagnetic tomography (sLORETA) to identify electrophysiological correlates of re-experience affect-laden and non-affective past events, as well as pre-experiencing a future anticipated event. Our results confirm previous research and are also novel in that we illustrate common and distinct electrophysiological correlates of re-experiencing affective episodic events. Furthermore, research from this experiment yields results outlining a pattern of activation in the frontal and temporal regions is correlated with the time frame of past or future events subjects imagined. Copyright © 2010 Elsevier Inc. All rights reserved.
Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro
2017-05-01
Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.
Social interaction and pain: An arctic expedition.
Block, Per; Heathcote, Lauren C; Burnett Heyes, Stephanie
2018-01-01
Complex human behaviour can only be understood within its social environment. However, disentangling the causal links between individual outcomes and social network position is empirically challenging. We present a research design in a closed real-world setting with high-resolution temporal data to understand this interplay within a fundamental human experience - physical pain. Study participants completed an isolated 3-week hiking expedition in the Arctic Circle during which they were subject to the same variation in environmental conditions and only interacted amongst themselves. Adolescents provided daily ratings of pain and social interaction partners. Using longitudinal network models, we analyze the interplay between social network position and the experience of pain. Specifically, we test whether experiencing pain is linked to decreasing popularity (increasing isolation), whether adolescents prefer to interact with others experiencing similar pain (homophily), and whether participants are increasingly likely to report similar pain as their interaction partners (contagion). We find that reporting pain is associated with decreasing popularity - interestingly, this effect holds for males only. Further exploratory analyses suggest this is at least partly driven by males withdrawing from contact with females when in pain, enhancing our understanding of pain and masculinity. Contrary to recent experimental and clinical studies, we found no evidence of pain homophily or contagion in the expedition group. Copyright © 2018 Elsevier Ltd. All rights reserved.
Safety of direct endoscopic necrosectomy in patients with gastric varices
Storm, Andrew C; Thompson, Christopher C
2016-01-01
AIM: To determine the feasibility and safety of transgastric direct endoscopic necrosectomy (DEN) in patients with walled-off necrosis (WON) and gastric varices. METHODS: A single center retrospective study of consecutive DEN for WON was performed from 2012 to 2015. All DEN cases with gastric fundal varices noted on endoscopy, computed tomography (CT) or magnetic resonance imaging (MRI) during the admission for DEN were collected for analysis. In all cases, external urethral sphincter (EUS) with doppler was used to exclude the presence of intervening gastric varices or other vascular structures prior to 19 gauge fine-needle aspiration (FNA) needle access into the cavity. The tract was serially dilated to 20 mm and was entered with an endoscope for DEN. Pigtail stents were placed to facilitate drainage of the cavity. Procedure details were recorded. Comprehensive chart review was performed to evaluate for complications and WON recurrence. RESULTS: Fifteen patients who underwent DEN for WON had gastric varices at the time of their procedure. All patients had an INR < 1.5 and platelets > 50. Of these patients, 11 had splenic vein thrombosis and 2 had portal vein thrombosis. Two patients had isolated gastric varices, type 1 and the remaining 13 had > 5 mm gastric submucosal varices on imaging by CT, MRI or EUS. No procedures were terminated without completing the DEN for any reason. One patient had self-limited intraprocedural bleeding related to balloon dilation of the tract. Two patients experienced delayed bleeding at 2 and 5 d post-op respectively. One required no therapy or intervention and the other received 1 unit transfusion and had an EGD which revealed no active bleeding. Resolution rate of WON was 100% (after up to 2 additional DEN in one patient) and no patients required interventional radiology or surgical interventions. CONCLUSION: In patients with WON and gastric varices, DEN using EUS and doppler guidance may be performed safely. Successful resolution of WON does not appear to be compromised by the presence of gastric varices, with similar rates of resolution and only minor bleeding events. Experienced centers should not consider gastric varices a contraindication to DEN. PMID:27247707
The Abscopal Effect Associated With a Systemic Anti-melanoma Immune Response
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stamell, Emily F.; Wolchok, Jedd D.; Ludwig Institute for Cancer Research, Memorial Sloan-Kettering Cancer Center, New York, New York
2013-02-01
The clearance of nonirradiated tumors after localized radiation therapy is known as the abscopal effect. Activation of an antitumor immune response has been proposed as a mechanism for the abscopal effect. Here we report a patient with metastatic melanoma who received palliative radiation to his primary tumor with subsequent clearance of all his nonirradiated in-transit metastases. Anti-MAGEA3 antibodies were found upon serological testing, demonstrating an association between the abscopal effect and a systemic antitumor immune response. A brain recurrence was then treated with a combination of stereotactic radiosurgery and immunotherapy with ipilimumab. The patient experienced a complete remission that includedmore » resolution of nodal metastases, with a concomitant increase in MAGEA3 titers and a new response to the cancer antigen PASD1. This case supports the immune hypothesis for the abscopal effect, and illustrates the potential of combining radiotherapy and immunotherapy in the treatment of melanoma.« less
Symptomatic Shigella sonnei urinary tract infection in pregnancy.
Baka, S; Spathi, A; Tsouma, I; Kouskouni, E
2013-01-01
This report describes a case of urinary tract infection (UTI) due to Shigella sonnei during pregnancy. A 31-year-old pregnant woman was admitted complaining of left-flank tenderness, dysuria, and fever. Following examination, significant laboratory data were collected including increased leukocyte count (10,800/ul with 86% neutrophils) and C-reactive protein (9.6 mg/dl). Urinalysis revealed 30 to 50 leukocytes per high power field while from the quantitative urine culture Shigella sonnei was recovered after 24 h incubation at 37 degrees C. After a two-week course with 750 mg cefuroxime every 8 h, the patient experienced gradual resolution of all symptoms and urinary cultures were negative two weeks and one month, respectively, after completing the therapy. The gestational course was uneventful and the patient delivered a healthy baby girl at term. Shigella sonnei can be responsible for UTI during pregnancy even when no predisposing factors or an apparent source of infection can be identified.
Heterosis and outbreeding depression: A multi-locus model and an application to salmon production
Emlen, John M.
1991-01-01
Both artificial propagation and efforts to preserve or augment natural populations sometimes involve, wittingly or unwittingly, the mixing of different gene pools. The advantages of such mixing vis-à-vis the alleviation of inbreeding depression are well known. Acknowledged, but less well understood, are the complications posed by outbreeding depression. This paper derives a simple model of outbreeding depression and demonstrates that it is reasonably possible to predict the generation-to-generation fitness course of hybrids derived from parents from different origins. Genetic difference, or distance between parental types, is defined by the drop in fitness experienced by one type reared at the site to which the other is locally adapted. For situations where decisions involving stock mixing must be made in the absence of complete information, a sensitivity analysis-based conflict resolution method (the Good-Bad-Ugly model) is described.
Hampton, Cheri M; Strauss, Joshua D; Ke, Zunlong; Dillard, Rebecca S; Hammonds, Jason E; Alonas, Eric; Desai, Tanay M; Marin, Mariana; Storms, Rachel E; Leon, Fredrick; Melikyan, Gregory B; Santangelo, Philip J; Spearman, Paul W; Wright, Elizabeth R
2016-01-01
Correlative light and electron microscopy (CLEM) combines spatiotemporal information from fluorescence light microscopy (fLM) with high-resolution structural data from cryo-electron tomography (cryo-ET). These technologies provide opportunities to bridge knowledge gaps between cell and structural biology. Here we describe our protocol for correlated cryo-fLM, cryo-electron microscopy (cryo-EM), and cryo-ET (i.e., cryo-CLEM) of virus-infected or transfected mammalian cells. Mammalian-derived cells are cultured on EM substrates, using optimized conditions that ensure that the cells are spread thinly across the substrate and are not physically disrupted. The cells are then screened by fLM and vitrified before acquisition of cryo-fLM and cryo-ET images, which is followed by data processing. A complete session from grid preparation through data collection and processing takes 5–15 d for an individual experienced in cryo-EM. PMID:27977021
Insulinoma as rare cause of severe post-partum hypoglycemia.
Holstein, Andreas; Morgenstern, Thomas; Dienst, Henry; Hiller, Wolfgang
2015-11-01
Post-partum hypoglycemia in non-diabetic women is a rare condition. We report the exceptional case of a 38-year-old obese woman who experienced recurrent neuroglycopenia 3 weeks after delivery. Corresponding to severe hypoglycemia with blood glucose levels of <30 mg/dL, there was no suppression of insulin or C-peptide. Through endoscopic ultrasound we detected a hypoechoic lesion of 8 × 9 mm localized in the head of the pancreas. Thus, the diagnosis of insulinoma was most probable. Complete surgical enucleation of the insulinoma resulted in immediate and permanent resolution of hypoglycemia. The postoperative course was complicated by recurrent episodes of pancreatitis requiring endoscopic ultrasound-guided punctures of pseudocysts and temporary stenting of the pancreatic duct. In conclusion, insulinoma is a very rare, nonetheless important, differential diagnosis of post-partum hypoglycemia. © 2015 Japan Society of Obstetrics and Gynecology.
A patient with mushroom allergy; a new etiological agent of Kounis syndrome.
Tepetam, Fatma Merve; Dağdeviren, Bahadır; Bulut, İsmet; Karabay, Can Yücel; Barış, Safa; Aydıner Karakoç, Elif
2016-06-01
Kounis syndrome (KS) is a rarely diagnosed condition which should always be kept in mind when an acute myocardial infarction (AMI) happens in the context of anaphylactic reactions. We report a case of a 31-year old female; 2 hours after the ingestion of the mushroom (Pleurotus ostreatus); she experienced nausea, stomachache, vomiting, dyspnea and chest pain. Electrocardiogram (ECG) showed an ST segment elevation in D1, AVL, precordial leads V1-V4. The blood analysis revealed high levels of CK-MB fraction and troponin T values. The diagnosis of Kounis syndrome was made in the catheterization laboratory via the complete resolution of angina, along with electrocardiographic changes that took place after intracoronary nitrate therapy and skin prick to prick test positivism with the mushroom. To the best of our knowledge, this is the first case of a type I variant of Kounis syndrome due to Pleurotus ostreatus allergy reported so far.
An unusual cause of intractable heel pain.
Ghani, Samuel; Fazal, Muhammad Ali
2011-01-01
We report a case of severe heel pain that did not respond to noninvasive measures. Magnetic resonance imaging scans revealed a soft tissue mass that after complete surgical excision was found to be an epidermal cyst. The patient experienced full resolution of the symptoms after excision of the epidermal cyst. To our knowledge, intractable heel pain due to an epidermal cyst is rare. We were unable to identify a previous publication describing the presence of an epidermal cyst localized to the heel without a history of previous trauma. From our experience with the present case, we believe that clinicians should consider the possibility of an epidermal inclusion cyst and should have a low threshold for obtaining magnetic resonance imaging scans, in particular, before the initiation of invasive treatment, in the case of intractable heel pain. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Purtscher's retinopathy that occurred 6 months before acute pancreatitis.
Sharma, Ashish G; Kazim, Nadia A; Eliott, Dean; Houghton, Odette; Abrams, Gary W
2006-01-01
To report Purtscher's retinopathy in a patient with chronic pancreatitis 6 months before the development of fulminant acute pancreatitis. Observational case report. Review of clinical chart, photographs, fluorescein angiography, and optical coherence tomography. A 45-year-old man with a history of alcohol abuse with a 3-day history of decreased vision in both eyes was examined. Diffuse retinal whitening and intraretinal hemorrhages that were consistent with Purtscher's retinopathy were present in both eyes. Serum amylase and lipase levels were normal. Six months later, he experienced intractable abdominal pain. Serum amylase and lipase levels were elevated markedly. Abdominal computed tomography and endoscopic retrograde cholangiopancreatography confirmed acute pancreatitis, with evidence of coexisting chronic pancreatitis. His funduscopic examination after the development of acute pancreatitis was improved, with almost complete resolution of retinal whitening and hemorrhages. Visual acuity remained poor because of retinal ischemia. Purtscher's retinopathy can be associated with chronic pancreatitis and can precede the development of fulminant acute pancreatitis.
Matito, A; Álvarez-Twose, I; Morgado, J M; Sánchez-Muñoz, L; Orfao, A; Escribano, L
2011-01-01
The impact of pregnancy on mast cell (MC)-related symptoms and newborn outcome in women with mastocytosis is not well described. We report a series of 30 women who had 45 pregnancies. Patients completed a specific questionnaire concerning MC mediator release symptoms graded according to their frequency to detect clinical changes occurring during pregestation and pregnancy as well as postpartum. Information about the medications received during pregnancy and labor and about newborn medical complications was also recorded. Worsening of MC-related symptoms during pregnancy was observed in 10 cases (22%); additionally, 1 woman developed skin lesions as a manifestation of indolent systemic mastocytosis (ISM) within the third trimester of pregnancy. Conversely, 15 cases (33%) experienced clinical improvement during pregnancy, with a complete resolution of pregestational symptoms in 7 cases. MC mediator release symptoms intrapartum were observed in 5 cases (11%) without any fatal outcome. Newborn medical complications (e.g. prematurity, low birth weight, and respiratory distress) were detected in 7 infants (16%) who were all successfully managed with conservative measures. One infant developed cutaneous mastocytosis several years after birth. Mastocytosis has a heterogeneous clinical behavior during pregnancy: the profile of MC-related symptoms remained unchanged in half of the cases, while in the other half pregnant women experienced either an improvement or an exacerbation of the symptoms, with the manifestation of ISM during pregnancy in 1 case. To prevent potential life-threatening MC-related symptoms, adequate prophylactic antimediator therapy intrapartum should be systematically administered. The absence of both maternal and infant severe complications suggests that patients with nonaggressive categories of mastocytosis should not be advised against pregnancy. Copyright © 2011 S. Karger AG, Basel.
Gaffney, Hannah; Mansell, Warren; Edwards, Rachel; Wright, Jason
2014-11-01
Computerized self-help that has an interactive, conversational format holds several advantages, such as flexibility across presenting problems and ease of use. We designed a new program called MYLO that utilizes the principles of METHOD of Levels (MOL) therapy--based upon Perceptual Control Theory (PCT). We tested the efficacy of MYLO, tested whether the psychological change mechanisms described by PCT mediated its efficacy, and evaluated effects of client expectancy. Forty-eight student participants were randomly assigned to MYLO or a comparison program ELIZA. Participants discussed a problem they were currently experiencing with their assigned program and completed measures of distress, resolution and expectancy preintervention, postintervention and at 2-week follow-up. MYLO and ELIZA were associated with reductions in distress, depression, anxiety and stress. MYLO was considered more helpful and led to greater problem resolution. The psychological change processes predicted higher ratings of MYLO's helpfulness and reductions in distress. Positive expectancies towards computer-based problem solving correlated with MYLO's perceived helpfulness and greater problem resolution, and this was partly mediated by the psychological change processes identified. The findings provide provisional support for the acceptability of the MYLO program in a non-clinical sample although its efficacy as an innovative computer-based aid to problem solving remains unclear. Nevertheless, the findings provide tentative early support for the mechanisms of psychological change identified within PCT and highlight the importance of client expectations on predicting engagement in computer-based self-help.
NASA Astrophysics Data System (ADS)
Carroll, M.; McCarty, J. L.; Neigh, C. S. R.; Wooten, M.
2016-12-01
Very high resolution (VHR) satellite data is experiencing rapid annual growth, producing petabytes of remotely sensed data per year. The WorldView constellation, operated by DigitalGlobe, images over 1.2 billion km2 annually at a > 2 m spatial resolution. Due to computation, data cost, and methodological concerns, VHR satellite data has mainly been used to produce needed geospatial information for site-specific phenomenon. This project produced a VHR spatiotemporally-explicit wall-to-wall cropland area map for the rainfed residential cropland mosaic of Tigray Region, Ethiopia, which is comprised entirely of smallholder farms. Moderate resolution satellite data is not adequate in spatial or temporal resolution to capture total area occupied by smallholder farms, i.e., farms with agricultural fields of ≥ 45 × 45 m in dimension. In order to accurately map smallholder crop area over a large region, hundreds of VHR images spanning two or more years are needed. Sub-meter WorldView-1 and WorldView-2 segmentation results were combined median phenology amplitude from Landsat 8 data. VHR WorldView-1, -2 data were obtained from the U.S. National Geospatial-Intelligence Agency (NGA) Commercial Archive Data at NASA Goddard Space Flight Center (GSFC) (http://cad4nasa.gsfc.nasa.gov/). Over 2700 scenes were processed from raw imagery to completed crop map in 1 week in a semi-automated method using the large computing capacity of the Advanced Data Analytics Platform (ADAPT) at NASA GSFC's NCCS (http://www.nccs.nasa.gov/services/adapt). This methodology is extensible to any land cover type and can easily be expanded to run on much larger regions.
Hess, Karl; Goad, Jeffery; Wu, Joanne; Johnson, Kathleen
2009-01-01
The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacist-managed LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants were university students diagnosed with LTBI. The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p=.04 and p=.03, respectively). LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.
Strassman, R J; Qualls, C R; Uhlenhuth, E H; Kellner, R
1994-02-01
Validation of animal models of hallucinogenic drugs' subjective effects requires human data. Previous human studies used varied groups of subjects and assessment methods. Rating scales for hallucinogen effects emphasized psychodynamic principles or the drugs' dysphoric properties. We describe the subjective effects of graded doses of N,N-dimethyltryptamine (DMT), an endogenous hallucinogen and drug of abuse, in a group of experienced hallucinogen users. We also present preliminary data from a new rating scale for these effects. Twelve highly motivated volunteers received two doses (0.04 and 0.4 mg/kg) of intravenous (IV) dimethyltryptamine fumarate "nonblind," before entering a double-blind, saline placebo-controlled, randomized study using four doses of IV DMT. Subjects were carefully interviewed after resolution of drug effects, providing thorough and systematic descriptions of DMT's effects. They also were administered a new instrument, the Hallucinogen Rating Scale (HRS). The HRS was drafted from interviews obtained from an independent sample of 19 experienced DMT users, and modified during early stages of the study. Psychological effects of IV DMT began almost immediately after administration, peaked at 90 to 120 seconds, and were almost completely resolved by 30 minutes. This time course paralleled DMT blood levels previously described. Hallucinogenic effects were seen after 0.2 and 0.4 mg/kg of dimethyltryptamine fumarate, and included a rapidly moving, brightly colored visual display of images. Auditory effects were less common. "Loss of control," associated with a brief, but overwhelming "rush," led to a dissociated state, where euphoria alternated or coexisted with anxiety. These effects completely replaced subjects' previously ongoing mental experience and were more vivid and compelling than dreams or waking awareness. Lower doses, 0.1 and 0.05 mg/kg, were primarily affective and somaesthetic, while 0.1 mg/kg elicited the least desirable effects. Clustering of HRS items, using either a clinical, mental status method or principal components factor analysis provided better resolution of dose effects than did the biological variables described previously. These clinical and preliminary quantitative data provide bases for further psychopharmacologic characterization of DMT's properties in humans. They also may be used to compare the effects of other agents affecting relevant brain receptors in volunteer and psychiatric populations.
Hyperbaric Oxygen Therapy for Radiation-Induced Cystitis and Proctitis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Oliai, Caspian; Fisher, Brandon; Jani, Ashish
Purpose: To provide a retrospective analysis of the efficacy of hyperbaric oxygen therapy (HBOT) for treating hemorrhagic cystitis (HC) and proctitis secondary to pelvic- and prostate-only radiotherapy. Methods and Materials: Nineteen patients were treated with HBOT for radiation-induced HC and proctitis. The median age at treatment was 66 years (range, 15-84 years). The range of external-beam radiation delivered was 50.0-75.6 Gy. Bleeding must have been refractory to other therapies. Patients received 100% oxygen at 2.0 atmospheres absolute pressure for 90-120 min per treatment in a monoplace chamber. Symptoms were retrospectively scored according to the Late Effects of Normal Tissues-Subjective, Objective,more » Management, Analytic (LENT-SOMA) scale to evaluate short-term efficacy. Recurrence of hematuria/hematochezia was used to assess long-term efficacy. Results: Four of the 19 patients were lost to follow-up. Fifteen patients were evaluated and received a mean of 29.8 dives: 11 developed HC and 4 proctitis. All patients experienced a reduction in their LENT-SOMA score. After completion of HBOT, the mean LENT-SOMA score was reduced from 0.78 to 0.20 in patients with HC and from 0.66 to 0.26 in patients with proctitis. Median follow-up was 39 months (range, 7-70 months). No cases of hematuria were refractory to HBOT. Complete resolution of hematuria was seen in 81% (n = 9) and partial response in 18% (n = 2). Recurrence of hematuria occurred in 36% (n = 4) after a median of 10 months. Complete resolution of hematochezia was seen in 50% (n = 2), partial response in 25% (n = 1), and refractory bleeding in 25% (n = 1). Conclusions: Hyperbaric oxygen therapy is appropriate for radiation-induced HC once less time-consuming therapies have failed to resolve the bleeding. In these conditions, HBOT is efficacious in the short and long term, with minimal side effects.« less
Ferrario, Catherine G
2003-01-01
To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (> or = 5 years' experience) and novice (< 5 years' experience) emergency nurses. Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less-experienced emergency nurses (N = 219). Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses. Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote student's cognitive development through strategies that promote active, reflective, and integrative learning.
Physalis and physaloids: A recent and complex evolutionary history.
Zamora-Tavares, María Del Pilar; Martínez, Mahinda; Magallón, Susana; Guzmán-Dávalos, Laura; Vargas-Ponce, Ofelia
2016-07-01
The complex evolutionary history of the subtribe Physalinae is reflected in the poor resolution of the relationships of Physalis and the physaloid genera. We hypothesize that this low resolution is caused by recent evolutionary history in a complex geographic setting. The aims of this study were twofold: (1) To determine the phylogenetic relationships of the current genera recognized in Physalinae in order to identify monophyletic groups and resolve the physaloid grade; and (2) to determine the probable causes of the recent divergence in Physalinae. We conducted phylogenetic analyses with maximum likelihood (ML) and Bayesian inference with 50 Physalinae species and 19 others as outgroups, using morphological and molecular data from five plastid and two nuclear regions. A relaxed molecular clock was obtained from the ML topology and ancestral area reconstruction was conducted using the DEC model. The genera Chamaesaracha, Leucophysalis, and Physalis subgenus Rydbergis were recovered as monophyletic. Three clades, Alkekengi-Calliphysalis, Schraderanthus-Tzeltalia, and Witheringia-Brachistus, also received good support. However, even with morphological data and that of the DNA of seven regions, the tree was not completely resolved and many clades remained unsupported. Physalinae diverged at the end of the Miocene (∼9.22Mya) with one trend indicating that the greatest diversification within the subtribe occurred during the last 5My. The Neotropical region presented the highest probability (45%) of being the ancestral area of Physalinae followed by the Mexican Transition Zone (35%). During the Pliocene and Pleistocene, the geographical areas where species were found experienced significant geological and climatic changes, giving rise to rapid and relatively recent diversification events in Physalinae. Thus, recent origin, high diversification, and morphological complexity have contributed, at least with the currently available methods, to the inability to completely disentangle the phylogenetic relationships of Physalinae. Copyright © 2016 Elsevier Inc. All rights reserved.
Fabris, Enrico; van 't Hof, Arnoud; Hamm, Christian W; Lapostolle, Frédéric; Lassen, Jens F; Goodman, Shaun G; Ten Berg, Jurriën M; Bolognese, Leonardo; Cequier, Angel; Chettibi, Mohamed; Hammett, Christopher J; Huber, Kurt; Janzon, Magnus; Merkely, Béla; Storey, Robert F; Zeymer, Uwe; Cantor, Warren J; Tsatsaris, Anne; Kerneis, Mathieu; Diallo, Abdourahmane; Vicaut, Eric; Montalescot, Gilles
2017-08-01
In the ATLANTIC (Administration of Ticagrelor in the catheterization laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery) trial the early use of aspirin, anticoagulation, and ticagrelor coupled with very short medical contact-to-balloon times represent good indicators of optimal treatment of ST-elevation myocardial infarction and an ideal setting to explore which factors may influence coronary reperfusion beyond a well-established pre-hospital system. This study sought to evaluate predictors of complete ST-segment resolution after percutaneous coronary intervention in ST-elevation myocardial infarction patients enrolled in the ATLANTIC trial. ST-segment analysis was performed on electrocardiograms recorded at the time of inclusion (pre-hospital electrocardiogram), and one hour after percutaneous coronary intervention (post-percutaneous coronary intervention electrocardiogram) by an independent core laboratory. Complete ST-segment resolution was defined as ≥70% ST-segment resolution. Complete ST-segment resolution occurred post-percutaneous coronary intervention in 54.9% ( n=800/1456) of patients and predicted lower 30-day composite major adverse cardiovascular and cerebrovascular events (odds ratio 0.35, 95% confidence interval 0.19-0.65; p<0.01), definite stent thrombosis (odds ratio 0.18, 95% confidence interval 0.02-0.88; p=0.03), and total mortality (odds ratio 0.43, 95% confidence interval 0.19-0.97; p=0.04). In multivariate analysis, independent negative predictors of complete ST-segment resolution were the time from symptoms to pre-hospital electrocardiogram (odds ratio 0.91, 95% confidence interval 0.85-0.98; p<0.01) and diabetes mellitus (odds ratio 0.6, 95% confidence interval 0.44-0.83; p<0.01); pre-hospital ticagrelor treatment showed a favorable trend for complete ST-segment resolution (odds ratio 1.22, 95% confidence interval 0.99-1.51; p=0.06). This study confirmed that post-percutaneous coronary intervention complete ST-segment resolution is a valid surrogate marker for cardiovascular clinical outcomes. In the current era of ST-elevation myocardial infarction reperfusion, patients' delay and diabetes mellitus are independent predictors of poor reperfusion and need specific attention in the future.
Experience of Surgical Treatment for Occipital Migraine in Taiwan.
Lin, Shang-Hsi; Lin, Huwang-Chi; Jeng, Chu-Hsu; Hsieh, Cheng-Han; Lin, Yu-Hsien; Chen, Cha-Chun
2016-03-01
Refractory migraine surgery developed since 2003 has excellent results over the past 10 years. According to the pioneer of migraine surgery, Dr. Bahman Guyuron, 5 major surgical classifications of migraines are described in the field of plastic surgery, namely, frontal migraine, temporal migraine, rhinogenic migraine, occipital migraine, and auriculotemporal migraine. In this study, we present the preliminary surgical results of the occipital migraine surgery. A total of 22 patients with simple occipital migraines came to our outpatient clinic for help from June 2014 to February 2015. Thirteen cases were excluded owing to ineligibility for operation or other reasons. The patients who concurrently experienced other types of migraines were precluded even if they received combined migraine surgery. Therefore, 9 simple occipital migraine cases were enrolled in this study. Migraine severity was evaluated by uniform questionnaires to identify the source of migraine. Neurolysis was performed under general anesthesia, with the patient in a prone position. Postoperative conditions were evaluated at the second, fourth, sixth, and eighth weeks by posttreatment questionnaires. Of all the 9 patients, 5 experienced single-sided migraines of greater occipital nerve origin (2 left-sided and 3 right-sided cases). Two patients had bilateral migraines of greater occipital nerve origin, and unilateral right lesser occipital nerve origin was noted in one patient. The last patient had right-sided migraines of greater and lesser occipital nerve origin. As a result in the follow-up, a response rate greater than 90% was documented, and complete resolution was observed in 2 patients. Drug doses were reduced more than 50% in the remaining patients. The overall efficacy of occipital migraine surgery in this study was 88.8% (8/9 cases). Some patients with migraine are good candidates for surgical resolution with appropriate and meticulous selection. Similar to what is observed in Western countries, the migraine surgery is promising and could provide a better quality of life to selected refractory migraine patients in Taiwan.
Depression and parenting by nonoffending mothers of children who experienced sexual abuse.
Santa-Sosa, Eileen J; Steer, Robert A; Deblinger, Esther; Runyon, Melissa K
2013-01-01
Parenting may be one mechanism by which depression in nonoffending mothers impacts child emotional and behavioral adjustment after sexual abuse. This study examined the relationship between self-reported maternal depression and parenting behaviors by nonoffending mothers of children who experienced sexual abuse. The participants were 204 nonoffending biological mother-child pairs recruited from a clinic providing services for children who experienced sexual abuse. The mothers completed pretreatment self-report measures of demographic information, depression, and parenting behaviors. Children (7 to 17 years) completed a measure of mothers' parenting behaviors. Mothers with clinically high levels of self-reported depression employed more inconsistent parenting behavior and provided poorer monitoring/supervision of their children than mothers without clinically high levels of self-reported depression. Implications for clinical practice and future research are discussed.
McVea, Charmaine S; Gow, Kathryn; Lowe, Roger
2011-07-01
This study investigated the process of resolving painful emotional experience during psychodrama group therapy, by examining significant therapeutic events within seven psychodrama enactments. A comprehensive process analysis of four resolved and three not-resolved cases identified five meta-processes which were linked to in-session resolution. One was a readiness to engage in the therapeutic process, which was influenced by client characteristics and the client's experience of the group; and four were therapeutic events: (1) re-experiencing with insight; (2) activating resourcefulness; (3) social atom repair with emotional release; and (4) integration. A corrective interpersonal experience (social atom repair) healed the sense of fragmentation and interpersonal disconnection associated with unresolved emotional pain, and emotional release was therapeutically helpful when located within the enactment of this new role relationship. Protagonists who experienced resolution reported important improvements in interpersonal functioning and sense of self which they attributed to this experience.
Cryopyrin-associated periodic syndromes and the eye.
Oberg, Thomas J; Vitale, Albert T; Hoffman, Robert O; Bohnsack, John F; Warner, Judith E
2013-08-01
To describe the ophthalmologic findings in two patients with Muckle-Wells Syndrome, a phenotype of the Cryopyrin Associated Periodic Syndromes (CAPS) spectrum. There is currently sparse ophthalmic literature regarding the ocular manifestations of CAPS. We hope to increase awareness of this spectrum of diseases and the importance of proper treatment amongst eye care professionals. Interventional Case Series. Patient 1 experienced resolution of aseptic meningitis, papilledema, and anterior uveitis following treatment with anikinra. Patient 2 experienced resolution of panuveitis following treatment with anikinra. The severe ocular manifestations of the most severe CAPS phenotype, Chronic Infantile Neurological Cutaneous and Articular Syndrome/Neonatal Onset Multisystem Inflammatory Disease Syndrome (CINCA/NOMID) have been previously described. There is increasing evidence that patients may experience similar ocular disease with the milder phenotype of Muckle-Wells Sydnrome. There is also increasing evidence that appropriate therapy can have a profound effect on patient prognosis.
Curiosity and time: from not knowing to almost knowing.
Noordewier, Marret K; van Dijk, Eric
2017-04-01
How does it feel to be curious? We reasoned that there are two sides to curiosity: not knowing something (i.e. information-gap) and almost knowing something (i.e. anticipation of resolution). In three experiments, we showed that time affects the relative impact of these two components: When people did not expect to close their information-gap soon (long time-to-resolution) not knowing affected the subjective experience of curiosity more strongly than when they expected to close their information-gap quickly (short time-to-resolution). As such, people experienced less positive affect, more discomfort, and more annoyance with lack of information in a long than a short time-to-resolution situation. Moreover, when time in the long time-to-resolution setting passed, the anticipation of the resolution became stronger, positive affect increased, and discomfort and annoyance with lack of information decreased. Time is thus a key factor in the experience of curiosity.
30 CFR 48.6 - Experienced miner training.
Code of Federal Regulations, 2010 CFR
2010-07-01
.... (b) Experienced miners must complete the training prescribed in this section before beginning work... to work environment. The course shall include a visit and tour of the mine. The methods of mining... responsibilities of such supervisors and miners' representatives; and an introduction to the operator's rules and...
Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study.
VonHoltz, Lauren A Houdek; Frasso, Rosemary; Golinkoff, Jesse M; Lozano, Alicia J; Hanlon, Alexandra; Dowshen, Nadia
2018-05-22
Youth experiencing homelessness are at a risk for a variety of adverse outcomes. Given the widespread use of the internet and social media, these new technologies may be used to address their needs and for outreach purposes. However, little is known about how this group uses these resources. This study investigated how homeless adolescents use these technologies for general and health-related purposes, whether the scope of their use changes with housing status, and their interest in a website dedicated to youth experiencing homelessness. A convenience sample of youth aged 18 to 21 years was recruited from a youth-specific homeless shelter. All participants completed a 47-item survey, with 10 individuals completing a semistructured interview. Descriptive statistics, exact testing, logistic regression, and generalized estimating equation modeling was performed for quantitative data analysis. Interviews were transcribed verbatim, and NVivo 10 (QSR International) was employed to facilitate double coding and thematic analysis. A total of 87 participants completed the survey with a mean age of 19.4 (SD 1.1) years. While experiencing homelessness, 56% (49/87) accessed the internet at least once a day, with 86% (75/87) accessing once a week. Access to a smartphone was associated with a 3.03 greater odds of accessing the internet and was the most frequently used device (66% of participants, 57/87). While experiencing homelessness, subjects reported a 68% decreased odds in internet access frequency (odds ratio [OR] 0.32, P<.001), 75% decreased odds in spending greater amounts of time on the internet (OR 0.25, P<.001), and an 87% decreased odds of social media use (OR 0.13, P=.01). Ten participants completed the semistructured interview. Several themes were identified, including (1) changes in internet behaviors while experiencing homelessness, (2) health status as a major concern and reason for Internet use, and (3) interest in a website dedicated to youth experiencing homelessness. While experiencing homelessness, participants indicated their behaviors were more goal-oriented and less focused on leisure or entertainment activities. While homeless youth experience changes in the frequency, amount of time, and specific uses of the internet and social media, study participants were able to access the internet regularly. The internet was used to search health-related topics. Given the importance of smartphones in accessing the internet, mobile-optimized websites may be an effective method for reaching this group. ©Lauren A Houdek VonHoltz, Rosemary Frasso, Jesse M Golinkoff, Alicia J Lozano, Alexandra Hanlon, Nadia Dowshen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2018.
Mangnall, Louise A R; Dietrich, Thomas; Scholey, John M
2013-01-01
Objective: To determine patient experience of pain during treatment with fixed orthodontic appliances, expectations of pain during debond and whether biting on a soft acrylic wafer during debond decreases pain experience. Design: Multicentre randomized controlled trial. Setting: Three UK hospital based orthodontic departments: Mid-Staffordshire NHS Foundation Trust, Birmingham Dental Hospital and University Hospital of North Staffordshire. Materials and methods: Ninety patients were randomly allocated to either the control (n = 45) or wafer group (n = 45). A visual analogue scale-based questionnaire was completed pre-debond to determine pain experience during treatment and expectations of pain during debond. The appliances were debonded and those in the wafer group bit on a soft acrylic wafer. A second questionnaire was completed post-debond to assess the pain experienced. Results: Biting on an acrylic wafer significantly reduced the pain experienced when debonding the posterior teeth (P≤0·05). Thirty-nine per cent found the lower anterior teeth the most painful. The expected pain was significantly greater than that actually experienced (P≤0·0001). Greater pain during treatment correlated with increased expectations and increased actually experienced pain (P≤0·0001). Conclusions: Biting on a soft acrylic wafer during debond of the posterior teeth reduces the pain experienced. The lower anterior teeth are the most painful. The pain expected is significantly greater than actually experienced. Patients who had greater pain during treatment expected and experienced greater pain at debond. PMID:24009318
Kanwar, Siddak M; Noheria, Amit; DeSimone, Christopher V; Rabinstein, Alejandro A; Asirvatham, Samuel J
2016-03-01
We analyzed the literature to assess the coincidental impact on migraines of transcatheter patent foramen ovale (PFO) closure performed for secondary stroke prevention. We searched Medline, EMBASE, and the Cochrane database for studies published up until August 2013. We included English-language studies that provided information on complete resolution or improvement in migraine headaches following PFO closure. Two study authors identified 375 original articles and both independently reviewed 32 relevant manuscripts. Data including study methodology, inclusion criteria, PFO closure and migraine outcomes were extracted manually from all eligible studies. Pooled odds (and probability) of resolution or improvement of migraine headaches were calculated using random-effects models. Twenty studies were analyzed. Most were uncontrolled studies that included a small number of patients with cryptogenic stroke who had undergone PFO closure and had variable time of followup. The probability of complete resolution of migraine with PFO closure (18 studies, 917 patients) was 0.46 (95% confidence interval 0.39, 0.53) and of any improvement in migraine (17 studies, 881 patients) was 0.78 (0.74, 0.82). There was evidence for publication bias in studies reporting on improvement in migraines (Begg's p=0.002), but not for studies on complete resolution of migraine (p=0.3). In patients with aura, the probability of complete resolution of migraine post-PFO closure was 0.54 (0.43, 0.65), and in those without aura, complete resolution occurred in 0.39 (0.29, 0.51). Among patients with unexplained stroke and migraine undergoing transcatheter PFO closure, resolution of headaches occurred in a majority of patients with aura and for a smaller proportion of patients without aura.
Dodson, Elizabeth A; Langston, Marvin; Cardick, Lauren C; Johnson, Nancy; Clayton, Paula; Brownson, Ross C
2014-02-20
Regular physical activity can help prevent chronic diseases, yet only half of US adults meet national physical activity guidelines. One barrier to physical activity is a lack of safe places to be active, such as bike paths and sidewalks. Complete Streets, streets designed to enable safe access for all users, can help provide safe places for activity. This community case study presents results from interviews with residents and policymakers of Topeka, Kansas, who played an integral role in the passage of a Complete Streets resolution in 2009. It describes community engagement processes used to include stakeholders, assess existing roads and sidewalks, and communicate with the public and decision-makers. Key informant interviews were conducted with city council members and members of Heartland Healthy Neighborhoods in Topeka to learn how they introduced a Complete Streets resolution and the steps they took to ensure its successful passage in the City Council. Interviews were recorded, transcribed, and analyzed by using focused-coding qualitative analysis. Results included lessons learned from the process of passing the Complete Streets resolution and advice from participants for other communities interested in creating Complete Streets in their communities. Lessons learned can apply to other communities pursuing Complete Streets. Examples include clearly defining Complete Streets; educating the public, advocates, and decision-makers about Complete Streets and how this program enhances a community; building a strong and diverse network of supporters; and using stories and examples from other communities with Complete Streets to build a convincing case.
Langston, Marvin; Cardick, Lauren C.; Johnson, Nancy; Clayton, Paula; Brownson, Ross C.
2014-01-01
Background Regular physical activity can help prevent chronic diseases, yet only half of US adults meet national physical activity guidelines. One barrier to physical activity is a lack of safe places to be active, such as bike paths and sidewalks. Complete Streets, streets designed to enable safe access for all users, can help provide safe places for activity. Community Context This community case study presents results from interviews with residents and policymakers of Topeka, Kansas, who played an integral role in the passage of a Complete Streets resolution in 2009. It describes community engagement processes used to include stakeholders, assess existing roads and sidewalks, and communicate with the public and decision-makers. Methods Key informant interviews were conducted with city council members and members of Heartland Healthy Neighborhoods in Topeka to learn how they introduced a Complete Streets resolution and the steps they took to ensure its successful passage in the City Council. Interviews were recorded, transcribed, and analyzed by using focused-coding qualitative analysis. Outcome Results included lessons learned from the process of passing the Complete Streets resolution and advice from participants for other communities interested in creating Complete Streets in their communities. Interpretation Lessons learned can apply to other communities pursuing Complete Streets. Examples include clearly defining Complete Streets; educating the public, advocates, and decision-makers about Complete Streets and how this program enhances a community; building a strong and diverse network of supporters; and using stories and examples from other communities with Complete Streets to build a convincing case. PMID:24556251
Relationship between resolution and accuracy of four intraoral scanners in complete-arch impressions
Pascual-Moscardó, Agustín; Camps, Isabel
2018-01-01
Background The scanner does not measure the dental surface continually. Instead, it generates a point cloud, and these points are then joined to form the scanned object. This approximation will depend on the number of points generated (resolution), which can lead to low accuracy (trueness and precision) when fewer points are obtained. The purpose of this study is to determine the resolution of four intraoral digital imaging systems and to demonstrate the relationship between accuracy and resolution of the intraoral scanner in impressions of a complete dental arch. Material and Methods A master cast of the complete maxillary arch was prepared with different dental preparations. Using four digital impression systems, the cast was scanned inside of a black methacrylate box, obtaining a total of 40 digital impressions from each scanner. The resolution was obtained by dividing the number of points of each digital impression by the total surface area of the cast. Accuracy was evaluated using a three-dimensional measurement software, using the “best alignment” method of the casts with a highly faithful reference model obtained from an industrial scanner. Pearson correlation was used for statistical analysis of the data. Results Of the intraoral scanners, Omnicam is the system with the best resolution, with 79.82 points per mm2, followed by True Definition with 54.68 points per mm2, Trios with 41.21 points per mm2, and iTero with 34.20 points per mm2. However, the study found no relationship between resolution and accuracy of the study digital impression systems (P >0.05), except for Omnicam and its precision. Conclusions The resolution of the digital impression systems has no relationship with the accuracy they achieve in the impression of a complete dental arch. The study found that the Omnicam scanner is the system that obtains the best resolution, and that as the resolution increases, its precision increases. Key words:Trueness, precision, accuracy, resolution, intraoral scanner, digital impression. PMID:29750097
ERIC Educational Resources Information Center
Yarhouse, Mark A.; Nowacki-Butzen, Stephanie; Brooks, D. Fredrica
2009-01-01
The authors explored the experiences of African American men who identified as Christian and experienced same-sex attraction. Participants completed an online questionnaire addressing experiences of same-sex attraction; meaning attributed to their attractions; the sharing of their experiences with others; and perceptions regarding the intersection…
Granulomatous Lobular Mastitis.
Mahlab-Guri, Keren; Asher, Ilan; Allweis, Tanir; Diment, Judith; Sthoeger, Zev M; Mavor, Eliezer
2015-08-01
Granulomatous lobular mastitis (GLM) is a rare disorder that can clinically mimic breast carcinoma. The recommendation for diagnosis and treatment of GLM has not yet been established. To assess a series of GLM patients, including their clinical presentation, diagnosis, treatment and outcome. We retrospectively analyzed the clinical data and treatment of 17 female patients with biopsy-proven GLM. Breast tissue was obtained by a core needle biopsy (15 patients) or open biopsy (2 patients). Images were reviewed by an experienced radiologist. The mean age of the patients at diagnosis was 44.6 ± 12.6 years. Five patients (29%) presented with bilateral disease, and seven (41%) presented with a mass, suggesting the initial diagnosis of breast carcinoma. Treatment comprised observation alone (23%), antibiotics (58.8%) and/or corticosteroids (with or without methotrexate) (35%). At the end of the study 70.6% of the patients demonstrated complete remission. None of the patients developed any systemic (granulomatous) disease or breast carcinoma during the follow-up period (4.7 ± 3.8 years). Core needle biopsy is mandatory for the diagnosis of GLM and the exclusion of breast carcinoma. The recommended treatment modalities are observation alone or corticosteroids; surgery should be avoided. GLM is a benign disease with a high rate of resolution and complete remission.
A monolithic patch-clamping amplifier with capacitive feedback.
Prakash, J; Paulos, J J; Jensen, D N
1989-03-01
Patch-clamping is an established method for directly measuring ionic transport through cellular membranes with sufficient resolution to observe open/close transitions of individual channel molecules. This paper describes an alternative technique for patch-clamping which uses a capacitor as the transimpedance element. This approach eliminates bandwidth and saturation limitations experienced with resistive patch-clamping amplifiers. A complete monolithic design featuring an on-chip operational amplifier, a capacitor array with gain-ranging from 30 pF down to 0.03 pF, and reset and gain ranging switches has been fabricated using 5 microns CMOS technology. It is shown that the voltage noise of the CMOS operational amplifier limits the overall noise performance, but that performance competitive with conventional instruments can be achieved over a 10 kHz bandwidth, at least for small input capacitances (less than or equal to 5 pF). Results are presented along with an analysis and comparison of noise performance using both resistive and capacitive elements.
Ultrasound-Guided Steroid Injection of the Pisotriquetral Joint: A Multidisciplinary Effort.
Brose, Steven W; Montfort, Janel; Gustafson, Kenneth J; Mittebrun, Ionica; Gauriloff, Samantha; Mosher, Mary; Bourbeau, Dennis J
2017-12-01
From the perspective of a multidisciplinary team, the authors describe the first reported use of ultrasound guidance for steroid injection into the pisotriquetral joint to relieve wrist pain of a person with spinal cord injury undergoing acute inpatient rehabilitation. Musculoskeletal ultrasound guidance was used to improve the accuracy of a corticosteroid injection of the pisotriquetral joint and the basal thumb in a 70-year-old man with paraplegia experiencing multifocal degenerative wrist pain. There was no bleeding or bruising after the injections, and the patient reported complete pain resolution 1 wk after the injections, which continued for over 1 yr. A multidisciplinary team was key in diagnosis, selection of treatment, and evaluation of treatment effect. Corticosteroid injection of the pisotriquetral joint under ultrasound guidance can be used as a treatment modality for managing wrist pain stemming from that joint. Further investigation and studies evaluating the use of ultrasound versus other imaging modalities for injection of the wrist are indicated.
Jarc, Anthony M; Curet, Myriam
2015-08-01
Validated training exercises are essential tools for surgeons as they develop technical skills to use robot-assisted minimally invasive surgical systems. The purpose of this study was to show face, content, and construct validity of four, inanimate training exercises using the da Vinci (®) Si surgical system configured with Single-Site (™) instrumentation. New (N = 21) and experienced (N = 6) surgeons participated in the study. New surgeons (11 Gynecology [GYN] and 10 General Surgery [GEN]) had not completed any da Vinci Single-Site cases but may have completed multiport cases using the da Vinci system. They participated in this study prior to attending a certification course focused on da Vinci Single-Site instrumentation. Experienced surgeons (5 GYN and 1 GEN) had completed at least 25 da Vinci Single-Site cases. The surgeons completed four inanimate training exercises and then rated them with a questionnaire. Raw metrics and overall normalized scores were computed using both video recordings and kinematic data collected from the surgical system. The experienced surgeons significantly outperformed new surgeons for many raw metrics and the overall normalized scores derived from video review (p < 0.05). Only one exercise did not achieve a significant difference between new and experienced surgeons (p = 0.08) when calculating an overall normalized score using both video and advanced metrics derived from kinematic data. Both new and experienced surgeons rated the training exercises as appearing, to train and measure technical skills used during da Vinci Single-Site surgery and actually testing the technical skills used during da Vinci Single-Site surgery. In summary, the four training exercises showed face, content, and construct validity. Improved overall scores could be developed using additional metrics not included in this study. The results suggest that the training exercises could be used in an overall training curriculum aimed at developing proficiency in technical skills for surgeons new to da Vinci Single-Site instrumentation.
Androgyny, Ego Development and Psychosocial Crisis Resolution.
ERIC Educational Resources Information Center
Prager, Karen J.; Bailey, John M.
The present study examined the relationship of psychological androgyny with ego development in the context of Loevinger's theory, and with psychosocial crisis resolution from the perspective of Erikson's theory. A sample of 30 male and 30 female adults completed the Bem Sex Role Inventory, the Washington University Sentence Completion Test and the…
Realized Potential or Lost Talent: High School Variables and Bachelor's Degree Completion
ERIC Educational Resources Information Center
Trusty, Jerry; Niles, Spencer G.
2004-01-01
This study examined how background and high school variables affected participants in either realizing their potential by completing a bachelor's degree or experiencing lost talent by not completing a bachelor's degree. A sample of participants who had demonstrated above average cognitive ability and had high postsecondary educational goals when…
The Organization of Wariness of Heights in Experienced Crawlers
ERIC Educational Resources Information Center
Ueno, Mika; Uchiyama, Ichiro; Campos, Joseph J.; Dahl, Audun; Anderson, David I.
2012-01-01
Most infants with more than 6 weeks of crawling experience completely avoid the deep side of a visual cliff (Campos, Bertenthal, & Kermoian, 1992; Gibson & Walk, 1960). However, some experienced crawlers do move onto the transparent surface suspended several feet above the ground. An important question is whether these "nonavoiders" lack wariness…
[Evaluation of a training system for middle ear surgery with optoelectric detection].
Strauss, G; Bahrami, N; Pössneck, A; Strauss, M; Dietz, A; Korb, W; Lüth, T; Haase, R; Moeckel, H; Grunert, R
2009-10-01
This work presents a new training concept for surgery of the temporal bone. It is based on a model of gypsum plastic with optoelectric detection of risk structures. A prototypical evaluation is given. The training models are based on high-resolution computed tomographic data of a human skull. The resulting data set was printed by a three-dimensional (3D) printer. A 3D phantom is created from gypsum powder and a bonding agent. Risks structures are the facial nerve, semicircular canal, cochlea, ossicular chain, sigmoid sinus, dura, and internal carotid artery. An electrically conductive metal (Wood's metal) and a fiber-optic cable were used as detection materials for the risk structures. For evaluating the training system, a study was done with eight inexperienced and eight experienced ear surgeons. They were asked to perform temporal bone surgery using two identical training models (group A). In group B, the same surgeons underwent surgical training with human cadavers. In the case of injuries, the number, point in time, degree (facial nerve), and injured structure were documented during the training on the model. In addition, the total time needed was noted. The training systems could be used in all cases. Evaluation of the anatomic accuracy of the models showed results that were between 49.5% and 90% agreement with the anatomic origin. Error detection was evaluated with values between 79% and 100% agreement with the perception of an experienced surgeon. The operating setting was estimated to be better than the previous"gold standard." The possibility of completely replacing the previous training method, which uses cadavers, with the examined training model was affirmed. This study shows that the examined system fulfills the conditions for a new training concept for temporal bone surgery. The system connects the preliminary work with printed and sintered models with the possibilities of microsystem engineering. In addition, the model's digital database permits a complete virtual representation of the model with appropriate further applications ("look behind the wall," virtual endoscopy).
Jeffries, William L; Gelaude, Deborah J; Torrone, Elizabeth A; Gasiorowicz, Mari; Oster, Alexandra M; Spikes, Pilgrim S; McCree, Donna Hubbard; Bertolli, Jeanne
2017-01-01
Unfavourable social environments can negatively affect the health of gay, bisexual, and other men who have sex with men (MSM). We described how experienced homonegativity - negative perceptions and treatment that MSM encounter due to their sexual orientations - can increase HIV vulnerability among young MSM. Participants (n = 44) were young MSM diagnosed with HIV infection during January 2006-June 2009. All participants completed questionnaires that assessed experienced homonegativity and related factors (e.g. internalised homonegativity). We focus this analysis on qualitative interviews in which a subset of participants (n = 28) described factors that they perceived to have placed them at risk for HIV infection. Inductive content analysis identified themes within qualitative interviews, and we determined the prevalence of homonegativity and related factors using questionnaires. In qualitative interviews, participants reported that young MSM commonly experienced homonegativity. They described how homonegativity generated internalised homonegativity, HIV stigma, silence around homosexuality, and forced housing displacement. These factors could promote HIV risk. Homonegative experiences were more common among young Black (vs. non-Black) MSM who completed questionnaires. Results illustrate multiple pathways through which experienced homonegativity may increase HIV vulnerability among young MSM. Interventions that target homonegativity might help to reduce the burden of HIV within this population.
Zaidi, Hasan A; Cote, David J; Burke, William T; Castlen, Joseph P; Bi, Wenya Linda; Laws, Edward R; Dunn, Ian F
2016-12-01
Pituitary tumor apoplexy can result from either hemorrhagic or infarctive expansion of pituitary adenomas, and the related mass effect can result in compression of critical neurovascular structures. The time course of recovery of visual field deficits, headaches, ophthalmoparesis, and pituitary dysfunction after endoscopic transsphenoidal surgery has not been well established. Medical records were retrospectively reviewed for all patients who underwent endoscopic transsphenoidal surgery for pituitary tumor apoplexy from April 2008 to November 2014. Of 578 patients who underwent transsphenoidal surgery, pituitary tumor apoplexy was identified in 44 patients (7.6%). Two patients had prior surgery, leaving 42 patients for final analysis. These included infarction-related apoplexy in 7 (14.4%) patients, and hemorrhagic apoplexy in 35 (85.6%) patients. Hemorrhagic adenomas had a larger axial tumor diameter than patients with infarctive adenomas (4.4 ± 4.1 cm vs. 1.8 ± 0.8 cm; P < 0.01), but were otherwise equivalent. At an average last follow-up of 2.52 years (range, 0.1-6.7 years), resolution of ophthalmoparesis as a result of pituitary tumor apoplexy demonstrated the longest recovery course (range, 2.4 ± 2.2 months) compared with visual field deficits (range, 8.0 ± 9.9 days), headaches (range, 1.9 ± 3.0 days), or pituitary dysfunction (range, 2.0 ± 1.8 weeks; P < 0.01). All patients who presented with headaches (n = 37) and/or visual disturbances (n = 22) had complete resolution of symptoms at last follow-up, whereas 83.3% of patients who presented with ophthalmoplegia experienced resolution. Endocrinologic dysfunction remained relatively consistent after surgery. Endoscopic transsphenoidal surgery can provide durable resolution of symptoms for patients presenting with pituitary tumor apoplexy. Recovery from headaches, visual, and pituitary dysfunction may be more rapid compared with ophthalmoparesis. Copyright © 2016 Elsevier Inc. All rights reserved.
Somatic experiencing: using interoception and proprioception as core elements of trauma therapy
Payne, Peter; Levine, Peter A.; Crane-Godreau, Mardi A.
2015-01-01
Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing® (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic, and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of SE treatment; based on this example, we offer a possible neurophysiological rationale for the mechanisms involved, including a theory of trauma and chronic stress as a functional dysregulation of the complex dynamical system formed by the subcortical autonomic, limbic, motor and arousal systems, which we term the core response network (CRN). We demonstrate how the methods of SE help restore functionality to the CRN, and we emphasize the importance of taking into account the instinctive, bodily based protective reactions when dealing with stress and trauma, as well as the effectiveness of using attention to interoceptive, proprioceptive and kinesthetic sensation as a therapeutic tool. Finally, we point out that SE and similar somatic approaches offer a supplement to cognitive and exposure therapies, and that mechanisms similar to those discussed in the paper may also be involved in the benefits of meditation and other somatic practices. PMID:25699005
NASA Astrophysics Data System (ADS)
Ozendi, Mustafa; Topan, Hüseyin; Cam, Ali; Bayık, Çağlar
2016-10-01
Recently two optical remote sensing satellites, RASAT and GÖKTÜRK-2, launched successfully by the Republic of Turkey. RASAT has 7.5 m panchromatic, and 15 m visible bands whereas GÖKTÜRK-2 has 2.5 m panchromatic and 5 m VNIR (Visible and Near Infrared) bands. These bands with various resolutions can be fused by pan-sharpening methods which is an important application area of optical remote sensing imagery. So that, the high geometric resolution of panchromatic band and the high spectral resolution of VNIR bands can be merged. In the literature there are many pan-sharpening methods. However, there is not a standard framework for quality investigation of pan-sharpened imagery. The aim of this study is to investigate pan-sharpening performance of RASAT and GÖKTÜRK-2 images. For this purpose, pan-sharpened images are generated using most popular pan-sharpening methods IHS, Brovey and PCA at first. This procedure is followed by quantitative evaluation of pan-sharpened images using Correlation Coefficient (CC), Root Mean Square Error (RMSE), Relative Average Spectral Error (RASE), Spectral Angle Mapper (SAM) and Erreur Relative Globale Adimensionnelle de Synthése (ERGAS) metrics. For generation of pan-sharpened images and computation of metrics SharpQ tool is used which is developed with MATLAB computing language. According to metrics, PCA derived pan-sharpened image is the most similar one to multispectral image for RASAT, and Brovey derived pan-sharpened image is the most similar one to multispectral image for GÖKTÜRK-2. Finally, pan-sharpened images are evaluated qualitatively in terms of object availability and completeness for various land covers (such as urban, forest and flat areas) by a group of operators who are experienced in remote sensing imagery.
