[An old woman with sudden pareses and blindness].

PubMed

Arntzen, Kjell Arne; Albretsen, Claus; Bajic, Radoslav

2007-03-01

We present a patient with Posterior Reversible Encephalopathy Syndrome (PRES). A 74-year-old woman was admitted with sepsis, which originated from erysipelas on her neck the following day. She developed respiratory obstruction due to oedema, septic shock, disseminated intravascular coagulation (DIC), acute renal failure and atrial fibrillation. She responded well to treatment and improved rapidly, despite of her serious condition. When she had almost fully recovered after 15 days, her general condition worsened, and she developed confusion, blindness and pareses. MRI showed vasogenic oedema in the parietooccipital regions of the brain and in the cerebellum, consistent with PRES. PRES is a clinical and radiological diagnosis consisting of headache, confusion, cortical blindness, convulsions and sometimes pareses. MRI of the cerebrum with diffusion-weighted imaging (DWI) and Apparent Diffusion Coefficient (ADC) map are decisive to the diagnosis, and usually shows a characteristic bilateral vasogenic oedema in the parietooccipital region. This can distinguish PRES from brain infarction, which shows a cytotoxic oedema on MRI. We discuss our patient in the light of different conditions leading to PRES, possible pathophysiological factors and treatment options.

Anharmonic Rovibrational Partition Functions for Fluxional Species at High Temperatures via Monte Carlo Phase Space Integrals

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

Jasper, Ahren W.; Gruey, Zackery B.; Harding, Lawrence B.

Monte Carlo phase space integration (MCPSI) is used to compute full dimensional and fully anharmonic, but classical, rovibrational partition functions for 22 small- and medium-sized molecules and radicals. Several of the species considered here feature multiple minima and low-frequency nonlocal motions, and efficiently sampling these systems is facilitated using curvilinear (stretch, bend, and torsion) coordinates. The curvilinear coordinate MCPSI method is demonstrated to be applicable to the treatment of fluxional species with complex rovibrational structures and as many as 21 fully coupled rovibrational degrees of freedom. Trends in the computed anharmonicity corrections are discussed. For many systems, rovibrational anharmonicities atmore » elevated temperatures are shown to vary consistently with the number of degrees of freedom and with temperature once rovibrational coupling and torsional anharmonicity are accounted for. Larger corrections are found for systems with complex vibrational structures, such as systems with multiple large-amplitude modes and/or multiple minima.« less

The consistency of positive fully fuzzy linear system

NASA Astrophysics Data System (ADS)

Malkawi, Ghassan O.; Alfifi, Hassan Y.

2017-11-01

In this paper, the consistency of fuzziness of positive solution of the n × n fully fuzzy linear system (P - FFLS) is studied based on its associated linear system (P - ALS). That can consist of the whole entries of triangular fuzzy numbers in a linear system without fuzzy operations. The nature of solution is differentiated in case of fuzzy solution, non-fuzzy solution and fuzzy non-positive solution. Moreover, the analysis reveals that the P - ALS is applicable to provide the set of infinite number of solutions. Numerical examples are presented to illustrate the proposed analysis.

A predictive Bayesian approach to the design and analysis of bridging studies.

PubMed

Gould, A Lawrence; Jin, Tian; Zhang, Li Xin; Wang, William W B

2012-09-01

Pharmaceutical product development culminates in confirmatory trials whose evidence for the product's efficacy and safety supports regulatory approval for marketing. Regulatory agencies in countries whose patients were not included in the confirmatory trials often require confirmation of efficacy and safety in their patient populations, which may be accomplished by carrying out bridging studies to establish consistency for local patients of the effects demonstrated by the original trials. This article describes and illustrates an approach for designing and analyzing bridging studies that fully incorporates the information provided by the original trials. The approach determines probability contours or regions of joint predictive intervals for treatment effect and response variability, or endpoints of treatment effect confidence intervals, that are functions of the findings from the original trials, the sample sizes for the bridging studies, and possible deviations from complete consistency with the original trials. The bridging studies are judged consistent with the original trials if their findings fall within the probability contours or regions. Regulatory considerations determine the region definitions and appropriate probability levels. Producer and consumer risks provide a way to assess alternative region and probability choices. [Supplemental materials are available for this article. Go to the Publisher's online edition of the Journal of Biopharmaceutical Statistics for the following free supplemental resource: Appendix 2: R code for Calculations.].

A Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant

PubMed Central

Lefebvre, Philippe P.; Gisbert, Javier; Cuda, Domenico; Tringali, Stéphane; Deveze, Arnaud

2017-01-01

Objective To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement. Study Design Multicentre retrospective, observational survey. Setting Five tertiary referral centres. Patients Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer. Methods Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised. Results The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference. Conclusion Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible. PMID:28052264

Low intensity laser therapy: the clinical approach

NASA Astrophysics Data System (ADS)

Kahn, Fred

2006-02-01

Recently, there has been significant improvement in the process of research and application of Low Intensity Laser Therapy (LILT). Despite this positive direction, a wide discrepancy between the research component and clinical understanding of the technology remains. In our efforts to achieve better clinical results and more fully comprehend the mechanisms of interaction between light and cells, further studies are required. The clinical results presented in this paper are extrapolated from a wide range of musculoskeletal problems including degenerative osteoarthritis, repetitive motion injuries, sports injuries, etc. The paper includes three separate clinical studies comprising 151, 286 and 576 consecutive patient discharges at our clinic. Each patient studied received a specific course of treatment that was designed for that individual and was modified on a continuing basis as the healing process advanced. On each visit, clinical status correlation with the duration, dosage and other parameters was carried out. The essentials of the treatment consisted of a three stage approach. This involved a photon stream emanating from a number of specified gallium-aluminum-arsenide diodes; stage one, red light array, stage two consisting of an array of infrared diodes and stage three consisting of the application of an infrared laser diode probe. On average, each of these groups required less than 10 treatments per patient and resulted in a significant improvement / cure rate greater than 90% in all conditions treated. This report clearly demonstrates the benefits of LILT, indicating that it should be more widely adapted in all medical therapeutic settings.

Monte Carlo simulations in radiotherapy dosimetry.

PubMed

Andreo, Pedro

2018-06-27

The use of the Monte Carlo (MC) method in radiotherapy dosimetry has increased almost exponentially in the last decades. Its widespread use in the field has converted this computer simulation technique in a common tool for reference and treatment planning dosimetry calculations. This work reviews the different MC calculations made on dosimetric quantities, like stopping-power ratios and perturbation correction factors required for reference ionization chamber dosimetry, as well as the fully realistic MC simulations currently available on clinical accelerators, detectors and patient treatment planning. Issues are raised that include the necessity for consistency in the data throughout the entire dosimetry chain in reference dosimetry, and how Bragg-Gray theory breaks down for small photon fields. Both aspects are less critical for MC treatment planning applications, but there are important constraints like tissue characterization and its patient-to-patient variability, which together with the conversion between dose-to-water and dose-to-tissue, are analysed in detail. Although these constraints are common to all methods and algorithms used in different types of treatment planning systems, they make uncertainties involved in MC treatment planning to still remain "uncertain".

Purification and characterization of two fully deuterated enzymes

NASA Technical Reports Server (NTRS)

Crespi, H. L.; Katz, J. J.; Parmerter, S.; Rokop, S.

1969-01-01

Comparative data reveal little difference between kinetic and thermal stabilities of pure preparations of two ordinary enzymes and their fully deuterated counterparts. The effects of temperature on the enzymes proved to be consistent with earlier results.

Molecular dynamics study of intermediate phase of long chain alkyl sulfonate/water systems.

PubMed

Poghosyan, Armen H; Arsenyan, Levon H; Shahinyan, Aram A

2013-01-08

Using atomic level simulation we aimed to investigate various intermediate phases of the long chain alkyl sulfonate/water system. Overall, about 800 ns parallel molecular dynamics simulation study was conducted for a surfactant/water system consisting of 128 sodium pentadecyl sulfonate and 2251 water molecules. The GROMACS software code with united atom force field was applied. Despite some differences, the analysis of main structural parameters is in agreement with X-ray experimental findings. The mechanism of self-assembly of SPDS molecules was also examined. At T = 323 K we obtained both tilted fully interdigitated and liquid crystalline-like disordered hydrocarbon chains; hence, the presence of either gel phase that coexists with a lamellar phase or metastable gel phase with fraction of gauche configuration can be assumed. Further increase of temperature revealed that the system underwent a transition to a lamellar phase, which was clearly identified by the presence of fully disordered hydrocarbon chains. The transition from gel-to-fluid phase was implemented by simulated annealing treatment, and the phase transition point at T = 335 K was identified. The surfactant force field in its presented set is surely enabled to fully demonstrate the mechanism of self-assembly and the behavior of phase transition making it possible to get important information around the phase transition point.

Long-read sequencing of nascent RNA reveals coupling among RNA processing events.

PubMed

Herzel, Lydia; Straube, Korinna; Neugebauer, Karla M

2018-06-14

Pre-mRNA splicing is accomplished by the spliceosome, a megadalton complex that assembles de novo on each intron. Because spliceosome assembly and catalysis occur cotranscriptionally, we hypothesized that introns are removed in the order of their transcription in genomes dominated by constitutive splicing. Remarkably little is known about splicing order and the regulatory potential of nascent transcript remodeling by splicing, due to the limitations of existing methods that focus on analysis of mature splicing products (mRNAs) rather than substrates and intermediates. Here, we overcome this obstacle through long-read RNA sequencing of nascent, multi-intron transcripts in the fission yeast Schizosaccharomyces pombe Most multi-intron transcripts were fully spliced, consistent with rapid cotranscriptional splicing. However, an unexpectedly high proportion of transcripts were either fully spliced or fully unspliced, suggesting that splicing of any given intron is dependent on the splicing status of other introns in the transcript. Supporting this, mild inhibition of splicing by a temperature-sensitive mutation in prp2 , the homolog of vertebrate U2AF65, increased the frequency of fully unspliced transcripts. Importantly, fully unspliced transcripts displayed transcriptional read-through at the polyA site and were degraded cotranscriptionally by the nuclear exosome. Finally, we show that cellular mRNA levels were reduced in genes with a high number of unspliced nascent transcripts during caffeine treatment, showing regulatory significance of cotranscriptional splicing. Therefore, overall splicing of individual nascent transcripts, 3' end formation, and mRNA half-life depend on the splicing status of neighboring introns, suggesting crosstalk among spliceosomes and the polyA cleavage machinery during transcription elongation. © 2018 Herzel et al.; Published by Cold Spring Harbor Laboratory Press.

A selection model for accounting for publication bias in a full network meta-analysis.

PubMed

Mavridis, Dimitris; Welton, Nicky J; Sutton, Alex; Salanti, Georgia

2014-12-30

Copas and Shi suggested a selection model to explore the potential impact of publication bias via sensitivity analysis based on assumptions for the probability of publication of trials conditional on the precision of their results. Chootrakool et al. extended this model to three-arm trials but did not fully account for the implications of the consistency assumption, and their model is difficult to generalize for complex network structures with more than three treatments. Fitting these selection models within a frequentist setting requires maximization of a complex likelihood function, and identification problems are common. We have previously presented a Bayesian implementation of the selection model when multiple treatments are compared with a common reference treatment. We now present a general model suitable for complex, full network meta-analysis that accounts for consistency when adjusting results for publication bias. We developed a design-by-treatment selection model to describe the mechanism by which studies with different designs (sets of treatments compared in a trial) and precision may be selected for publication. We fit the model in a Bayesian setting because it avoids the numerical problems encountered in the frequentist setting, it is generalizable with respect to the number of treatments and study arms, and it provides a flexible framework for sensitivity analysis using external knowledge. Our model accounts for the additional uncertainty arising from publication bias more successfully compared to the standard Copas model or its previous extensions. We illustrate the methodology using a published triangular network for the failure of vascular graft or arterial patency. Copyright © 2014 John Wiley & Sons, Ltd.

Vasospasm is a significant factor in cyclosporine-induced neurotoxicity: case report.

PubMed

Braakman, Hilde M H; Lodder, Jan; Postma, Alida A; Span, Lambert F R; Mess, Werner H

2010-05-11

The aetiology of central nervous system lesions observed in cerebral cyclosporine neurotoxicity remains controversial. We report a 48-year-old woman with a non-severe aplastic anaemia who presented with stroke-like episodes while on cyclosporine treatment.Transcranial Doppler ultrasound revealed severely elevated flow velocities in several cerebral vessels, consistent with vasospasm. Immediately after reducing the cyclosporine dose, the stroke-like episodes disappeared. Only after cyclosporine withdrawal the transcranial Doppler ultrasound abnormalities fully resolved. This case demonstrates a significant role of vasospasm in the pathway of cyclosporine-induced neurotoxicity. Transcranial Doppler ultrasound is an effective tool for the diagnosis and follow-up of cyclosporine-induced vasospasm.

[Prevention of cardiovascular diseases].

PubMed

Prochaska, J H; Arnold, N; Jünger, C; Münzel, T; Wild, P S

2018-02-01

The incidence of cardiovascular diseases can be reduced by the early detection and targeted treatment of risk factors and subclinical forms of the disease. Primary prevention provides several opportunities for successful interventions. In addition to a drug-based therapy, especially life style-modifying measures, such as physical activity, normalization of body weight, consistent nicotine abstinence and the consideration of psychosocial aspects represent core components of prevention programs. Healthcare data indicate that risk factors still often remain undetected and that the full potential of risk factor management has not yet been fully exploited at a population level. Especially motivation of patients and adherence to therapy represent key elements of successful prevention efforts.

Constrained fixed-fulcrum reverse shoulder arthroplasty improves functional outcome in epileptic patients with recurrent shoulder instability

PubMed Central

Thangarajah, Tanujan; Higgs, Deborah; Bayley, J I L; Lambert, Simon M

2016-01-01

AIM: To report the results of fixed-fulcrum fully constrained reverse shoulder arthroplasty for the treatment of recurrent shoulder instability in patients with epilepsy. METHODS: A retrospective review was conducted at a single facility. Cases were identified using a computerized database and all clinic notes and operative reports were reviewed. All patients with epilepsy and recurrent shoulder instability were included for study. Between July 2003 and August 2011 five shoulders in five consecutive patients with epilepsy underwent fixed-fulcrum fully constrained reverse shoulder arthroplasty for recurrent anterior shoulder instability. The mean duration of epilepsy in the cohort was 21 years (range, 5-51) and all patients suffered from grand mal seizures. RESULTS: Mean age at the time of surgery was 47 years (range, 32-64). The cohort consisted of four males and one female. Mean follow-up was 4.7 years (range, 4.3-5 years). There were no further episodes of instability, and no further stabilisation or revision procedures were performed. The mean Oxford shoulder instability score improved from 8 preoperatively (range, 5-15) to 30 postoperatively (range, 16-37) (P = 0.015) and the mean subjective shoulder value improved from 20 (range, 0-50) preoperatively to 60 (range, 50-70) postoperatively (P = 0.016). Mean active forward elevation improved from 71° preoperatively (range, 45°-130°) to 100° postoperatively (range, 80°-90°) and mean active external rotation improved from 15° preoperatively (range, 0°-30°) to 40° (20°-70°) postoperatively. No cases of scapular notching or loosening were noted. CONCLUSION: Fixed-fulcrum fully constrained reverse shoulder arthroplasty should be considered for the treatment of recurrent shoulder instability in patients with epilepsy. PMID:27458554

Comparison of a fully mapped plot design to three alternative designs for volume and area estimates using Maine inventory data

Treesearch

Stanford L. Arner

1998-01-01

A fully mapped plot design is compared to three alternative designs using data collected for the recent inventory of Maine's forest resources. Like the fully mapped design, one alternative eliminates the bias of previous procedures, and should be less costly and more consistent. There was little difference in volume and area estimates or in sampling errors among...

Can gastritis symptoms be evaluated in clinical trials? An overview of treatment of gastritis, nonulcer dyspepsia and Campylobacter-associated gastritis.

PubMed

Veldhuyzen van Zanten, S J; Tytgat, K M; Jalali, S; Goodacre, R L; Hunt, R H

1989-10-01

We carried out a review of the literature on Campylobacter pylori-associated gastritis and nonulcer dyspepsia (NUD) to determine whether or not symptoms related to these conditions can be measured reliably and whether or not any study to date has shown that treatment alters symptoms. Search strategies consisted of online Medline searching, a forward search of three articles using the Science Citation Index, a manual search of five gastroenterological journals, and a fully recursive search of cited references. Inclusion and quality criteria were applied to all retrieved studies. Nine of 23 studies did not fulfill the inclusion criteria. Of the 14 studies analyzed, two measured symptoms reliably. Neither showed a therapeutic benefit on symptoms. The difficulties encountered in conducting such studies and the methods of recording symptoms reliably are discussed. We conclude that to date, no treatment is of proven benefit in the relief of symptoms associated with C. pylori gastritis and NUD.

Mediation of symptom changes during inpatient treatment for eating disorders: the role of obsessive-compulsive features.

PubMed

Olatunji, Bunmi O; Tart, Candyce D; Shewmaker, Shona; Wall, David; Smits, Jasper A J

2010-10-01

The present study examined the relative contributions of changes in obsessive-compulsive symptoms among eating-disorder patients with (n = 254) and without (n = 254) obsessive-compulsive disorder (OCD) to eating-disorder symptom improvement observed with inpatient treatment. Consistent with hypothesis, multilevel mediation analyses revealed that improvements in OCD symptoms over time accounted for significant variance in the improvements in eating-disorder symptoms over time, with stronger mediation evident among eating-disorder patients with comorbid OCD (percent mediated; P(M) = 22.5%) compared to those without OCD (P(M) = 12.2%). However, decreases in eating-disorder symptoms over time fully mediated improvements in OCD symptoms over time, and this mediated pathway did not vary substantially as a function of comorbid OCD status. The theoretical and treatment implications of these findings for conceptualizing the relationship between eating disorders and OCD are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Fully covered stents versus partially covered stents for palliative treatment of esophageal cancer: Is there a difference?

PubMed

Alonso Lárraga, J O; Flores Carmona, D Y; Hernández Guerrero, A; Ramírez Solís, M E; de la Mora Levy, J G; Sánchez Del Monte, J C

2018-02-26

Malignant dysphagia is difficulty swallowing resulting from esophageal obstruction due to cancer. The goal of palliative treatment is to reduce the dysphagia and improve oral dietary intake. Self-expandable metallic stents are the current treatment of choice, given that they enable the immediate restoration of oral intake. The aim of the present study was to describe the results of using totally covered and partially covered esophageal stents for palliating esophageal cancer. A retrospective study was conducted on patients with inoperable esophageal cancer treated with self-expandable metallic stents. The 2 groups formed were: group A, which consisted of patients with a fully covered self-expandable stent (SX-ELLA ® ), and group B, which was made up of patients with a partially covered self-expandable stent (Ultraflex ® ). Of the 69-patient total, 50 were included in the study. Group A had 19 men and 2 women and their mean age was 63.6 years (range 41-84). Technical success was achieved in 100% (n=21) of the cases and clinical success in 90.4% (n=19). Group B had 24 men and 5 women and their mean age was 67.5 years (range 43-92). Technical success was achieved in 100% (n=29) of the cases and clinical success in 89.6% (n=26). Complications were similar in both groups (33.3 vs. 51.7%). There was no difference between the 2 types of stent for the palliative treatment of esophageal cancer with respect to technical success, clinical success, or complications. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Surgical treatment for medically refractory focal epilepsy in a patient with fragile X syndrome.

PubMed

Kenmuir, Cynthia; Richardson, Mark; Ghearing, Gena

2015-10-01

Medication resistant temporal lobe epilepsy occurs in a small population of patients with fragile X syndrome. We present the case of a 24-year-old man with medically refractory temporal lobe epilepsy and fragile X syndrome who underwent left anterior temporal lobectomy resulting in cessation of seizures. Our patient was diagnosed with fragile X syndrome with a fully mutated, fully methylated FMR1 gene resulting in 572 CGG repeats. He developed seizures initially controlled with Depakote monotherapy, but progressed to become medically refractive to combination treatment with Depakote, lamotrigine and zonisamide. Prolonged video EEG monitoring revealed interictal left temporal sharp waves and slowing as well as subclinical and clinical seizures, each with left temporal onset. 3T MRI was consistent with left mesial temporal sclerosis. After discussing the case in our multidisciplinary surgical epilepsy conference, he was referred for presurgical evaluation including neuropsychological testing and Wada testing. He underwent an asleep left anterior temporal lobectomy, sparing the superior temporal gyrus. Pathology showed neuronal loss and gliosis in the hippocampus and amygdala. Twelve months after surgery, the patient has not experienced a seizure. He is described by his parents as less perseverative and less restless. We have presented the case of a 24 year-old-man with fragile X syndrome who underwent successful left anterior temporal lobectomy for the treatment of medically refractory epilepsy who is now seizure free without further functional impairment. This case report demonstrates the feasibility of surgical treatment for a patient with comorbid fragile X syndrome and mesial temporal sclerosis. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Methylmercury-induced alterations in astrocyte functions are attenuated by ebselen.

PubMed

Yin, Zhaobao; Lee, Eunsook; Ni, Mingwei; Jiang, Haiyan; Milatovic, Dejan; Rongzhu, Lu; Farina, Marcelo; Rocha, Joao B T; Aschner, Michael

2011-06-01

Methylmercury (MeHg) preferentially accumulates in glia of the central nervous system (CNS), but its toxic mechanisms have yet to be fully recognized. In the present study, we tested the hypothesis that MeHg induces neurotoxicity via oxidative stress mechanisms, and that these effects are attenuated by the antioxidant, ebselen. Rat neonatal primary cortical astrocytes were pretreated with or without 10 μM ebselen for 2h followed by MeHg (0, 1, 5, and 10 μM) treatments. MeHg-induced changes in astrocytic [(3)H]-glutamine uptake were assessed along with changes in mitochondrial membrane potential (ΔΨ(m)), using the potentiometric dye tetramethylrhodamine ethyl ester (TMRE). Western blot analysis was used to detect MeHg-induced ERK (extracellular-signal related kinase) phosphorylation and caspase-3 activation. MeHg treatment significantly decreased (p<0.05) astrocytic [(3)H]-glutamine uptake at all time points and concentrations. Ebselen fully reversed MeHg's (1 μM) effect on [(3)H]-glutamine uptake at 1 min. At higher MeHg concentrations, ebselen partially reversed the MeHg-induced astrocytic inhibition of [(3)H]-glutamine uptake [at 1 min (5 and 10 μM) (p<0.05); 5 min (1, 5 and 10 μM) (p<0.05)]. MeHg treatment (1h) significantly (p<0.05) dissipated the ΔΨ(m) in astrocytes as evidenced by a decrease in mitochondrial TMRE fluorescence. Ebselen fully reversed the effect of 1 μM MeHg treatment for 1h on astrocytic ΔΨ(m) and partially reversed the effect of 5 and 10 μM MeHg treatments for 1h on ΔΨ(m). In addition, ebselen inhibited MeHg-induced phosphorylation of ERK (p<0.05) and blocked MeHg-induced activation of caspase-3 (p<0.05-0.01). These results are consistent with the hypothesis that MeHg exerts its toxic effects via oxidative stress and that the phosphorylation of ERK and the dissipation of the astrocytic mitochondrial membrane potential are involved in MeHg toxicity. In addition, the protective effects elicited by ebselen reinforce the idea that organic selenocompounds represent promising strategies to counteract MeHg-induced neurotoxicity. Copyright © 2011 Elsevier Inc. All rights reserved.

Design of a HIFU array for the treatment of deep venous thrombosis: a simulation study

NASA Astrophysics Data System (ADS)

Smirnov, Petr; Hynynen, Kullervo

2017-08-01

Deep venous thrombosis of the iliofemoral veins is a common and morbid disease, with the recommended interventional treatment carrying a high risk of hemorrhaging and complications. High intensity focused ultrasound delivered with a single element transducer has been shown to successfully precipitate thrombolysis non-invasively in vitro and in vivo. However, in all previous studies damage to the veins or surrounding tissue has been observed. Using a simulation model of the human thigh, this study investigated whether a phased array device could overcome the large focal region limitations faced by single transducer treatment devices. Effects of the size, shape and frequency of the array on its focal region were considered. It was found that a λ/2 spaced array of 7680 elements operating at 500 kHz could consistently focus to a region fully contained within the femoral vein. Furthermore, it is possible to reduce the number of elements required by building arrays operating at lower frequencies. The results suggest that phased transducer arrays hold potential for developing a safe, non-invasive treatment of thrombolysis.

Viewpoint: Availability of oestrogen receptor and HER2 status for the breast multidisciplinary meeting discussion; time to get it right.

PubMed

Francis, A; Bartlett, J; Rea, D; Pinder, S E; Stein, R C; Stobart, H; Purdie, C A; Rakha, E; Thompson, A; Shaaban, A M

2016-07-01

The efficacy and pivotal role of the multidisciplinary meeting (MDM) in informed decision making is well established. It aims to provide a forum in which clinical evidence combines with individual patient data to create a personalized treatment plan. It does not fulfil this role adequately when undertaken without the full results of the patient's investigations being available. Neither doctor nor patient can make an informed decision about treatment options without knowledge of the tumour receptor status. Both targeted therapies and the aim to treat a majority of patients within clinical trials must now drive MDM decision making to be based on accuracy and best available treatment choices. A fully informed decision on treatment delayed by 1-2 weeks is clearly preferable to rushed time target-driven decisions made without the patient being offered a fully informed choice as ratified by a multidisciplinary team. Whilst the early anxiety of waiting for all relevant information to be available may be stressful for patients, not being sure that they have been offered fully informed treatment choices is also stressful and could cause longer lasting anxiety both during and after treatment. MDMs need to develop (along with targeted therapies) to retain their role as a forum whereby patients receive a correct, but specifically a full diagnosis and allow a fully informed discussion of all treatment options, including pre-operative clinical trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

Conduction in fully ionized liquid metals

NASA Technical Reports Server (NTRS)

Stevenson, D. J.; Ashcroft, N. W.

1973-01-01

Electron transport is considered in high density fully ionized liquid metals. Ionic structure is described in terms of hard-sphere correlation functions and the scattering is determined from self-consistently screened point ions. Applications to the physical properties of the deep interior of Jupiter are briefly considered.

Using robot fully assisted functional movements in upper-limb rehabilitation of chronic stroke patients: preliminary results.

PubMed

Caimmi, Marco; Chiavenna, Andrea; Scano, Alessandro; Gasperini, Giulio; Giovanzana, Chiara; Molinari Tosatti, Lorenzo; Molteni, Franco

2017-06-01

Robotic rehabilitation is promising to promote function in stroke patients. The assist as needed training paradigm has shown to stimulate neuroplasticity but often cannot be used because stroke patients are too impaired to actively control the robot against gravity. To verify whether a rehabilitation intervention based on robot fully assisted reaching against gravity (RCH) and hand-to-mouth (HTM) can promote upper-limb function in chronic stroke. Cohort study. Chronic stroke outpatients referring to the robotic rehabilitation lab of a rehabilitation centre. Ten chronic stroke patients with mild to moderate upper-limb hemiparesis. Patients underwent 12 sessions (3 per week) of robotic treatment using an end-effector robot Every session consisted of 20 minutes each of RCH and HtM; movements were fully assisted, but patients were asked to try to actively participate. The Fugl-Meyer Assessment (FMA) was the primary outcome measure; Medical Research Council and Modified Ashworth Scale were the secondary outcome measures. All patients, but one, show functional improvements (FMA section A-D, mean increment 7.2±3.9 points, P<0.008). This preliminary study shows that a robotic intervention based on functional movements, fully assisted, can be effective in promoting function in chronic stroke patients. These results are promising considering the short time of the intervention (1 month) and the time from the stroke event, which was large (27±20 months). A larger study, comprehensive of objective instrumental measures, is necessary to confirm the results. This intervention could be extended even to subacute stroke and other neurological disorders.