Dynamics of Saturn’s 2010 Great White Spot from high-resolution Cassini ISS observations
NASA Astrophysics Data System (ADS)
Hueso, Ricardo; Sánchez-Lavega, A.; del Río-Gaztelurrutia, T.
2012-10-01
On December 5th 2010 a storm erupted in Saturn’s North Temperate latitudes which were experiencing early spring season. The storm quickly developed to a planet-wide disturbance of the Great White Spot type. The ISS instrument onboard Cassini acquired its first images of the storm on 23th December 2010 and performed repeated observations with a variety of spatial resolutions over the nearly 10 months period the storm continued active. Here we present an analysis of two of the image sequences with better spatial resolution of the mature storm when it was fully developed and very active. We used an image correlation algorithm to measure the cloud motions obtained from images separated 20 minutes and obtained 16,000 wind tracers in a domain of 60 degrees longitude per 20 degrees in latitude. Intense zonal and meridional motions accompanied the storm and reached values of 120 m/s in particular regions of the active storm. The storm released a chain of anticyclonic and cyclonic vortices at planetocentric latitudes of 36° and 32° respectively. The short time difference between the images results in estimated wind uncertainties of 15 m/s that did not allow to perform a complete analysis of the turbulence and kinetic spectrum of the motions. We identify locations of the updrafts and link those with the morphology in different observing filters. The global behaviour of the storm was examined in images separated by 10 hours confirming the intensity of the winds and the global behaviour of the vortices. Acknowledgments: This work was supported by the Spanish MICIIN project AYA2009-10701 with FEDER funds, by Grupos Gobierno Vasco IT-464-07 and by Universidad País Vasco UPV/EHU through program UFI11/55.
Moriichi, Kentaro; Fujiya, Mikihiro; Sato, Ryu; Watari, Jiro; Nomura, Yoshiki; Nata, Toshie; Ueno, Nobuhiro; Maeda, Shigeaki; Kashima, Shin; Itabashi, Kentaro; Ishikawa, Chisato; Inaba, Yuhei; Ito, Takahiro; Okamoto, Kotaro; Tanabe, Hiroki; Mizukami, Yusuke; Saitoh, Yusuke; Kohgo, Yutaka
2012-06-22
Some patients under close colonoscopic surveillance still develop colorectal cancer, thus suggesting the overlook of colorectal adenoma by endoscopists. AFI detects colorectal adenoma as a clear magenta, therefore the efficacy of AFI is expected to improve the detection ability of colorectal adenoma. The aim of this study is to determine the efficacy of AFI in detecting colorectal adenoma. This study enrolled 88 patients who underwent colonoscopy at Asahikawa Medical University and Kushiro Medical Association Hospital. A randomly selected colonoscopist first observed the sigmoid colon and rectum with conventional high resolution endosopy (HRE). Then the colonoscopist changed the mode to AFI and handed to the scope to another colonoscopist who knew no information about the HRE. Then the second colonoscopist observed the sigmoid colon and rectum. Each colonoscopist separately recorded the findings. The detection rate, miss rate and procedural time were assessed in prospective manner. The detection rate of flat and depressed adenoma, but not elevated adenoma, by AFI is significantly higher than that by HRE. In less-experienced endoscopists, AFI dramatically increased the detection rate (30.3%) and reduced miss rate (0%) of colorectal adenoma in comparison to those of HRE (7.7%, 50.0%), but not for experienced endoscopists. The procedural time of HRE was significantly shorter than that of AFI. AFI increased the detection rate and reduced the miss rate of flat and depressed adenomas. These advantages of AFI were limited to less-experienced endoscopists because experienced endoscopists exhibited a substantially high detection rate for colorectal adenoma with HRE.
2012-01-01
Background Some patients under close colonoscopic surveillance still develop colorectal cancer, thus suggesting the overlook of colorectal adenoma by endoscopists. AFI detects colorectal adenoma as a clear magenta, therefore the efficacy of AFI is expected to improve the detection ability of colorectal adenoma. The aim of this study is to determine the efficacy of AFI in detecting colorectal adenoma. Methods This study enrolled 88 patients who underwent colonoscopy at Asahikawa Medical University and Kushiro Medical Association Hospital. A randomly selected colonoscopist first observed the sigmoid colon and rectum with conventional high resolution endosopy (HRE). Then the colonoscopist changed the mode to AFI and handed to the scope to another colonoscopist who knew no information about the HRE. Then the second colonoscopist observed the sigmoid colon and rectum. Each colonoscopist separately recorded the findings. The detection rate, miss rate and procedural time were assessed in prospective manner. Results The detection rate of flat and depressed adenoma, but not elevated adenoma, by AFI is significantly higher than that by HRE. In less-experienced endoscopists, AFI dramatically increased the detection rate (30.3%) and reduced miss rate (0%) of colorectal adenoma in comparison to those of HRE (7.7%, 50.0%), but not for experienced endoscopists. The procedural time of HRE was significantly shorter than that of AFI. Conclusions AFI increased the detection rate and reduced the miss rate of flat and depressed adenomas. These advantages of AFI were limited to less-experienced endoscopists because experienced endoscopists exhibited a substantially high detection rate for colorectal adenoma with HRE. PMID:22726319
Pignolo, Robert J; Bedford-Gay, Christopher; Liljesthröm, Moira; Durbin-Johnson, Blythe P; Shore, Eileen M; Rocke, David M; Kaplan, Frederick S
2016-03-01
Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive global assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.
Calvopiña, Manuel; Cevallos, William; Paredes, Yolanda; Puebla, Edison; Flores, Jessica; Loor, Richard; Padilla, José
2017-11-01
Meglumine Antimoniate (MA), administered intramuscularly for 21 continuous days is the recommended treatment of leishmaniases in Ecuador. However, because of its toxicity and requirement for intramuscular injections, treatment is frequently abandoned before completion. In addition, therapeutic failure and reactivation are not uncommon. Here we evaluate the efficacy and safety of MA administered intralesionally (IL) in leishmaniasis recidiva cutis (LRC). LRC is a special clinical variant of cutaneous leishmaniasis, characterized by reactivation at the edges of a primary cured lesion, presenting with active papules around the scar. Twenty-one patients were included in the study. All were diagnosed parasitologically by one of three diagnostic methods (smear, culture, and Leishmanin skin test). Each patient received MA intralesionally weekly for 4 weeks. Each papule was infiltrated until complete saturation. On average, patients received 1 mL of MA per administration. The criterion of cure was the complete resolution of the papules. Follow up was performed at 30, 90, and 180 days after treatment. At day 30 after treatment, 19 (90.5%) of 21 patients were clinically cured. The two patients, who did not heal by the fourth application, were cured on the seventh and eighth dose, achieving a clinical cure of 100% without subsequent reactivation. Mild to moderate local pain during infiltration was the only adverse reaction experienced by 81% of patients. In one case, subsequent infiltrations were discontinued because of a local allergic reaction. Complete compliance of patients to treatment and the small volume of drug administered make this method of administering MA an effective, safe, and inexpensive alternative. Consequently, IL could replace intramuscular administration in the treatment of LRC in Ecuador.
Phylogenomic Analysis and Dynamic Evolution of Chloroplast Genomes in Salicaceae
Huang, Yuan; Wang, Jun; Yang, Yongping; Fan, Chuanzhu; Chen, Jiahui
2017-01-01
Chloroplast genomes of plants are highly conserved in both gene order and gene content. Analysis of the whole chloroplast genome is known to provide much more informative DNA sites and thus generates high resolution for plant phylogenies. Here, we report the complete chloroplast genomes of three Salix species in family Salicaceae. Phylogeny of Salicaceae inferred from complete chloroplast genomes is generally consistent with previous studies but resolved with higher statistical support. Incongruences of phylogeny, however, are observed in genus Populus, which most likely results from homoplasy. By comparing three Salix chloroplast genomes with the published chloroplast genomes of other Salicaceae species, we demonstrate that the synteny and length of chloroplast genomes in Salicaceae are highly conserved but experienced dynamic evolution among species. We identify seven positively selected chloroplast genes in Salicaceae, which might be related to the adaptive evolution of Salicaceae species. Comparative chloroplast genome analysis within the family also indicates that some chloroplast genes are lost or became pseudogenes, infer that the chloroplast genes horizontally transferred to the nucleus genome. Based on the complete nucleus genome sequences from two Salicaceae species, we remarkably identify that the entire chloroplast genome is indeed transferred and integrated to the nucleus genome in the individual of the reference genome of P. trichocarpa at least once. This observation, along with presence of the large nuclear plastid DNA (NUPTs) and NUPTs-containing multiple chloroplast genes in their original order in the chloroplast genome, favors the DNA-mediated hypothesis of organelle to nucleus DNA transfer. Overall, the phylogenomic analysis using chloroplast complete genomes clearly elucidates the phylogeny of Salicaceae. The identification of positively selected chloroplast genes and dynamic chloroplast-to-nucleus gene transfers in Salicaceae provide resources to better understand the successful adaptation of Salicaceae species. PMID:28676809
Eggleston, A; Katelaris, P H; Nandurkar, S; Thorpe, P; Holtmann, G
2009-05-01
A trial of empirical PPI therapy is usual practice for most patients with symptoms of gastro-oesophageal reflux disease (GERD) in primary care. To determine if the 4-week efficacy of rabeprazole 20 mg for resolving heartburn and regurgitation symptoms is non-inferior to esomeprazole 40 mg or 20 mg. In all, 1392 patients were randomized to rabeprazole 20 mg, esomeprazole 20 mg or 40 mg once daily. Patients, doctors and assessors were blinded. Symptom resolution data were collected on days 0-7 and day-28 using the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index with a shortened version used on days 8-27. Rabeprazole 20 mg was non-inferior to esomeprazole 40 mg for complete resolution of regurgitation and satisfactory resolution of heartburn and regurgitation. For complete heartburn resolution, the efficacy of rabeprazole 20 mg and esomeprazole 40 mg was statistically indistinguishable, although the non-inferiority test was inconclusive. Rabeprazole 20 mg was non-inferior to esomeprazole 20 mg for all outcomes. In uninvestigated GERD patients, rabeprazole 20 mg was non-inferior to esomeprazole 40 mg for complete and satisfactory relief of regurgitation and satisfactory relief of heartburn, and not different for complete resolution of heartburn.
Understanding the Phenomenon of Overcoming Academic Challenges and Failure to Achieve Academic Goals
ERIC Educational Resources Information Center
Jama, Sam
2017-01-01
This study explored the experiences of 10 adults who had experienced academic challenges during their studies, yet were able to return to academic studies and complete one or more graduate degrees. The participants were separated into two groups. "Group A" participants experienced academic failure and were asked to withdraw from their…
ERIC Educational Resources Information Center
Lewis, Erin E.; Dozier, Mary; Ackerman, John; Sepulveda-Kozakowski, Sandra
2007-01-01
This study assessed relations among placement instability, inhibitory control, and caregiver-rated child behavior. The sample included 33 adopted children who had experienced placement instability, 42 adopted children who had experienced 1 stable placement, and 27 children never placed in foster care. Five- and 6-year-old children completed the…
Ismail, Rita; Linder, Lauri A; MacPherson, Catherine Fiona; Fugate Woods, Nancy
2016-01-01
To evaluate feasibility, including usability and utility, of the Computerized Symptom Capture Tool for Menopause (C-SCAT-M), a symptom heuristics application (app) for the iPad, with midlife women. Thirty midlife women aged 40-60 and experiencing symptoms they associated with menopause were recruited through flyers posted on a university campus, primary care and women's health clinics. The C-SCAT-M guided participants to identify symptoms they experienced, draw temporal and causal relationships between symptoms and identify symptom clusters. Women were encouraged to think aloud as they encountered questions or problems and their comments were audio recorded. After completing the C-SCAT-M, they completed a 22-item acceptability survey and a demographic survey. Data were downloaded from catalyst website and analyzed using SPSS. Women completed the C-SCAT-M with minimal difficulty, with most indicating that using the app was very/extremely easy and most (57%) preferred using the iPad app to paper. Most women stated that the final diagrams were very/extremely accurate depictions of their symptom clusters and relationships (77%). The C-SCAT-M demonstrated initial feasibility, including usability and utility, for collecting data about symptom clusters experienced by midlife women.
Sentinel events predicting later unwanted sex among girls: A national survey in Haiti, 2012.
Sumner, Steven A; Marcelin, Louis H; Cela, Toni; Mercy, James A; Lea, Veronica; Kress, Howard; Hillis, Susan D
2015-12-01
Sexual violence against children is a significant global public health problem, yet limited studies exist from low-resource settings. In Haiti we conducted the country's first, nationally representative survey focused on childhood violence to help inform the development of a national action plan for violence against children. The Haiti Violence Against Children Survey was a household-level, multistage, cluster survey among youth age 13-24. In this analysis we sought to determine whether sexual violence sentinel events (unwanted sexual touching or unwanted attempted sex) were predictive of later unwanted, completed, penetrative sex in Haiti. We also sought to explore characteristics of sentinel events and help-seeking behavior among Haitian children. Multivariable logistic regression was used to test associations between sentinel events and later unwanted, completed, penetrative sex. Overall, 1,457 females reported on experiences of sexual violence occurring in childhood (before age 18). A sentinel event occurred in 40.4% of females who experienced subsequent unwanted completed sex. Females experiencing a sentinel event were approximately two and a half times more likely to experience later unwanted completed sex (adjusted odds ratio=2.40, p=.004) compared to individuals who did not experience a sentinel event. The mean lag time from first sentinel event to first unwanted completed sex was 2.3 years. Only half (54.6%) of children experiencing a sentinel event told someone about their experience of sexual violence. Among children, sentinel events occur frequently before later acts of completed unwanted sex and may represent a useful point of intervention. Reporting of sexual violence by children in Haiti is low and can be improved to better act on sentinel events. Published by Elsevier Ltd.
Takase, Naoto; Matsumoto, Koji; Onoe, Takuma; Kitao, Akihito; Tanioka, Maki; Kikukawa, Yoshitaka; Yamaguchi, Satoshi; Fujiwara, Kiyoshi; Negoro, Shunichi
2015-06-01
Platinum agents are essential for treating gynecological malignancies, particularly ovarian cancer. However, multiple carboplatin doses may cause hypersensitivity reactions (HSRs). Carboplatin desensitization prevents life-threatening HSRs and promotes the successful completion of planned chemotherapy. Since January 2010, carboplatin desensitization was performed at our institution. Solutions with 1/1000, 1/100, and 1/10 dilutions of carboplatin and an undiluted solution were prepared in 250 mL of 5% glucose. Each solution was administered as a 1-h intravenous infusion (4-step 4-h protocol). This retrospective analysis was approved by the institutional review board. From January 2010 to December 2013, 20 patients with gynecological malignancies (median age 62 years, range 43-74 years) received desensitization treatment. The International Federation of Gynecology and Obstetrics stages at presentation were I, II, III, and IV in 1, 1, 15, 13 patients, respectively. During first-line and second-line treatments, 3 and 17 patients, respectively, experienced carboplatin-induced HSRs. The median carboplatin cycle number was 11 (range 2-16). In the first desensitization cycle, 17 (85%) patients completed treatment without adverse events, 2 experienced Grade 1 HSRs but completed treatment, and 1 experienced Grade 3 HSR and discontinued treatment. The first desensitization cycle completion rate was 95%. Of 83 desensitization cycles administered, 79 (95.2%) were completed. No treatment-related deaths occurred. Most patients completed the planned chemotherapy. Our protocol could be conducted safely with shorter duration and simpler procedures than previous protocols. Carboplatin desensitization seems beneficial for patients with a history of carboplatin-induced HSRs; however, the risk of HSR recurrence still remains. Desensitization should therefore be performed only by well-trained staff.
ERIC Educational Resources Information Center
Austin, Manila S.; Harkins, Debra A.
2008-01-01
Research Findings: Collaborative work and supportive relationships are highly valued by teachers and school administrators. Collaboration, however, necessitates constructive conflict resolution (P. M. Senge, 1990); yet conflict is often experienced as interpersonally threatening and undermining supportive working conditions. This contradiction is…
Perceptual impairment and psychomotor control in virtual laparoscopic surgery.
Wilson, Mark R; McGrath, John S; Vine, Samuel J; Brewer, James; Defriend, David; Masters, Richard S W
2011-07-01
It is recognised that one of the major difficulties in performing laparoscopic surgery is the translation of two-dimensional video image information to a three-dimensional working area. However, research has tended to ignore the gaze and eye-hand coordination strategies employed by laparoscopic surgeons as they attempt to overcome these perceptual constraints. This study sought to examine if measures related to tool movements, gaze strategy, and eye-hand coordination (the quiet eye) differentiate between experienced and novice operators performing a two-handed manoeuvres task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Twenty-five right-handed surgeons were categorised as being either experienced (having led more than 60 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The 10 experienced and 15 novice surgeons completed the "two-hand manoeuvres" task from the LAP Mentor basic skills learning environment while wearing a gaze registration system. Performance, movement, gaze, and eye-hand coordination parameters were recorded and compared between groups. The experienced surgeons completed the task significantly more quickly than the novices, used significantly fewer movements, and displayed shorter tool paths. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. A more detailed analysis of a difficult subcomponent of the task revealed that experienced operators used a significantly longer aiming fixation (the quiet eye period) to guide precision grasping movements and hence needed fewer grasp attempts. The findings of the study provide further support for the utility of examining strategic gaze behaviour and eye-hand coordination measures to help further our understanding of how experienced surgeons attempt to overcome the perceptual difficulties inherent in the laparoscopic environment.
Stress Associated with Transportation: A Survey of Persons with Visual Impairments
ERIC Educational Resources Information Center
Crudden, Adele; Cmar, Jennifer L.; McDonnall, Michele C.
2017-01-01
Introduction: This study evaluated transportation-related stress and factors predicting stress among persons with visual impairments. Methods: Participants with visual impairments completed electronic surveys rating their stress levels experienced when completing various walking and public transportation tasks. They also indicated activities they…
Phantom sensations in people with complete spinal cord lesions: a grounded theory perspective.
Drysdale, Daren G; Shem, Kazuko; Walbom, Agnes; Miner, Maureen D; Maclachlan, Malcolm
2009-01-01
Phantom sensations are somatic phenomena arising from denervated parts of the body. There is very little research, and much diagnostic confusion, regarding such experiences in people with spinal cord injuries. In the case of 'complete' spinal cord lesions, phantom experiences may challenge, and indeed, contradict, the understanding that both clinicians and patients have of such injuries. This paper seeks to provide a better understanding of such 'phantom' sensations in spinal cord injury. We used grounded theory methods to explore 'phantom' sensations as experienced by individuals with complete (ASIA A) spinal lesions. Eight people with complete lesions, who were selected through theoretical sampling, participated in a semi-structured interview. Emergent themes included injury context, sensations experienced, the meaning of sensations, body connectivity, attitude and communication about sensations. Our results provide an enhanced understanding of the embodied experience of phantom sensations, and important insights regarding self-construction and rehabilitative processes in people with spinal cord injury who experience such anomalous sensations.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Scheurig-Muenkler, C., E-mail: christian.scheurig@charite.de; Poellinger, A., E-mail: alexander.poellinger@charite.de; Wagner, M., E-mail: moritz.wagner@charite.de
Purpose: To evaluate the safety and outcome of ovarian artery embolization (OAE) in patients with collateral supply to symptomatic uterine leiomyomata. Materials and Methods: Thirteen patients with relevant leiomyoma perfusion by way of enlarged ovarian arteries underwent additional OAE during the same (N = 10) or a second procedure (N = 3). Uterine artery embolization (UAE) was performed bilaterally in 10 and unilaterally in 2 patients with a single artery. One patient had no typical uterine arteries but bilaterally enlarged ovarian arteries, prompting bilateral OAE. OAE was accomplished with coil embolization in one and particle embolization in 12 patients. Symptomsmore » before therapy and clinical outcome were assessed using a standardized questionnaire. Contrast-enhanced magnetic resonance (MR) imaging after embolization was available in 11 of 13 patients and was used to determine the percentage of fibroid infarction. Results: UAE and OAE were technically successful in all patients. One patient experienced prolonged irritation at the puncture site. Median clinical follow-up time was 16 months (range 4-37). Ten of 13 patients showed improvement or complete resolution of clinical symptoms. One patient reported only slight improvement of her symptoms. These women presented with regular menses. Two patients (15%), 47 and 48 years, both with unilateral OAE, reported permanent amenorrhea directly after embolization. Their symptoms completely resolved. Seven patients showed complete and 4 showed >90% fibroid infarction after embolization therapy. Conclusions: OAE is technically safe and effective in patients with ovarian artery collateral supply to symptomatic uterine leiomyomata. The risk of permanent amenorrhea observed in this study is similar to the reported incidence after UAE.« less
ERIC Educational Resources Information Center
National Center for Homeless Education at SERVE, 2015
2015-01-01
Since the College Cost Reduction and Access Act ([CCRAA], 20 U.S.C. § 1001 et seq.) was signed into law in September of 2007, the issue of college access for youth experiencing homelessness has garnered increased attention. Among other provisions, the CCRAA confers independent student status on unaccompanied homeless youth. This status allows…
Mentoring Preservice Teachers: Identifying Tensions and Possible Resolutions
ERIC Educational Resources Information Center
Hudson, Peter; Hudson, Sue
2018-01-01
Tensions can occur in the mentor-mentee relationship during school-based professional experiences that require problem solving. What are the tensions for mentor teachers in preservice teacher education and how might these tensions be resolved? This qualitative study collected data from 31 high school mentor teachers about tensions experienced with…
Many water utilities in the US using chloramine as disinfectant treatment in their distribution systems have experienced nitrification episodes, which detrimentally impact the water quality. Here, we used 16S rRNA sequencing data to generate high-resolution taxonomic profiles of...
Experiencing Action Evaluation's Cyclic Process: Partnering Conflict, Reflection, and Action
ERIC Educational Resources Information Center
Burrows, Andrea C.; Harkness, Shelly Sheats
2016-01-01
In this article, the authors describe experiences in and offer suggestions from a course entitled "Educational Innovation for Excellence Through Action Research, Conflict Resolution, and Organizational Learning"--an action evaluation (AE). The class was taught using the principles of action research and AE. The authors explore the impact…
Pak, Jaewoo; Lee, Jung Hun; Jeon, Jeong Ho; Lee, Sang Hee
2014-12-01
We report a case of a 43-year-old man with early stage (stage 1) avascular necrosis (AVN) of the femoral head treated with adipose tissue-derived stem cells (ASCs) and platelet-rich plasma (PRP). ASC-containing stromal vascular fraction was mixed with PRP and hyaluronic acid. This mixture was then injected into the diseased hip under ultrasound guidance. The affected hip was reinjected weekly with additional PRP for 4 weeks. The patient was followed-up with sequential magnetic resonance imaging (MRI) scans at 3, 18, and 21 months after treatment, together with Visual Analogue Scale (VAS) Walking Index, Functional Rating Index, Harris Hip Score, and Range of Motion (ROM) assessments. The patient's severe hip pain was considerably improved at 3 months after treatment, with pain scores, ROM and MRI showing near complete resolution of AVN. Pain scores, ROM and MRI at 18 and 21 months after treatment indicated complete resolution of AVN. This case represents the first evidence of complete resolution of early stage AVN of the hip following treatment with ASCs/PRP. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
The Teaching Decisions Simulation: An Interactive Vehicle for Mapping Teaching Decisions.
ERIC Educational Resources Information Center
Strang, Harold R.
1996-01-01
Describes the Teaching Decisions Simulation, a program that allows participants to make decisions regarding lesson plan activities and student and teacher spatial arrangement or interactions. Postlesson feedback includes variables such as completion time and performance measures. Experienced teachers exhibited more deliberation in completing the…
NASA Astrophysics Data System (ADS)
McGrane, S. J.; Hutchins, M. G.; Kjeldsen, T. R.; Miller, J. D.; Bussi, G.; Loewenthal, M.
2015-12-01
Urban areas are widely recognised as a key source of contaminants entering our freshwater systems, yet in spite of this, our understanding of stormwater quality dynamics remains limited. The development of in-situ, high-resolution monitoring equipment has revolutionised our capability to capture flow and water quality data at a sub-hourly resolution, enabling us to potentially enhance our understanding of hydrochemical variations from contrasting landscapes during storm events. During the winter of 2013/2014, the United Kingdom experienced a succession of intense storm events, where the south of the country experienced 200% of the average rainfall, resulting in widespread flooding across the Thames basin. We applied high-frequency (15 minute resolution) water quality monitoring across ten contrasting subcatchments (including rural, urban and mixed land-use catchments), seeking to classify the disparity in water quality conditions both within- and between events. Rural catchments increasingly behave like "urban" catchments as soils wet up and become increasingly responsive to subsequent events, however water quality response during the winter months remains limited. By contrast, increasingly urban catchments yield greater contaminant loads during events, and pre-event baseline chemistry highlights a resupply source in dense urban catchments. Wastewater treatment plants were shown to dominate baseline chemistry during low-flow events but also yield a considerable impact on stormwater outputs during peak-flow events, as hydraulic push results in the outflow of untreated solid wastes into the river system. Results are discussed in the context of water quality policy; urban growth scenarios and BMP for stormwater runoff in contrasting landscapes.
Young, Eric D; Ingram, Davis; Metcalf-Doetsch, William; Khan, Dilshad; Al Sannaa, Ghadah; Le Loarer, Francois; Lazar, Alexander J F; Slopis, John; Torres, Keila E; Lev, Dina; Pollock, Raphael E; McCutcheon, Ian E
2017-09-08
OBJECTIVE While sporadic peripheral schwannomas (SPSs) are generally well treated with surgery, their biology is not well understood. Consequently, treatment options are limited. The aim of this study was to provide a comprehensive description of SPS. The authors describe clinicopathological features and treatment outcomes of patients harboring these tumors, and they assess expression of biomarkers using a clinically annotated tissue microarray. Together, these data give new insight into the biology and management of SPS. METHODS Patients presenting with a primary SPS between 1993 and 2011 (n = 291) were selected from an institutional registry to construct a clinical database. All patients underwent follow-up, and short- and long-term outcomes were assessed. Expression of relevant biomarkers was assessed using a new tissue microarray (n = 121). RESULTS SPSs were generally large (mean 5.5 cm) and frequently painful at presentation (55%). Most patients were treated with surgery (80%), the majority of whom experienced complete resolution (52%) or improvement (18%) of their symptoms. Tumors that were completely resected (85%) did not recur. Some patients experienced short-term (16%) and long-term (4%) complications postoperatively. Schwannomas expressed higher levels of platelet-derived growth factor receptor-β (2.1) than malignant peripheral nerve sheath tumors (MPNSTs) (1.5, p = 0.004) and neurofibromas (1.33, p = 0.007). Expression of human epidermal growth factor receptor-2 was greater in SPSs (0.91) than in MPNSTs (0.33, p = 0.002) and neurofibromas (0.33, p = 0.026). Epidermal growth factor receptor was expressed in far fewer SPS cells (10%) than in MPNSTs (58%, p < 0.0001) or neurofibromas (37%, p = 0.007). SPSs more frequently expressed cytoplasmic survivin (66% of tumor cells) than normal nerve (46% of cells), but SPS expressed nuclear survivin in fewer tumor cells than in MPNSTs (24% and 50%, respectively; p = 0.018). CONCLUSIONS Complete resection is curative for SPS. Left untreated, however, these tumors can cause significant morbidity, and not all patients are candidates for resection. SPSs express a pattern of biomarkers consistent with the dysregulation of the tumor suppressor merlin observed in neurofibromatosis Type 2-associated schwannomas, suggesting a shared etiology. This SPS pattern is distinct from that of other tumors of the peripheral nerve sheath.
Grief Experiences Among Female American and Arab Undergraduate College Students.
Varga, Mary Alice; McClam, Tricia M; Hassane, Sofoh
2015-01-01
The purpose of this study was to compare the incidence of grief among American and Arab female undergraduate students, the effects of their grief, and risk of prolonged grief disorder. A total of 471 female undergraduate students, 308 (65.4%) from the United Arab Emirates and 163 (34.6%) from the United States, completed a survey about their grief experiences. Students experiencing a significant loss also completed the Prolonged Grief Disorder Questionnaire. Findings revealed that overall approximately 38.4% (n = 181) of all 471 students experienced the loss of a significant person in their lives within the past 24 months; a similar percentage was found in each sub group. Students reported various grief effects with American students experiencing more effects related to sleep, relationships, academics, physical well-being, religion/spirituality, and outlook on life than Arab students. Only a small number (10, 5.52%) of students met the criteria for prolonged grief disorder; however, most students were female Arab students. Limitations of the study and recommendations for future research are provided.
Liu, Xu; Huang, Xiwei; Jiang, Yu; Xu, Hang; Guo, Jing; Hou, Han Wei; Yan, Mei; Yu, Hao
2017-08-01
Based on a 3.2-Megapixel 1.1- μm-pitch super-resolution (SR) CMOS image sensor in a 65-nm backside-illumination process, a lens-free microfluidic cytometer for complete blood count (CBC) is demonstrated in this paper. Backside-illumination improves resolution and contrast at the device level with elimination of surface treatment when integrated with microfluidic channels. A single-frame machine-learning-based SR processing is further realized at system level for resolution correction with minimum hardware resources. The demonstrated microfluidic cytometer can detect the platelet cells (< 2 μm) required in CBC, hence is promising for point-of-care diagnostics.
High Resolution Regional Climate Simulations over Alaska
NASA Astrophysics Data System (ADS)
Monaghan, A. J.; Clark, M. P.; Arnold, J.; Newman, A. J.; Musselman, K. N.; Barlage, M. J.; Xue, L.; Liu, C.; Gutmann, E. D.; Rasmussen, R.
2016-12-01
In order to appropriately plan future projects to build and maintain infrastructure (e.g., dams, dikes, highways, airports), a number of U.S. federal agencies seek to better understand how hydrologic regimes may shift across the country due to climate change. Building on the successful completion of a series of high-resolution WRF simulations over the Colorado River Headwaters and contiguous USA, our team is now extending these simulations over the challenging U.S. States of Alaska and Hawaii. In this presentation we summarize results from a newly completed 4-km resolution WRF simulation over Alaska spanning 2002-2016 at 4-km spatial resolution. Our aim is to gain insight into the thermodynamics that drive key precipitation processes, particularly the extremes that are most damaging to infrastructure.
High resolution manometry findings in patients with esophageal epiphrenic diverticula.
Vicentine, Fernando P P; Herbella, Fernando A M; Silva, Luciana C; Patti, Marco G
2011-12-01
The pathophysiology of esophageal epiphrenic diverticula is still uncertain even though a concomitant motility disorder is found in the majority of patients in different series. High resolution manometry may allow detection of motor abnormalities in a higher number of patients with esophageal epiphrenic diverticula compared with conventional manometry. This study aims to evaluate the high resolution manometry findings in patients with esophageal epiphrenic diverticula. Nine individuals (mean age 63 ± 10 years, 4 females) with esophageal epiphrenic diverticula underwent high resolution manometry. A single diverticulum was observed in eight patients and multiple diverticula in one. Visual analysis of conventional tracings and color pressure plots for identification of segmental abnormalities was performed by two researchers experienced in high resolution manometry. Upper esophageal sphincter was normal in all patients. Esophageal body was abnormal in eight patients; lower esophageal sphincter was abnormal in seven patients. Named esophageal motility disorders were found in seven patients: achalasia in six, diffuse esophageal spasm in one. In one patient, a segmental hypercontractile zone was noticed with pressure of 196 mm Hg. High resolution manometry demonstrated motor abnormalities in all patients with esophageal epiphrenic diverticula.
covariate balance, using matching. We found that Veterans who completed EBP for PTS experienced a significant improvement in PTSD Checklist (PCL...To compare effectiveness of evidence-based psychotherapy (EBP) for PTS in Iraq and Afghanistan War Veterans who use Veterans Health Administration...scores compared to the non-completers (i.e., 5.4-point improvement on the PCL). We also completed an analysis of factors associated with completing EBP
NASA Astrophysics Data System (ADS)
Fuchsberger, Jürgen; Kirchengast, Gottfried; Bichler, Christoph; Kabas, Thomas; Lenz, Gunther; Leuprecht, Armin
2017-04-01
The Feldbach region in southeast Austria, characteristic for experiencing a rich variety of weather and climate patterns, has been selected as the focus area for a pioneering weather and climate observation network at very high resolution: The WegenerNet comprises 153 meteorological stations measuring temperature, humidity, precipitation, and other parameters, in a tightly spaced grid within an area of about 20 km × 15 km centered near the city of Feldbach (46.93°N, 15.90°E). With its stations about every 2 km2, each with 5-min time sampling, the network provides regular measurements since January 2007. Detailed information is available in the recent description by Kirchengast et al. (2014) and via www.wegcenter.at/wegenernet. As a smaller "sister network" of the WegenerNet Feldbach region, the WegenerNet Johnsbachtal consists of eleven meteorological stations (complemented by one hydrographic station at the Johnsbach creek), measuring temperature, humidity, precipitation, radiation, wind, and other parameters in an alpine setting at altitudes ranging from below 700 m to over 2100 m. Data are available partly since 2007, partly since more recent dates and have a temporal resolution of 10 minutes. The networks are set to serve as a long-term monitoring and validation facility for weather and climate research and applications. Uses include validation of nonhydrostatic models operated at 1-km-scale resolution and of statistical downscaling techniques (in particular for precipitation), validation of radar and satellite data, study of orography-climate relationships, and many others. Quality-controlled station time series and gridded field data (spacing 200 m × 200 m) are available in near-real time (data latency less than 1-2 h) for visualization and download via a data portal (www.wegenernet.org). This data portal has been undergoing a complete renewal over the last year, and now serves as a modern gateway to the WegenerNet's more than 10 years of high-resolution data. The poster gives a brief introduction to the WegenerNet design and setup and shows a detailed overview of the new data portal. It also focuses on showing examples for high-resolution precipitation measurements, especially heavy-precipitation and convective events. Reference: Kirchengast, G., T. Kabas, A. Leuprecht, C. Bichler, and H. Truhetz (2014): WegenerNet: A pioneering high-resolution network for monitoring weather and climate. Bull. Amer. Meteor. Soc., 95, 227-242, doi:10.1175/BAMS-D-11-00161.1.
Fluoroscopically Guided Peritendinous Corticosteroid Injection for Proximal Hamstring Tendinopathy
Nicholson, Luke T.; DiSegna, Steven; Newman, Joel S.; Miller, Suzanne L.
2014-01-01
Background: Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy. Purpose: This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy. Study Design: Case series; Level of evidence, 4. Methods: Eighteen athletes with 22 cases of magnetic resonance imaging–confirmed proximal hamstring tendinopathy were treated with corticosteroid injection and later contacted to evaluate the efficacy of the injection with the use of a questionnaire. Results: The visual analog score decreased from 7.22 preinjection to 3.94 postinjection (P < .001), level of athletic participation increased from 28.76% to 68.82% (P < .001) at a mean follow-up of 21 months, and 38.8% of patients experienced complete resolution at a mean follow-up of 24.8 months. The mean lower extremity function score at the time of follow-up was 60. Conclusion: A trial of fluoroscopically guided corticosteroid injection is warranted in patients presenting with symptoms of proximal hamstring tendinopathy refractory to conservative therapy. PMID:26535310
Nicholson, Luke T; DiSegna, Steven; Newman, Joel S; Miller, Suzanne L
2014-03-01
Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy. This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy. Case series; Level of evidence, 4. Eighteen athletes with 22 cases of magnetic resonance imaging-confirmed proximal hamstring tendinopathy were treated with corticosteroid injection and later contacted to evaluate the efficacy of the injection with the use of a questionnaire. The visual analog score decreased from 7.22 preinjection to 3.94 postinjection (P < .001), level of athletic participation increased from 28.76% to 68.82% (P < .001) at a mean follow-up of 21 months, and 38.8% of patients experienced complete resolution at a mean follow-up of 24.8 months. The mean lower extremity function score at the time of follow-up was 60. A trial of fluoroscopically guided corticosteroid injection is warranted in patients presenting with symptoms of proximal hamstring tendinopathy refractory to conservative therapy.
Patel, Samir J; Kuten, Samantha A; Knight, Richard J; Hong, Dana M; Gaber, A Osama
2014-01-01
Ganciclovir-resistant cytomegalovirus (CMV) is associated with significant morbidity in solid organ transplant recipients. Management of ganciclovir-resistant CMV may be complicated by nephrotoxicity which is commonly observed with recommended therapies and/or rejection induced by "indirect" viral effects or reduction of immunosuppression. Herein, we report a series of four high serologic risk (donor CMV positive/recipient CMV negative) kidney transplant patients diagnosed with ganciclovir-resistant CMV disease. All patients initially developed "breakthrough" viremia while still receiving valganciclovir prophylaxis after transplant and were later confirmed to exhibit UL97 mutations after failing to eradicate virus on adequate dosages of valganciclovir. The patients were subsequently and successfully treated with reduced-dose (1-2 mg/kg) cidofovir and CMV-hyperimmune globulin, given in 2-week intervals. In addition, all patients exhibited stable renal function after completion of therapy, and none experienced acute rejection. The combination of reduced-dose cidofovir and CMV-hyperimmune globulin appeared to be a safe and effective regimen in patients with mild disease due to ganciclovir-resistant CMV.
Parent-Adolescent Conflicts, Conflict Resolution Types, and Adolescent Adjustment
ERIC Educational Resources Information Center
Branje, Susan J. T.; van Doorn, Muriel; van der Valk, Inge; Meeus, Wim
2009-01-01
The current study examined the moderating role of conflict resolution on the association between parent-adolescent conflicts and adolescent problematic adjustment. Participants were 1313 Dutch early and middle adolescents who completed measures on conflict frequency, conflict resolution with parents, and internalizing and externalizing adjustment…
Peacock, James E; Stafford, Jeanette M; Le, Katherine; Sohail, Muhammad Rizwan; Baddour, Larry M; Prutkin, Jordan M; Danik, Stephan B; Vikram, Holenarasipur R; Hernandez-Meneses, Marta; Miró, José M; Blank, Elisabeth; Naber, Christoph K; Carrillo, Roger G; Greenspon, Arnold J; Tseng, Chi-Hong; Uslan, Daniel Z
2018-03-08
Published guidelines mandate complete device removal in cases of cardiovascular implantable electronic device (CIED) infection. Clinical predictors of successful salvage of infected CIEDs have not been defined. Data from the Multicenter Electrophysiologic Device Infection Collaboration, a prospective, observational, multinational cohort study of CIED infection, were used to investigate whether clinical predictors of successful salvage of infected devices could be identified. Of 433 adult patients with CIED infections, 306 (71%) underwent immediate device explantation. Medical management with device retention and antimicrobial therapy was initially attempted in 127 patients (29%). "Early failure" of attempted salvage occurred in 74 patients (58%) who subsequently underwent device explantation during the index hospitalization. The remaining 53 patients (42%) in the attempted salvage group retained their CIED. Twenty-six (49%) had resolution of CIED infection (successful salvage group) whereas 27 patients (51%) experienced "late" salvage failure. Upon comparing the salvage failure group, early and late (N = 101), to the group experiencing successful salvage of an infected CIED (N = 26), no clinical or laboratory predictors of successful salvage were identified. However, by univariate analysis, coagulase-negative staphylococci as infecting pathogens (P = 0.0439) and the presence of a lead vegetation (P = 0.024) were associated with overall failed salvage. In patients with definite CIED infections, clinical and laboratory variables cannot predict successful device salvage. Until new data are forthcoming, device explantation should remain a mandatory and early management intervention in patients with CIED infection in keeping with existing expert guidelines unless medical contraindications exist or patients refuse device removal. © 2018 Wiley Periodicals, Inc.
Tsuboi, Kazuya; Yamamoto, Hiroshi; Somura, Fuji; Goto, Hiromi
2015-01-01
Enzyme replacement therapy (ERT) is the only approved therapy for Fabry disease. In June 2009, there was a worldwide shortage of agalsidase beta, necessitating dose reductions or switching to agalsidase alfa in some patients. We present two cases of Fabry disease (a parent and a child) who received agalsidase beta for 27 months at the licensed dose and 10 months at a reduced dose, followed by a switch to agalsidase alfa for 28 months. Case 1, a 26-year-old male had severe coughing and fatigue during ERT with agalsidase beta requiring antitussive and asthmatic drug therapy. After switching to agalsidase alfa, the coughing gradually resolved completely. Case 2, a 62-year-old female had advanced cardiac manifestations at the time of diagnosis. Despite receiving ERT with the approved dose of agalsidase beta, she experienced aggravation of congestive heart failure and was hospitalized. After switching to agalsidase alfa with standard care in heart disease, BNP level, echocardiographic parameters, eGFR rate and lyso-Gb3 levels were improved or stabilized. We report on two Fabry disease patients who experienced severe adverse events while on approved and/or reduced doses of agalsidase beta. Switching to agalsidase alfa associated with standard care in heart disease led to resolution or improvement in the cardiorespiratory status. And reduction in dose associated with standard care in respiratory disease was useful for decrease in cough and fatigue. Plasma BNP level was useful for monitoring heart failure and the effects of ERT.
Morbidity of direct MR arthrography.
Giaconi, Joseph C; Link, Thomas M; Vail, Thomas P; Fisher, Zachary; Hong, Richard; Singh, Ravi; Steinbach, Lynne S
2011-04-01
The purpose of this study was to determine the incidence and severity of arthrographic pain after intraarticular injection of a gadolinium mixture diluted in normal saline for direct MR arthrography. From March 2009 until January 2010, 155 consecutive patients underwent direct MR arthrography; 20 patients were lost to follow-up. Patients were contacted by telephone between 3 and 7 days after joint injection. Using an 11-point numeric pain rating scale, patients were asked to report if they had experienced joint pain that was different or more intense than their preinjection baseline, the severity of pain, the duration of pain, time to onset of pain, and eventual resolution of pain. The incidence of postarthrographic pain was 66% (89/135), with an average intensity of pain of 4.8 ± 2.4 (range, 1-10). Postarthrographic pain lasted an average of 44.4 ± 30.5 hours (range, 6-168 hours). The time to onset of pain after joint injection was on average 16.6 ± 13.1 hours (range, 4-72 hours). There was no significant difference regarding the severity or incidence of postarthrographic pain between groups on the basis of patient age (p = 0.20 and 0.26), patient sex (p = 0.20 and 0.86), contrast mixture contents (p = 0.83 and 0.49), or joint injected (p = 0.51 and 0.47). No patients experienced any other serious side effects. Sixty-six percent of patients who undergo direct MR arthrography will experience a fairly severe delayed onset of pain that completely resolves over the course of several days.
Jian, Zhongping; Pearce, Jeremy; Mittleman, Daniel M
2003-07-18
We describe observations of the amplitude and phase of an electric field diffusing through a three-dimensional random medium, using terahertz time-domain spectroscopy. These measurements are spatially resolved with a resolution smaller than the speckle spot size and temporally resolved with a resolution better than one optical cycle. By computing correlation functions between fields measured at different positions and with different temporal delays, it is possible to obtain information about individual scattering events experienced by the diffusing field. This represents a new method for characterizing a multiply scattered wave.
NASA Technical Reports Server (NTRS)
Lackner, J. R.; Graybiel, A.
1978-01-01
A blindfolded recumbent subject experiences a variety of postural illusions when rotated about his Z axis. Initially, during the acceleratory phase of rotation, turning about his Z axis is experienced; but, as rotary velocity increases, a spiraling of the body outward in the direction opposite to true rotation is experienced as well. Above 15-20 rpm, only orbital motion of the body is experienced, with the subject feeling that he is always facing in the same direction. One cycle of the apparent orbit is completed each time the subject actually rotates 360 deg. The reverse sequence of illusory motion is experienced during deceleration. The illusory motion all subjects experience during Z-axis recumbent rotation is shown to depend upon the touch and pressure stimulation of the body surface generated by contact forces of support.
A Case Study of Violence Prevention in an Elementary School
ERIC Educational Resources Information Center
Crawford, Diane Lynn
2013-01-01
This case study was initiated to explore how 6 fourth-grade student mediators implemented an inner-city elementary school's violence prevention program based on peer mediation in the context of psychosocial theory. The participants were trained in conflict resolution to intervene with disputants who experienced unresolved disagreements. To…
Issues and Agency: Postgraduate Student and Tutor Experiences with Written Feedback
ERIC Educational Resources Information Center
Sanchez, Hugo Santiago; Dunworth, Katie
2015-01-01
This paper examines the issues which postgraduate students and tutors experienced as they engaged in receiving, providing and requesting feedback, as well as the strategies which they adopted as they sought resolution of these issues. The study employed a case study approach, using data obtained from semi-structured and stimulated recall…
The proliferation of non-indigenous species is a world-wide issue. Environmental managers need improved methods of detecting and monitoring the distribution of such invaders over large areas. In recent decades, numerous estuaries of the Pacific Northwest USA have experienced th...
Experience of workplace violence during medical speciality training in Turkey.
Acik, Yasemin; Deveci, S Erhan; Gunes, Gulsen; Gulbayrak, Canan; Dabak, Sennur; Saka, Gunay; Vural, Gulsen; Can, Gunay; Bilgin, Nursel Gamsiz; Dundar, Pinar Erbay; Erguder, Toker; Tokdemir, Mehmet
2008-08-01
To determine the type, extent and effects of workplace violence among residents during postgraduate speciality training in various departments of medical schools in Turkey. A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured 'violence questionnaire' addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience. A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%). Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.
Li, Yumeng; Lubelski, Daniel; Abdullah, Kalil G; Mroz, Thomas E; Steinmetz, Michael P
2014-03-01
Bertolotti's syndrome consists of low-back pain caused by lumbosacral transitional vertebrae (LSTVs) and LSTV-associated biomechanical spinal changes. There is a lack of consensus regarding the cause, clinical significance, and treatment of this condition. The authors aim to characterize the clinical presentation of patients with Bertolotti's syndrome and describe a minimally invasive surgical treatment for this condition. Seven patients who underwent minimally invasive paramedian tubular-based resection of the LSTV for Bertolotti's syndrome were identified over the course of 5 years. Diagnosis was based on patient history of chronic low-back pain, radiographic findings of LSTV, and pain relief on trigger-site injection with steroid and/or anesthetics. Electronic medical records were reviewed to identify demographics, operative data, and outcomes. All patients presented with severe, chronic low-back pain lasting an average of 8 years that was resistant to nonoperative care. At presentation, 6 (86%) of 7 patients experienced radicular pain that was ipsilateral to the LSTV. Radiographic evidence showed a presence of LSTV in all patients on the left (43%), right (29%), or bilaterally (29%). Degenerative disc changes at the L4-5 level immediately above the anomalous LSTV were observed in 6 of 7 (86%) patients; these changes were not seen at the level below the LSTV. Following pseudo-joint injection, all patients experienced temporary relief of their symptoms. All patients underwent a minimally invasive, paramedian tubular-based approach for resection of the LSTV. Three (43%) of 7 patients reported complete resolution of low-back pain, 2 (29%) of 7 patients had reduced low-back pain, and 2 patients (29%) experienced initial relief but return of low-back pain at 1 and 4 years postoperatively. Three (50%) of the 6 patients with radicular pain had complete relief of this symptom. The median follow-up time was 12 months. No intraoperative complication was reported. Two (29%) of 7 patients developed postoperative complications including one with a wound hematoma and another with new L-5 radiculopathy that resolved 2 years after surgery. Diagnosis of Bertolotti's syndrome should be considered with adequate patient history, imaging studies, and diagnostic injections. A minimally invasive surgical approach for resection of the LSTV is presented here for symptomatic treatment of select patients with Bertolotti's syndrome whose conditions are refractory to conventional therapy and who have pain that can be attributed to the LSTV. Several short-term complications were noted with this procedure, but overall this procedure is effective for treating symptoms related to Bertolotti's syndrome.
Himmelstein, M. S.; Gorin, A. A.; Suh, Y. J.
2017-01-01
Summary Objective Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma‐reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight‐based stigma. Methods Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma‐reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self‐report measures assessing experienced and internalized weight stigma. Results Most participants assigned high importance to all stigma‐reduction strategies, with school‐based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti‐harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. Conclusion These findings underscore the importance of including people with stigmatized identities in stigma‐reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight‐based inequities and prioritize such efforts. PMID:28392929
Patients' Experiences With Communication-and-Resolution Programs After Medical Injury.
Moore, Jennifer; Bismark, Marie; Mello, Michelle M
2017-11-01
Dissatisfaction with medical malpractice litigation has stimulated interest by health care organizations in developing alternatives to meet patients' needs after medical injury. In communication-and-resolution programs (CRPs), hospitals and liability insurers communicate with patients about adverse events, use investigation findings to improve patient safety, and offer compensation when substandard care caused harm. Despite increasing interest in this approach, little is known about patients' and family members' experiences with CRPs. To explore the experiences of patients and family members with medical injuries and CRPs to understand different aspects of institutional responses to injury that promoted and impeded reconciliation. From January 6 through June 30, 2016, semistructured interviews were conducted with patients (n = 27), family members (n = 3), and staff (n = 10) at 3 US hospitals that operate CRPs. Patients and families were eligible for participation if they experienced a CRP, spoke English, and could no longer file a malpractice claim because they had accepted a settlement or the statute of limitations had expired. The CRP administrators identified hospital and insurer staff who had been involved in a CRP event and had a close relationship with the injured patient and/or family. They identified patients and families by applying the inclusion criteria to their CRP databases. Of 66 possible participants, 40 interviews (61%) were completed, including 30 of 50 invited patients and families (60%) and 10 of 16 invited staff (63%). Patients' reported satisfaction with disclosure and reconciliation efforts made by hospitals. A total of 40 participants completed interviews (15 men and 25 women; mean [range] age, 46 [18-67] years). Among the 30 patients and family members interviewed, 27 patients experienced injuries attributed to error and received compensation. The CRP experience was positive overall for 18 of the 30 patients and family members, and 18 patients continued to receive care at the hospital. Satisfaction was highest when communications were empathetic and nonadversarial, including compensation negotiations. Patients and families expressed a strong need to be heard and expected the attending physician to listen without interrupting during conversations about the event. Thirty-five of the 40 respondents believed that including plaintiffs' attorneys in these discussions was helpful. Sixteen of the 30 patients and family members deemed their compensation to be adequate but 17 reported that the offer was not sufficiently proactive. Patients and families strongly desired to know what the hospital did to prevent recurrences of the event, but 24 of 30 reported receiving no information about safety improvement efforts. As hospitals strive to provide more patient-centered care, opportunities exist to improve institutional responses to injuries and promote reconciliation.
Aboriginal Students' Perspectives on the Factors Influencing High School Completion
ERIC Educational Resources Information Center
MacIver, Marion
2012-01-01
The Canadian education system is failing its Aboriginal students as evidenced by the significant proportion not completing high school. The Aboriginal population has experienced a significantly greater proportion of people living in poverty and higher rates of unemployment than has the non-Aboriginal population. These factors can be linked to the…
Learning To Compete: Post-graduate Training in an Aerospace Company.
ERIC Educational Resources Information Center
Hyland, Paul; Sloan, Terry; Beckett, Ron
2002-01-01
A master of technology management degree program was offered to aerospace employees on site; many completed modules and 20 completed degrees. Responses from 38.5% of 65 participants indicated both personal and company benefits (improved capacity for change, movement toward a learning culture), but some experienced problems in applying learning on…
Gieger, Tracy; Rassnick, Kenneth; Siegel, Sheri; Proulx, David; Bergman, Philip; Anderson, Christine; LaDue, Tracy; Smith, Annette; Northrup, Nicole; Roberts, Royce
2008-01-01
Data from 48 dogs with nasal carcinomas treated with palliative radiation therapy (PRT) were retrospectively reviewed. Factors potentially influencing resolution of clinical signs and survival after PRT were evaluated. Clinical signs completely resolved in 66% of dogs for a median of 120 days. The overall median survival time was 146 days. Duration of response to PRT was shorter in dogs that had clinical signs for <90 days before PRT. Survival times were shorter in dogs that had partial or no resolution of clinical signs after PRT than in dogs that had complete resolution of clinical signs.
O’Connell, Grant; Graff, Donald W.; D’Ruiz, Carl D.
2016-01-01
Abstract Changes in fifteen urine, blood and exhaled breath BoEs of HPHCs representing classes of compounds reported by FDA to be significant contributors to smoking-associated disease risks were measured in 105 clinical-confined subjects following randomization and a five-day forced-switch from usual brand conventional combustible cigarettes to: (i) exclusive commercial e-cigarette use; (ii) dual-use of commercial e-cigarettes and the subject’s usual cigarette brand; or (iii) discontinued use of all tobacco or nicotine products. Levels of urinary biomarkers in subjects that completely substituted their usual cigarette with e-cigarettes were significantly lower (29–95%) after 5 days. Percent reductions in eight of nine urinary BoEs were indistinguishable to smokers who had quit smoking, except for nicotine equivalents, which declined by 25–40%. Dual users who halved self-reported daily cigarette consumption with e-cigarettes exhibited reductions (7–38%) in eight of nine urinary biomarkers, but had increase (1–20%) in nicotine equivalents. Reductions were broadly proportional to the reduced numbers of cigarettes smoked. Dual user urinary nicotine equivalents were slightly higher, but not statistically significant. After 5 days, blood nicotine biomarker levels were lower in the cessation (75–96%) and exclusive use groups (11–83%); with dual users experiencing no significant reductions. All subjects experienced significant decreases in exhaled CO. Decreases in the cessation and exclusive groups ranged from 88–89% and 27–32% in dual users. Exhaled NO increased in the cessation and exclusive groups (46–63% respectively), whereas the dual users experienced minimal changes. Overall, smokers who completely or partially substituted conventional cigarettes with e-cigarettes over five days, experienced reductions in HPHCs. PMID:27401591
O'Connell, Grant; Graff, Donald W; D'Ruiz, Carl D
2016-07-01
Changes in fifteen urine, blood and exhaled breath BoEs of HPHCs representing classes of compounds reported by FDA to be significant contributors to smoking-associated disease risks were measured in 105 clinical-confined subjects following randomization and a five-day forced-switch from usual brand conventional combustible cigarettes to: (i) exclusive commercial e-cigarette use; (ii) dual-use of commercial e-cigarettes and the subject's usual cigarette brand; or (iii) discontinued use of all tobacco or nicotine products. Levels of urinary biomarkers in subjects that completely substituted their usual cigarette with e-cigarettes were significantly lower (29-95%) after 5 days. Percent reductions in eight of nine urinary BoEs were indistinguishable to smokers who had quit smoking, except for nicotine equivalents, which declined by 25-40%. Dual users who halved self-reported daily cigarette consumption with e-cigarettes exhibited reductions (7-38%) in eight of nine urinary biomarkers, but had increase (1-20%) in nicotine equivalents. Reductions were broadly proportional to the reduced numbers of cigarettes smoked. Dual user urinary nicotine equivalents were slightly higher, but not statistically significant. After 5 days, blood nicotine biomarker levels were lower in the cessation (75-96%) and exclusive use groups (11-83%); with dual users experiencing no significant reductions. All subjects experienced significant decreases in exhaled CO. Decreases in the cessation and exclusive groups ranged from 88-89% and 27-32% in dual users. Exhaled NO increased in the cessation and exclusive groups (46-63% respectively), whereas the dual users experienced minimal changes. Overall, smokers who completely or partially substituted conventional cigarettes with e-cigarettes over five days, experienced reductions in HPHCs.
[Homogeneous spinal-shortening axial decompression procedure for tethered cord syndrome].
Wang, Haibo; Sun, Jingchuan; Wang, Yuan; Wu, Zhao; Xu, Tao; Chen, Kefu; Shi, Guodong; Yuan, Wen; Jia, Lianshun; Shi, Jiangang
2015-06-16
Surgical detethering is a traditional treatment for symptomatic tethered cord syndrome. However, such complications as cerebrospinal fluid leakage and neurologic deterioration are common. Homogeneous spinal-shortening axial decompression (HSAD) is a modified procedure of monosegmental spinal-shortening osteotomy and it is a novel surgical alternative of reducing neural tension indirectly. The objective was to evaluate the surgical outcomes of HSAD for tethered cord syndrome. The surgical outcomes were examined for 15 consecutive patients with tethered cord syndrome undergoing HSAD from April 2010 to July 2014. Improvements of neurological symptoms including urinary dysfunction, lower-extremity motor and sensory disturbances and/or gait abnormalities, low-back and/or lower-extremity pain, bowel incontinence and sexual dysfunction were evaluated. Their average follow-up period was 21.5 months. The length of spinal column shortening was 17.2 ± 2.9 mm. Urinary dysfunction (n = 9) was the most common residual deficit. All 9 patients with urological symptoms reported improvements, although deficits persisted at the last follow-up. All patients with lower-extremity motor dysfunction improved and 4 (50.0%) noted complete resolution of preoperative lower-extremity sensory symptoms. All patients reported immediate low-back or lower-extremity pain relief after HSAD. One patient reported improved sexual functioning and regained complete erectile capabilities. Two patients (11%) experienced less satisfactory symptomatic or functional benefit from HSAD. However, the main objective of surgery was to prevent further worsening of neurological status. Complete bone union at osteotomy site was noted in all cases at the last follow-up. As a novel surgical option for tethered cord syndrome, HSAD may avoid such complications as cerebrospinal fluid leakage or neurologic deterioration commonly encountered during traditional detethering surgery. All patients gain satisfactory functional outcomes without complications compared to their preoperative symptoms.
ERIC Educational Resources Information Center
Frick, William C.
2009-01-01
Purpose: This research seeks to explore the inevitable internal struggle experienced by school leaders when making ethically-informed judgments. The study acquired principals' intimate reflections about professional decision making in response to personal versus organizational and/or professional value discrepancy as identified in the ethic of the…
ERIC Educational Resources Information Center
Sellman, Edward
2011-01-01
This article presents the findings from research conducted at nine schools (seven primary, two secondary) in England, which had previously implemented a peer mediation service for students experiencing interpersonal conflict. This analysis was informed by themes from a previous stage of research conducted at one additional primary school, where…
A tool for rapid post-hurricane urban tree debris estimates using high resolution aerial imagery
Zoltan Szantoi; Sparkle L Malone; Francisco Escobedo; Orlando Misas; Scot Smith; Bon Dewitt
2012-01-01
Coastal communities in the southeast United States have regularly experienced severe hurricane impacts. To better facilitate recovery efforts in these communities following natural disasters, state and federal agencies must respond quickly with information regarding the extent and severity of hurricane damage and the amount of tree debris volume. A tool was developed...
J. Morgan Grove; Mary L. Cadenasso; William R., Jr. Burch; Steward T. Pickett; Kirsten Schwarz; Jarlath O' Neil-Dunne; Matthew Wilson; Austin Troy; Christopher Boone
2006-01-01
Recent advances in remote sensing and the adoption of geographic information systems (GIS) have greatly increased the availibility of high-resolution spatial and attribute data for examing the relationship between social and vegetation structure in urban areas. There are several motivations for understanding this relationship. First, the United States has experienced a...
ERIC Educational Resources Information Center
Snarey, John; And Others
1987-01-01
A longitudinal study investigated variations in the coping patterns of 52 married men who experienced infertility problems in their first marriage. Styles of coping considered were initial substitutes, subsequent parenting resolutions, and final marital outcomes and the impact of these variations on the men's subsequent success in achieving…
Antibiotics for otitis media with effusion in children.
van Zon, Alice; van der Heijden, Geert J; van Dongen, Thijs M A; Burton, Martin J; Schilder, Anne G M
2012-09-12
Otitis media with effusion (OME) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. In approximately one in three children with OME, however, a bacterial pathogen is identified in the middle ear fluid. In most cases, OME causes mild hearing impairment of short duration. When experienced in early life and when episodes of (bilateral) OME persist or recur, the associated hearing loss may be significant and have a negative impact on speech development and behaviour. Since most cases of OME will resolve spontaneously, only children with persistent middle ear effusion and associated hearing loss potentially require treatment. Previous Cochrane reviews have focused on the effectiveness of ventilation tube insertion, adenoidectomy, autoinflation, antihistamines, decongestants, and oral and topical intranasal steroids in OME. This review focuses on the effectiveness of antibiotics in children with OME. To assess the effects of antibiotics in children up to 18 years with OME. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 22 February 2012. Randomised controlled trials comparing oral antibiotics with placebo, no treatment or therapy of unproven effectiveness. Our primary outcome was complete resolution of OME at two to three months. Secondary outcomes included resolution of OME at other time points, hearing, language and speech, ventilation tube insertion and adverse effects. Two authors independently extracted data using standardised data extraction forms and assessed the quality of the included studies using the Cochrane 'Risk of bias' tool. We presented dichotomous results as risk differences as well as risk ratios, with their 95% confidence intervals. If heterogeneity was greater than 75% we did not pool data. We included 23 studies (3027 children) covering a range of antibiotics, participants, outcome measures and time points of evaluation. Overall, we assessed the studies as generally being at low risk of bias.Our primary outcome was complete resolution of OME at two to three months. The differences (improvement) in the proportion of children having such resolution (risk difference (RD)) in the five individual included studies ranged from 1% (RD 0.01, 95% CI -0.11 to 0.12; not significant) to 45% (RD 0.45, 95% CI 0.25 to 0.65). Results from these studies could not be pooled due to clinical and statistical heterogeneity.Pooled analysis of data for complete resolution at more than six months was possible, with an increase in resolution of 13% (RD 0.13, 95% CI 0.06 to 0.19).Pooled analysis was also possible for complete resolution at the end of treatment, with the following increases in resolution rates: 17% (RD 0.17, 95% CI 0.09 to 0.24) for treatment for 10 days to two weeks, 34% (RD 0.34, 95% CI 0.19 to 0.50) for treatment for four weeks, 32% (RD 0.32, 95% CI 0.17 to 0.47) for treatment for three months, and 14% (RD 0.14, 95% CI 0.03 to 0.24) for treatment continuously for at least six months.We were unable to find evidence of a substantial improvement in hearing as a result of the use of antibiotics for otitis media with effusion; nor did we find an effect on the rate of ventilation tube insertion. We did not identify any trials that looked at speech, language and cognitive development or quality of life. Data on the adverse effects of antibiotic treatment reported in six studies could not be pooled due to high heterogeneity. Increases in the occurrence of adverse events varied from 3% (RD 0.03, 95% CI -0.01 to 0.07; not significant) to 33% (RD 0.33, 95% CI 0.22 to 0.44) in the individual studies. The results of our review do not support the routine use of antibiotics for children up to 18 years with otitis media with effusion. The largest effects of antibiotics were seen in children treated continuously for four weeks and three months. Even when clear and relevant benefits of antibiotics have been demonstrated, these must be balanced against the potential adverse effects when making treatment decisions. Immediate adverse effects of antibiotics are common and the emergence of bacterial resistance has been causally linked to the widespread use of antibiotics for common conditions such as otitis media.
Gridless, pattern-driven point cloud completion and extension
NASA Astrophysics Data System (ADS)
Gravey, Mathieu; Mariethoz, Gregoire
2016-04-01
While satellites offer Earth observation with a wide coverage, other remote sensing techniques such as terrestrial LiDAR can acquire very high-resolution data on an area that is limited in extension and often discontinuous due to shadow effects. Here we propose a numerical approach to merge these two types of information, thereby reconstructing high-resolution data on a continuous large area. It is based on a pattern matching process that completes the areas where only low-resolution data is available, using bootstrapped high-resolution patterns. Currently, the most common approach to pattern matching is to interpolate the point data on a grid. While this approach is computationally efficient, it presents major drawbacks for point clouds processing because a significant part of the information is lost in the point-to-grid resampling, and that a prohibitive amount of memory is needed to store large grids. To address these issues, we propose a gridless method that compares point clouds subsets without the need to use a grid. On-the-fly interpolation involves a heavy computational load, which is met by using a GPU high-optimized implementation and a hierarchical pattern searching strategy. The method is illustrated using data from the Val d'Arolla, Swiss Alps, where high-resolution terrestrial LiDAR data are fused with lower-resolution Landsat and WorldView-3 acquisitions, such that the density of points is homogeneized (data completion) and that it is extend to a larger area (data extension).
2017-01-26
Naval Research Laboratory Washington, DC 20375-5320 NRL/MR/5514--17-9692 High Resolution Bathymetry Estimation Improvement with Single Image Super...collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources...gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate
Knapp, Ashlee E; Knapp, Darin J; Brown, Cameron C; Larson, Jeffry H
2017-01-01
Trauma from female incestuous child sexual abuse may result in negative psychological consequences affecting adult relationships. This study explored relational consequences of incestuous child sexual abuse, focusing on conflict resolution styles, relationship satisfaction, and relationship stability. Using the RELATionship Evaluation dataset, 457 heterosexual couples in which female partners experienced incestuous child sexual abuse were compared to a group of 1,827 couples with no sexual abuse history. Analyses tested differences in the frequencies of reported conflict resolution styles for incestuous child sexual abuse and non-incestuous child sexual abuse groups, the mediating effects of conflict resolution styles on the relationship between incestuous child sexual abuse, and self- and partner-reported relationship satisfaction and stability. Significant differences in the reports of types of conflict resolution styles were found for incestuous child sexual abuse versus non-incestuous child sexual abuse groups. Incestuous child sexual abuse and conflict resolution styles were negatively related to relationship satisfaction and stability and there was a significant indirect effect between female incestuous child sexual abuse, female volatility, and relationship instability. Clinical applications for couple relationships are discussed.
Sociocultural and Familial Factors Associated with Weight Bias Internalization
Pearl, Rebecca L.; Wadden, Thomas A.; Shaw Tronieri, Jena; Chao, Ariana M.; Alamuddin, Naji; Bakizada, Zayna M.; Pinkasavage, Emilie; Berkowitz, Robert I.
2018-01-01
Background/Aims Sociocultural and familial factors associated with weight bias internalization (WBI) are currently unknown. The present study explored the relationship between interpersonal sources of weight stigma, family weight history, and WBI. Methods Participants with obesity (N = 178, 87.6% female, 71.3% black) completed questionnaires that assessed the frequency with which they experienced weight stigma from various interpersonal sources. Participants also reported the weight status of their family members and completed measures of WBI, depression, and demographics. Participant height and weight were measured to calculate body mass index (BMI). Results Linear regression results (controlling for demographics, BMI, and depression) showed that stigmatizing experiences from family and work predicted greater WBI. Experiencing weight stigma at work was associated with WBI above and beyond the effects of other sources of stigma. Participants who reported higher BMIs for their mothers had lower levels of WBI. Conclusion Experiencing weight stigma from family and at work may heighten WBI, while having a mother with a higher BMI may be a protective factor against WBI. Prospective research is needed to understand WBI's developmental course and identify mechanisms that increase or mitigate its risk. PMID:29656285
Impact of the Career Style Interview on Individuals with Career Concerns
ERIC Educational Resources Information Center
Rehfuss, Mark C.; Del Corso, Jennifer; Galvin, Kevin; Wykes, Scott
2011-01-01
A total of 18 participants ranging in age from 20 to 55 were administered the career style interview (CSI) and completed a follow-up interview 2 weeks later. Consensual qualitative research analysis of follow-up interview data indicated that after completing the CSI, participants "generally" felt helped and also "typically" experienced awareness,…
USDA-ARS?s Scientific Manuscript database
A recent outbreak of particularly virulent disease caused by porcine reproductive and respiratory syndrome virus has occurred in swine herds across the United States. We report here the complete genome sequence of eight viral isolates from four Nebraska herds experiencing an outbreak of severe dise...
The Impact of Previous Online Course Experience RN Students' Perceptions of Quality
ERIC Educational Resources Information Center
Hixon, Emily; Barczyk, Casimir; Ralston-Berg, Penny; Buckenmeyer, Janet
2016-01-01
The purpose of this paper is to explore whether experienced online students (who have completed seven or more online courses) perceive the quality of their courses differently than novice online students (who have completed three or fewer online courses) or students with an intermediate level of online course experience (those who have completed…
Experienced and potential medical tourists' service quality expectations.
Guiry, Michael; Scott, Jeannie J; Vequist, David G
2013-01-01
The paper's aim is to compare experienced and potential US medical tourists' foreign health service-quality expectations. Data were collected via an online survey involving 1,588 US consumers engaging or expressing an interest in medical tourism. The sample included 219 experienced and 1,369 potential medical tourists. Respondents completed a SERVQUAL questionnaire. Mann-Whitney U-tests were used to determine significant differences between experienced and potential US medical tourists' service-quality expectations. For all five service-quality dimensions (tangibles, reliability, responsiveness, assurance and empathy) experienced medical tourists had significantly lower expectations than potential medical tourists. Experienced medical tourists also had significantly lower service-quality expectations than potential medical tourists for 11 individual SERVQUAL items. Results suggest using experience level to segment medical tourists. The study also has implications for managing medical tourist service-quality expectations at service delivery point and via external marketing communications. Managing medical tourists' service quality expectations is important since expectations can significantly influence choice processes, their experience and post-consumption behavior. This study is the first to compare experienced and potential US medical tourist service-quality expectations. The study establishes a foundation for future service-quality expectations research in the rapidly growing medical tourism industry.
Long-Term Follow-Up of the Edmonton Protocol of Islet Transplantation in the United States.
Brennan, D C; Kopetskie, H A; Sayre, P H; Alejandro, R; Cagliero, E; Shapiro, A M J; Goldstein, J S; DesMarais, M R; Booher, S; Bianchine, P J
2016-02-01
We report the long-term follow-up of the efficacy and safety of islet transplantation in seven type 1 diabetic subjects from the United States enrolled in the multicenter international Edmonton Protocol who had persistent islet function after completion of the Edmonton Protocol. Subjects were followed up to 12 years with serial testing for sustained islet allograft function as measured by C-peptide. All seven subjects demonstrated continued islet function longer than a decade from the time of first islet transplantation. One subject remained insulin independent without the need for diabetic medications or supplemental transplants. One subject who was insulin-independent for over 8 years experienced graft failure 10.9 years after the first islet transplant. The remaining six subjects demonstrated continued islet function upon trial completion, although three had received a supplemental islet transplant each. At trial completion, five subjects were receiving insulin and two remained insulin independent, although one was treated with liraglutide. The median hemoglobin A1c was 6.3% (45 mmol/mol). All subjects experienced progressive decline in the C-peptide/glucose ratio. No patients experienced severe hypoglycemia, opportunistic infection, or lymphoma. Thus, although the rate and duration of insulin independence was low, the Edmonton Protocol was safe in the long term. Alternative approaches to islet transplantation are under investigation. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
The effects of ergonomics training on the knowledge, attitudes, and practices of teleworkers.
Harrington, Susan S; Walker, Bonnie L
2004-01-01
The rapid growth of teleworking has raised several social and legal issues regarding an employer's responsibility for the safety of an employee's home office. In this paper, researchers discuss the need for safety training for teleworkers and the effectiveness of a home office ergonomics training program. Study participants (N = 50) were randomly assigned into a treatment or control group. The treatment group completed the ergonomics training and a pre- and posttest. The control group completed the pre- and posttests without training. The study demonstrated the need for teleworker ergonomics training. More than 85% of participants had not received teleworker training before, and 44% had experienced pain or discomfort while teleworking. Participants who completed the training significantly improved their scores on knowledge, attitude, and practices subtests. In a follow-up survey, participants indicated that they had made ergonomic changes to their offices based on the training. Several participants indicated that the pain or discomfort that they had been experiencing was eliminated or reduced as a result of the training.
Perilloux, Carin; Duntley, Joshua D; Buss, David M
2012-10-01
The current study examined costs experienced by victims of completed rape (n=49) and attempted sexual assault (n=91) using quantitative analyses of 13 domains: health, self-esteem, self-perceived attractiveness, self-perceived mate value, family relationships,work life, social life, social reputation, sexual reputation, desire to have sex, frequency of sex, enjoyment of sex, and long-term, committed relationships. Women also provided descriptive accounts of their experiences, and we used these to illustrate the costs in the victims' own words.Compared to victims of an attempted sexual assault, victims of a completed rape reported significantly more negative outcomes in 11 of the 13 domains. The most negatively affected domains were self-esteem, sexual reputation, frequency of sex, desire to have sex, and self-perceived mate value. Although victims of rape experienced more negative effects than victims of attempted sexual assault,both groups of victims reported negative effects in every domain.Discussion focuses on the implications of the differing degrees and patterns of the costs of attempted and completed sexual victimization.
NASA Astrophysics Data System (ADS)
Cavanaugh, C.; Gille, J.; Francis, G.; Nardi, B.; Hannigan, J.; McInerney, J.; Krinsky, C.; Barnett, J.; Dean, V.; Craig, C.
2005-12-01
The High Resolution Dynamics Limb Sounder (HIRDLS) instrument onboard the NASA Aura spacecraft experienced a rupture of the thermal blanketing material (Kapton) during the rapid depressurization of launch. The Kapton draped over the HIRDLS scan mirror, severely limiting the aperture through which HIRDLS views space and Earth's atmospheric limb. In order for HIRDLS to achieve its intended measurement goals, rapid characterization of the anomaly, and rapid recovery from it were required. The recovery centered around a new processing module inserted into the standard HIRDLS processing scheme, with a goal of minimizing the effect of the anomaly on the already existing processing modules. We describe the software infrastructure on which the new processing module was built, and how that infrastructure allows for rapid application development and processing response. The scope of the infrastructure spans three distinct anomaly recovery steps and the means for their intercommunication. Each of the three recovery steps (removing the Kapton-induced oscillation in the radiometric signal, removing the Kapton signal contamination upon the radiometric signal, and correcting for the partially-obscured atmospheric view) is completely modularized and insulated from the other steps, allowing focused and rapid application development towards a specific step, and neutralizing unintended inter-step influences, thus greatly shortening the design-development-test lifecycle. The intercommunication is also completely modularized and has a simple interface to which the three recovery steps adhere, allowing easy modification and replacement of specific recovery scenarios, thereby heightening the processing response.
Safadi, Reema; Swigart, Valerie; Hamdan-Mansour, Ayman M; Banimustafa, Radwan; Constantino, Rose E
2013-01-01
We interviewed 12 Jordanian women who had experienced domestic violence (DV) and were receiving assistance at the Jordanian Women's Union (JWU). Our aim was to explore the history and factors supporting attainment of freedom from DV. Narratives revealed themes of DV toward girls; forced marriage; physical, psychological, or sexual abuse before and during marriage; and escalation and enduring DV. Escaping from DV required family and JWU support. In the context of a strongly patriarchal, religious society, we observed a process of resolution by shifting cultural values and themes of empowerment, with an undercurrent of suffering blamed on inequalities in the legal process.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Prabhu, Roshan S., E-mail: rprabhu@emory.edu; Kandula, Shravan; Liebman, Lang
2013-03-01
Purpose: To retrospectively evaluate institutional outcomes for patients treated with modern radiation therapy (RT) for biopsied orbital pseudotumor (OP). Methods and Materials: Twenty patients (26 affected orbits) with OP were treated with RT between January 2002 and December 2011. All patients underwent biopsy with histopathologic exclusion of other disease processes. Sixteen patients (80%) were treated with intensity modulated RT, 3 (15%) with opposed lateral beams, and 1 (5%) with electrons. Median RT dose was 27 Gy (range 25.2-30.6 Gy). Response to RT was evaluated at 4 months post-RT. Partial response (PR) was defined as improvement in orbital symptoms without anmore » increase in steroid dose. Complete response (CR) 1 and CR 2 were defined as complete resolution of orbital symptoms with reduction in steroid dose (CR 1) or complete tapering of steroids (CR 2). The median follow-up period was 18.6 months (range 4-81.6 months). Results: Seventeen patients (85%) demonstrated response to RT, with 7 (35%), 1 (5%), and 9 (45%) achieving a PR, CR 1, and CR 2, respectively. Of the 17 patients who had ≥PR at 4 months post-RT, 6 (35%) experienced recurrence of symptoms. Age (>46 years vs ≤46 years, P=.04) and clinical response to RT (CR 2 vs CR 1/PR, P=.05) were significantly associated with pseudotumor recurrence. Long-term complications were seen in 7 patients (35%), including 4 with cataract formation, 1 with chronic dry eye, 1 with enophthalmos, and 1 with keratopathy. Conclusions: RT is an effective treatment for improving symptoms and tapering steroids in patients with a biopsy supported diagnosis of OP. Older age and complete response to RT were associated with a significantly reduced probability of symptom recurrence. The observed late complications may be related to RT, chronic use of steroids/immunosuppressants, medical comorbidities, or combination of factors.« less
Controlling High-Resolution LROC NAC Polar Mosaics to LOLA Track Data
NASA Astrophysics Data System (ADS)
Archinal, B.; Lee, E.; Weller, L.; Richie, J.; Edmundson, K.; Laura, J.; Robinson, M.; Speyerer, E.; Boyd, A.; Bowman-Cisneros, E.; Wagner, R.; Nefian, A.
2016-11-01
We describe our progress on completing 1 m resolution geodetically controlled LROC NAC illumination mosaics of both lunar poles out to 85 degrees latitude, constrained using matching to LOLA track data.
Transoral robotic-assisted laryngeal cleft repair in the pediatric patient.
Leonardis, Rachel L; Duvvuri, Umamaheswar; Mehta, Deepak
2014-09-01
To assess the feasibility of performing robotic-assisted laryngeal cleft repair in the pediatric population. Retrospective chart review at a tertiary academic children's hospital. All patients underwent transoral robotic-assisted laryngeal cleft repair from March 2011 to June 2013. Demographics, robotic docking time, operative time, and postoperative course and swallowing function were collected and analyzed. Five children, three male and two female, underwent successful transoral robotic-assisted laryngeal cleft repair for closure of a type I laryngeal cleft. Mean age at time of surgery was 21.6 months (standard deviation 6.1 months; range, 15-29 months). From case 1 to case 5, robotic docking time (18-10 minutes), robotic operative time (102-36 minutes), and total operating room time (173-105 minutes) decreased. There were no complications with time until extubation (range, 2-3 days), length of intensive care unit stay (range, 3-4 days), and total hospital stay (range, 3-5 days) within acceptable range following laryngeal cleft repair. Modified barium swallow (two patients) or fiberoptic endoscopic evaluation of swallowing (three patients) was performed postoperatively, with all patients showing complete resolution of penetration and aspiration. In addition, all patients experienced subjective resolution of dysphagia and/or choking with feeds postoperatively. Transoral robotic-assisted laryngeal cleft repair may offer specific advantages over a traditional endoscopic approach. In our experience, the procedure was well tolerated and associated with definitive surgical cure in all patients. The scope of robotic technology continually expands and should be considered a feasible tool at an institution-based level. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Fibrinolytic therapy for mechanical pulmonary valve thrombosis.
Khajali, Zahra; Mohammadzadeh, Shabnam; Maleki, Majid; Peighambari, Mohammad Mehdi; Sadeghpoor, Anita; Ghavidel, Alireza; Elahi, Behrad; Mirzaaghayan, Mohammadreza
2015-01-01
Treatment of prosthetic heart valve thrombosis using intravenous thrombolytics, although an acceptable alternative to surgery, is not complication free, and the literature has a dearth of data on the subject. This study analyzed the results of fibrinolytic treatment (FT) among a single-center group of patients with mechanical pulmonary valve thrombosis. Between 2000 and 2013, 23 consecutive patients with 25 episodes of pulmonary valve thrombosis received FT. The diagnosis of mechanical pulmonary valve thrombosis was established by fluoroscopy and echocardiography. Streptokinase (SK) was used in 24 cases and alteplase in 1 case. The FT was continued a second day for 14 patients (58.3%), a third day for 1 patient, and a fourth day for 1 patient. Echocardiography and fluoroscopy were performed every day until improvement of malfunction was achieved. Of the 23 patients, 19 had complete resolution of hemodynamic abnormalities after FT, 1 had partial resolution, and 2 showed no change. No patient had major complications. Five minor complications were detected, namely, fever, nausea, thrombophlebitis, epistaxi, and pain. Seven patients (30%) experienced recurrence of thrombosis, whereas four patients had surgery (biological pulmonary valve replacement) without re-thrombolytic therapy, one patient was treated with Alteplase, one patient received SK, and one patient received intense anticoagulation using heparin and warfarin. Overall, FT had a success rate of 84%. The results indicate that regardless of the time to pulmonary valve replacement and echocardiographic and fluoroscopic findings, FT was effective in most cases of mechanical pulmonary valve thrombosis. The efficacy increased with second-day thrombolytic therapy. Major complications were not common after lytic therapy for mechanical pulmonary valve thrombosis.
Ending prematurely a weight loss programme: the impact of child and family characteristics.
Braet, C; Jeannin, R; Mels, S; Moens, E; Van Winckel, M
2010-01-01
The present study evaluates the pre-treatment child and family characteristics as well as the parental motives and experienced barriers when ending prematurely a weight loss programme for their obese child, in accordance with the 'barriers-to-treatment model' and subsequent research on dimensions underlying treatment termination decision. Treatment seeking youngsters (n = 72) with a mean of 10.46 years (SD = 2.56) were followed over a 1-year period. Dropout, child and family characteristics were measured both during assessment and treatment. The 'barriers-to-treatment' data were collected at the 1-year follow-up via mail (response rate = 65%; n = 47). Results showed that dropout could be successfully predicted at intake by age, psychopathology in the child and motivation of the parents. Results indicated further that there are few differences in total barriers score between completers and non-completers. Item content analysis revealed two themes that were more often reported by non-completers (appointment arrangements and perceived relevance of treatment). The hypothesis that non-completers (compared to completers) experienced more barriers that burden their willingness to continue a weight loss programme could not be confirmed. Besides demographic characteristics, specifically motivation of the parents at intake seems an important area for future research. © 2009 John Wiley & Sons, Ltd.
The influence of Driving Status on Transportation Challenges Experienced by Older Adults.
Weeks, Lori E; Stadnyk, Robin; Begley, Lorraine; MacDonald, Dany J
2015-06-01
We explored the severity, number, and reasons for transportation challenges experienced by older adult drivers, nondrivers who live with a driver, and nondrivers who do not live with a driver. A random sample of 1,670 Atlantic Canadian community-dwelling older adults completed a mailed survey. Drivers comprised 80% of the participants. Just more than one fifth of participants experienced at least occasional transportation challenges. Two thirds of nondrivers who lived with a driver reported having no transportation challenges. Almost half of the nondrivers who did not live with a driver indicated never experiencing transportation challenges, and 84% of drivers had no transportation challenges. Nondrivers who did not live with a driver experienced greater frequency and severity of transportation challenges. This research contributes to our understanding of the characteristics of older adults with different driving statuses and their transportation challenges, which can contribute to providing appropriate transportation supports for older adults in the future. © The Author(s) 2013.
ERIC Educational Resources Information Center
Van Doorn, Muriel D.; Branje, Susan J. T.; Meeus, Wim H. J.
2011-01-01
In this study, changes in three conflict resolution styles in parent-adolescent relationships were investigated: positive problem solving, conflict engagement, and withdrawal. Questionnaires about these conflict resolution styles were completed by 314 early adolescents (M = 13.3 years; 50.6% girls) and both parents for four consecutive years.…
ERIC Educational Resources Information Center
Ciftci, Ayse; Demir, Ayhan; Bikos, Lynette Heim
2008-01-01
This study investigated the effect of loneliness on the conflict resolution strategies of adolescents toward their friends, mothers, and fathers. High school students (N = 180) from 8 different schools in Ankara, Turkey, completed the UCLA Loneliness Scale and Conflict Resolution Questionnaire with respect to their friends, mothers, and fathers.…
Chasen, M R; Feldstain, A; Gravelle, D; Macdonald, N; Pereira, J
2013-12-01
After treatment, patients with active cancer face a considerable burden from the effects of both the disease and its treatment. The Palliative Rehabilitation Program (prp) is designed to ameliorate disease effects and to improve the patient's functioning. The present study evaluated predictors of program completion and changes in functioning, symptoms, and well-being after the program. The program received referrals for 173 patients who had finished anticancer therapy. Of those 173 patients, 116 with advanced cancer were eligible and enrolled in the 8-week interprofessional prp; 67 completed it. Measures of physical, nutritional, social, and psychological functioning were evaluated at entry to the program and at completion. Participants experienced significant improvements in physical performance (p < 0.000), nutrition (p = 0.001), symptom severity (p = 0.005 to 0.001), symptom interference with functioning (p = 0.003 to 0.001), fatigue (p = 0.001), and physical endurance, mobility, and balance or function (p = 0.001 to 0.001). Reasons that participants did not complete the prp were disease progression, geographic inaccessibility, being too well (program not challenging enough), death, and personal or unknown reasons. A normal level of C-reactive protein (<10 mg/L, p = 0.029) was a predictor of program completion. Patients living with advanced cancers who underwent the interprofessional prp experienced significant improvement in functioning across several domains. Program completion can be predicted by a normal level of C-reactive protein.
Gallagher, A G; Lederman, A B; McGlade, K; Satava, R M; Smith, C D
2004-04-01
Increasing constraints on the time and resources needed to train surgeons have led to a new emphasis on finding innovative ways to teach surgical skills outside the operating room. Virtual reality training has been proposed as a method to both instruct surgical students and evaluate the psychomotor components of minimally invasive surgery ex vivo. The performance of 100 laparoscopic novices was compared to that of 12 experienced (>50 minimally invasive procedures) and 12 inexperienced (<10 minimally invasive procedures) laparoscopic surgeons. The values of the experienced surgeons' performance were used as benchmark comparators (or criterion measures). Each subject completed six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) three times. The outcome measures were time to complete the task, number of errors, economy of instrument movement, and economy of diathermy. After three trials, the mean performance of the medical students approached that of the experienced surgeons. However, 7-27% of the scores of the students fell more than two SD below the mean scores of the experienced surgeons (the criterion level). The MIST-VR system is capable of evaluating the psychomotor skills necessary in laparoscopic surgery and discriminating between experts and novices. Furthermore, although some novices improved their skills quickly, a subset had difficulty acquiring the psychomotor skills. The MIST-VR may be useful in identifying that subset of novices.
NASA Astrophysics Data System (ADS)
Tullos, D. D.; Walter, C.; Dunham, J.
2016-12-01
This study investigated how the resolution of observation influences interpretation of how fish, juvenile Coho Salmon (Oncorhynchus kisutch), exploit the hydraulic environment in streams. Our objectives were to evaluate how spatial resolution of the flow field observation influenced: 1) the velocities considered to be representative of habitat units; 2) patterns of use of the hydraulic environment by fish; and 3) estimates of energy expenditure. We addressed these objectives using observations within a 1:1 scale physical model of a full-channel log jam in an outdoor experimental stream. Velocities were measured with Acoustic Doppler Velocimetry at a 10 cm grid spacing, whereas fish locations and tailbeat frequencies were documented over time using underwater videogrammetry. Results highlighted that resolution of observation did impact perceived habitat use and energy expenditure, as did the location of measurement within habitat units and the use of averaging to summarize velocities within a habitat unit. In this experiment, the range of velocities and energy expenditure estimates increased with coarsening resolution, reducing the likelihood of measuring the velocities locally experienced by fish. In addition, the coarser resolutions contributed to fish appearing to select velocities that were higher than what was measured at finer resolutions. These findings indicate the need for careful attention to and communication of resolution of observation in investigating the hydraulic environment and in determining the habitat needs and bioenergetics of aquatic biota.
van Roode, Thea; Dickson, Nigel Patrick; Righarts, Alida Antoinette; Gillett, Wayne Richard
2015-04-01
To estimate the cumulative incidence of infertility for men and women in a population-based sample. Longitudinal study of a birth cohort. Research unit. A population-based birth cohort of 1,037 men and women born in Dunedin, New Zealand, between 1972 and 1973. None. Cumulative incidence of infertility by age 32 and 38, distribution of causes and service use for infertility, live birth subsequent to infertility, and live birth by age 38. The cumulative incidence of infertility by age 38 ranged from 14.4% to 21.8% for men and from 15.2% to 26.0% for women depending on the infertility definition and data used. Infertility, defined as having tried to conceive for 12 months or more or having sought medical help to conceive, was experienced by 21.8% (95% confidence interval [CI], 17.7-26.2) of men and 26.0% (95% CI, 21.8-30.6) of women by age 38. For those who experienced infertility, 59.8% (95% CI, 48.3-70.4) of men and 71.8% (95% CI, 62.1-80.3) of women eventually had a live birth. Successful resolution of infertility and entry into parenthood by age 38 were much lower for those who first experienced infertility in their mid to late thirties compared with at a younger age. Comparison of reports from two assessments in this cohort study suggests infertility estimates from a single cross-sectional study may underestimate lifetime infertility. The lower rate of resolution and entry into parenthood for those first experiencing infertility in their mid to late thirties highlights the consequences of postponing parenthood and could result in involuntary childlessness and fewer children than desired. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Prasad, Megha; Geske, Jeffrey B; Sorajja, Paul; Ommen, Steve R; Schaff, Hartzell V; Gersh, Bernard J; Nishimura, Rick A
2016-11-15
We aimed to assess the utility of changes in systolic and diastolic function by isoproterenol challenge in predicting symptom resolution post-myectomy in selected patients with hypertrophic cardiomyopathy (HCM) and labile obstruction. In a subset of symptomatic HCM patients without resting/provocable obstruction on noninvasive assessment, isoproterenol challenge during hemodynamic catheterization may elicit labile left ventricular outflow tract (LVOT) obstruction, and demonstrate the effect of obstruction on diastolic function. These changes may determine whether patients achieve complete symptom resolution post-myectomy. Between February 2003 and April 2009, 18 symptomatic HCM patients without LVOT obstruction on noninvasive testing underwent isoproterenol provocation and septal myectomy due to presence of provocable gradient and were followed for 4 (IQR 3-7) years. Thirteen (72.2%) had complete symptom resolution, while 5 (27.8%) had improved, but persistent symptoms. Those with provoked gradient >100 mm Hg or increase in left atrial pressure (LAP) with isoproterenol had symptom resolution. Symptomatic HCM patients without LVOT gradient on noninvasive testing may demonstrate labile obstruction with isoproterenol. With isoproterenol, patients with high LVOT gradient or increase in LAP concomitant with an increase in gradient achieved complete symptom resolution post-myectomy. Thus, improved diastolic filling as well as outflow gradient production in patients with HCM may predict symptom response to myectomy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
29 CFR 1404.5 - Listing on the roster, criteria for listing and removal, procedure for removal.
Code of Federal Regulations, 2010 CFR
2010-07-01
... that he or she: (i) Is experienced, competent and acceptable in decision-making roles in the resolution... listing on the Roster. The Director shall make all final decisions as to whether an applicant may be listed on the Roster. Each applicant shall be notified in writing of the Director's decision and the...
Making good use of online case study materials.
Keefer, Matthew Wilks
2005-07-01
Web-based access to engaging instructional materials for SEE instruction represents an increasingly viable and attractive opportunity for educators. This paper will review research findings that demonstrate important differences in more experienced and novice ethical responses to engaging online materials, including authentic cases, codes, and commentaries. Results demonstrate that experienced ethical thinkers are more likely than novices to appeal to middle level principles that identify professional role-specific obligations (RSO); to make greater use of professional knowledge in order to recognize moral issues and relevant facts; and to employ more 'contextually sensitive' reasoning strategies when crafting resolutions to moral problems--e.g., identify alternative moral issues, assess the moral implications of actions, and provide alternative practical resolutions to conflicts. These findings suggest that when effectively integrated into SEE courses, authentic instructional materials have the potential to effectively challenge students and enhance student learning. However, there is evidence that the uses and benefits of these materials are not well understood. In the second part of this paper, five research-based instructional principles will be identified and discussed that can help SEE instructors better understand how to effectively integrate these materials into their courses.
NASA Technical Reports Server (NTRS)
Bradley, John
1994-01-01
The 'pyroxene' interplanetary dust particles (IDP's) may be the best samples for investigation of primordial grain-forming reactions because they appear to have experienced negligible post-accretional alteration. They are likely to continue to yield information about gas-to-solid condensation and other grain-forming reactions that may have occurred either in the solar nebular or presolar interstellar environments. An immediate challenge lies in understanding the nanometer-scale petrography of the ultrafine-grained aggregates in 'pyroxene' IDP's. Whether these aggregates contain components from diverse grain-forming environments may ultimately be answered by systematic petrographic studies using electron microscopes capable of high spatial resolution microanalysis. It may be more difficult to decipher evidence of grain formation and evolution in 'olivine' and 'layer silicate' IDP's because they appear to have experienced post-accretional alteration. Most of the studied 'olivine' IDPs have been subjected to heating and equilibration, perhaps during atmospheric entry, while the 'layer silicate' IDP's have experienced aqueous alteration.
Development and Application of a Soil Moisture Downscaling Method for Mobility Assessment
2011-05-01
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send...REPORT Development and Application of a Soil Moisture Downscaling Method for Mobility Assessment 14. ABSTRACT 16. SECURITY CLASSIFICATION OF: Soil...cells). Thus, a method is required to downscale intermediate-resolution patterns to finer resolutions. Fortunately, fine-resolution variations in
Personality, Emotional Qualities of Leisure, and Subjective Well-Being in the Elderly.
Kahlbaugh, Patricia; Huffman, Loreen
2017-07-01
In this study, we examined personality traits of older adults and their emotional experiences associated with engaging in specific leisure activities. Older individuals (17 males, 32 females), ages ranging from 65 to 97 years (mean age 74), completed measures of Big Five personality traits, positive and negative affect, subjective well-being (SWB), independent functioning, and an emotion-activity inventory. As expected, Extraversion, Agreeableness, Conscientiousness, and Openness to experience were related to positive affect, while Neuroticism was related to negative affect. Openness and Agreeableness were related to positive emotions experienced in social and cognitive domains, and Agreeableness was related to greater SWB, greater positive affect, and more positively experienced activities. Neuroticism was related to lower SWB and fewer positively experienced activities. These findings suggest that assessing the fit between personality and emotions experienced during activities should be considered when creating programs tailored to elderly individuals, with the goal of encouraging more active and rewarding lives.
Resolution of the carbon contamination problem in ion irradiation experiments
NASA Astrophysics Data System (ADS)
Was, G. S.; Taller, S.; Jiao, Z.; Monterrosa, A. M.; Woodley, D.; Jennings, D.; Kubley, T.; Naab, F.; Toader, O.; Uberseder, E.
2017-12-01
The widely experienced problem of carbon uptake in samples during ion irradiation was systematically investigated to identify the source of carbon and to develop mitigation techniques. Possible sources of carbon included carbon ions or neutrals incorporated into the ion beam, hydrocarbons in the vacuum system, and carbon species on the sample and fixture surfaces. Secondary ion mass spectrometry, atom probe tomography, elastic backscattering spectrometry, and principally, nuclear reaction analysis, were used to profile carbon in a variety of substrates prior to and following irradiation with Fe2+ ions at high temperature. Ion irradiation of high purity Si and Ni, and also of alloy 800H coated with a thin film of alumina eliminated the ion beam as the source of carbon. Hydrocarbons in the vacuum and/or on the sample and fixtures was the source of the carbon that became incorporated into the samples during irradiation. Plasma cleaning of the sample and sample stage, and incorporation of a liquid nitrogen cold trap both individually and especially in combination, completely eliminated the uptake of carbon during heavy ion irradiation. While less convenient, coating the sample with a thin film of alumina was also effective in eliminating carbon incorporation.
NASA Astrophysics Data System (ADS)
Meitzen, Kimberly M.; Phillips, John N.; Perkins, Thaïs; Manning, Aspen; Julian, Jason P.
2018-03-01
The Blanco River, which flows through the limestone Balcones Canyonlands of central Texas (USA), experienced catastrophic flooding in May 2015 that resulted in significant biogeomorphic disturbance to its riparian corridor. High-resolution aerial and satellite imagery from pre- and post-flooding for a 55-km reach of river were used to map and categorize patterns of disturbance by degree of severity ranging from complete floodplain stripping to no disturbance. The most severe disturbance occurred within the floodway near the channel and decreased with lateral distance into the 100- and 500-year floodplains. Disturbance patterns previously identified in the literature including meander scour, parallel chute scour, convex bank erosion, and macroturbulent scour were all present following this event, as well as substantial disturbance proximal to tributary confluences. In the aftermath of this event, TreeFolks, a local nonprofit organization, engaged with the community to actively replant and restore the riparian corridor of the Blanco River on public and private lands. These reforestation efforts supplement the natural passive recovery of the riparian corridor, enabling the system to recover more quickly and be resilient to future flood events.
Pre- and Post-Columbian Land Cover Changes and Associated Climate Impacts
NASA Astrophysics Data System (ADS)
Cook, B. I.; Puma, M. J.; Kaplan, J. O.; Anchukaitis, K. J.
2011-12-01
Central America experienced extensive expansion of agricultural land during development of the major Central American societies, followed by widespread abandonment and regrowth of natural vegetation after the European conquest. Here we use a high resolution climate model, in combination with a new land cover reconstruction, to investigate the impact of pre- (1490 C.E.) and post- (1650 C.E.) Columbian land cover change on climate in this region. Pre-Columbian land cover causes significant precipitation reductions over coastal Mexico, the Yucatan, and southern Mexico during the wet season, as replacement of forests with agricultural land reduces evapotranspiration fluxes to the atmosphere. Conversely, precipitation over the Yucatan increases during the dry season, as increased surface warming moves additional moisture into this region from the surrounding oceans. With the post-Columbian period, during which major population declines led to large scale agricultural abandonment, the forest recovery results in a partial, though not complete, return to wetter conditions. Our study finds support for previous work speculating that land cover change associated with the Mayan civilizations may have amplified major droughts in the region, and points to the possibility of a direct biogeophysical response to the forest recovery following the arrival of Europeans.
de Paula, Lúcia Cândida Soares; Siqueira, Fernanda Corsante; Juliani, Regina Célia Turola Passos; de Carvalho, Werther Brunow; Ceccon, Maria Esther Jurfest Rivero; Tannuri, Uenis
2014-01-01
Atelectasis is a pulmonary disorder that lengthens the hospitalization time of newborns in intensive care units, resulting in increased morbidity among these infants. High-flow nasal cannulae have been used in newborns to prevent atelectasis and/or expand pulmonary regions affected by atelectasis; however, to date, no evidence-based data regarding this approach have been reported. In this paper, we report on the cases of two male newborn patients. The first and second patients described in this report were hospitalized for a neurosurgical procedure and the treatment of abdominal disease, respectively, and were subjected to invasive mechanical ventilation for 4 and 36 days, respectively. After extubation, these patients continued receiving oxygen therapy but experienced clinical and radiological worsening typical of atelectasis. In both cases, by 24 hours after the implantation of an high-flow nasal cannulae to provide noninvasive support, radiological examinations revealed the complete resolution of atelectasis. In these cases, the use of an high-flow nasal cannulae was effective in reversing atelectasis. Thus, this approach may be utilized as a supplemental noninvasive ventilatory therapy to avoid unnecessary intubation.
Commissariat, Persis V; Volkening, Lisa K; Guo, Zijing; ElBach, Jessica L; Butler, Deborah A; Laffel, Lori M
2018-02-01
This cross-sectional study assessed the type of major life events occurring in a contemporary sample of teens with type 1 diabetes and the association between event frequency and demographic, diabetes management, and psychosocial characteristics. Parents of 178 teens completed the Life Events Checklist to report major events teens had experienced in the last year: 42% experienced 0 to 1 event (n = 75), 32% experienced 2 to 3 events (n = 57), and 26% experienced 4+ events (n = 46). Teens and parents completed validated measures of treatment adherence, diabetes-specific self-efficacy, quality of life, and diabetes-specific family conflict. Parent-youth interview and chart review provided demographics and diabetes management data. Mean number of events/teen was 2.6 ± 2.7 (range = 0-15). The most common events were "Hospitalization of a family member" (24%), "Getting a bad report card" (20%), "Serious arguments between parents" (19%), and "Serious illness/injury in a family member" (19%). Compared with teens experiencing 0 to 1 event, teens experiencing 4+ events were less likely to have married parents (P = .01) and a parent with a college degree (P = .006). Teens with 4+ events had significantly poorer adherence (P = .002 teen, P = .02 parent), lower self-efficacy (P = .03 teen, P < .0001 parent), poorer quality of life (P < .0001 teen, P < .0001 parent), and more conflict (P = .006 teen, P = .02 parent) than teens with fewer events. In a multivariate model (R 2 = 0.21, P < .0001) controlling for demographic and diabetes management characteristics, fewer events was associated with lower A1c (P = .0009). Occurrence of more major life events was associated with poorer diabetes care and A1c and more negative psychosocial qualities in teens with type 1 diabetes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Akahoshi, Yu; Kimura, Shun-Ichi; Gomyo, Ayumi; Hayakawa, Jin; Tamaki, Masaharu; Harada, Naonori; Kusuda, Machiko; Kameda, Kazuaki; Ugai, Tomotaka; Wada, Hidenori; Ishihara, Yuko; Kawamura, Koji; Sakamoto, Kana; Sato, Miki; Terasako-Saito, Kiriko; Kikuchi, Misato; Nakasone, Hideki; Kako, Shinichi; Kanda, Yoshinobu
2018-04-01
Consensus has yet to be reached regarding secondary prophylaxis in allogeneic hematopoietic stem cell transplantation (HSCT) with a complete resolution of invasive aspergillosis (IA) confirmed by chest computed tomography (CT). We retrospectively evaluated the feasibility of antifungal prophylaxis with fluconazole in allogeneic HSCT recipients who had previously developed IA which showed complete resolution as confirmed by chest CT before HSCT. Consecutive adult patients who underwent allogeneic HSCT at our institution and who had received fluconazole as systemic antifungal prophylaxis from June 2007 to January 2015 were included. We compared the clinical outcomes between patients with a past history of IA who showed a complete resolution of chest CT abnormalities (n = 13) and those without a previous history of IA (n = 137). The cumulative incidence of proven or probable IA was 8.8% in the group without a past history of IA and 0.0% in the group with a past history of IA (p = .268). The cumulative incidence of proven or probable invasive fungal disease (IFD) within 100 days after allogeneic HSCT was 10.9% in the group without a past history of IA and 15.4% in the group with a past history of IA (p = .647). Fluconazole was switched to anti-mould agents in two-thirds of the patients in each group by day 100 after HSCT. Fluconazole was confirmed to be an acceptable prophylactic agent early after allogeneic HSCT in appropriately selected patients.
Aubin-Pouliot, Annick; Delagnes, Elise A; Eisele, David W; Chang, Jolie L; Ryan, William R
2016-01-01
Introduce the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire to quantify chronic sialadenitis symptoms and assess the impact of sialendoscopic-assisted salivary duct surgery (SASDS). Retrospective outcome symptoms questionnaire study. The COSS questionnaire assesses the severity of sialadenitis symptoms from 0 to 100. Patients who underwent SASDS from April 2006 to December 2013 completed the COSS questionnaire and the ShortForm8 Health Survey (SF-8) based on current symptoms, and reported whether they had complete, partial, or no symptomatic response to SASDS. Sixty-six of the 156 (43%) contacted patients completed the questionnaires who had had symptoms in 26 submandibular ducts and 53 parotid ducts. The mean COSS score was higher for parotid ducts (12.0; interquartile range [IQR] 1.0-20.0) than for submandibular ducts (7.6; IQR 0.5-15.0) but not significantly so (P = 0.20). Thirty-eight (60%) patients reported complete resolution of symptoms, with a mean COSS score of 4.5 (IQR 0-7). Twenty-one (33%) patients reported partial resolution, with a mean COSS score of 18.5 (IQR 11.3-22.8). Five (8%) patients reported no improvement, with a mean COSS score of 25.1 (IQR 15.2-35). Thirty-six (46%) ducts with sialoliths had a significantly lower mean COSS score (5.8; IQR 0-9.5) compared to those without sialoliths (14.2; IQR 4.5-21.5, P = 0.0004). There was no significant difference in SF-8 survey scores between these groups. The COSS questionnaire is a novel survey instrument to measure obstructive sialadenitis symptom severity that could be helpful in defining outcomes of SASDS. COSS scores under 10 correlate with complete resolution of symptoms, whereas scores between 10 and 25 correlate with partial resolution. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Kim, Jong Won; Park, Sang O; Lee, Kyeong Ryong; Hong, Dae Young; Baek, Kwang Je; Lee, Young Hwan; Lee, Jeong Hun; Choi, Pil Cho
2016-08-01
This study compared endotracheal intubation (ETI) performance during cardiopulmonary resuscitation (CPR) between direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) by experienced intubators (>50 successful ETIs). This was a prospective randomized controlled study conducted in an emergency department between 2011 and 2013. Intubators who used DL or VL were randomly allocated to ETI during CPR. Data were collected from recorded video clips and rhythm sheets. The success, speed, complications, and chest compressions interruption were compared between the two devices. Total 140 ETIs by experienced intubators using DL (n=69) and VL (n=71) were analysed. There were no significant differences between DL and VL in the ETI success rate (92.8% vs. 95.8%; p=0.490), first-attempt success rate (87.0% vs. 94.4%; p=0.204), and median time to complete ETI (51 [36-67] vs. 42 [34-62]s; p=0.143). In both groups, oesophageal intubation and dental injuries seldom occurred. However, longer chest compressions interruption occurred using DL (4.0 [1.0-11.0]s) compared with VL (0.0 [0.0-1.0]s) and frequent serious no-flow (interruption>10s) occurred with DL (18/69 [26.1%]) compared with VL (0/71) (p<0.001). For highly experienced intubators (>80 successful ETIs), frequent serious no-flow occurred in DL (14/55 [25.5%] vs. 0/57 in VL). The ETI success, speed and complications during CPR did not differ significantly between the two devices for experienced intubators. However, the VL was superior in terms of completion of ETI without chest compression interruptions. Clinical Research Information Service (CRIS) in South Korea KCT0000849. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Wilson, Mark; McGrath, John; Vine, Samuel; Brewer, James; Defriend, David; Masters, Richard
2010-10-01
Surgical simulation is increasingly used to facilitate the adoption of technical skills during surgical training. This study sought to determine if gaze control parameters could differentiate between the visual control of experienced and novice operators performing an eye-hand coordination task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Typically adopted hand movement metrics reflect only one half of the eye-hand coordination relationship; therefore, little is known about how hand movements are guided and controlled by vision. A total of 14 right-handed surgeons were categorised as being either experienced (having led more than 70 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The eight experienced and six novice surgeons completed the eye-hand coordination task from the LAP Mentor basic skills package while wearing a gaze registration system. A variety of performance, movement, and gaze parameters were recorded and compared between groups. The experienced surgeons completed the task significantly more quickly than the novices, but only the economy of movement of the left tool differentiated skill level from the LAP Mentor parameters. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. The findings of the study provide support for the utility of assessing strategic gaze behaviour to better understand the way in which surgeons utilise visual information to plan and control tool movements in a virtual reality laparoscopic environment. It is hoped that by better understanding the limitations of the psychomotor system, effective gaze training programs may be developed.
Impact of Dry Eye Symptoms and Daily Activities in a Modern Office.
van Tilborg, Mirjam M; Murphy, Paul J; Evans, Katharine S
2017-06-01
Modern offices and the use of electronic devices are increasing factors in work-related eye symptoms. However, symptoms of eye fatigue or dry eye sensation can be mixed and confusing. This study surveys the eye symptoms reported during a working day at modern offices to investigate the possible inhibition on daily work activities. Two online digital surveys were sent to three different work locations, by direct e-mail. Survey A consisted of 14 questions that investigated eye symptoms experienced during daily activities at work and the impact on daily activities. Survey B consisted of four general questions, the Dutch Ocular Surface Disease Index, the Work Productivity and Activity Index, and the Illness Perception Questionnaire. A total of 505 participants completed survey A, and 213 completed survey B. The participants reported that a high proportion of their day was spent working on a computer (60%). The majority experienced an air draft (79.1%) and had no adjustable light (81.5%) at their workspace. Dry eye-related symptoms were reported at a significantly higher frequency at work than at home (P < .001). Up to 70% experienced some inhibition of daily activity at work due to eye symptoms, with more than 5% experiencing symptoms most or all of the time. Indoor environment, work environment, and general health were perceived as the main reasons for developing dry eye. Compared with males, females showed a statistically significant higher Ocular Surface Disease Index score (P < .001) and experienced more inhibition and adverse effects on daily life and work productivity. This investigation shows that dry eye symptoms have a negative impact on daily activities at work. These findings suggest that multidisciplinary understanding of the negative impact of dry eye by a range of specialists will be of help in managing work-related dry eye.
Davis, Melanie L; Thwaites, Richard; Freeston, Mark H; Bennett-Levy, James
2015-01-01
The need for effective training methods for enhancing cognitive-behavioural therapist competency is not only relevant to new therapists but also to experienced therapists looking to retain and further enhance their skills. Self-practice/self-reflection (SP/SR) is a self-experiential cognitive-behavioural therapy (CBT) training programme, which combines the experience of practicing CBT methods on oneself with structured reflection on the implications of the experience for clinical practice. In order to build on previous qualitative studies of SP/SR, which have mainly focused on trainee CBT therapists, the aim of the current study was to quantify the impact of SP/SR on the therapeutic skills of an experienced cohort of CBT therapists. Fourteen CBT therapists were recruited to participate in an SP/SR programme specifically adapted for experienced therapists. In the context of a quasi-experimental design including multiple baselines within a single-case methodology, therapists provided self-ratings of technical cognitive therapy skill and interpersonal empathic skill at four critical time points: baseline, pre-SP/SR and post-SP/SR and follow-up. Analysis of programme completers (n = 7) indicated that SP/SR enhances both technical skill and interpersonal therapeutic skill. Further intention-to-treat group (n = 14) analyses including both those who left the programme early (n = 3) and those who partially completed the programme (n = 4) added to the robustness of findings with respect to technical cognitive therapy skills but not interpersonal empathic skills. It was concluded that SP/SR, as a training and development programme, could offer an avenue to further therapeutic skill enhancement in already experienced CBT therapists. Copyright © 2014 John Wiley & Sons, Ltd.
McGrath, John; Vine, Samuel; Brewer, James; Defriend, David; Masters, Richard
2010-01-01
Background Surgical simulation is increasingly used to facilitate the adoption of technical skills during surgical training. This study sought to determine if gaze control parameters could differentiate between the visual control of experienced and novice operators performing an eye-hand coordination task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Typically adopted hand movement metrics reflect only one half of the eye-hand coordination relationship; therefore, little is known about how hand movements are guided and controlled by vision. Methods A total of 14 right-handed surgeons were categorised as being either experienced (having led more than 70 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The eight experienced and six novice surgeons completed the eye-hand coordination task from the LAP Mentor basic skills package while wearing a gaze registration system. A variety of performance, movement, and gaze parameters were recorded and compared between groups. Results The experienced surgeons completed the task significantly more quickly than the novices, but only the economy of movement of the left tool differentiated skill level from the LAP Mentor parameters. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. Conclusion The findings of the study provide support for the utility of assessing strategic gaze behaviour to better understand the way in which surgeons utilise visual information to plan and control tool movements in a virtual reality laparoscopic environment. It is hoped that by better understanding the limitations of the psychomotor system, effective gaze training programs may be developed. PMID:20333405
Spontaneous resolution of hemorrhagic polyps of the true vocal fold.
Klein, Adam M; Lehmann, Marcus; Hapner, Edie R; Johns, Michael M
2009-01-01
Hemorrhagic polyps are the most common benign lesions surgically removed from the vocal folds. Although this modality does offer satisfactory results in most of the cases, there is a subset of polyps that seems to resolve with conservative therapy. This study was performed to examine this subset of polyps. Thirty-four consecutive subjects diagnosed with hemorrhagic polyps of the true vocal fold were retrospectively reviewed to determine the incidence of spontaneous resolution of the lesions with nonsurgical therapy. Sixteen subjects began conservative therapy, consisting of voice therapy and proper vocal hygiene, often while awaiting an optimal personal time for surgical intervention. Of these subjects, nine (56.3%) experienced a resolution of their lesion and symptoms without undergoing surgical therapy. Surgical removal of hemorrhagic polyps is often considered the standard of treatment for these benign lesions. However, these observations support a regimen of voice therapy and observation in select cases.