Self-consistent hybrid functionals for solids: a fully-automated implementation

NASA Astrophysics Data System (ADS)

Erba, A.

2017-08-01

A fully-automated algorithm for the determination of the system-specific optimal fraction of exact exchange in self-consistent hybrid functionals of the density-functional-theory is illustrated, as implemented into the public Crystal program. The exchange fraction of this new class of functionals is self-consistently updated proportionally to the inverse of the dielectric response of the system within an iterative procedure (Skone et al 2014 Phys. Rev. B 89, 195112). Each iteration of the present scheme, in turn, implies convergence of a self-consistent-field (SCF) and a coupled-perturbed-Hartree-Fock/Kohn-Sham (CPHF/KS) procedure. The present implementation, beside improving the user-friendliness of self-consistent hybrids, exploits the unperturbed and electric-field perturbed density matrices from previous iterations as guesses for subsequent SCF and CPHF/KS iterations, which is documented to reduce the overall computational cost of the whole process by a factor of 2.

Design and synthesis of a series of bioavailable fatty acid synthase (FASN) KR domain inhibitors for cancer therapy.

PubMed

Lu, Tianbao; Schubert, Carsten; Cummings, Maxwell D; Bignan, Gilles; Connolly, Peter J; Smans, Karine; Ludovici, Donald; Parker, Michael H; Meyer, Christophe; Rocaboy, Christian; Alexander, Richard; Grasberger, Bruce; De Breucker, Sabine; Esser, Norbert; Fraiponts, Erwin; Gilissen, Ron; Janssens, Boudewijn; Peeters, Danielle; Van Nuffel, Luc; Vermeulen, Peter; Bischoff, James; Meerpoel, Lieven

2018-05-08

We designed and synthesized a new series of fatty acid synthase (FASN) inhibitors with potential utility for the treatment of cancer. Extensive SAR studies led to highly active FASN inhibitors with good cellular activity and oral bioavailability, exemplified by compound 34. Compound 34 is a potent inhibitor of human FASN (IC 50  = 28 nM) that effectively inhibits proliferation of A2780 ovarian cells (IC 50  = 13 nM) in lipid-reduced serum (LRS). This cellular activity can be rescued by addition of palmitate, consistent with an on-target effect. Compound 34 is also active in many other cell types, including PC3M (IC 50  = 25 nM) and LnCaP-Vancouver prostate cells (IC 50  = 66 nM), and is highly bioavailable (F 61%) with good exposure after oral administration. In a pharmacodynamics study in H460 lung xenograft-bearing mice, oral treatment with compound 34 results in elevated tumor levels of malonyl-CoA and decreased tumor levels of palmitate, fully consistent with the desired target engagement. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17 beta-oestradiol on ovarian function in comparison to a monophasic combined oral contraceptive containing drospirenone and ethinylestradiol.

PubMed

Duijkers, Ingrid J M; Klipping, Christine; Grob, Paul; Korver, Tjeerd

2010-10-01

To compare the effects on ovarian activity of two oral contraceptives containing nomegestrol acetate (NOMAC)/17 beta-oestradiol (E2) or drospirenone (DRSP)/ethinylestradiol (EE). In this open-label, randomised, six-cycle study, 32 subjects using NOMAC/E2 (2.5-1.5 mg; 24/4-day regimen) were compared to 16 subjects using DRSP/EE (3 mg-30 microg; 21/7-day regimen). Measurements included serum oestradiol, progesterone, follicle stimulating hormone (FSH) and luteinising hormone (LH), and ultrasonography of follicular diameter. No ovulations occurred during treatment. Progesterone was fully suppressed, with mean maximum values <2 nmol/l in both groups over all cycles. For NOMAC/E2, mean maximum follicular diameter decreased from 19.3 mm before treatment to between 6.9 and 8.2 mm during treatment, with no subject having a follicular diameter ≥15 mm. For DRSP/EE, a decrease from 19.6 to between 7.4 and 10.8 mm was observed, with two subjects (12.5%) having a maximum follicle diameter ≥15 mm. These findings were consistent with observed FSH reductions; full suppression of LH surges was observed in both groups. Post-treatment return of ovulation in both groups occurred on average 21 days after the last active tablet intake. NOMAC/E2 achieves consistent ovulation inhibition, with suppressive effects on the ovaries at least similar to those of DRSP/EE.

Computational study of the reactions of methanol with the hydroperoxyl and methyl radicals. 1. Accurate thermochemistry and barrier heights.

PubMed

Alecu, I M; Truhlar, Donald G

2011-04-07

The reactions of CH(3)OH with the HO(2) and CH(3) radicals are important in the combustion of methanol and are prototypes for reactions of heavier alcohols in biofuels. The reaction energies and barrier heights for these reaction systems are computed with CCSD(T) theory extrapolated to the complete basis set limit using correlation-consistent basis sets, both augmented and unaugmented, and further refined by including a fully coupled treatment of the connected triple excitations, a second-order perturbative treatment of quadruple excitations (by CCSDT(2)(Q)), core-valence corrections, and scalar relativistic effects. It is shown that the M08-HX and M08-SO hybrid meta-GGA density functionals can achieve sub-kcal mol(-1) agreement with the high-level ab initio results, identifying these functionals as important potential candidates for direct dynamics studies on the rates of these and homologous reaction systems.

A simple quantum mechanical treatment of scattering in nanoscale transistors

NASA Astrophysics Data System (ADS)

Venugopal, R.; Paulsson, M.; Goasguen, S.; Datta, S.; Lundstrom, M. S.

2003-05-01

We present a computationally efficient, two-dimensional quantum mechanical simulation scheme for modeling dissipative electron transport in thin body, fully depleted, n-channel, silicon-on-insulator transistors. The simulation scheme, which solves the nonequilibrium Green's function equations self consistently with Poisson's equation, treats the effect of scattering using a simple approximation inspired by the "Büttiker probes," often used in mesoscopic physics. It is based on an expansion of the active device Hamiltonian in decoupled mode space. Simulation results are used to highlight quantum effects, discuss the physics of scattering and to relate the quantum mechanical quantities used in our model to experimentally measured low field mobilities. Additionally, quantum boundary conditions are rigorously derived and the effects of strong off-equilibrium transport are examined. This paper shows that our approximate treatment of scattering, is an efficient and useful simulation method for modeling electron transport in nanoscale, silicon-on-insulator transistors.

A hybrid incremental projection method for thermal-hydraulics applications

NASA Astrophysics Data System (ADS)

Christon, Mark A.; Bakosi, Jozsef; Nadiga, Balasubramanya T.; Berndt, Markus; Francois, Marianne M.; Stagg, Alan K.; Xia, Yidong; Luo, Hong

2016-07-01

A new second-order accurate, hybrid, incremental projection method for time-dependent incompressible viscous flow is introduced in this paper. The hybrid finite-element/finite-volume discretization circumvents the well-known Ladyzhenskaya-Babuška-Brezzi conditions for stability, and does not require special treatment to filter pressure modes by either Rhie-Chow interpolation or by using a Petrov-Galerkin finite element formulation. The use of a co-velocity with a high-resolution advection method and a linearly consistent edge-based treatment of viscous/diffusive terms yields a robust algorithm for a broad spectrum of incompressible flows. The high-resolution advection method is shown to deliver second-order spatial convergence on mixed element topology meshes, and the implicit advective treatment significantly increases the stable time-step size. The algorithm is robust and extensible, permitting the incorporation of features such as porous media flow, RANS and LES turbulence models, and semi-/fully-implicit time stepping. A series of verification and validation problems are used to illustrate the convergence properties of the algorithm. The temporal stability properties are demonstrated on a range of problems with 2 ≤ CFL ≤ 100. The new flow solver is built using the Hydra multiphysics toolkit. The Hydra toolkit is written in C++ and provides a rich suite of extensible and fully-parallel components that permit rapid application development, supports multiple discretization techniques, provides I/O interfaces, dynamic run-time load balancing and data migration, and interfaces to scalable popular linear solvers, e.g., in open-source packages such as HYPRE, PETSc, and Trilinos.

A hybrid incremental projection method for thermal-hydraulics applications

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

Christon, Mark A.; Bakosi, Jozsef; Nadiga, Balasubramanya T.

In this paper, a new second-order accurate, hybrid, incremental projection method for time-dependent incompressible viscous flow is introduced in this paper. The hybrid finite-element/finite-volume discretization circumvents the well-known Ladyzhenskaya–Babuška–Brezzi conditions for stability, and does not require special treatment to filter pressure modes by either Rhie–Chow interpolation or by using a Petrov–Galerkin finite element formulation. The use of a co-velocity with a high-resolution advection method and a linearly consistent edge-based treatment of viscous/diffusive terms yields a robust algorithm for a broad spectrum of incompressible flows. The high-resolution advection method is shown to deliver second-order spatial convergence on mixed element topology meshes,more » and the implicit advective treatment significantly increases the stable time-step size. The algorithm is robust and extensible, permitting the incorporation of features such as porous media flow, RANS and LES turbulence models, and semi-/fully-implicit time stepping. A series of verification and validation problems are used to illustrate the convergence properties of the algorithm. The temporal stability properties are demonstrated on a range of problems with 2 ≤ CFL ≤ 100. The new flow solver is built using the Hydra multiphysics toolkit. The Hydra toolkit is written in C++ and provides a rich suite of extensible and fully-parallel components that permit rapid application development, supports multiple discretization techniques, provides I/O interfaces, dynamic run-time load balancing and data migration, and interfaces to scalable popular linear solvers, e.g., in open-source packages such as HYPRE, PETSc, and Trilinos.« less

A hybrid incremental projection method for thermal-hydraulics applications

DOE PAGES

Christon, Mark A.; Bakosi, Jozsef; Nadiga, Balasubramanya T.; ...

2016-07-01

In this paper, a new second-order accurate, hybrid, incremental projection method for time-dependent incompressible viscous flow is introduced in this paper. The hybrid finite-element/finite-volume discretization circumvents the well-known Ladyzhenskaya–Babuška–Brezzi conditions for stability, and does not require special treatment to filter pressure modes by either Rhie–Chow interpolation or by using a Petrov–Galerkin finite element formulation. The use of a co-velocity with a high-resolution advection method and a linearly consistent edge-based treatment of viscous/diffusive terms yields a robust algorithm for a broad spectrum of incompressible flows. The high-resolution advection method is shown to deliver second-order spatial convergence on mixed element topology meshes,more » and the implicit advective treatment significantly increases the stable time-step size. The algorithm is robust and extensible, permitting the incorporation of features such as porous media flow, RANS and LES turbulence models, and semi-/fully-implicit time stepping. A series of verification and validation problems are used to illustrate the convergence properties of the algorithm. The temporal stability properties are demonstrated on a range of problems with 2 ≤ CFL ≤ 100. The new flow solver is built using the Hydra multiphysics toolkit. The Hydra toolkit is written in C++ and provides a rich suite of extensible and fully-parallel components that permit rapid application development, supports multiple discretization techniques, provides I/O interfaces, dynamic run-time load balancing and data migration, and interfaces to scalable popular linear solvers, e.g., in open-source packages such as HYPRE, PETSc, and Trilinos.« less

Advancements in the treatment of agitation in Alzheimer's disease.

PubMed

Antonsdottir, Inga M; Smith, Jessica; Keltz, Melanie; Porsteinsson, Anton P

2015-01-01

Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks well-established long-term interventions that are both effective and safe. While non-pharmacological interventions are the suggested first-line treatment, it isn't effective in managing symptoms for every patient. In such cases, clinicians turn to the use of pharmacological interventions. Traditionally, these interventions consist of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine and antidepressants, where the efficacy doesn't necessarily outweigh the associated risks. Gains made in understanding the neurobiological mechanisms underlying agitation have fueled several recent clinical trials. A comprehensive literature search for published articles evaluating pharmacologic interventions for agitation in AD was done. A review of some of these clinical trials was completed: dextromethorphan/quinidine, scyllo-inositol, brexpiprazole, prazosin, cannabinoids, dronabinol and citalopram show promise in treating agitation. Neurobiological findings and enhanced trial designs have re-ignited the area of pharmacological treatment of NPS. Although further research is needed to fully determine the safety, tolerability and efficacy of these treatments, the mission to finding effective treatments for NPS such as agitation in patients with dementia is well underway.

A transition from using multi-step procedures to a fully integrated system for performing extracorporeal photopheresis: A comparison of costs and efficiencies.

PubMed

Azar, Nabih; Leblond, Veronique; Ouzegdouh, Maya; Button, Paul

2017-12-01

The Pitié Salpêtrière Hospital Hemobiotherapy Department, Paris, France, has been providing extracorporeal photopheresis (ECP) since November 2011, and started using the Therakos ® CELLEX ® fully integrated system in 2012. This report summarizes our single-center experience of transitioning from the use of multi-step ECP procedures to the fully integrated ECP system, considering the capacity and cost implications. The total number of ECP procedures performed 2011-2015 was derived from department records. The time taken to complete a single ECP treatment using a multi-step technique and the fully integrated system at our department was assessed. Resource costs (2014€) were obtained for materials and calculated for personnel time required. Time-driven activity-based costing methods were applied to provide a cost comparison. The number of ECP treatments per year increased from 225 (2012) to 727 (2015). The single multi-step procedure took 270 min compared to 120 min for the fully integrated system. The total calculated per-session cost of performing ECP using the multi-step procedure was greater than with the CELLEX ® system (€1,429.37 and €1,264.70 per treatment, respectively). For hospitals considering a transition from multi-step procedures to fully integrated methods for ECP where cost may be a barrier, time-driven activity-based costing should be utilized to gain a more comprehensive understanding the full benefit that such a transition offers. The example from our department confirmed that there were not just cost and time savings, but that the time efficiencies gained with CELLEX ® allow for more patient treatments per year. © 2017 The Authors Journal of Clinical Apheresis Published by Wiley Periodicals, Inc.

A transition from using multi‐step procedures to a fully integrated system for performing extracorporeal photopheresis: A comparison of costs and efficiencies

PubMed Central

Leblond, Veronique; Ouzegdouh, Maya; Button, Paul

2017-01-01

Abstract Introduction The Pitié Salpêtrière Hospital Hemobiotherapy Department, Paris, France, has been providing extracorporeal photopheresis (ECP) since November 2011, and started using the Therakos® CELLEX® fully integrated system in 2012. This report summarizes our single‐center experience of transitioning from the use of multi‐step ECP procedures to the fully integrated ECP system, considering the capacity and cost implications. Materials and Methods The total number of ECP procedures performed 2011–2015 was derived from department records. The time taken to complete a single ECP treatment using a multi‐step technique and the fully integrated system at our department was assessed. Resource costs (2014€) were obtained for materials and calculated for personnel time required. Time‐driven activity‐based costing methods were applied to provide a cost comparison. Results The number of ECP treatments per year increased from 225 (2012) to 727 (2015). The single multi‐step procedure took 270 min compared to 120 min for the fully integrated system. The total calculated per‐session cost of performing ECP using the multi‐step procedure was greater than with the CELLEX® system (€1,429.37 and €1,264.70 per treatment, respectively). Conclusions For hospitals considering a transition from multi‐step procedures to fully integrated methods for ECP where cost may be a barrier, time‐driven activity‐based costing should be utilized to gain a more comprehensive understanding the full benefit that such a transition offers. The example from our department confirmed that there were not just cost and time savings, but that the time efficiencies gained with CELLEX® allow for more patient treatments per year. PMID:28419561

[Progress in the development of insulin pumps and their advanced automatic functions].

PubMed

Prázný, Martin

2015-04-01

Patients with type 1 diabetes are exposed to permanent burden consisting of careful glucose self-monitoring and precise insulin dosage based on measured glucose values, carbohydrates content in the food and both planned and non-planned physical activity. Erroneous insulin dosing causes frequent both hypoglycemia and hyperglycemia. Hypoglycemia is, however, the most clinically significant complication limiting the optimal diabetes control. Automatic features for insulin dosage integrated in insulin pumps are thus very important. Low glucose suspend (LGS) and Predictive Low Glucose Management (PLGM) use glucose sensor values to prevent hypoglycemia, shorten the time spent in hypoglycemic range and present further step forward to fully closed-loop system of insulin treatment.

Efficacy of Danger Ideation Reduction Therapy in Obsessive-Compulsive Disorder Washer with Poor Insight: A Case Study and Literature Review

PubMed Central

Maqbool, Masood; Sengar, K. S.; Vikas; Kumar, Mohit; Uparikar, Premkant Damodhar

2017-01-01

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Treatment usually consists of serotonergic medications along with exposure therapies. Danger ideation reduction therapy (DIRT) is an alternative therapy predominantly for washing compulsions and focuses on reduction of danger ideations. DIRT was tried on Ms. S. with a history of OCD for 15 years and improvement was noticed on Yale–Brown Obsessive Compulsive Scale, Padua Inventory, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale after 15 sessions of DIRT though she was not fully symptom-free. Thus, DIRT was found to improve OCD symptoms and improved her insight into illness. PMID:28852254

Design and Impacts of Land-Biogenic-Atmosphere Coupling in the NASA-Unified WRF (NU-WRF) Modeling System

NASA Technical Reports Server (NTRS)

Tan, Qian; Santanello, Joseph A., Jr.; Zhou, Shujia; Tao, Zhining; Peters-Lidard, Christa d.; Chn, Mian

2011-01-01

Land-Atmosphere coupling is typically designed and implemented independently for physical (e.g. water and energy) and chemical (e.g. biogenic emissions and surface depositions)-based models and applications. Differences in scale, data requirements, and physics thus limit the ability of Earth System models to be fully coupled in a consistent manner. In order for the physical-chemical-biological coupling to be complete, treatment of the land in terms of surface classification, condition, fluxes, and emissions must be considered simultaneously and coherently across all components. In this study, we investigate a coupling strategy for the NASA-Unified Weather Research and Forecasting (NU-WRF) model that incorporates the traditionally disparate fluxes of water and energy through NASA's LIS (Land Information System) and biogenic emissions through BEIS (Biogenic Emissions Inventory System) and MEGAN (Model of Emissions of Gases and Aerosols from Nature) into the atmosphere. In doing so, inconsistencies across model inputs and parameter data are resolved such that the emissions from a particular plant species are consistent with the heat and moisture fluxes calculated for that land cover type. In turn, the response of the atmospheric turbulence and mixing in the planetary boundary layer (PBL) acts on the identical surface type, fluxes, and emissions for each. In addition, the coupling of dust emission within the NU-WRF system is performed in order to ensure consistency and to maximize the benefit of high-resolution land representation in LIS. The impacts of those self-consistent components on' the simulation of atmospheric aerosols are then evaluated through the WRF-Chem-GOCART (Goddard Chemistry Aerosol Radiation and Transport) model. Overall, this ambitious project highlights the current difficulties and future potential of fully coupled. components. in Earth System models, and underscores the importance of the iLEAPS community in supporting improved knowledge of processes and innovative approaches for models and observations.

Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia: A Randomized Waitlist Controlled Trial

PubMed Central

Lancee, Jaap; Griffioen-Both, Fiemke; Spruit, Sandor; Fitrianie, Siska; Neerincx, Mark A; Beun, Robbert Jan; Brinkman, Willem-Paul

2017-01-01

Background This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have insomnia. Objective The objective of our study was to investigate the efficacy of CBT-I delivered via the Sleepcare mobile phone app, compared with a waitlist control group, in a randomized controlled trial. Methods We recruited participants in the Netherlands with relatively mild insomnia disorder. After answering an online pretest questionnaire, they were randomly assigned to the app (n=74) or the waitlist condition (n=77). The app packaged a sleep diary, a relaxation exercise, sleep restriction exercise, and sleep hygiene and education. The app was fully automated and adjusted itself to a participant’s progress. Program duration was 6 to 7 weeks, after which participants received posttest measurements and a 3-month follow-up. The participants in the waitlist condition received the app after they completed the posttest questionnaire. The measurements consisted of questionnaires and 7-day online diaries. The questionnaires measured insomnia severity, dysfunctional beliefs about sleep, and anxiety and depression symptoms. The diary measured sleep variables such as sleep efficiency. We performed multilevel analyses to study the interaction effects between time and condition. Results The results showed significant interaction effects (P<.01) favoring the app condition on the primary outcome measures of insomnia severity (d=–0.66) and sleep efficiency (d=0.71). Overall, these improvements were also retained in a 3-month follow-up. Conclusions This study demonstrated the efficacy of a fully automated mobile phone app in the treatment of relatively mild insomnia. The effects were in the range of what is found for Web-based treatment in general. This supports the applicability of such technical tools in the treatment of insomnia. Future work should examine the generalizability to a more diverse population. Furthermore, the separate components of such an app should be investigated. It remains to be seen how this app can best be integrated into the current health regimens. Trial Registration Netherlands Trial Register: NTR5560; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5560 (Archived by WebCite at http://www.webcitation.org/6noLaUdJ4) PMID:28400355

A heat treatment procedure to produce fine-grained lamellar microstructures in a P/M titanium aluminide alloy

NASA Astrophysics Data System (ADS)

Au, Peter

A process for fabricating advanced aerospace titanium aluminide alloys starting from metal powders (the hot isostatically consolidated P/M process) is presented in this thesis. This process does not suffer the difficulties of chemical inhomogeneities and coarse grain structure of castings. In addition heat treatments which take advantage of the refined structure of HIP processed materials are developed to achieve microstructure control and subsequent mechanical property control. It is shown that a better "property balance" is possible after the heat treatment of HIP consolidated materials than it is with alternative processing. It is well understood that the standard microstructures (near-gamma, duplex, nearly lamellar, and fully lamellar) do not have the balanced mechanical properties (tensile, yield, creep and fatigue strength, ductility and fracture toughness) necessary for optimal performance in aero engine and automotive applications. In this work a fine-grained fully lamellar (FGFL) microstructure is developed for property control and in particular for achieving a much improved property balance. A heat treatment procedure for this purpose which consists of cyclic processing in the alpha transus temperature region to achieve an FGFL structure with grain sizes in the range of 50 mum to 150 mum is presented. Compared with conventional duplex structured materials, the minimum creep rate is an order of magnitude lower with only a 10% loss in tensile yield strength. Moreover, a three-fold increase in tensile elongation is possible by converting to an FGFL structure with only a 30% loss in minimum creep rate. These are attractive trade-offs when considering the use of these alloys for aerospace purposes. A thorough literature review of the mechanisms of formation of standard microstructures and their deformation under mechanical loading is contained in the thesis. In addition, conventional techniques to produce FGFL microstructures in wrought and cast materials are discussed in detail. Beyond the review, the results of experiments are described for determining the alpha transus temperature, the phase transformation kinetics in this region and the effects of heat treatment time and cooling rate on microstructure. Based on this preliminary work, a heat treatment to achieve a FGFL microstructure with grain sizes in the range of 50 mum to 150 mum is proposed and confirmed. The room temperature and high temperature mechanical properties of these materials are compared with those of conventional duplex and fully lamellar structures. The results of this experimentation are discussed in terms of the fundamental mechanisms for controlling microstructure and mechanical properties in these materials. The potential for applying cyclic heat treatments to cast and wrought materials to improve the mechanical property balance in engineering practice is discussed.

Effect of well disinfection on arsenic in ground water

USGS Publications Warehouse

Gotkowitz, M.; Ellickson, K.; Clary, A.; Bowman, G.; Standridge, J.; Sonzogni, W.

2008-01-01

Domestic water wells are routinely subjected to in situ chemical disinfection treatments to control nuisance or pathogenic bacteria. Most treatments are chlorine based and presumably cause strongly oxidizing conditions in the wellbore. Water resource managers in Wisconsin were concerned that such treatments might facilitate release of arsenic from sulfide minerals disseminated within a confined sandstone aquifer. To test this hypothesis, a well was subjected to four disinfection treatments over 9 months time. The first treatment consisted of routine pumping of the well without chemical disinfection; three subsequent treatments included chlorine disinfection and pumping. Pretreatment arsenic concentrations in well water ranged from 7.4 to 18 ??g/L. Elevated arsenic concentrations up to 57 ??g/L in the chemical treatment solutions purged from the well are attributed to the disintegration or dissolution of biofilms or scale. Following each of the four treatments, arsenic concentrations decreased to less than 10 ??g/L during a period of pumping. Arsenic concentrations generally returned to pretreatment levels under stagnant, nonpumping conditions imposed following each treatment. Populations of iron-oxidizing, heterotrophic, and sulfate-reducing bacteria decreased following chemical treatments but were never fully eradicated from the well. Strongly oxidizing conditions were induced by the chlorine-based disinfections, but the treatments did not result in sustained increases in well water arsenic. Results suggest that disruption of biofilm and mineral deposits in the well and the water distribution system in tandem with chlorine disinfection can improve water quality in this setting. ?? 2008 The Author(s).

Systems Pharmacology Dissection of Traditional Chinese Medicine Wen-Dan Decoction for Treatment of Cardiovascular Diseases.

PubMed

Lan, Tao-Hua; Zhang, Lu-Lu; Wang, Yong-Hua; Wu, Huan-Lin; Xu, Dan-Ping

2018-01-01

Cardiovascular diseases (CVDs) have been recognized as first killer of human health. The underlying mechanisms of CVDs are extremely complicated and not fully revealed, leading to a challenge for CVDs treatment in modern medicine. Traditional Chinese medicine (TCM) characterized by multiple compounds and targets has shown its marked effects on CVDs therapy. However, system-level understanding of the molecular mechanisms is still ambiguous. In this study, a system pharmacology approach was developed to reveal the underlying molecular mechanisms of a clinically effective herb formula (Wen-Dan Decoction) in treating CVDs. 127 potential active compounds and their corresponding 283 direct targets were identified in Wen-Dan Decoction. The networks among active compounds, targets, and diseases were built to reveal the pharmacological mechanisms of Wen-Dan Decoction. A "CVDs pathway" consisted of several regulatory modules participating in therapeutic effects of Wen-Dan Decoction in CVDs. All the data demonstrates that Wen-Dan Decoction has multiscale beneficial activity in CVDs treatment, which provides a new way for uncovering the molecular mechanisms and new evidence for clinical application of Wen-Dan Decoction in cardiovascular disease.

Development and use of a computer system in a radiotherapy department: SISGRAD.

PubMed

Costa, A; Lalanne, C M; Marcié, S; Leca, M; Rameau, P; Chauvel, P; Héry, M; Lagrange, J L; Verschoore, J

1987-12-01

SISGRAD, the interactive computer system of the Antoine-Lacassagne Cancer Center Radiotherapy Department, has been operational since January 1982. It completes the computerized dosimetry system installed several years earlier and is fully integrated with the institution's central network. SISGRAD is in charge of surveillance of the radiotherapy treatments given by the Center's three radiotherapy units (1400 patients per year); it is also used for administrative purposes in the Department and physically connects all of the Department's operating stations. SISGRAD consists of a series of microcomputers connected to a common mass memory; each microcomputer is used as an intelligent console. SISGRAD was developed to guarantee that the treatments comply with prescriptions, to supply extemporaneous dosimetric data, to improve administrative work, and to supply banks with data for statistical analysis and research. SISGRAD actively intervenes to guarantee treatment quality and helps to improve therapy-related security factors. The present text describes the results of clinical use over a 4-year period. The consequences of integration of the system within the Department are analyzed, with special emphasis being placed on SISGRAD's role in the prevention and detection of errors in treatment prescription and delivery.

Self Consistent Bathymetric Mapping From Robotic Vehicles in the Deep Ocean

DTIC Science & Technology

2005-06-01

that have been aligned in a consistent manner. Experimental results from the fully automated processing of a multibeam survey over the TAG hydrothermal structure at the Mid-Atlantic ridge are presented to validate the proposed method.

[Screening of full human anthrax lethal factor neutralizing antibody in transgenic mice].

PubMed

Wang, Xiaolin; Chi, Xiangyang; Liu, Ju; Liu, Weicen; Liu, Shuling; Qiu, Shunfang; Wen, Zhonghua; Fan, Pengfei; Liu, Kun; Song, Xiaohong; Fu, Ling; Zhang, Jun; Yu, Changming

2016-11-25

Anthrax is a highly lethal infectious disease caused by the spore-forming bacterium Bacillus anthracis. The major virulence factor of B. anthracis consists of protective antigen (PA), lethal factor (LF) and edema factor (EF). PA binds with LF to form lethal toxin (LT), and PA binds with EF to form edema toxin (ET). Antibiotics is hard to work in advanced anthrax infections, because injuries and deaths of the infected are mainly caused by lethal toxin (LT). Thus, the therapeutic neutralizing antibody is the most effective treatment of anthrax. Currently most of the anthrax toxin antibodies are monoclonal antibodies (MAbs) for PA and US FDA has approved ABTHRAX humanized PA monoclonal antibody for the treatment of inhalational anthrax. Once B. anthracis was artificially reconstructed or PA had mutations within recognized neutralization epitopes, anti-PA MAbs would no longer be effective. Therefore, anti-LF MAbs is an important supplement for anthrax treatment. Most of the anti-LF antibodies are murine or chimeric antibodies. By contrast, fully human MAbs can avoid the high immunogenicity of murine antibodies. First, we used LF to immunize the transgenic mice and used fluorescent cell sorting to get antigen-specific memory B cells from transgenic mice spleen lymphocytes. By single cell PCR method, we quickly found two strains of anti-LF MAbs with binding activity, 1D7 and 2B9. Transiently transfected Expi 293F cells to obtain MAbs protein after purification. Both 1D7 and 2B9 efficiently neutralized LT in vitro, and had good synergistic effect when mixed with anti-PA MAbs. In summary, combining the advantages of transgenic mice, fluorescent cell sorting and single-cell PCR methods, this study shows new ideas and methods for the rapid screening of fully human monoclonal antibodies.

Hydrodynamic and Chemical Factors in Clogging by Montmorillonite in Porous Media

PubMed Central

Mays, David C.; Hunt, James R.

2008-01-01

Clogging by colloid deposits is important in water treatment filters, groundwater aquifers, and petroleum reservoirs. The complexity of colloid deposition and deposit morphology preclude models based on first principles, so this study extends an empirical approach to quantify clogging using a simple, one-parameter model. Experiments were conducted with destabilized suspensions of sodium- and calcium-montmorillonite to quantify the hydrodynamic and chemical factors important in clogging. Greater clogging is observed at slower fluid velocity, consistent with previous investigations. However, calcium-montmorillonite causes one order of magnitude less clogging per mass of deposited particles compared to sodium-montmorillonite or a previously published summary of clogging in model granular media. Steady state conditions, in which the permeability and the quantity of deposited material are both constant, were not observed, even though the experimental conditions were optimized for that purpose. These results indicate that hydrodynamic aspects of clogging by these natural materials are consistent with those of simplified model systems, and they demonstrate significant chemical effects on clogging for fully destabilized montmorillonite clay. PMID:17874771

Hydrodynamic and chemical factors in clogging by montmorillonite in porous media.

PubMed

Mays, David C; Hunt, James R

2007-08-15

Clogging by colloid deposits is important in water treatment filters, groundwater aquifers, and petroleum reservoirs. The complexity of colloid deposition and deposit morphology preclude models based on first principles, so this study extends an empirical approach to quantify clogging using a simple, one-parameter model. Experiments were conducted with destabilized suspensions of sodium- and calcium-montmorillonite to quantify the hydrodynamic and chemical factors important in clogging. Greater clogging is observed at slower fluid velocity, consistent with previous investigations. However, calcium-montmorillonite causes 1 order of magnitude less clogging per mass of deposited particles compared to sodium-montmorillonite or a previously published summary of clogging in model granular media. Steady-state conditions, in which the permeability and the quantity of deposited material are both constant, were not observed, even though the experimental conditions were optimized for that purpose. These results indicate that hydrodynamic aspects of clogging by these natural materials are consistent with those of simplified model systems, and they demonstrate significant chemical effects on clogging for fully destabilized montmorillonite clay.

Formation of Partially and Fully Elaborated Generalized Equivalence Classes

ERIC Educational Resources Information Center

Fields, Lanny; Moss, Patricia

2008-01-01

Most complex categories observed in real-world settings consist of perceptually disparate stimuli, such as a picture of a person's face, the person's name as written, and the same name as heard, as well as dimensional variants of some or all of these stimuli. The stimuli function as members of a single partially or fully elaborated generalized…

Genetic risk factors for inhibitors in haemophilia A.

PubMed

Bardi, Edit; Astermark, Jan

2015-02-01

The current most serious side effect of haemophilia treatment is inhibitor development. Significant progress has been made over the last decades to understand why this complication occurs in some patients and it seems clear that both genetic and non-genetic factors are involved. Several issues however remain to be settled. A review was undertaken to summarise some key findings regarding the current view and available data on genetic markers of potential importance within this area. The causative F8 mutation, together with the HLA class II alleles, plays a pivotal pathophysiological role in inhibitor development. The types of mutation most frequently associated with inhibitors are large deletions, nonsense mutations, inversions, small deletions/insertions without A-runs, splice-site mutations at conserved nucleotides and certain missense mutations. Regarding HLA class II allele, it has been hard to consistently identify risk alleles. Ethnicity has consistently been associated with inhibitor risk, but the causality of this has so far not been resolved. Among immune regulatory molecules, several polymorphic molecules have been suggested to be of importance. Most of these need additional studies and immune system challenges have to be fully evaluated. Inhibitor risk should be further defined, as patients in the future may be offered non-immunogenic treatments. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Neurophysiological model of tinnitus: dependence of the minimal masking level on treatment outcome.

PubMed

Jastreboff, P J; Hazell, J W; Graham, R L

1994-11-01

Validity of the neurophysiological model of tinnitus (Jastreboff, 1990), outlined in this paper, was tested on data from multicenter trial of tinnitus masking (Hazell et al., 1985). Minimal masking level, intensity match of tinnitus, and the threshold of hearing have been evaluated on a total of 382 patients before and after 6 months of treatment with maskers, hearing aids, or combination devices. The data has been divided into categories depending on treatment outcome and type of approach used. Results of analysis revealed that: i) the psychoacoustical description of tinnitus does not possess a predictive value for the outcome of the treatment; ii) minimal masking level changed significantly depending on the treatment outcome, decreasing on average by 5.3 dB in patients reporting improvement, and increasing by 4.9 dB in those whose tinnitus remained the same or worsened; iii) 73.9% of patients reporting improvement had their minimal masking level decreased as compared with 50.5% for patients not showing improvement, which is at the level of random change; iv) the type of device used has no significant impact on the treatment outcome and minimal masking level change; v) intensity match and threshold of hearing did not exhibit any significant changes which can be related to treatment outcome. These results are fully consistent with the neurophysiological interpretation of mechanisms involved in the phenomenon of tinnitus and its alleviation.

Astaxanthin as a Potential Neuroprotective Agent for Neurological Diseases

PubMed Central

Wu, Haijian; Niu, Huanjiang; Shao, Anwen; Wu, Cheng; Dixon, Brandon J.; Zhang, Jianmin; Yang, Shuxu; Wang, Yirong

2015-01-01

Neurological diseases, which consist of acute injuries and chronic neurodegeneration, are the leading causes of human death and disability. However, the pathophysiology of these diseases have not been fully elucidated, and effective treatments are still lacking. Astaxanthin, a member of the xanthophyll group, is a red-orange carotenoid with unique cell membrane actions and diverse biological activities. More importantly, there is evidence demonstrating that astaxanthin confers neuroprotective effects in experimental models of acute injuries, chronic neurodegenerative disorders, and neurological diseases. The beneficial effects of astaxanthin are linked to its oxidative, anti-inflammatory, and anti-apoptotic characteristics. In this review, we will focus on the neuroprotective properties of astaxanthin and explore the underlying mechanisms in the setting of neurological diseases. PMID:26378548

Waste treatment of kraft effluents by white-rot fungi

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

Kondo, R.

1996-10-01

The residual lignin in unbleached kraft pulp is commonly removed to afford a fully bleached pulp through a multi-stage bleaching process consisting of chlorination and alkaline-extraction stages. The effluent from such a bleaching process is of growing environmental concern because it shows a dark brown color and contains numerous chlorinated organic substances. Moreover, this effluent is not easily recycled within a mill recovery system because of the potential corrosion problems created by its high chlorine content. White-rot fungi have even heavily modified lignin such as kraft lignin and atoms demonstrated that kraft bleaching effluent can be rot fungi, in particular,more » Trametes versicolor and this review lecture, the possibility of the application of kraft effluents will be discussed.« less

Minimal Invasive Linea Alba Reconstruction for the Treatment of Umbilical and Epigastric Hernias with Coexisting Rectus Abdominis Diastasis.

PubMed

Köhler, Gernot; Fischer, Ines; Kaltenböck, Richard; Schrittwieser, Rudolf

2018-04-05

Patients with umbilical or epigastric hernias benefit from mesh- based repairs, and even more so if a concomitant rectus diastasis (RD) is present. The ideal technique is, however, still under debate. In this study we introduce the minimal invasive linea alba reconstruction (MILAR) with the supraaponeurotic placement of a fully absorbable synthetic mesh. Midline reconstruction with anterior rectus sheath repair and mesh augmentation by an open approach is a well-known surgical technique for ventral hernia repair. Between December 1, 2016, and November 30, 2017, 20 patients with symptomatic umbilical and/or epigastric hernias, and coexisting RD underwent a minimally invasive complete reconstruction of the midline through a small access route. The inner part of both incised and medialized anterior rectus sheaths was replaced by a fully absorbable synthetic mesh placed in a supraaponeurotic position. Patients were hospitalized for an average of 4 days and the mean operating time was 79 minutes. The mean hernia defect size was 1.5 cm in diameter and the mean mesh size was recorded as 15.8 cm in length and 5.2 cm in width. Two patients sustained surgical postoperative complications in terms of symptomatic seroma occurrences with successful interventional treatment.The early results (mean follow-up period of 5 months) showed no recurrences and only 1 patient reported occasional pain following exertion without rest. MILAR is a modification of the recently published endoscopic linea alba reconstruction restoring the normal anatomy of the abdominal wall. A new linea alba is formed with augmentation of autologous tissue consisting of the plicated anterior rectus sheaths. Supraaponeurotic placement of a fully absorbable synthetic mesh eliminates potential long-term mesh-associated complications. Regarding MILAR, there is no need for endoscopic equipment due to the uniquely designed flexible lighted retractors, meaning one assistant less is required.

Applied Ecosystem Analysis - Background : EDT the Ecosystem Diagnosis and Treatment Method.

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

Mobrand, Lars E.

1996-05-01

This volume consists of eight separate reports. We present them as background to the Ecosystem Diagnosis and Treatment (EDT) methodology. They are a selection from publications, white papers, and presentations prepared over the past two years. Some of the papers are previously published, others are currently being prepared for publication. In the early to mid 1980`s the concern for failure of both natural and hatchery production of Columbia river salmon populations was widespread. The concept of supplementation was proposed as an alternative solution that would integrate artificial propagation with natural production. In response to the growing expectations placed upon themore » supplementation tool, a project called Regional Assessment of Supplementation Project (RASP) was initiated in 1990. The charge of RASP was to define supplementation and to develop guidelines for when, where and how it would be the appropriate solution to salmon enhancement in the Columbia basin. The RASP developed a definition of supplementation and a set of guidelines for planning salmon enhancement efforts which required consideration of all factors affecting salmon populations, including environmental, genetic, and ecological variables. The results of RASP led to a conclusion that salmon issues needed to be addressed in a manner that was consistent with an ecosystem approach. If the limitations and potentials of supplementation or any other management tool were to be fully understood it would have to be within the context of a broadly integrated approach - thus the Ecosystem Diagnosis and Treatment (EDT) method was born.« less

Computational Study of the Reactions of Methanol with the Hydroperoxyl and Methyl Radicals. Part I: Accurate Thermochemistry and Barrier Heights

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

Alecu, I. M.; Truhlar, D. G.

2011-04-07

The reactions of CH 3OH with the HO 2 and CH 3 radicals are important in the combustion of methanol and are prototypes for reactions of heavier alcohols in biofuels. The reaction energies and barrier heights for these reaction systems are computed with CCSD(T) theory extrapolated to the complete basis set limit using correlation-consistent basis sets, both augmented and unaugmented, and further refined by including a fully coupled treatment of the connected triple excitations, a second-order perturbative treatment of quadruple excitations (by CCSDT(2) Q), core–valence corrections, and scalar relativistic effects. It is shown that the M08-HX and M08-SO hybrid meta-GGAmore » density functionals can achieve sub-kcal mol -1 agreement with the high-level ab initio results, identifying these functionals as important potential candidates for direct dynamics studies on the rates of these and homologous reaction systems.« less

Affect labeling enhances exposure effectiveness for public speaking anxiety.

PubMed

Niles, Andrea N; Craske, Michelle G; Lieberman, Matthew D; Hur, Christopher

2015-05-01

Exposure is an effective treatment for anxiety but many patients do not respond fully. Affect labeling (labeling emotional experience) attenuates emotional responding. The current project examined whether affect labeling enhances exposure effectiveness in participants with public speaking anxiety. Participants were randomized to exposure with or without affect labeling. Physiological arousal and self-reported fear were assessed before and after exposure and compared between groups. Consistent with hypotheses, participants assigned to Affect Labeling, especially those who used more labels during exposure, showed greater reduction in physiological activation than Control participants. No effect was found for self-report measures. Also, greater emotion regulation deficits at baseline predicted more benefit in physiological arousal from exposure combined with affect labeling than exposure alone. The current research provides evidence that behavioral strategies that target prefrontal-amygdala circuitry can improve treatment effectiveness for anxiety and these effects are particularly pronounced for patients with the greatest deficits in emotion regulation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Fractionated Er:YAG laser versus fully ablative Er:YAG laser for scar revision: Results of a split scar, double blinded, prospective trial.

PubMed

Tidwell, W James; Owen, Cindy E; Kulp-Shorten, Carol; Maity, Abhishek; McCall, Michael; Brown, Timothy S

2016-11-01

Ablative laser resurfacing is a common treatment for post-surgical scars. Fractional ablative laser resurfacing has been an emerging treatment option that is replacing fully ablative lasers in many applications. Data comparing fractionated and fully ablative lasers in treating post-operative scars are lacking. Twenty patients were enrolled in a split scar study following excisions from dermatologic surgery. Wounds had to be older than 8 weeks but less than 1 year. The scars were randomly divided into two halves. One half of the scar was treated with fully ablative erbium-doped yttrium aluminum garnet (Er:YAG) and the other was treated with fractionated Er:YAG. The scars were treated at monthly intervals for 3 months, then followed up at months 1 and 2 after the last treatment. POSAS was used to evaluate the scars by a panel of dermatologists blinded to the lasers in conjunction with the patients, who were also blinded. Physicians and patients both observed a superior outcome of 32.5% (P = 0.019) and 58.1% (P = 0.001), respectively, using the POSAS. There was no trend in difference in pain reported by the patient between the two lasers. Patients overwhelmingly preferred the fractionated Er:YAG laser (94%) to the fully ablative laser when asked at the end of the study. Although this study is limited by a short follow-up period, it shows a statistically significant superior outcome in fractionated Er:YAG over fully ablative Er:YAG for scar revision. It also adds quantitative values to the assessment of scar appearance when treated with fractionated lasers compared to fully ablative lasers. It was also found that the fractionated Er:YAG had increased patient satisfaction, but there was no difference in reported pain scores. These data are useful when counseling patients undergoing laser surgery. Lasers Surg. Med. 48:837-843, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Interleukin-17 inhibitors. A new era in treatment of psoriasis and other skin diseases.

PubMed

Wasilewska, Agnieszka; Winiarska, Marta; Olszewska, Małgorzata; Rudnicka, Lidia

2016-08-01

Psoriasis is a chronic skin disease caused by the excessive secretion of inflammatory cytokines. Available therapeutic options include biologic drugs such as tumor necrosis factor alpha inhibitors and interleukin 12/23 (IL-12/23) inhibitors. The recent discovery of IL-17, which contributes to development of psoriasis, opened new possibilities for further treatment modalities. Currently, one anti-IL17 biological agent is approved for the treatment - a fully human monoclonal antibody that targets IL-17A (secukinumab). Further clinical trials, including a humanized IgG4 specific for IL-17 (ixekizumab) and a fully human antibody that targets the IL-17 receptor A (brodalumab).

Multivariate therapeutic approach to binge-eating disorder: combined nutritional, psychological and pharmacological treatment.

PubMed

Brambilla, Francesca; Samek, Lorenzo; Company, Marta; Lovo, Francesca; Cioni, Luisa; Mellado, Carmen

2009-11-01

Treatment for binge-eating disorder (BED) is directed towards either the physical or psychopathological impairments, and often does not cover all the alterations characterizing the disease. In 30 BED patients, we monitored the effects of three types of 6-month treatment, randomly assigned to one of the three treatment groups, each consisting of 10 patients. Group 1 received a 1700-kcal diet (21% proteins, 27% lipids, 52% carbohydrate), cognitive-behavioural therapy (CBT), sertraline (50-150 mg/day) and topiramate (25-150 mg/day); group 2 received the same diet, CBT, sertraline; and group 3 received nutritional counselling and CBT. Binge frequency and weight were assessed every month. The Eating Disorder Inventory-2, the Symptoms Check List-90-Revised (SCL-90-R) and the Personality Diagnostic Questionnaire-4-Revised (PDQ-4-R) were administered before and after treatment. Binge frequency and excessive weight decreased significantly only in group 1 patients, in whom improvement was noted in total Eating Disorder Inventory-2 scores and the subitems 'bulimia', 'drive for thinness', 'maturity fear', 'ascetism', in total SCL-90-R scores and in the subitem 'somatization', in PDQ-4-R subitems 'schizotypic personality' and 'dependent personality'. Group 2 patients improved on the SCL-90-R subitems 'depression' and 'interpersonal relationship' and in the PDQ-4-R 'schizoid personality'. Combination therapy seems to be the only fully effective treatment in BED patients.

Changes in root length during orthodontic treatment: advantages for immature teeth.

PubMed

Mavragani, Maria; Bøe, Olav Egil; Wisth, Per Johan; Selvig, Knut Andreas

2002-02-01

The purpose of the study was to investigate root lengthening during orthodontic treatment in relation to the age of the patient, the developmental stage of the root, and the anticipated growth. Specifically, the potential benefit of treating young teeth was addressed. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars, and edgewise technique with 0.018-inch slot brackets. Additionally, a cross-sectional control group of 66 untreated individuals matched to gender, and pre- and post-treatment age of the experimental group was included. Crown and root lengths of the maxillary incisors were measured on peri-apical radiographs before and after treatment, and corrected for image distortion. The stage of root development before treatment was recorded. Root elongation during treatment was found for 50 out of the 280 examined teeth. Age at treatment start was significantly higher among the patients showing root shortening of the lateral incisors during treatment than among those showing root elongation (P < 0.05). The stage of root development was significantly related to the direction of root length change, i.e. shortening or elongation. Roots elongated during treatment did not differ in length from untreated teeth of similarly aged individuals. There was no significant difference in the extent of root lengthening between the roots elongated during treatment and the normal root lengthening in age-matched untreated individuals. Post-treatment root length was significantly related to pre-treatment age. Roots that were incompletely developed before treatment reached a significantly greater length than those that were fully developed at the start of treatment. The results of this study show a definite advantage for younger teeth with regard to post-treatment root length. This finding may influence treatment planning strategy.

Effective metrics and a fully covariant description of constitutive tensors in electrodynamics

NASA Astrophysics Data System (ADS)

Schuster, Sebastian; Visser, Matt

2017-12-01

Using electromagnetism to study analogue space-times is tantamount to considering consistency conditions for when a given (meta-) material would provide an analogue space-time model or—vice versa—characterizing which given metric could be modeled with a (meta-) material. While the consistency conditions themselves are by now well known and studied, the form the metric takes once they are satisfied is not. This question is mostly easily answered by keeping the formalisms of the two research fields here in contact as close to each other as possible. While fully covariant formulations of the electrodynamics of media have been around for a long while, they are usually abandoned for (3 +1 )- or six-dimensional formalisms. Here we use the fully unified and fully covariant approach. This enables us even to generalize the consistency conditions for the existence of an effective metric to arbitrary background metrics beyond flat space-time electrodynamics. We also show how the familiar matrices for permittivity ɛ , permeability μ-1, and magnetoelectric effects ζ can be seen as the three independent pieces of the Bel decomposition for the constitutive tensor Za b c d, i.e., the components of an orthogonal decomposition with respect to a given observer with four-velocity Va. Finally, we use the Moore-Penrose pseudoinverse and the closely related pseudodeterminant to then gain the desired reconstruction of the effective metric in terms of the permittivity tensor ɛa b, the permeability tensor [μ-1]a b, and the magnetoelectric tensor ζa b, as an explicit function geff(ɛ ,μ-1,ζ ).

Automatic Segmentation of the Eye in 3D Magnetic Resonance Imaging: A Novel Statistical Shape Model for Treatment Planning of Retinoblastoma

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

Ciller, Carlos, E-mail: carlos.cillerruiz@unil.ch; Ophthalmic Technology Group, ARTORG Center of the University of Bern, Bern; Centre d’Imagerie BioMédicale, University of Lausanne, Lausanne

Purpose: Proper delineation of ocular anatomy in 3-dimensional (3D) imaging is a big challenge, particularly when developing treatment plans for ocular diseases. Magnetic resonance imaging (MRI) is presently used in clinical practice for diagnosis confirmation and treatment planning for treatment of retinoblastoma in infants, where it serves as a source of information, complementary to the fundus or ultrasonographic imaging. Here we present a framework to fully automatically segment the eye anatomy for MRI based on 3D active shape models (ASM), and we validate the results and present a proof of concept to automatically segment pathological eyes. Methods and Materials: Manualmore » and automatic segmentation were performed in 24 images of healthy children's eyes (3.29 ± 2.15 years of age). Imaging was performed using a 3-T MRI scanner. The ASM consists of the lens, the vitreous humor, the sclera, and the cornea. The model was fitted by first automatically detecting the position of the eye center, the lens, and the optic nerve, and then aligning the model and fitting it to the patient. We validated our segmentation method by using a leave-one-out cross-validation. The segmentation results were evaluated by measuring the overlap, using the Dice similarity coefficient (DSC) and the mean distance error. Results: We obtained a DSC of 94.90 ± 2.12% for the sclera and the cornea, 94.72 ± 1.89% for the vitreous humor, and 85.16 ± 4.91% for the lens. The mean distance error was 0.26 ± 0.09 mm. The entire process took 14 seconds on average per eye. Conclusion: We provide a reliable and accurate tool that enables clinicians to automatically segment the sclera, the cornea, the vitreous humor, and the lens, using MRI. We additionally present a proof of concept for fully automatically segmenting eye pathology. This tool reduces the time needed for eye shape delineation and thus can help clinicians when planning eye treatment and confirming the extent of the tumor.« less

Automatic Segmentation of the Eye in 3D Magnetic Resonance Imaging: A Novel Statistical Shape Model for Treatment Planning of Retinoblastoma.

PubMed

Ciller, Carlos; De Zanet, Sandro I; Rüegsegger, Michael B; Pica, Alessia; Sznitman, Raphael; Thiran, Jean-Philippe; Maeder, Philippe; Munier, Francis L; Kowal, Jens H; Cuadra, Meritxell Bach

2015-07-15

Proper delineation of ocular anatomy in 3-dimensional (3D) imaging is a big challenge, particularly when developing treatment plans for ocular diseases. Magnetic resonance imaging (MRI) is presently used in clinical practice for diagnosis confirmation and treatment planning for treatment of retinoblastoma in infants, where it serves as a source of information, complementary to the fundus or ultrasonographic imaging. Here we present a framework to fully automatically segment the eye anatomy for MRI based on 3D active shape models (ASM), and we validate the results and present a proof of concept to automatically segment pathological eyes. Manual and automatic segmentation were performed in 24 images of healthy children's eyes (3.29 ± 2.15 years of age). Imaging was performed using a 3-T MRI scanner. The ASM consists of the lens, the vitreous humor, the sclera, and the cornea. The model was fitted by first automatically detecting the position of the eye center, the lens, and the optic nerve, and then aligning the model and fitting it to the patient. We validated our segmentation method by using a leave-one-out cross-validation. The segmentation results were evaluated by measuring the overlap, using the Dice similarity coefficient (DSC) and the mean distance error. We obtained a DSC of 94.90 ± 2.12% for the sclera and the cornea, 94.72 ± 1.89% for the vitreous humor, and 85.16 ± 4.91% for the lens. The mean distance error was 0.26 ± 0.09 mm. The entire process took 14 seconds on average per eye. We provide a reliable and accurate tool that enables clinicians to automatically segment the sclera, the cornea, the vitreous humor, and the lens, using MRI. We additionally present a proof of concept for fully automatically segmenting eye pathology. This tool reduces the time needed for eye shape delineation and thus can help clinicians when planning eye treatment and confirming the extent of the tumor. Copyright © 2015 Elsevier Inc. All rights reserved.

Enforced abstinence from tobacco during in-patient dual-diagnosis treatment improves substance abuse treatment outcomes in smokers.

PubMed

Stuyt, Elizabeth B

2015-04-01

Although the prevalence of tobacco use in those in substance abuse treatment is known to be quite high, most treatment programs do not address tobacco. The purpose of this study was to determine substance abuse recovery rates a year after treatment in a fully integrated, 90-day inpatient, dual diagnosis treatment program where patients are required to quit tobacco use in addition to drug and alcohol use for the duration of their 3 month stay. Tobacco is treated in the same way as other drugs and alcohol. One hundred fifty-four patients enrolled in a yearlong follow-up after treatment study consisting of monthly phone contact to assess recovery from substance abuse. One hundred forty (n=140) patients completed the year follow-up. At the time of entry into the program 120 (86%) were using tobacco daily. At the end of the year this decreased to 102 (73%). Patients who were using tobacco were more likely to relapse to other drugs or alcohol (p = .01). Patients who actively attempted to abstain from tobacco after treatment were significantly more likely to remain continuously abstinent throughout the year (p = .03). This study demonstrates that tobacco use is correlated with relapse and addressing tobacco in treatment as seriously as and in the same fashion as other drugs, improves outcomes. When provided with a tobacco free treatment environment for 90 days, patients with substance abuse and mental illness can and do make the decision to quit tobacco and stay quit, aiding their ability to remain sober. © American Academy of Addiction Psychiatry.

International Primary Care Respiratory Group (IPCRG) Guidelines: management of asthma.