Quadrupole mass filter: design and performance for operation in stability zone 3.
Syed, Sarfaraz U A H; Hogan, Thomas J; Antony Joseph, Mariya J; Maher, Simon; Taylor, Stephen
2013-10-01
The predicted performance of a quadrupole mass filter (QMF) operating in Mathieu stability zone 3 is described in detail using computer simulations. The investigation considers the factors that limit the ultimate maximum resolution (Rmax) and percentage transmission (%Tx), which can be obtained for a given QMF for a particular scan line of operation. The performance curve (i.e., the resolution (R) versus number (N) of radio frequency (rf) cycles experienced by the ions in the mass filter) has been modeled for the upper and lower tip of stability zone 3. The saturation behavior of the performance curve observed in practice for zone 3 is explained. Furthermore, new design equations are presented by examining the intersection of the scan line with stability zone 3. Resolution versus transmission characteristics of stability zones 1 and 3 are compared and the dependence of performance for zones 1 and 3 is related to particular instrument operating parameters.
Nishina, Adrienne
2012-01-01
The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or experienced and witnessed negative events, or they completed no daily reports. General maladjustment was measured in 2-week intervals before, at the end of, and 2 weeks after the daily report study. Daily maladjustment either decreased or did not change across the 5 daily report exposures. General maladjustment decreased across the three 2-week intervals. Combined, results indicate that short-term daily report studies do not place youth at risk for increased maladjustment. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.
Yu, Li; Li, Yi-Wei; Ryder, Oliver A; Zhang, Ya-Ping
2007-10-24
Despite the small number of ursid species, bear phylogeny has long been a focus of study due to their conservation value, as all bear genera have been classified as endangered at either the species or subspecies level. The Ursidae family represents a typical example of rapid evolutionary radiation. Previous analyses with a single mitochondrial (mt) gene or a small number of mt genes either provide weak support or a large unresolved polytomy for ursids. We revisit the contentious relationships within Ursidae by analyzing complete mt genome sequences and evaluating the performance of both entire mt genomes and constituent mtDNA genes in recovering a phylogeny of extremely recent speciation events. This mitochondrial genome-based phylogeny provides strong evidence that the spectacled bear diverged first, while within the genus Ursus, the sloth bear is the sister taxon of all the other five ursines. The latter group is divided into the brown bear/polar bear and the two black bears/sun bear assemblages. These findings resolve the previous conflicts between trees using partial mt genes. The ability of different categories of mt protein coding genes to recover the correct phylogeny is concordant with previous analyses for taxa with deep divergence times. This study provides a robust Ursidae phylogenetic framework for future validation by additional independent evidence, and also has significant implications for assisting in the resolution of other similarly difficult phylogenetic investigations. Identification of base composition bias and utilization of the combined data of whole mitochondrial genome sequences has allowed recovery of a strongly supported phylogeny that is upheld when using multiple alternative outgroups for the Ursidae, a mammalian family that underwent a rapid radiation since the mid- to late Pliocene. It remains to be seen if the reliability of mt genome analysis will hold up in studies of other difficult phylogenetic issues. Although the whole mitochondrial DNA sequence based phylogeny is robust, it remains in conflict with phylogenetic relationships suggested by analysis of limited nuclear-encoded data, a situation that will require gathering more nuclear DNA sequence information.
Yu, Li; Li, Yi-Wei; Ryder, Oliver A; Zhang, Ya-Ping
2007-01-01
Background Despite the small number of ursid species, bear phylogeny has long been a focus of study due to their conservation value, as all bear genera have been classified as endangered at either the species or subspecies level. The Ursidae family represents a typical example of rapid evolutionary radiation. Previous analyses with a single mitochondrial (mt) gene or a small number of mt genes either provide weak support or a large unresolved polytomy for ursids. We revisit the contentious relationships within Ursidae by analyzing complete mt genome sequences and evaluating the performance of both entire mt genomes and constituent mtDNA genes in recovering a phylogeny of extremely recent speciation events. Results This mitochondrial genome-based phylogeny provides strong evidence that the spectacled bear diverged first, while within the genus Ursus, the sloth bear is the sister taxon of all the other five ursines. The latter group is divided into the brown bear/polar bear and the two black bears/sun bear assemblages. These findings resolve the previous conflicts between trees using partial mt genes. The ability of different categories of mt protein coding genes to recover the correct phylogeny is concordant with previous analyses for taxa with deep divergence times. This study provides a robust Ursidae phylogenetic framework for future validation by additional independent evidence, and also has significant implications for assisting in the resolution of other similarly difficult phylogenetic investigations. Conclusion Identification of base composition bias and utilization of the combined data of whole mitochondrial genome sequences has allowed recovery of a strongly supported phylogeny that is upheld when using multiple alternative outgroups for the Ursidae, a mammalian family that underwent a rapid radiation since the mid- to late Pliocene. It remains to be seen if the reliability of mt genome analysis will hold up in studies of other difficult phylogenetic issues. Although the whole mitochondrial DNA sequence based phylogeny is robust, it remains in conflict with phylogenetic relationships suggested by analysis of limited nuclear-encoded data, a situation that will require gathering more nuclear DNA sequence information. PMID:17956639
Wetland Vegetation Integrity Assessment with Low Altitude Multispectral Uav Imagery
NASA Astrophysics Data System (ADS)
Boon, M. A.; Tesfamichael, S.
2017-08-01
The use of multispectral sensors on Unmanned Aerial Vehicles (UAVs) was until recently too heavy and bulky although this changed in recent times and they are now commercially available. The focus on the usage of these sensors is mostly directed towards the agricultural sector where the focus is on precision farming. Applications of these sensors for mapping of wetland ecosystems are rare. Here, we evaluate the performance of low altitude multispectral UAV imagery to determine the state of wetland vegetation in a localised spatial area. Specifically, NDVI derived from multispectral UAV imagery was used to inform the determination of the integrity of the wetland vegetation. Furthermore, we tested different software applications for the processing of the imagery. The advantages and disadvantages we experienced of these applications are also shortly presented in this paper. A JAG-M fixed-wing imaging system equipped with a MicaScene RedEdge multispectral camera were utilised for the survey. A single surveying campaign was undertaken in early autumn of a 17 ha study area at the Kameelzynkraal farm, Gauteng Province, South Africa. Structure-from-motion photogrammetry software was used to reconstruct the camera position's and terrain features to derive a high resolution orthoretified mosaic. MicaSense Atlas cloud-based data platform, Pix4D and PhotoScan were utilised for the processing. The WET-Health level one methodology was followed for the vegetation assessment, where wetland health is a measure of the deviation of a wetland's structure and function from its natural reference condition. An on-site evaluation of the vegetation integrity was first completed. Disturbance classes were then mapped using the high resolution multispectral orthoimages and NDVI. The WET-Health vegetation module completed with the aid of the multispectral UAV products indicated that the vegetation of the wetland is largely modified ("D" PES Category) and that the condition is expected to deteriorate (change score) in the future. However a lower impact score were determined utilising the multispectral UAV imagery and NDVI. The result is a more accurate estimation of the impacts in the wetland.
A high-resolution imaging technique using a whole-body, research photon counting detector CT system
NASA Astrophysics Data System (ADS)
Leng, S.; Yu, Z.; Halaweish, A.; Kappler, S.; Hahn, K.; Henning, A.; Li, Z.; Lane, J.; Levin, D. L.; Jorgensen, S.; Ritman, E.; McCollough, C.
2016-03-01
A high-resolution (HR) data collection mode has been introduced to a whole-body, research photon-counting-detector CT system installed in our laboratory. In this mode, 64 rows of 0.45 mm x 0.45 mm detector pixels were used, which corresponded to a pixel size of 0.25 mm x 0.25 mm at the iso-center. Spatial resolution of this HR mode was quantified by measuring the MTF from a scan of a 50 micron wire phantom. An anthropomorphic lung phantom, cadaveric swine lung, temporal bone and heart specimens were scanned using the HR mode, and image quality was subjectively assessed by two experienced radiologists. High spatial resolution of the HR mode was evidenced by the MTF measurement, with 15 lp/cm and 20 lp/cm at 10% and 2% modulation. Images from anthropomorphic phantom and cadaveric specimens showed clear delineation of small structures, such as lung vessels, lung nodules, temporal bone structures, and coronary arteries. Temporal bone images showed critical anatomy (i.e. stapes superstructure) that was clearly visible in the PCD system. These results demonstrated the potential application of this imaging mode in lung, temporal bone, and vascular imaging. Other clinical applications that require high spatial resolution, such as musculoskeletal imaging, may also benefit from this high resolution mode.
NASA Astrophysics Data System (ADS)
Poeggel, Sven; Tosi, Daniele; Duraibabu, Dineshbabu; Sannino, Simone; Lupoli, Laura; Ippolito, Juliet; Fusco, Fernando; Mirone, Vincenzo; Leen, Gabriel; Lewis, Elfed
2014-05-01
The all-glass optical fibre pressure and temperature sensor (OFPTS), present here is a combination of an extrinsic Fabry Perot Interferometer (EFPI) and an fiber Bragg gratings (FBG), which allows a simultaneously measurement of both pressure and temperature. Thermal effects experienced by the EFPI can be compensated by using the FBG. The sensor achieved a pressure measurement resolution of 0.1mmHg with a frame-rate of 100Hz and a low drift rate of < 1 mmHg/hour drift. The sensor has been evaluated using a cardiovascular simulator and additionally has been evaluated in-vivo in a urodynamics application under medical supervision.
Degefu, Dagmawi Mulugeta; Weijun, He; Zaiyi, Liao; Liang, Yuan; Zhengwei, Huang; Min, An
2018-02-01
Currently fresh water scarcity is an issue with huge socio-economic and environmental impacts. Transboundary river and lake basins are among the sources of fresh water facing this challenge. Previous studies measured blue water scarcity at different spatial and temporal resolutions. But there is no global water availability and footprint assessment done at country-basin mesh based spatial and monthly temporal resolutions. In this study we assessed water scarcity at these spatial and temporal resolutions. Our results showed that around 1.6 billion people living within the 328 country-basin units out of the 560 we assessed in this study endures severe water scarcity at least for a month within the year. In addition, 175 country-basin units goes through severe water scarcity for 3-12 months in the year. These sub-basins include nearly a billion people. Generally, the results of this study provide insights regarding the number of people and country-basin units experiencing low, moderate, significant and severe water scarcity at a monthly temporal resolution. These insights might help these basins' sharing countries to design and implement sustainable water management and sharing schemes.
Issues and Attitudes Concerning Combat-Experienced Black Vietnam Veterans
Oxley, Leo L.
1987-01-01
The therapist, whether black, white, or a member of any other ethnic group, must improve his or her objectivity and empathic accessibility by becoming knowledgeable about a minority subculture. The goal is to assist the black veteran to come to some resolution with an imperfect society and to become a legitimate, productive, contributing citizen, who happens to live in a hostile environment. PMID:3820329
Structural Analysis of Titan's Tholins by Ultra-High Resolution Mass Spectrometry
NASA Astrophysics Data System (ADS)
Vuitton, V.; Frisari, M.; Thissen, R.; Dutuit, O.; Bonnet, J.-Y.; Quirico, E.; Sciamma O'Brien, E.; Szopa, C.; Carrasco, N.; Somogyi, A.; Smith, M.; Hörst, S. M.; Yelle, R.
2010-04-01
We propose here a systematic ultra-high resolution mass spectrometry and MS/MS study in order to provide a more coherent and complete characterization of the structure of the molecules making up the soluble fraction of the Titan tholins.
Tullos, Desiree D.; Walter, Cara; Dunham, Jason B.
2016-01-01
This study investigated how the resolution of observation influences interpretation of how fish, juvenile Coho Salmon (Oncorhynchus kisutch), exploit the hydraulic environment in streams. Our objectives were to evaluate how spatial resolution of the flow field observation influenced: (1) the velocities considered to be representative of habitat units; (2) patterns of use of the hydraulic environment by fish; and (3) estimates of energy expenditure. We addressed these objectives using observations within a 1:1 scale physical model of a full-channel log jam in an outdoor experimental stream. Velocities were measured with Acoustic Doppler Velocimetry at a 10 cm grid spacing, whereas fish locations and tailbeat frequencies were documented over time using underwater videogrammetry. Results highlighted that resolution of observation did impact perceived habitat use and energy expenditure, as did the location of measurement within habitat units and the use of averaging to summarize velocities within a habitat unit. In this experiment, the range of velocities and energy expenditure estimates increased with coarsening resolution (grid spacing from 10 to 100 cm), reducing the likelihood of measuring the velocities locally experienced by fish. In addition, the coarser resolutions contributed to fish appearing to select velocities that were higher than what was measured at finer resolutions. These findings indicate the need for careful attention to and communication of resolution of observation in investigating the hydraulic environment and in determining the habitat needs and bioenergetics of aquatic biota.
Leung, Janet T Y; Shek, Daniel T L
2014-01-01
We examined the relationships between parent-adolescent discrepancies in perceived parenting characteristics (indexed by parental responsiveness, parental demandingness, and parental control) and adolescent developmental outcomes (indexed by achievement motivation and psychological competence) in poor families in Hong Kong. A sample of 275 intact families having at least one child aged 11-16 experiencing economic disadvantage were invited to participate in the study. Fathers and mothers completed the Parenting Style Scale and Chinese Parental Control Scale, and adolescents completed the Social-Oriented Achievement Motivation Scale and Chinese Positive Youth Development Scale in addition to paternal and maternal Parenting Style Scale and Chinese Parental Control Scale. Results indicated that parents and adolescents had different perceptions of parental responsiveness, parental demandingness, and paternal control, with adolescents generally perceived lower levels of parenting behaviors than did their parents. While father-adolescent discrepancy in perceived paternal responsiveness and mother-adolescent discrepancy in perceived maternal control negatively predicted adolescent achievement motivation, mother-adolescent discrepancy in perceptions of maternal responsiveness negatively predicted psychological competence in adolescents experiencing economic disadvantage. The present findings provided support that parent-child discrepancies in perceived parenting characteristics have negative impacts on the developmental outcomes of adolescents experiencing economic disadvantage. The present study addresses parent-child discrepancies in perceived parental behaviors as "legitimate" constructs, and explores their links with adolescent psychosocial development, which sheds light for researchers and clinical practitioners in helping the Chinese families experiencing economic disadvantage.
Hurst, R.; Hale, B.; Smith, D.; Collins, D.
2000-01-01
Objectives—To investigate psychological correlates of exercise dependence in experienced and inexperienced bodybuilders and weightlifters. Secondary objectives included measuring social physique anxiety, bodybuilding identity, and social support among bodybuilders and weightlifters. Methods—Thirty five experienced bodybuilders, 31 inexperienced bodybuilders, and 23 weightlifters completed the bodybuilding dependence scale, a bodybuilding version of the athletic identity measurement scale, the social physique anxiety scale, and an adapted version of the social support survey-clinical form. Results—A between subjects multivariate analysis of variance was calculated on the scores of the three groups of lifters for the four questionnaires. Univariate F tests and follow up tests indicated that experienced bodybuilders scored significantly higher than inexperienced bodybuilders and weightlifters on bodybuilding dependence (p<0.001), social identity and exclusivity subscales of bodybuilding identity (p<0.001), and social support scales (p<.001), and significantly lower on social physique anxiety (p<0.001). Conclusion—Experienced bodybuilders exhibit more exercise dependence, show greater social support behaviour, and experience less social physique anxiety than inexperienced bodybuilders and weightlifters. Key Words: bodybuilding; exercise dependence; social physical anxiety; social support; athletic identity PMID:11131230
DOE Office of Scientific and Technical Information (OSTI.GOV)
Turgeon, Guy-Anne; Souhami, Luis, E-mail: luis.souhami@muhc.mcgill.ca; Cury, Fabio L.
2014-02-01
Purpose/Objective(s): To review our experience with bladder-preserving trimodality treatment (TMT) using hypofractionated intensity modulated radiation therapy (IMRT) for the treatment of elderly patients with muscle-invasive bladder cancer. Methods and Materials: Retrospective study of elderly patients treated with TMT using hypofractionated IMRT (50 Gy in 20 fractions) with concomitant weekly radiosensitizing chemotherapy. Eligibility criteria were as follows: age ≥70 years, a proven diagnosis of muscle-invasive transitional cell bladder carcinoma, stage T2-T3N0M0 disease, and receipt of TMT with curative intent. Response rate was assessed by cystoscopic evaluation and bladder biopsy. Results: 24 patients with a median age of 79 years were eligible.more » A complete response was confirmed in 83% of the patients. Of the remaining patients, 1 of them underwent salvage cystectomy, and no disease was found in the bladder on histopathologic assessment. After a median follow-up time of 28 months, of the patients with a complete response, 2 patients had muscle-invasive recurrence, 1 experienced locoregional failure, and 3 experienced distant metastasis. The overall and cancer-specific survival rates at 3 years were 61% and 71%, respectively. Of the surviving patients, 75% have a disease-free and functioning bladder. All patients completed hypofractionated IMRT, and 19 patients tolerated all 4 cycles of chemotherapy. Acute grade 3 gastrointestinal or genitourinary toxicities occurred in only 4% of the patients, and acute grade 3 or 4 hematologic toxicities, liver toxicities, or both were experienced by 17% of the cohort. No patient experienced grade 4 gastrointestinal or genitourinary toxicity. Conclusions: Hypofractionated IMRT with concurrent radiosensitizing chemotherapy appears to be an effective and well-tolerated curative treatment strategy in the elderly population and should be considered for patients who are not candidates for cystectomy or who wish to avoid cystectomy.« less
Rules of engagement: incomplete and complete pronoun resolution.
Love, Jessica; McKoon, Gail
2011-07-01
Research on shallow processing suggests that readers sometimes encode only a superficial representation of a text and fail to make use of all available information. Greene, McKoon, and Ratcliff (1992) extended this work to pronouns, finding evidence that readers sometimes fail to automatically identify referents even when these are unambiguous. In this paper we revisit those findings. In 11 recognition probe, priming, and self-report experiments, we manipulated Greene et al.'s stories to discover under what circumstances a pronoun's referent is automatically understood. We lengthened the stories from 4 to 8 lines. This simple manipulation led to automatic and correct resolution, which we attribute to readers' increased engagement with the stories. We found evidence of resolution even when the additional text did not mention the pronoun's referent. In addition, our results suggest that the pronoun temporarily boosts the referent's accessibility, an advantage that disappears by the end of the next sentence. Finally, we present evidence from memory experiments that supports complete pronoun resolution for the longer but not the shorter stories.
Identity styles and conflict resolution styles: associations in mother-adolescent dyads.
Missotten, Lies Christine; Luyckx, Koen; Branje, Susan; Vanhalst, Janne; Goossens, Luc
2011-08-01
Adolescent identity and parent-adolescent conflict have each attracted considerable research interest. However, few studies have examined the important link between the two constructs. The present study examined the associations between adolescent identity processing styles and adolescent conflict resolution styles in the mother-adolescent dyad. Questionnaires about conflict frequency and resolution were completed by 796 adolescents (66% female, mostly Caucasian) and their mothers. Adolescents also completed a measure on identity styles. Each identity style was hypothesized to relate to a specific conflict resolution behavior. Hierarchical regression analyses showed that the information-oriented identity style was positively associated with positive problem solving and negatively with conflict engagement and withdrawal, the normative style was positively associated with compliance, and, finally, the diffuse-avoidant style was positively associated with withdrawal and conflict engagement and negatively with positive problem solving. Our results demonstrated that the way in which adolescents tackle identity-relevant issues is related to the way in which they deal with conflicts with their mothers. Implications and suggestions for future research are discussed.
Monastirli, Alexandra; Antoniades, George; Kapranos, Nikiforos; Pasmatzi, Efstathia; Badavanis, George; Tsambaos, Dionysios
2017-11-15
Eosinophilic pustular folliculitis (EPF) is a rare noninfectious pruritic dermatosis, first described by Ise and Ofuji in 1965. We report the case of a 15-year oldimmunocompetent girl that presented with a widespread papulopustular eruption four days after her arrival in Japan. The clinical diagnosis of the classicform of EPF was confirmed by histological examination of the lesional skin that revealed an intense, mainly eosinophilic, dermal infiltrate within and aroundpilosebaceous units. Oral administration of lowdose indomethacin (25 mg/day) led to a complete resolution of the eruption within 6 weeks without causing any side effects. The patient is presently completing a 15-month follow-up and remains free ofrelapses. To the best of our knowledge, it is the first time that low-dose oral indomethacin is reported to be capable of causing a rapid and complete resolutionof the classic form of EPF.
2015-01-01
Background PubMed is the largest biomedical bibliographic information source on the Internet. PubMed has been considered one of the most important and reliable sources of up-to-date health care evidence. Previous studies examined the effects of domain expertise/knowledge on search performance using PubMed. However, very little is known about PubMed users’ knowledge of information retrieval (IR) functions and their usage in query formulation. Objective The purpose of this study was to shed light on how experienced/nonexperienced PubMed users perform their search queries by analyzing a full-day query log. Our hypotheses were that (1) experienced PubMed users who use system functions quickly retrieve relevant documents and (2) nonexperienced PubMed users who do not use them have longer search sessions than experienced users. Methods To test these hypotheses, we analyzed PubMed query log data containing nearly 3 million queries. User sessions were divided into two categories: experienced and nonexperienced. We compared experienced and nonexperienced users per number of sessions, and experienced and nonexperienced user sessions per session length, with a focus on how fast they completed their sessions. Results To test our hypotheses, we measured how successful information retrieval was (at retrieving relevant documents), represented as the decrease rates of experienced and nonexperienced users from a session length of 1 to 2, 3, 4, and 5. The decrease rate (from a session length of 1 to 2) of the experienced users was significantly larger than that of the nonexperienced groups. Conclusions Experienced PubMed users retrieve relevant documents more quickly than nonexperienced PubMed users in terms of session length. PMID:26139516
Epidural Hematoma Following Cervical Spine Surgery.
Schroeder, Gregory D; Hilibrand, Alan S; Arnold, Paul M; Fish, David E; Wang, Jeffrey C; Gum, Jeffrey L; Smith, Zachary A; Hsu, Wellington K; Gokaslan, Ziya L; Isaacs, Robert E; Kanter, Adam S; Mroz, Thomas E; Nassr, Ahmad; Sasso, Rick C; Fehlings, Michael G; Buser, Zorica; Bydon, Mohamad; Cha, Peter I; Chatterjee, Dhananjay; Gee, Erica L; Lord, Elizabeth L; Mayer, Erik N; McBride, Owen J; Nguyen, Emily C; Roe, Allison K; Tortolani, P Justin; Stroh, D Alex; Yanez, Marisa Y; Riew, K Daniel
2017-04-01
A multicentered retrospective case series. To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment ( P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.
Mailles, Alexandra; De Broucker, Thomas; Costanzo, Pascale; Martinez-Almoyna, Laurent; Vaillant, Véronique; Stahl, Jean-Paul
2012-05-01
A prospective study of infectious encephalitis was conducted in France in 2007. In total, 253 patients were enrolled with a proven etiological diagnosis for 52%. The cohort of surviving patients with encephalitis was assessed for sequelae and impairment 3 years after enrollment. Patients, their family, and general practitioners (GPs) were interviewed by phone to document persisting symptoms, return to work, and past and current leisure activities, with standardized questionnaires. The IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) was completed with relatives. The global outcome was determined in all patients with the Glasgow outcome scale. In 2010, 20 patients (10%) were unavailable for follow-up, 2 (1%) were excluded, and 18 (9%) had died since hospital discharge. Data were available for 167 survivors and 9 patients whose death was related to the encephalitis. The outcome was favorable in 108 of 176 patients (61%) (71 with complete resolution), 31 (18%) were mildly impaired, 25 (14%) were severely impaired, and 3 (1%) were in a vegetative state. The most frequent symptoms were difficulty concentrating (42%), behavioral disorders (27%), speech disorders (20%), and memory loss (19%). Fifteen of 63 patients (24%) previously employed were still unable to resume work. Long-term outcome was significantly associated with comorbid conditions, age, level of education, and the causative agent of encephalitis. Most patients with encephalitis experienced a favorable outcome 3 years after hospital discharge. However, minor to severe disability persists in a high number of cases with consequences for everyday life. Physical and mental impairment should be evaluated in all patients with encephalitis, and neuropsychological rehabilitation implemented whenever needed.
Flow control techniques for Onyx embolization of intracranial dural arteriovenous fistulae.
Shi, Zhong-Song; Loh, Yince; Gonzalez, Nestor; Tateshima, Satoshi; Feng, Lei; Jahan, Reza; Duckwiler, Gary; Viñuela, Fernando
2013-07-01
Experience of flow control techniques during endovascular treatment of intracranial dural arteriovenous fistulas (DAVFs) using the Onyx liquid embolic system is reported, with an emphasis on high flow shunts. Data were evaluated in patients with DAVFs treated endovascularly with Onyx. Adjunctive techniques with coils, acrylics and balloon assistance were utilized to reduce the rate of flow with transarterial and transvenous approaches. The following types of adjunctive techniques were used in 58 patients who underwent a total of 84 embolization sessions with Onyx: transvenous coiling with transvenous or transarterial Onyx embolization in 36 patients, transarterial coiling with transarterial Onyx embolization in eight patients, arterial or venous balloon assisted technique with transarterial or transvenous Onyx embolization in 11 patients, transarterial high concentration acrylics with transarterial Onyx embolization in one patient and staged transarterial or transvenous coiling and Onyx embolization in two patients. Complete obliteration of the fistulae was achieved in 41 patients (70.7%) and 27 patients (65.9%) with high flow fistulae after endovascular treatment alone. Periprocedural complications were encountered in 16 patients, and 13 complications were associated with the adjunctive techniques. There were four neurologic and two non-neurologic clinical sequelae. Distal Onyx migration occurred in four, microcatheter retention in three and cranial neuropathy in three patients. There was one instance each of cerebellar hemorrhage, thromboembolism, coil stretching and retention, and dissection. 56 survivors experienced complete resolution or significant improvement of their symptoms on follow-up. Flow control techniques are safe and effective adjunctive methods in primary endovascular Onyx embolization of high flow DAVFs.
NASA Astrophysics Data System (ADS)
Norris, Hannah; Zhang, Yakun; Frush, Jack; Sturgeon, Gregory M.; Minhas, Anum; Tward, Daniel J.; Ratnanather, J. Tilak; Miller, M. I.; Frush, Donald; Samei, Ehsan; Segars, W. Paul
2014-03-01
With the increased use of CT examinations, the associated radiation dose has become a large concern, especially for pediatrics. Much research has focused on reducing radiation dose through new scanning and reconstruction methods. Computational phantoms provide an effective and efficient means for evaluating image quality, patient-specific dose, and organ-specific dose in CT. We previously developed a set of highly-detailed 4D reference pediatric XCAT phantoms at ages of newborn, 1, 5, 10, and 15 years with organ and tissues masses matched to ICRP Publication 89 values. We now extend this reference set to a series of 64 pediatric phantoms of a variety of ages and height and weight percentiles, representative of the public at large. High resolution PET-CT data was reviewed by a practicing experienced radiologist for anatomic regularity and was then segmented with manual and semi-automatic methods to form a target model. A Multi-Channel Large Deformation Diffeomorphic Metric Mapping (MC-LDDMM) algorithm was used to calculate the transform from the best age matching pediatric reference phantom to the patient target. The transform was used to complete the target, filling in the non-segmented structures and defining models for the cardiac and respiratory motions. The complete phantoms, consisting of thousands of structures, were then manually inspected for anatomical accuracy. 3D CT data was simulated from the phantoms to demonstrate their ability to generate realistic, patient quality imaging data. The population of pediatric phantoms developed in this work provides a vital tool to investigate dose reduction techniques in 3D and 4D pediatric CT.
Ross, Sandy A; Rice, Clinton; Von Behren, Kristyn; Meyer, April; Alexander, Rachel; Murfin, Scott
2015-01-01
The purpose of this study was to establish intra-rater, intra-session, and inter-rater, reliability of sagittal plane hip, knee, and ankle angles with and without reflective markers using the GAITRite walkway and single video camera between student physical therapists and an experienced physical therapist. This study included thirty-two healthy participants age 20-59, stratified by age and gender. Participants performed three successful walks with and without markers applied to anatomical landmarks. GAITRite software was used to digitize sagittal hip, knee, and ankle angles at two phases of gait: (1) initial contact; and (2) mid-stance. Intra-rater reliability was more consistent for the experienced physical therapist, regardless of joint or phase of gait. Intra-session reliability was variable, the experienced physical therapist showed moderate to high reliability (intra-class correlation coefficient (ICC) = 0.50-0.89) and the student physical therapist showed very poor to high reliability (ICC = 0.07-0.85). Inter-rater reliability was highest during mid-stance at the knee with markers (ICC = 0.86) and lowest during mid-stance at the hip without markers (ICC = 0.25). Reliability of a single camera system, especially at the knee joint shows promise. Depending on the specific type of reliability, error can be attributed to the testers (e.g. lack of digitization practice and marker placement), participants (e.g. loose fitting clothing) and camera systems (e.g. frame rate and resolution). However, until the camera technology can be upgraded to a higher frame rate and resolution, and the software can be linked to the GAITRite walkway, the clinical utility for pre/post measures is limited.
Dainty, R Scott; Alcorn, Eric; Ferguson, Chantelle A; Gregory, Diane E
2014-01-01
Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder.
Darvall, J N; Handscombe, M; Leslie, K
2017-01-01
A novel treatment, chewing gum, may be non-inferior to ondansetron in inhibiting postoperative nausea and vomiting (PONV) in female patients after laparoscopic or breast surgery. In this pilot study, we tested the feasibility of a large randomized controlled trial. We randomized 94 female patients undergoing laparoscopic or breast surgery to ondansetron 4 mg i.v. or chewing gum if PONV was experienced in the postanaesthesia care unit (PACU). The primary outcome was full resolution of PONV, with non-inferiority defined as a difference between groups of <15% in a per protocol analysis. Secondary outcomes were PACU stay duration, anti-emetic rescue use, and acceptability of anti-emetic treatment. The feasibility of implementing the protocol in a larger trial was assessed. Postoperative nausea and vomiting in the PACU occurred in 13 (28%) ondansetron patients and 15 (31%) chewing gum patients (P=0.75). Three chewing gum patients could not chew gum when they developed PONV. On a per protocol basis, full resolution of PONV occurred in five of 13 (39%) ondansetron vs nine of 12 (75%) chewing gum patients [risk difference 37% (6.3-67%), P=0.07]. There was no difference in secondary outcomes between groups. Recruitment was satisfactory, the protocol was acceptable to anaesthetists and nurses, and data collection was complete. In this pilot trial, chewing gum was not inferior to ondansetron for treatment of PONV after general anaesthesia for laparoscopic or breast surgery in female patients. Our findings demonstrate the feasibility of a larger, multicentred randomized controlled trial to investigate this novel therapy. Australian New Zealand Clinical Trials Registry: ACTRN12615001327572. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
NASA Astrophysics Data System (ADS)
Werner, K.; Rauch, T.
2014-09-01
PG 1159 stars are very hot (effective temperatures Teff = 75 000-200 000 K), hydrogen-deficient (pre-) white dwarfs. They probably are the result of a late helium-shell flash that laid bare the He, C, and O rich intershell matter of the progenitor Asymptotic Giant Branch (AGB) star. Their chemical surface composition thus allows to conclude on details of AGB-star nucleosynthesis. Due to their very high effective temperatures, detailed spectral analyses are usually completely reliant on ultraviolet observations, except for some species in the hottest PG 1159 stars (Teff ≳ 130 000 K), which do exhibit highly excited lines from the CNO elements and neon (C iv, N v, O vi, Ne vii-viii) in optical spectra. Particularly problematic are, however, the coolest members of the PG 1159 class that exclusively show C iv lines in the optical. Access to the nitrogen abundance is important to decide which of the late-thermal pulse evolutionary scenarios was experienced by a particular star, while a high oxygen abundance is an important marker that the star could pulsate. In the present paper, we investigate high-resolution high signal-to-noise optical spectra of three "cool" PG 1159 stars (PG 0122+200, PG 2131+066, MCT 0130-1937, Teff = 80 000-95 000 K). With the help of non-LTE model atmospheres and synthetic spectra, we are able to identify a large number of weak CNO lines (C iii, N iv, O iii-v) that were not detected before in these stars. They allow abundance determinations and enable us to constrain the effective temperature to high precision through ionization equilibria without the requirement to access the ultraviolet spectral range.
Dey, Mahua; Stadnik, Agnieszka; Riad, Fady; Zhang, Lingjiao; McBee, Nichol; Kase, Carlos; Carhuapoma, J Ricardo; Ram, Malathi; Lane, Karen; Ostapkovich, Noeleen; Aldrich, Francois; Aldrich, Charlene; Jallo, Jack; Butcher, Ken; Snider, Ryan; Hanley, Daniel; Ziai, Wendy; Awad, Issam A
2015-03-01
Retrospective series report varied rates of bleeding and infection with external ventricular drainage (EVD). There have been no prospective studies of these risks with systematic surveillance, threshold definitions, or independent adjudication. To analyze the rate of complications in the ongoing Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR III) trial, providing a comparison with a systematic review of complications of EVD in the literature. Patients were prospectively enrolled in the CLEAR III trial after placement of an EVD for obstructive intraventricular hemorrhage and randomized to receive recombinant tissue-type plasminogen activator or placebo. We counted any detected new hemorrhage (catheter tract hemorrhage or any other distant hemorrhage) on computed tomography scan within 30 days from the randomization. Meta-analysis of published series of EVD placement was compiled with STATA software. Growing or unstable hemorrhage was reported as a cause of exclusion from the trial in 74 of 5707 cases (1.3%) screened for CLEAR III. The first 250 patients enrolled have completed adjudication of adverse events. Forty-two subjects (16.8%) experienced ≥1 new bleeds or expansions, and 6 of 250 subjects (2.4%) suffered symptomatic hemorrhages. Eleven cases (4.4%) had culture-proven bacterial meningitis or ventriculitis. Risks of bleeding and infection in the ongoing CLEAR III trial are comparable to those previously reported in EVD case series. In the present study, rates of new bleeds and bacterial meningitis/ventriculitis are very low despite multiple daily injections, blood in the ventricles, the use of thrombolysis in half the cases, and generalization to >60 trial sites.
Arabshahi, Bita; Dewitt, Esi Morgan; Cahill, Ann Marie; Kaye, Robin D; Baskin, Kevin M; Towbin, Richard B; Cron, Randy Q
2005-11-01
To assess the effects of computed tomography (CT)-guided injection of corticosteroid into the temporomandibular joint (TMJ) in children with juvenile idiopathic arthritis (JIA) and clinical and magnetic resonance imaging (MRI) evidence of TMJ inflammation. Twenty-three children ages 4-16 years with JIA and MRI evidence of TMJ inflammation received CT-guided TMJ injections of corticosteroid (triamcinolone acetonide [n = 16] or triamcinolone hexacetonide [n = 7]). Jaw pain or dysfunction and maximal incisal opening (MIO) distance were assessed before and after injection. Fourteen patients had followup MRI studies of the TMJ 6-12 months after injection. Of the 13 patients with symptoms of jaw pain prior to corticosteroid treatment, 10 (77%) had complete resolution of pain (P < 0.05). Prior to corticosteroid injection, MIO in all 23 patients was below age-matched normal values. After injection, the MIO was improved by at least 0.5 cm in 10 patients (43%) (P = 0.0017). Patients under 6 years of age at the time of injection showed the best response, with a postinjection MIO similar to that in age-matched controls (P = 0.2267). There was involvement of 23 TMJs in the 14 patients who had followup MRI studies; resolution of effusions was observed in 11 (48%) of the TMJs. Other than short-term facial swelling in 2 patients, there were no side effects. The majority of children with symptomatic TMJ arthritis improved after intraarticular corticosteroid injection. Approximately half the patients experienced significant improvement in MIO and TMJ effusion. These data suggest that corticosteroid injection may be a useful procedure for the prevention and treatment of morbidities associated with TMJ arthritis in JIA.
Li, Hai; Liu, Jianbin; Feng, Xiujuan; Liu, Liehua; Wei, Guohong; Cao, Xiaopei; Li, Yanbing
2017-12-01
To test the efficacy of a strategy based on CT imaging and clinical characteristics on lateralizing origin of excess aldosterone secretion in primary aldosteronism. Consecutive patients with diagnosed primary hyperaldosteronism from June 2006 to July 2012 in our center underwent adrenal surgeries without pre-operational adrenal venous sampling (AVS) if all the three criteria were met: (1) round- or oval-shaped occupational lesion of low density after contrast enhancement with diameter >1 cm on CT scan was located in one adrenal gland; (2) unequivocally normal contralateral adrenal gland; (3) serum potassium level lower than 3.5 mmol/L. Subjects who had received operation were taken into analysis and follow-ups. One hundred and twenty-five patients fulfilled the criteria and were recruited into our research. One hundred and twenty-two operated patients (97.6%) experienced complete resolution of hypokalemia as well as resolution or improvement in hypertension with reduction in antihypertensive medication, while 3 patients (2.4%) failed to obtain normal kalemia and continued on spironolactone therapy. At a median of 65-month (range 21-93) follow-up of these 122 subjects, 27 patients dropped out (22.1%). The 95 responding patients reported no episodes of paralysis or confirmed hypokalemia or any supplementation of potassium. Multivariate linear correlation analysis showed that plasma potassium level was correlated inversely with tumor diameter (r = -0.258, 95% CI -0.076, -0.514, p = 0.037) and basal plasma aldosterone level (r = -0.251, 95% CI -0.040, -0.464, p = 0.042). Most patients with typical unilateral adrenal macroadenomas, normal contralateral glands and hypokalemia could attain favorable surgical therapeutic outcomes without pre-operational AVS lateralization.
Prevalence of Individuals Experiencing the Effects of Stroke in Canada: Trends and Projections.
Krueger, Hans; Koot, Jacqueline; Hall, Ruth E; O'Callaghan, Christina; Bayley, Mark; Corbett, Dale
2015-08-01
Previous estimates of the number and prevalence of individuals experiencing the effects of stroke in Canada are out of date and exclude critical population groups. It is essential to have complete data that report on stroke disability for monitoring and planning purposes. The objective was to provide an updated estimate of the number of individuals experiencing the effects of stroke in Canada (and its regions), trending since 2000 and forecasted prevalence to 2038. The prevalence, trends, and projected number of individuals experiencing the effects of stroke were estimated using region-specific survey data and adjusted to account for children aged <12 years and individuals living in homes for the aged. In 2013, we estimate that there were 405 000 individuals experiencing the effects of stroke in Canada, yielding a prevalence of 1.15%. This value is expected to increase to between 654 000 and 726 000 by 2038. Trends in stroke data between 2000 and 2012 suggest a nonsignificant decrease in stroke prevalence, but a substantial and rising increase in the number of individuals experiencing the effects of stroke. Stroke prevalence varied considerably between regions. Previous estimates of stroke prevalence have underestimated the true number of individuals experiencing the effects of stroke in Canada. Furthermore, the projected increases that will result from population growth and demographic changes highlight the importance of maintaining up-to-date estimates. © 2015 American Heart Association, Inc.
Bendyk-Szeffer, Maja; Łagocka, Ryta; Trusewicz, Matylda; Lipski, Mariusz; Buczkowska-Radlińska, Jadwiga
2015-02-01
An extensive perforating internal root resorption accompanied by apical periodontitis and odontogenic sinus mucositis was detected on preoperative cone-beam computed tomographic scans in a first maxillary molar. After the chemomechanical debridement of the root canals, calcium hydroxide was placed as a temporary dressing for 7 days. Mineral trioxide aggregate was used to fill the perforation site with the aid of a surgical microscope. At the next visit, the root with the resorption defect was filled with warm vertical compaction of gutta-percha. A control cone-beam computed tomographic scan acquired 6 months after the endodontic treatment revealed complete resolution of the sinus retention cyst. Moreover, the patient's frequent otolaryngologic disturbances ceased. The tooth was functional with satisfactory clinical and radiographic results after 12 months. Based on the results of this case, successful repair of an extensive, perforating internal resorption with mineral trioxide aggregate may lead to complete resolution of apical periodontitis and maxillary sinus retention cyst. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Thermophysical modelling for high-resolution digital terrain models
NASA Astrophysics Data System (ADS)
Pelivan, I.
2018-07-01
A method is presented for efficiently calculating surface temperatures for highly resolved celestial body shapes. A thorough investigation of the necessary conditions leading to reach model convergence shows that the speed of surface temperature convergence depends on factors such as the quality of initial boundary conditions, thermal inertia, illumination conditions, and resolution of the numerical depth grid. The optimization process to shorten the simulation time while increasing or maintaining the accuracy of model results includes the introduction of facet-specific boundary conditions such as pre-computed temperature estimates and pre-evaluated simulation times. The individual facet treatment also allows for assigning other facet-specific properties such as local thermal inertia. The approach outlined in this paper is particularly useful for very detailed digital terrain models in combination with unfavourable illumination conditions such as little-to-no sunlight at all for a period of time as experienced locally on comet 67P/Churyumov-Gerasimenko. Possible science applications include thermal analysis of highly resolved local (landing) sites experiencing seasonal, environment, and lander shadowing. In combination with an appropriate roughness model, the method is very suitable for application to disc-integrated and disc-resolved data. Further applications are seen where the complexity of the task has led to severe shape or thermophysical model simplifications such as in studying surface activity or thermal cracking.
Thermophysical modeling for high-resolution digital terrain models
NASA Astrophysics Data System (ADS)
Pelivan, I.
2018-04-01
A method is presented for efficiently calculating surface temperatures for highly resolved celestial body shapes. A thorough investigation of the necessary conditions leading to reach model convergence shows that the speed of surface temperature convergence depends on factors such as the quality of initial boundary conditions, thermal inertia, illumination conditions, and resolution of the numerical depth grid. The optimization process to shorten the simulation time while increasing or maintaining the accuracy of model results includes the introduction of facet-specific boundary conditions such as pre-computed temperature estimates and pre-evaluated simulation times. The individual facet treatment also allows for assigning other facet-specific properties such as local thermal inertia. The approach outlined in this paper is particularly useful for very detailed digital terrain models in combination with unfavorable illumination conditions such as little to no sunlight at all for a period of time as experienced locally on comet 67P/Churyumov-Gerasimenko. Possible science applications include thermal analysis of highly resolved local (landing) sites experiencing seasonal, environment and lander shadowing. In combination with an appropriate roughness model, the method is very suitable for application to disk-integrated and disk-resolved data. Further applications are seen where the complexity of the task has led to severe shape or thermophysical model simplifications such as in studying surface activity or thermal cracking.
Bouso, José Carlos; Fábregas, Josep Maria; Antonijoan, Rosa Maria; Rodríguez-Fornells, Antoni; Riba, Jordi
2013-12-01
Ayahuasca, a South American psychotropic plant tea containing the psychedelic 5-HT2A receptor agonist N,N-dimethyltryptamine, has been shown to increase regional cerebral blood flow in prefrontal brain regions after acute administration to humans. Despite interactions at this level, neuropsychological studies have not found cognitive deficits in abstinent long-term users. Here, we wished to investigate the effects of acute ayahuasca intake on neuropsychological performance, specifically on working memory and executive function. Twenty-four ayahuasca users (11 long-term experienced users and 13 occasional users) were assessed in their habitual setting using the Stroop, Sternberg, and Tower of London tasks prior to and following ayahuasca intake. Errors in the Sternberg task increased, whereas reaction times in the Stroop task decreased and accuracy was maintained for the whole sample following ayahuasca intake. Interestingly, results in the Tower of London showed significantly increased execution and resolution times and number of movements for the occasional but not the experienced users. Additionally, a correlation analysis including all subjects showed that impaired performance in the Tower of London was inversely correlated with lifetime ayahuasca use. Acute ayahuasca administration impaired working memory but decreased stimulus-response interference. Interestingly, detrimental effects on higher cognition were only observed in the less experienced group. Rather than leading to increased impairment, greater prior exposure to ayahuasca was associated with reduced incapacitation. Compensatory or neuromodulatory effects associated with long-term ayahuasca intake could underlie preserved executive function in experienced users.
The Inelastic Instrument suite at the SNS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Granroth, Garrett E; Abernathy, Douglas L; Ehlers, Georg
2008-01-01
Abstract The instruments in the extensive suite of spectrometers at the SNS are in various stages of installation and commissioning. The Back Scattering Spectrometer (BASIS) is installed and is in commissioning. It's near backscattering analyzer crystals provide the 3 eV resolution as expected. BASIS will enter the user program in the fall of 2007. The ARCS wide angular-range thermal to epithermal neutron spectrometer will come on line in the fall of 2007 followed shortly by the Cold Neutron Chopper Spectrometer. These two direct geometry instruments provide moderate resolution and the ability to trade resolution for flux. In addition both instrumentsmore » have detector coverage out to 140o to provide a large Q range. The SEQUOIA spectrometer, complete in 2008, is the direct geometry instrument that will provide fine resolution in the thermal to epithermal range. The Spin-Echo spectrometer, to be completed on a similar time scale, will provide the finest energy resolution worldwide. The HYSPEC spectrometer, available no later than 2011, will provide polarized capabilities and optimized flux in the thermal energy range. Finally, the Vision chemical spectrometer will use crystal analyzers to study energy transfers into the epithermal range« less
Forgey, Mary Ann; Badger, Lee
2010-01-01
A sample of 248 enlisted active duty females married to civilian spouses completed a self-report survey that asked about their own and their spouse's violence. The survey also asked about their sex-role attitudes, marital satisfaction, alcohol use, childhood trauma, and depression. Results identified patterns of intimate partner violence and their relationship to the psychosocial risk factors. Females experiencing severe bidirectional violence were likely to be the most depressed and to have a history of child sexual abuse. Females experiencing minor bidirectional violence did not share any of the psychosocial risk factors found for severe bidirectional violence. Females perpetrating unilateral violence toward their spouses were found to be as satisfied in their marriages as nonviolent couples and less depressed than the females experiencing bidirectional violence.
Brock, Malcolm; Chung, Tae Hwan; Gaddam, Sathvika Reddy; Kathait, Anjaneya Singh; Ober, Cecily; Georgiades, Christos
2016-12-01
Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.
Ulnar hammer syndrome: a systematic review of the literature.
Vartija, Larisa; Cheung, Kevin; Kaur, Manraj; Coroneos, Christopher James; Thoma, Achilleas
2013-11-01
Ulnar hammer syndrome is an uncommon form of arterial insufficiency. Many treatments have been described, and debate continues about the best option. The goal of this systematic review was to determine whether ulnar hammer syndrome has an occupational association, to identify the most reliable diagnostic test, and to determine the best treatment modality. A comprehensive literature search was conducted using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, and EMBASE. Data from articles meeting inclusion criteria were collected in duplicate. Methodological quality of studies was assessed using the Methodological Index for Nonrandomized Studies scale. Thirty studies were included in the systematic review. No randomized controlled trials were identified. There is low-quality evidence suggestive of an association between exposure to repetitive hand trauma and vibration and ulnar hammer syndrome. Various diagnostic investigations were used, but few were compared, making it difficult to determine the most reliable diagnostic test. Numerous nonoperative and operative treatments were reported. With nonoperative treatment, 12 percent had complete resolution and 70 percent had partial resolution of their symptoms. Of patients treated operatively, 42.5 percent had complete resolution and 42.5 percent had partial resolution of their symptoms. The heterogeneity in study design and outcome measures limits definitive conclusions about occupational association, best diagnostic test, and treatment for ulnar hammer syndrome. However, there is low-quality evidence that suggests that most patients with ulnar hammer syndrome will have partial relief of symptoms with nonoperative treatment, and operative treatment results in complete or partial resolution of symptoms in the majority of cases. Therapeutic, IV.
Keating, Leah; Tasca, Giorgio A; Bissada, Hany
2015-03-01
Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity. Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms. Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety. These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms. That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders. © 2014 The British Psychological Society.
Lee, Jungyong; Nussbaum, Maury A; Kyung, Gyouhyung
2014-01-01
Repetitive lifting/lowering is associated with an increased risk of work-related low back disorders (WRLBDs), and fatigue may exacerbate such risk. Work methods used by experienced workers are potential models for developing worker training to reduce WRLBDs, though whether experience modifies the effects of fatigue on WRLBD risk is largely unknown. Here, six novices and six experienced workers completed 185 cycles of repetitive, asymmetric lifts/lowers. Physical demands, whole-body balance and torso movement stability were assessed using torso kinematics/kinetics, linear/angular momenta and Lyapunov exponents, respectively. Several fatigue-induced changes in movement strategies were evident. Novices decreased and experienced workers increased peak lumbar moments post-fatigue, suggesting lower WRLBD risks among the former in terms of torso kinetics. Other than lumbar moments, though, fatigue substantially reduced group-level differences in torso twisting velocities and accelerations. Post-fatigue movement strategies of experienced workers thus did not appear to be advantageous in terms of WRLBD risk.
NASA Astrophysics Data System (ADS)
Huda, Nizlel; Sutawidjaja, Akbar; Subanji; Rahardjo, Swasono
2018-04-01
Metacognitive activity is very important in mathematical problems solving. Metacognitive activity consists of metacognitive awareness, metacognitive evaluation and metacognitive regulation. This study aimed to reveal the errors of metacognitive evaluation in students’ metacognitive failure in solving mathematical problems. 20 students taken as research subjects were grouped into three groups: the first group was students who experienced one metacognitive failure, the second group was students who experienced two metacognitive failures and the third group was students who experienced three metacognitive failures. One person was taken from each group as the reasearch subject. The research data was collected from worksheets done using think aload then followed by interviewing the research subjects based on the results’ of subject work. The findings in this study were students who experienced metacognitive failure in solving mathematical problems tends to miscalculate metacognitive evaluation in considering the effectiveness and limitations of their thinking and the effectiveness of their chosen strategy of completion.
Borges, Nicole J; Thompson, Britta M; Roman, Brenda J; Townsend, Mark H; Carchedi, Lisa R; Cluver, Jeff S; Frank, Julia B; Haidet, Paul M; Levine, Ruth E
2015-12-01
This study examined the relationship between team emotional intelligence, quality of team interactions, and gender. Psychiatry clerkship students participating in Team-Based Learning (TBL, n = 484) or no TBL (control, n = 265) completed the Workgroup Emotional Intelligence Profile (WEIP-S) and the Team Performance Scale (TPS). Significant correlations (p < 0.01) existed between quality of team interactions (i.e., TPS) and team emotional intelligence (i.e., WEIP-S) subscales, but not gender. Control and TBL groups experienced significant increases in WEIP-S subscales pre to post (p < 0.01, η (2) = .08), with the TBL group experiencing significantly higher gains in three of four subscales. Control group scored higher on TPS. A significant relationship exists between team emotional intelligence and quality of team interactions. Gender was unrelated to TPS or WEIP-S subscales. TBL group experienced higher gains in WEIP-S subscales while the control group experienced slightly higher TPS scores. Results suggest implications for medical educators who use TBL.
Experienced and Anticipated Pride and Shame as Predictors of Goal-Directed Behavior.
Gilchrist, Jenna D; Conroy, David E; Sabiston, Catherine M
2017-12-01
This study examined how experienced and anticipated pride and shame were related to time spent training and effort expended toward training the following week. Participants (N = 158, 76% women; M age = 35.51, SD = 10.29 years) training for a marathon/half-marathon completed a weekly online questionnaire for 5 weeks leading up to a race. In the multilevel models, time spent training was positively predicted by race proximity, age, and effort expended that week. Effort expended toward training was predicted by the current week's effort, the amount of time spent training that week, and was greater for participants who usually reported experiencing more pride than others. Neither anticipated pride or shame predicted time or effort, nor did experienced shame. The findings indicate that it is functional to foster high levels of pride when training for a long-distance race. Further work is needed to ascertain the relationship between anticipated emotions on goal-directed behavior.
42 CFR 438.408 - Resolution and notification: Grievances and appeals.
Code of Federal Regulations, 2010 CFR
2010-10-01
... AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Grievance System § 438.408 Resolution and notification: Grievances and appeals. (a) Basic rule. The MCO or PIHP must dispose of each... was completed. (2) For appeals not resolved wholly in favor of the enrollees— (i) The right to request...
Flexible high-resolution display systems for the next generation of radiology reading rooms
NASA Astrophysics Data System (ADS)
Caban, Jesus J.; Wood, Bradford J.; Park, Adrian
2007-03-01
A flexible, scalable, high-resolution display system is presented to support the next generation of radiology reading rooms or interventional radiology suites. The project aims to create an environment for radiologists that will simultaneously facilitate image interpretation, analysis, and understanding while lowering visual and cognitive stress. Displays currently in use present radiologists with technical challenges to exploring complex datasets that we seek to address. These include resolution and brightness, display and ambient lighting differences, and degrees of complexity in addition to side-by-side comparison of time-variant and 2D/3D images. We address these issues through a scalable projector-based system that uses our custom-designed geometrical and photometrical calibration process to create a seamless, bright, high-resolution display environment that can reduce the visual fatigue commonly experienced by radiologists. The system we have designed uses an array of casually aligned projectors to cooperatively increase overall resolution and brightness. Images from a set of projectors in their narrowest zoom are combined at a shared projection surface, thus increasing the global "pixels per inch" (PPI) of the display environment. Two primary challenges - geometric calibration and photometric calibration - remained to be resolved before our high-resolution display system could be used in a radiology reading room or procedure suite. In this paper we present a method that accomplishes those calibrations and creates a flexible high-resolution display environment that appears seamless, sharp, and uniform across different devices.
Sowunmi, A; Adedeji, A A; Sowunmi, C O; Falade, C O; Falade, A G; Ohaeri, B; Happi, T C; Oduola, A M
2001-01-01
The clinical characteristics and the kinetics of the disposition of the hepatomegaly associated with acute, uncomplicated Plasmodium falciparum malaria were investigated in 162 children in an endemic area of Nigeria. Hepatomegaly was significantly more common in the younger than in the older children. Complete resolution occurred in 48% following antimalarial chemotherapy. In the children in whom hepatomegaly did not resolve, a reduction in liver size of < 17% by the time parasitaemia was cleared (usually on day 3) was associated with non-resolution of hepatomegaly by days 7 or 14 of follow-up. An increase in liver size to at least 125% of the baseline value by day 4 or 5 was associated with a lack of therapeutic response, providing the child involved was aged < 5 years. In the children who had complete clearance of parasitaemia and resolution of hepatomegaly, there was no significant relationship between the parasitaemia-derived conventional indices of therapeutic response [i.e. time to clearance of 50% (PC50) or 90% (PC90) of the parasitaemia, and the parasite-clearance time (PCT)] and the corresponding parameters derived from measurement of liver size [i.e. time for resolution of 50% (HR50) or 90% (HR90) of the hepatomegaly and the hepatomegaly-resolution time (HRT)] in the same patients. However, as the HR50:PC50, HR90:PC90 and HRT:PCT ratios were similar (range = 1.6-2.1), the liver parameters may have therapeutic application. In the children with drug-sensitive P. falciparum infections and in whom hepatomegaly completely resolved, the area produced by plotting liver size against time (i.e. the area under the curve of hepatomegaly v. time, or AUChp) increased in proportion to the liver size below the costal margin (P = 0.02, from analysis of variance), but there was no significant difference in the half-lives of hepatomegaly (t1/2hp) or in the ratios of liver size to AUChp, indicating that the kinetics of the resolution of hepatomegaly were linear in the range examined. Comparison of the kinetic indices of hepatomegaly and parasitaemia showed that, although the half-lives of parasitaemia and hepatomegaly and the corresponding clearance values were similar, there was no correlation between these parameters among those in whom hepatomegaly completely resolved and parasitaemia completely cleared. These results indicate that routine clinical measurement of the liver size in children with hepatomegaly during acute, uncomplicated, P. falciparum malaria may have some use in evaluating and monitoring the therapeutic responses of infections. The resolution of hepatomegaly, a reflection of pathological changes, lags behind clearance of parasitaemia in children with P. falciparum malaria, and supports the use of the liver 'rate' as a malariometric index for assessing the intensity of transmission in endemic areas.