PubMed

van der Molen, Thys; Østrem, Anders; Stallberg, Bjorn; Østergaard, Marianne Stubbe; Singh, Raj B

2006-02-01

Worldwide, most patients with asthma are treated in primary care. Optimal primary care management of asthma is therefore of considerable importance. This IPCRG Guideline paper on the management of asthma in primary care is fully consistent with GINA guidelines. It is split into two sections, the first on the management of adults and schoolchildren, and the second on the management of pre-school children. It highlights the treatment goals for asthma and gives an overview of optimal management including the topics which should be covered by the primary care health professional when educating a patient about asthma. It covers the classification of the disease, the stepwise approach to pharmacologic therapy, disease monitoring, the management of exacerbations, and the identification of patients at risk of asthma death.

Effect of a novel mobilization with movement procedure on anterolateral ankle impingement - A case report.

PubMed

Anandkumar, Sudarshan

2018-07-01

This case report describes a 50-year-old male who presented with right anterolateral ankle pain managed unsuccessfully with rest, medications, bracing, injection, physical therapy, and massage therapy. Clinical diagnosis of anterolateral ankle impingement was based on concordant symptom reproduction with palpatory tenderness and a positive lateral synovial impingement test. This case report is a potential first time description of the successful management of anterolateral ankle impingement utilizing a novel Mulligan's mobilization with movement procedure (consisting of internal rotation of the distal tibia) and taping with immediate improvements noted in pain, range of motion, and function. The patient was seen twice a week and was discharged after four treatment sessions. A follow-up after 4 months revealed that the patient was pain free and fully functional.

Novel approaches to the study of particle dark matter in astrophysics

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

Argüelles, C. R., E-mail: carlos.arguelles@icranet.org; Ruffini, R., E-mail: ruffini@icra.it; Rueda, J. A., E-mail: jorge.rueda@icra.it

A deep understanding of the role of the dark matter in the different astrophysical scenarios of the local Universe such as galaxies, represent a crucial step to describe in a more consistent way the role of dark matter in cosmology. This kind of studies requires the interconnection between particle physics within and beyond the Standard Model, and fundamental physics such as thermodynamics and statistics, within a fully relativistic treatment of Gravity. After giving a comprehensive summary of the different types of dark matter and their role in astrophysics, we discuss the recent efforts in describing the distribution of dark mattermore » in the center and halo of galaxies from first principles such as gravitational interactions, quantum statistics and particle physics; and its implications with the observations.« less

Characterization of the Sol-Gel Transition for Zirconia-Toughened Alumina Precursors

NASA Technical Reports Server (NTRS)

Moeti, I.; Karikari, E.; Chen, J.

1998-01-01

High purity ZTA ceramic powders with and without yttria were produced using metal alkoxide precursors. ZTA ceramic powders with varying volume percents of zirconia were prepared (7, 15, and 22%). Aluminum tri-sec butoxide, zirconium propoxide, and yttrium isopropoxide were the reagents used. Synthesis conditions were varied to control the hydrolysis and the aging conditions for the sol to gel transition. FTIR analysis and theological characterization were used to follow the structural evolution during the sol to gel transition. The greater extent of hydrolysis and the build-up of structure measured from viscoelastic properties were consistent. Heat treatment was conducted to produce submicron grain fully crystalline ZTA ceramic powders. In all experimental cases a-alumina and tetragonal zirconia phases were confirmed even in the absence of yttria.

Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia: A Randomized Waitlist Controlled Trial.

PubMed

Horsch, Corine Hg; Lancee, Jaap; Griffioen-Both, Fiemke; Spruit, Sandor; Fitrianie, Siska; Neerincx, Mark A; Beun, Robbert Jan; Brinkman, Willem-Paul

2017-04-11

This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have insomnia. The objective of our study was to investigate the efficacy of CBT-I delivered via the Sleepcare mobile phone app, compared with a waitlist control group, in a randomized controlled trial. We recruited participants in the Netherlands with relatively mild insomnia disorder. After answering an online pretest questionnaire, they were randomly assigned to the app (n=74) or the waitlist condition (n=77). The app packaged a sleep diary, a relaxation exercise, sleep restriction exercise, and sleep hygiene and education. The app was fully automated and adjusted itself to a participant's progress. Program duration was 6 to 7 weeks, after which participants received posttest measurements and a 3-month follow-up. The participants in the waitlist condition received the app after they completed the posttest questionnaire. The measurements consisted of questionnaires and 7-day online diaries. The questionnaires measured insomnia severity, dysfunctional beliefs about sleep, and anxiety and depression symptoms. The diary measured sleep variables such as sleep efficiency. We performed multilevel analyses to study the interaction effects between time and condition. The results showed significant interaction effects (P<.01) favoring the app condition on the primary outcome measures of insomnia severity (d=-0.66) and sleep efficiency (d=0.71). Overall, these improvements were also retained in a 3-month follow-up. This study demonstrated the efficacy of a fully automated mobile phone app in the treatment of relatively mild insomnia. The effects were in the range of what is found for Web-based treatment in general. This supports the applicability of such technical tools in the treatment of insomnia. Future work should examine the generalizability to a more diverse population. Furthermore, the separate components of such an app should be investigated. It remains to be seen how this app can best be integrated into the current health regimens. Netherlands Trial Register: NTR5560; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5560 (Archived by WebCite at http://www.webcitation.org/6noLaUdJ4). ©Corine HG Horsch, Jaap Lancee, Fiemke Griffioen-Both, Sandor Spruit, Siska Fitrianie, Mark A Neerincx, Robbert Jan Beun, Willem-Paul Brinkman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.04.2017.

49 CFR Appendix B to Part 222 - Alternative Safety Measures

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Engineering ASMs, and Engineering ASMs. Modified SSMs are SSMs that do not fully comply with the provisions... reduction credit for pre-existing modified SSMs under the final rule. Non-engineering ASMs consist of... reduce risk within a quiet zone. Engineering ASMs consist of engineering improvements that address...

49 CFR Appendix B to Part 222 - Alternative Safety Measures

Code of Federal Regulations, 2011 CFR

2011-10-01

...-Engineering ASMs, and Engineering ASMs. Modified SSMs are SSMs that do not fully comply with the provisions... reduction credit for pre-existing modified SSMs under the final rule. Non-engineering ASMs consist of... reduce risk within a quiet zone. Engineering ASMs consist of engineering improvements that address...

Fully Integrated e-Services for Prevention, Diagnosis, and Treatment of Sexually Transmitted Infections: Results of a 4-County Study in California

PubMed Central

Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P.; Padian, Nancy; Blake, Diane R.; Gaydos, Charlotte A.

2014-01-01

Objectives. We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. Methods. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. Results. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. Conclusions. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost. PMID:25320878

Fully integrated e-services for prevention, diagnosis, and treatment of sexually transmitted infections: results of a 4-county study in California.

PubMed

Spielberg, Freya; Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P; Padian, Nancy; Blake, Diane R; Gaydos, Charlotte A

2014-12-01

We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost.

Surrogacy Assessment Using Principal Stratification and a Gaussian Copula Model

PubMed Central

Taylor, J.M.G.; Elliott, M.R.

2014-01-01

In clinical trials, a surrogate outcome (S) can be measured before the outcome of interest (T) and may provide early information regarding the treatment (Z) effect on T. Many methods of surrogacy validation rely on models for the conditional distribution of T given Z and S. However, S is a post-randomization variable, and unobserved, simultaneous predictors of S and T may exist, resulting in a non-causal interpretation. Frangakis and Rubin1 developed the concept of principal surrogacy, stratifying on the joint distribution of the surrogate marker under treatment and control to assess the association between the causal effects of treatment on the marker and the causal effects of treatment on the clinical outcome. Working within the principal surrogacy framework, we address the scenario of an ordinal categorical variable as a surrogate for a censored failure time true endpoint. A Gaussian copula model is used to model the joint distribution of the potential outcomes of T, given the potential outcomes of S. Because the proposed model cannot be fully identified from the data, we use a Bayesian estimation approach with prior distributions consistent with reasonable assumptions in the surrogacy assessment setting. The method is applied to data from a colorectal cancer clinical trial, previously analyzed by Burzykowski et al..2 PMID:24947559

Surrogacy assessment using principal stratification and a Gaussian copula model.

PubMed

Conlon, Asc; Taylor, Jmg; Elliott, M R

2017-02-01

In clinical trials, a surrogate outcome ( S) can be measured before the outcome of interest ( T) and may provide early information regarding the treatment ( Z) effect on T. Many methods of surrogacy validation rely on models for the conditional distribution of T given Z and S. However, S is a post-randomization variable, and unobserved, simultaneous predictors of S and T may exist, resulting in a non-causal interpretation. Frangakis and Rubin developed the concept of principal surrogacy, stratifying on the joint distribution of the surrogate marker under treatment and control to assess the association between the causal effects of treatment on the marker and the causal effects of treatment on the clinical outcome. Working within the principal surrogacy framework, we address the scenario of an ordinal categorical variable as a surrogate for a censored failure time true endpoint. A Gaussian copula model is used to model the joint distribution of the potential outcomes of T, given the potential outcomes of S. Because the proposed model cannot be fully identified from the data, we use a Bayesian estimation approach with prior distributions consistent with reasonable assumptions in the surrogacy assessment setting. The method is applied to data from a colorectal cancer clinical trial, previously analyzed by Burzykowski et al.

Heat-machine control by quantum-state preparation: from quantum engines to refrigerators.

PubMed

Gelbwaser-Klimovsky, D; Kurizki, G

2014-08-01

We explore the dependence of the performance bounds of heat engines and refrigerators on the initial quantum state and the subsequent evolution of their piston, modeled by a quantized harmonic oscillator. Our goal is to provide a fully quantized treatment of self-contained (autonomous) heat machines, as opposed to their prevailing semiclassical description that consists of a quantum system alternately coupled to a hot or a cold heat bath and parametrically driven by a classical time-dependent piston or field. Here, by contrast, there is no external time-dependent driving. Instead, the evolution is caused by the stationary simultaneous interaction of two heat baths (having distinct spectra and temperatures) with a single two-level system that is in turn coupled to the quantum piston. The fully quantized treatment we put forward allows us to investigate work extraction and refrigeration by the tools of quantum-optical amplifier and dissipation theory, particularly, by the analysis of amplified or dissipated phase-plane quasiprobability distributions. Our main insight is that quantum states may be thermodynamic resources and can provide a powerful handle, or control, on the efficiency of the heat machine. In particular, a piston initialized in a coherent state can cause the engine to produce work at an efficiency above the Carnot bound in the linear amplification regime. In the refrigeration regime, the coefficient of performance can transgress the Carnot bound if the piston is initialized in a Fock state. The piston may be realized by a vibrational mode, as in nanomechanical setups, or an electromagnetic field mode, as in cavity-based scenarios.

Molecular effects of fractional carbon dioxide laser resurfacing on photodamaged human skin.

PubMed

Reilly, Michael J; Cohen, Marc; Hokugo, Akishige; Keller, Gregory S

2010-01-01

Objective To elucidate the sequential changes in protein expression that play a role in the clinically beneficial results seen with fractional carbon dioxide (CO(2)) laser resurfacing of the face and neck. Methods Nine healthy volunteers were recruited for participation from the senior author's facial plastic surgery practice. After informed consent was obtained, each volunteer underwent a 2-mm punch biopsy from a discrete area of infra-auricular neck skin prior to laser treatment. Patients then immediately underwent laser resurfacing of photodamaged face and neck skin at a minimal dose (30 W for 0.1 second) with the Pixel Perfect fractional CO(2) laser. On completion of the treatment, another biopsy specimen was taken adjacent to the first site. Additional biopsy specimens were subsequently taken from adjacent skin at 2 of 3 time points (day 7, day 14, or day 21). RNA was extracted from the specimens, and reverse transcriptase-polymerase chain reaction and protein microarray analysis were performed. Comparisons were then made between time points using pairwise comparison testing. Results We found statistically significant changes in the gene expression of several matrix metalloproteinases (MMPs). The data demonstrate a consistent up-regulation of MMPs 1, 3, 9, and 13, all of which have been previously reported for fully ablative CO(2) laser resurfacing. There was also a statistically significant increase in MMP-10 and MMP-11 levels in this data set. Conclusion This study suggests that the molecular mechanisms of action are similar for both fractional and fully ablative CO(2) laser resurfacing.

Heat-machine control by quantum-state preparation: From quantum engines to refrigerators

NASA Astrophysics Data System (ADS)

Gelbwaser-Klimovsky, D.; Kurizki, G.

2014-08-01

We explore the dependence of the performance bounds of heat engines and refrigerators on the initial quantum state and the subsequent evolution of their piston, modeled by a quantized harmonic oscillator. Our goal is to provide a fully quantized treatment of self-contained (autonomous) heat machines, as opposed to their prevailing semiclassical description that consists of a quantum system alternately coupled to a hot or a cold heat bath and parametrically driven by a classical time-dependent piston or field. Here, by contrast, there is no external time-dependent driving. Instead, the evolution is caused by the stationary simultaneous interaction of two heat baths (having distinct spectra and temperatures) with a single two-level system that is in turn coupled to the quantum piston. The fully quantized treatment we put forward allows us to investigate work extraction and refrigeration by the tools of quantum-optical amplifier and dissipation theory, particularly, by the analysis of amplified or dissipated phase-plane quasiprobability distributions. Our main insight is that quantum states may be thermodynamic resources and can provide a powerful handle, or control, on the efficiency of the heat machine. In particular, a piston initialized in a coherent state can cause the engine to produce work at an efficiency above the Carnot bound in the linear amplification regime. In the refrigeration regime, the coefficient of performance can transgress the Carnot bound if the piston is initialized in a Fock state. The piston may be realized by a vibrational mode, as in nanomechanical setups, or an electromagnetic field mode, as in cavity-based scenarios.

Peach response to water deficit in a semi-arid region

NASA Astrophysics Data System (ADS)

Paltineanu, C.; Septar, L.; Moale, C.; Nicolae, S.; Nicola, C.

2013-09-01

During three years a deficit irrigation experiment was performed on peach response under the semi-arid conditions of south-eastern Romania. Three sprinkler-irrigated treatments were investigated: fully irrigated, deficit irrigation treatment, and non-irrigated control treatment. Soil water content ranged between 60 and 76% of the plant available soil water capacity in fully irrigated, between 40 and 62% in deficit irrigation treatment, and between 30 and 45% in control. There were significant differences in fruit yield between the treatments. Irrigation water use efficiency was maximum in deficit irrigation treatment. Fruit yield correlated significantly with irrigation application. Total dry matter content, total solids content and titrable acidity of fruit were significantly different in the irrigated treatments vs. the control. Significant correlation coefficients were found between some fruit chemical components. For the possible future global warming conditions, when water use becomes increasingly restrictive, deficit irrigation will be a reasonable solution for water conservation in regions with similar soil and climate conditions.

[Comments on the seven clinical questions & answers in Japanese gastric treatment guidelines of the 4th edition].

PubMed

Xu, J M

2017-03-23

Japanese gastric cancer treatment guidelines of the 4th Edition proposed solutions to 7 clinically contentious questions. However, the solutions to question 1-3 are not complete and may cause ambiguity. In order to avoid the wrong choice of surgical resection, the solutions to question 1-3 should be clearly defined. For question 1-3, we suggest provisos be added such as patients with resectable M1 disease and without any other non-curable factors, after whose status and tumor biological behavior being fully understood and being fully discussed by a multidisciplinary team, can be recommended to receive comprehensive treatment including surgical resection.

THERMAL FATIGUE OF INCONEL ALLOY DA718

DTIC Science & Technology

2016-10-27

this material meets the required improvement and offers a low cost alternative to powder metallurgy Rene’95. However, its thermal fatigue resistance ...remains to be fully clarified. Its nominal chemical composition is shown in Table B-1. In the fully heat treated condition, DA718 consists of a γ...chromel-alumel thermocouple , spot-welded to the mid-length of the specimen. The thermal strain, induced by the expansion and contraction of the

Current multiple sclerosis treatments have improved our understanding of MS autoimmune pathogenesis.

PubMed

Martin, Roland; Sospedra, Mireia; Rosito, Maria; Engelhardt, Britta

2016-09-01

Multiple sclerosis (MS) is the most common inflammatory disorder of the central nervous system (CNS) in young adults. When MS is not treated, it leads to irreversible and severe disability. The etiology of MS and its pathogenesis are not fully understood. The recent discovery that MS-associated genetic variants code for molecules related to the function of specific immune cell subsets is consistent with the concept of MS as a prototypic, T-cell-mediated autoimmune disease targeting the CNS. While the therapeutic efficacy of the currently available immunomodulatory therapies further strengthen this concept, differences observed in responses to MS treatment as well as additional clinical and imaging observations have also shown that the autoimmune pathogenesis underlying MS is much more complex than previously thought. There is therefore an unmet need for continued detailed phenotypic and functional analysis of disease-relevant adaptive immune cells and tissues directly derived from MS patients to unravel the immune etiology of MS in its entire complexity. In this review, we will discuss the currently available MS treatment options and approved drugs, including how they have contributed to the understanding of the immune pathology of this autoimmune disease. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Performance of repair welds on aged Cr-Mo piping girth welds

NASA Astrophysics Data System (ADS)

Viswanathan, R.; Gandy, D. W.

1999-10-01

This article documents the results of an industry survey of weld repair practices and describes the results of experimental evaluations performed on service-aged 21/4 Cr-1Mo steel piping using SMAW with both conventional postweld heat treatments and temper bead repair techniques. The overall results of this program provide substantial evidence that service-aged piping systems can be successfully weld repaired with and without postweld heat treatments and that life extension by several decades is achievable under the right design and repair conditions. Weld repairs performed on degraded exservice welds resulted in restoration or improvement of tensile and creep properties. Microhardness test results within the heat-affected zone of each weldment indicated that the temper bead weld repairs produced only slightly higher peak hardness values than those measured for the fully postweld heat treated repairs. Finally, in terms of toughness, temper bead weld repairs consistently produced higher impact properties than those measured for the postweld heat treated weldments. Gas tungsten arc weld repairs with postweld heat treatment resulted in the best combination of tensile strength, uniform microhardness distribution across the weld, Charpy toughness, and creep rupture life.

Robotic digital subtraction angiography systems within the hybrid operating room.

PubMed

Murayama, Yuichi; Irie, Koreaki; Saguchi, Takayuki; Ishibashi, Toshihiro; Ebara, Masaki; Nagashima, Hiroyasu; Isoshima, Akira; Arakawa, Hideki; Takao, Hiroyuki; Ohashi, Hiroki; Joki, Tatsuhiro; Kato, Masataka; Tani, Satoshi; Ikeuchi, Satoshi; Abe, Toshiaki

2011-05-01

Fully equipped high-end digital subtraction angiography (DSA) within the operating room (OR) environment has emerged as a new trend in the fields of neurosurgery and vascular surgery. To describe initial clinical experience with a robotic DSA system in the hybrid OR. A newly designed robotic DSA system (Artis zeego; Siemens AG, Forchheim, Germany) was installed in the hybrid OR. The system consists of a multiaxis robotic C arm and surgical OR table. In addition to conventional neuroendovascular procedures, the system was used as an intraoperative imaging tool for various neurosurgical procedures such as aneurysm clipping and spine instrumentation. Five hundred one neurosurgical procedures were successfully conducted in the hybrid OR with the robotic DSA. During surgical procedures such as aneurysm clipping and arteriovenous fistula treatment, intraoperative 2-/3-dimensional angiography and C-arm-based computed tomographic images (DynaCT) were easily performed without moving the OR table. Newly developed virtual navigation software (syngo iGuide; Siemens AG) can be used in frameless navigation and in access to deep-seated intracranial lesions or needle placement. This newly developed robotic DSA system provides safe and precise treatment in the fields of endovascular treatment and neurosurgery.

Initial results utilizing combination therapy for patients with a suboptimal response to either alprostadil or sildenafil monotherapy.

PubMed

Mydlo, J H; Volpe, M A; Macchia, R J

2000-07-01

Intraurethral alprostadil and oral sildenafil are useful in selected patients. However, there continues to be a significant treatment failure rate. Since their mechanisms of action are different, we wanted to evaluate the effectiveness of combination therapy. Of 214 patients treated for erectile dysfunction (ED), 65 were not fully satisfied with the firmness of their erections via monotherapy. Responses were evaluated using the International Index for Erectile Function (IIEF) questionnaire before and after treatment. Group I consisted of 33 patients who tried maximal dose intraurethral alprostadil monotherapy initially, followed by the maximal dose of sildenafil monotherapy, and were still unsatisfied. Group II consisted of 32 patients who tried the maximal dose sildenafil monotherapy initially, followed by the maximal dose of alprostadil monotherapy, and were also unsatisfied. There 65 patients then underwent combination therapy. 60 out of the 65 patients stated they were satisfied with combination therapy. Questionnaire scores for erectile function were 23.1+/-2.0 (114%) for combination therapy vs. 19.2+/-1.8 (77%) and 15.2+/-1.6 (41%) for sildenafil and alprostadil monotherapies (p<0.05). There were no significant differences in responses between the two groups. The men also reported improvement in intercourse and overall satisfaction. Combination therapy may be an option for motivated patients who have a suboptimal response from monotherapy.

In Vitro Modeling of Repetitive Motion Injury and Myofascial Release

PubMed Central

Meltzer, Kate R.; Cao, Thanh V.; Schad, Joseph F.; King, Hollis; Stoll, Scott T.; Standley, Paul R.

2010-01-01

Objective In this study we modeled repetitive motion strain (RMS) and myofascial release (MFR) in vitro to investigate possible cellular and molecular mechanisms to potentially explain the immediate clinical outcomes associated with RMS and MFR. Method Cultured human fibroblasts were strained with 8 hours RMS, 60 seconds MFR and combined treatment; RMS+MFR. Fibroblasts were immediately sampled upon cessation of strain and evaluated for cell morphology, cytokine secretions, proliferation, apoptosis, and potential changes to intracellular signaling molecules. Results RMS induced fibroblast elongation of lameopodia, cellular decentralization, reduction of cell to cell contact and significant decreases in cell area to perimeter ratios compared to all other experimental groups (p<0.0001). Cellular proliferation indicated no change among any treatment group; however RMS resulted in a significant increase in apoptosis rate (p<0.05) along with increases in death-associated protein kinase (DAPK) and focal adhesion kinase (FAK) phosphorylation by 74% and 58% respectively, when compared to control. These responses were not observed in the MFR and RMS+MFR group. Of the twenty cytokines measured there was a significant increase in GRO secretion in the RMS+MFR group when compared to control and MFR alone. Conclusion Our modeled injury (RMS) appropriately displayed enhanced apoptosis activity and loss of intercellular integrity that is consistent with pro-apoptotic DAPK2 and FAK signaling. Treatment with MFR following RMS resulted in normalization in apoptotic rate and cell morphology both consistent with changes observed in DAPK2. These in vitro studies build upon the cellular evidence base needed to fully explain clinical efficacy of manual manipulative therapies. PMID:20226363

Implementing Treat-to-Target Practices for Chronic Pain Through Shared Decision Making: Requisites, Prospects, and Challenges.

PubMed

Falzer, Paul R

2017-02-01

Treat-to-target (T2T) includes a target or goal, standard symptom assessment, and a treatment decision. In specialties that threat chronic pain, T2T is expected to be implemented collaboratively. The ability of patients to participate fully has been questioned, but these concerns have not been demonstrated empirically. The current study examined how patient self-assessed symptom measures and illness beliefs affect their willingness to change their current treatment. A total of 157 patients with rheumatoid arthritis completed a standard "disease activity" (DA) battery consisting of current joint pain, recent pain, daily functioning, and generality disability assessments, along with an illness belief questionnaire and a willingness to change measure. Data were collected at 2-month intervals over a 6-month period. Single and multiple influences on willingness to change were examined using linear mixed models. Willingness is strongly and directly associated with DA scores. Beliefs that were significant as single factors became nonsignificant once DA scores were introduced. The findings established a strong and consistent link between DA scores and willingness, and ruled out the prospect that illness beliefs mediate or moderate this relationship. It was also found that willingness to change is directly related to the number of significant self-reported symptoms. Concerns about the ability of patients to participate in a collaborative implementation of T2T were not substantiated. Future studies can examine the subtle interplay of goals, assessments, and treatment decisions and clarify outstanding issues about the practice of clinical decision making. © 2016 World Institute of Pain.

Fully implicit moving mesh adaptive algorithm

NASA Astrophysics Data System (ADS)

Chacon, Luis

2005-10-01

In many problems of interest, the numerical modeler is faced with the challenge of dealing with multiple time and length scales. The former is best dealt with with fully implicit methods, which are able to step over fast frequencies to resolve the dynamical time scale of interest. The latter requires grid adaptivity for efficiency. Moving-mesh grid adaptive methods are attractive because they can be designed to minimize the numerical error for a given resolution. However, the required grid governing equations are typically very nonlinear and stiff, and of considerably difficult numerical treatment. Not surprisingly, fully coupled, implicit approaches where the grid and the physics equations are solved simultaneously are rare in the literature, and circumscribed to 1D geometries. In this study, we present a fully implicit algorithm for moving mesh methods that is feasible for multidimensional geometries. A crucial element is the development of an effective multilevel treatment of the grid equation.ootnotetextL. Chac'on, G. Lapenta, A fully implicit, nonlinear adaptive grid strategy, J. Comput. Phys., accepted (2005) We will show that such an approach is competitive vs. uniform grids both from the accuracy (due to adaptivity) and the efficiency standpoints. Results for a variety of models 1D and 2D geometries, including nonlinear diffusion, radiation-diffusion, Burgers equation, and gas dynamics will be presented.

Chronic total occlusion successfully treated with a bioresorbable everolimus-eluting vascular scaffold

PubMed Central

Mattesini, Alessio; Dall'Ara, Gianni; Mario, Carlo Di

2014-01-01

Fully bioresorbable vascular scaffolds (BVS) are a new approach to the percutaneous treatment of coronary artery disease. The BVS have not yet been fully tested in complex lesions, including chronic total occlusion (CTO). We report a CTO case successfully treated with a second-generation bioabsorbable drug-eluting scaffold. PMID:25061461

Nucleolus-like bodies of fully-grown mouse oocytes contain key nucleolar proteins but are impoverished for rRNA.

PubMed

Shishova, Kseniya V; Lavrentyeva, Elena A; Dobrucki, Jurek W; Zatsepina, Olga V

2015-01-15

It is well known that fully-grown mammalian oocytes, rather than typical nucleoli, contain prominent but structurally homogenous bodies called "nucleolus-like bodies" (NLBs). NLBs accumulate a vast amount of material, but their biochemical composition and functions remain uncertain. To clarify the composition of the NLB material in mouse GV oocytes, we devised an assay to detect internal oocyte proteins with fluorescein-5-isothiocyanate (FITC) and applied the fluorescent RNA-binding dye acridine orange to examine whether NLBs contain RNA. Our results unequivocally show that, similarly to typical nucleoli, proteins and RNA are major constituents of transcriptionally active (or non-surrounded) NLBs as well as of transcriptionally silent (or surrounded) NLBs. We also show, by exposing fixed oocytes to a mild proteinase K treatment, that the NLB mass in oocytes of both types contains nucleolar proteins that are involved in all major steps of ribosome biogenesis, including rDNA transcription (UBF), early rRNA processing (fibrillarin), and late rRNA processing (NPM1/nucleophosmin/B23, nucleolin/C23), but none of the nuclear proteins tested, including SC35, NOBOX, topoisomerase II beta, HP1α, and H3. The ribosomal RPL26 protein was detected within the NLBs of NSN-type oocytes but is virtually absent from NLBs of SN-type oocytes. Taking into account that the major class of nucleolar RNA is ribosomal RNA (rRNA), we applied fluorescence in situ hybridization with oligonucleotide probes targeting 18S and 28S rRNAs. The results show that, in contrast to active nucleoli, NLBs of fully-grown oocytes are impoverished for the rRNAs, which is consistent with the absence of transcribed ribosomal genes in the NLB mass. Overall, the results of this study suggest that NLBs of fully-grown mammalian oocytes serve for storing major nucleolar proteins but not rRNA. Copyright © 2014 Elsevier Inc. All rights reserved.

The effect of alternative graphical displays used to present the benefits of antibiotics for sore throat on decisions about whether to seek treatment: a randomized trial.

PubMed

Carling, Cheryl L L; Kristoffersen, Doris Tove; Flottorp, Signe; Fretheim, Atle; Oxman, Andrew D; Schünemann, Holger J; Akl, Elie A; Herrin, Jeph; MacKenzie, Thomas D; Montori, Victor M

2009-08-01

We conducted an Internet-based randomized trial comparing four graphical displays of the benefits of antibiotics for people with sore throat who must decide whether to go to the doctor to seek treatment. Our objective was to determine which display resulted in choices most consistent with participants' values. This was the first of a series of televised trials undertaken in cooperation with the Norwegian Broadcasting Company. We recruited adult volunteers in Norway through a nationally televised weekly health program. Participants went to our Web site and rated the relative importance of the consequences of treatment using visual analogue scales (VAS). They viewed the graphical display (or no information) to which they were randomized and were asked to decide whether to go to the doctor for an antibiotic prescription. We compared four presentations: face icons (happy/sad) or a bar graph showing the proportion of people with symptoms on day three with and without treatment, a bar graph of the average duration of symptoms, and a bar graph of proportion with symptoms on both days three and seven. Before completing the study, all participants were shown all the displays and detailed patient information about the treatment of sore throat and were asked to decide again. We calculated a relative importance score (RIS) by subtracting the VAS scores for the undesirable consequences of antibiotics from the VAS score for the benefit of symptom relief. We used logistic regression to determine the association between participants' RIS and their choice. 1,760 participants completed the study. There were statistically significant differences in the likelihood of choosing to go to the doctor in relation to different values (RIS). Of the four presentations, the bar graph of duration of symptoms resulted in decisions that were most consistent with the more fully informed second decision. Most participants also preferred this presentation (38%) and found it easiest to understand (37%). Participants shown the other three presentations were more likely to decide to go to the doctor based on their first decision than everyone based on the second decision. Participants preferred the graph using faces the least (14.4%). For decisions about going to the doctor to get antibiotics for sore throat, treatment effects presented by a bar graph showing the duration of symptoms helped people make decisions more consistent with their values than treatment effects presented as graphical displays of proportions of people with sore throat following treatment. ISRCTN58507086.

What is the optimal systemic treatment of men with metastatic, hormone-naive prostate cancer? A STOPCAP systematic review and network meta-analysis.

PubMed

Vale, C L; Fisher, D J; White, I R; Carpenter, J R; Burdett, S; Clarke, N W; Fizazi, K; Gravis, G; James, N D; Mason, M D; Parmar, M K B; Rydzewska, L H; Sweeney, C J; Spears, M R; Sydes, M R; Tierney, J F

2018-05-01

Our prior Systemic Treatment Options for Cancer of the Prostate systematic reviews showed improved survival for men with metastatic hormone-naive prostate cancer when abiraterone acetate plus prednisolone/prednisone (AAP) or docetaxel (Doc), but not zoledronic acid (ZA), were added to androgen-deprivation therapy (ADT). Trial evidence also suggests a benefit of combining celecoxib (Cel) with ZA and ADT. To establish the optimal treatments, a network meta-analysis (NMA) was carried out based on aggregate data (AD) from all available studies. Overall survival (OS) and failure-free survival data from completed Systemic Treatment Options for Cancer of the Prostate reviews of Doc, ZA and AAP and from recent trials of ZA and Cel contributed to this comprehensive AD-NMA. The primary outcome was OS. Correlations between treatment comparisons within one multi-arm, multi-stage trial were estimated from control-arm event counts. Network consistency and a common heterogeneity variance were assumed. We identified 10 completed trials which had closed to recruitment, and one trial in which recruitment was ongoing, as eligible for inclusion. Results are based on six trials including 6204 men (97% of men randomised in all completed trials). Network estimates of effects on OS were consistent with reported comparisons with ADT alone for AAP [hazard ration (HR) = 0.61, 95% confidence interval (CI) 0.53-0.71], Doc (HR = 0.77, 95% CI 0.68-0.87), ZA + Cel (HR = 0.78, 95% CI 0.62-0.97), ZA + Doc (HR = 0.79, 95% CI 0.66-0.94), Cel (HR = 0.94 95% CI 0.75-1.17) and ZA (HR = 0.90 95% CI 0.79-1.03). The effect of ZA + Cel is consistent with the additive effects of the individual treatments. Results suggest that AAP has the highest probability of being the most effective treatment both for OS (94% probability) and failure-free survival (100% probability). Doc was the second-best treatment of OS (35% probability). Uniquely, we have included all available results and appropriately accounted for inclusion of multi-arm, multi-stage trials in this AD-NMA. Our results support the use of AAP or Doc with ADT in men with metastatic hormone-naive prostate cancer. AAP appears to be the most effective treatment, but it is not clear to what extent and whether this is due to a true increased benefit with AAP or the variable features of the individual trials. To fully account for patient variability across trials, changes in prognosis or treatment effects over time and the potential impact of treatment on progression, a network meta-analysis based on individual participant data is in development.

Prostatectomy: information provision and education for patients.

PubMed

Simpson, Paula

Following the diagnosis of prostate cancer, information should be imparted to ensure an informed decision regarding treatment can be made. The impact of a cancer diagnosis could lead men to opt for surgical intervention without fully understanding the consequences of treatment. Effective communication of evidence-based information can assist men to fully understand the consequences of treatment. Radical prostatectomy, whether robotically assisted laparoscopic or retropubic, will lead to quality-of-life issues with functional outcomes such as erectile dysfunction and urinary incontinence being at the forefront. Issues should be discussed and communicated in depth so that frustration and regret following treatment are avoided. A cautious approach to information provision should be considered so the patient does not feel in a position of information overload. Advanced communication skills are of utmost importance to ensure information is tailored to suit individual needs, as no one model of information giving suits all. This article is a rapid literature search relating to post-prostatectomy functional outcomes and how communication and information giving before treatment assists with acceptance of treatment outcomes.

Once hurt, twice shy: Social pain contributes to social anxiety.

PubMed

Fung, Klint; Alden, Lynn E

2017-03-01

Social rejection has been consistently linked to the development of social anxiety. However, mechanisms underlying the relation have been largely unexplored, which presents an obstacle to fully understanding the origins of social anxiety and to the development of effective prevention and treatment strategies. Two studies were conducted to test the hypothesis that the emotion of social pain following rejection promotes the development of social anxiety in subsequent situations. In Study 1, undergraduate participants were exposed to 2 social situations (Cyberball) 2 days apart. Participants who were rejected in the first situation reported higher social anxiety before and during the second situation relative to those who were included. This effect was fully mediated by initial social pain intensity. In Study 2, all participants were initially rejected. Using double-blinded drug administration, participants were randomly assigned to ingest acetaminophen to alleviate the social pain from rejection, or a sugar placebo. As predicted, the acetaminophen group reported lower social anxiety before and during the second situation. Approximately half of the effect was mediated by reduction in social pain. Notably, the immediate effect of acetaminophen was specific to social pain rather than social anxiety. Results were discussed in the context of literature on the etiology of social anxiety and social pain. Future directions were suggested. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Occurrence of pharmaceuticals in river water and their elimination in a pilot-scale drinking water treatment plant.

PubMed

Vieno, Niina M; Härkki, Heli; Tuhkanen, Tuula; Kronberg, Leif

2007-07-15

The occurrence of four beta blockers, one antiepileptic drug, one lipid regulator, four anti-inflammatories, and three fluoroquinolones was studied in a river receiving sewage effluents. All compounds but two of the fluoroquinolones were observed in the water above their limit of quantification concentrations. The highest concentrations (up to 107 ng L(-1)) of the compounds were measured during the winter months. The river water was passed to a pilot-scale drinking water treatment plant, and the elimination of the pharmaceuticals was followed during the treatment. The processes applied by the plant consisted of ferric salt coagulation, rapid sand filtration, ozonation, two-stage granular activated carbon filtration (GAC), and UV disinfection. Following the coagulation, sedimentation, and rapid sand filtration, the studied pharmaceuticals were found to be eliminated only by an average of 13%. An efficient elimination was found to take place during ozonation at an ozone dose of about 1 mg L(-1) (i.e., 0.2-0.4 mg of O3/ mg of TOC). Following this treatment, the concentrations of the pharmaceuticals dropped to below the quantification limits with the exception of ciprofloxacin. Atenolol, sotalol, and ciprofloxacin, the most hydrophilic of the studied pharmaceuticals, were not fully eliminated during the GAC filtrations. All in all, the treatment train was found to very effectively eliminate the pharmaceuticals from the rawwater. The only compound that was found to pass almost unaffected through all the treatment steps was ciprofloxacin.

Relaxation-induced anxiety: Effects of peak and trajectories of change on treatment outcome for generalized anxiety disorder.

PubMed

Newman, Michelle G; Lafreniere, Lucas S; Jacobson, Nicholas C

2018-07-01

Evidence is mixed regarding whether relaxation-induced anxiety (RIA) impedes relaxation training (RT) efficacy. Unlike past studies that averaged RIA across sessions, we examined peak RIA, change in RIA level across sessions, and timing of peak RIA with outcome. This was a secondary analysis of Borkovec, Newman, Pincus, and Lytle [2002. A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70, 288-298. doi: 10.1037/0022-006X.70.2.288 ]. Forty-one GAD participants were assigned randomly to CBT (n = 22) or BT (n = 19). Both treatments contained RT and RIA ratings within 13/14 sessions. Analyses used generalized additive mixed models (GAMMs), which accounted for longitudinal nonindependence and examined nonlinear trajectories of change. All participants improved significantly regardless of RIA. "Change trajectory of RIA level did not predict outcome". Instead, lower peak RIA predicted fewer GAD symptoms at post-treatment and greater likelihood to continue to improve during follow-up. Also, timing of peak was important. Whereas lower peak early in therapy did not predict outcome, lower peak during the last third of treatment did. Peak RIA's effect was neither accounted for by baseline symptom severity, treatment condition, comorbidity, nor by preceding or concurrent anxiety symptom change. People with consistently low peak RIA and/or who fully habituate to RIA by the end of therapy respond optimally to relaxation-based treatments.

SU-G-TeP4-06: An Integrated Application for Radiation Therapy Treatment Plan Directives, Management, and Reporting

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

Matuszak, M; Anderson, C; Lee, C

Purpose: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. Methods: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record. Using the Eclipse Scripting Applicationmore » Programming Interface, a plug-in script with an associated domain-specific SQL Server database was created to manage the information in (i)–(iv). The system’s user interface and database were designed by a team of physicians, clinical physicists, database experts, and software engineers to ensure usability and robustness for clinical use. Results: The resulting system has been fully integrated within the TPS via a custom script and database. Planning scenario templates, version control, approvals, and logic-based quality control allow this system to fully track and document the planning process as well as physician approval of tradeoffs while improving the consistency of the data. Multiple plans and prescriptions are supported along with non-traditional dose objectives and evaluation such as biologically corrected models, composite dose limits, and management of localization goals. User-specific custom views were developed for the attending physician review, physicist plan checks, treating therapists, and peer review in chart rounds. Conclusion: A method was developed to maintain cohesive information throughout the planning process within one integrated system by using a custom treatment planning management application that interfaces directly with the TPS. Future work includes quantifying the improvements in quality, safety and efficiency that are possible with the routine clinical use of this system. Supported in part by NIH-P01-CA-059827.« less

Sample size requirements for one-year treatment effects using deep gray matter volume from 3T MRI in progressive forms of multiple sclerosis.

PubMed

Kim, Gloria; Chu, Renxin; Yousuf, Fawad; Tauhid, Shahamat; Stazzone, Lynn; Houtchens, Maria K; Stankiewicz, James M; Severson, Christopher; Kimbrough, Dorlan; Quintana, Francisco J; Chitnis, Tanuja; Weiner, Howard L; Healy, Brian C; Bakshi, Rohit

2017-11-01

The subcortical deep gray matter (DGM) develops selective, progressive, and clinically relevant atrophy in progressive forms of multiple sclerosis (PMS). This patient population is the target of active neurotherapeutic development, requiring the availability of outcome measures. We tested a fully automated MRI analysis pipeline to assess DGM atrophy in PMS. Consistent 3D T1-weighted high-resolution 3T brain MRI was obtained over one year in 19 consecutive patients with PMS [15 secondary progressive, 4 primary progressive, 53% women, age (mean±SD) 50.8±8.0 years, Expanded Disability Status Scale (median, range) 5.0, 2.0-6.5)]. DGM segmentation applied the fully automated FSL-FIRST pipeline ( http://fsl.fmrib.ox.ac.uk ). Total DGM volume was the sum of the caudate, putamen, globus pallidus, and thalamus. On-study change was calculated using a random-effects linear regression model. We detected one-year decreases in raw [mean (95% confidence interval): -0.749 ml (-1.455, -0.043), p = 0.039] and annualized [-0.754 ml/year (-1.492, -0.016), p = 0.046] total DGM volumes. A treatment trial for an intervention that would show a 50% reduction in DGM brain atrophy would require a sample size of 123 patients for a single-arm study (one-year run-in followed by one-year on-treatment). For a two-arm placebo-controlled one-year study, 242 patients would be required per arm. The use of DGM fraction required more patients. The thalamus, putamen, and globus pallidus, showed smaller effect sizes in their on-study changes than the total DGM; however, for the caudate, the effect sizes were somewhat larger. DGM atrophy may prove efficient as a short-term outcome for proof-of-concept neurotherapeutic trials in PMS.

Facile mechanical shaking method is an improved isolation approach for islet preparation and transplantation.

PubMed

Yin, Nina; Chen, Tao; Yu, Yuling; Han, Yongming; Yan, Fei; Zheng, Zhou; Chen, Zebin

2016-12-01

Successful islet isolation is crucial for islet transplantation and cell treatment for type 1 diabetes. Current isolation methods are able to obtain 500-1,000 islets per rat, which results in a waste of ≥50% of total islets. In the present study, a facile mechanical shaking method for improving islet yield (up to 1,500 per rat) was developed and summarized, which was demonstrated to be more effective than the existing well-established stationary method. The present results showed that isolated islets have a maximum yield of 1,326±152 when shaking for 15 min for the fully-cannulated pancreas. For both fully-cannulated and half-cannulated pancreas in the presence of rat DNAse inhibitor, the optimal shaking time was amended to 20 min with a further increased yield of 1,344±134 and 1,286±124 islets, respectively. Furthermore, the majority of the isolated islets were morphologically intact with a well-defined surface and almost no central necrotic zone, which suggested that the condition of islets obtained via the mechanical shaking method was consistent with the stationary method. Islet size distribution was also calculated and it was demonstrated that islets from the stationary method exhibited the same size distribution as the non-cannulated group, which had more larger islets than the fully-cannulated and half-cannulated groups isolated via the shaking method. In addition, the results of glucose challenge showed that the refraction index of each group was >2.5, which indicated the well-preserved function of isolated islets. Furthermore, the transplanted islets exhibited a therapeutic effect after 1 day of transplantation; however, they failed to control blood glucose levels after ~7 days of transplantation. In conclusion, these results demonstrated that the facile mechanical shaking method may markedly improve the yield of rat islet isolation, and in vitro and in vivo investigation demonstrated the well-preserved function of isolated islets in the control of blood glucose. Therefore, the facile mechanical shaking method may be an alternative improved procedure to obtain higher islet yield for islet preparation and transplantation in the treatment of type 1 diabetes.

FDNY and 9/11: Clinical services and health outcomes in World Trade Center-exposed firefighters and EMS workers from 2001 to 2016.

PubMed

Yip, Jennifer; Webber, Mayris P; Zeig-Owens, Rachel; Vossbrinck, Madeline; Singh, Ankura; Kelly, Kerry; Prezant, David J

2016-09-01

After the World Trade Center (WTC) attacks on September 11, 2001, the Fire Department of the City of New York (FDNY) instituted a WTC medical monitoring and treatment program and established a data center to document health outcomes in the WTC-exposed workforce of ∼16,000 firefighters and EMS workers. FDNY schedules routine monitoring exams every 12-18 months and physical and mental health treatment appointments, as required. FDNY research studies have consistently found that early arrival to work and/or prolonged work at the WTC-site increased the risks for adverse physical and mental health outcomes. To date, a substantial proportion has been diagnosed with obstructive airways disease, chronic rhinosinusitis, and gastroesophageal reflux disease; a quarter has two or more of these conditions. While much has been learned, the entire spectrum and trajectory of WTC-related disorders and their mechanisms of onset and persistence remain to be fully described. Am. J. Ind. Med. 59:695-708, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

308nm Excimer Laser in Dermatology

PubMed Central

Mehraban, Shadi

2014-01-01

308nm xenon-chloride excimer laser, a novel mode of phototherapy, is an ultraviolet B radiation system consisting of a noble gas and halide. The aim of this systematic review was to investigate the literature and summarize all the experiments, clinical trials and case reports on 308-nm excimer laser in dermatological disorders. 308-nm excimer laser has currently a verified efficacy in treating skin conditions such as vitiligo, psoriasis, atopic dermatitis, alopecia areata, allergic rhinitis, folliculitis, granuloma annulare, lichen planus, mycosis fungoides, palmoplantar pustulosis, pityriasis alba, CD30+ lympho proliferative disorder, leukoderma, prurigo nodularis, localized scleroderma and genital lichen sclerosus. Although the 308-nm excimer laser appears to act as a promising treatment modality in dermatology, further large-scale studies should be undertaken in order to fully affirm its safety profile considering the potential risk, however minimal, of malignancy, it may impose. PMID:25606333

Collisionless plasma expansion into vacuum: Two new twists on an old problem

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

Arefiev, Alexey V.; Breizman, Boris N.

The paper deals with a generic problem of collisionless plasma expansion into vacuum in the regimes where the expanding plasma consists of hot electrons and cold ions. The expansion is caused by electron pressure and serves as an energy transfer mechanism from electrons to ions. This process is often described under the assumption of Maxwellian electrons, which easily fails in the absence of collisions. The paper discusses two systems with a naturally occurring non-Maxwellian distribution: an expanding laser-irradiated nanoplasma and a supersonic jet coming out of a magnetic nozzle. The presented rigorous kinetic description demonstrates how the deviation from themore » Maxwellian distribution fundamentally alters the process of ion acceleration during plasma expansion. This result points to the critical importance of a fully kinetic treatment in problems with collisionless plasma expansion.« less

Perturbation theory for water with an associating reference fluid

NASA Astrophysics Data System (ADS)

Marshall, Bennett D.

2017-11-01

The theoretical description of the thermodynamics of water is challenged by the structural transition towards tetrahedral symmetry at ambient conditions. As perturbation theories typically assume a spherically symmetric reference fluid, they are incapable of accurately describing the liquid properties of water at ambient conditions. In this paper we address this problem by introducing the concept of an associated reference perturbation theory (APT). In APT we treat the reference fluid as an associating hard sphere fluid which transitions to tetrahedral symmetry in the fully hydrogen bonded limit. We calculate this transition in a theoretically self-consistent manner without appealing to molecular simulations. This associated reference provides the reference fluid for a second order Barker-Henderson perturbative treatment of the long-range attractions. We demonstrate that this approach gives a significantly improved description of water as compared to standard perturbation theories.

Bilateral sudden sensorineural hearing loss as a presenting feature of systemic lupus erythematosus

PubMed Central

Chawki, Sylvain; Aouizerate, Jessie; Trad, Selim; Prinseau, Jacques; Hanslik, Thomas

2016-01-01

Abstract Introduction: Sudden sensorineural hearing loss is an unusual presenting clinical feature of systemic lupus erythematosus. Case report: We report the case of a young woman who was admitted to hospital for sudden sensorineural hearing loss and hemophagocytic syndrome which was attributed to systemic lupus erythematosus on the basis of specific renal involvement, thrombocytopenia, and consistent autoantibodies. Favorable outcome was obtained on high-dose corticosteroids, and the hearing fully recovered. Discussion: Sudden sensorineural hearing loss in systemic lupus erythematosus is seemingly more frequently associated with severe systemic involvement and antiphospholipid antibodies may be present. Although management remains empirical, the high risk of permanent hearing impairment seems to justify emergency treatment with high-dose corticosteroids. When the clinical and laboratory criteria of antiphospholipid syndrome are met, antiplatelets agents or anticoagulation therapy shall be considered. PMID:27603334

Relationship of microstructure properties to oxygen impurities in nanocrystalline silicon photovoltaic materials

NASA Astrophysics Data System (ADS)

Xu, H.; Wen, C.; Liu, H.; Li, Z. P.; Shen, W. Z.

2013-03-01

We have fully investigated the correlation of microstructure properties and oxygen impurities in hydrogenated nanocrystalline silicon photovoltaic films. The achievement has been realized through a series of different hydrogen dilution ratio treatment by plasma enhanced chemical vapor deposition system. Raman scattering, x-ray diffraction, and ultraviolet-visible transmission techniques have been employed to characterize the physical structural characterization and to elucidate the structure evolution. The bonding configuration of the oxygen impurities was investigated by x-ray photoelectron spectroscopy and the Si-O stretching mode of infrared-transmission, indicating that the films were well oxidized in SiO2 form. Based on the consistence between the proposed structure factor and the oxygen content, we have demonstrated that there are two dominant disordered structure regions closely related to the post-oxidation contamination: plate-like configuration and clustered microvoids.

Extracting Information about the Initial State from the Black Hole Radiation.

PubMed

Lochan, Kinjalk; Padmanabhan, T

2016-02-05

The crux of the black hole information paradox is related to the fact that the complete information about the initial state of a quantum field in a collapsing spacetime is not available to future asymptotic observers, belying the expectations from a unitary quantum theory. We study the imprints of the initial quantum state contained in a specific class of distortions of the black hole radiation and identify the classes of in states that can be partially or fully reconstructed from the information contained within. Even for the general in state, we can uncover some specific information. These results suggest that a classical collapse scenario ignores this richness of information in the resulting spectrum and a consistent quantum treatment of the entire collapse process might allow us to retrieve much more information from the spectrum of the final radiation.

Collisionless plasma expansion into vacuum: Two new twists on an old problema)

NASA Astrophysics Data System (ADS)

Arefiev, Alexey V.; Breizman, Boris N.

2009-05-01

The paper deals with a generic problem of collisionless plasma expansion into vacuum in the regimes where the expanding plasma consists of hot electrons and cold ions. The expansion is caused by electron pressure and serves as an energy transfer mechanism from electrons to ions. This process is often described under the assumption of Maxwellian electrons, which easily fails in the absence of collisions. The paper discusses two systems with a naturally occurring non-Maxwellian distribution: an expanding laser-irradiated nanoplasma and a supersonic jet coming out of a magnetic nozzle. The presented rigorous kinetic description demonstrates how the deviation from the Maxwellian distribution fundamentally alters the process of ion acceleration during plasma expansion. This result points to the critical importance of a fully kinetic treatment in problems with collisionless plasma expansion.

Shaping charge excitations in chiral edge states with a time-dependent gate voltage

NASA Astrophysics Data System (ADS)

Misiorny, Maciej; Fève, Gwendal; Splettstoesser, Janine

2018-02-01

We study a coherent conductor supporting a single edge channel in which alternating current pulses are created by local time-dependent gating and sent on a beam-splitter realized by a quantum point contact. The current response to the gate voltage in this setup is intrinsically linear. Based on a fully self-consistent treatment employing a Floquet scattering theory, we analyze the effect of different voltage shapes and frequencies, as well as the role of the gate geometry on the injected signal. In particular, we highlight the impact of frequency-dependent screening on the process of shaping the current signal. The feasibility of creating true single-particle excitations with this method is confirmed by investigating the suppression of excess noise, which is otherwise created by additional electron-hole pair excitations in the current signal.

Navy Collaborative Integrated Information Technology Initiative (NAVCIITI)

DTIC Science & Technology

2004-09-01

We investigated a new type of antenna array consisting of sub- elements that are excited together to form the primary element. All of the sub...elements of the array are excited for the highest operating band. Only the primary elements are excited for the low frequency band. This fractal geometry has...fully active array. The fully active input impedance is the input impedance of an element in an array when all elements are excited . It is a function

Random location of fuel treatments in wildland community interfaces: a percolation approach

Treesearch

Michael Bevers; Philip N. Omi; John G. Hof

2004-01-01

We explore the use of spatially correlated random treatments to reduce fuels in landscape patterns that appear somewhat natural while forming fully connected fuelbreaks between wildland forests and developed protection zones. From treatment zone maps partitioned into grids of hexagonal forest cells representing potential treatment sites, we selected cells to be treated...

Neoclassical simulation of tokamak plasmas using the continuum gyrokinetic code TEMPEST.

PubMed

Xu, X Q

2008-07-01

We present gyrokinetic neoclassical simulations of tokamak plasmas with a self-consistent electric field using a fully nonlinear (full- f ) continuum code TEMPEST in a circular geometry. A set of gyrokinetic equations are discretized on a five-dimensional computational grid in phase space. The present implementation is a method of lines approach where the phase-space derivatives are discretized with finite differences, and implicit backward differencing formulas are used to advance the system in time. The fully nonlinear Boltzmann model is used for electrons. The neoclassical electric field is obtained by solving the gyrokinetic Poisson equation with self-consistent poloidal variation. With a four-dimensional (psi,theta,micro) version of the TEMPEST code, we compute the radial particle and heat fluxes, the geodesic-acoustic mode, and the development of the neoclassical electric field, which we compare with neoclassical theory using a Lorentz collision model. The present work provides a numerical scheme for self-consistently studying important dynamical aspects of neoclassical transport and electric field in toroidal magnetic fusion devices.

Neoclassical simulation of tokamak plasmas using the continuum gyrokinetic code TEMPEST

NASA Astrophysics Data System (ADS)

Xu, X. Q.

2008-07-01

We present gyrokinetic neoclassical simulations of tokamak plasmas with a self-consistent electric field using a fully nonlinear (full- f ) continuum code TEMPEST in a circular geometry. A set of gyrokinetic equations are discretized on a five-dimensional computational grid in phase space. The present implementation is a method of lines approach where the phase-space derivatives are discretized with finite differences, and implicit backward differencing formulas are used to advance the system in time. The fully nonlinear Boltzmann model is used for electrons. The neoclassical electric field is obtained by solving the gyrokinetic Poisson equation with self-consistent poloidal variation. With a four-dimensional (ψ,θ,γ,μ) version of the TEMPEST code, we compute the radial particle and heat fluxes, the geodesic-acoustic mode, and the development of the neoclassical electric field, which we compare with neoclassical theory using a Lorentz collision model. The present work provides a numerical scheme for self-consistently studying important dynamical aspects of neoclassical transport and electric field in toroidal magnetic fusion devices.

Blue light differentially represses mesophyll conductance in high vs low latitude genotypes of Populus trichocarpa Torr. & Gray.