Exploring the impact of workplace cyberbullying on trainee doctors.
Farley, Samuel; Coyne, Iain; Sprigg, Christine; Axtell, Carolyn; Subramanian, Ganesh
2015-04-01
Workplace bullying is an occupational hazard for trainee doctors. However, little is known about their experiences of cyberbullying at work. This study examines the impact of cyberbullying among trainee doctors, and how attributions of blame for cyberbullying influence individual and work-related outcomes. Doctors at over 6 months into training were asked to complete an online survey that included measures of cyberbullying, blame attribution, negative emotion, job satisfaction, interactional justice and mental strain. A total of 158 trainee doctors (104 women, 54 men) completed the survey. Overall, 73 (46.2%) respondents had experienced at least one act of cyberbullying. Cyberbullying adversely impacted on job satisfaction (β = - 0.19; p < 0.05) and mental strain (β = 0.22; p < 0.001), although attributions of blame for the cyberbullying influenced its impact and the path of mediation. Negative emotion mediated the relationship between self-blame for a cyber-bullying act and mental strain, whereas interactional injustice mediated the association between blaming the perpetrator and job dissatisfaction. Acts of cyberbullying had been experienced by nearly half of the sample during their training and were found to significantly relate to ill health and job dissatisfaction. The deleterious impact of cyberbullying can be addressed through both workplace policies, and training for trainee doctors and experienced medical professionals. © 2015 John Wiley & Sons Ltd.
Silverman, Michael J
2013-10-01
Stigma is a major social barrier that can restrict access to and willingness to seek psychiatric care. Psychiatric consumers may use secrecy and withdrawal in an attempt to cope with stigma. The purpose of this study was to determine the effects of music therapy on self- and experienced stigma in acute care psychiatric inpatients using a randomized design with wait-list control. Participants (N=83) were randomly assigned by cluster to one of three single-session group-based conditions: music therapy, education, or wait-list control. Participants in the music therapy and education conditions completed only posttests while participants in the wait-list control condition completed only pretests. The music therapy condition was a group songwriting intervention wherein participants composed lyrics for "the stigma blues." Results indicated significant differences in measures of discrimination (experienced stigma), disclosure (self-stigma), and total stigma between participants in the music therapy condition and participants in the wait-list control condition. From the results of this randomized controlled investigation, music therapy may be an engaging and effective psychosocial technique to treat stigma. Limitations, suggestions for future research, and implications for clinical practice and psychiatric music therapy research are provided. © 2013.
Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack
2018-02-01
Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ 2 = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ 2 = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.
Self-Esteem and HIV Risk Practices among Young Adult “Ecstasy” Users
Klein, Hugh; Elifson, Kirk W.; Sterk, Claire E.
2013-01-01
In this paper, we examine the role that self-esteem plays in HIV-related risk taking among users of the drug, ecstasy. The first part of the analysis focuses on the relationship of self-esteem to HIV risk-taking. The second part of the analysis examines predictors of self-esteem in this population. The research is based on a sample of 283 young adult ecstasy users. The study took place between August 2002 and August 2004 and entailed face-to-face interviews that were completed with the use of computer-assisted structured interviews. Study participants were recruited in the Atlanta, Georgia metropolitan area using a targeted sampling and ethnographic mapping approach. Interviews took approximately two hours to complete. Results of multivariate analyses indicated that self-esteem is associated with a variety of risky practices, including: the number of sex partners that people reported having, individuals’ likelihood of having multiple sex partners, the number of different types of illegal drugs that people reported using, and their condom use self-efficacy. The multivariate analysis conducted to ascertain the factors that impact young adult ecstasy users’ levels of self-esteem yielded six such factors: educational attainment (positive), coming from a family-of-origin whose members got along well (positive), the extent of alcohol problems experienced recently (negative), the number of positive effects experienced recently as a result of ecstasy use (positive), the number of negative effects experienced recently as a result of ecstasy use (negative), and the extent of experiencing symptoms of post-traumatic stress disorder (negative). PMID:21305909
Lukeš, Tomáš; Pospíšil, Jakub; Fliegel, Karel; Lasser, Theo; Hagen, Guy M
2018-03-01
Super-resolution single molecule localization microscopy (SMLM) is a method for achieving resolution beyond the classical limit in optical microscopes (approx. 200 nm laterally). Yellow fluorescent protein (YFP) has been used for super-resolution single molecule localization microscopy, but less frequently than other fluorescent probes. Working with YFP in SMLM is a challenge because a lower number of photons are emitted per molecule compared with organic dyes, which are more commonly used. Publically available experimental data can facilitate development of new data analysis algorithms. Four complete, freely available single molecule super-resolution microscopy datasets on YFP-tagged growth factor receptors expressed in a human cell line are presented, including both raw and analyzed data. We report methods for sample preparation, for data acquisition, and for data analysis, as well as examples of the acquired images. We also analyzed the SMLM datasets using a different method: super-resolution optical fluctuation imaging (SOFI). The 2 modes of analysis offer complementary information about the sample. A fifth single molecule super-resolution microscopy dataset acquired with the dye Alexa 532 is included for comparison purposes. This dataset has potential for extensive reuse. Complete raw data from SMLM experiments have typically not been published. The YFP data exhibit low signal-to-noise ratios, making data analysis a challenge. These datasets will be useful to investigators developing their own algorithms for SMLM, SOFI, and related methods. The data will also be useful for researchers investigating growth factor receptors such as ErbB3.
Laghi, A; Iafrate, F; Paolantonio, P; Iannaccone, R; Baeli, I; Ferrari, R; Catalano, C; Passariello, R
2002-04-01
To assess the normal anatomy of the anal sphincter complex using high-resolution MR imaging with phased -array coil. Twenty patients, 13 males and 7 females, ranging in age between 27 and 56 years underwent MRI evaluation of the pelvic region, using a superconductive 1.5 T magnet (maximum gradient strength, 25 mT/m; minimum rise time 600 microseconds, equipped with phased-array coil. High-resolution T2-weighted Turbo Spin Echo sequences (TR, 4055 ms; TE, 132 ms; matrix 390x512; in-plane resolution, 0.67x0.57 mm) were acquired on multiple axial, sagittal and coronal planes. Images were reviewed by two experienced gastrointestinal radiologists in order to evaluate the normal anal sphincter complex. Optimal image quality of the anal sphincter complex was obtained in all cases. Different muscular layers were observed between the upper and lower aspects of the anal canal. In the lower part of the anal canal, internal and external sphincter muscles could be observed; in the upper part, puborectal and internal sphincter muscles were depicted. Good visualization of intersphincteric space, levator ani muscle and ischioanal space was also obtained in all cases. High-resolution MR images with phased-array coil provide optimal depiction of the anal canal and the anal sphincter complex.
Elnegaard, Sandra; Andersen, Rikke Sand; Pedersen, Anette Fischer; Jarbøl, Dorte Ejg
2017-10-15
To describe patterns of disclosure of symptoms experienced among people in the general population to persons in their personal and/or professional network. A population-based cross-sectional study. Data were collected from a web-based survey. The general population in Denmark. 100 000 individuals randomly selected, representative of the adult Danish population aged ≥20 years were invited. Approximately 5% were not eligible for inclusion. 49 706 (men=23 240; women=26 466) of 95 253 eligible individuals completed the questionnaire; yielding a response rate of 52.2%. Individuals completing all questions regarding social network relations form the study base (n=44 313). Activation of personal and/or professional relations when experiencing a symptom. The 44 313 individuals reported in total 260 079 symptom experiences within the last 4 weeks. No professional network relation was used in two-thirds of all reported symptoms. The general practitioner (GP) was the most frequently reported professional relation activated (22.5%). People reporting to have available personal relations were slightly less inclined to contact the GP (21.9%) when experiencing a symptom compared with people with no reported personal relations (26.8%). The most commonly activated personal relations were spouse/partner (56.4%) and friend (19.6%). More than a quarter of all reported symptom experiences was not shared with anyone, personal nor professional. The symptom experiences with the lowest frequency of network activation were symptoms such as black stool, constipation, change in stool texture and frequent urination. This study emphasises variation in the activation of network relations when experiencing a symptom. Symptoms were shared with both personal and professional relations, but different patterns of disclosures were discovered. For symptoms derived from the urogenital or colorectal region, the use of both personal and professional relations was relatively small, which might indicate reticence to involve other people when experiencing symptoms of that nature. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Elnegaard, Sandra; Andersen, Rikke Sand; Pedersen, Anette Fischer; Jarbøl, Dorte Ejg
2017-01-01
Objective To describe patterns of disclosure of symptoms experienced among people in the general population to persons in their personal and/or professional network. Design A population-based cross-sectional study. Data were collected from a web-based survey. Setting The general population in Denmark. Participants 100 000 individuals randomly selected, representative of the adult Danish population aged ≥20 years were invited. Approximately 5% were not eligible for inclusion. 49 706 (men=23 240; women=26 466) of 95 253 eligible individuals completed the questionnaire; yielding a response rate of 52.2%. Individuals completing all questions regarding social network relations form the study base (n=44 313). Primary and secondary outcome measures Activation of personal and/or professional relations when experiencing a symptom. Results The 44 313 individuals reported in total 260 079 symptom experiences within the last 4 weeks. No professional network relation was used in two-thirds of all reported symptoms. The general practitioner (GP) was the most frequently reported professional relation activated (22.5%). People reporting to have available personal relations were slightly less inclined to contact the GP (21.9%) when experiencing a symptom compared with people with no reported personal relations (26.8%). The most commonly activated personal relations were spouse/partner (56.4%) and friend (19.6%). More than a quarter of all reported symptom experiences was not shared with anyone, personal nor professional. The symptom experiences with the lowest frequency of network activation were symptoms such as black stool, constipation, change in stool texture and frequent urination. Conclusion This study emphasises variation in the activation of network relations when experiencing a symptom. Symptoms were shared with both personal and professional relations, but different patterns of disclosures were discovered. For symptoms derived from the urogenital or colorectal region, the use of both personal and professional relations was relatively small, which might indicate reticence to involve other people when experiencing symptoms of that nature. PMID:29038185
Intimate Partner Violence and Women’s Cancer Quality of Life
Coker, Ann L.; Follingstad, Diane R.; Garcia, Lisandra S.; Bush, Heather M.
2016-01-01
Purpose Because Intimate partner violence (IPV) may disproportionately impact women’s quality of life (QOL) when undergoing cancer treatment, women experiencing IPV were hypothesized to have (a) more symptoms of depression or stress and (b) lower QOL as measured with the Functional Assessment of Cancer Therapy (FACT-B) and Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) Scales relative to those never experiencing IPV. Methods Women, ages 18–79, who were included in one of two state cancer registries from 2009–2015 with a recent incident, primary, invasive biopsy-confirmed cancer diagnosis were recruited and asked to complete a phone interview, within 12 months of diagnosis. This interview measured IPV by timing (current and past) and type (physical, sexual, psychological), socio-demographics, and health status. Cancer registries provided consenting women’s cancer stage, site, date of diagnosis, and age. Results In this large cohort of 3,278 women who completed a phone interview, 1,221 (37.3%) disclosed lifetime IPV (10.6% sexual, 24.5% physical, and 33.6% psychological IPV). Experiencing IPV (particularly current IPV) was associated with poorer cancer-related QOL defined as having more symptoms of depression and stress after cancer diagnosis and lower FACIT-SP and FACT scores than women not experiencing IPV and controlling for confounders including demographic factors, cancer stage, site and number of comorbid conditions. Current IPV was more strongly associated with poorer QOL. When compared with those experiencing past IPV (and no IPV), women with cancer who experienced current IPV had significantly higher depression and stress symptoms scores and lower FACIT-SP and FACT-G scores indicating poorer QOL for all domains. While IPV was not associated with being diagnosed at a later cancer stage, current IPV was significantly associated with having more than one comorbid physical conditions at interview (adjusted rate ratio = 1.35; 95% confidence interval: 1.19–1.54) and particularly for women diagnosed with cancer when <55 years of age. Conclusions Current and past IPV were associated with poorer mental and physical health functioning among women recently diagnosed with cancer. Including clinical IPV screening may improve women’s cancer-related quality of life. PMID:27943059
Effect of image resolution manipulation in rearfoot angle measurements obtained with photogrammetry
Sacco, I.C.N.; Picon, A.P.; Ribeiro, A.P.; Sartor, C.D.; Camargo-Junior, F.; Macedo, D.O.; Mori, E.T.T.; Monte, F.; Yamate, G.Y.; Neves, J.G.; Kondo, V.E.; Aliberti, S.
2012-01-01
The aim of this study was to investigate the influence of image resolution manipulation on the photogrammetric measurement of the rearfoot static angle. The study design was that of a reliability study. We evaluated 19 healthy young adults (11 females and 8 males). The photographs were taken at 1536 pixels in the greatest dimension, resized into four different resolutions (1200, 768, 600, 384 pixels) and analyzed by three equally trained examiners on a 96-pixels per inch (ppi) screen. An experienced physiotherapist marked the anatomic landmarks of rearfoot static angles on two occasions within a 1-week interval. Three different examiners had marked angles on digital pictures. The systematic error and the smallest detectable difference were calculated from the angle values between the image resolutions and times of evaluation. Different resolutions were compared by analysis of variance. Inter- and intra-examiner reliability was calculated by intra-class correlation coefficients (ICC). The rearfoot static angles obtained by the examiners in each resolution were not different (P > 0.05); however, the higher the image resolution the better the inter-examiner reliability. The intra-examiner reliability (within a 1-week interval) was considered to be unacceptable for all image resolutions (ICC range: 0.08-0.52). The whole body image of an adult with a minimum size of 768 pixels analyzed on a 96-ppi screen can provide very good inter-examiner reliability for photogrammetric measurements of rearfoot static angles (ICC range: 0.85-0.92), although the intra-examiner reliability within each resolution was not acceptable. Therefore, this method is not a proper tool for follow-up evaluations of patients within a therapeutic protocol. PMID:22911379
Effect of image resolution manipulation in rearfoot angle measurements obtained with photogrammetry.
Sacco, I C N; Picon, A P; Ribeiro, A P; Sartor, C D; Camargo-Junior, F; Macedo, D O; Mori, E T T; Monte, F; Yamate, G Y; Neves, J G; Kondo, V E; Aliberti, S
2012-09-01
The aim of this study was to investigate the influence of image resolution manipulation on the photogrammetric measurement of the rearfoot static angle. The study design was that of a reliability study. We evaluated 19 healthy young adults (11 females and 8 males). The photographs were taken at 1536 pixels in the greatest dimension, resized into four different resolutions (1200, 768, 600, 384 pixels) and analyzed by three equally trained examiners on a 96-pixels per inch (ppi) screen. An experienced physiotherapist marked the anatomic landmarks of rearfoot static angles on two occasions within a 1-week interval. Three different examiners had marked angles on digital pictures. The systematic error and the smallest detectable difference were calculated from the angle values between the image resolutions and times of evaluation. Different resolutions were compared by analysis of variance. Inter- and intra-examiner reliability was calculated by intra-class correlation coefficients (ICC). The rearfoot static angles obtained by the examiners in each resolution were not different (P > 0.05); however, the higher the image resolution the better the inter-examiner reliability. The intra-examiner reliability (within a 1-week interval) was considered to be unacceptable for all image resolutions (ICC range: 0.08-0.52). The whole body image of an adult with a minimum size of 768 pixels analyzed on a 96-ppi screen can provide very good inter-examiner reliability for photogrammetric measurements of rearfoot static angles (ICC range: 0.85-0.92), although the intra-examiner reliability within each resolution was not acceptable. Therefore, this method is not a proper tool for follow-up evaluations of patients within a therapeutic protocol.
Chairat, Rungnapa; Puttisri, Adisom; Pamarapa, Asani; Wongrach, Nongnoot; Tawichasri, Chamaiporn; Patumanond, Jayanton; Tantraworasin, Apichat; Charoentum, Chaiyut
2014-09-01
To describe the pattern of disease progression and to describe locoregional recurrence, distant recurrence, and death rates in breast cancer patients after complete treatment. Medical records of women diagnosed with breast cancer at two university affiliated tertiary care hospitals in the Northern Thailand that had complete treatments between 2006 and 2010 were traced. Extracted key information included patient clinical profiles and documented recurrence of cancer The causes of death were verified from breast cancer case registration database, death certificates through The Ministry of Internal Affairs'civil registration, by direct telephone contact, or by distributed prepaid postcards. Medical records of 829 women diagnosed with breast cancer without prior evidence ofdistant metastasis, and had complete recommended treatment were included. Six hundred thirty seven women had not experienced any events up to the end of the follow-up (76.8%). The first occurring events were focused and categorized into three distinct types, locoregional recurrence (n = 83, median follow-up time = 34.2 months), distant recurrence (n = 78, median follow-up time = 35.4 months), and death without any evidences of locoregional or distant recurrences (n = 12, median follow-up time = 36.7 months). Distant recurrence after locoregional recurrence was reported (n = 33). There were 109 patient who had died (breast cancer related death) up to the end of the follow-up (13.2%). The three types of consecutively occurring deaths were death after locoregional recurrence without any distant recurrences (n = 15), death after distant recurrence with locoregional recurrence (n = 21), and death after documenited distant recurrence without any locoregional recurrences (n = 61). The trend was that the rate of the first occurring locoregional recurrence was slightly higher than that of distant recurrence, The death rate in patients without any recurrences was much lower than in those experiencing prior recurrences. The rates of disease progression from local recurrence to distant recurrence and to death were approximately 5 to 7 times faster in patients who had experienced earlierprogressions.
Huttner, Angela; Kowalczyk, Anna; Turjeman, Adi; Babich, Tanya; Brossier, Caroline; Eliakim-Raz, Noa; Kosiek, Katarzyna; Martinez de Tejada, Begoña; Roux, Xavier; Shiber, Shachaf; Theuretzbacher, Ursula; von Dach, Elodie; Yahav, Dafna; Leibovici, Leonard; Godycki-Cwirko, Maciek; Mouton, Johan W; Harbarth, Stephan
2018-05-01
The use of nitrofurantoin and fosfomycin has increased since guidelines began recommending them as first-line therapy for lower urinary tract infection (UTI). To compare the clinical and microbiologic efficacy of nitrofurantoin and fosfomycin in women with uncomplicated cystitis. Multinational, open-label, analyst-blinded, randomized clinical trial including 513 nonpregnant women aged 18 years and older with symptoms of lower UTI (dysuria, urgency, frequency, or suprapubic tenderness), a positive urine dipstick result (with detection of nitrites or leukocyte esterase), and no known colonization or previous infection with uropathogens resistant to the study antibiotics. Recruitment took place from October 2013 through April 2017 at hospital units and outpatient clinics in Geneva, Switzerland; Lodz, Poland; and Petah-Tiqva, Israel. Participants were randomized in a 1:1 ratio to oral nitrofurantoin, 100 mg 3 times a day for 5 days (n = 255), or a single 3-g dose of oral fosfomycin (n = 258). They returned 14 and 28 days after therapy completion for clinical evaluation and urine culture collection. The primary outcome was clinical response in the 28 days following therapy completion, defined as clinical resolution (complete resolution of symptoms and signs of UTI without prior failure), failure (need for additional or change in antibiotic treatment due to UTI or discontinuation due to lack of efficacy), or indeterminate (persistence of symptoms without objective evidence of infection). Secondary outcomes included bacteriologic response and incidence of adverse events. Among 513 patients who were randomized (median age, 44 years [interquartile range, 31-64]), 475 (93%) completed the trial and 377 (73%) had a confirmed positive baseline culture. Clinical resolution through day 28 was achieved in 171 of 244 patients (70%) receiving nitrofurantoin vs 139 of 241 patients (58%) receiving fosfomycin (difference, 12% [95% CI, 4%-21%]; P = .004). Microbiologic resolution occurred in 129 of 175 (74%) vs 103 of 163 (63%), respectively (difference, 11% [95% CI, 1%-20%]; P = .04). Adverse events were few and primarily gastrointestinal; the most common were nausea and diarrhea (7/248 [3%] and 3/248 [1%] in the nitrofurantoin group vs 5/247 [2%] and 5/247 [1%] in the fosfomycin group, respectively). Among women with uncomplicated UTI, 5-day nitrofurantoin, compared with single-dose fosfomycin, resulted in a significantly greater likelihood of clinical and microbiologic resolution at 28 days after therapy completion. ClinicalTrials.gov Identifier: NCT01966653.
Lehuluante, Abraraw; Fransson, Per
2014-06-01
The aim of this study was to explore if there were some specific factors pertinent to health-related quality of life (HRQoL) that could affect self-experienced suicide ideation in men with prostate cancer (PCa). Questionnaires containing 45 items were distributed to members of the Swedish Prostate Cancer Federation in May 2012. Out of 6,400 distributed questionnaires, 3,165 members (50 %) with PCa completed the questionnaires. Those members expressed their experienced HRQoL and experienced suicide ideation using VAS-like scales as well as multiple-choice questions. Both descriptive and analytical statistical methods were employed. A regression model was used to explore the relationship between experienced health-related quality of life and experienced suicide ideation. Generally, the respondents rated their self-experienced health-related quality of life as good. About 40 % of the participants had experienced problem with incontinence, and 23 % had obstructions during miction. About 7 % of the respondents experienced suicidal ideation, at least sometime. The regression model showed statistically significant relationships between suicide ideation, on the one hand, and lower self-rated health-related quality of life (P < 0.001), physical pain (P = 0.04), pain during miction (P = 0.03), and low-rated mental / physical energy (P = 0.03), on the other. It is quite necessary to know which specific disease and treatment-related problems can trigger suicide ideations in men with prostate cancer and to try to direct treatment, care, and psychosocial resources to alleviate these problems in time.
Williams, Warwick; Carter, Lyndal
2017-04-01
To study the relationship of life-time noise exposure and experience of tinnitus. Audiometric measures included otoscopy, pure tone air- and bone-conduction hearing threshold levels (HTL) and otoacoustic emissions (OAEs). Participants completed questionnaires including demographic information, past hearing health, history of participation in loud leisure activities, and attitudes to noise. A representative sample (1435) of the young (11-35 years old) Australian population. Of the sample, 63% indicated they experienced tinnitus in some form. There was no correlation of tinnitus experience with HTL or OAE amplitudes. Although median octave band HTLs for those who experienced tinnitus "all the time" were slightly higher for those who did not, neither group exhibited HTLs outside clinically-normal values. Of those who experienced tinnitus a direct correlation was found between frequency of experience of tinnitus and increasing cumulative, life-time noise exposure. Those who experienced tinnitus were more likely to report noticing deterioration in their hearing ability over time and to report difficulty hearing in quiet and/or noisy situations. Experience of tinnitus was found throughout this young population but not associated with HTLs or variation in OAE amplitudes. Males experienced 'permanent' tinnitus at significantly greater rate than females.
Association Between Experiencing Relational Bullying and Adolescent Health-Related Quality of Life.
Chester, Kayleigh L; Spencer, Neil H; Whiting, Lisa; Brooks, Fiona M
2017-11-01
Bullying is a public health concern for the school-aged population, however, the health outcomes associated with the subtype of relational bullying are less understood. The purpose of this study was to examine the association between relational bullying and health-related quality of life (HRQL) among young people. This study utilized data from 5335 students aged 11-15 years, collected as part of the 2014 Health Behavior in School-aged Children (HBSC) study conducted in England. Data were collected through self-completed surveys. Multilevel analysis modeled the relationship between relational bullying and HRQL. Demographic variables (sex, age, ethnicity, socioeconomic status) and other forms of bullying were controlled for. Experiencing relational bullying had a significant negative association with HRQL whilst controlling for other forms of bullying. Weekly relational bullying resulted in an estimated 5.352 (95% confidence interval (CI), -4.178, -6.526) decrease in KIDSCREEN-10 score compared with those not experiencing relational bullying. Experiencing relational bullying is associated with poorer HRQL. The findings question the perception of relational bullying as being a predominantly female problem. Girls were more likely to report experiencing relational bullying, but the negative association with HRQL was equal for boys and girls. © 2017, American School Health Association.
Brandelli Costa, Angelo; Pasley, Andrew; Machado, Wagner de Lara; Alvarado, Ernesto; Dutra-Thomé, Luciana; Koller, Silvia Helena
2017-01-01
This study was intended to analyze the intersection of experience of sexual stigma low-socioeconomic status, and suicide attempt amongst young Brazilians (11–24 years old). In each of the data collection periods (2004–2006: n = 7185; 2010–2012: n = 2734), participants completed a questionnaire-based instrument. Network analysis provided support for a Minority Stress Model, oriented around whether participants had experienced sexual stigma. Although suicide attempts decreased by 20% for participants who had not experienced sexual stigma, there was a 60% increase for those who had experienced sexual stigma. Of particular note were the increases in rates of reported community and familial physical assault, molestation, and rape for those who had experienced sexual stigma. An analysis of centrality statistics demonstrated that both experiences of this Minority Stress Model were fundamentally different, and that those disparities increased over the time frame observed in this study. At the center of this model, shortest paths statistics exhibited a direct conditioned connection between experiencing sexual stigma and suicide attempts. We discuss the social and historical contexts that contributed to these dynamics, and emphasize the need for policy change. PMID:28275356
How to make selective enforcement work : lessons from completed evaluations.
DOT National Transportation Integrated Search
1986-01-01
Selective enforcement, the practice of targeting specific traffic offenses which figure prominently in the crash problems experienced by a community, is an integral part of practically every traffic safety program. The purpose of this report was to s...
ERIC Educational Resources Information Center
Black, Susan
2001-01-01
Of all art forms, dance is experienced least and considered low-priority. Art educators and the NAEP's arts education framework view dance as essential for every child's complete development. The National Dance Association has set high standards. Baltimore and South Bronx programs are profiled. (MLH)
Elewski, Boni E; Vlahovic, Tracey C
2014-07-01
Econazole nitrate is a broad-spectrum topical antifungal with activity against a variety of dermatophytes and yeasts. A new topical dosage form, econazole nitrate topical foam 1%, utilizing patented Proderm Technology® has been developed for treatment of interdigital tinea pedis. To evaluate econazole nitrate foam 1% versus foam vehicle for treatment of interdigital tinea pedis. Two randomized, double-blind, parallel-group, vehicle-controlled, multicenter studies enrolled males and females ≥12 years old with a clinical diagnosis of interdigital tinea pedis and baseline fungal culture positive for a dermatophyte. Subjects applied econazole nitrate foam 1% (n=246) or foam vehicle (n=249) once daily for 4 weeks. The primary endpoint was proportion of subjects achieving a complete cure (negative KOH, negative fungal culture, complete resolution of all signs and symptoms) at 2 weeks post-treatment (Day 43). Secondary endpoints included mycologic cure (negative KOH and negative culture) and effective treatment (mycologic cure + no or mild erythema and/or scaling and all other signs and symptoms absent). The complete cure rate at Day 43 was 24.3% for econazole nitrate foam 1% vs 3.6% for foam vehicle. In addition, higher rates of mycologic cure (67.6% vs 16.9%) and effective treatment (48.6% vs 10.8%) were observed with econazole nitrate foam 1% versus the foam vehicle. There were few adverse events and only nasopharyngitis and headache were experienced by >1% of subjects. No serious adverse events were reported for econazole nitrate foam 1%. Econazole nitrate foam 1% exhibited superiority over foam vehicle for the primary and secondary endpoints with a high mycologic cure rate for all pathogens evaluated. Econazole nitrate foam 1% was safe and well tolerated with a safety profile comparable with the foam vehicle. Econazole nitrate foam 1% presents a novel alternative for the management of tinea pedis.
Development of a supervisory skills course for hospital pharmacy workplaces.
Woloschuk, Donna M M; Raymond, Colette B
2010-07-01
Many Canadian hospital pharmacies are experiencing difficulties recruiting supervisory personnel. It was expected that, through a "learning-by-doing" course, pharmacy staff would learn to apply basic skills in the day-to-day supervision of pharmacy operations and human resources and to apply the principles of supervisory documentation. A supervisory skills course targeted to pharmacy staff members was developed and implemented by the pharmacy department of a large urban health region. The course was initially offered to practising pharmacy technicians. The course design emphasized a constructivist framework incorporating authentic learning and reflective practice during seminars, with experiential and self-directed learning in the workplace. Preceptors assisted learners to achieve the course goals. Learners and preceptors provided feedback about hours spent (as the course progressed) and about their satisfaction with the course itself (at the end of the course). Learners and preceptors completed a post-program evaluation 2 months after completing the course to help in the assessment of the transfer of learning (lasting impact) associated with the course. Overall performance in the course was assessed on a pass/fail basis. Eighteen pharmacy technicians were admitted to the program, but one withdrew because of a job change. All learners successfully completed the course. Two months after the course, learners and preceptors described enhanced organization, time management, leadership, communication, and conflict-resolution skills on the part of learners, as well as their increased confidence, maturity, and ability to supervise staff. Learners' evaluations revealed a broadened perspective of pharmacy. The preceptors valued the enhancement of learners' skills and their increased enthusiasm. At the time of writing, 6 of the participants had secured supervisory positions. Creating formal instruction that engages pharmacy staff to pursue management positions is challenging. Instructional design grounded in constructivist theory and incorporating authentic learning experiences and reflection resulted in high learner satisfaction with learning outcomes.
Development of a Supervisory Skills Course for Hospital Pharmacy Workplaces
Woloschuk, Donna M M; Raymond, Colette B
2010-01-01
Background and Objective: Many Canadian hospital pharmacies are experiencing difficulties recruiting supervisory personnel. It was expected that, through a “learning-by-doing” course, pharmacy staff would learn to apply basic skills in the day-to-day supervision of pharmacy operations and human resources and to apply the principles of supervisory documentation. Methods: A supervisory skills course targeted to pharmacy staff members was developed and implemented by the pharmacy department of a large urban health region. The course was initially offered to practising pharmacy technicians. The course design emphasized a constructivist framework incorporating authentic learning and reflective practice during seminars, with experiential and self-directed learning in the workplace. Preceptors assisted learners to achieve the course goals. Learners and preceptors provided feedback about hours spent (as the course progressed) and about their satisfaction with the course itself (at the end of the course). Learners and preceptors completed a post-program evaluation 2 months after completing the course to help in the assessment of the transfer of learning (lasting impact) associated with the course. Overall performance in the course was assessed on a pass/fail basis. Results: Eighteen pharmacy technicians were admitted to the program, but one withdrew because of a job change. All learners successfully completed the course. Two months after the course, learners and preceptors described enhanced organization, time management, leadership, communication, and conflict-resolution skills on the part of learners, as well as their increased confidence, maturity, and ability to supervise staff. Learners’ evaluations revealed a broadened perspective of pharmacy. The preceptors valued the enhancement of learners’ skills and their increased enthusiasm. At the time of writing, 6 of the participants had secured supervisory positions. Conclusion: Creating formal instruction that engages pharmacy staff to pursue management positions is challenging. Instructional design grounded in constructivist theory and incorporating authentic learning experiences and reflection resulted in high learner satisfaction with learning outcomes. PMID:22478992
Navaneethan, Udayakumar; Hasan, Muhammad K; Kommaraju, Kiran; Zhu, Xiang; Hebert-Magee, Shantel; Hawes, Robert H; Vargo, John J; Varadarajulu, Shyam; Parsi, Mansour A
2016-10-01
Digital cholangioscopes provide higher-resolution imaging of the pancreatobiliary tract compared with fiberoptic instruments. The role of a new, digital, single-operator cholangiopancreatoscopy (SOC) system for diagnosis and treatment of pancreatobiliary disorders in clinical practice is not known. We performed a multicenter, observational study of 105 consecutive patients with suspected pancreatobiliary disorders. The main outcome measures were (1) sensitivity and specificity of SOC visual appearance and biopsies in the diagnosis of indeterminate biliary strictures and (2) achieving complete duct clearance in patients with biliary or pancreatic duct stones. A total of 98 cholangioscopy and 7 pancreatoscopy procedures were performed in 105 patients. Superior views of the ductal lumen and mucosa were obtained in all 44 patients with indeterminate biliary strictures. Among the 44 patients who underwent SOC-guided biopsies, the specimen was adequate for histologic evaluation in 43 patients (97.7%). The sensitivity and specificity of SOC visual impression for diagnosis of malignancy was 90% (95% confidence interval [CI], 69.9%-97.2%) and 95.8% (95% CI, 79.8%-99.3%), respectively. The sensitivity and specificity of SOC-guided biopsies for diagnosis of malignancy was 85% (95% CI, 64.0%-94.8%) and 100% (95% CI, 86.2%-100%). In patients with biliary or pancreatic duct stones (N = 36), complete duct clearance with stone removal in 1 session was accomplished in 86.1% of patients (31/36). Three patients (2.9%) experienced SOC-related adverse events that included cholangitis in 2 patients and postprocedure pancreatitis in 1 patient. SOC has become an integral part of the ERCP armamentarium and has high accuracy in the evaluation of indeterminate biliary strictures. Complete stone clearance was achieved in all but 1 patient with challenging biliary or pancreatic duct stones. ( NCT01815619.). Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
Resolution of fish allergy: a case report.
Solensky, Roland
2003-10-01
Fish allergy is one of the most common food allergies, and it is believed to be lifelong. There are no published reports, to my knowledge, of resolution of fish allergy. To report a case of resolution of IgE-mediated fish allergy. The patient was a 68-year-old man with a history of fish-induced anaphylaxis who had previously undergone prick-puncture skin testing to several fish species. Additional skin testing was performed in October 2002. Subsequently, he underwent an open challenge with halibut. The patient's previous skin tests showed him to have strongly positive reactions to several fish species. However, testing performed in October 2002 produced negative results to a number of fish species. In addition, he tolerated an open challenge with halibut. In the ensuing 8 months, he has regularly ingested salmon, cod, and halibut without experiencing any allergic reactions. This case illustrates that fish allergy is not invariably lifelong. Hence, allergists should consider reevaluating the allergy status of adults with a history of fish hypersensitivity.
Advances in Structural Biology and the Application to Biological Filament Systems.
Popp, David; Koh, Fujiet; Scipion, Clement P M; Ghoshdastider, Umesh; Narita, Akihiro; Holmes, Kenneth C; Robinson, Robert C
2018-04-01
Structural biology has experienced several transformative technological advances in recent years. These include: development of extremely bright X-ray sources (microfocus synchrotron beamlines and free electron lasers) and the use of electrons to extend protein crystallography to ever decreasing crystal sizes; and an increase in the resolution attainable by cryo-electron microscopy. Here we discuss the use of these techniques in general terms and highlight their application for biological filament systems, an area that is severely underrepresented in atomic resolution structures. We assemble a model of a capped tropomyosin-actin minifilament to demonstrate the utility of combining structures determined by different techniques. Finally, we survey the methods that attempt to transform high resolution structural biology into more physiological environments, such as the cell. Together these techniques promise a compelling decade for structural biology and, more importantly, they will provide exciting discoveries in understanding the designs and purposes of biological machines. © 2018 The Authors. BioEssays Published by WILEY Periodicals, Inc.
Investigations of Martian history
NASA Technical Reports Server (NTRS)
Hartmann, W. K.
1976-01-01
Geologic and stratigraphic analyses of Martian channels were accomplished using Mariner frames of high resolution. Crater counts were made to determine which forms had the least relative age. Results indicate that major channel and chaotic systems were relatively young, and that Mars experienced periods of enhanced erosive activity during a period of early dense atmospheric activity with rain. The problem of absolute age determination is discussed and geomorphological studies of selected Local Martian Regions are presented.
Energy cost of the Trondheim firefighter test for experienced firefighters.
von Heimburg, Erna; Medbø, Jon Ingulf
2013-01-01
The aim of this study was to measure aerobic demands of fire fighting activities including exercise in the heat. Twenty-two experienced firefighters performed the Trondheim test simulating fire fighting tasks including work in the heat. Maximal oxygen uptake (VO2 max), heart rate (HR) and ventilation were recorded continuously. Data were compared with results obtained during a treadmill test during which the participants were dressed as smoke divers. The participants completed physical parts of the Trondheim test in ˜12 min (range: 7.5-17.4). Time to complete the test was closely related to the participant's VO2 max. HR of ˜170 beats/min and pulmonary ventilation of ˜100 L/min were higher than at lactate threshold (LT) during laboratory tests. VO2 averaged over the test's physical part was 35 ± 7 ml/min/kg, which was at the same or below the level corresponding to the participants' LT. Physically fit participants completed the test faster than less fit participants. Slower and physically less fit participants consumed more air and used more oxygen than faster and physically more fit participants. The Trondheim test is physically demanding; it distinguishes physically fit and less fit participants.
Resolution enhancement using simultaneous couple illumination
NASA Astrophysics Data System (ADS)
Hussain, Anwar; Martínez Fuentes, José Luis
2016-10-01
A super-resolution technique based on structured illumination created by a liquid crystal on silicon spatial light modulator (LCOS-SLM) is presented. Single and simultaneous pairs of tilted beams are generated to illuminate a target object. Resolution enhancement of an optical 4f system is demonstrated by using numerical simulations. The resulting intensity images are recorded at a charged couple device (CCD) and stored in the computer memory for further processing. One dimension enhancement can be performed with only 15 images. Two dimensional complete improvement requires 153 different images. The resolution of the optical system is extended three times compared to the band limited system.
Thottam, Prasad John; Bathula, Samba S; Poulik, Janet M; Madgy, David N
2014-01-01
Branchial cleft anomalies make up 30% of all pediatric neck masses, but complete second branchial cleft anomalies are extremely rare. We report an unusual case of a complete second branchial cleft anomaly that presented as a draining neck fistula and a tonsillar cyst in an otherwise healthy 3-month-old girl. At the age of 7 months, the patient had been experiencing feeding difficulties, and there was increasing concern about the risk of persistent infections. At that point, the anomaly was excised in its entirety. Our suspicion that the patient had a complete second branchial cleft anomaly was confirmed by imaging, surgical excision, and histopathologic analysis.
Hammond, Simon P; Cross, Jane L; Shepstone, Lee; Backhouse, Tamara; Henderson, Catherine; Poland, Fiona; Sims, Erika; MacLullich, Alasdair; Penhale, Bridget; Howard, Robert; Lambert, Nigel; Varley, Anna; Smith, Toby O; Sahota, Opinder; Donell, Simon; Patel, Martyn; Ballard, Clive; Young, John; Knapp, Martin; Jackson, Stephen; Waring, Justin; Leavey, Nick; Howard, Gregory; Fox, Chris
2017-12-04
Health and social care provision for an ageing population is a global priority. Provision for those with dementia and hip fracture has specific and growing importance. Older people who break their hip are recognised as exceptionally vulnerable to experiencing confusion (including but not exclusively, dementia and/or delirium and/or cognitive impairment(s)) before, during or after acute admissions. Older people experiencing hip fracture and confusion risk serious complications, linked to delayed recovery and higher mortality post-operatively. Specific care pathways acknowledging the differences in patient presentation and care needs are proposed to improve clinical and process outcomes. This protocol describes a multi-centre, feasibility, cluster-randomised, controlled trial (CRCT) to be undertaken across ten National Health Service hospital trusts in the UK. The trial will explore the feasibility of undertaking a CRCT comparing the multicomponent PERFECTED enhanced recovery intervention (PERFECT-ER), which acknowledges the differences in care needs of confused older patients experiencing hip fracture, with standard care. The trial will also have an integrated process evaluation to explore how PERFECT-ER is implemented and interacts with the local context. The study will recruit 400 hip fracture patients identified as experiencing confusion and will also recruit "suitable informants" (individuals in regular contact with participants who will complete proxy measures). We will also recruit NHS professionals for the process evaluation. This mixed methods design will produce data to inform a definitive evaluation of the intervention via a large-scale pragmatic randomised controlled trial (RCT). The trial will provide a preliminary estimate of potential efficacy of PERFECT-ER versus standard care; assess service delivery variation, inform primary and secondary outcome selection, generate estimates of recruitment and retention rates, data collection difficulties, and completeness of outcome data and provide an indication of potential economic benefits. The process evaluation will enhance knowledge of implementation delivery and receipt. ISRCTN, 99336264 . Registered on 5 September 2016.
The Circumstellar Environment of Low Mass Star Forming Regions
NASA Technical Reports Server (NTRS)
Butner, Harold M.
1997-01-01
We have obtained the complete SED from 10 microns out to 1.3 mm for all of our sources. We have the FIR imaging data, processed to reveal the maximum angular resolution possible, which allows us to model the disk. To model the disk, we have high resolution millimeter interferometry data.
ERIC Educational Resources Information Center
Henry, Wilma J.; Mitcham, Michelle A.; Henry, Lynette M.
2013-01-01
This article examines the challenges faced by nontraditional college students who are coparents as a result of divorce. The need for college counseling centers to have counseling options designed to assist this special population in successfully completing their academic pursuits is presented. Conflict resolution techniques based on the Parenting…
Rules of Engagement: Incomplete and Complete Pronoun Resolution
Love, Jessica; McKoon, Gail
2011-01-01
Research on shallow processing suggests that readers sometimes encode only a superficial representation of a text, failing to make use of all available information. Greene, McKoon and Ratcliff (1992) extended this work to pronouns, finding evidence that readers sometimes fail to automatically identify referents even when they are unambiguous. In this paper we revisit those findings. In 11 recognition probe, priming, and self-report experiments, we manipulated Greene et al.’s stories to discover under what circumstances a pronoun’s referent is automatically understood. We lengthened the stories from four to eight lines, a simple manipulation that led to automatic and correct resolution, which we attribute to readers’ increased engagement with the stories. We found evidence of resolution even when the additional text did not mention the pronoun’s referent. In addition, our results suggest that the pronoun temporarily boosts the referent’s accessibility, an advantage that disappears by the end of the next sentence. Finally, we present evidence from memory experiments that support complete pronoun resolution for the longer, but not the shorter, stories. PMID:21480757
Sub-10 fs Time-Resolved Vibronic Optical Microscopy
2016-01-01
We introduce femtosecond wide-field transient absorption microscopy combining sub-10 fs pump and probe pulses covering the complete visible (500–650 nm) and near-infrared (650–950 nm) spectrum with diffraction-limited optical resolution. We demonstrate the capabilities of our system by reporting the spatially- and spectrally-resolved transient electronic response of MAPbI3–xClx perovskite films and reveal significant quenching of the transient bleach signal at grain boundaries. The unprecedented temporal resolution enables us to directly observe the formation of band-gap renormalization, completed in 25 fs after photoexcitation. In addition, we acquire hyperspectral Raman maps of TIPS pentacene films with sub-400 nm spatial and sub-15 cm–1 spectral resolution covering the 100–2000 cm–1 window. Our approach opens up the possibility of studying ultrafast dynamics on nanometer length and femtosecond time scales in a variety of two-dimensional and nanoscopic systems. PMID:27934055
Gillespie, Gordon Lee; Pekar, Bunnany; Byczkowski, Terri L; Fisher, Bonnie S
2017-03-04
Workplace violence committed by patients and visitors has high propensity to occur against emergency department employees. This article reports the association of worker, workplace, and community/environmental factors with violence risks. A cross-sectional research design was used with 280 employees from six emergency departments in the Midwest United States. Respondents completed the Survey of Violence Experienced by Staff and a 10-item demographic questionnaire. Data were analyzed using frequencies, percentages, Chi-square tests, and adjusted relative risks with 95% confidence intervals. Over 80% of respondents experienced at least one type of workplace violence with their current employer and approximately 40% experienced all three types. Risks for workplace violence were significantly higher for registered nurses and hospital-based emergency departments. Workplace violence can impact all employees in the emergency department regardless of worker, workplace, and community/environmental factors.
Assessment of pediatric residents burnout in a tertiary academic centre
Jamjoom, Roaa S.; Park, Yoon S.
2018-01-01
Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4) in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital). The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally. PMID:29543309
The First Microwave Image of the Complete Moon from Chang'E-1 Lunar Orbiter
NASA Astrophysics Data System (ADS)
Zheng, Y.-C.; Chan, K. L.; Tsang, K. T.; Zhang, F.; Zou, Y. L.; Ouyang, Z. Y.
2011-03-01
The first microwave image of the complete Moon from China's CE-1 MRM is presented. These new results are incomparable to any groundbased observation in spatial resolution and temperature sensitivity, and could be unsurpassed in the near future.
Storm, Douglas W; Hogan, Mark J; Jayanthi, Venkata R
2010-12-01
Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique. A retrospective review of all patients who underwent percutaneous embolization and sclerotherapy of a varicocele at our institution was performed. There were 27 patients with a mean age of 16 years (range 13-19 years). Indications included pain (48%), varicocele size (30%) and persistent testicular asymmetry (22%). Four patients had experienced failure of a previous surgical repair. Follow-up data were available for 21 patients (mean 9 months). The varicocele resolved in 19 patients (91%) with no evidence of hydrocele formation in any of the boys. There was resolution of pain in all patients for whom this was the indication for the procedure. In the two failures, access to the lower spermatic vein was not possible owing to the number and tortuosity of the vessels. Percutaneous embolization and sclerotherapy represent a truly minimally invasive treatment with low morbidity, minimal pain and rapid recovery. In our early experience, since lymphatic channels are completely avoided, there appears to be no risk of hydrocele formation. Copyright © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Orliac, M. J.; Gilissen, E.
2012-01-01
The study of brain evolution, particularly that of the neocortex, is of primary interest because it directly relates to how behavioural variations arose both between and within mammalian groups. Artiodactyla is one of the most diverse mammalian clades. However, the first 10 Myr of their brain evolution has remained undocumented so far. Here, we used high-resolution X-ray computed tomography to investigate the endocranial cast of Diacodexis ilicis of earliest Eocene age. Its virtual reconstruction provides unprecedented access to both metric parameters and fine anatomy of the most complete endocast of the earliest artiodactyl. This picture is assessed in a broad comparative context by reconstructing endocasts of 14 other Early and Middle Eocene representatives of basal artiodactyls, allowing the tracking of the neocortical structure of artiodactyls back to its simplest pattern. We show that the earliest artiodactyls share a simple neocortical pattern, so far never observed in other ungulates, with an almond-shaped gyrus instead of parallel sulci as previously hypothesized. Our results demonstrate that artiodactyls experienced a tardy pulse of encephalization during the Late Neogene, well after the onset of cortical complexity increase. Comparisons with Eocene perissodactyls show that the latter reached a high level of cortical complexity earlier than the artiodactyls. PMID:22764165
DOE Office of Scientific and Technical Information (OSTI.GOV)
Reynolds, R. Michael; Long, Charles N.
Sea surface temperature (SST) is one of the most appropriate and important climate parameters: a widespread increase is an indicator of global warming and modifications of the geographical distribution of SST are an extremely sensitive indicator of climate change. There is high demand for accurate, reliable, high-spatial-and-temporal-resolution SST measurements for the parameterization of ocean-atmosphere heat, momentum, and gas (SST is therefore critical to understanding the processes controlling the global carbon dioxide budget) fluxes, for detailed diagnostic and process-orientated studies to better understand the behavior of the climate system, as model boundary conditions, for assimilation into climate models, and for themore » rigorous validation of climate model output. In order to achieve an overall net flux uncertainty < 10 W/m 2 (Bradley and Fairall, 2006), the sea surface (skin) temperature (SSST) must be measured to an error < 0.1 C and a precision of 0.05 C. Anyone experienced in shipboard meteorological measurements will recognize this is a tough specification. These demands require complete confidence in the content, interpretation, accuracy, reliability, and continuity of observational SST data—criteria that can only be fulfilled by the successful implementation of an ongoing data product validation strategy.« less
Pregnancy and Electroconvulsive Therapy: A Multidisciplinary Approach.
Ray-Griffith, Shona L; Coker, Jessica L; Rabie, Nader; Eads, Lou Ann; Golden, Kimberly J; Stowe, Zachary N
2016-06-01
To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine these data with a literature review to refine the treatment guidelines for ECT during pregnancy. A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women's mental health program. A total of 8 pregnant women treated with ECT were identified from January 2012 to August 2014. Information was extracted from the medical records of a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range, 1-7). All women were diagnosed as having a mood disorder (either unipolar or bipolar), and 5 of the 8 women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications after the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania after ECT. Obstetrical complications included 2 women with preterm delivery-one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The 5 women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in 6 of the 8 women. Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.
Blonski, Wojciech C; Campbell, Mical S; Faust, Thomas; Metz, David C
2006-01-01
Simple liver cysts are congenital with a prevalence of 2.5%-4.25%. Imaging, whether by US, CT or MRI, is accurate in distinguishing simple cysts from other etiologies, including parasitic, neoplastic, duct-related, and traumatic cysts. Symptomatic simple liver cysts are rare, and the true frequency of symptoms is not known. Symptomatic simple liver cysts are predominantly large (> 4 cm), right-sided, and more common in women and older patients. The vast majority of simple hepatic cysts require no treatment or follow-up, though large cysts (> 4 cm) may be followed initially with serial imaging to ensure stability. Attribution of symptoms to a large simple cyst should be undertaken with caution, after alternative diagnoses have been excluded. Aspiration may be performed to test whether symptoms are due to the cyst; however, cyst recurrence should be expected. Limited experience with both laparoscopic deroofing and aspiration, followed by instillation of a sclerosing agent has demonstrated promising results for the treatment of symptomatic cysts. Here, we describe a patient with a large, symptomatic, simple liver cyst who experienced complete resolution of symptoms following cyst drainage and alcohol ablation, and we present a comprehensive review of the literature. PMID:16718826
A compact high-speed mechanical sample shuttle for field-dependent high-resolution solution NMR
NASA Astrophysics Data System (ADS)
Chou, Ching-Yu; Chu, Minglee; Chang, Chi-Fon; Huang, Tai-huang
2012-01-01
Analysis of NMR relaxation data has provided significant insight on molecular dynamic, leading to a more comprehensive understanding of macromolecular functions. However, traditional methodology allows relaxation measurements performed only at a few fixed high fields, thus severely restricting their potential for extracting more complete dynamic information. Here we report the design and performance of a compact high-speed servo-mechanical shuttle assembly adapted to a commercial 600 MHz high-field superconducting magnet. The assembly is capable of shuttling the sample in a regular NMR tube from the center of the magnet to the top (fringe field ˜0.01 T) in 100 ms with no loss of sensitivity other than that due to intrinsic relaxation. The shuttle device can be installed by a single experienced user in 30 min. Excellent 2D- 15N-HSQC spectra of (u- 13C, 15N)-ubiquitin with relaxation at low fields (3.77 T) and detection at 14.1 T were obtained to illustrate its utility in R 1 measurements of macromolecules at low fields. Field-dependent 13C-R 1 data of (3,3,3-d)-alanine at various field strengths were determined and analyzed to assess CSA and 1H- 13C dipolar contributions to the carboxyl 13C-R 1.
Nd:YAG laser therapy for rectal and vaginal venous malformations.
Gurien, Lori A; Jackson, Richard J; Kiser, Michelle M; Richter, Gresham T
2017-08-01
Limited therapeutic options exist for rectal and vaginal venous malformations (VM). We describe our center's experience using Nd:YAG laser for targeted ablation of abnormal veins to treat mucosally involved pelvic VM. Records of patients undergoing non-contact Nd:YAG laser therapy of pelvic VM at a tertiary children's hospital were reviewed. Symptoms, operative findings and details, complications, and outcomes were evaluated. Nine patients (age 0-24) underwent Nd:YAG laser therapy of rectal and/or vaginal VM. Rectal bleeding was present in all patients and vaginal bleeding in all females (n = 5). 5/7 patients had extensive pelvic involvement on MRI. Typical settings were 30 (rectum) and 20-25 W (vagina), with 0.5-1.0 s pulse duration. Patients underwent the same-day discharge. Treatment intervals ranged from 14 to 180 (average = 56) weeks, with 6.1-year mean follow-up. Five patients experienced symptom relief with a single treatment. Serial treatments managed recurrent bleeding successfully in all patients, with complete resolution of vaginal lesions in 40% of cases. No complications occurred. Nd:YAG laser treatment of rectal and vaginal VM results in substantial improvement and symptom control, with low complication risk. Given the high morbidity of surgical resection, Nd:YAG laser treatment of pelvic VM should be considered as first line therapy.
NASA Astrophysics Data System (ADS)
Barr, Christopher M.; Felfer, Peter J.; Cole, James I.; Taheri, Mitra L.
2018-06-01
Radiation induced segregation in austenitic Fe-Ni-Cr stainless steels is a key detrimental microstructural modification experienced in the current generation of light water reactors. In particular, Cr depletion at grain boundaries can be a significant factor in irradiation-assisted stress corrosion cracking. Therefore, having a complete knowledge and mechanistic understanding of radiation induced segregation at high dose and after a long thermal history is desired for continued sustainability of existing reactors. Here, we examine a 12% cold worked AISI 316 stainless steel hexagonal duct exposed in the lower dose, outer blanket region of the EBR-II reactor, by using advanced characterization and analysis techniques including atom probe tomography and analytical scanning transmission electron microscopy. Contrary to existing literature, we observe an oscillatory w-shape Cr and M-shape Ni concentration profile at 31 dpa. The presence and characterization through advanced atom probe tomography analysis of the w-shape Cr RIS profile is discussed in the context of the localized GB plane interfacial excess of the other major and minor alloying elements. The key finding of a co-segregation phenomena coupling Cr, Mo, and C is discussed in the context of the existing solute segregation literature under irradiation with emphasis on improved spatial and chemical resolution of atom probe tomography.
Færden, Karl; Lund, May Brit; Aaløkken, Trond Mogens; Eduard, Wijnand; Søstrand, Per; Langård, Sverre; Kongerud, Johny
2014-01-01
Background: The long-term prognosis of repeated acute episodes of hypersensitivity pneumonitis (HP) is not well described. We report on a 10-year follow-up of a 10-person cluster from a Norwegian sawmill who had all experienced relapsing episodes of HP. Objectives: To evaluate the health symptoms, work-related sick-leave, and lung function of 10 workers exposed to mold in a Norwegian sawmill. Methods: Participants were evaluated at baseline and 10 years later at follow-up. A structured interview, measurement of serum IgG antibodies to Rhizopus microsporus (R. microsporus) antigens, lung function tests, high resolution computed tomography (HRCT) of the chest, and personal measurements of exposure to mold spores and dust were completed for each participant. Results: At baseline, nearly all workers reported acute episodes of HP more than twice a month. At follow-up, both the frequency and intensity of symptoms had declined. Sick-leave was reduced and gas diffusing capacity improved – paralleling the gradually reduced air levels of mold spores. Conclusions: In spite of an initially high occurrence of symptoms, long-term clinical and physiological outcome was good. With reduced exposure to mold spores, symptoms declined and lung function was restored. PMID:24999852
Singh, Mandeep; Lee, Jaehoon; Gupta, Neil; Gaddam, Srinivas; Smith, Bryan K.; Wani, Sachin B.; Sullivan, Debra K.; Rastogi, Amit; Bansal, Ajay; Donnelly, Joseph E.; Sharma, Prateek
2013-01-01
Objective Weight gain is an important risk factor for gastroesophageal reflux disease (GERD); however, whether weight loss can lead to resolution of GERD symptoms is not clear. Our aim was to measure the impact of weight loss on GERD symptoms. Design and Methods In a prospective cohort study at a tertiary referral center, overweight/obese subjects (BMI 25-39.9 kg/m2) were enrolled in a structured weight loss program. Weight loss strategies included dietary modifications, increased physical activity and behavioral changes. At baseline and at 6 months, BMI and waist circumference were measured and all participants completed a validated reflux disease questionnaire. Results A total of 332 adult subjects, mean age 46 years and 66% women were prospectively enrolled. At baseline, the mean body weight, BMI, and waist circumference were 101 (±18) kg, 35 (±5) kg/m2 and 103 (±13) cm. At 6 months, majority of the subjects (97%) lost weight (average weight loss: 13 ± 7.7 kg) and as compared with baseline, there was a significant decrease in the overall prevalence of GERD (15 vs. 37%; P < 0.01) and the mean GERD symptom score (1.8 vs. 5.5; P < 0.01). Overall, 81% of the subjects had reduction in GERD symptom scores; 65% had complete resolution and 15% had partial resolution of reflux symptoms. There was a significant correlation between % body weight loss and reduction in GERD symptom scores (r = 0.17, P < 0.05). Conclusions In conclusion, the overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects. PMID:23532991
NASA Astrophysics Data System (ADS)
Engelman, Jonathan
Changing student conceptions in physics is a difficult process and has been a topic of research for many years. The purpose of this study was to understand what prompted students to change or not change their incorrect conceptions of Newtons Second or Third Laws in response to an intervention, Interactive Video Vignettes (IVVs), designed to overcome them. This study is based on prior research reported in the literature which has found that a curricular framework of elicit, confront, resolve, and reflect (ECRR) is important for changing student conceptions (McDermott, 2001). This framework includes four essential parts such that during an instructional event student conceptions should be elicited, incorrect conceptions confronted, these conflicts resolved, and then students should be prompted to reflect on their learning. Twenty-two undergraduate student participants who completed either or both IVVs were studied to determine whether or not they experienced components of the ECRR framework at multiple points within the IVVs. A fully integrated, mixed methods design was used to address the study purpose. Both quantitative and qualitative data were collected iteratively for each participant. Successive data collections were informed by previous data collections. All data were analyzed concurrently. The quantitative strand included a pre/post test that participants took before and after completing a given IVV and was used to measure the effect of each IVV on learning. The qualitative strand included video of each participant completing the IVV as well as an audio-recorded video elicitation interview after the post-test. The qualitative data collection was designed to describe student experiences with each IVV as well as to observe how the ECRR framework was experienced. Collecting and analyzing data using this mixed methods approach helped develop a more complete understanding of how student conceptions of Newtons Second and Third Laws changed through completion of IVVs and how the ECRR framework was experienced. In answering the research questions, two major conclusions were reached: (1) while the ECRR framework was experienced in both the Newtons 2nd Law and Newtons 3rd Law IVVs, these experiences were qualitatively different from each other and these differences help support the differences in gain scores on the post-tests for the participants; and (2) both IVVs were able to change certain misconceptions associated with either Newtons 2nd or 3rd laws more than others. Therefore, in researching student experiences while completing the Newtons 2nd Law and Newtons 3rd Law IVVs, I determined that a complete, sequential experience of the elicit, confront, resolve, reflect framework led to the greatest change in student conceptions. This dissertation adds to the field of physics education through finding the positive impact of the ECRR framework, as IVVs are still being created and disseminated. Physics educators and researchers interested in conceptual change can use these findings to provide evidence on what students think when interacting with videos designed to change their conceptions. Finally, this dissertation supports the conceptual change literature in that the full, sequential experience involving each component of the ECRR framework led to a change in student conceptions.
Radioisotope bone scanning in a case of sarcoidosis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cinti, D.C.; Hawkins, H.B.; Slavin, J.D. Jr.
1985-03-01
The application of radioisotope scanning to osseous involvement from systemic sarcoidosis has been infrequently described in the scientific literature. Most commonly, the small bones of the hands and feet are affected if sarcoidosis involves the skeleton. Nonetheless, there are also occasional manifestations of sarcoid in the skull, long bones, and vertebral bodies. This paper describes a case of sarcoid involving the lung parenchyma with multiple lesions in the skull and ribs demonstrated by bone scanning with Tc-99m MDP. Following treatment with steroids, the bone scan showed complete resolution of the rib lesions and almost complete resolution of the lesions inmore » the calvarium.« less
Phase-ambiguity resolution for QPSK modulation systems. Part 1: A review
NASA Technical Reports Server (NTRS)
Nguyen, Tien Manh
1989-01-01
Part 1 reviews the current phase-ambiguity resolution techniques for QPSK coherent modulation systems. Here, those known and published methods of resolving phase ambiguity for QPSK with and without Forward-Error-Correcting (FEC) are discussed. The necessary background is provided for a complete understanding of the second part where a new technique will be discussed. An appropriate technique to the Consultative Committee for Space Data Systems (CCSDS) is recommended for consideration in future standards on phase-ambiguity resolution for QPSK coherent modulation systems.
Challenges in the development of very high resolution Earth System Models for climate science
NASA Astrophysics Data System (ADS)
Rasch, Philip J.; Xie, Shaocheng; Ma, Po-Lun; Lin, Wuyin; Wan, Hui; Qian, Yun
2017-04-01
The authors represent the 20+ members of the ACME atmosphere development team. The US Department of Energy (DOE) has, like many other organizations around the world, identified the need for an Earth System Model capable of rapid completion of decade to century length simulations at very high (vertical and horizontal) resolution with good climate fidelity. Two years ago DOE initiated a multi-institution effort called ACME (Accelerated Climate Modeling for Energy) to meet this an extraordinary challenge, targeting a model eventually capable of running at 10-25km horizontal and 20-400m vertical resolution through the troposphere on exascale computational platforms at speeds sufficient to complete 5+ simulated years per day. I will outline the challenges our team has encountered in development of the atmosphere component of this model, and the strategies we have been using for tuning and debugging a model that we can barely afford to run on today's computational platforms. These strategies include: 1) evaluation at lower resolutions; 2) ensembles of short simulations to explore parameter space, and perform rough tuning and evaluation; 3) use of regionally refined versions of the model for probing high resolution model behavior at less expense; 4) use of "auto-tuning" methodologies for model tuning; and 5) brute force long climate simulations.
Hawrilenko, Matt; Fleming, CJ Eubanks; Goldstein, Alana; Cordova, James V.
2015-01-01
Studies regarding the effectiveness of homework assignments in cognitive-behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time-varying relationship of recommendation completion with treatment response in a brief couples intervention (N=108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed six-months after the intervention, but no discernible differences at one year post-intervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed. PMID:26456167
Separham, Ahmad; Ghaffari, Samad; Sohrabi, Bahram; Aslanabadi, Naser; Hadavi Bavil, Mozhgan; Lotfollahi, Hasanali
2017-01-01
Low level of testosterone may be associated with cardiovascular diseases in men, as some evidence suggests a protective role for testosterone in cardiovascular system. Little is known about the possible role of serum testosterone in response to reperfusion therapy in ST-elevation myocardial infarction (STEMI) and its relationship with ST-segment recovery. The present study was conducted to evaluate the association of serum testosterone levels with ST-segment resolution following primary percutaneous coronary intervention (PPCI) in male patients with acute STEMI. Forty-eight men (mean age 54.55 ± 12.20) with STEMI undergoing PPCI were enrolled prospectively. Single-lead ST segment resolution in the lead with maximum baseline ST-elevation was measured and patients were divided into two groups according to the degree of ST-segment resolution: complete (> or =50%) or incomplete (<50%). The basic and demographic data of all patients, their left ventricular ejection fraction (LVEF) and laboratory findings including serum levels of free testosterone and cardiac enzymes were recorded along with angiographic finding and baseline TIMI (Thrombolysis in Myocardial Infarction) flow and also in-hospital complications and then these variables were compared between two groups. A complete ST-resolution (≥50%) was observed in 72.9% of the patients. The serum levels of free testosterone ( P = 0.04), peak cardiac troponin ( P = 0.03) were significantly higher and hs-CRP ( P = 0.02) were lower in patients with complete ST-resolution compared to those with incomplete ST-resolution. In-hospital complications were observed in 31.2% of patients. The patients with a lower baseline TIMI flow ( P = 0.03) and those who developed complications ( P = 0.04) had lower levels of free testosterone. A significant positive correlation was observed between the left ventricular function and serum levels of free testosterone ( P = 0.01 and r = +0.362). This study suggests that in men with STEMI undergoing PPCI, higher serum levels of testosterone are associated with a better reperfusion response, fewer complications and a better left ventricular function.
ERIC Educational Resources Information Center
Scaglione, Chris
1998-01-01
In 2000, any automated system that processes dates may stop working completely or produce unexpected or unwanted results. School administrators should obtain a complete listing of all currently used systems, prioritize them, contact hardware and software providers to verify Y2K compliance, develop resolution plans with vendors, develop assessment…
Home-to-work trips during the transportation strikes in Ile-de-France at the end of 1995
DOT National Transportation Integrated Search
1998-10-01
In November and December 1995, the region of Ile-de- France experienced strikes resulting in a virtually complete interruption of public transport. During this period, a majority of economic activity continued. The Direction Rigionale de Iquipement (...
Adolescent Parent Relationships and Academic Performance.
ERIC Educational Resources Information Center
Zook, Joan M.; Repinski, Daniel J.
This study examined associations between parent-child relationships and adolescents' academic performance. Adolescents in 7th and 10th grade completed self-report questionnaires assessing 6 features of parent-adolescent relationships: time spent together, number of activities, degree of influence, frequency of experiencing positive emotions,…
Are You Trapped In a Cycle of Mindless Munching? 5 Common Signs
Have you ever sat down to watch TV only to notice a few minutes later that the bag of chips or pint of ice cream was completely empty? If so, then it’s likely you’ve experienced “mindless munching!”
Computer training program improves teen drivers' attention to the road : traffic tech.
DOT National Transportation Integrated Search
2011-12-01
Research indicates that when completing in-vehicle tasks : such as looking at a road map, teen drivers are much more : likely than are experienced drivers to look away from the : road for long periods. Other studies indicate that glances : away from ...
Toward a Further Understanding of Students' Emotional Responses to Classroom Injustice
ERIC Educational Resources Information Center
Chory, Rebecca M.; Horan, Sean M.; Carton, Shannon T.; Houser, Marian L.
2014-01-01
Guided by emotional response theory, we examined students' emotional reactions to perceptions of classroom injustice. Undergraduates from three universities participated by completing questionnaires. Students most frequently reported procedural injustice, but experienced the most severe and most negative emotional responses to violations involving…
The previous paper [R.C. Henry, B.M. Kim, Extension of self-modeling curve resolution to mixtures of more than three components: Part 1. Finding the basic feasible region, Chemometrics and Intelligent Laboratory Systems 8 (1990) 205¯216] explained an extension ...
High resolution metric imaging payload
NASA Astrophysics Data System (ADS)
Delclaud, Y.
2017-11-01
Alcatel Space Industries has become Europe's leader in the field of high and very high resolution optical payloads, in the frame work of earth observation system able to provide military government with metric images from space. This leadership allowed ALCATEL to propose for the export market, within a French collaboration frame, a complete space based system for metric observation.
Army Communicator. Volume 32, Number 3, Summer 2007
2007-01-01
goal of bringing people from across the Army together to talk about the issues and challenges they are experiencing in the field and try to work out...actually facing the challenges . Each work- shop had a mediator who collected information on issues being faced and suggested solutions to these problems...these possible items that Signal Center actions may be put forth to bring about resolutions to the challenges facing the warfighter in the field. “I
Marchell, Richard; Locatis, Craig; Burges, Gene; Maisiak, Richard; Liu, Wei-Li; Ackerman, Michael
2017-03-01
There is little teledermatology research directly comparing remote methods, even less research with two in-person dermatologist agreement providing a baseline for comparing remote methods, and no research using high definition video as a live interactive method. To compare in-person consultations with store-and-forward and live interactive methods, the latter having two levels of image quality. A controlled study was conducted where patients were examined in-person, by high definition video, and by store-and-forward methods. The order patients experienced methods and residents assigned methods rotated, although an attending always saw patients in-person. The type of high definition video employed, lower resolution compressed or higher resolution uncompressed, was alternated between clinics. Primary and differential diagnoses, biopsy recommendations, and diagnostic and biopsy confidence ratings were recorded. Concordance and confidence were significantly better for in-person versus remote methods and biopsy recommendations were lower. Store-and-forward and higher resolution uncompressed video results were similar and better than those for lower resolution compressed video. Dermatology residents took store-and-forward photos and their quality was likely superior to those normally taken in practice. There were variations in expertise between the attending and second and third year residents. The superiority of in-person consultations suggests the tendencies to order more biopsies or still see patients in-person are often justified in teledermatology and that high resolution uncompressed video can close the resolution gap between store-and-forward and live interactive methods.
Curran, K; Thamm, D H
2016-08-01
Standard of care treatment of dogs with multicentric lymphoma includes combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP); however, owners may be hesitant to commit the resources necessary to complete a lengthy, multi-drug protocol. One hundred thirty-four client-owned dogs with multicentric lymphoma were treated with a 15-week CHOP chemotherapy protocol. The overall response rate was 98% with 104 dogs experiencing a complete response (CR). The median progression-free survival (PFS) time for all dogs was 176 days, and the median disease-specific overall survival time was 311 days. Prognostic factors identified on multivariate analysis as significant for PFS included substage, immunophenotype, hospitalization for adverse events, need for dose reduction, presence of neutrophilia at diagnosis, presence of anemia and experiencing a CR as best response to therapy. In conclusion, this protocol may be a viable alternative to CHOP protocols using a larger number of treatments. © 2015 John Wiley & Sons Ltd.
Self-Compassion and the Self-Regulation of Exercise: Reactions to Recalled Exercise Setbacks.
Semenchuk, Brittany N; Strachan, Shaelyn M; Fortier, Michelle
2018-02-01
Self-compassion facilitates health behavior self-regulation; few studies have examined self-compassion and exercise. This online, cross-sectional study investigated self-compassion's relationship with exercise self-regulation of an exercise setback. Adults (N = 105) who had experienced an exercise setback within the last 6 months completed baseline measures, recalled an exercise setback, and completed questionnaires assessing self-regulation in this context. Self-compassion associated with self-determined motivations and exercise goal reengagement, and negatively related to extrinsic motivations, state rumination, and negative affect. Self-compassion predicted unique variance, beyond self-esteem, in exercise goal reengagement, external regulation, state rumination, and negative affect experienced after an exercise setback. Self-compassion and self-esteem had unique relationships with goal reengagement, state rumination, and situational motivation, while having a complementary relationship with negative affect. This research adds to the few studies that examine the role of self-compassion in exercise self-regulation by examining how self-compassion and self-esteem relate to reactions to a recalled exercise setback.
Land Ahoy! Understanding Submarine Command and Control During the Completion of Inshore Operations.
Roberts, Aaron P J; Stanton, Neville A; Fay, Daniel
2017-12-01
The aim of this study was to use multiple command teams to provide empirical evidence for understanding communication flow, information pertinence, and tasks undertaken in a submarine control room when completing higher- and lower-demand inshore operation (INSO) scenarios. The focus of submarine operations has changed, and submarines are increasingly required to operate in costal littoral zones. However, submarine command team performance during INSO is not well understood, particularly from a sociotechnical systems perspective. A submarine control-room simulator was built. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during INSO. The Event Analysis of Systematic Teamwork method was used to model the social, task, and information networks and to describe command team performance. Ten teams were recruited for the study, affording statistical comparisons of how command-team roles and level of demand affected performance. Results indicated that the submarine command-team members are required to rapidly integrate sonar and visual data as the periscope is used, periodically, in a "duck-and-run" fashion, to maintain covertness. The fusion of such information is primarily completed by the operations officer (OPSO), with this operator experiencing significantly greater demand than any other operator. The OPSO was a bottleneck in the command team when completing INSO, experiencing similar load in both scenarios, suggesting that the command team may benefit from data synthesis tasks being more evenly distributed within the command team. The work can inform future control-room design and command-team ways of working by identifying bottlenecks in terms of information and task flow between operators.
Yoon, Dok Hyun; Sohn, Byeong Seok; Oh, Sung Yong; Lee, Won-Sik; Lee, Sang Min; Yang, Deok-Hwan; Huh, Jooryung; Suh, Cheolwon
2017-02-21
The appropriate number of chemotherapy cycles for limited stage diffuse large B-cell lymphoma (DLBCL) patients without gross residual lesions after complete resection, has not been specifically questioned. We performed a multicenter, single-arm, phase 2 study to investigate the feasibility of 3 cycles of abbreviated R-CHOP chemotherapy in low-risk patients with completely resected localized CD20+ DLBCL. Between December 2010 and May 2013, we recruited 23 patients. One was excluded due to ineligibility, and hence, 22 were included in the final analysis. The primary sites comprised the intestine (n = 15), cervical lymph nodes (n = 4), stomach (n = 1), tonsil (n = 1), and spleen (n = 1). All patients successfully completed the 3 cycles of planned R-CHOP chemotherapy. Over a median follow-up of 39.5 months (95% confidence interval, 29.9-47.1 months), both the estimated 2-year disease-free survival and overall survival rates was 95% confidence interval, 85.9-104.1%. Only one patient with an international prognostic index of 2 experienced relapse and died. The most common grade 3 or 4 toxicity condition included neutropenia (n = 8, 36.4%). Three patients experienced grade 3 febrile neutropenia, but no grade 3 or 4 non-hematologic toxicity was observed. DLBCL patients without residual lesions after resection were enrolled and R-CHOP chemotherapy was repeated at 3-week-intervals over 3 cycles. The primary endpoint was 2-year disease-free survival. Three cycles of abbreviated R-CHOP immunochemotherapy is feasible for completely resected low risk localized DLBCL.
Howard, A Fuchsia; Hasan, Haroon; Bobinski, Mary Anne; Nurcombe, Wendy; Olson, Robert; Parkinson, Maureen; Goddard, Karen
2014-09-01
Paediatric brain tumour survivors (PBTS) are at high risk for medical, neurocognitive and psychological sequelea during adulthood. Details illustrating the types and breadth of these chronic sequelae are essential to fully comprehend their impact on daily living. This study describes Canadian parents of PBTS perspectives of life challenges experienced by their now adult son or daughter related to work and finances, daily and social functioning, and legal difficulties. Parents of PBTS completed an anonymous online exploratory survey. Forty-six of 60 invited parents completed the survey. Parents reported that PBTS experienced difficulty gaining or sustaining employment (65 %) because of their health and/or a disability and employers reticence to hire and adequately support PBTS. Independent living was considered unaffordable for PBTS who received a disability allowance (82 %) and those who were employed (50 %). Thirty percent indicated their family experienced hardship because of PBTS medical expenses, which were usually paid for out of pocket (76 %). Although the majority of PBTS were independent with daily tasks and social functioning, a subgroup required continuous support. Forty percent of employed PBTS received limited assistance to accommodate their special needs. Parents indicated their son or daughter had been the victim of theft, fraud or assault (37 %), and commonly considered them vulnerable, in need of protection and feared for their future safety. Research that further illuminates the hardships facing PBTS and informs the development of support and resources to address PBTS vulnerabilities is warranted. PBTS are at risk for unemployment, financial challenges and legal difficulties, which appear to be poorly addressed by health and social programs.
Validation of the second-generation Olympus colonoscopy simulator for skills assessment.
Haycock, A V; Bassett, P; Bladen, J; Thomas-Gibson, S
2009-11-01
Simulators have potential value in providing objective evidence of technical skill for procedures within medicine. The aim of this study was to determine face and construct validity for the Olympus colonoscopy simulator and to establish which assessment measures map to clinical benchmarks of expertise. Thirty-four participants were recruited: 10 novices with no prior colonoscopy experience, 13 intermediate (trainee) endoscopists with fewer than 1000 previous colonoscopies, and 11 experienced endoscopists with more than 1000 previous colonoscopies. All participants completed three standardized cases on the simulator and experts gave feedback regarding the realism of the simulator. Forty metrics recorded automatically by the simulator were analyzed for their ability to distinguish between the groups. The simulator discriminated participants by experience level for 22 different parameters. Completion rates were lower for novices than for trainees and experts (37 % vs. 79 % and 88 % respectively, P < 0.001) and both novices and trainees took significantly longer to reach all major landmarks than the experts. Several technical aspects of competency were discriminatory; pushing with an embedded tip ( P = 0.03), correct use of the variable stiffness function ( P = 0.004), number of sigmoid N-loops ( P = 0.02); size of sigmoid N-loops ( P = 0.01), and time to remove alpha loops ( P = 0.004). Out of 10, experts rated the realism of movement at 6.4, force feedback at 6.6, looping at 6.6, and loop resolution at 6.8. The Olympus colonoscopy simulator has good face validity and excellent construct validity. It provides an objective assessment of colonoscopic skill on multiple measures and benchmarks have been set to allow its use as both a formative and a summative assessment tool. Georg Thieme Verlag KG Stuttgart. New York.
The lived experience of surviving breast cancer.
Pelusi, J
1997-09-01
To explore women's perspectives of the experience of surviving breast cancer. Descriptive, phenomenologic. A community in the Southwestern United States. Eight women, ages 34-70 (mean = 54.6 years), who had completed breast cancer therapy. Average time since completion of therapy was 7.6 years (range = 2-15 years). Open-ended, audiotaped interviews were transcribed and analyzed using Colaizzi's method. Woman's description of the experience of surviving breast cancer. Nine theme categories were identified from the data: a future of uncertainty, abandonment, sanctuaries along the way, self-transcendence, finding resolution to the financial cost of cancer, mediating expectations of others, survivors' lifelines, circle of influences, and the journey. The themes were developed into an essential structure. The essential structure of the experience of surviving breast cancer is one of facing the unknown and experiencing many losses. At the same time, this journey evolves into one of growth and enlightenment, providing the woman with many unexpected and new opportunities. In searching for the meaning of the journey (which changes over time), one grows and finds comfort and challenge in the midst of uncertainty. The journey affects not only the women themselves but also those around them. Surviving breast cancer evokes many feelings and concerns for the women and those around them. By identifying, acknowledging, and addressing these feelings and concerns, women can find meaning in their journey, which provides comfort and self-growth while facing the unknown future. This journey continues and changes over time, as does the meaning of the journey. An awareness and description of current issues and feelings surrounding survivors of breast cancer can assist the multidisciplinary healthcare team in caring for and supporting women and their families and friends during this experience.
Price, Travis K.; Dune, Tanaka; Hilt, Evann E.; Thomas-White, Krystal J.; Kliethermes, Stephanie; Brincat, Cynthia; Brubaker, Linda; Wolfe, Alan J.
2016-01-01
Enhanced quantitative urine culture (EQUC) detects live microorganisms in the vast majority of urine specimens reported as “no growth” by the standard urine culture protocol. Here, we evaluated an expanded set of EQUC conditions (expanded-spectrum EQUC) to identify an optimal version that provides a more complete description of uropathogens in women experiencing urinary tract infection (UTI)-like symptoms. One hundred fifty adult urogynecology patient-participants were characterized using a self-completed validated UTI symptom assessment (UTISA) questionnaire and asked “Do you feel you have a UTI?” Women responding negatively were recruited into the no-UTI cohort, while women responding affirmatively were recruited into the UTI cohort; the latter cohort was reassessed with the UTISA questionnaire 3 to 7 days later. Baseline catheterized urine samples were plated using both standard urine culture and expanded-spectrum EQUC protocols: standard urine culture inoculated at 1 μl onto 2 agars incubated aerobically; expanded-spectrum EQUC inoculated at three different volumes of urine onto 7 combinations of agars and environments. Compared to expanded-spectrum EQUC, standard urine culture missed 67% of uropathogens overall and 50% in participants with severe urinary symptoms. Thirty-six percent of participants with missed uropathogens reported no symptom resolution after treatment by standard urine culture results. Optimal detection of uropathogens could be achieved using the following: 100 μl of urine plated onto blood (blood agar plate [BAP]), colistin-nalidixic acid (CNA), and MacConkey agars in 5% CO2 for 48 h. This streamlined EQUC protocol achieved 84% uropathogen detection relative to 33% detection by standard urine culture. The streamlined EQUC protocol improves detection of uropathogens that are likely relevant for symptomatic women, giving clinicians the opportunity to receive additional information not currently reported using standard urine culture techniques. PMID:26962083
Németh, Krisztina; Tárkányi, Gábor; Varga, Erzsébet; Imre, Tímea; Mizsei, Réka; Iványi, Róbert; Visy, Júlia; Szemán, Julianna; Jicsinszky, László; Szente, Lajos; Simonyi, Miklós
2011-02-20
Capillary electrophoresis (CE) methods for chiral resolution of five antimalarial drugs (primaquine, tafenoquine, mefloquine, chloroquine and quinacrine) were developed by using a wide selection of neutral and anionic cyclodextrin (CD) derivatives. The use of sulfobutyl-β-CD and carboxymethyl-β-CD (CMBCD) resulted in good resolution of quinacrine and tafenoquine, respectively. New results are presented for resolutions of chloroquine and mefloquine. Application of carboxyalkyl- and sulfobutyl-CD derivatives provided improved resolution for primaquine. The impurity in primaquine sample detected by CE was identified as quinocide by MS and NMR. CMBCD provided not only the best separation of primaquine from quinocide but also the simultaneous complete resolution of both compounds. Copyright © 2010 Elsevier B.V. All rights reserved.
Eyrich-Garg, Karin M; Moss, Shadiya L
2017-02-01
Three barriers investigators often encounter when conducting longitudinal work with homeless or other marginalized populations are difficulty tracking participants, high rates of no-shows for follow-up interviews, and high rates of loss to follow-up. Recent research has shown that homeless populations have substantial access to information technologies, including mobile devices and computers. These technologies have the potential both to make longitudinal data collection with homeless populations easier and to minimize some of these methodological challenges. This pilot study's purpose was to test whether individuals who were homeless and sleeping on the streets-the "street homeless"-would answer questions remotely through a web-based data collection system at regular "follow-up" intervals. We attempted to simulate longitudinal data collection in a condensed time period. Participants (N = 21) completed an in-person baseline interview. Each participant was given a remotely reloadable gift card. Subsequently, weekly for 8 weeks, participants were sent an email with a link to a SurveyMonkey questionnaire. Participants were given 48 h to complete each questionnaire. Data were collected about life on the streets, service use, community inclusion, substance use, and high-risk sexual behaviors. Ten dollars was remotely loaded onto each participant's gift card when they completed the questionnaire within the completion window. A substantial number of participants (67% of the total sample and 86% of the adjusted sample) completed at least seven out of the eight follow-up questionnaires. Most questionnaires were completed at public libraries, but several were completed at other types of locations (social service agencies, places of employment, relative/friend/acquaintance's domiciles, or via mobile phone). Although some of the questions were quite sensitive, very few participants skipped any questions. The only variables associated with questionnaire completion were frequency of computer use and education-both positive associations. This pilot study suggests that collecting longitudinal data online may be feasible with a subpopulation of persons experiencing homelessness. We suspect that participant follow-up rates using web-based data collection methods have the potential to exceed follow-up rates using traditional in-person interviews. If this population of persons experiencing street homelessness can be successful with this method of data collection, perhaps other disenfranchised, difficult-to-track, or difficult-to-reach populations could be followed using web-based data collection methods. Local governments are striving to decrease the "digital divide," providing free or greatly discounted wi-fi connectivity as well as mobile computer lab access to low-income geographic areas. These actions, in combination with increased smart phone ownership, may permit vulnerable populations to connect and communicate with investigators.
The characteristics of failure among students who experienced pseudo thinking
NASA Astrophysics Data System (ADS)
Anggraini, D.; Kusmayadi, T. A.; Pramudya, I.
2018-04-01
The purpose of this research is to describe the thinking process of students who experienced pseudo thinking when solving the straight line equation. The result of this study shows the characteristics of error that caused students to experience pseudo thinking when solving the problem and their relation with students’ metacognition skill. This qualitative research was conducted in State 16 Junior High School in Surakarta, Indonesia during the odd semester of 2017/2018 academic year. The subjects of the study were students Junior High School students of 8th grade chosen using purposive sampling technique. Data were collected through the administration of think aloud method. The result showed that the characteristics of errors among the subjects are: 1) the answers resulted from pseudo thinking when solving the problem were obtained from the spontaneous, fast, unconscious and uncontrolled thinking process; 2) students had misconception; 3) students had tendency to memorize the formula and imitate the completion procedure; 4) students experienced fuzzy memory when solving the problem. From the mistakes among students who experienced pseudo thinking, their metacognition ability could be inferred.
Thiry, Heather; Weston, Timothy J.; Laursen, Sandra L.; Hunter, Anne-Barrie
2012-01-01
This mixed-methods study explores differences in novice and experienced undergraduate students’ perceptions of their cognitive, personal, and professional gains from engaging in scientific research. The study was conducted in four different undergraduate research (UR) programs at two research-extensive universities; three of these programs had a focus on the biosciences. Seventy-three entry-level and experienced student researchers participated in in-depth, semi-structured interviews and completed the quantitative Undergraduate Research Student Self-Assessment (URSSA) instrument. Interviews and surveys assessed students’ developmental outcomes from engaging in UR. Experienced students reported distinct personal, professional, and cognitive outcomes relative to their novice peers, including a more sophisticated understanding of the process of scientific research. Students also described the trajectories by which they developed not only the intellectual skills necessary to advance in science, but also the behaviors and temperament necessary to be a scientist. The findings suggest that students benefit from multi-year UR experiences. Implications for UR program design, advising practices, and funding structures are discussed. PMID:22949423
Andersen, Lars Peter Holst; Klein, Mads; Gögenur, Ismail; Rosenberg, Jacob
2012-02-01
Surgical procedures are mentally and physically demanding, and stress during surgery may compromise patient safety. We investigated the impact of surgical experience on surgeons' stress levels and how perioperative sleep quality may influence surgical performance. Eight experienced and 8 inexperienced surgeons each performed 1 laparoscopic cholecystectomy. Questionnaires measuring perioperative mental and physical strain using validated visual analog scale and Borg scales were completed. Preoperative and postoperative sleep quality of the surgeon was registered and correlated to perioperative strain parameters. Preoperative to postoperative frustration among experienced surgeons was significantly reduced and this was not found in the inexperienced surgeons (visual analog scale: preoperative 13 (2-65) mm, postoperative 4 (0-51) mm vs. preoperative 5(0-10) mm, postoperative 5(1-46) mm; P=0.04). Physical strain was significantly induced in both groups in the upper extremities. Preoperative and postoperative sleep quality was significantly correlated to postoperative mental strain parameters. Perioperative frustration levels were different among inexperienced and experienced surgeons. Perioperative sleep quality may influence postoperative mental strain and should be considered in studies examining surgeons' stress.
DOT National Transportation Integrated Search
1986-01-01
The study analyzed the effectiveness of commercial school programs, concluded that students successfully completing their driving instruction at these schools had driving records worse than those for students completing their instruction in the publi...
Experiencing reproductive concerns as a female cancer survivor is associated with depression.
Gorman, Jessica R; Su, H Irene; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L
2015-03-15
Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. This cross-sectional study included 200 female cancer survivors between the ages of 18 and 35 years who completed a Web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality-of-life indicators. The mean age of the participants was 28 years (standard deviation, 4.4 years), and almost two-thirds were diagnosed within 5 years of survey completion. A multivariate logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (odds ratio for each 5-unit increase in the Reproductive Concerns After Cancer [RCAC] score, 1.30; 95% confidence interval, 1.06-1.60). Among those with moderate to severe depression, 23% had high RCAC scores, whereas 6% of those with minimal to mild depression did (P < .001). A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention for improving the psychosocial health of young survivors. © 2014 American Cancer Society.
Interpersonal stressors predict ghrelin and leptin levels in women.
Jaremka, Lisa M; Belury, Martha A; Andridge, Rebecca R; Malarkey, William B; Glaser, Ronald; Christian, Lisa; Emery, Charles F; Kiecolt-Glaser, Janice K
2014-10-01
Stressful events enhance risk for weight gain and adiposity. Ghrelin and leptin, two hormones that are implicated in appetite regulation, may link stressful events to weight gain; a number of rodent studies suggest that stressors increase ghrelin production. The present study investigated the links among daily stressors, ghrelin and leptin, and dietary intake in humans. Women (n=50) completed three study appointments that were scheduled at least 2 weeks apart. At each visit, women arrived fasting and ate a standardized breakfast and lunch. Blood samples were collected 45min after each meal. Women completed a self-report version of the Daily Inventory of Stressful Events (DISE) at each appointment. Two composites were created from the DISE data, reflecting the number of stressors that did and did not involve interpersonal tension. Women who experienced more stressors involving interpersonal tension had higher ghrelin and lower leptin levels than those who experienced fewer interpersonal stressors. Furthermore, women who experienced more interpersonal stressors had a diet that was higher in calories, fat, carbohydrates, protein, sugar, sodium, and fiber, and marginally higher in cholesterol, vegetables (but not fruits), vitamin A, and vitamin C. Stressors that did not involve interpersonal tension were unrelated to ghrelin and leptin levels or any of the dietary components examined. These data suggest that ghrelin and leptin may link daily interpersonal stressors to weight gain and obesity. Copyright © 2014 Elsevier Ltd. All rights reserved.
Schuurs, Alana; Green, Heather J
2013-05-01
This research aimed to address the gap in evidence-based treatment available for cancer survivors who are experiencing cognitive dysfunction, through piloting a novel treatment intervention. The overall research question was whether a group cognitive rehabilitation intervention would be feasible for improving cognitive function and quality of life for people who have completed cancer treatment. Three groups of adults were recruited as follows: an intervention group of 23 cancer survivors who completed a 4-week group cognitive rehabilitation treatment, a comparison group of nine cancer survivors, and a community sample of 23 adults who had never experienced cancer. Measures of objective and subjective cognitive function, quality of life, psychosocial distress, and illness perceptions were used. The research design was non-randomised. The results indicated that the intervention was effective in improving overall cognitive function, visuospatial/constructional performance, immediate memory, and delayed memory beyond practice effects alone. It was helpful in reducing participants' perceptions of cognitive impairment and psychosocial distress, as well as promoting social functioning and understanding of cognition. The improvements were maintained at 3 months after the intervention. Participants reported a high level of satisfaction with the treatment. The results provided evidence for the feasibility of a brief group-based cognitive rehabilitation intervention to treat cognitive problems experienced by cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.
Interpersonal Stressors Predict Ghrelin and Leptin Levels in Women
Jaremka, Lisa M.; Belury, Martha A.; Andridge, Rebecca R.; Malarkey, William B.; Glaser, Ronald; Christian, Lisa; Emery, Charles F.; Kiecolt-Glaser, Janice K.
2014-01-01
Objective Stressful events enhance risk for weight gain and adiposity. Ghrelin and leptin, two hormones that are implicated in appetite regulation, may link stressful events to weight gain; a number of rodent studies suggest that stressors increase ghrelin production. The present study investigated the links among daily stressors, ghrelin and leptin, and dietary intake in humans. Method Women (N = 50) completed three study appointments that were scheduled at least 2 weeks apart. At each visit, women arrived fasting and ate a standardized breakfast and lunch. Blood samples were collected 45 minutes after each meal. Women completed a self-report version of the Daily Inventory of Stressful Events (DISE) at each appointment. Two composites were created from the DISE data, reflecting the number of stressors that did and did not involve interpersonal tension. Results Women who experienced more stressors involving interpersonal tension had higher ghrelin and lower leptin levels than those who experienced fewer interpersonal stressors. Furthermore, women who experienced more interpersonal stressors had a diet that was higher in calories, fat, carbohydrates, protein, sugar, sodium, and fiber, and marginally higher in cholesterol, vegetables (but not fruits), vitamin A, and vitamin C. Stressors that did not involve interpersonal tension were unrelated to ghrelin and leptin levels or any of the dietary components examined. Conclusions These data suggest that ghrelin and leptin may link daily interpersonal stressors to weight gain and obesity. PMID:25032903
Experiencing reproductive concerns as a female cancer survivor is associated with depression
Gorman, Jessica R.; Su, H. Irene; Roberts, Samantha C.; Dominick, Sally A.; Malcarne, Vanessa L.
2014-01-01
Background Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. Methods This cross-sectional study includes 200 female cancer survivors between the ages of 18 and 35 years who completed a web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality of life indicators. Results The mean age of participants was 28 years (SD = 4.4) and almost two-thirds were diagnosed within 5 years of completing the survey. Multivariable logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (OR = 1.30, 95% CI = 1.06–1.60 for each 5 unit increase in RCAC score). Of those with moderate to severe depression, 23% had high RCAC scores as compared to 6% of those with minimal to mild depression (p < 0.001). Conclusion A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention to improve the psychosocial health of young survivors. PMID:25377593
Communication self-assessment by public prosecutors in a north-eastern Brazilian state.
Sales, Neuza Josina; Castaneda, Daniel Francisco Neyra; Barreto, Íkaro Daniel de Carvalho; Paoliello, Marina; Campanha, Silvia Márcia Andrade
2016-01-01
To describe how public prosecutors self-assess their communication approaches and how listeners react to them; to analyze how this relates to gender, age, and work experience. Descriptive, transversal study. A questionnaire was developed and sent to 126 public prosecutors for completion. Thirty-three completed questionnaires were sent back. The independent variables were gender, age, and number of years of professional experience. The dependent variables were communication self-assessment throughout the years of work, communication parameters used, and listeners' reactions. A descriptive analyzis and Fisher's Exact Test was carried out. the sample contained both male and female participants with a median age of 43 years and an average of 20 years of professional experience. Most of the respondents claimed they had experienced demotivation, insecurity, tension, and difficulty when trying to convince listeners. More women than men reported they felt that their communication had worsened throughout their careers. All the women reported they experienced insecurity when speaking in public. One third of the public prosecutors stated they suffered from disorders on their voice. Those respondents aged over 43, experienced greater proportion on voice change than younger ones. In contrast to their younger colleagues, the majority of public prosecutors with more than 20 years of professional experience revealed that they felt insecure when speaking in public. the public prosecutors identified their strong and weak communication parameters. Gender, age, and work experience affect communicative performance.
Evaluations of alcohol consequences moderate social anxiety risk for problematic drinking.
Nitka, Danit; O'Connor, Roisin M
2017-02-01
The link between social anxiety (SA) and problematic drinking is complex; this seems predominantly true among young adults. Individuals high on SA are thought to be particularly sensitive to the negative effects of alcohol, which should deter them from drinking. Yet, some evidence suggests that those high on SA continue to drink despite experiencing negative alcohol-related consequences (NACs) (Morris, Stewart, & Ham, 2005). Although traditionally, researchers assume NACs are perceived as averse, emerging evidence suggests these are not categorically viewed as negative by undergraduates. The study goal was to test whether evaluations of NACs moderate the effect of SA on problematic drinking. It was hypothesized that high SA would predict elevated alcohol use and number of NACs experienced, but only for those who evaluate NACs as less negative. Undergraduate drinkers (N=130, 80 women) completed self-reports of social anxiety, NAC evaluations (ratings of how 'bad' experiencing each alcohol-related consequence would be), alcohol use, and NACs experienced. Regression analyses revealed that NAC evaluations moderated the effect of SA on number of NACs experienced, but not the effect of SA on weekly alcohol use. Simple slopes analyses showed that high SA was associated with elevated NACs experienced for those with weak negative NAC evaluations, controlling for alcohol use. These findings help explain the mixed SA-problematic drinking literature by identifying perceptions of NACs as an important moderator of SA risk for experiencing NACs. Moreover, clinical interventions aimed at reducing SA risk for undergraduate problematic drinking may benefit from targeting NAC evaluations. Copyright © 2016 Elsevier Ltd. All rights reserved.
Gallagher, Anthony G; Henn, Patrick J; Neary, Paul C; Senagore, Anthony J; Marcello, Peter W; Bunting, Brendan P; Seymour, Neal E; Satava, Richard M
2018-05-01
Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency. In study one, 100 experienced laparoscopic surgeons' performances on virtual reality and box-trainer simulators were assessed for two similar laparoscopic tasks. In study two, 15 experienced surgeons and 16 trainee colorectal surgeons performed one simulated hand-assisted laparoscopic colorectal procedure. Performance scores of experienced surgeons in both studies were standardized (i.e. Z-scores) using the mean and standard deviations (SDs). Performances >1.96 SDs from the mean were excluded in proficiency definitions. In study one, 1-5% of surgeons' performances were excluded having performed significantly below their colleagues. Excluded surgeons made significantly fewer correct incisions (mean = 7 (SD = 2) versus 19.42 (SD = 4.6), P < 0.0001) and a greater proportion of incorrect incisions (mean = 45.71 (SD = 10.48) versus 5.25 (SD = 6.6), P < 0.0001). In study two, one experienced colorectal surgeon performance was >4 SDs for time to complete the procedure and >6 SDs for path length. After their exclusions, experienced surgeons' performances were significantly better than trainees for path length: P = 0.031 and for time: P = 0.002. Objectively assessed atypical expert performances were few. Z-score standardization identified them and produced a more robust quantitative definition of proficiency. © 2018 Royal Australasian College of Surgeons.
Verwoerd, Johan; Wessel, Ineke; de Jong, Peter J
2009-06-01
This study explored whether a relatively poor ability to resist or inhibit interference from irrelevant information in working memory is associated with experiencing undesirable intrusive memories. Non-selected participants (N=91) completed a self-report measure of intrusive memories, and carried out experimental tasks intended to measure two different types of inhibition: resistance to proactive interference and response inhibition (i.e., the ability to prevent automatically triggered responses). The results showed a significant relationship between inhibition at the cognitive level (i.e., resistance to proactive interference) and the frequency of intrusive memories (especially in the group of female participants) whereas no such relationship with measures of response inhibition emerged. These findings are consistent with the idea that deficient inhibitory control reflects a vulnerability factor for experiencing intrusive memories. Implications for research investigating risk factors for the development of posttraumatic stress disorder (PTSD) are discussed.
Emotional abuse in intimate relationships: The role of gender and age
Karakurt, Günnur; Silver, Kristin E.
2012-01-01
The present study aimed to investigate the moderating roles of gender and age on emotional abuse within intimate relationships. This study included 250 participants with an average age of 27 years. Participants completed the Emotional Abuse Questionnaire (EAQ; Jacobson and Gottman, 1998), whose four subscales are isolation, degradation, sexual abuse, and property damage. Multigroup analysis with two groups, female (n = 141) and male (n = 109), was used to test the moderation effect. Younger men reported experiencing higher levels of emotional abuse, which declined with age. Older females reported experiencing less emotional abuse than older males. Overall, emotional abuse was more common in younger participants. Younger women experienced higher rates of isolation, and women’s overall experience of property damage was higher than that of men and increased with age. Results are interpreted through the Social Exchange and Conflict frameworks. PMID:24364124
Boissoneault, Jeff; Bunch, Jennifer R.; Robinson, Michael
2015-01-01
To investigate the association of ethnicity, sex, and parental pain modeling on the evaluation of experienced and imagined painful events, 173 healthy volunteers (96 women) completed the Prior Pain Experience Questionnaire, a 79-question assessment of the intensity of painful events, and a questionnaire regarding exposure to parental pain models. Consistent with existing literature, greater ratings of experienced pain were noted among Black vs. White participants. Parental pain modeling was associated with higher imagined pain ratings, but only when the parent matched the participant’s sex. This effect was greater among White and Asian participants than Black or Hispanic participants, implying ethno-cultural effects may moderate the influence of pain modeling on the evaluation of imagined pain events. The clinical implications of these findings, as well as the predictive ability of imagined pain ratings for determining future experiences of pain, should be investigated in future studies. PMID:26085306
Bajoghli, Hafez; Joshaghani, Narges; Mohammadi, Mohammad Reza; Holsboer-Trachsler, Edith; Brand, Serge
2011-09-01
Experiencing romantic love is important in individual development. Little is known about romantic love among adolescents in non-Western countries. The aim of the present study was therefore to explore romantic love among Iranian female adolescents. Eighty-six females (mean age: 17.97 years) took part in the study; 38 of them (44%) indicated they were experiencing romantic love at the time of survey, and 48 (56%) indicated they were not in love. Participants completed questionnaires related to affective states and physical activity, and a sleep log for seven consecutive nights. Compared to controls, participants in love had higher scores for hypomanic-like states, positive mood, physical activity, but not for better sleep quality or for depressive symptoms. Against expectations, hypomania scores increased with the duration of the romantic relationship, suggesting that culture-related issues might shape the way romantic love may be experienced.
Osborn, Chandra Y.; Mayberry, Lindsay S.; Wagner, Julie A.; Welch, Garry W.
2014-01-01
Studies examining the impact of stressors on diabetes self-care have been limited by focusing on a single stressor or have been largely qualitative. Therefore, we assessed the stressors experienced by a high-risk population with type 2 diabetes, and tested whether having more stressors was associated with less adherence to multiple self-care behaviors. Participants were recruited from a Federally Qualified Health Center and 192 completed a stressors checklist. Experiencing more stressors was associated with less adherence to diet recommendations and medications among participants who were trying to be adherent, but was not associated with adherence to other self-care behaviors. Because having more stressors was also associated with more depressive symptoms, we further adjusted for depressive symptoms; stressors remained associated with less adherence to medications, but not to diet recommendations. For adults engaged in adherence, experiencing numerous chronic stressors presents barriers to adherence that are distinct from associated depressive symptoms. PMID:24569697
A carer burden and stigma in schizophrenia and affective disorders: Experiences from Sri Lanka.
Fernando, Sunera M; Deane, Frank P; McLeod, Hamish J; Davis, Esther L
2017-04-01
Stigma compounds the burden experienced by family members of those with a mental illness. This study aimed to examine burden experienced by carers of people with schizophrenia or affective disorders and to explore the relationship between carer burden and stigma. A cross sectional descriptive study was conducted with patient-carer dyads involving 67 patients diagnosed with schizophrenia and 51 diagnosed with affective disorder. Carers completed the Zarit Burden Interview (short version) and stigma was measured using the Stigma Scale and the Internalised Stigma of Mental Illness Scale. Carer burden was significantly higher for schizophrenia than affective disorders. Female carers experienced significantly higher burden than male carers. Diagnosis, gender of carer and stigma predicted 22% of the variance in carer burden, with gender identified as a significant predictor. Reducing stigma related to disclosure of mental illness in carers has the potential to reduce carer burden. Copyright © 2017 Elsevier B.V. All rights reserved.
Dewey, Daniel; Schuldberg, David; Madathil, Renee
2014-08-01
This study investigated whether specific peritraumatic emotions differentially predict PTSD symptom clusters in individuals who have experienced stressful life events. Hypotheses were developed based on the SPAARS model of PTSD. It was predicted that the peritraumatic emotions of anger, disgust, guilt, and fear would significantly predict re-experiencing and avoidance symptoms, while only fear would predict hyperarousal. Undergraduate students (N = 144) participated in this study by completing a packet of self-report questionnaires. Multiple regression analyses were conducted with PCL-S symptom cluster scores as dependent variables and peritraumatic fear, guilt, anger, shame, and disgust as predictor variables. As hypothesized, peritraumatic anger, guilt, and fear all significantly predicted re-experiencing. However, only fear predicted avoidance, and anger significantly predicted hyperarousal. Results are discussed in relation to the theoretical role of emotions in the etiology of PTSD following the experience of a stressful life event.
Observer performance assessment of JPEG-compressed high-resolution chest images
NASA Astrophysics Data System (ADS)
Good, Walter F.; Maitz, Glenn S.; King, Jill L.; Gennari, Rose C.; Gur, David
1999-05-01
The JPEG compression algorithm was tested on a set of 529 chest radiographs that had been digitized at a spatial resolution of 100 micrometer and contrast sensitivity of 12 bits. Images were compressed using five fixed 'psychovisual' quantization tables which produced average compression ratios in the range 15:1 to 61:1, and were then printed onto film. Six experienced radiologists read all cases from the laser printed film, in each of the five compressed modes as well as in the non-compressed mode. For comparison purposes, observers also read the same cases with reduced pixel resolutions of 200 micrometer and 400 micrometer. The specific task involved detecting masses, pneumothoraces, interstitial disease, alveolar infiltrates and rib fractures. Over the range of compression ratios tested, for images digitized at 100 micrometer, we were unable to demonstrate any statistically significant decrease (p greater than 0.05) in observer performance as measured by ROC techniques. However, the observers' subjective assessments of image quality did decrease significantly as image resolution was reduced and suggested a decreasing, but nonsignificant, trend as the compression ratio was increased. The seeming discrepancy between our failure to detect a reduction in observer performance, and other published studies, is likely due to: (1) the higher resolution at which we digitized our images; (2) the higher signal-to-noise ratio of our digitized films versus typical CR images; and (3) our particular choice of an optimized quantization scheme.
Pessimism and Homework in CBT for Depression.
Sachsenweger, Mieke A; Fletcher, Richard B; Clarke, Dave
2015-12-01
To investigate the moderating effects of attributional style on the relationship between client-rated benefits of homework completion and depression throughout a course of cognitive behavior therapy (CBT). A total of 28 clients, aged 20 to 65 years, experiencing their first major depressive episode completed up to 20 sessions of CBT plus a follow-up session at 2 months. Clients, therapists, and independent observers completed the measures. Multilevel modeling was used for a within-person longitudinal analysis of data. Pessimism slightly moderated the relationship between quantity-quality of homework completion and depression severity over time. Decreases in depression severity were largely independent of level of homework completion. While CBT is effective in reducing depression, pessimistic attributional style can affect the perception that clients bring to the quantity and quality of homework completion. Clinicians could thus focus on dealing with pessimistic style for treatment and homework to moderate the severity of depression. © 2015 Wiley Periodicals, Inc.
Managing Large-Scale Online Graduate Programs
ERIC Educational Resources Information Center
Singleton, Jacques; Bowser, Audrey; Hux, Annette; Neal, Gwendolyn
2013-01-01
As with most states, Arkansas is experiencing substantial growth in the delivery of academic programs and courses by distance learning provided by institutions of higher education. At Arkansas State University faculty have adhered to the need of students and developed a completely online certification and master's program in Educational…
Augmented Self-Modeling as a Treatment for Children with Selective Mutism.
ERIC Educational Resources Information Center
Kehle, Thomas J.; Madaus, Melissa R.; Baratta, Victoria S.; Bray, Melissa A.
1998-01-01
Describes the treatment of three children experiencing selective mutism. The procedure utilized incorporated self-modeling, mystery motivators, self-reinforcement, stimulus fading, spacing, and antidepressant medication. All three children evidenced a complete cessation of selective mutism and maintained their treatment gains at follow-up.…
Intentional Teenage Pregnancy: Correlates of Children Who Want Children.
ERIC Educational Resources Information Center
Ruchman, Miriam Reitman; Jemmott, John B., III; Jemmott, Loretta Sweet
This study explored the differences between African American and Latina female adolescents who desire to become pregnant and those who do not. Five hundred and thirty-one sexually experienced, never pregnant adolescents completed surveys containing questions about demographics, sexual behavior and contraceptive use, sexual and contraceptive…
Men's Reactions to Participating in Interpersonal Violence Research
ERIC Educational Resources Information Center
Edwards, Katie M.; Gidycz, Christine A.; Desai, Angeli D.
2012-01-01
This study assessed college men's reactions immediately following and 2 months after completing self-report measures of interpersonal violence. Results showed that 4.3% of men experienced immediate negative emotional reactions. Greater immediate negative reactions were related to personal benefits to research participation, anticipation of future…
The Reading Connection: Literacy Development and Homeless Children.
ERIC Educational Resources Information Center
Hanning, Eileen
Educational and developmental researchers suggest that children who have experienced homelessness suffer both in self-esteem and in literacy development, although early research is not complete. The Reading Connection (TRC), a community-based nonprofit organization in northern Virginia, focuses on the social aspect of reading, rather than…
Instructions to Adopt an External Focus Enhance Muscular Endurance
ERIC Educational Resources Information Center
Marchant, David C.; Greig, Matt; Bullough, Jonathan; Hitchen, Daniel
2011-01-01
The influence of internal (movement focus) and external (outcome focus) attentional-focusing instructions on muscular endurance were investigated using three exercise protocols with experienced exercisers. Twenty-three participants completed a maximal repetition, assisted bench-press test on a Smith's machine. An external focus of attention…
DOT National Transportation Integrated Search
1973-12-01
The State-Trait Anxiety Inventory (STAI) was used to assess the anxiety of air traffic controllers who had experienced difficult and easy work shifts. Eighty volunteers completed the STAI before and after two or more eight-hour work shifts. Controlle...
Preservice Teachers' Technology Self-Efficacy
ERIC Educational Resources Information Center
Kent, Andrea M.; Giles, Rebecca M.
2017-01-01
Since efficacy of experienced teachers is difficult to change (Hoy, 2000), preservice teachers' technology self-efficacy is a creditable indicator of graduates' likelihood to use instructional technology throughout their careers. A study was conducted with elementary preservice teachers (n = 62) who completed a 5-item, Likert-type survey measuring…
Evaluation of image quality of MRI data for brain tumor surgery
NASA Astrophysics Data System (ADS)
Heckel, Frank; Arlt, Felix; Geisler, Benjamin; Zidowitz, Stephan; Neumuth, Thomas
2016-03-01
3D medical images are important components of modern medicine. Their usefulness for the physician depends on their quality, though. Only high-quality images allow accurate and reproducible diagnosis and appropriate support during treatment. We have analyzed 202 MRI images for brain tumor surgery in a retrospective study. Both an experienced neurosurgeon and an experienced neuroradiologist rated each available image with respect to its role in the clinical workflow, its suitability for this specific role, various image quality characteristics, and imaging artifacts. Our results show that MRI data acquired for brain tumor surgery does not always fulfill the required quality standards and that there is a significant disagreement between the surgeon and the radiologist, with the surgeon being more critical. Noise, resolution, as well as the coverage of anatomical structures were the most important criteria for the surgeon, while the radiologist was mainly disturbed by motion artifacts.
[Ethical problems experienced by nurses in primary health care: integrative literature review].
Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida
2015-03-01
The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.
Kassam, Zain; Lee, Christine H; Yuan, Yuhong; Hunt, Richard H
2013-04-01
The clinical and economic burden of Clostridium difficile infection (CDI) is significant. Recurrent CDI management has emerged as a major challenge with suboptimal response to standard therapy. Fecal microbiota transplantation (FMT) has been used as a treatment to reconstitute the normal microbial homeostasis and break the cycle of antibiotic agents that may further disrupt the microbiome. Given the lack of randomized-controlled trials (RCTs) and limitations in previous systematic reviews, we aimed to conduct a systematic review with robust methods to determine the efficacy and safety profile of FMT in CDI. An electronic search was conducted using MEDLINE (1946-March 2012), EMBASE (1974-March 2012) and Cochrane Central Register of Controlled Trials (2012). The search strategy was not limited by language. Abstract data were excluded and only completed studies that underwent the full, rigorous peer-review process were included. Studies that used FMT via any delivery modality for laboratory or endoscopically proven CDI with clinical resolution as primary outcome were included. A sample size of 10 or more patients was a further criterion. Elements of the Centre for Reviews and Dissemination checklist and the National Institute of Clinical Excellence quality assessment for case series checklist were employed to determine study quality. Eligibility assessment and data extraction were performed by two independent researchers. Both unweighted pooled resolution rates (UPR) and weighted pooled resolution rates (WPR) were calculated with corresponding 95% confidence intervals (CI) for overall studies, as well as predefined subgroups. Eleven studies with a total of 273 CDI patients treated with FMT were identified; no RCTs were found as none have been published. Two-hundred and forty-five out of 273 patients experienced clinical resolution (UPR 89.7%; WPR 89.1% (95% CI 84 to 93%)). There was no statistically significant heterogeneity between studies (Cochran Q test P=0.13, I(2)=33.7%). A priori subgroup analysis suggested that lower gastrointestinal FMT delivery (UPR 91.4%; WPR 91.2% (95% CI 86 to 95%)) led to a trend towards higher clinical resolution rates than the upper gastrointestinal route (UPR 82.3%; WPR 80.6% (95% CI 69-90%)) (proportion difference of WPR was 10.6% (95% CI -0.6 to 22%)). No difference in clinical outcomes was detected between anonymous vs. patient selected donors. There were no reported adverse events associated with FMT and follow-up was variable from weeks to years. FMT holds considerable promise as a therapy for recurrent CDI but well-designed, RCTs and long-term follow-up registries are still required. These are needed to identify the right patient, efficacy and safety profile of FMT before this approach can be widely advocated.