PubMed

Momayyezi, Mina; Guy, Robert D

2017-06-01

To explore what role chloroplast positioning might have in relation to latitudinal variation in mesophyll conductance (g m ) of Populus trichocarpa Torr. & Gray (black cottonwood), we examined photosynthetic response to different blue light treatments in six representative genotypes (three northern and three southern). The proportion of blue (B) to red light was varied from 0:100, 10:90, 20:80, 40:60, and 60:40 while keeping the total photosynthetic photon flux density constant. Mesophyll conductance was estimated by monitoring chlorophyll fluorescence in combination with gas exchange. Compared to the control (10% B), g m was significantly lower with increasing blue light. Consistent with a change in chloroplast positioning, there was a simultaneous but reversible decrease in chlorophyll content index (CCI), as measured by foliar greenness, while the extracted, actual chlorophyll content (ACC) remained unchanged. Blue-light-induced decreases in g m and CCI were greater in northern genotypes than in southern genotypes, both absolutely and proportionally, consistent with their inherently higher photosynthetic rate. Treatment of leaves with cytochalasin D, an inhibitor of actin-based chloroplast motility, reduced both CCI and ACC but had no effect on the CCI/ACC ratio and fully blocked any effect of blue light on CCI. Cytochalasin D reduced g m by ∼56% under 10% B, but did not block the effect of 60% B on g m , which was reduced a further 20%. These results suggest that the effect of high blue light on g m is at least partially independent of chloroplast repositioning. High blue light reduced carbonic anhydrase activity by 20% (P<0.05), consistent with a possible reduction in protein-mediated facilitation of CO 2 diffusion. Copyright © 2017 Elsevier GmbH. All rights reserved.

First Line Treatment Response in Patients with Transmitted HIV Drug Resistance and Well Defined Time Point of HIV Infection: Updated Results from the German HIV-1 Seroconverter Study

PubMed Central

zu Knyphausen, Fabia; Scheufele, Ramona; Kücherer, Claudia; Jansen, Klaus; Somogyi, Sybille; Dupke, Stephan; Jessen, Heiko; Schürmann, Dirk; Hamouda, Osamah; Meixenberger, Karolin; Bartmeyer, Barbara

2014-01-01

Background Transmission of drug-resistant HIV-1 (TDR) can impair the virologic response to antiretroviral combination therapy. Aim of the study was to assess the impact of TDR on treatment success of resistance test-guided first-line therapy in the German HIV-1 Seroconverter Cohort for patients infected with HIV between 1996 and 2010. An update of the prevalence of TDR and trend over time was performed. Methods Data of 1,667 HIV-infected individuals who seroconverted between 1996 and 2010 were analysed. The WHO drug resistance mutations list was used to identify resistance-associated HIV mutations in drug-naïve patients for epidemiological analysis. For treatment success analysis the Stanford algorithm was used to classify a subset of 323 drug-naïve genotyped patients who received a first-line cART into three resistance groups: patients without TDR, patients with TDR and fully active cART and patients with TDR and non-fully active cART. The frequency of virologic failure 5 to 12 months after treatment initiation was determined. Results Prevalence of TDR was stable at a high mean level of 11.9% (198/1,667) in the HIV-1 Seroconverter Cohort without significant trend over time. Nucleotide reverse transcriptase inhibitor resistance was predominant (6.0%) and decreased significantly over time (OR = 0.92, CI = 0.87–0.98, p = 0.01). Non-nucleoside reverse transcriptase inhibitor (2.4%; OR = 1.00, CI = 0.92–1.09, p = 0.96) and protease inhibitor resistance (2.0%; OR = 0.94, CI = 0.861.03, p = 0.17) remained stable. Virologic failure was observed in 6.5% of patients with TDR receiving fully active cART, 5,6% of patients with TDR receiving non-fully active cART and 3.2% of patients without TDR. The difference between the three groups was not significant (p = 0.41). Conclusion Overall prevalence of TDR remained stable at a rather high level. No significant differences in the frequency of virologic failure were identified during first-line cART between patients with TDR and fully-active cART, patients with TDR and non-fully active cART and patients without TDR. PMID:24788613

Photorejuvenation: still not a fully established clinical tool for cosmetic treatment

NASA Astrophysics Data System (ADS)

Gong, Wei; Xie, Shusen; Li, Hui

2006-01-01

Several methods have been used to improve the esthetic appearance of photodamaged skin including dermabrasion, chemical peels and laser resurfacing using CO2 and Er:YAG laser. These procedures sacrifice epidermis, resulting in a long recuperation period and potential complications including persistent scarring, infection, hyperpigmentation, etc. Compared to ablative CO2 or Er:YAG laser resurfacing, non-ablative photorejuvenation technologies are playing an increasing role in the treatment of photodamaged skin. The clinical objective of which is to maximize thermal damage to upper dermis while minimizing injury to overlying skin. A variety of laser and non-laser systems have been used in the initial stage for this treatment. In our review, different treatment modalities have resulted in varying degrees of clinical effects. The basic mechanisms relate to improvement in employing non-ablative technologies are also discussed. Photorejuvenation is still not a fully established clinical tool for cosmetic treatment according to our review, therefore more research on basic mechanisms should be made.

Startup, Shutdown, & Malfunction (SSM) Emissions

EPA Pesticide Factsheets

EPA issued a final action to ensure states have plans in place that are fully consistent with the Clean Air Act and recent court decisions concerning startup, shutdown and malfunction (SSM) operations.

Many-body Green’s function theory for electron-phonon interactions: Ground state properties of the Holstein dimer

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

Säkkinen, Niko; Leeuwen, Robert van; Peng, Yang

2015-12-21

We study ground-state properties of a two-site, two-electron Holstein model describing two molecules coupled indirectly via electron-phonon interaction by using both exact diagonalization and self-consistent diagrammatic many-body perturbation theory. The Hartree and self-consistent Born approximations used in the present work are studied at different levels of self-consistency. The governing equations are shown to exhibit multiple solutions when the electron-phonon interaction is sufficiently strong, whereas at smaller interactions, only a single solution is found. The additional solutions at larger electron-phonon couplings correspond to symmetry-broken states with inhomogeneous electron densities. A comparison to exact results indicates that this symmetry breaking is stronglymore » correlated with the formation of a bipolaron state in which the two electrons prefer to reside on the same molecule. The results further show that the Hartree and partially self-consistent Born solutions obtained by enforcing symmetry do not compare well with exact energetics, while the fully self-consistent Born approximation improves the qualitative and quantitative agreement with exact results in the same symmetric case. This together with a presented natural occupation number analysis supports the conclusion that the fully self-consistent approximation describes partially the bipolaron crossover. These results contribute to better understanding how these approximations cope with the strong localizing effect of the electron-phonon interaction.« less

Early Hypoparathyroidism Reversibility with Treatment of Riedel's Thyroiditis.

PubMed

Stan, Marius N; Haglind, Elizabeth G; Drake, Matthew T

2015-09-01

Riedel's thyroiditis (RT) is a rare, fibroinflammatory condition which induces gradual thyroid gland destruction and adjacent soft-tissue fibrous infiltration. About one- seventh of RT cases are associated with hypoparathyroidism, necessitating long-term therapy for symptomatic hypocalcemia. The reversibility of the parathyroid hormone deficit has not been fully described. A 40-year-old woman with no prior history of thyroid disease presented with a six month history of progressive thyroid enlargement complicated by worsening dysphagia and positional dyspnea. Her past medical history was remarkable only for retroperitoneal fibrosis. Physical examination revealed a large, hard, non-mobile goiter. Thyroid indices while maintained on levothyroxine were normal, but marked asymptomatic hypocalcemia with an inappropriately normal parathyroid hormone level was noted. Thyroid imaging and fine needle aspiration were consistent with RT. Isthmectomy and subsequent serial corticosteroid and tamoxifen treatment led to rapid symptom improvement. Serum calcium and parathyroid hormone levels returned to the reference range within three months. We describe a case of RT in which hypoparathyroidism resolved after treatment targeted the mechanical compression and the fibroinflammatory milieu of the patient's thyroidal disease. RT can be associated with hypoparathyroidism that is clinically silent at presentation. Mechanical decompression of the goiter and immunomodulatory therapy can reverse the fibrosclerotic process and lead to rapid recovery of parathyroid gland function, as in this patient. However, in most cases hypoparathyroidism is persistent and requires continued treatment to prevent symptomatic hypocalcemia.

Phenformin enhances the efficacy of ERK inhibition in NF1-mutant melanoma

PubMed Central

Shaw, Fiona M.; Yao, Zhan; Ran, Yuping; Shakuntala, Tiwari; Merghoub, Taha; Manstein, Dieter; Rosen, Neal; Cantley, Lewis C.; Zippin, Jonathan H.; Zheng, Bin

2017-01-01

Inactivation of the tumor suppressor neurofibromin 1 (NF1) presents a newly characterized melanoma subtype, for which currently no targeted therapies are clinically available. Pre-clinical studies suggest that ERK inhibitors are likely to provide benefit, albeit with limited efficacy as single agent; therefore, there is a need for rationally designed combination therapies. Here, we evaluate the combination of the ERK inhibitor SCH772984 and the biguanide phenformin. Combination of both compounds showed potent synergy in cell viability assays and cooperatively induced apoptosis. Treatment with both drugs was required to fully suppress mTOR signaling, a known effector of NF1 loss. Mechanistically, SCH772984 increased the oxygen consumption rate (OCR), indicating that these cells relied more on oxidative phosphorylation upon treatment. Consistently, SCH772984 increased expression of the mitochondrial transcriptional co-activator PGC1α. In contrast, co-treatment with phenformin, an inhibitor of complex I of the respiratory chain, decreased the OCR. SCH772984 also promoted the expansion of the H3K4 demethylase KDM5B (also known as JARID1B)-positive subpopulation of melanoma cells, which are slow-cycling and treatment-resistant. Importantly, phenformin suppressed this KDM5B-positive population, which reduced the emergence of SCH772984-resistant clones in long-term cultures. Our results warrant the clinical investigation of this combination therapy in patients with NF1 mutant melanoma. PMID:28143781

Endoscopic balloon dilatation as an effective treatment for lower and upper benign gastrointestinal system anastomotic stenosis.

PubMed

Akarsu, Cevher; Unsal, Mustafa Gokhan; Dural, Ahmet Cem; Kones, Osman; Kocatas, Ali; Karabulut, Mehmet; Kankaya, Burak; Ates, Mustafa; Alis, Halil

2015-04-01

Endoscopic balloon dilatation (EBD) is currently accepted as an effective, safe, and first-line treatment of postoperative benign gastrointestinal anastomosis stenosis (BGAS); however, a limited number of publications on the subject exist in the literature. The aim of the study was to retrospectively evaluate the efficiency of endoscopic dilatation in patients with postoperative intestinal anastomotic stenoses at a single surgical center. Patients with postoperative BGAS treated by EBD at our institution from February 2008 to 2012 were included. The dilatations were all performed using through-the-scope balloons. The balloon was introduced into the stricture using a guidewire under radiologic guidance. Each dilatation session consisted of 2 to 3 two-minute multistep inflations of the balloon until adequate dilatation was achieved. Of the 48 patients included in the study, 44 patients (91.7%) fully recovered and 4 (8.3%) did not respond to treatment. The mean follow-up period was 24 months (range, 3 to 57 mo). Four patients who did not respond to the procedure were treated surgically. Two patients (4.1%) with intestinal perforation during EBD were treated conservatively with a stent. EBD has a low rate of complications and a high success rate, is well tolerated, and avoids further surgical procedures for BGAS. Therefore, EBD should be the first choice of treatment for postoperative anastomotic stenoses.

A smartphone-based ecological momentary assessment of parental behavioral consistency: Associations with parental stress and child ADHD symptoms.

PubMed

Li, James J; Lansford, Jennifer E

2018-06-01

Inconsistent parental discipline is a robust correlate of child attention-deficit/hyperactivity disorder (ADHD) symptoms, but few studies have considered the role of inconsistent positive parenting on ADHD, as well as the effects of stress on negative and positive parental consistency. This study advanced a novel ecological momentary assessment (EMA) using participant smartphones to measure parental consistency, and examined its associations with family, social, and parenting-related dimensions of stress and child ADHD symptoms. Participants were 184 kindergartners with and without ADHD and their parents. Harsh and warm dimensions of parental behavior were assessed using questionnaires, observations, and an EMA administered through parents' smartphones, which measured parent-child behaviors every day for a period of 1 week. Family, social, and parenting-related stress were assessed from questionnaires, and child ADHD symptoms were assessed from a fully structured diagnostic interview with the parent. Child ADHD symptoms were associated with variability in warm parenting behaviors, and higher levels of parenting-related stress were related to greater variability in harsh parenting behaviors. No significant interactions were detected between parental stress and child ADHD on parental variability. These findings suggest that different factors influence the consistency in parenting behavior, depending on whether positive parenting or negative parenting is assessed. Parent-based treatment programs for children with ADHD should include a stronger focus on reducing stress from parenting (e.g., teaching coping skills for parents), as this may lead to greater consistency in parental behavior more generally, and presumably better child outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Interactions of fuel treatments, wildfire severity, and carbon dynamics in dry conifer forests

Treesearch

Larissa L. Yocom Kent; Kristen L. Shive; Barbara A. Strom; Carolyn H. Sieg; Molly E. Hunter; Camille S. Stevens-Rumann; Peter Z. Fule

2015-01-01

Wildfires have been increasing in size and severity over recent decades. Forest managers use fuel treatments, including tree thinning and prescribed burning, to reduce the risk of high-severity fire. The impact of fuel treatments on carbon dynamics is not fully understood; previous research indicates that because carbon is removed during fuel treatments, the net effect...

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

PubMed Central

Court, Laurence E.; Kisling, Kelly; McCarroll, Rachel; Zhang, Lifei; Yang, Jinzhong; Simonds, Hannah; du Toit, Monique; Trauernicht, Chris; Burger, Hester; Parkes, Jeannette; Mejia, Mike; Bojador, Maureen; Balter, Peter; Branco, Daniela; Steinmann, Angela; Baltz, Garrett; Gay, Skylar; Anderson, Brian; Cardenas, Carlos; Jhingran, Anuja; Shaitelman, Simona; Bogler, Oliver; Schmeller, Kathleen; Followill, David; Howell, Rebecca; Nelson, Christopher; Peterson, Christine; Beadle, Beth

2018-01-01

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated arc therapy (VMAT) plans for patients with head/neck cancer and 4-field box plans for patients with cervical cancer. It is a combination of specially developed in-house software that uses an application programming interface to communicate with a commercial radiotherapy treatment planning system. It also interfaces with a commercial secondary dose verification software. The necessary inputs to the system are a Treatment Plan Order, approved by the radiation oncologist, and a simulation computed tomography (CT) image, approved by the radiographer. The RPA then generates a complete radiotherapy treatment plan. For the cervical cancer treatment plans, no additional user intervention is necessary until the plan is complete. For head/neck treatment plans, after the normal tissue and some of the target structures are automatically delineated on the CT image, the radiation oncologist must review the contours, making edits if necessary. They also delineate the gross tumor volume. The RPA then completes the treatment planning process, creating a VMAT plan. Finally, the completed plan must be reviewed by qualified clinical staff. PMID:29708544

Fully integrated carbon nanotube composite thin film strain sensors on flexible substrates for structural health monitoring

NASA Astrophysics Data System (ADS)

Burton, A. R.; Lynch, J. P.; Kurata, M.; Law, K. H.

2017-09-01

Multifunctional thin film materials have opened many opportunities for novel sensing strategies for structural health monitoring. While past work has established methods of optimizing multifunctional materials to exhibit sensing properties, comparatively less work has focused on their integration into fully functional sensing systems capable of being deployed in the field. This study focuses on the advancement of a scalable fabrication process for the integration of multifunctional thin films into a fully integrated sensing system. This is achieved through the development of an optimized fabrication process that can create a broad range of sensing systems using multifunctional materials. A layer-by-layer deposited multifunctional composite consisting of single walled carbon nanotubes (SWNT) in a polyvinyl alcohol and polysodium-4-styrene sulfonate matrix are incorporated with a lithography process to produce a fully integrated sensing system deposited on a flexible substrate. To illustrate the process, a strain sensing platform consisting of a patterned SWNT-composite thin film as a strain-sensitive element within an amplified Wheatstone bridge sensing circuit is presented. Strain sensing is selected because it presents many of the design and processing challenges that are core to patterning multifunctional thin film materials into sensing systems. Strain sensors fabricated on a flexible polyimide substrate are experimentally tested under cyclic loading using standard four-point bending coupons and a partial-scale steel frame assembly under lateral loading. The study reveals the material process is highly repeatable to produce fully integrated strain sensors with linearity and sensitivity exceeding 0.99 and 5 {{V}}/{ε }, respectively. The thin film strain sensors are robust and are capable of high strain measurements beyond 3000 μ {ε }.

Active immunotherapy with ultraviolet B-irradiated autologous whole melanoma cells plus DETOX in patients with metastatic melanoma.

PubMed

Eton, O; Kharkevitch, D D; Gianan, M A; Ross, M I; Itoh, K; Pride, M W; Donawho, C; Buzaid, A C; Mansfield, P F; Lee, J E; Legha, S S; Plager, C; Papadopoulos, N E; Bedikian, A Y; Benjamin, R S; Balch, C M

1998-03-01

Our objective was to determine the clinical activity, toxicity, and immunological effects of active immunotherapy using UVB-irradiated (UVR) autologous tumor (AT) cells plus adjuvant DETOX in metastatic melanoma patients. Eligibility included nonanergic patients fully recovered after resection of 5 or more grams of metastatic melanoma. Treatment consisted of intradermal injections of 10(7) UVR-AT plus 0.25 ml of DETOX every 2 weeks x 6, then monthly. Peripheral blood mononuclear cells (PBMCs) were harvested for cytotoxicity assays, and skin testing was performed for delayed-type hypersensitivity (DTH) determinations before the first, fourth, seventh, and subsequent treatments. Forty-two patients were treated, 18 in the adjuvant setting and 24 with measurable disease. Among the latter group, there were two durable responses in soft-tissue sites and in a bone metastasis. Treatment was well tolerated. Thirty-five patients were assessable for immunological parameters; 10 of these patients, including the 2 responders, demonstrated early induction of PBMC cytotoxicity against AT cells that persisted up to 10 months on treatment before falling to background levels. In five of seven patients, the fall-off heralded progressive disease. Late induction of a weak DTH reaction to AT cells was observed in eight patients. Active immunotherapy with UVR-AT + DETOX had modest but definite clinical activity in advanced melanoma. The induction of both PBMC cytotoxicity and DTH reactivity to AT cells supported a specific systemic immune effect of treatment, although the former more closely followed disease course in this study.

Double ionization of helium by ion impact: second Born order treatment at the fully differential level

NASA Astrophysics Data System (ADS)

López, S. D.; Otranto, S.; Garibotti, C. R.

2015-01-01

In this work, a theoretical study of the double ionization of He by ion impact at the fully differential level is presented. Emphasis is made in the role played by the projectile in the double emission process depending on its charge and the amount of momentum transferred to the target. A Born-CDW model including a second-order term in the projectile charge is introduced and evaluated within an on-shell treatment. We find that emission geometries for which the second-order term dominates lead to asymmetric structures around the momentum transfer direction, a typical characteristic of higher order transitions.

Impact of early treatment programs on HIV epidemics: An immunity-based mathematical model.

PubMed

Rahman, S M Ashrafur; Vaidya, Naveen K; Zou, Xingfu

2016-10-01

While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria. Using our model, we evaluate the effects of early treatment on the new infection transmission, disease death, basic reproduction number, HIV prevalence, and the community-level immunity. Our model predicts that the programs with early treatments significantly reduce the new infection transmission and increase the community-level immunity, but the treatments alone may not be enough to eliminate HIV epidemics. These findings, including the community-level immunity, might provide helpful information for proper implementation of HIV treatment programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Nucleus Accumbens AMPA Receptors Are Necessary for Morphine-Withdrawal-Induced Negative-Affective States in Rats

PubMed Central

Russell, Shayla E.; Puttick, Daniel J.; Sawyer, Allison M.; Potter, David N.; Mague, Stephen; Carlezon, William A.

2016-01-01

Dependence is a hallmark feature of opiate addiction and is defined by the emergence of somatic and affective withdrawal signs. The nucleus accumbens (NAc) integrates dopaminergic and glutamatergic inputs to mediate rewarding and aversive properties of opiates. Evidence suggests that AMPA glutamate-receptor-dependent synaptic plasticity within the NAc underlies aspects of addiction. However, the degree to which NAc AMPA receptors (AMPARs) contribute to somatic and affective signs of opiate withdrawal is not fully understood. Here, we show that microinjection of the AMPAR antagonist NBQX into the NAc shell of morphine-dependent rats prevented naloxone-induced conditioned place aversions and decreases in sensitivity to brain stimulation reward, but had no effect on somatic withdrawal signs. Using a protein cross-linking approach, we found that the surface/intracellular ratio of NAc GluA1, but not GluA2, increased with morphine treatment, suggesting postsynaptic insertion of GluA2-lacking AMPARs. Consistent with this, 1-naphthylacetyl spermine trihydrochloride (NASPM), an antagonist of GluA2-lacking AMPARs, attenuated naloxone-induced decreases in sensitivity to brain stimulation reward. Naloxone decreased the surface/intracellular ratio and synaptosomal membrane levels of NAc GluA1 in morphine-dependent rats, suggesting a compensatory removal of AMPARs from synaptic zones. Together, these findings indicate that chronic morphine increases synaptic availability of GluA1-containing AMPARs in the NAc, which is necessary for triggering negative-affective states in response to naloxone. This is broadly consistent with the hypothesis that activation of NAc neurons produces acute aversive states and raises the possibility that inhibiting AMPA transmission selectively in the NAc may have therapeutic value in the treatment of addiction. SIGNIFICANCE STATEMENT Morphine dependence and withdrawal result in profound negative-affective states that play a major role in the maintenance of addiction. However, the underlying neurobiological mechanisms are not fully understood. We use a rat model of morphine dependence to show that GluA1 subunits of AMPA glutamate receptors in the nucleus accumbens (NAc), a brain region critical for modulating affective states, are necessary for aversive effects of morphine withdrawal. Using biochemical methods in NAc tissue, we show that morphine dependence increases cell surface expression of GluA1, suggesting that neurons in this area are primed for increased AMPA receptor activation upon withdrawal. This work is important because it suggests that targeting AMPA receptor trafficking and activation could provide novel targets for addiction treatment. PMID:27225765

NITRATE CONVERSION OF HB-LINE REILLEXTM HPQ RESIN

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

Steimke, J.; Williams, M.; Steeper, T.

Reillex{trademark} HPQ ion exchange resin is used by HB Line to remove plutonium from aqueous streams. Reillex{trademark} HPQ resin currently available from Vertellus Specialties LLC is a chloride ionic form, which can cause stress corrosion cracking in stainless steels. Therefore, HB Line Engineering requested that Savannah River National Laboratory (SRNL) convert resin from chloride form to nitrate form in the Engineering Development Laboratory (EDL). To perform this task, SRNL treated two batches of resin in 2012. The first batch of resin from Reilly Industries Batch 80302MA was initially treated at SRNL in 2001 to remove chloride. This batch of resin,more » nominally 30 liters, has been stored wet in carboys since that time until being retreated in 2012. The second batch of resin from Batch 23408 consisted of 50 kg of new resin purchased from Vertellus Specialties in 2012. Both batches were treated in a column designed to convert resin using downflow of 1.0 M sodium nitrate solution through the resin bed followed by rinsing with deionized water. Both batches were analyzed for chloride concentration, before and after treatment, using Neutron Activation Analysis (NAA). The resin specification [Werling, 2003] states the total chlorine and chloride concentration shall be less than 250 ppm. The resin condition for measuring this concentration is not specified; however, in service the resin would always be fully wet. Measurements in SRNL showed that changing from oven dry resin to fully wet resin, with liquid in the particle interstices but no supernatant, increases the total weight by a factor of at least three. Therefore, concentration of chlorine or chloride expressed as parts per million (ppm) decreases by a factor of three. Therefore, SRNL recommends measuring chlorine concentration on an oven dry basis, then dividing by three to estimate chloride concentration in the fully wet condition. Chloride concentration in the first batch (No.80302MA) was nearly the same before the current treatment (759 ppm dry) and after treatment (745 ppm dry or {approx}248 ppm wet). Treatment of the second batch of resin (No.23408) was very successful. Chloride concentration decreased from 120,000 ppm dry to an average of 44 ppm dry or {approx}15ppm wet, which easily passes the 250 ppm wet criterion. Per guidance from HB Line Engineering, SRNL blended Batch 80302 resin with Batch P9059 resin which had been treated previously by ResinTech to remove chloride. The chloride concentrations for the two drums of Batch P9059 were 248 ppm dry ({approx}83 ppm wet) {+-}22.8% and 583 ppm dry ({approx}194 ppm wet) {+-} 11.8%. The blended resin was packaged in five gallon buckets.« less

21 CFR 660.51 - Processing.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Processing method. (1) The processing method shall be one that has been shown to yield consistently a... be colored green. (3) Only that material which has been fully processed, thoroughly mixed in a single...

Cost-effectiveness of available treatment options for patients suffering from severe COPD in the UK: a fully incremental analysis.

PubMed

Hertel, Nadine; Kotchie, Robert W; Samyshkin, Yevgeniy; Radford, Matthew; Humphreys, Samantha; Jameson, Kevin

2012-01-01

Frequent exacerbations which are both costly and potentially life-threatening are a major concern to patients with chronic obstructive pulmonary disease (COPD), despite the availability of several treatment options. This study aimed to assess the lifetime costs and outcomes associated with alternative treatment regimens for patients with severe COPD in the UK setting. A Markov cohort model was developed to predict lifetime costs, outcomes, and cost-effectiveness of various combinations of a long-acting muscarinic antagonist (LAMA), a long-acting beta agonist (LABA), an inhaled corticosteroid (ICS), and roflumilast in a fully incremental analysis. Patients willing and able to take ICS, and those refusing or intolerant to ICS were analyzed separately. Efficacy was expressed as relative rate ratios of COPD exacerbation associated with alternative treatment regimens, taken from a mixed treatment comparison. The analysis was conducted from the UK National Health Service (NHS) perspective. Parameter uncertainty was explored using one-way and probabilistic sensitivity analysis. Based on the results of the fully incremental analysis a cost-effectiveness frontier was determined, indicating those treatment regimens which represent the most cost-effective use of NHS resources. For ICS-tolerant patients the cost-effectiveness frontier suggested LAMA as initial treatment. Where patients continue to exacerbate and additional therapy is required, LAMA + LABA/ICS can be a cost-effective option, followed by LAMA + LABA/ICS + roflumilast (incremental cost-effectiveness ratio [ICER] versus LAMA + LABA/ICS: £16,566 per quality-adjusted life-year [QALY] gained). The ICER in ICS-intolerant patients, comparing LAMA + LABA + roflumilast versus LAMA + LABA, was £13,764/QALY gained. The relative rate ratio of exacerbations was identified as the primary driver of cost-effectiveness. The treatment algorithm recommended in UK clinical practice represents a cost-effective approach for the management of COPD. The addition of roflumilast to the standard of care regimens is a clinical and cost-effective treatment option for patients with severe COPD, who continue to exacerbate despite existing bronchodilator therapy.

Lives in isolation: stories and struggles of low-income African American women with panic disorder.

PubMed

Johnson, Michael; Mills, Terry L; Deleon, Jessica M; Hartzema, Abraham G; Haddad, Judella

2009-01-01

Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.

Evidence-based decision-making as a practice-based learning skill: a pilot study.