DOE Office of Scientific and Technical Information (OSTI.GOV)
McKinsey, Daniel Nicholas
The McKinsey group at Yale has been awarded a grant from DTRA for the building of a Liquid Xenon Gamma Ray Color Camera (LXe-GRCC), which combines state-of-the-art detection of LXe scintillation light and time projection chamber (TPC) charge readout. The DTRA application requires a movable detector and hence only a single phase (liquid) xenon detector can be considered in this case. We propose to extend the DTRA project to applications that allow a two phase (liquid/gas) xenon TPC. This entails additional (yet minimal) hardware and extension of the research effort funded by DTRA. The two phase detector will have bettermore » energy and angular resolution. Such detectors will be useful for PET medical imaging and detection of special nuclear material in stationary applications (e.g. port of entry). The expertise of the UConn group in gas phase TPCs will enhance the capabilities of the Yale group and the synergy between the two groups will be very beneficial for this research project as well as the education and research projects of the two universities. The LXe technology to be used in this project has matured rapidly over the past few years, developed for use in detectors for nuclear physics and astrophysics. This technology may now be applied in a straightforward way to the imaging of gamma rays. According to detailed Monte Carlo simulations recently performed at Yale University, energy resolution of 1% and angular resolution of 3 degrees may be obtained for 1.0 MeV gamma rays, using existing technology. With further research and development, energy resolution of 0.5% and angular resolution of 1.3 degrees will be possible at 1.0 MeV. Because liquid xenon is a high density, high Z material, it is highly efficient for scattering and capturing gamma rays. In addition, this technology scales elegantly to large detector areas, with several square meter apertures possible. The Yale research group is highly experienced in the development and use of noble liquid detectors for astrophysics, most recently in the XENON10 experiment. The existing facilities at Yale are fully adequate for the completion of this project. The facilities of the UConn group at the LNS at Avery Point include a (clean) lab for detector development and this group recently delivered an Optical Readout TPC (O-TPC) for research in Nuclear Astrophysics at the TUNL in Duke University. The machine shop at UConn will be used (free of charge) for producing the extra hardware needed for this project including grids and frames.« less
Histologic Inflammatory Response to Transvaginal Polypropylene Mesh: A Systematic Review.
Thomas, Dominique; Demetres, Michelle; Anger, Jennifer T; Chughtai, Bilal
2018-01-01
To evaluate the inflammatory response following transvaginal implantation of polypropylene (PP) mesh. A comprehensive literature search was performed in the following databases from inception in April 2017: Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library (Wiley). The studies retrieved were screened for eligibility against predefined inclusion and exclusion criteria. Twenty-three articles were included in this review. Following the implantation of PP mesh, there are immediate and local inflammatory responses. PP mesh elicits an inflammatory response that decreases over time; however, no studies documented a complete resolution. Further studies are needed to determine if there is a complete resolution of inflammation or if it persists. Copyright © 2017 Elsevier Inc. All rights reserved.
Bone marrow hypoplasia associated with fenbendazole administration in a dog.
Gary, Anthony T; Kerl, Marie E; Wiedmeyer, Charles E; Turnquist, Susan E; Cohn, Leah A
2004-01-01
A 1.5-year-old Doberman pinscher was presented with sudden-onset of fever and malaise. Twelve days prior to presentation, fenbendazole therapy was initiated for a suspected lungworm infection. Results of a complete blood count on presentation showed pancytopenia, while histopathological evaluation of a bone marrow core sample revealed bone marrow hypoplasia of undetermined etiology. Bactericidal antibiotics and fluid therapy, as well as discontinuation of fenbendazole administration, led to a complete resolution of clinical and hematological abnormalities within 15 days. An idiosyncratic reaction to fenbendazole was suspected based on the absence of infectious, neoplastic, autoimmune, and toxic etiologies, as well as resolution of clinical signs and pancytopenia upon drug withdrawal.
Emotional strain in caregiving among African American grandmothers raising their grandchildren.
Conway, Francine; Jones, Samuel; Speakes-Lewis, Amandia
2011-01-01
African Americans are disproportionately represented in the number of grandparents raising their grandchildren. Using Role Strain Theory and Socioemotional Selectivity Theory, this study examines how older grandmothers fare relative to their younger counterparts. Eighty-five custodial African American grandmothers, aged 33-88 years old, completed demographic questionnaires and scales of Role Demand, Emotional Strain, Caregiving Strain Index, and Level of Care. Results showed older grandmothers experienced less emotional and caregiving strain relative to younger grandmothers. Furthermore, married grandmothers experienced less caregiving strain, and their age did not insulate them from the strain associated with the level of care. Implications are discussed.
Sekiguchi, Kenji; Yasui, Naoko; Kowa, Hisatomo; Kanda, Fumio; Toda, Tatsushi
2016-01-01
We herein present two cases of acute disseminated encephalomyelitis (ADEM) following vaccination against human papilloma virus (HPV). Case 1 experienced diplopia and developed an unstable gait 14 days after a second vaccination of Cervarix. Brain magnetic resonance imaging (MRI) showed an isolated small, demyelinating lesion in the pontine tegmentum. Case 2 experienced a fever and limb dysesthesia 16 days after a second vaccination of Gardasil. Brain MRI revealed hyperintense lesion in the pons with slight edema on a T2-weighted image. Both cases resolved completely. It is important to accumulate further data on confirmed cases of ADEM temporally associated with HPV vaccination. PMID:27803416
HRI observations of the Pleiades
NASA Technical Reports Server (NTRS)
Harnden, F. R., Jr.; Caillault, J.-P.; Damiani, F.; Kashyap, V.; Micela, G.; Prosser, C.; Rosner, R.; Sciortino, S.; Stauffer, J.
1996-01-01
The preliminary analysis of the data from the first four Rosat high resolution imager (HRI) pointings provided many new faint Pleiades detections. The completion of the high resolution survey of the most source-confused regions of this open cluster will lead to the construction of proper X-ray luminosity functions and will yield a definitive assessment of the coronal emission of the Pleiades members.
Kent, T; Davidson, A; Newman, D; Buck, G; D'Cruz, D
2017-09-01
Objective The objective of this study was to assess the impact of systemic lupus erythematosus (SLE) on patients and carers. Methods Adults with SLE and carers of SLE patients completed a UK-specific online survey covering many aspects of the disease. Surveys were developed in collaboration with an NHS lupus unit and a lupus patient organization. Results A total of 121 patients and 31 carers completed the surveys. Of the 70% of patients initially misdiagnosed with another condition, 59% received treatment for the misdiagnosis. Fatigue was the most debilitating symptom, experienced daily by 79% of patients. The proportion of patients not reporting flares to healthcare providers varied with flare severity: mild flares (43%), moderate flares (15%) and severe flares (5%). Most patients (89%) reported reduced ability to socialize, and 76% had changed employment; of these, 52% stopped working completely. Over one-half (52%) of carers in paid employment missed time from work, and 55% of carers reported a worsened financial status. Most carers (87%) experienced interference with social activities. Conclusion SLE is commonly misdiagnosed and has a considerable impact on the physical, social and financial status of patients and carers. Increased awareness of the disease among healthcare providers and employers of patients and their carers is needed.
High resolution observations: The state of the art and beyond
NASA Technical Reports Server (NTRS)
Title, A.; Tarbell, T.; Shine, R.; Topka, K.; Frank, Z.
1992-01-01
The meaning of high resolution and its scientific importance with regard to solar observations is discussed. The state of the art is reviewed, looking into Solar Optical Universal Polarimeter (SOUP) observations, image selection techniques, and adaptive optics. It is concluded that until there are observations in space, complete understanding of processes in the solar photosphere, chromosphere, transition region, and corona will be impossible. The importance of high resolution is considered with regard to solar surface and convection, solar photosphere inside and outside magnetic fields, and sunspot geometry.
Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization
Bryant, Mary K; Dorn, David P; Zarzour, Jessica; Smith, J Kevin; Redden, David T; Saddekni, Souheil; Aal, Ahmed Kamel Abdel; Gray, Stephen H; Eckhoff, Devin E; DuBay, Derek A
2014-01-01
Background Radiographical features associated with a favourable response to trans-arterial chemoembolization (TACE) are poorly defined for patients with hepatocellular carcinoma (HCC). Methods From 2008 to 2012, all first TACE interventions for HCC performed at the University of Alabama at Birmingham (UAB) were retrospectively reviewed. Only patients with a pre-TACE and a post-TACE computed tomography (CT) scan were included in the analyses (n = 115). HCC tumour response to TACE was quantified via the the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Univariate and multivariable analyses were constructed. Results The index HCC tumours experienced a > 90% or complete tumour necrosis in 59/115 (51%) of patients after the first TACE intervention. On univariate analysis, smaller tumour size, peripheral tumour location and arterial enhancement were associated with a > 90% or complete tumour necrosis, whereas, only smaller tumour size [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.48, 0.81] and peripheral location (OR 6.91; 95% CI 1.75, 27.29) were significant on multivariable analysis. There was a trend towards improved survival in the patients that experienced a > 90% or complete tumour necrosis (P = 0.08). Conclusions Peripherally located smaller HCC tumours are most likely to experience a > 90% or complete tumour necrosis after TACE. Surprisingly, arterial-phase enhancement and portal venous-phase washout were not significantly predictive of TACE-induced tumour necrosis. The TACE response was not statistically associated with improved survival. PMID:23980917
Gerson, C D; Gerson, M-J
2014-02-01
Patient reported outcome (PRO) is an important healthcare concept that describes patient's participation in their care by self-evaluation, usually in the form of questionnaires. This report describes an unique computerized technique, electronic PRO (ePRO), for following the progress of patients with irritable bowel syndrome (IBS). Patients first completed a series of questionnaires, including questions about their illness history, symptom severity, and, in this application, psychological and relationship issues. The symptom severity and psychological questionnaires were then completed at intervals by the patients on their own computers. The ePRO was constructed to allow scores to be automatically summed and placed on a time-line graph for review at the time of the next office visit. Of the 32 patients who completed the initial set of questionnaires, 20 maintained participation in the program for a 6-month period. Of those 20 patients, median number of submissions was 7.0; median interval between questionnaire submissions was 3.0 weeks, whereas median interval between office visits was 5.9 weeks. On average, questionnaire completion took less than 5 min and was positively experienced by the patients. The ePRO program proved to be technically feasible, clinically useful, and positively experienced by the patients. It provides a focus on a collaborative conversation between physician and patient. It has significant potential as a technique for evaluating outcome in response to various therapies. © 2013 John Wiley & Sons Ltd.
Chakraborty, Nalanda; Logan, Kenneth J
To examine the effects of measurement method and transcript availability on the accuracy, reliability, and efficiency of inexperienced raters' stuttering frequency measurements. 44 adults, all inexperienced at evaluating stuttered speech, underwent 20 min of preliminary training in stuttering measurement and then analyzed a series of sentences, with and without access to transcripts of sentence stimuli, using either a syllable-based analysis (SBA) or an utterance-based analysis (UBA). Participants' analyses were compared between groups and to a composite analysis from two experienced evaluators. Stuttering frequency scores from the SBA and UBA groups differed significantly from the experienced evaluators' scores; however, UBA scores were significantly closer to the experienced evaluators' scores and were completed significantly faster than the SBA scores. Transcript availability facilitated scoring accuracy and efficiency in both groups. The internal reliability of stuttering frequency scores was acceptable for the SBA and UBA groups; however, the SBA group demonstrated only modest point-by-point agreement with ratings from the experienced evaluators. Given its accuracy and efficiency advantages over syllable-based analysis, utterance-based fluency analysis appears to be an appropriate context for introducing stuttering frequency measurement to raters who have limited experience in stuttering measurement. To address accuracy gaps between experienced and inexperienced raters, however, use of either analysis must be supplemented with training activities that expose inexperienced raters to the decision-making processes used by experienced raters when identifying stuttered syllables. Copyright © 2018 Elsevier Inc. All rights reserved.
From an Intuitive Practitioner to a Professional Novice Leader
ERIC Educational Resources Information Center
Mevorach, Miriam; Miron, Mordechai
2015-01-01
This study examined the professional and personal transition undergone by eight experienced early childhood (EC) teachers after completing their graduate studies. The data were collected through interviews and online communication. Three main categories arose in the qualitative content analysis of the text: (1) personal process of change; (2)…
ERIC Educational Resources Information Center
Hallett, Ronald E.; Crutchfield, Rashida
2017-01-01
This monograph explores how homelessness intersects most social issues that marginalize individuals and negatively influence postsecondary completion, including poverty, foster care, and LGBTQ+ (lesbian, gay, bisexual, trans*, queer/questioning, and others) discrimination. As becomes evident, students experiencing homelessness should be considered…
English in Action: School Based Teacher Development in Bangladesh
ERIC Educational Resources Information Center
Power, Tom; Shaheen, Robina; Solly, Mike; Woodward, Clare; Burton, Sonia
2012-01-01
In the Least Economically Developed Countries (LEDCs), School Based Teacher Development (SBTD) is sometimes advocated as a potential mechanism for improving the classroom practices experienced by millions of children in a complete school system, as quickly as possible. Robust evidence is required for approaches to be implemented with some…
The Emotional Components of Jealousy: A Multivariate Investigation.
ERIC Educational Resources Information Center
Ray, Lisa
To investigate the emotional parameters of jealousy and to examine the differences between male and female labeling of jealousy, 288 college undergraduates completed the Emotional Parameters of Jealousy Questionnaire. The questionnaire consists of 59 statements that refer to emotions experienced by a person in a situation in which he/she feels…
NASA Technical Reports Server (NTRS)
Whitehead, J.
1981-01-01
A LOFT program was developed as part of the DC-9 training program which serves as a prototype for much of Delta's other aircraft training programs. The LOFT used differs little from the ideology presented in the Advisory Circular. Difficulty and experienced concerns regarding the effectiveness of LOFT as a complete training vehicle are explored.
Drinking Motivations and Experiences of Unwanted Sexual Advances among Undergraduate Students
ERIC Educational Resources Information Center
Novik, Melinda G.; Howard, Donna E.; Boekeloo, Bradley O.
2011-01-01
This study examined the relationship between drinking motivations and college students' experiences with unwanted sexual advances. Undergraduates, from a public university in the mid-Atlantic region, who reported recent (30 day) alcohol use (n = 289) completed an online survey midway through the spring 2007 academic semester. Experiencing an…
Cyberbullying Behaviors among Female College Students: Witnessing, Perpetration, and Victimization
ERIC Educational Resources Information Center
Selkie, Ellen M.; Kota, Rajitha; Moreno, Megan
2016-01-01
Problem: Cyberbullying is common among adolescents, and emerging studies also describe this phenomenon in college students. Less is known about specific cyberbullying behaviors and roles in cyberbullying incidents experienced by college females. Methods: 249 female students from 4 colleges completed online surveys assessing involvement in 11…
Preparing Reflective Community College Leaders in a Graduate Leadership Course
ERIC Educational Resources Information Center
Sullivan, Leila González; Palmer, Shelby
2014-01-01
This study measured the knowledge construction and reflection that occurred in a doctoral course designed to introduce major leadership theories and encourage reflection as a community college leadership practice. At each session, students completed forms reporting new learning and insights they experienced, as well as responding to reflection…
Counselor Training Level and the Formation of the Psychotherapeutic Working Alliance.
ERIC Educational Resources Information Center
Mallinckrodt, Brent; Nelson, Mary Lee
1991-01-01
Investigated relation of training level to working alliance in 50 counselor-client dyads. Counselors were novices, advanced trainees, or experienced counselors. After three sessions, counselors and clients completed Working Alliance Inventory. Results revealed significant main effects for training level of counselor. Found no difference for bond…
Socio-Psychological Predictors of Acculturative Stress among Latino Adults.
ERIC Educational Resources Information Center
Miranda, Alexis O.; Matheny, Kenneth B.
2000-01-01
A random sample (N=197) of two social service agencies completed a questionnaire to assess family cohesion and adaptability, acculturation, acculturative stress, and coping-resources effectiveness among Latino adults. The results suggest that acculturative stress experienced by Latinos relates to the efficacy of stress-coping resources, degree of…
ERIC Educational Resources Information Center
Murnen, Sarah K.; Smolak, Linda
2000-01-01
Investigated elementary students' interpretations of sexual harassment and how they related to self-esteem and body esteem. After hearing scenarios exemplifying peer harassment, students expressed their thoughts and completed gender role, self-esteem, and body esteem scales. Most children had experienced peer harassment. Total harassment…
Parental Death in Childhood and Loneliness in Young Adults.
ERIC Educational Resources Information Center
Murphy, Patricia Ann
1987-01-01
Examined relationship between self-esteem and reported mourning behavior as it pertains to loneliness in young adults who, as children, had experienced parental death. Subjects (N=184) aged 18 to 25 completed four questionnaires. Revealed that self-esteem was the single best predictor of loneliness; reported mourning behaviors significantly added…
Campus Sexual Violence: The Impact of Disclosure on Mental Health
ERIC Educational Resources Information Center
Double, Katelin B.
2018-01-01
A mixed methodological approach was used to examine the impact of disclosure characteristics on mental health among individuals who have experienced campus sexual violence occurring at Christian and non-religiously affiliated universities. After completing an online survey, a sample of 97 participants qualified for the study. No disclosure and…
Audiovisual Processing in Children with and without Autism Spectrum Disorders
ERIC Educational Resources Information Center
Mongillo, Elizabeth A.; Irwin, Julia R.; Whalen, D. H.; Klaiman, Cheryl; Carter, Alice S.; Schultz, Robert T.
2008-01-01
Fifteen children with autism spectrum disorders (ASD) and twenty-one children without ASD completed six perceptual tasks designed to characterize the nature of the audiovisual processing difficulties experienced by children with ASD. Children with ASD scored significantly lower than children without ASD on audiovisual tasks involving human faces…
Episodic Future Thinking in Children with Autism Spectrum Disorder
ERIC Educational Resources Information Center
Terrett, Gill; Rendell, Peter G.; Raponi-Saunders, Sandra; Henry, Julie D.; Bailey, Phoebe E.; Altgassen, Mareike
2013-01-01
The capacity to imagine oneself experiencing future events has important implications for effective daily living but investigation of this ability in autism spectrum disorder (ASD) is limited. This study investigated future thinking in 30 children with high functioning ASD (IQ > 85) and 30 typically developing children. They completed the…
ERIC Educational Resources Information Center
Fink, Stephen; Markholt, Anneke
2017-01-01
In her 24 years as an educator, Principal Lori Duckstein has experienced many kinds of professional development aimed at improving leadership and instruction. And, like school leaders and teachers everywhere, she has completed many one- and two-day training workshops only to return to her school and reflect on her learning in isolation. Recently,…
Helping the Transition: Mentorship to Support International Students in Canada
ERIC Educational Resources Information Center
Thomson, Clint; Esses, Victoria M.
2016-01-01
We developed a program that paired newcomer international students with Canadian student mentors. These pairs met weekly throughout a semester and international student participants completed measures at both the beginning and end of the program. We found that program participants experienced positive changes in sociocultural and psychological…
Primary Treatment and Sludge Digestion Workshop.
ERIC Educational Resources Information Center
Ontario Ministry of the Environment, Toronto.
This manual was developed for use at workshops designed to upgrade the knowledge of experienced wastewater treatment plant operators. Each of the sixteen lessons has clearly stated behavioral objectives to tell the trainee what he should know or do after completing that topic. Areas covered in this manual include: sewage characteristics;…
29 CFR 1904.6 - Determination of new cases.
Code of Federal Regulations, 2010 CFR
2010-07-01
... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... same type that affects the same part of the body, or (2) The employee previously experienced a recorded injury or illness of the same type that affected the same part of the body but had recovered completely...
Activated Sludge Process Workshop Manual.
ERIC Educational Resources Information Center
Ontario Ministry of the Environment, Toronto.
This manual was developed for use at workshops designed to upgrade the knowledge of experienced wastewater treatment plant operators. Each of the lessons in this document has clearly stated behavioral objectives to tell the trainee what he should know or do after completing that topic. Areas covered in this manual include: types and factors…
Teaching Leadership: Do Students Remember and Utilize the Concepts We Teach?
ERIC Educational Resources Information Center
Williams, Jennifer R.; Townsend, Christine D.; Linder, James R.
2015-01-01
The purpose of this study was to determine how leadership competencies are remembered and utilized following instruction in a structured collegiate leadership course. The population for this study consisted of experienced collegiate leaders who completed an introductory leadership theory course. The purposive sample included 74 students who…
Attitudes and Experiences of Death Workshop Attendees
ERIC Educational Resources Information Center
Kubler-Ross, Elisabeth; Worden, J. William
1977-01-01
Attendees at workshops and lectures were asked to complete a questionnaire which assessed the following: 1) First death experience, 2) Present conceptualization of death, 3) Anticipated reactions to a personal terminal illness, 4) Resources in managing one's own death, and 5) Difficulties experienced in working with dying persons. (Author)
The Link Between Daycare Experience and Attitudes Toward Daycare and Maternal Employment
ERIC Educational Resources Information Center
Shpancer, Noam; Bennett-Murphy, Laura
2006-01-01
Participants (n = 308; mean age = 20 years) completed questionnaires about their history, attitudes, and expectations regarding childcare, maternal employment and future parenting. Participants who experienced non-parental care as children had more favorable attitudes toward such care and toward maternal employment than did home-reared…
Experiences of Differential Treatment among College Students of Color.
ERIC Educational Resources Information Center
Suarez-Balcazar, Yolanda; Orellana-Damacela, Lucia; Portillo, Nelson; Rowan, Jean M.; Andrews-Guillen, Chelsea
2003-01-01
Studied perceptions of differential treatment of students of color through surveys completed by Caucasian (n=500) and non-Caucasian (n=495) college students. Findings show African Americans experienced more incidents of differential treatment in peer-faculty situations and females rated higher both the degree of offensiveness and degree of…
Surface Water Treatment Workshop Manual.
ERIC Educational Resources Information Center
Ontario Ministry of the Environment, Toronto.
This manual was developed for use at workshops designed to increase the knowledge of experienced water treatment plant operators. Each of the fourteen lessons in this document has clearly stated behavioral objectives to tell the trainee what he should know or do after completing that topic. Areas covered in this manual include: basic water…
ERIC Educational Resources Information Center
Nader, Kathleen, Ed.
2012-01-01
Together, "School Rampage Shootings and Other Youth Disturbances" and its accompanying CD provide a complete toolkit for using early preventative interventions with elementary-school age children. In ten thoughtful, clearly written chapters, both new and experienced practitioners will find a wealth of research- and evidence-based…
Referent Predictability Is Affected by Syntactic Structure: Evidence from Chinese
ERIC Educational Resources Information Center
Cheng, Wei; Almor, Amit
2017-01-01
This paper examines the effect of syntactic structures on referent predictability. Focusing on stimulus-experiencer (SE) verbs, we conducted two sentence-completion experiments in Chinese by contrasting SE verbs in three structures (active canonical, active "ba," and passive). The results showed that although verb semantics and discourse…
Frequency of Use and Cost of Selected Anesthetic Induction and Neuromuscular Blocking Agents
1997-07-15
persons with a known egg allergy caused by the use of egg lecithin to prepare the emulsion (Geniton, 1992). Pain may be experienced upon injection...Barash et al. , 1992; Katzung, 1995) and rapid spontaneous recovery (Bevan, 1994). It is completely and rapidly hydrolyzed by plasma cholinesterase
Frequency of Use and Cost of Selected Anesthetic Induction and Neuromuscular Blocking Agents
1997-10-02
with a known egg allergy caused by the use of egg lecithin to prepare the emulsion (Geniton, 1992). Pain may be experienced upon injection of propofol...spontaneous recovery (Bevan, 1994). It is completely and rapidly hydrolyzed by plasma cholinesterase (pseudocholinesterase) which terminates its action
Driving Anger and Driving Behavior in Adults with ADHD
ERIC Educational Resources Information Center
Richards, Tracy L.; Deffenbacher, Jerry L.; Rosen, Lee A.; Barkley, Russell A.; Rodricks, Trisha
2006-01-01
Objective: This study assesses whether anger in the context of driving is associated with the negative driving outcomes experienced by individuals with ADHD. Method: ADHD adults (n = 56) complete measures of driving anger, driving anger expression, angry thoughts behind the wheel, and aggressive, risky, and crash-related behavior. Results are…
Gender Differences in Cognitive and Affective Responses to Sexual Coercion
ERIC Educational Resources Information Center
Byers, E. Sandra; Glenn, Shannon A.
2012-01-01
This study examined gender differences in responses to sexual coercive experiences in mixed-sex (male-female) relationships. Participants were 112 women and 28 men who had experienced sexual coercion and completed measures of cognitive (attributions to self, attributions to the coercer, internal attributions) and affective (guilt, shame)…
Examining Children's Healthcare Experiences through Drawings
ERIC Educational Resources Information Center
Burns-Nader, Sherwood
2017-01-01
This study examines children's anxieties about healthcare experiences using drawings. Fifty children, either experiencing a doctor's appointment or hospitalization, completed a drawing of a person in the hospital. Using the Child Drawing: Hospital (CD:H), drawings were scored on individual items which were summed for a total score of projected…
Secondary Conditions in People with Developmental Disability
ERIC Educational Resources Information Center
Koritsas, Stella; Iacono, Teresa
2011-01-01
The authors investigated secondary conditions in people with developmental disabilities in terms of (a) the average number of conditions experienced and overall health and independence, (b) their degree and nature, and (c) gender differences. Information was obtained by a questionnaire completed by the caregivers for 659 people with developmental…
B-52 and KC-135 Mission Qualification and Continuation Training: A review and Analysis
1991-08-01
physical resources for completing the training requirements. Training is developed, scheduled, verified, and tracked primarily by the unit DOT, in...experienced EWs to develop their programs. To date, standard academic materials to support them, such as coursebooks , have not been produced. Due to
Quantum Observables and Effect Algebras
NASA Astrophysics Data System (ADS)
Dvurečenskij, Anatolij
2018-03-01
We study observables on monotone σ-complete effect algebras. We find conditions when a spectral resolution implies existence of the corresponding observable. We characterize sharp observables of a monotone σ-complete homogeneous effect algebra using its orthoalgebraic skeleton. In addition, we study compatibility in orthoalgebras and we show that every orthoalgebra satisfying RIP is an orthomodular poset.
Solid polymer membrane program
NASA Technical Reports Server (NTRS)
1971-01-01
The results are presented for a solid polymer electrolyte fuel cell development program. Failure mechanism was identified and resolution of the mechanism experienced in small stack testing was demonstrated. The effect included laboratory analysis and evaluation of a matrix of configurations and operational variables for effects on the degree of hydrogen fluoride released from the cell and on the degree of blistering/delamination occurring in the reactant inlet areas of the cell and to correlate these conditions with cell life capabilities. The laboratory evaluation tests were run at conditions intended to accelerate the degradation of the solid polymer electrolyte in order to obtain relative evaluations as quick as possible. Evaluation of the resolutions for the identified failure mechanism in space shuttle configuration cell assemblies was achieved with the fabrication and life testing of two small stack buildups of four cell assemblies and eight cells each.
Task analysis exemplified: the process of resolving unfinished business.
Greenberg, L S; Foerster, F S
1996-06-01
The steps of a task-analytic research program designed to identify the in-session performances involved in resolving lingering bad feelings toward a significant other are described. A rational-empirical methodology of repeatedly cycling between rational conjecture and empirical observations is demonstrated as a method of developing an intervention manual and the components of client processes of resolution. A refined model of the change process developed by these procedures is validated by comparing 11 successful and 11 unsuccessful performances. Four performance components-intense expression of feeling, expression of need, shift in representation of other, and self-validation or understanding of the other-were found to discriminate between resolution and nonresolution performances. These components were measured on 4 process measures: the Structural Analysis of Social Behavior, the Experiencing Scale, the Client's Emotional Arousal Scale, and a need scale.
Sonographic Evaluation of the Anterolateral Ligament of the Knee: A Cadaveric Study.
Zappia, Marcello; Oliva, Francesco; Chianca, Vito; Di Pietto, Francesco; Maffulli, Nicola
2018-05-31
Rotational stability of the knee involves not only the cruciate ligaments but also another structure named anterolateral ligament (ALL), the function of which is still controversial. This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection. The ALL was identified in each cadaver limb by the musculoskeletal radiologist. US is a useful imaging modality to identify and evaluate the ALL. The ability of US to fully evaluate injuries involving the ALL still needs to be demonstrated in a clinical setting. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
NASA Astrophysics Data System (ADS)
Fuhrer, Oliver; Chadha, Tarun; Hoefler, Torsten; Kwasniewski, Grzegorz; Lapillonne, Xavier; Leutwyler, David; Lüthi, Daniel; Osuna, Carlos; Schär, Christoph; Schulthess, Thomas C.; Vogt, Hannes
2018-05-01
The best hope for reducing long-standing global climate model biases is by increasing resolution to the kilometer scale. Here we present results from an ultrahigh-resolution non-hydrostatic climate model for a near-global setup running on the full Piz Daint supercomputer on 4888 GPUs (graphics processing units). The dynamical core of the model has been completely rewritten using a domain-specific language (DSL) for performance portability across different hardware architectures. Physical parameterizations and diagnostics have been ported using compiler directives. To our knowledge this represents the first complete atmospheric model being run entirely on accelerators on this scale. At a grid spacing of 930 m (1.9 km), we achieve a simulation throughput of 0.043 (0.23) simulated years per day and an energy consumption of 596 MWh per simulated year. Furthermore, we propose a new memory usage efficiency (MUE) metric that considers how efficiently the memory bandwidth - the dominant bottleneck of climate codes - is being used.
A high resolution gravity model for Venus - GVM-1
NASA Technical Reports Server (NTRS)
Nerem, R. S.; Bills, B. G.; Mcnamee, J. B.
1993-01-01
A spherical harmonic model of the gravitational field of Venus complete to degree and order 50 has been developed using the S-band Doppler tracking data of the Pioneer Venus Orbiter (PVO) collected between 1979 and 1982. The short wavelengths of this model could only be resolved near the PVO periapse location (about 14 deg N latitude), therefore a priori constraints were applied to the model to bias poorly observed coefficients towards zero. The resulting model has a half-wavelength resolution of 400 km near the PVO periapse location, but the resolution degrades to greater than 1000 km near the poles. This gravity model correlates well with a degree 50 spherical harmonic expansion of the Venus topography derived from a combination of Magellan and PVO data. New tracking data from Magellan's gravity mission should provide some improvement to this model, although a complete model of the Venusian gravity field will depend on tracking of Magellan after the circularization of its orbit using aerobraking.
DeVience, Stephen J; Mayer, Dirk
2017-03-01
To improve the temporal and spatial resolution of dynamic 13 C spiral chemical shift imaging via incoherent sampling and low-rank matrix completion (LRMC). Spiral CSI data were both simulated and acquired in rats, and undersampling was implemented retrospectively and prospectively by pseudorandomly omitting a fraction of the spiral interleaves. Undersampled data were reconstructed with both LRMC and a conventional inverse nonuniform fast Fourier transform (iNUFFT) and compared with fully sampled data. Two-fold undersampling with LRMC reconstruction enabled a two-fold improvement in temporal or spatial resolution without significant artifacts or spatiotemporal distortion. Conversely, undersampling with iNUFFT reconstruction created strong artifacts that obscured the image. LRMC performed better at time points with strong metabolite signal. Incoherent undersampling and LRMC provides a way to increase the spatiotemporal resolution of spiral CSI without degrading data integrity. Magn Reson Med 77:951-960, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.
Iglesias Fernández, C; Chimenti Camacho, P; Vázquez López, P; Guerrero Soler, M; Blanco Bravo, D
2006-10-01
Complete aortic thrombosis is rare in neonates. Because it carries high morbidity and mortality, this entity requires aggressive and early treatment. This report describes an 8-day-old healthy and exclusively breast-fed infant, without specific coagulopathy, who developed complete aortic and cerebral venous thrombosis, which was attributed to inadequate breast-feeding and severe hypernatremic dehydration. Early systemic anticoagulation and thrombolytic therapy allowed complete resolution of the problem.
NASA Astrophysics Data System (ADS)
Swenson, J. J.; Schwantes, A. M.; Johnson, D. M.; Domec, J. C.; Wigneron, J. P.
2017-12-01
Climate change is bringing more frequent and intense droughts that are causing broad scale tree mortality events. Detecting regional drought stress is now more frequently monitored with passive microwave satellite sensing of soil moisture (SM) and vegetation water status (through the vegetation optical depth (VOD) index), that can be validated with in-situ measurements of soil moisture or corroborated with satellite multispectral indices of greenness. The detection of canopy death however marks the passing of a definitive physiological threshold. We compare soil moisture from the L-band SMOS-IC passive microwave product (2010-20176) to an accurate and detailed (30-m spatial resolution) map of canopy loss across the US state of Texas during the record breaking 2011 drought. The SMOS-IC product (25 km) is a new and simpler product of soil moisture and VOD that has been shown to be more accurate than past SMOS products and it is independent of ancillary data. Canopy loss was mapped from Landsat imagery trained with 186, 41 km2 subplots of classified National Agriculture Inventory Program color infrared aerial imagery recorded before and after the drought. Bringing these two datasets of disparate spatial resolution together and averaging them across the state, we find that areas with at least 25% tree cover that experienced the most canopy loss (highest quartile) had lower soil moisture compared to areas with less canopy loss in 2011. These areas with the most loss, experienced up to 9 weeks of the growing season at < 0.05 SM (m3/m3), while the rest of Texas forests, experienced just 1 week at that SM. The following years, 2012 - 2016, dropped below 0.05 SM very rarely (two weeks each in 2012 and 2015, and never for 2013, 2014, 2016). Forests during the drought of 2011 experienced the absolute lowest SM (0.031) and had the earliest onset of low SM across the 6 years analyzed. Analyzing areas of drought induced canopy loss with SM preceding and during drought across a large area provides the opportunity to better understand plant behavior under stress as well as the effects of topography, soil, and climate. Having more information on plant hydraulic limits would lend itself to modeling and prediction of die offs based on satellite tracked SM.
Numerical Simulation and Scaling Analysis of Cell Printing
NASA Astrophysics Data System (ADS)
Qiao, Rui; He, Ping
2011-11-01
Cell printing, i.e., printing three dimensional (3D) structures of cells held in a tissue matrix, is gaining significant attention in the biomedical community. The key idea is to use inkjet printer or similar devices to print cells into 3D patterns with a resolution comparable to the size of mammalian cells. Achieving such a resolution in vitro can lead to breakthroughs in areas such as organ transplantation. Although the feasibility of cell printing has been demonstrated recently, the printing resolution and cell viability remain to be improved. Here we investigate a unit operation in cell printing, namely, the impact of a cell-laden droplet into a pool of highly viscous liquids. The droplet and cell dynamics are quantified using both direct numerical simulation and scaling analysis. These studies indicate that although cell experienced significant stress during droplet impact, the duration of such stress is very short, which helps explain why many cells can survive the cell printing process. These studies also revealed that cell membrane can be temporarily ruptured during cell printing, which is supported by indirect experimental evidence.
Kennedy, W Joshua; Slinker, Keith A; Volk, Brent L; Koerner, Hilmar; Godar, Trenton J; Ehlert, Gregory J; Baur, Jeffery W
2015-12-23
A technique is reported for measuring and mapping the maximum internal temperature of a structural epoxy resin with high spatial resolution via the optically detected shape transformation of embedded gold nanorods (AuNRs). Spatially resolved absorption spectra of the nanocomposites are used to determine the frequencies of surface plasmon resonances. From these frequencies the AuNR aspect ratio is calculated using a new analytical approximation for the Mie-Gans scattering theory, which takes into account coincident changes in the local dielectric. Despite changes in the chemical environment, the calculated aspect ratio of the embedded nanorods is found to decrease over time to a steady-state value that depends linearly on the temperature over the range of 100-200 °C. Thus, the optical absorption can be used to determine the maximum temperature experienced at a particular location when exposure times exceed the temperature-dependent relaxation time. The usefulness of this approach is demonstrated by mapping the temperature of an internally heated structural epoxy resin with 10 μm lateral spatial resolution.
Stephenson, John; Farndon, Lisa; Concannon, Michael
2016-06-01
This study assesses the effect of salicylic acid plasters on the time to resolution of 324 corns experienced by 201 participants taking part in a randomized controlled trial. While the rate of corn resolution was substantively higher in the treatment group than in the control group, treatment was found to be not significantly related to time to corn recurrence when analyzed over the full 12-month follow-up period. Parametric survival analysis modeling of interval-censored data and incorporating patient-specific frailty terms was utilized, to model correlation of corns within patients (hazard ratio [HR], 1.189; 95% confidence interval [CI], 0.780-1.813; P = 0.422). Median resolution times were 10.0 months for corns in the treatment group and 13.4 months for corns in the control group. Controlling for treatment, corn type was found to be related to resolution time, with dorsal/interdigital (ID) corns showing better resolution than plantar corns (HR, 1.670; 95% CI, 1.061-2.630; P = 0.027). Median resolution times were 5.9 months for dorsal/ID corns and 14.9 months for plantar corns. Secondary measures relating to quality of life (QoL) and foot-related disability, using the EQ-5D questionnaire and the Manchester Foot Pain and Disability Index (MFPDI), were also assessed at the patient level in multivariate models. Treatment was not significantly related to any of these measures over the whole period of analysis. However, a trend analysis revealed a quadratic trend in QoL and MFPDI scores, arising from a substantive initial improvement between baseline and 3 months, followed by a gradual decrease between 3 and 12 months. © 2015 Japanese Dermatological Association.
Quantitative subsurface analysis using frequency modulated thermal wave imaging
NASA Astrophysics Data System (ADS)
Subhani, S. K.; Suresh, B.; Ghali, V. S.
2018-01-01
Quantitative depth analysis of the anomaly with an enhanced depth resolution is a challenging task towards the estimation of depth of the subsurface anomaly using thermography. Frequency modulated thermal wave imaging introduced earlier provides a complete depth scanning of the object by stimulating it with a suitable band of frequencies and further analyzing the subsequent thermal response using a suitable post processing approach to resolve subsurface details. But conventional Fourier transform based methods used for post processing unscramble the frequencies with a limited frequency resolution and contribute for a finite depth resolution. Spectral zooming provided by chirp z transform facilitates enhanced frequency resolution which can further improves the depth resolution to axially explore finest subsurface features. Quantitative depth analysis with this augmented depth resolution is proposed to provide a closest estimate to the actual depth of subsurface anomaly. This manuscript experimentally validates this enhanced depth resolution using non stationary thermal wave imaging and offers an ever first and unique solution for quantitative depth estimation in frequency modulated thermal wave imaging.
Locatis, Craig; Burges, Gene; Maisiak, Richard; Liu, Wei-Li; Ackerman, Michael
2017-01-01
Abstract Background: There is little teledermatology research directly comparing remote methods, even less research with two in-person dermatologist agreement providing a baseline for comparing remote methods, and no research using high definition video as a live interactive method. Objective: To compare in-person consultations with store-and-forward and live interactive methods, the latter having two levels of image quality. Methods: A controlled study was conducted where patients were examined in-person, by high definition video, and by store-and-forward methods. The order patients experienced methods and residents assigned methods rotated, although an attending always saw patients in-person. The type of high definition video employed, lower resolution compressed or higher resolution uncompressed, was alternated between clinics. Primary and differential diagnoses, biopsy recommendations, and diagnostic and biopsy confidence ratings were recorded. Results: Concordance and confidence were significantly better for in-person versus remote methods and biopsy recommendations were lower. Store-and-forward and higher resolution uncompressed video results were similar and better than those for lower resolution compressed video. Limitations: Dermatology residents took store-and-forward photos and their quality was likely superior to those normally taken in practice. There were variations in expertise between the attending and second and third year residents. Conclusion: The superiority of in-person consultations suggests the tendencies to order more biopsies or still see patients in-person are often justified in teledermatology and that high resolution uncompressed video can close the resolution gap between store-and-forward and live interactive methods. PMID:27705083
Whitley, Elizabeth M; Raich, Peter C; Dudley, Donald J; Freund, Karen M; Paskett, Electra D; Patierno, Steven R; Simon, Melissa; Warren-Mears, Victoria; Snyder, Frederick R
2016-01-01
Background Whether patient navigation improves outcomes in patients with comorbidities is unknown. Study aims were to determine the effect of comorbidities on time to diagnostic resolution following an abnormal cancer screening test, and to examine for patients with comorbidities, if patient navigation improves timeliness and likelihood of diagnostic resolution compared to patients without navigation. Methods A secondary analysis from the Patient Navigation Research Program sites that collected comorbidity data using the Charlson Comorbidity Index (CCI) was conducted. Participants were 6,349 patients with abnormal breast, cervical, colon or prostate cancer screening tests between 2007 and 2011. The intervention was patient navigation or usual care. CCI data were highly skewed across projects and cancer sites and were categorized as 0, no comorbidities identified, CCI score of 0 (76% of cases); 1, CCI score of 1 (16% of cases); or 2, CCI score of ≥2 (8% of cases). A separate adjusted hazards ratio for each site and cancer type was obtained, and then pooled using meta-analysis random effects methodology. Results Having a CCI score of ≥2 delayed the time to diagnostic resolution following an abnormal cancer screening test compared with those with fewer than one comorbidity. Patient Navigation reduced delays in diagnostic resolution with the greatest benefit seen in those with a CCI score of ≥2. Conclusions Persons with a CCI score of ≥2 experienced significant delays in timely diagnostic care compared to patients without comorbidities. Patient navigation was effective in reducing delays in diagnostic resolution among those with CCI scores > 1. PMID:27648520
NASA Astrophysics Data System (ADS)
Fewtrell, Timothy J.; Duncan, Alastair; Sampson, Christopher C.; Neal, Jeffrey C.; Bates, Paul D.
2011-01-01
This paper describes benchmark testing of a diffusive and an inertial formulation of the de St. Venant equations implemented within the LISFLOOD-FP hydraulic model using high resolution terrestrial LiDAR data. The models are applied to a hypothetical flooding scenario in a section of Alcester, UK which experienced significant surface water flooding in the June and July floods of 2007 in the UK. The sensitivity of water elevation and velocity simulations to model formulation and grid resolution are analyzed. The differences in depth and velocity estimates between the diffusive and inertial approximations are within 10% of the simulated value but inertial effects persist at the wetting front in steep catchments. Both models portray a similar scale dependency between 50 cm and 5 m resolution which reiterates previous findings that errors in coarse scale topographic data sets are significantly larger than differences between numerical approximations. In particular, these results confirm the need to distinctly represent the camber and curbs of roads in the numerical grid when simulating surface water flooding events. Furthermore, although water depth estimates at grid scales coarser than 1 m appear robust, velocity estimates at these scales seem to be inconsistent compared to the 50 cm benchmark. The inertial formulation is shown to reduce computational cost by up to three orders of magnitude at high resolutions thus making simulations at this scale viable in practice compared to diffusive models. For the first time, this paper highlights the utility of high resolution terrestrial LiDAR data to inform small-scale flood risk management studies.
ERIC Educational Resources Information Center
Campbell, Wenonah N.; Skarakis-Doyle, Elizabeth
2011-01-01
This preliminary study explored peer conflict resolution knowledge in children with and without language impairment (LI). Specifically, it evaluated the utility of a visual analogue scale (VAS) for measuring nuances in such knowledge. Children aged 9-12 years, 26 with typically developing language (TLD) and 6 with LI, completed a training protocol…
Mid-Frequency Sonar Interactions with Beaked Whales
2011-06-30
Beaked Whale, was not completed. However, several other goals were achieved, including synthesis of a morphometric model of a beaked whale. This and work...induced acoustic fields inside beaked whales and other marine mammals. Another high-level goal was to acquire new high-resolution morphometric and...range 1-10 kHz; collecting high-resolution morphometric data through computerized tomography (CT) scans on marine mammal specimens, and constructing
Finding the best resolution for the Kingman-Tajima coalescent: theory and applications.
Sainudiin, Raazesh; Stadler, Tanja; Véber, Amandine
2015-05-01
Many summary statistics currently used in population genetics and in phylogenetics depend only on a rather coarse resolution of the underlying tree (the number of extant lineages, for example). Hence, for computational purposes, working directly on these resolutions appears to be much more efficient. However, this approach seems to have been overlooked in the past. In this paper, we describe six different resolutions of the Kingman-Tajima coalescent together with the corresponding Markov chains, which are essential for inference methods. Two of the resolutions are the well-known n-coalescent and the lineage death process due to Kingman. Two other resolutions were mentioned by Kingman and Tajima, but never explicitly formalized. Another two resolutions are novel, and complete the picture of a multi-resolution coalescent. For all of them, we provide the forward and backward transition probabilities, the probability of visiting a given state as well as the probability of a given realization of the full Markov chain. We also provide a description of the state-space that highlights the computational gain obtained by working with lower-resolution objects. Finally, we give several examples of summary statistics that depend on a coarser resolution of Kingman's coalescent, on which simulations are usually based.
Consolidated fuel reprocessing program
NASA Astrophysics Data System (ADS)
1985-04-01
A survey of electrochemical methods applications in fuel reprocessing was completed. A dummy fuel assembly shroud was cut using the remotely operated laser disassembly equipment. Operations and engineering efforts have continued to correct equipment operating, software, and procedural problems experienced during the previous uranium compaigns. Fuel cycle options were examined for the liquid metal reactor fuel cycle. In high temperature gas cooled reactor spent fuel studies, preconceptual designs were completed for the concrete storage cask and open field drywell storage concept. These and other tasks operating under the consolidated fuel reprocessing program are examined.
The structure of patients' presenting concerns: the completion relevance of current symptoms.
Robinson, Jeffrey D; Heritage, John
2005-07-01
This article uses conversation analysis to investigate the problem-presentation phase of 302 visits between primary-care physicians and patients with acute problems. It analyzes the social-interactional organization of problem presentation, focusing on how participants recognize and negotiate its completion. It argues that physicians and patients mutually orient to the presentation of current symptoms--that is, concrete symptoms presented as somehow being experienced in the here-and-now--as a locus of transition between the patient-controlled problem-presentation phase of the visit and the physician-controlled information-gathering phase. This is a resource for physicians to distinguish between complete and incomplete presentations, and for patients to manipulate this distinction.
Stochastic Downscaling of Digital Elevation Models
NASA Astrophysics Data System (ADS)
Rasera, Luiz Gustavo; Mariethoz, Gregoire; Lane, Stuart N.
2016-04-01
High-resolution digital elevation models (HR-DEMs) are extremely important for the understanding of small-scale geomorphic processes in Alpine environments. In the last decade, remote sensing techniques have experienced a major technological evolution, enabling fast and precise acquisition of HR-DEMs. However, sensors designed to measure elevation data still feature different spatial resolution and coverage capabilities. Terrestrial altimetry allows the acquisition of HR-DEMs with centimeter to millimeter-level precision, but only within small spatial extents and often with dead ground problems. Conversely, satellite radiometric sensors are able to gather elevation measurements over large areas but with limited spatial resolution. In the present study, we propose an algorithm to downscale low-resolution satellite-based DEMs using topographic patterns extracted from HR-DEMs derived for example from ground-based and airborne altimetry. The method consists of a multiple-point geostatistical simulation technique able to generate high-resolution elevation data from low-resolution digital elevation models (LR-DEMs). Initially, two collocated DEMs with different spatial resolutions serve as an input to construct a database of topographic patterns, which is also used to infer the statistical relationships between the two scales. High-resolution elevation patterns are then retrieved from the database to downscale a LR-DEM through a stochastic simulation process. The output of the simulations are multiple equally probable DEMs with higher spatial resolution that also depict the large-scale geomorphic structures present in the original LR-DEM. As these multiple models reflect the uncertainty related to the downscaling, they can be employed to quantify the uncertainty of phenomena that are dependent on fine topography, such as catchment hydrological processes. The proposed methodology is illustrated for a case study in the Swiss Alps. A swissALTI3D HR-DEM (with 5 m resolution) and a SRTM-derived LR-DEM from the Western Alps are used to downscale a SRTM-based LR-DEM from the eastern part of the Alps. The results show that the method is capable of generating multiple high-resolution synthetic DEMs that reproduce the spatial structure and statistics of the original DEM.
Benson, John C.; Idiyatullin, Djaudat; Snyder, Angela L.; Snyder, Carl J.; Hutter, Diane; Everson, Lenore I.; Eberly, Lynn E.; Nelson, Michael T.; Garwood, Michael
2015-01-01
Purpose To report the results of sweep imaging with Fourier transformation (SWIFT) magnetic resonance (MR) imaging for diagnostic breast imaging. Materials and Methods Informed consent was obtained from all participants under one of two institutional review board–approved, HIPAA-compliant protocols. Twelve female patients (age range, 19–54 years; mean age, 41.2 years) and eight normal control subjects (age range, 22–56 years; mean age, 43.2 years) enrolled and completed the study from January 28, 2011, to March 5, 2013. Patients had previous lesions that were Breast Imaging Reporting and Data System 4 and 5 based on mammography and/or ultrasonographic imaging. Contrast-enhanced SWIFT imaging was completed by using a 4-T research MR imaging system. Noncontrast studies were completed in the normal control subjects. One of two sized single-breast SWIFT-compatible transceiver coils was used for nine patients and five controls. Three patients and five control subjects used a SWIFT-compatible dual breast coil. Temporal resolution was 5.9–7.5 seconds. Spatial resolution was 1.00 mm isotropic, with later examinations at 0.67 mm isotropic, and dual breast at 1.00 mm or 0.75 mm isotropic resolution. Results Two nonblinded breast radiologists reported SWIFT image findings of normal breast tissue, benign fibroadenomas (six of six lesions), and malignant lesions (10 of 12 lesions) concordant with other imaging modalities and pathologic reports. Two lesions in two patients were not visualized because of coil field of view. The images yielded by SWIFT showed the presence and extent of known breast lesions. Conclusion The SWIFT technique could become an important addition to breast imaging modalities because it provides high spatial resolution at all points during the dynamic contrast-enhanced examination. © RSNA, 2014 PMID:25247405
Hawrilenko, Matt; Eubanks Fleming, C J; Goldstein, Alana S; Cordova, James V
2016-07-01
Studies regarding the effectiveness of homework assignments in cognitive-behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time-varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed. © 2015 American Association for Marriage and Family Therapy.
Understanding the Educational Attainment of Sexual Minority Women and Men*
Mollborn, Stefanie; Everett, Bethany
2015-01-01
National studies have not analyzed sexual identity disparities in high school completion, college enrollment, or college completion in the United States. Using Add Health data, we document the relationship between adult sexual orientation and each of these outcomes. Many sexual minority respondents experienced disadvantages in adolescent academic achievement, school experiences, and social environments. This translates into educational attainment in complex, gendered ways. We find that the socially privileged completely heterosexual identity predicts higher educational attainment for women, while for men it is often a liability. Mostly heterosexual and gay identities are educationally beneficial for men but not women. There are college completion disparities between gay and mostly heterosexual women and their completely heterosexual counterparts. Bisexual respondents, especially women, have particularly problematic outcomes. Adolescent experiences, attitudes, and social contexts explain some of these differences. From adolescence through college, sexual minority groups, but especially females, need intervention to reduce substantial educational disparities. PMID:26257457
Off-axis full-field swept-source optical coherence tomography using holographic refocusing
NASA Astrophysics Data System (ADS)
Hillmann, Dierck; Franke, Gesa; Hinkel, Laura; Bonin, Tim; Koch, Peter; Hüttmann, Gereon
2013-03-01
We demonstrate a full-field swept-source OCT using an off-axis geometry of the reference illumination. By using holographic refocusing techniques, a uniform lateral resolution is achieved over the measurement depth of approximately 80 Rayleigh lengths. Compared to a standard on-axis setup, artifacts and autocorrelation signals are suppressed and the measurement depth is doubled by resolving the complex conjugate ambiguity. Holographic refocusing was done efficiently by Fourier-domain resampling as demonstrated before in inverse scattering and holoscopy. It allowed to reconstruct a complete volume with about 10μm resolution over the complete measurement depth of more than 10mm. Off-axis full-field swept-source OCT enables high measurement depths, spanning many Rayleigh lengths with reduced artifacts.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wood, B.D.
The objective of this project is to advance lower cost solar cooling technology with the feasibility analysis, design and evaluation of proof-of-concept open cycle solar cooling concepts. The work is divided into three phases, with planned completion of each phase before proceeding with the following phase: Phase I - performance/economic/environmental related analysis and exploratory studies; Phase II - design and construction of an experimental system, including evaluative testing; Phase III - extended system testing during operation and engineering modifications as required. For Phase I, analysis and resolution of critical issues were completed with the objective of developing design specifications formore » an improved prototype OCA system.« less
Ultrasound-Guided Drainage of Supralevator Hematoma in a Hemodynamically Stable Patient.
Mukhopadhyay, Debjani; Jennings, Paul E; Banerjee, Mamta; Gada, Ruta
2015-12-01
Paravaginal hematomas can be life-threatening. In patients with intact vaginal walls and perineum, they may pose a diagnostic and therapeutic challenge. Supralevator hematomas are much less common than infralevator hematomas. We present a case of puerperal hemorrhagic shock after a normal vaginal delivery in a low-risk parous woman resulting from an occult supralevator hematoma. Because the woman was hemodynamically unstable initially, she underwent a vaginal surgical drainage. A week later, the supravaginal hematoma reformed. At this time the patient was hemodynamically stable, and ultrasound-guided drainage was performed, which resulted in complete resolution of the hematoma within 10 days. In a clinically stable puerperal patient, ultrasound-guided drainage of a supralevator hematoma resulted in rapid and complete resolution of symptoms.
Evans blue dye-enhanced capillary-resolution photoacoustic microscopy in vivo
NASA Astrophysics Data System (ADS)
Yao, Junjie; Maslov, Konstantin; Hu, Song; Wang, Lihong V.
2009-09-01
Complete and continuous imaging of microvascular networks is crucial for a wide variety of biomedical applications. Photoacoustic tomography can provide high resolution microvascular imaging using hemoglobin within red blood cells (RBCs) as an endogenic contrast agent. However, intermittent RBC flow in capillaries results in discontinuous and fragmentary capillary images. To overcome this problem, we use Evans blue (EB) dye as a contrast agent for in vivo photoacoustic imaging. EB has strong optical absorption and distributes uniformly in the blood stream by chemically binding to albumin. With the help of EB, complete and continuous microvascular networks--especially capillaries--are imaged. The diffusion dynamics of EB leaving the blood stream and the clearance dynamics of the EB-albumin complex are also quantitatively investigated.
Complete description of the optical path difference of a novel spectral zooming imaging spectrometer
NASA Astrophysics Data System (ADS)
Li, Jie; Wu, Haiying; Qi, Chun
2018-03-01
A complete description of the optical path difference of a novel spectral zooming imaging spectrometer (SZIS) is presented. SZIS is designed based on two identical Wollaston prisms with an adjustable air gap. Thus, interferogram with arbitrary spectral resolution and great reduction of spectral image size can be conveniently formed to adapt to different application requirements. Ray tracing modeling in arbitrary incidence with a quasi-parallel-plate approximation scheme is proposed to analyze the optical path difference of SZIS. In order to know the characteristics of the apparatus, exact calculations of the corresponding spectral resolution and field of view are both derived and analyzed in detail. We also present a comparison of calculation and experiment to prove the validity of the theory.
Deepa, D; Mehta, D S; Puri, Viren K; Shetty, Sadashiva
2010-04-01
Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I.), scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years) results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function.
Yu, Ting; Wang, Yun; Wu, Gaojue; Xu, Qinrong; Tang, Yurong; Lin, Lin
2016-08-01
To investigate the characteristics of high-resolution anorectal manometry (HR-ARM) in Parkinson disease (PD) patients with defecation disorder (DD) compared with patients with functional defecation disorder (FDD). DD is a common gastrointestinal symptom in PD. HR-ARM is a relatively new and reliable method for detecting DD. A cohort of PD patients with DD was matched with FDD patients. Defecatory symptoms were investigated by questionnaire. Anorectal motility and sensation were evaluated by HR-ARM. Differences in defecatory symptoms, sensorimotor parameters, and DD type were analyzed. Defecatory symptoms and manometric variables obtained in early-stage PD were compared with advanced stage, and relationships between manometric parameters and evacuatory symptoms explored. Straining and sensation of blockage was experienced significantly more in PD than FDD, and stool consistency more severely affected. Maximum squeeze and intrarectal pressure during defecation in PD was lower than in FDD. Anal resting and residual pressures, duration of sustained squeeze, threshold volumes for first sensation, urgency, and maximum discomfort were similar between groups. PD patients presented predominantly with inadequate propulsive forces, whereas FDD patients showed dyssynergic defecation. Defecatory symptoms and manometric parameters did not differ between stages of PD. PD patients with DD experienced more straining and sensation of blockage than FDD patients, possibly related to inadequate anorectal motility and paradoxical anal contraction of pelvic floor. Impaired squeeze response and inadequate propulsive forces are specific to anorectal function of PD patients with DD, compared with FDD, with abnormalities unchanged between early and advanced PD.
Simulations of forest mortality in Colorado River basin
NASA Astrophysics Data System (ADS)
Wei, L.; Xu, C.; Johnson, D. J.; Zhou, H.; McDowell, N.
2017-12-01
The Colorado River Basin (CRB) had experienced multiple severe forest mortality events under the recent changing climate. Such forest mortality events may have great impacts on ecosystem services and water budget of the watershed. It is hence important to estimate and predict the forest mortality in the CRB with climate change. We simulated forest mortality in the CRB with a model of plant hydraulics within the FATES (the Functionally Assembled Terrestrial Ecosystem Simulator) coupled to the DOE Earth System model (ACME: Accelerated Climate Model of Energy) at a 0.5 x 0.5 degree resolution. Moreover, we incorporated a stable carbon isotope (δ13C) module to ACME(FATE) and used it as a new predictor of forest mortality. The δ13C values of plants with C3 photosynthetic pathway (almost all trees are C3 plants) can indicate the water stress plants experiencing (the more intensive stress, the less negative δ13C value). We set a δ13C threshold in model simulation, above which forest mortality initiates. We validate the mortality simulations with field data based on Forest Inventory and Analysis (FIA) data, which were aggregated into the same spatial resolution as the model simulations. Different mortality schemes in the model (carbon starvation, hydraulic failure, and δ13C) were tested and compared. Each scheme demonstrated its strength and the plant hydraulics module provided more reliable simulations of forest mortality than the earlier ACME(FATE) version. Further testing is required for better forest mortality modelling.
Training Impact on Novice and Experienced Research Coordinators.
Behar-Horenstein, Linda S; Potter, JoNell Efantis; Prikhidko, Alena; Swords, Stephanie; Sonstein, Stephen; Kolb, H Robert
2017-12-01
Competency-based training and professional development is critical to the clinical research enterprise. Understanding research coordinators' perspectives is important for establishing a common core curriculum. The purpose of this study was to describe participants' perspectives regarding the impact of online and classroom training sessions. 27 participants among three institutions, completed a two-day classroom training session. 10 novice and seven experienced research coordinators participated in focus group interviews. Grounded theory revealed similarities in novice and experienced coordinator themes including Identifying Preferences for Instruction and Changing Self Perceptions. Differences, seen in experienced participants, focused on personal change, in the theme of Re-Assessing Skills. Infrastructure and cultural issues were evident in their theme, Promoting Leadership and Advocacy. Novice participants recommended ways to improve training via their theme of Making Programmatic Improvements. Participants reported a clear preference for classroom learning. Training played an influential role in changing participants' self-perceptions by validating their experiences. The findings provided guidance for developing a standardized curriculum. Training must be carefully tailored to the needs of participants while considering audience needs based on work experience, how technology can be used and offering content that is most urgently needed.
Training Impact on Novice and Experienced Research Coordinators
Behar-Horenstein, Linda S.; Potter, JoNell Efantis; Prikhidko, Alena; Swords, Stephanie; Sonstein, Stephen; Kolb, H. Robert
2017-01-01
Competency-based training and professional development is critical to the clinical research enterprise. Understanding research coordinators’ perspectives is important for establishing a common core curriculum. The purpose of this study was to describe participants’ perspectives regarding the impact of online and classroom training sessions. 27 participants among three institutions, completed a two-day classroom training session. 10 novice and seven experienced research coordinators participated in focus group interviews. Grounded theory revealed similarities in novice and experienced coordinator themes including Identifying Preferences for Instruction and Changing Self Perceptions. Differences, seen in experienced participants, focused on personal change, in the theme of Re-Assessing Skills. Infrastructure and cultural issues were evident in their theme, Promoting Leadership and Advocacy. Novice participants recommended ways to improve training via their theme of Making Programmatic Improvements. Participants reported a clear preference for classroom learning. Training played an influential role in changing participants’ self-perceptions by validating their experiences. The findings provided guidance for developing a standardized curriculum. Training must be carefully tailored to the needs of participants while considering audience needs based on work experience, how technology can be used and offering content that is most urgently needed. PMID:29308457
Current alcohol use is associated with a reduced risk of hot flashes in midlife women.
Schilling, Chrissy; Gallicchio, Lisa; Miller, Susan R; Babus, Janice K; Lewis, Lynn M; Zacur, Howard; Flaws, Jodi A
2005-01-01
To examine the relation between current alcohol use, estradiol, estrone, and testosterone levels, and hot flashes in midlife women using a case-control study design. Cases were midlife women (45-54 years) who reported ever experiencing hot flashes. Controls were midlife women (45-54 years) who reported never experiencing hot flashes. Each participant completed a questionnaire and provided a blood sample that was used to measure estradiol, estrone, and testosterone levels by enzyme-linked immunosorbent assay. The results indicate that current alcohol use (at least one day per month) was significantly associated with a reduced risk of hot flashes compared to non-use of alcohol, independent of age and smoking habits. The hot flashes experienced by current alcohol users were less severe and less frequent than those experienced by non-users of alcohol. Further, current alcohol users had similar levels of estradiol, estrone, and testosterone compared to non-users of alcohol. These data suggest that current alcohol use is associated with a reduced risk of any, severe, and frequent hot flashes in midlife women by a mechanism that may not include changes in sex steroid hormone levels.
Crosby, Richard A; Mena, Leandro
2017-05-01
This study of young Black MSM (YBMSM) explored the correlates and outcomes of enhanced sexual pleasure from condom-protected sex. Six-hundred YBMSM were enrolled from an sexually transmitted infection clinic in the southern United States. Men completed a computer-assisted self-interview. A 3-item scale assessed perceptions related to condoms enhancing sexual pleasure. Nine of 14 correlates met the screening level of significance and were tested in a regression model. Three obtained multivariable significance: (1) Men discussing condom use with sex partners had greater odds (AOR = 1.67, 95 % CI 1.20-2.34) of experiencing enhanced pleasure; (2) Insertive-partners had lower odds (AOR = 0.63, 95 % CI 0.44-0.91) of experiencing enhanced pleasure; and (3) men scoring higher in internalized homophobia had lower odds (AOR = 0.66, 95 % CI 0.47-0.93) of experiencing enhanced pleasure. Also, men experiencing enhanced pleasure were less likely to report any condomless anal sex. The experience of enhanced sexual pleasure during condom-protected sex may be an important "target" of behavioral intervention efforts.
The Joint Astrophysical Plasmadynamic Experiment (J-PEX): a high-resolution rocket spectrometer
NASA Astrophysics Data System (ADS)
Barstow, Martin A.; Bannister, Nigel P.; Cruddace, Raymond G.; Kowalski, Michael P.; Wood, Kent S.; Yentis, Daryl J.; Gursky, Herbert; Barbee, Troy W., Jr.; Goldstein, William H.; Kordas, Joseph F.; Fritz, Gilbert G.; Culhane, J. Leonard; Lapington, Jonathan S.
2003-02-01
We report on the successful sounding rocket flight of the high resolution (R=3000-4000) J-PEX EUV spectrometer. J-PEX is a novel normal incidence instrument, which combines the focusing and dispersive elements of the spectrometer into a single optical element, a multilayer-coated grating. The high spectral resolution achieved has had to be matched by unprecedented high spatial resolution in the imaging microchannel plate detector used to record the data. We illustrate the performance of the complete instrument through an analysis of the 220-245Å spectrum of the white dwarf G191-B2B obtained with a 300 second exposure. The high resolution allows us to detect a low-density ionized helium component along the line of sight to the star and individual absorption lines from heavier elements in the photosphere.
Optimization as a Tool for Consistency Maintenance in Multi-Resolution Simulation
NASA Technical Reports Server (NTRS)
Drewry, Darren T; Reynolds, Jr , Paul F; Emanuel, William R
2006-01-01
The need for new approaches to the consistent simulation of related phenomena at multiple levels of resolution is great. While many fields of application would benefit from a complete and approachable solution to this problem, such solutions have proven extremely difficult. We present a multi-resolution simulation methodology that uses numerical optimization as a tool for maintaining external consistency between models of the same phenomena operating at different levels of temporal and/or spatial resolution. Our approach follows from previous work in the disparate fields of inverse modeling and spacetime constraint-based animation. As a case study, our methodology is applied to two environmental models of forest canopy processes that make overlapping predictions under unique sets of operating assumptions, and which execute at different temporal resolutions. Experimental results are presented and future directions are addressed.
Aye, Tandy; Reiss, Allan L.; Kesler, Shelli; Hoang, Sherry; Drobny, Jessica; Park, Yaena; Schleifer, Kristin; Baumgartner, Heidi; Wilson, Darrell M.; Buckingham, Bruce A.
2011-01-01
OBJECTIVE To determine if frequent exposures to hypoglycemia and hyperglycemia during early childhood lead to neurocognitive deficits and changes in brain anatomy. RESEARCH DESIGN AND METHODS In this feasibility, cross-sectional study, young children, aged 3 to 10 years, with type 1 diabetes and age- and sex-matched healthy control (HC) subjects completed neuropsychologic (NP) testing and magnetic resonance imaging (MRI) scans of the brain. RESULTS NP testing and MRI scanning was successfully completed in 98% of the type 1 diabetic and 93% of the HC children. A significant negative relationship between HbA1c and Wechsler Intelligence Scale for Children (WISC) verbal comprehension was observed. WISC index scores were significantly reduced in type 1 diabetic subjects who had experienced seizures. White matter volume did not show the expected increase with age in children with type 1 diabetes compared with HC children (diagnosis by age interaction, P = 0.005). A similar trend was detected for hippocampal volume. Children with type 1 diabetes who had experienced seizures showed significantly reduced gray matter and white matter volumes relative to children with type 1 diabetes who had not experienced seizures. CONCLUSIONS It is feasible to perform MRI and NP testing in young children with type 1 diabetes. Further, early signs of neuroanatomic variation may be present in this population. Larger cross-sectional and longitudinal studies of neurocognitive function and neuroanatomy are needed to define the effect of type 1 diabetes on the developing brain. PMID:21562318
Precollege Predictors of Incapacitated Rape Among Female Students in Their First Year of College
Carey, Kate B.; Durney, Sarah E.; Shepardson, Robyn L.; Carey, Michael P.
2015-01-01
Objective: The first year of college is an important transitional period for young adults; it is also a period associated with elevated risk of incapacitated rape (IR) for female students. The goal of this study was to identify prospective risk factors associated with experiencing attempted or completed IR during the first year of college. Method: Using a prospective cohort design, we recruited 483 incoming first-year female students. Participants completed a baseline survey and three follow-up surveys over the next year. At baseline, we assessed precollege alcohol use, marijuana use, sexual behavior, and, for the subset of sexually experienced participants, sex-related alcohol expectancies. At the baseline and all follow-ups, we assessed sexual victimization. Results: Approximately 1 in 6 women (18%) reported IR before entering college, and 15% reported IR during their first year of college. In bivariate analyses, precollege IR history, precollege heavy episodic drinking, number of precollege sexual partners, and sex-related alcohol expectancies (enhancement and disinhibition) predicted first-year IR. In multivariate analyses with the entire sample, only precollege IR (odds ratio = 4.98, p < .001) remained a significant predictor. However, among the subset of sexually experienced participants, both enhancement expectancies and precollege IR predicted IR during the study year. Conclusions: IR during the first year of college is independently associated with a history of IR and with expectancies about alcohol’s enhancement of sexual experience. Alcohol expectancies are a modifiable risk factor that may be a promising target for prevention efforts. PMID:26562590
Management of Contaminated Autologous Grafts in Plastic Surgery
Centeno, Robert F; Desai, Ankit R; Watson, Marla E
2008-01-01
Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American Society of Aesthetic Plastic Surgery members were asked to complete an online survey that asked about the number and causes of graft contaminations experienced, how surgeons dealt with the problem, the clinical outcomes, and patient disclosure. Results: Nineteen hundred surgeons were asked to participate in the survey, and 223 responded. Of these, 70% had experienced at least 1 graft contamination incident, with 26% experiencing 4 or more. The most frequently reported reason for graft contamination was a graft falling on the floor (reported by 75%). Nearly two thirds of the contaminated grafts related to craniofacial procedures. Ninety-four percent of grafts were managed with decontamination and completion of the operation. The most common method of decontamination was washing with povidone-iodine, but this practice is contrary to recommendations in the literature. Only 3 surgeons (1.9%) said a clinical infection developed following decontaminated graft use. Patients were not informed in 60% of graft contamination incidents. The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure. Conclusions: Although autologous grafts do become contaminated in plastic surgery, the overwhelming majority can be safely decontaminated and produce minimal or no clinical sequelae. The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur. PMID:18496583
Senn, Theresa E; Walsh, Jennifer L; Carey, Michael P
2016-07-01
Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly funded STI clinic in the U.S. (54 % male, M age = 27.93, 68 % African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective.
Senn, Theresa E.; Walsh, Jennifer L.; Carey, Michael P.
2016-01-01
Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly-funded STI clinic in the U.S. (54% male, Mage = 27.93, 68% African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective. PMID:27000155
Factors Associated with Pain Severity in Children with Calcaneal Apophysitis (Sever Disease).
James, Alicia M; Williams, Cylie M; Luscombe, Michelle; Hunter, Reshele; Haines, Terry P
2015-08-01
To identify any association between the pain experienced as a result of calcaneal apophysitis, anthropometric data, and lower limb measurements. This study was a cross-sectional study, nested within a wider randomized, comparative efficacy trial. One hundred twenty-four children between the ages of 8 and 14 years with a clinical diagnosis of calcaneal apophysitis were recruited for this study. Of the participating children, 72 were male. The measures recorded were height, weight, waist circumference, body mass index, foot posture, and ankle joint range of motion; comparison with normative values was also completed. Univariate and multivariable regression analyses were undertaken to identify factors associated with the severity of pain experienced (visual analog scale). The children within this study had a higher mean body mass index (P < .001), increased weight (P < .001), and were taller (P < .001) compared with normative values. The children also demonstrated differences in foot posture and ankle joint range of motion. Multivariable regression analyses identified that older participants (P = .046) and those who had experienced pain for longer (P = .043) reported higher pain severity. Children presenting with calcaneal apophysitis were anthropometrically different from their peers and had experienced a lengthy period of pain. Therefore, early management focussing on the anthropometric differences may minimize the intensity and duration of pain experienced. Registered with Australian New Zealand Clinical Trials Registry: ACTRN12609000696291. Copyright © 2015 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Gasmi, Taieb
2018-04-01
An extra-cavity CO2-TEA laser pulse clipper for high spatial resolution atmospheric monitoring is presented. The clipper uses pulsed high voltageto facilitate the breakdown of the gas within the clipper cell. Complete extinction of the nitrogen tail, that degrades the range resolution of LIDARS, is obtained at pressures from 375 up to 1500 Torr for nitrogen and argon gases whereas an attenuation coefficient of almost 102 is achieved for helium. Excellent energy stability and pulse width repeatability were achieved using high voltage pre-ionized gas technique.
Managing Chronic Conditions in College: Findings from Prompted Health Incidents Diaries
ERIC Educational Resources Information Center
Ravert, Russell D.; Russell, Luke T.; O'Guin, Monica B.
2017-01-01
Objective: This pilot study assessed an electronic health diary method designed to collect data about critical health incidents experienced by college students who have chronic health conditions. Participants: Nine university students with chronic medical conditions were recruited to complete a series of e-mail-based surveys, sent once every…
Supervising Counsellors and Psychotherapists Who Work with Trauma: A Delphi Study
ERIC Educational Resources Information Center
West, Angela
2010-01-01
In this study the Delphi technique was used to identify the main supervision issues that require attention and consideration when supervising counsellors and psychotherapists working with trauma. A panel of supervisors, who were additionally experienced in working with trauma in adulthood, completed a series of three questionnaires comprising two…
ERIC Educational Resources Information Center
Nishina, Adrienne
2012-01-01
The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or…
Changes to southern Appalachian water yield and stormflow after loss of a foundation species
Steven T. Brantley; Chelcy Ford Miniat; Katherine J. Elliott; Stephanie H. Laseter; James M. Vose
2014-01-01
Few studies have examined how insect outbreaks affect landscape-level hydrologic processes. We report the hydrologic effects of the invasive, exotic hemlock woolly adelgid (HWA) in a headwater catchment in the southern Appalachian Mountains. The study watershed experienced complete mortality of an evergreen tree species, Tsuga canadensis (L.) Carr. (...
Students' Emotions during Homework: Structures, Self-Concept Antecedents, and Achievement Outcomes
ERIC Educational Resources Information Center
Goetz, Thomas; Nett, Ulrike E.; Martiny, Sarah E.; Hall, Nathan C.; Pekrun, Reinhard; Dettmers, Swantje; Trautwein, Ulrich
2012-01-01
In the present study (N = 553; 8th and 11th grade students; 52% female) we investigated students' enjoyment, pride, anxiety, anger, and boredom while completing homework (homework emotions), and contrasted these emotions with those experienced during class (classroom emotions). Both homework emotions and classroom emotions were assessed separately…
Executive and Phonological Processes in Second-Language Acquisition
ERIC Educational Resources Information Center
Engel de Abreu, Pascale M. J.; Gathercole, Susan E.
2012-01-01
This article reports a latent variable study exploring the specific links among executive processes of working memory, phonological short-term memory, phonological awareness, and proficiency in first (L1), second (L2), and third (L3) languages in 8- to 9-year-olds experiencing multilingual education. Children completed multiple L1-measures of…
2017-06-11
Marshall Space Flight Center employees view the August 21, 2017 solar eclipse at the center’s activities building. The Huntsville area experienced 97 percent occultation, nearly a complete blocking out of the sun by the orbit of Earth's moon. The next opportunity to view a solar eclipse in the eastern and central United States will occur in April 2024.
Components of the Lonely Experience in Adolescents and Young Adults.
ERIC Educational Resources Information Center
Goswick, Ruth Ann; And Others
Research has identified high school and college students as the groups experiencing the greatest severity of loneliness. The manifestations of loneliness in adolescents and young adults were examined in a group of college (N=192) and high school (N=98) students. All subjects completed the Revised Loneliness Scale and a questionnaire about…
Primary Treatment and Sludge Digestion Workshop. Second Edition (Revised).
ERIC Educational Resources Information Center
Ontario Ministry of the Environment, Toronto.
This manual was developed for use at workshops designed to upgrade the knowledge of experienced wastewater treatment plant operators. Each of the sixteen lessons has clearly stated behavioral objectives to tell the trainee what he should know or do after completing that topic. The body of the text provides content information, procedure outlines,…
The Impact of Disadvantage on VET Completion and Employment Gaps. Research Report
ERIC Educational Resources Information Center
McVicar, Duncan; Tabasso, Domenico
2016-01-01
Increasing educational attainment is generally tied to better employment outcomes. The vocational education and training (VET) sector is often used as an entry point into post-compulsory education for individuals who have experienced disadvantage in their lives. But does increasing participation in VET by disadvantaged individuals necessarily lead…
ERIC Educational Resources Information Center
Awan, Seher
2014-01-01
Numerous studies have been conducted examining leadership within community colleges, participatory governance and its role, as well as conditions that support organizational change. However, no analysis has been completed documenting the rebuilding of trust within a community college after a trauma is experienced on an institutional level. Broken…
Alexithymia and Grief Reactions in Bereaved Japanese Women
ERIC Educational Resources Information Center
Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji
2005-01-01
To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a…
The Crisis in Credit and the Rise of Non-Credit
ERIC Educational Resources Information Center
Arena, Meaghan L.
2013-01-01
With institutions of higher education experiencing lower completion rates than our international counterparts and with rising student loan debt, the American higher education system is in crisis. As faculty members and administrators work to solve these growing problems in the credit-bearing side of higher education, the non-credit side is largely…
ERIC Educational Resources Information Center
Lee, Dong Yul; Gee, Angela; Uhleman, Max R.
2000-01-01
Study attempts to determine whether clinicians' attitudes toward feminism influence their perception of a client's problem. After completing a scale assessing their endorsement of feminist attitudes, counselor-trainees (N=150) viewed videotaped counseling interviews of a male counselor interviewing a male or female experiencing depression. Results…
Shame and Guilt in Men Exposed to Childhood Sexual Abuse: A Qualitative Investigation
ERIC Educational Resources Information Center
Dorahy, Martin J.; Clearwater, Ken
2012-01-01
This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the…
ERIC Educational Resources Information Center
Flessner, Christopher A.; Woods, Douglas W.
2006-01-01
In this study, the authors collected data on the demographic characteristics, phenomenology, and social and economic impact of skin picking. A total of 92 participants completed an anonymous, Internet-based survey through a link to the Trichotillomania Learning Center's home page. Results indicated that skin pickers experienced social,…
ERIC Educational Resources Information Center
Chou, Yueh-Ching; Lu, Jane Zxy-Yann; Pu, Cheng-Yun
2009-01-01
Background: Perimenstrual syndrome (PMS) among women with an intellectual disability (ID) has not been investigated in Taiwan. This study explores the prevalence/severity of PMS experienced by women with ID who are institutionalised. Method: Ninety two female residents aged 15 to 54 at six public institutions completed a structured interview…
Coping Styles among Mothers of Adults with Mental Retardation.
ERIC Educational Resources Information Center
Krauss, Marty Wyngaarden
This paper describes the use of various coping strategies of mothers of adult children with mental retardation, and examines whether there is a relation between specific styles of coping and maternal characteristics and personal well-being. A group of 349 mothers completed the "Coping Orientations to Problems Experienced" scale. On average,…
Psychosocial Predictors of Rule Following in Hostels for Women Experiencing Homelessness
ERIC Educational Resources Information Center
White, Katherine; Wood, Maria
2011-01-01
This study examined the psychosocial factors impacting upon the rule-following behaviour of residents of a hostel providing crisis accommodation to women who are homeless. After their arrival, residents of a women's hostel (N=83) completed questionnaires assessing the theory of planned behaviour constructs of attitude, subjective norm, perceived…
Integrating Geographic Information Systems in Business School Curriculum: An Initial Example
ERIC Educational Resources Information Center
King, Michael A.; Arnette, Andrew N.
2011-01-01
Geographic information systems have experienced rapid growth and user adoption over the last four decades, due to an increasing value to the business community. However, business schools are not teaching geospatial concepts and the related location intelligence to their students. This curriculum decision seems completely at odds with business'…
2003-09-05
KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, United Space Alliance worker Mike Hyatt (above) completes installation of a Reinforced Carbon Carbon (RCC) panel onto the leading edge of the wing of the orbiter Atlantis. The gray carbon composite RCC panels have sufficient strength to withstand the aerodynamic forces experienced during launch and reentry, which can reach as high as 800 pounds per square foot. The operating range of RCC is from minus 250º F to about 3,000º F, the temperature produced by friction with the atmosphere during reentry.
Lu, Yong-Chen; Yao, Xin; Li, Yong F.; El-Gamil, Mona; Dudley, Mark E.; Yang, James C.; Almeida, Jorge R.; Douek, Daniel C.; Samuels, Yardena; Rosenberg, Steven A.; Robbins, Paul F.
2013-01-01
Adoptive cell therapy with tumor infiltrating lymphocytes (TILs) represents an effective treatment for patients with metastatic melanoma. However, most of the antigen targets recognized by effective melanoma reactive TILs remain elusive. In this study, patient 2369 experienced a complete response, including regressions of bulky liver tumor masses ongoing beyond seven years following adoptive TILs transfer. The screening of a cDNA library generated from the autologous melanoma cell line resulted in the isolation of a mutated PPP1R3B (protein phosphatase 1, regulatory (inhibitor) subunit 3B) gene product. The mutated PPP1R3B peptide represents the immunodominant epitope recognized by tumor reactive T cells in TIL 2369. Five years following adoptive transfer, peripheral blood T lymphocytes obtained from patient 2369 recognized the mutated PPP1R3B epitope. These results demonstrate that adoptive T cell therapy targeting a tumor-specific antigen can mediate long-term survival for a patient with metastatic melanoma. This study also provides an impetus to develop personalized immunotherapy targeting tumor-specific, mutated antigens. PMID:23690473
Sports participation after rehabilitation: Barriers and facilitators.
Jaarsma, Eva A; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U
2016-01-01
To analyse barriers to, and facilitators of, sports participation among people with physical disabilities after rehabilitation and to compare differences between inactive and active participants regarding these experienced barriers and facilitators. Participants were 1,223 adults (mean age 51.6 years, standard deviation 15.1 years) treated in the Rehabilitation Centre of the University Medical Center Groningen, who completed a questionnaire. The questionnaire consisted of a self-constructed questionnaire regarding barriers and facilitators. Fifty-eight percent of the participants were active in sports after their rehabilitation. Younger age and a higher level of education were positively associated with sports participation, whereas using assistive devices and experiencing environmental barriers were negatively associated. Facilitators of sports participation were health, fun and increasing physical strength, and advice from rehabilitation professionals. Rehabilitation professionals should emphasize the health benefits of, and enjoyment from, sports participation for people with physical disabilities. They should repeatedly remind people with physical disabilities to stay/become active after completing their rehabilitation programme. Rehabilitation professionals should also provide information about strategies to reduce environmental barriers to sports participation, which could help people using assistive devices to overcome these barriers.
Blogging to Quit Smoking: Sharing Stories from Women of Childbearing Years in Ontario
Minian, Nadia; Noormohamed, Aliya; Dragonetti, Rosa; Maher, Julie; Lessels, Christina; Selby, Peter
2016-01-01
This study examined the degree to which the pregnant or postpartum women, in the process of quitting smoking, felt that writing in a blog about their smoking cessation journeys helped them in their efforts to become or remain smoke free. Five women who blogged for Prevention of Gestational and Neonatal Exposure to Tobacco Smoke (a website designed to help pregnant and postpartum women quit smoking) were interviewed about their experiences as bloggers. Participants were asked to complete an online survey, which had closed-ended questions regarding their sociodemographic and smoking characteristics. Once they completed the survey, semistructured qualitative interviews were conducted over the phone. Findings suggest that blogging might combine several evidence-based behavioral strategies for tobacco cessation, such as journaling and getting support from others who use tobacco. Being part of a blogging community of women who have experienced or are experiencing similar challenges can be therapeutic and help women gain confidence in their ability to quit smoking. In conclusion, blogging may help pregnant and postpartum women quit smoking by increasing their social support and promoting self-reflection. PMID:27199562
Parrish, Jared W; Lanier, Paul; Newby-Kew, Abigail; Arvidson, Joshua; Shanahan, Meghan
2016-02-01
We conducted a population-based prospective cohort study to help elucidate the predictive relationship between a maternal prebirth self-reported history of intimate partner violence (IPV) and any postbirth reported allegation to Child Protective Services (CPS) by age 2. We linked data from the 2009-2010 Alaska Pregnancy Risk Assessment Monitoring System with CPS data through 2012. Among this cohort, we found that 8.0%w self-reported experiencing IPV 12 months prior or during pregnancy, and 8.0%w of the offspring experienced at least one CPS report of alleged maltreatment during the study period. The predictive relationship varied by maternal educational attainment. Among mothers with 12+ years education completed, the odds of a CPS report were 3.9 times compared to those with no IPV, while among mothers with <12 years education completed, no association was noted. These results suggest that for a subset of Alaskan families, maternal history of IPV is a strong independent predictor of future CPS contact. © The Author(s) 2015.
Coastal Vulnerability to Sea Level Rise and Erosion in Northwest Alaska (Invited)
NASA Astrophysics Data System (ADS)
Gorokhovich, Y.; Leiserowitz, A.
2009-12-01
Northwest Alaska is experiencing significant climate change and human impacts. The study area includes the coastal zone of Kotzebue Sound and the Chukchi Sea and provides the local population (predominantly Inupiaq Eskimo) with critical subsistence resources of meat, fish, berries, herbs, and wood. The geomorphology of the coast includes barrier islands, inlets, estuaries, deltas, cliffs, bluffs, and beaches that host modern settlements and infrastructure. Coastal dynamics and sea-level rise are contributing to erosion, intermittent erosion/accretion patterns, landslides, slumps and coastal retreat. These factors are causing the sedimentation of deltas and lagoons, and changing local bathymetry, morphological parameters of beaches and underwater slopes, rates of coastal dynamics, and turbidity and nutrient cycling in coastal waters. This study is constructing vulnerability maps to help local people and federal officials understand the potential consequences of sea-level rise and coastal erosion on local infrastructure, subsistence resources, and culturally important sites. A lack of complete and uniform data (in terms of methods of collection, geographic scale and spatial resolution) creates an additional level of uncertainty that complicates geographic analysis. These difficulties were overcome by spatial modeling with selected spatial resolution using extrapolation methods. Data include subsistence resource maps obtained using Participatory GIS with local hunters and elders, geological and geographic data on coastal dynamics from satellite imagery, aerial photos, bathymetry and topographic maps, and digital elevation models. These data were classified and ranked according to the level of coastal vulnerability (Figure 1). The resulting qualitative multicriteria model helps to identify the coastal areas with the greatest vulnerability to coastal erosion and of the potential loss of subsistence resources. Acknowldgements: Dr. Ron Abileah (private consultant, jOmegak) helped in preliminary analysis of Landsat imagery, Mr. Alex Whiting provided valuable information on subsistence resources in Kotzebue region, hunters and elders of villages in Kivalina, Kotzebue, Selawik and Deering provided input in GIS database on subsistence resources.
Taveira-DaSilva, Angelo M.; Hathaway, Olanda; Stylianou, Mario; Moss, Joel
2011-01-01
Background Lymphangioleiomyomatosis (LAM) is a disorder that affects women and is characterized by cystic lung destruction, chylous effusions, lymphangioleiomyomas, and angiomyolipomas. It is caused by proliferation of abnormal smooth muscle–like cells. Sirolimus is a mammalian target of rapamycin inhibitor that has been reported to decrease the size of neoplastic growths in animal models of tuberous sclerosis complex and to reduce the size of angiomyolipomas and stabilize lung function in humans. Objective To assess whether sirolimus therapy is associated with improvement in lung function and a decrease in the size of chylous effusions and lymphangioleiomyomas in patients with LAM. Design Observational study. Setting The National Institutes of Health Clinical Center. Patients 19 patients with rapidly progressing LAM or chylous effusions. Intervention Treatment with sirolimus. Measurements Lung function and the size of chylous effusions and lymphangioleiomyomas before and during sirolimus therapy. Results Over a mean of 2.5 years before beginning sirolimus therapy, the mean (±SE) FEV1 decreased by 2.8% ± 0.8% predicted and diffusing capacity of the lung for carbon monoxide (DLCO) decreased by 4.8% ± 0.9% predicted per year. In contrast, over a mean of 2.6 years of sirolimus therapy, the mean (± SE) FEV1 increased by 1.8% ± 0.5% predicted and DLCO increased by 0.8% ± 0.5% predicted per year (P < 0.001). After beginning sirolimus therapy, 12 patients with chylous effusions and 11 patients with lymphangioleiomyomas experienced almost complete resolution of these conditions. In 2 of the 12 patients, sirolimus therapy enabled discontinuation of pleural fluid drainage. Limitations This was an observational study. The resolution of effusions may have affected improvements in lung function. Conclusion Sirolimus therapy is associated with improvement or stabilization of lung function and reduction in the size of chylous effusions and lymphangioleiomyomas in patients with LAM. Primary Funding Source Intramural Research Program, National Heart, Lung, and Blood Institute, National Institutes of Health. PMID:21690594
Superficial retinal precipitates in patients with syphilitic retinitis.
Fu, Evelyn X; Geraets, Ryan L; Dodds, Emilio M; Echandi, Laura V; Colombero, Daniel; McDonald, H Richard; Jumper, J Michael; Cunningham, Emmett T
2010-01-01
The purpose of this study was to describe the occurrence of superficial retinal precipitates in patients with syphilitic retinitis. This was a retrospective, observational case series of nine eyes of eight patients with syphilitic retinitis associated with superficial retinal precipitates. The clinical, photographic, angiographic, and laboratory records were reviewed. Characteristics and treatment response of these superficial retinal precipitates were observed. All patients were Caucasian men, including 5 men who have sex with men (62.5%) and 6 (75.0%) who were positive for human immunodeficiency virus. None of the patients were previously diagnosed with syphilis. All patients developed panuveitis and a distinctly diaphanous or ground-glass retinitis associated with creamy yellow superficial retinal precipitates. In 3 patients (37.5%), the retinitis had a distinctive wedge-shaped appearance. Five patients (62.5%) had associated retinal vasculitis, 3 (37.5%) had serous retinal detachment, 2 (22.2%) had intraretinal hemorrhage, and 2 (22.2%) had papillitis. Within 2 weeks of initiating intravenous penicillin treatment, 7 patients (87.5%) experienced visual recovery to >or= 20/40. All affected eyes showed rapid resolution of clinical signs with minimal alternations of the retinal pigment epithelium in areas of prior retinitis after completion of antibiotic therapy. Characteristic superficial retinal precipitates may occur over areas of syphilitic retinitis. Improved recognition of this highly suggestive clinical sign may aid in early diagnosis and treatment.
Minimally invasive surgical treatment of Bertolotti's Syndrome: case report.
Ugokwe, Kene T; Chen, Tsu-Lee; Klineberg, Eric; Steinmetz, Michael P
2008-05-01
This article aims to provide more insight into the presentation, diagnosis, and treatment of Bertolotti's syndrome, which is a rare spinal disorder that is very difficult to recognize and diagnose correctly. The syndrome was first described by Bertolotti in 1917 and affects approximately 4 to 8% of the population. It is characterized by an enlarged transverse process at the most caudal lumbar vertebra with a pseudoarticulation of the transverse process and the sacral ala. It tends to present with low back pain and may be confused with facet and sacroiliac joint disease. In this case report, we describe a 40-year-old man who presented with low back pain and was eventually diagnosed with Bertolotti's syndrome. The correct diagnosis was made based on imaging studies which included computed tomographic scans, plain x-rays, and magnetic resonance imaging scans. The patient experienced temporary relief when the abnormal pseudoarticulation was injected with a cocktail consisting of lidocaine and steroids. In order to minimize the trauma associated with surgical treatment, a minimally invasive approach was chosen to resect the anomalous transverse process with the accompanying pseudoarticulation. The patient did well postoperatively and had 97% resolution of his pain at 6 months after surgery. As with conventional surgical approaches, a complete knowledge of anatomy is required for minimally invasive spine surgery. This case is an example of the expanding utility of minimally invasive approaches in treating spinal disorders.
Impulsive Personality and Alcohol Use: Bidirectional Relations Over One Year
Kaiser, Alison; Bonsu, Jacqueline A.; Charnigo, Richard J.; Milich, Richard; Lynam, Donald R.
2016-01-01
Objective: Impulsive personality traits have been found to be robust predictors of substance use and problems in both cross-sectional and longitudinal research. Studies examining the relations of substance use and impulsive personality over time indicate a bidirectional relation, where substance use is also predictive of increases in later impulsive personality. The present study sought to build on these findings by examining the bidirectional relations among the different impulsive personality traits assessed by the UPPS-P Impulsive Behavior Scale, with an interest in urgency (the tendency to act rashly when experiencing strong affect). Method: Participants were 525 first-year college students (48.0% male, 81.1% White), who completed self-report measures assessing personality traits and a structured interview assessing past and current substance use. Data collection took place at two different time points: the first occurred during the participants’ first year of college, and the second occurred approximately 1 year later. Bidirectional relations were examined using structural equation modeling. Results: Time 1 (T1) positive urgency predicted higher levels of alcohol use at Time 2 (T2), whereas T1 lack of perseverance predicted lower levels of alcohol use at T2. T1 alcohol use predicted higher levels of positive urgency, negative urgency, sensation seeking, and lack of premeditation at T2. Conclusions: Findings provide greater resolution in characterizing the bidirectional relation between impulsive personality traits and substance use. PMID:27172580
Should We Treat a Patient's Symptoms or Angiography Image in TIA?: Two Case Reports.
Karpatová, Hana; Jankových, Jana; Mikulík, Robert
2016-11-01
Data on vascular status in the first hours after onset of transient ischemic attack (TIA) and its clinical significance are missing. Also, it is not known whether arterial occlusion, if present in TIA, should be the target for revascularization. We present 2 patients to demonstrate that TIA can be due to acute major intracranial arterial occlusion and to show how such arterial occlusion may affect the outcome. Two patients (54 and 63 years old) were diagnosed with TIA and at the same time had occlusion of the middle cerebral artery. No recanalization therapy was performed, as there was no or minimal neurological deficit. After several hours, the condition of both patients clinically deteriorated. One patient experienced spontaneous recanalization in the first 24 hours and clinical improvement over the subsequent days, resulting in complete resolution of the neurological deficit. The other patient did not recanalize and developed a significant brain infarction as well as hemorrhagic transformation requiring decompression surgery. Over the long term, the patient remained hemiplegic, unable to walk, and dependent on assistance for most activities of daily living. The cases presented here raise important questions: (1) How frequently is arterial occlusion present in clinically asymptomatic patients? (2) If occlusion is present but not symptoms, is stroke a more correct diagnosis than TIA? and (3) What would be the benefit of recanalization therapy? Studies addressing these questions should be conducted.
Cardiac conduction disturbance after loperamide abuse.
Marraffa, J M; Holland, M G; Sullivan, R W; Morgan, B W; Oakes, J A; Wiegand, T J; Hodgman, M J
2014-11-01
Prescription opioid abuse is a major public health concern and an ongoing epidemic in the United States. Loperamide is a widely available and inexpensive over-the-counter antidiarrheal with peripheral mu-opioid receptor activity. Online resources discuss the use of loperamide for the amelioration of withdrawal symptoms or recreational abuse. We describe the clinical course of 5 patients abusing loperamide, 3 of whom had life-threatening cardiac arrhythmias. In this observational case series, patients with cardiac arrhythmias or history of loperamide abuse with cardiac arrhythmias were identified; 5 patients were identified and 4 of the 5 patients were seen directly at the bedside. Clinical profile and outcome of patients is reported. We report 5 patients with history of loperamide abuse; 3 of the 5 patients had life-threatening cardiac arrhythmias. One of the patients experienced a second life-threatening arrhythmia after he resumed loperamide abuse. Loperamide levels were obtained in 4 of the 5 patients and were at least one order of magnitude greater than therapeutic concentrations. Discontinuation of loperamide resulted in complete resolution of cardiac conduction disturbances. This case series describes several patients with cardiac conduction abnormalities and life-threatening ventricular arrhythmias temporally related to loperamide abuse. With the recent efforts to restrict the diversion of prescription opioids, increasing abuse of loperamide as an opioid substitute may be seen. Toxicologists should be aware of these risks and we urge all clinicians to report such cases to FDA Medwatch(®).
Pregnancy and Electroconvulsive Therapy: A Multidisciplinary Approach
Ray-Griffith, Shona L.; Coker, Jessica L.; Rabie, Nader; Eads, Lou Ann; Golden, Kimberly J.; Stowe, Zachary N.
2016-01-01
Objective To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine this data with a literature review to refine the treatment guidelines for ECT during pregnancy. Methods A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women’s mental health program. Results A total of eight pregnant women treated with ECT were identified from 01/2012–08/2014. Information was extracted from the medical record from a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range 1–7). All women were diagnosed with a mood disorder (either unipolar or bipolar), and five of the eight women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications following the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania following ECT. Obstetrical complications included two women with pre-term delivery – one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The five women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in six of the eight women. Conclusions Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation. PMID:26796501
External bioresorbable airway rigidification to treat refractory localized tracheomalacia.
Gorostidi, François; Reinhard, Antoine; Monnier, Philippe; Sandu, Kishore
2016-11-01
Our study evaluates the efficacy of extraluminal bioresorbable plates to treat refractory localized airway malacia in patients undergoing corrective surgery for complex multilevel laryngotracheal stenosis. Retrospective case series. Secondary malacic airway segments were characterized (severity, site, type) by a dynamic transnasal flexible laryngotracheobronchoscopy before surgery. Extraluminal bioresorbable plates were used to stabilize the malacic segment through a transcervical approach under intraoperative flexible endoscopic guidance. Results were evaluated subjectively and by a postoperative dynamic endoscopy. We report our experience in seven patients (6 children, 1 adult). External tracheal stiffening allowed complete or partial resolution of refractory proximal airway malacia in six of seven complex cases described (result in one case is awaited). It allowed quick decannulation in four of seven patients who experienced multiple previous failures. Decannulation failures were due to recurrence of stenosis. With up to 2 years of follow-up, we report no direct complications related to the presence of extraluminal bioresorbable plates around the airway. Extraluminal biodegradable tracheal stiffening represents a valid therapeutic option in select cases of upper airway malacia. It can be highly useful in cases of complex multilevel airway obstructions. External stiffening needs to be planned on a case-to-case basis according to the type of malacia and must be performed under endoscopic guidance. 4. Laryngoscope, 126:2605-2610, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
A compact high-speed mechanical sample shuttle for field-dependent high-resolution solution NMR.
Chou, Ching-Yu; Chu, Minglee; Chang, Chi-Fon; Huang, Tai-Huang
2012-01-01
Analysis of NMR relaxation data has provided significant insight on molecular dynamic, leading to a more comprehensive understanding of macromolecular functions. However, traditional methodology allows relaxation measurements performed only at a few fixed high fields, thus severely restricting their potential for extracting more complete dynamic information. Here we report the design and performance of a compact high-speed servo-mechanical shuttle assembly adapted to a commercial 600 MHz high-field superconducting magnet. The assembly is capable of shuttling the sample in a regular NMR tube from the center of the magnet to the top (fringe field ∼0.01 T) in 100 ms with no loss of sensitivity other than that due to intrinsic relaxation. The shuttle device can be installed by a single experienced user in 30 min. Excellent 2D-(15)N-HSQC spectra of (u-(13)C, (15)N)-ubiquitin with relaxation at low fields (3.77 T) and detection at 14.1T were obtained to illustrate its utility in R(1) measurements of macromolecules at low fields. Field-dependent (13)C-R(1) data of (3,3,3-d)-alanine at various field strengths were determined and analyzed to assess CSA and (1)H-(13)C dipolar contributions to the carboxyl (13)C-R(1). Copyright © 2011 Elsevier Inc. All rights reserved.
Amos, Kate; Yeoh, Sue-Ching; Farah, Camile S
2011-01-01
To evaluate retrospectively the efficacy of administering an anticonvulsant medication, clonazepam, by dissolving tablets slowly orally before swallowing, for the management of burning mouth syndrome (BMS). A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2006 and June 2009. Patients were prescribed 0.5 mg clonazepam three times daily, and changes were made to this regimen based on their individual response. Patients were asked to dissolve the tablet orally before swallowing and were reviewed over a 6-month period. Pain was assessed by patients on an 11-point numerical scale (0 to 10). A nonparametric (Spearman) two-tailed correlation matrix and a two-tailed Mann-Whitney test were performed. A total of 36 patients (27 women, 9 men) met the criteria for inclusion. The mean (± SEM) pain score reduction between pretreatment and final appointment was 4.7 ± 0.4 points. A large percentage (80%) of patients obtained more than a 50% reduction in pain over the treatment period. One patient reported no reduction in pain symptoms, and one third of the patients had complete pain resolution. Approximately one third of patients experienced side effects that were transient and mild. This pilot study provides preliminary evidence that the novel protocol of combined topical and systemic clonazepam administration provides an effective BMS management tool.
Pain management in Guillain-Barre syndrome: a systematic review.
Peña, L; Moreno, C B; Gutierrez-Alvarez, A M
2015-09-01
Pain is a common symptom in patients with Guillain-Barre syndrome. Intensity is moderate to severe in most cases and pain may persist after resolution of the disease. Identify the most appropriate analgesic therapy for pain management in patients with Guillain-Barre syndrome. Systematic review and selection of scientific articles on treatment of pain in Guillain-Barre syndrome patients, published between January 1985 and December 2012. We included only randomised, double-blind, controlled trials assessing the effectiveness of drugs for pain management in these patients. Four articles met the inclusion criteria. One evaluated the use of gabapentin, another evaluated carbamazepine, a third compared gabapentin to carbamazepine, and the last evaluated use of methylprednisolone. Both carbamazepine and gabapentin were useful for pain management. Patients experienced lower-intensity pain with gabapentin treatment in the study comparing that drug to carbamazepine. Methylprednisolone was not shown to be effective for reducing pain. The published data did not permit completion of a meta-analysis. There is no robust evidence at present that would point to a single treatment option for this disorder. Further clinical studies of larger patient samples and with a longer duration are needed to characterise types of pain for each patient and measure pain intensity in an objective way. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.
Jacoby, Ann; Lane, Steven; Marson, Anthony; Baker, Gus A
2011-05-01
We defined a series of clinical trajectories represented among adult patients with new-onset seizures across a 4-year follow-up period; and linked these clinical trajectories to the quality of life (QOL) profiles and trajectories of those experiencing them. We examined both between- and within-group differences. Analyses were based on 253 individuals completing QOL questionnaires at baseline and 2 and 4 years subsequently. Based on patient self-report, we defined five "clinical trajectory" groups: individuals experiencing a single seizure only; individuals entering early remission; individuals experiencing late remission; individuals initially becoming seizure-free but subsequently relapsing; individuals with seizures persisting throughout follow-up. QOL profiles at each time point were compared using a validated QOL battery, NEWQOL. Even at baseline, there were significant between-group differences, with patients experiencing a single seizure only reporting the best QOL profile and those with seizures subsequently persisting across all time points reporting the worst. By 2 years, the QOL profiles of individuals experiencing early remission were similar to those of single seizure patients, as were those for late remission and relapse patients. A consistent pattern was seen, with "single seizure" individuals doing best and individuals with persistent seizures doing worst. Of particular concern is that even at baseline, individuals whose seizures persisted were doing poorly for QOL, suggesting the possibility that underlying neurobiologic mechanisms were operating. In contrast, our findings support previous reports of only short-lived and small QOL decrements for individuals experiencing a single or few seizures. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.
[Anti-emetic effect of granisetron in patients undergoing cranial and craniospinal radiotherapy].
Yamasaki, Fumiyuki; Watanabe, Yosuke; Nosaka, Ryo; Kenjo, Masahiro; Nakamura, Kazuhiro; Takayasu, Takeshi; Saito, Taiichi; Tominaga, Atsushi; Sugiyama, Kazuhiko; Kurisu, Kaoru
2014-01-01
Approximately 30-59% of patients undergoing cranial or craniospinal radiotherapy experience nausea and/or vomiting. Here, we evaluated the effectiveness of granisetron for controlling emesis in patients treated with cranial or craniospinal radiotherapy. Between December 2011 and January 2013, 34 patients(19 males, 15 females;age range, 3-80 years)received cranial or craniospinal radiotherapy at our department. All but one male patient, who developed meningitis during the irradiation period were enrolled in this retrospective study. Patients who experienced irradiation-induced vomiting(grade 1)or nausea(grade 2)were treated with granisetron as a rescue anti-emetic. Episodes were graded as(1)no vomiting, no nausea, no anti-emetic;(2)no vomiting, nausea, no anti-emetic;(3)no vomiting, nausea with anti-emetic;and(4)vomiting. Of the 9 patients who underwent whole-brain or whole neural-axis irradiation, 5(55.6%)experienced grade 2 nausea or vomiting. Two of 6 patients(33.3%)treated with whole ventricle irradiation experienced grade 2 nausea or vomiting. Three of 18 patients(16.7%)who underwent local-field irradiation experienced grade 2 nausea or vomiting. Patients who underwent wide-field irradiation experienced nausea, vomiting, and anorexia(p<0.05). Complete response(no vomiting, no additional rescue anti-emetic, and no nausea)was observed in 5 of 9 patients treated with granisetron. Four of 9 patients(44.4%)treated with granisetron experienced constipation(grade 1 or 2);its administration had no major adverse effects in our study population. Rescue therapy with granisetron is safe and effective to treat nausea and vomiting in patients subjected to cranial or craniospinal irradiation.
[Professional Development Processes of Trainee and Experienced Psychotherapists in Turkey].
Bilican, F Işıl; Soygüt, Gonca
2015-01-01
This study explored professional characteristics of psychotherapists in Turkey, examined the changes in their professional developmental processes, and compared the professional characteristics of the trainees and experienced therapists. The participants were 88 psychotherapists, including trainee (N=37) and experienced (N=51) psychotherapists in Turkey. They completed the Development of Psychotherapists International Study-Common Core Questionnaire (DPCCQ), developed by the Collaborative Research Network. The participants identified with the cognitive theoretical orientation most often. 30% of the participants had more than two salient orientations. The most prevalent therapy modality was individual, followed by couples, family, and group psychotherapy. Ongoing supervision rate was 44%. Trainees scored lower on effectiveness in engaging patients in a working alliance, feeling natural while working with patients, effectiveness in communicating their understanding and concern to their patients, and feeling confident in their role as a therapist. Experienced therapists made changes in the therapeutic contract and invited collaboration from families more compared to the trainees. 63% of the variance in Healing Involvement was explained by Overall Career Development, Currently Experienced Growth, being influenced by the humanistic approach, and the impact of the main therapeutic environment; 26% of the variance in Stressful Involvement was explained by the length of official supervision received and having control over the length of therapy sessions. Therapists were more cognitively oriented, less eclectic, and had less supervision compared to their international counterparts. Experienced therapists were more flexible, natural, and confident than the trainees. Supervision, a supportive work environment, the humanistic approach, and investing in career development were essential to providing a healing experience.
Mental health-related discrimination as a predictor of low engagement with mental health services.
Clement, Sarah; Williams, Paul; Farrelly, Simone; Hatch, Stephani L; Schauman, Oliver; Jeffery, Debra; Henderson, R Claire; Thornicroft, Graham
2015-02-01
This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.
The War Powers Resolution: After Thirty-Eight Years
2012-09-24
military forces to action in Yugoslavia without congressional authorization, Representative Tom Campbell used expedited procedures under the...Resolution to force a debate and votes on U.S. military action in Yugoslavia, and later sought, unsuccessfully, through a federal court suit to enforce...this case the military action was completed and U.S. armed forces had disengaged from the area of conflict when the report was made. The reports
Spontaneous Resolution of Massive Spontaneous Tubercular Pneumothorax
Kant, Surya; Saheer, S.; Hassan, G.; Parengal, Jabeed
2011-01-01
A 29-year-old female presented with complaints of fever and productive cough of three weeks duration. Pulmonary tuberculosis was diagnosed bacteriologically and she was prescribed antituberculosis drugs. During follow-up she developed massive pneumothorax, for which patient refused surgical management and was managed conservatively. After six months there was complete spontaneous resolution of pneumothorax. The unusual presentation and unexpected outcome prompted us to report this case. PMID:22937428
Video Completion in Digital Stabilization Task Using Pseudo-Panoramic Technique
NASA Astrophysics Data System (ADS)
Favorskaya, M. N.; Buryachenko, V. V.; Zotin, A. G.; Pakhirka, A. I.
2017-05-01
Video completion is a necessary stage after stabilization of a non-stationary video sequence, if it is desirable to make the resolution of the stabilized frames equalled the resolution of the original frames. Usually the cropped stabilized frames lose 10-20% of area that means the worse visibility of the reconstructed scenes. The extension of a view of field may appear due to the pan-tilt-zoom unwanted camera movement. Our approach deals with a preparing of pseudo-panoramic key frame during a stabilization stage as a pre-processing step for the following inpainting. It is based on a multi-layered representation of each frame including the background and objects, moving differently. The proposed algorithm involves four steps, such as the background completion, local motion inpainting, local warping, and seamless blending. Our experiments show that a necessity of a seamless stitching occurs often than a local warping step. Therefore, a seamless blending was investigated in details including four main categories, such as feathering-based, pyramid-based, gradient-based, and optimal seam-based blending.
Meeyai, Aronrag; Cooper, Ben S; Coker, Richard
2013-01-01
Objective To describe changes in reported influenza activity associated with the 2009 H1N1 pandemic in European countries and determine whether there is a correlation between these changes and completeness of national strategic pandemic preparedness. Design A retrospective correlational study. Setting Countries were included if their national strategic plans had previously been analysed and if weekly influenza-like illness (ILI) data from sentinel networks between week 21, 2006 and week 20, 2010 were more than 50% complete. Outcome measures For each country we calculated three outcomes: the percentage change in ILI peak height during the pandemic relative to the prepandemic mean; the timing of the ILI peak and the percentage change in total cases relative to the prepandemic mean. Correlations between these outcomes and completeness of a country's national strategic pandemic preparedness plan were assessed using the Pearson product–moment correlation coefficient. Results Nineteen countries were included. The ILI peak occurred earlier than the mean seasonal peak in 17 countries. In 14 countries the pandemic peak was higher than the seasonal peak, though the difference was large only in Norway, the UK and Greece. Nine countries experienced more total ILI cases during the pandemic compared with the mean for prepandemic years. Five countries experienced two distinct pandemic peaks. There was no clear pattern of correlation between overall completeness of national strategic plans and pandemic influenza outcome measures and no evidence of association between these outcomes and components of pandemic plans that might plausibly affect influenza outcomes (public health interventions, vaccination, antiviral use, public communication). Amongst the 17 countries with a clear pandemic peak, only the correlation between planning for essential services and change in total ILI cases significantly differed from zero: correlation coefficient (95% CI) 0.50 (0.02, 0.79). Conclusions The diversity of pandemic influenza outcomes across Europe is not explained by the marked variation in the completeness of pandemic plans. PMID:23524042
Incapacitated and forcible rape of college women: prevalence across the first year.
Carey, Kate B; Durney, Sarah E; Shepardson, Robyn L; Carey, Michael P
2015-06-01
The purpose of this study was to document the point and cumulative prevalence of incapacitated rape (IR) and forcible rape (FR) among first-year college women. Female students (N = 483) completed a health questionnaire (1) on arrival on campus; (2) at the end of the fall semester; (3) at the end of the spring semester; and (4) at the end of the summer following their first year of college. Before entering college, 18% reported IR (attempted and/or completed), and 15% reported FR (attempted and/or completed). During the first year of college, 15% reported IR (attempted or completed) and 9% reported FR (attempted or completed). By the start of the second year (lifetime prevalence), 26% and 22% had experienced IR and FR (attempted or completed), respectively. Both incapacitated and forcible sexual assaults and rape have reached epidemic levels among college women. Interventions to address sexual violence on campus are urgently needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Rose, Anne C
2011-11-01
A sharp and personal polemical style characterized psychology as a new human science in American universities at the turn of the 20th century. When the experimental pursuit of truth about the mind produced quarreling rather than clarity, psychologists experienced a crisis of confidence. One solution was rhetorical: the use of a disclaimer that all current knowledge was rudimentary and a call for further research to end contention. The wording established a public tone of modesty and fostered collegiality. Scientific disagreements and underlying personal tensions remained, but conventional phrases promising future resolution of disputes contributed to a language of good manners and thereby facilitated debate. Nonetheless, the verbal formula of deferred hopes also made uncertainty seem normative. Confessions of tentativeness helped lay a historical foundation for routine investigation in psychology, but emphasis on incompleteness as an explanation of discord also made experimentation seem perpetual and truth elusive.