PubMed

Falzer, Paul R; Garman, D Melissa

2012-03-01

As physicians are being trained to adapt their practices to the needs and experience of patients, initiatives to standardize care have been gaining momentum. The resulting conflict can be addressed through a practice-based learning and improvement (PBL) program that develops competency in using treatment guidelines as decision aids and incorporating patient-specific information into treatment recommendations. This article describes and tests a program that is consistent with the ACGME's multilevel competency-based approach, targets students at four levels of training, and features progressive learning objectives and assessments. The program was pilot-tested with 22 paid volunteer psychiatric residents and fellows. They were introduced to a schizophrenia treatment guideline and reviewed six case vignettes of varying complexity. PBL assessments were based on how treatment recommendations were influenced by clinical and patient-specific factors. The task permitted separate assessments of learning objectives all four training levels. Among the key findings at each level, most participants found the treatment guideline helpful in making treatment decisions. Recommendations were influenced by guideline-based assessment criteria and other clinical features. They were also influenced by patients' perceptions of their illness, patient-based progress assessments, and complications such as stressors and coping patterns. Recommendations were strongly influenced by incongruence between clinical facts and patient experience. Practical understanding of how patient experience joins with clinical knowledge can enhance the use of treatment guidelines as decision tools and enable clinicians to appreciate more fully how and why patients' perceptions of their illness should influence treatment recommendations. This PBL program can assist training facilities in preparing students to cope with contradictory demands to both standardize and adapt their practice. The program can be modified to accommodate various disorders and a range of clinical factors and patient-specific complications.

Startup, Shutdown, & Malfunction (SSM) Emissions at Industrial Facilities

EPA Pesticide Factsheets

EPA issued a final action to ensure states have plans in place that are fully consistent with the Clean Air Act and recent court decisions concerning startup, shutdown and malfunction (SSM) operations.

20 CFR 220.120 - The claimant's residual functional capacity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...

20 CFR 220.120 - The claimant's residual functional capacity.

Code of Federal Regulations, 2012 CFR

2012-04-01

... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...

20 CFR 220.120 - The claimant's residual functional capacity.

Code of Federal Regulations, 2013 CFR

2013-04-01

... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...

20 CFR 220.120 - The claimant's residual functional capacity.

Code of Federal Regulations, 2014 CFR

2014-04-01

... medically determinable impairment(s), such as skin impairment(s), epilepsy, impairment(s) of vision, hearing... with a low back disorder may be fully capable of the physical demands consistent with those of...

LIDT-DD: A New Self-Consistent Debris Disc Model Including Radiation Pressure and Coupling Dynamical and Collisional Evolution

NASA Astrophysics Data System (ADS)

Kral, Q.; Thebault, P.; Charnoz, S.

2014-01-01

The first attempt at developing a fully self-consistent code coupling dynamics and collisions to study debris discs (Kral et al. 2013) is presented. So far, these two crucial mechanisms were studied separately, with N-body and statistical collisional codes respectively, because of stringent computational constraints. We present a new model named LIDT-DD which is able to follow over long timescales the coupled evolution of dynamics (including radiation forces) and collisions in a self-consistent way.

A Fully Automated High-Throughput Zebrafish Behavioral Ototoxicity Assay.

PubMed

Todd, Douglas W; Philip, Rohit C; Niihori, Maki; Ringle, Ryan A; Coyle, Kelsey R; Zehri, Sobia F; Zabala, Leanne; Mudery, Jordan A; Francis, Ross H; Rodriguez, Jeffrey J; Jacob, Abraham

2017-08-01

Zebrafish animal models lend themselves to behavioral assays that can facilitate rapid screening of ototoxic, otoprotective, and otoregenerative drugs. Structurally similar to human inner ear hair cells, the mechanosensory hair cells on their lateral line allow the zebrafish to sense water flow and orient head-to-current in a behavior called rheotaxis. This rheotaxis behavior deteriorates in a dose-dependent manner with increased exposure to the ototoxin cisplatin, thereby establishing itself as an excellent biomarker for anatomic damage to lateral line hair cells. Building on work by our group and others, we have built a new, fully automated high-throughput behavioral assay system that uses automated image analysis techniques to quantify rheotaxis behavior. This novel system consists of a custom-designed swimming apparatus and imaging system consisting of network-controlled Raspberry Pi microcomputers capturing infrared video. Automated analysis techniques detect individual zebrafish, compute their orientation, and quantify the rheotaxis behavior of a zebrafish test population, producing a powerful, high-throughput behavioral assay. Using our fully automated biological assay to test a standardized ototoxic dose of cisplatin against varying doses of compounds that protect or regenerate hair cells may facilitate rapid translation of candidate drugs into preclinical mammalian models of hearing loss.

Performance and safety of an integrated bihormonal artificial pancreas for fully automated glucose control at home.

PubMed

Blauw, H; van Bon, A C; Koops, R; DeVries, J H

2016-07-01

To assess the performance and safety of an integrated bihormonal artificial pancreas system consisting of one wearable device and two wireless glucose sensor transmitters during short-term daily use at home. Adult patients with type 1 diabetes using an insulin pump were invited to enrol in this randomized crossover study. Treatment with the artificial pancreas started with a day and night in the clinical research centre, followed by 3 days at home. The control period consisted of 4 days of insulin pump therapy at home with blinded continuous glucose monitoring for data collection. Days 2-4 were predefined as the analysis period, with median glucose as the primary outcome. A total of 10 patients completed the study. The median [interquartile range (IQR)] glucose level was similar for the two treatments [7.3 (7.0-7.6) mmol/l for the artificial pancreas vs. 7.7 (7.0-9.0) mmol/l for the control; p = 0.123]. The median (IQR) percentage of time spent in euglycaemia (3.9-10 mmol/l) was longer during use of the artificial pancreas [84.7 (82.2-87.8)% for the artificial pancreas vs. 68.5 (57.9-83.6)% for the control; p = 0.007]. Time in hypoglycaemia was 1.3 (0.2-3.2)% for the artificial pancreas and 2.4 (0.4-10.3)% for the control treatment (p = 0.139). Separate analysis of daytime and night-time showed that the improvements were mainly achieved during the night. The results of this pilot study suggest that our integrated artificial pancreas provides better glucose control than insulin pump therapy in patients with type 1 diabetes at home and that the treatment is safe. © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Adherence to Antihypertensive Treatment and the Blood Pressure-Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial.

PubMed

Azizi, Michel; Pereira, Helena; Hamdidouche, Idir; Gosse, Philippe; Monge, Matthieu; Bobrie, Guillaume; Delsart, Pascal; Mounier-Véhier, Claire; Courand, Pierre-Yves; Lantelme, Pierre; Denolle, Thierry; Dourmap-Collas, Caroline; Girerd, Xavier; Michel Halimi, Jean; Zannad, Faiez; Ormezzano, Olivier; Vaïsse, Bernard; Herpin, Daniel; Ribstein, Jean; Chamontin, Bernard; Mourad, Jean-Jacques; Ferrari, Emile; Plouin, Pierre-François; Jullien, Vincent; Sapoval, Marc; Chatellier, Gilles

2016-09-20

The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure-lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control. One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients. The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (P=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was -6.7 mm Hg (P=0.0461) in fully adherent and -7.8 mm Hg (P=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients. In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01570777. © 2016 American Heart Association, Inc.

Fully kinetic particle simulations of high pressure streamer propagation

NASA Astrophysics Data System (ADS)

Rose, David; Welch, Dale; Thoma, Carsten; Clark, Robert

2012-10-01

Streamer and leader formation in high pressure devices is a dynamic process involving a hierarchy of physical phenomena. These include elastic and inelastic particle collisions in the gas, radiation generation, transport and absorption, and electrode interactions. We have performed 2D and 3D fully EM implicit particle-in-cell simulation model of gas breakdown leading to streamer formation under DC and RF fields. The model uses a Monte Carlo treatment for all particle interactions and includes discrete photon generation, transport, and absorption for ultra-violet and soft x-ray radiation. Central to the realization of this fully kinetic particle treatment is an algorithm [D. R. Welch, et al., J. Comp. Phys. 227, 143 (2007)] that manages the total particle count by species while preserving the local momentum distribution functions and conserving charge. These models are being applied to the analysis of high-pressure gas switches [D. V. Rose, et al., Phys. Plasmas 18, 093501 (2011)] and gas-filled RF accelerator cavities [D. V. Rose, et al. Proc. IPAC12, to appear].

Solving phase appearance/disappearance two-phase flow problems with high resolution staggered grid and fully implicit schemes by the Jacobian-free Newton–Krylov Method

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

Zou, Ling; Zhao, Haihua; Zhang, Hongbin

2016-04-01

The phase appearance/disappearance issue presents serious numerical challenges in two-phase flow simulations. Many existing reactor safety analysis codes use different kinds of treatments for the phase appearance/disappearance problem. However, to our best knowledge, there are no fully satisfactory solutions. Additionally, the majority of the existing reactor system analysis codes were developed using low-order numerical schemes in both space and time. In many situations, it is desirable to use high-resolution spatial discretization and fully implicit time integration schemes to reduce numerical errors. In this work, we adapted a high-resolution spatial discretization scheme on staggered grid mesh and fully implicit time integrationmore » methods (such as BDF1 and BDF2) to solve the two-phase flow problems. The discretized nonlinear system was solved by the Jacobian-free Newton Krylov (JFNK) method, which does not require the derivation and implementation of analytical Jacobian matrix. These methods were tested with a few two-phase flow problems with phase appearance/disappearance phenomena considered, such as a linear advection problem, an oscillating manometer problem, and a sedimentation problem. The JFNK method demonstrated extremely robust and stable behaviors in solving the two-phase flow problems with phase appearance/disappearance. No special treatments such as water level tracking or void fraction limiting were used. High-resolution spatial discretization and second- order fully implicit method also demonstrated their capabilities in significantly reducing numerical errors.« less

Nucleotides in 16S rRNA that are required in unmodified form for features recognized by ribosomal protein S8.

PubMed Central

Thurlow, D L; Ehresmann, C; Ehresmann, B

1983-01-01

Nucleotides in 16S rRNA which are required in unmodified form for specific recognition of ribosomal protein S8 from Escherichia coli were identified using a damage-selection experimental approach. Prior to complex formation with S8, 16S rRNA was treated under fully denaturing conditions with either diethyl pyrocarbonate or 25% hydrazine. Following separation of bound from unbound fragments of RNA, those associated with S8 were analyzed for their content of modified bases by treatment with aniline. Nucleotides found to be consistently unmodified in such fragments were located near the base of a stable helix (encompassing bases 581-656) or near the apex of the helix on the 3' proximal side. A minor S8 ribonucleoprotein particle was found to contain fragments which extended in the 3' direction to position 671. Images PMID:6356037

[Dupuytren disease].

PubMed

Wagner, Pablo; Román, Javier A; Vergara, Jorge

2012-09-01

Dupuytren disease (DD) is a connective tissue disorder that consists in fibromatosis of the palmar and digital fascia (in form of nodules or flanges) that leads to the development of flexion contractures of the palm and fingers. The little and ring finger are particularly affected. The disease can limit hand function, reducing the quality of life. The disease can have a traumatic origin and is also associated with conditions such as diabetes mellitus, alcoholism, dyslipidemia, epilepsy and AIDS, among others. However, none of these conditions can fully explain the genesis of DD. A hereditary component is described in 40% of patients and is attributed to an autosomal dominant gene of variable penetrance, probably related to collagen synthesis. However there are also spontaneous and recessive inheritance cases. The diagnosis is clinical and based on physical examination. Treatment ranges from observation or use of injectable collagenase to the surgical option in cases with significant functional limitations.

Chemically Derived Dense Alumina-Zirconia Composites for Improved Mechanical and Wear Erosion Properties

NASA Technical Reports Server (NTRS)

1998-01-01

As a result of this funded project high purity Zirconia-Toughened Alumina (ZTA) ceramic powders with and without yttria were produced using metal alkoxide precursors. ZTA ceramic powders with varying volume percents of zirconia were prepared (7, 15, and 22%). Aluminum tri-sec butoxide, zirconium propoxide, and yttrium isopropoxide were the reagents used. Synthesis conditions were varied to control the hydrolysis and the aging conditions for the sol to gel transition. FTIR analysis and rheological characterization were used to follow the structural evolution during the sol to gel transition. The greater extent of hydrolysis and the build-up of structure measured from viscoelastic properties were consistent. Heat treatment was conducted to produce submicron grain fully crystalline ZTA ceramic powders. This improved materials should have enhanced properties such strength, toughness, and wear resistance for advanced structural applications, for example engine components in high technology aerospace applications.

Both p53-PUMA/NOXA-Bax-mitochondrion and p53-p21cip1 pathways are involved in the CDglyTK-mediated tumor cell suppression

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

Yu, Zhendong, E-mail: zdyu@hotmail.com; Wang, Hao; Zhang, Libin

CDglyTK fusion suicide gene has been well characterized to effectively kill tumor cells. However, the exact mechanism and downstream target genes are not fully understood. In our study, we found that CDglyTK/prodrug treatment works more efficiently in p53 wild-type (HONE1) cells than in p53 mutant (CNE1) cells. We then used adenovirus-mediated gene delivery system to either knockdown or overexpress p53 and its target genes in these cells. Consistent results showed that both p53-PUMA/NOXA/Bcl2-Bax and p53-p21 pathways contribute to the CDglyTK induced tumor cell suppression. Our work for the first time addressed the role of p53 related genes in the CDglyTK/prodrugmore » system.« less

Autophagy in endometriosis: Friend or foe?

PubMed

Zhan, Lei; Li, Jun; Wei, Bing

2018-01-01

Endometriosis is a chronic, estrogen-dependent disease and characterized by the implantation of endometrial glands and stroma deep and haphazardly into the outside the uterine cavity. It affects an estimated 10% of the female population of reproductive age and results in obvious reduction in health-related quality of life. Unfortunately, there is no a consistent theory for the etiology of endometriosis. Furthermore, the endometriosis is hard to diagnose in early stage and the treatment methods are limited. Importantly, emerging evidence has investigated that there is a close relationship between endometriosis and autophagy. However, autophagy is a friend or foe in endometriosis is puzzling, the precise mechanism underlying autophagy in endometriosis has not been fully elucidated yet. Here, we provide an integrated view on the acquired findings of the connections between endometriosis and autophagy. We also discuss which may contribute to the abnormal level of autophagy in endometriosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Behavioral Addictions as Mental Disorders: To Be or Not To Be?

PubMed

Petry, Nancy M; Zajac, Kristyn; Ginley, Meredith K

2018-05-07

Should excessive and problematic engagement in nonsubstance use behaviors be mental disorders? The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) repositioned gambling disorder in the substance use disorders section and introduced Internet gaming disorder in the research appendix; the International Classification of Diseases (ICD-11) is also considering it. This article outlines pros and cons of considering behavioral addictions as mental disorders and also reviews the DSM-5 decision-making processes. It focuses on three conditions: gambling disorder, Internet gaming disorder (IGD), and Internet addiction (IA). We detail assessment methods and prevalence rates for these conditions and outline psychiatric comorbidities, demographic and biological risk factors, and promising treatment approaches. We also briefly discuss other putative behavioral addictions: eating/food, sex, exercise, shopping, and tanning "addictions." Overall, data are inconclusive, and consistent terminology and methodology are needed to define and evaluate these conditions more fully prior to considering them mental disorders.

BioMAJ: a flexible framework for databanks synchronization and processing.

PubMed

Filangi, Olivier; Beausse, Yoann; Assi, Anthony; Legrand, Ludovic; Larré, Jean-Marc; Martin, Véronique; Collin, Olivier; Caron, Christophe; Leroy, Hugues; Allouche, David

2008-08-15

Large- and medium-scale computational molecular biology projects require accurate bioinformatics software and numerous heterogeneous biological databanks, which are distributed around the world. BioMAJ provides a flexible, robust, fully automated environment for managing such massive amounts of data. The JAVA application enables automation of the data update cycle process and supervision of the locally mirrored data repository. We have developed workflows that handle some of the most commonly used bioinformatics databases. A set of scripts is also available for post-synchronization data treatment consisting of indexation or format conversion (for NCBI blast, SRS, EMBOSS, GCG, etc.). BioMAJ can be easily extended by personal homemade processing scripts. Source history can be kept via html reports containing statements of locally managed databanks. http://biomaj.genouest.org. BioMAJ is free open software. It is freely available under the CECILL version 2 license.

[Congenital talipes equinovarus--family occurrence].

PubMed

Kołecka, Ewa; Niedzielski, Kryspin Ryszard; Cukras, Zbigniew; Piotrowicz, Małgorzata

2011-01-01

Although congenital talipes equinovarus (CTEV) is one of the most frequently occurring congenital defects of locomotor organs, its ethiopathogenesis is still not fully known. Amongst the others, the inheritance patterns of that defect are not fully known, and that restricts genetic therapeutics and development of new treatment technologies. The aim of this study was analysis of family lineages of 205 children with CTEV (298 feet) treated at our centre in the years 1998-2008. The family occurrence of CTEV was found in 16 cases (8% of analysed group). 6 lineages, in which CTEV occurred in successive generations, were analysed in detail. Particularly interesting is the lineage of the family 1, in which the defect occurred in three successive generations. In case of that family, an autosomal dominant inheritance pattern is possible. Previously that pattern of CTEV inheritance was described only for isolated populations of Polynesians. In own material the family occurrence of CTEV was found to be less frequent than in bibliographic references. The defect occurred twice as often in boys, while the severe form was more frequently observed in girls, and that is consisted with data in the available bibliography. The analysis of presented lineages of families with CTEV did not allow unambiguous defining of the inheritance pattern for that defect. To confirm the autosomal dominant pattern of CTEV inheritance in the family in which the defect occurred in three successive generations, genetic tests would be necessary.

A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model

PubMed Central

Wang, Dong; Gan, Qi; Ye, Jian; Yue, Jian; Wang, Benzhong; Povoski, Stephen P.; Martin, Edward W.; Hitchcock, Charles L.; Yilmaz, Alper; Tweedle, Michael F.; Shao, Pengfei; Xu, Ronald X.

2016-01-01

Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG)—fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting. PMID:27367051

A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model.

PubMed

Zhang, Zeshu; Pei, Jing; Wang, Dong; Gan, Qi; Ye, Jian; Yue, Jian; Wang, Benzhong; Povoski, Stephen P; Martin, Edward W; Hitchcock, Charles L; Yilmaz, Alper; Tweedle, Michael F; Shao, Pengfei; Xu, Ronald X

2016-01-01

Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG)-fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting.

Neoclassical Simulation of Tokamak Plasmas using Continuum Gyrokinetc Code TEMPEST

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

Xu, X Q

We present gyrokinetic neoclassical simulations of tokamak plasmas with self-consistent electric field for the first time using a fully nonlinear (full-f) continuum code TEMPEST in a circular geometry. A set of gyrokinetic equations are discretized on a five dimensional computational grid in phase space. The present implementation is a Method of Lines approach where the phase-space derivatives are discretized with finite differences and implicit backwards differencing formulas are used to advance the system in time. The fully nonlinear Boltzmann model is used for electrons. The neoclassical electric field is obtained by solving gyrokinetic Poisson equation with self-consistent poloidal variation. Withmore » our 4D ({psi}, {theta}, {epsilon}, {mu}) version of the TEMPEST code we compute radial particle and heat flux, the Geodesic-Acoustic Mode (GAM), and the development of neoclassical electric field, which we compare with neoclassical theory with a Lorentz collision model. The present work provides a numerical scheme and a new capability for self-consistently studying important aspects of neoclassical transport and rotations in toroidal magnetic fusion devices.« less

Milieu Therapy with the Adolescent Sociopath.

ERIC Educational Resources Information Center

Walker, Betty A.

1978-01-01

This paper defines sociopathy and presents current findings on its causes and treatment. A milieu therapy program is described, including the preventive and active treatment methods used to keep the adolescent sociopath fully occupied in constructive activities and "sponsor" relationships to overcome antisocial behavior patterns. (Author/SJL)

A usability assessment on a virtual reality system for panic disorder treatment

NASA Astrophysics Data System (ADS)

Lee, Jaelin; Kawai, Takashi; Yoshida, Nahoko; Izawa, Shuhei; Nomura, Shinobu; Eames, Douglas; Kaiya, Hisanobu

2008-02-01

The authors have developed a virtual reality exposure system that reflects the Japanese culture and environment. Concretely, the system focuses on the subway environment, which is the environment most patients receiving treatment for panic disorder at hospitals in Tokyo, Japan tend to avoid. The system is PC based and features realistic video images and highly interactive functionality. In particular, the system enables instant transformation of the virtual space and allows situations to be freely customized according to the condition and symptoms expressed by each patient. Positive results achieved in therapy assessments aimed at patients with panic disorder accompanying agoraphobia indicate the possibility of indoor treatment. Full utilization of the functionality available requires that the interactive functions be easily operable. Accordingly, there appears to be a need for usability testing aimed at determining whether or not a therapist can operate the system naturally while focusing fully on treatment. In this paper, the configuration of the virtual reality exposure system focusing on the subway environment is outlined. Further, the results of usability tests aimed at assessing how naturally it can be operated while focusing fully on treatment are described.

Ultra-Smooth, Fully Solution-Processed Large-Area Transparent Conducting Electrodes for Organic Devices

PubMed Central

Jin, Won-Yong; Ginting, Riski Titian; Ko, Keum-Jin; Kang, Jae-Wook

2016-01-01

A novel approach for the fabrication of ultra-smooth and highly bendable substrates consisting of metal grid-conducting polymers that are fully embedded into transparent substrates (ME-TCEs) was successfully demonstrated. The fully printed ME-TCEs exhibited ultra-smooth surfaces (surface roughness ~1.0 nm), were highly transparent (~90% transmittance at a wavelength of 550 nm), highly conductive (sheet resistance ~4 Ω ◻−1), and relatively stable under ambient air (retaining ~96% initial resistance up to 30 days). The ME-TCE substrates were used to fabricate flexible organic solar cells and organic light-emitting diodes exhibiting devices efficiencies comparable to devices fabricated on ITO/glass substrates. Additionally, the flexibility of the organic devices did not degrade their performance even after being bent to a bending radius of ~1 mm. Our findings suggest that ME-TCEs are a promising alternative to indium tin oxide and show potential for application toward large-area optoelectronic devices via fully printing processes. PMID:27808221

Ultra-Smooth, Fully Solution-Processed Large-Area Transparent Conducting Electrodes for Organic Devices

NASA Astrophysics Data System (ADS)

Jin, Won-Yong; Ginting, Riski Titian; Ko, Keum-Jin; Kang, Jae-Wook

2016-11-01

A novel approach for the fabrication of ultra-smooth and highly bendable substrates consisting of metal grid-conducting polymers that are fully embedded into transparent substrates (ME-TCEs) was successfully demonstrated. The fully printed ME-TCEs exhibited ultra-smooth surfaces (surface roughness ~1.0 nm), were highly transparent (~90% transmittance at a wavelength of 550 nm), highly conductive (sheet resistance ~4 Ω ◻-1), and relatively stable under ambient air (retaining ~96% initial resistance up to 30 days). The ME-TCE substrates were used to fabricate flexible organic solar cells and organic light-emitting diodes exhibiting devices efficiencies comparable to devices fabricated on ITO/glass substrates. Additionally, the flexibility of the organic devices did not degrade their performance even after being bent to a bending radius of ~1 mm. Our findings suggest that ME-TCEs are a promising alternative to indium tin oxide and show potential for application toward large-area optoelectronic devices via fully printing processes.

Weighted interior penalty discretization of fully nonlinear and weakly dispersive free surface shallow water flows

NASA Astrophysics Data System (ADS)

Di Pietro, Daniele A.; Marche, Fabien

2018-02-01

In this paper, we further investigate the use of a fully discontinuous Finite Element discrete formulation for the study of shallow water free surface flows in the fully nonlinear and weakly dispersive flow regime. We consider a decoupling strategy in which we approximate the solutions of the classical shallow water equations supplemented with a source term globally accounting for the non-hydrostatic effects. This source term can be computed through the resolution of elliptic second-order linear sub-problems, which only involve second order partial derivatives in space. We then introduce an associated Symmetric Weighted Internal Penalty discrete bilinear form, allowing to deal with the discontinuous nature of the elliptic problem's coefficients in a stable and consistent way. Similar discrete formulations are also introduced for several recent optimized fully nonlinear and weakly dispersive models. These formulations are validated again several benchmarks involving h-convergence, p-convergence and comparisons with experimental data, showing optimal convergence properties.

Ultra-Smooth, Fully Solution-Processed Large-Area Transparent Conducting Electrodes for Organic Devices.

PubMed

Jin, Won-Yong; Ginting, Riski Titian; Ko, Keum-Jin; Kang, Jae-Wook

2016-11-03

A novel approach for the fabrication of ultra-smooth and highly bendable substrates consisting of metal grid-conducting polymers that are fully embedded into transparent substrates (ME-TCEs) was successfully demonstrated. The fully printed ME-TCEs exhibited ultra-smooth surfaces (surface roughness ~1.0 nm), were highly transparent (~90% transmittance at a wavelength of 550 nm), highly conductive (sheet resistance ~4 Ω ◻ -1 ), and relatively stable under ambient air (retaining ~96% initial resistance up to 30 days). The ME-TCE substrates were used to fabricate flexible organic solar cells and organic light-emitting diodes exhibiting devices efficiencies comparable to devices fabricated on ITO/glass substrates. Additionally, the flexibility of the organic devices did not degrade their performance even after being bent to a bending radius of ~1 mm. Our findings suggest that ME-TCEs are a promising alternative to indium tin oxide and show potential for application toward large-area optoelectronic devices via fully printing processes.

Asymptotic Normality of the Maximum Pseudolikelihood Estimator for Fully Visible Boltzmann Machines.

PubMed

Nguyen, Hien D; Wood, Ian A

2016-04-01

Boltzmann machines (BMs) are a class of binary neural networks for which there have been numerous proposed methods of estimation. Recently, it has been shown that in the fully visible case of the BM, the method of maximum pseudolikelihood estimation (MPLE) results in parameter estimates, which are consistent in the probabilistic sense. In this brief, we investigate the properties of MPLE for the fully visible BMs further, and prove that MPLE also yields an asymptotically normal parameter estimator. These results can be used to construct confidence intervals and to test statistical hypotheses. These constructions provide a closed-form alternative to the current methods that require Monte Carlo simulation or resampling. We support our theoretical results by showing that the estimator behaves as expected in simulation studies.

Automatic soldering machine

NASA Technical Reports Server (NTRS)

Stein, J. A.

1974-01-01

Fully-automatic tube-joint soldering machine can be used to make leakproof joints in aluminum tubes of 3/16 to 2 in. in diameter. Machine consists of temperature-control unit, heater transformer and heater head, vibrator, and associated circuitry controls, and indicators.

Interface- and discontinuity-aware numerical schemes for plasma 3-T radiation diffusion in two and three dimensions

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

Dai, William W., E-mail: dai@lanl.gov; Scannapieco, Anthony J.

2015-11-01

A set of numerical schemes is developed for two- and three-dimensional time-dependent 3-T radiation diffusion equations in systems involving multi-materials. To resolve sub-cell structure, interface reconstruction is implemented within any cell that has more than one material. Therefore, the system of 3-T radiation diffusion equations is solved on two- and three-dimensional polyhedral meshes. The focus of the development is on the fully coupling between radiation and material, the treatment of nonlinearity in the equations, i.e., in the diffusion terms and source terms, treatment of the discontinuity across cell interfaces in material properties, the formulations for both transient and steady states,more » the property for large time steps, and second order accuracy in both space and time. The discontinuity of material properties between different materials is correctly treated based on the governing physics principle for general polyhedral meshes and full nonlinearity. The treatment is exact for arbitrarily strong discontinuity. The scheme is fully nonlinear for the full nonlinearity in the 3-T diffusion equations. Three temperatures are fully coupled and are updated simultaneously. The scheme is general in two and three dimensions on general polyhedral meshes. The features of the scheme are demonstrated through numerical examples for transient problems and steady states. The effects of some simplifications of numerical schemes are also shown through numerical examples, such as linearization, simple average of diffusion coefficient, and approximate treatment for the coupling between radiation and material.« less

Addressing overuse in emergency medicine: evidence of a role for greater patient engagement.

PubMed

Newton, Erika H

2017-12-01

Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians' assumptions about what patients expect are often wrong, and overlook two of patients' most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them-to the extent appropriate or desired-in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients' concerns without the use of tests and treatments patients neither need nor value.

Addressing overuse in emergency medicine: evidence of a role for greater patient engagement

PubMed Central

Newton, Erika H.

2017-01-01

Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians’ assumptions about what patients expect are often wrong, and overlook two of patients’ most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them—to the extent appropriate or desired—in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients’ concerns without the use of tests and treatments patients neither need nor value. PMID:29306268

Effort testing in children: can cognitive and symptom validity measures differentiate malingered performances?

PubMed

Rambo, Philip L; Callahan, Jennifer L; Hogan, Lindsey R; Hullmann, Stephanie; Wrape, Elizabeth

2015-01-01

Recent efforts have contributed to significant advances in the detection of malingered performances in adults during cognitive assessment. However, children's ability to purposefully underperform has received relatively little attention. The purpose of the present investigation was to examine children's performances on common intellectual measures, as well as two symptom validity measures: the Test of Memory Malingering and the Dot-Counting Test. This was accomplished through the administration of measures to children ages 6 to 12 years old in randomly assigned full-effort (control) and poor-effort (treatment) conditions. Prior to randomization, children's general intellectual functioning (i.e., IQ) was estimated via administration of the Kaufman Brief Intellectual Battery-Second Edition (KBIT-2). Multivariate analyses revealed that the conditions significantly differed on some but not all administered measures. Specifically, children's estimated IQ in the treatment condition significantly differed from the full-effort IQ initially obtained from the same children on the KBIT-2, as well as from the IQs obtained in the full-effort control condition. These findings suggest that children are fully capable of willfully underperforming during cognitive testing; however, consistent with prior investigations, some measures evidence greater sensitivity than others in evaluating effort.

Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors.

PubMed

Koenig, Linda J; Nesheim, Steven; Abramowitz, Susan

2011-10-01

Because of widespread availability of highly active antiretroviral therapy in the developed world, a large proportion of children with perinatally acquired HIV have survived to adolescence and young adulthood. Although their survival is remarkable, many now experience the long-term effects of HIV infection and its treatment. Further, as these youths have entered adolescence, more is known about the impact of normative developmental transitions on health maintenance behaviors. Although perinatally infected adolescents are healthier than they were a decade or more ago, they are significantly experienced with antiretroviral therapy, with increased virological resistance and other consequences of extended antiretroviral use. Three behavioral health challenges have been documented in the first cohort of long-term survivors: decreased medication adherence, sexual debut and accompanying pregnancy and transmission risk, and mental health problems. These issues are consistent with a developmental press for autonomy, mature sexual relationships and future planning, but must be carefully managed to preserve health. Adolescents with perinatally acquired HIV require coordinated multidisciplinary support services - including adherence support, reproductive health counseling addressing both pregnancy planning and disease transmission, and mental health and educational/vocational planning - so that they can fully benefit from treatment advances. (C) 2011 Lippincott Williams & Wilkins, Inc.

The Future is Now: Reducing Psychological Distance to Increase Public Engagement with Climate Change.

PubMed

Jones, Charlotte; Hine, Donald W; Marks, Anthony D G

2017-02-01

Many people perceive climate change as psychologically distant-a set of uncertain events that might occur far in the future, impacting distant places and affecting people dissimilar to themselves. In this study, we employed construal level theory to investigate whether a climate change communication intervention could increase public engagement by reducing the psychological distance of climate change. Australian residents (N = 333) were randomly assigned to one of two treatment conditions: one framed to increase psychological distance to climate change (distal frame), and the other framed to reduce psychological distance (proximal frame). Participants then completed measures of psychological distance of climate change impacts, climate change concern, and intentions to engage in mitigation behavior. Principal components analysis indicated that psychological distance to climate change was best conceptualized as a multidimensional construct consisting of four components: geographic, temporal, social, and uncertainty. Path analysis revealed the effect of the treatment frame on climate change concern and intentions was fully mediated by psychological distance dimensions related to uncertainty and social distance. Our results suggest that climate communications framed to reduce psychological distance represent a promising strategy for increasing public engagement with climate change. © 2016 Society for Risk Analysis.

Ferulic acid exerts antitumor activity and inhibits metastasis in breast cancer cells by regulating epithelial to mesenchymal transition.

PubMed

Zhang, Xiang; Lin, Dan; Jiang, Rong; Li, Hongzhong; Wan, Jingyuan; Li, Hongyuan

2016-07-01

Metastasis, which frequently occurs in breast cancer, is the major cause of mortality; therefore, new treatment strategies are urgently needed. Ferulic acid, isolated from Ferula foetida, a perennial herb, has shown antineoplastic activity in various types of cancers, such as colon and lung cancer, and central nervous system tumors. However, its potential role in suppressing breast cancer metastasis has not been fully understood. In the present study, we evaluated the antitumor activity of ferulic acid in breast cancer cell line-based in vitro and in vivo models. We first showed that ferulic acid treatment resulted in decreased viability, increased apoptosis and suppression of metastatic potential in breast cancer cell line MDA-MB-231. Furthermore, it was demonstrated that the antitumor activity of ferulic acid and its role in suppressing metastasis were regulated by the reversal of epithelial-mesenchymal transition (EMT). Consistent with our findings in vitro, the antitumor potential of ferulic acid was also verified in an MDA-MB-231 xenograft mouse model where significantly decreased tumor volume, weight and increased apoptosis were observed. Taken together, these results indicate that ferulic acid may be used as an effective therapeutic agent against breast cancer.

Black veins: a case of minocycline-induced pigmentation post-sclerotherapy and a review of literature.

PubMed

Star, Phoebe; Choy, Carolyn; Parsi, Kurosh

2017-01-01

Minocycline-induced pigmentation (MIP) is an uncommon but well-described adverse effect of oral minocycline treatment. MIP is clinically and histopathologically distinct from post-sclerotherapy pigmentation. We report a case of a patient presenting with blackened skin overlying veins recently treated with endovenous laser and foam sclerotherapy. The patient was a 44-year-old male with systemic sclerosis who commenced minocycline for the treatment of rosacea 5 months prior. Histological examination of the discolored tissue and underlying vein revealed hemosiderin deposition in the dermis and pigmented macrophages within the sub-endothelial layer of the vein wall with a staining pattern consistent with MIP. Venous tissue has not previously been reported in the literature as a target of minocycline pigmentation. Our patient preferred to control his rosacea by continuing to take minocycline. Follow-up ultrasound examinations revealed the treated vessels to be fully occluded with no evidence of recanalization, residual flow or ongoing thrombophlebitis. Despite a good sclerotherapy outcome, the pigmentation did not subside over 2 years. This case demonstrates that oral minocycline may induce significant and potentially long-term pigmentation in predisposed patients undergoing sclerotherapy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PERFORMANCE IMPROVEMENT OF CREEP-RESISTANT FERRITIC STEEL WELDMENTS THROUGH THERMO-MECHANICAL TREATMENT AND ALLOY DESIGN

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

Yamamoto, Yukinori; Babu, Prof. Sudarsanam Suresh; Shassere, Benjamin

Two different approaches have been proposed for improvement of cross-weld creep properties of the high temperature ferrous structural materials for fossil-fired energy applications. The traditional creep strength-enhanced ferritic (CSEF) steel weldments suffer from Type IV failures which occur at the fine-grained heat affected zone (FGHAZ). In order to minimize the premature failure at FGHAZ in the existing CSEF steels, such as modified 9Cr-1Mo ferritic-martensitic steels (Grade 91), a thermo-mechanical treatment consisting of aus-forging/rolling and subsequent aus-aging is proposed which promotes the formation of stable MX carbonitrides prior to martensitic transformation. Such MX remains undissolved during welding process, even in FGHAZ,more » which successfully improves the cross-weld creep properties. Another approach is to develop a new fully ferrtic, creep-resistant FeCrAl alloy which is essentially free from Type IV failure issues. Fe-30Cr-3Al base alloys with minor alloying additions were developed which achieved a combination of good oxidation/corrosion resistance and improved tensile and creep performance comparable or superior to Grade 92 steel.« less

Evaluation of the Carefusion Alaris PC infusion pump for hyperbaric oxygen therapy conditions: Technical report.

PubMed

Smale, Andrew; Tsouras, Theo

2017-01-01

We present a standardized test methodology and results for our evaluation of the Carefusion Alaris PC infusion pump, comprising the model 8015 PC Unit and the model 8100 Large Volume Pump (LVP) module. The evaluation consisted of basic suitability testing, internal component inspection, surface temperature measurement of selected internal components, and critical performance testing (infusion rate accuracy and occlusion alarm pressure) during conditions of typical hyperbaric oxygen (HBO₂) treatment in our facility's class A multiplace chamber. We have found that the pumps pose no enhanced risk as an ignition source, and that the pumps operate within manufacturer's specifications for flow rate and occlusion alarms at all stages of HBO₂ treatments, up to 4.0 ATA and pressurization and depressurization rates up to 180 kPa/minute. The pumps do not require purging with air or nitrogen and can be used unmodified, subject to the following conditions: pumps are undamaged, clean, fully charged, and absent from alcohol cleaning residue; pumps are powered from the internal NiMH battery only; maximum pressure exposure 4.0 ATA; maximum pressurization and depressurization rate of 180 kPa/minute; LVP modules locked in place with retaining screws. Copyright© Undersea and Hyperbaric Medical Society.

Umbilical hernia alloplastic dual-mesh treatment in cirrhotic patients.

PubMed

Guriță, R E; Popa, F; Bălălău, C; Scăunașu, R V

2013-03-15

Abdominal wall hernias represent a pathology with an impressive prevalence among the population of patients with cirrhosis complicated by ascites. The aggressive surgical approach of umbilical hernia for patients with cirrhotic background remains a controversial problem, accompanied by anesthetic and surgical risk. Its indication remains fully justified in case of severe symptoms or life threatening complications: strangulation, incarceration, evisceration. This article evaluates results obtained by using dual-mesh alloplastic materials for surgical treatment of umbilical hernias affecting cirrhotic patients with incipient liver injury. Our lot consists of twelve patients with ages between 45 and 65 years, diagnosed with hepatic cirrhosis, without other associated comorbidities. All patients were admitted for strangulated umbilical hernia. Among the analyzed lot, no decease was encountered, the morbidity being limited to two cases of parietal suppuration, solved conservatively, without the mesh removal. There were no ascitic fistulas. No recurrences were registered for a 12 months tracking period. The presence of cirrhosis implies a high anesthetic and surgical risk, the intervention being grafted by a substantial increase of mortality and morbidity in an emergency setting. The development of new alloplastic materials, together with the modern anesthetic techniques, allows superior results for patients with incipient hepatic injury.

Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey

PubMed Central

Koehler, Andreas; Dekker, Arne; Sehner, Susanne; Nieder, Timo O.

2017-01-01

This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals’ gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients’ satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed moderately with concerns towards THC centres. 96.5% of participants would like high decision-making power concerning treatment-associated decisions. The results demonstrate the importance of patient-centred THC that takes patients' individual needs and realities into consideration and involves patients in decision-making processes. PMID:28846715

Fully inkjet-printed two-dimensional material field-effect heterojunctions for wearable and textile electronics.

PubMed

Carey, Tian; Cacovich, Stefania; Divitini, Giorgio; Ren, Jiesheng; Mansouri, Aida; Kim, Jong M; Wang, Chaoxia; Ducati, Caterina; Sordan, Roman; Torrisi, Felice

2017-10-31

Fully printed wearable electronics based on two-dimensional (2D) material heterojunction structures also known as heterostructures, such as field-effect transistors, require robust and reproducible printed multi-layer stacks consisting of active channel, dielectric and conductive contact layers. Solution processing of graphite and other layered materials provides low-cost inks enabling printed electronic devices, for example by inkjet printing. However, the limited quality of the 2D-material inks, the complexity of the layered arrangement, and the lack of a dielectric 2D-material ink able to operate at room temperature, under strain and after several washing cycles has impeded the fabrication of electronic devices on textile with fully printed 2D heterostructures. Here we demonstrate fully inkjet-printed 2D-material active heterostructures with graphene and hexagonal-boron nitride (h-BN) inks, and use them to fabricate all inkjet-printed flexible and washable field-effect transistors on textile, reaching a field-effect mobility of ~91 cm 2  V -1  s -1 , at low voltage (<5 V). This enables fully inkjet-printed electronic circuits, such as reprogrammable volatile memory cells, complementary inverters and OR logic gates.

LANDSAT-D data format control book. Volume 6: (Products)

NASA Technical Reports Server (NTRS)

Kabat, F.

1981-01-01

Four basic product types are generated from the raw thematic mapper (TM) and multispectral scanner (MSS) payload data by the NASA GSFC LANDSAT 4 data management system: (1) unprocessed data (raw sensor data); (2) partially processed data, which consists of radiometrically corrected sensor data with geometric correction information appended; (3) fully processed data, which consists of radiometrically and geometrically corrected sensor data; and (4) inventory data which consists of summary information about product types 2 and 3. High density digital recorder formatting and the radiometric correction process are described. Geometric correction information is included.

A single-group pretest posttest design using full kinetic chain manipulative therapy with rehabilitation in the treatment of 18 patients with hip osteoarthritis.

PubMed

Brantingham, James W; Globe, Gary A; Cassa, Tammy Kay; Globe, Denise; de Luca, Katie; Pollard, Henry; Lee, Felix; Bates, Charles; Jensen, Muffit; Mayer, Stephan; Korporaal, Charmaine

2010-01-01

Hip osteoarthritis (HOA) affects 30 million Americans or more, and is a leading cause of disability, suffering, and pain. Standard treatments are minimally effective and carry significant risk and expense. This study assessed treatment effects of a chiropractic protocol for HOA. Eighteen individuals, who did not qualify due to low baseline Western Ontario and McMaster Osteoarthritis Index scores (WOMAC) for other ongoing HOA randomized control trials, were selected. A prospectively planned protocol, consisting of axial manipulation to the affected hip with modified Thomas and active assisted stretch, was combined with full kinetic chain treatment or manipulative therapy to the spine, knee, ankle, or foot and assessed with use of valid and reliable outcome measures. The primary outcome measure, the Overall Therapy Effectiveness Tool, was assessed with chi(2) and demonstrated that 83.33% of participants were improved after the ninth visit, P = .005, and 78% improved at the 3-month follow-up, P = .018. Using the paired t test, WOMAC was improved 64% at the ninth visit, P = .000, and 47% at follow-up, P = .016. In HOA patients with lower WOMAC scores, a highly organized HOA treatment appears to have resulted in statistically and clinically meaningful intragroup changes in the Overall Effectiveness Therapy Tool, WOMAC, Harris Hip Scale, and range of motion, all with P

Children in Family Contexts. Second Edition. Perspectives on Treatment

ERIC Educational Resources Information Center

Graham, Lee Combrick, Ed.

2006-01-01

Now in a fully revised and updated second edition, this widely used text and professional resource provides a practical guide to family-based therapy for childhood emotional and behavioral problems. Presented are innovative assessment and treatment strategies that take into account children's developmental needs, different family forms, health and…

Computers in the treatment of chronic aphasia.

PubMed

Katz, Richard C

2010-02-01

Computers and related technology can increase the amount of treatment received by adults with chronic aphasia. Computers used in treatment, however, are only valuable to the patient if the intervention is efficacious. Real and potential applications of computer technology are discussed in the context of three roles of computerized aphasia treatment for adults with chronic aphasia. Pertinent studies regarding Phases 1 and 2 are briefly described. The only Phase 3 study of efficacy of computerized aphasia treatment is more fully described and its implications discussed.

Non-invasive different modalities of treatment for temporomandibular disorders: review of literature

PubMed Central

2018-01-01

Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs. PMID:29732308

Clinical remission following endoscopic placement of retrievable, fully covered metal stents in patients with esophageal achalasia.

PubMed

Zeng, Y; Dai, Y-M; Wan, X-J

2014-01-01

Metal stents may represent an alternative therapy in the treatment of achalasia. We therefore evaluated the effectiveness of retrievable, fully covered metal stents in patients with achalasia. Fifty-nine patients with achalasia were treated with retrievable, fully covered metal stents. Symptoms using a global symptom score (0-10), lower esophageal sphincter (LES) resting pressure, LES relaxation, and simultaneous contraction of the esophagus were analyzed before and 1 week and 1 month after intervention. Complications and treatment outcomes were followed up at 6, 12, 18, and 24 months postoperatively. Stent placement was successful, and clinical symptoms resolved (P < 0.01) in all patients. Regurgitation, dysphagia and chest pain improved significantly (all P < 0.01). Therapy improved LES resting pressure (51.4 ± 9.7 mmHg pretherapy vs. 20.9 ± 8.1 mmHg post-therapy), LES relaxation (58.1 ± 17.1% pretherapy vs. 84.5 ± 18.9% post-therapy), and simultaneous contraction of the esophagus (36.1 ± 8.6% pretherapy vs. 69.4 ± 23.1% post-therapy) 1 month after stent placement (all P < 0.01). The cumulative clinical remission rates 6, 12, 18, 24, 30, and 36 months after stent removal were 90.9%, 81.8%, 76.4%, 69.1%, 65.5%, and 49.1%, respectively. All patients tolerated stent placement. Twelve patients (25.5%) complained of substernal pain and five (10.6%) had substernal burning. Stents migrated in four patients (8.5%). Insertion of retrievable, fully covered metal stents is an effective and safe treatment in patients with achalasia. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Cannabinoids: is there a potential treatment role in epilepsy?

PubMed

Blair, Robert E; Deshpande, Laxmikant S; DeLorenzo, Robert J

2015-01-01

Cannabinoids have been used medicinally for centuries, and in the last decade, attention has focused on their broad therapeutic potential particularly in seizure management. While some cannabinoids have demonstrated anticonvulsant activity in experimental studies, their efficacy for managing clinical seizures has not been fully established. This commentary will touch on our understanding of the brain endocannabinoid system's regulation of synaptic transmission in both physiological and pathophysiological conditions, and review the findings from both experimental and clinical studies on the effectiveness of cannabinoids to suppress epileptic seizures. At present, there is preliminary evidence that non-psychoactive cannabinoids may be useful as anticonvulsants, but additional clinical trials are needed to fully evaluate the efficacy and safety of these compounds for the treatment of epilepsy.

Cannabinoids: is there a potential treatment role in epilepsy?

PubMed Central

Blair, Robert E; Deshpande, Laxmikant S; DeLorenzo, Robert J

2016-01-01

Cannabinoids have been used medicinally for centuries, and in the last decade, attention has focused on their broad therapeutic potential particularly in seizure management. While some cannabinoids have demonstrated anticonvulsant activity in experimental studies, their efficacy for managing clinical seizures has not been fully established. This commentary will touch on our understanding of the brain endocannabinoid system’s regulation of synaptic transmission in both physiological and pathophysiological conditions, and review the findings from both experimental and clinical studies on the effectiveness of cannabinoids to suppress epileptic seizures. At present, there is preliminary evidence that non-psychoactive cannabinoids may be useful as anticonvulsants, but additional clinical trials are needed to fully evaluate the efficacy and safety of these compounds for the treatment of epilepsy. PMID:26234319

Nasojejunal-stent technique (NJST): A new system to prevent fully covered metal stent migration in the treatment of benign esophageal diseases.

PubMed

Hernández Mondragón, Oscar Víctor; Cuellar, Raquel Palos; Murcio Pérez, Enrique

2018-05-19

Fully covered self-expandable metal stents (FCSEMS) have been used for the treatment of benign esophageal conditions such as perforation, leaks, and strictures [1]; high clinical success is reported [2]. Different anchoring methods have been described (clips, suturing devices, over-the-scope clips and Shim technique [2]), because of high migration rates (4-36%) [3,4]. However, not all cases are candidates, mostly in "difficult" cases where enteral feeding is needed [5]. We report the use of the nasojejunal-stent technique (NJST) to prevent migration of FCSEMS in three difficult cases. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Short course chemotherapy for tuberculous lymphadenitis in children.

PubMed

Jawahar, M S; Sivasubramanian, S; Vijayan, V K; Ramakrishnan, C V; Paramasivan, C N; Selvakumar, V; Paul, S; Tripathy, S P; Prabhakar, R

To assess the efficacy of a short course chemotherapy regimen for treating tuberculosis of the lymph nodes in children. Open, collaborative, outpatient clinical trial. Outpatient department of the Tuberculosis Research Centre, paediatric surgery departments of the Institute of Child Health and Hospital for Children and the Government Stanley Hospital, Madras, South India. Children aged 1-12 years with extensive, multiple site, superficial tuberculous lymphadenitis confirmed by biopsy (histopathology or culture). Patients were treated with a fully supervised intermittent chemotherapy regimen consisting of streptomycin, rifampicin, isoniazid, and pyrazinamide three times a week for two months followed by streptomycin and isoniazid twice a week for four months on an outpatient basis. Surgery was limited to biopsy of nodes for diagnosis and assessment. Response to chemotherapy was assessed by regression of lymph nodes and healing of sinuses and abscesses during treatment and follow up. Compliance with treatment and frequency of adverse reactions were also estimated. 197 Patients were admitted to the study and 168 into the analysis. The regimen was well tolerated and compliance was good with 101 (60%) patients receiving the prescribed chemotherapy within 15 days of the stipulated period of six months. Those whose chemotherapy extended beyond that period received the same total number of doses. Clinical response was favourable in most patients at the end of treatment. Sinuses and abscesses healed rapidly. Residual lymphadenopathy (exceeding 10 mm diameter) was present in 50 (30%) patients at the end of treatment; these nodes were biopsied. Fresh nodes, increase in size of nodes, and sinuses and abscesses occurred both during treatment and follow up. After 36 months of follow up after treatment only 5 (3%) patients required retreatment for tuberculosis. Tuberculous lymphadenitis in children can be successfully treated with a short course chemotherapy regimen of six months.

The antiallodynic action of pregabalin in neuropathic pain is independent from the opioid system

PubMed Central

Yalcin, Ipek; Nexon, Laurent; Wurtz, Xavier; Ceredig, Rhian Alice; Daniel, Dorothée; Hawkes, Rachael Aredhel; Salvat, Eric; Barrot, Michel

2016-01-01

Background Clinical management of neuropathic pain, which is pain arising as a consequence of a lesion or a disease affecting the somatosensory system, partly relies on the use of anticonvulsant drugs such as gabapentinoids. Therapeutic action of gabapentinoids such as gabapentin and pregabalin, which act by the inhibition of calcium currents through interaction with the α2δ-1 subunit of voltage-dependent calcium channels, is well documented. However, some aspects of the downstream mechanisms are still to be uncovered. Using behavioral, genetic, and pharmacological approaches, we tested whether opioid receptors are necessary for the antiallodynic action of acute and/or long-term pregabalin treatment in the specific context of neuropathic pain. Results Using the cuff model of neuropathic pain in mice, we show that acute pregabalin administration at high dose has a transitory antiallodynic action, while prolonged oral pregabalin treatment leads to sustained antiallodynic action, consistent with clinical observations. We show that pregabalin remains fully effective in μ-opioid receptor, in δ-opioid receptor and in κ-opioid receptor deficient mice, either female or male, and its antiallodynic action is not affected by acute naloxone. Our work also shows that long-term pregabalin treatment suppresses tumor necrosis factor-α overproduction induced by sciatic nerve constriction in the lumbar dorsal root ganglia. Conclusions We demonstrate that neither acute nor long-term antiallodynic effect of pregabalin in a context of neuropathic pain is mediated by the endogenous opioid system, which differs from opioid treatment of pain and antidepressant treatment of neuropathic pain. Our data are also supportive of an impact of gabapentinoid treatment on the neuroimmune aspect of neuropathic pain. PMID:27030724

LSD treatment in Scandinavia: emphasizing indications and short-term treatment outcomes of 151 patients in Denmark.

PubMed

Larsen, Jens Knud

2017-10-01

New research has suggested the clinical use of lysergic acid diethylamide (LSD) and psilocybin in selected patient populations. However, concerns about the clinical use of LSD were advanced in a large Danish follow-up study that assessed 151 LSD-treated psychiatric patients approximately 25 years after their treatment in the 1960s. The purpose of the present study was to give a retrospective account of the short-term outcome of LSD treatment in these 151 Danish psychiatric patients. The LSD case material in the Danish State Archives consists of medical case records of 151 LSD-treated patients, who complained and received economic compensation with the LSD Damages Law. The author carefully read and reviewed the LSD case material. LSD was used to treat a wide spectrum of mental disorders. Independent of diagnoses, 52 patients improved, and 48 patients worsened acutely with the LSD treatment. In a subgroup of 82 neurotic patients, the LSD dose-index (number of treatments multiplied by the maximal LSD dose) indicated the risk of acute worsening. In another subgroup of 19 patients with obsessive-compulsive neurosis, five patients later underwent psychosurgery. A small subgroup of 12 patients was treated with psilocybin. The long-term outcome was poor in most of the patients. Despite the significant limitations to a retrospective design, this database warrants caution in mental health patients. The use of LSD and psilocybin in mental health patients may be associated with serious short- and long-term side effects. Until further trials with rigorous designs have cleared these drugs of their potential harms, their clinical utility in these groups of patients has not been fully clarified.

The antiallodynic action of pregabalin in neuropathic pain is independent from the opioid system.

PubMed

Kremer, Mélanie; Yalcin, Ipek; Nexon, Laurent; Wurtz, Xavier; Ceredig, Rhian Alice; Daniel, Dorothée; Hawkes, Rachael Aredhel; Salvat, Eric; Barrot, Michel

2016-01-01

Clinical management of neuropathic pain, which is pain arising as a consequence of a lesion or a disease affecting the somatosensory system, partly relies on the use of anticonvulsant drugs such as gabapentinoids. Therapeutic action of gabapentinoids such as gabapentin and pregabalin, which act by the inhibition of calcium currents through interaction with the α2δ-1 subunit of voltage-dependent calcium channels, is well documented. However, some aspects of the downstream mechanisms are still to be uncovered. Using behavioral, genetic, and pharmacological approaches, we tested whether opioid receptors are necessary for the antiallodynic action of acute and/or long-term pregabalin treatment in the specific context of neuropathic pain. Using the cuff model of neuropathic pain in mice, we show that acute pregabalin administration at high dose has a transitory antiallodynic action, while prolonged oral pregabalin treatment leads to sustained antiallodynic action, consistent with clinical observations. We show that pregabalin remains fully effective in μ-opioid receptor, in δ-opioid receptor and in κ-opioid receptor deficient mice, either female or male, and its antiallodynic action is not affected by acute naloxone. Our work also shows that long-term pregabalin treatment suppresses tumor necrosis factor-α overproduction induced by sciatic nerve constriction in the lumbar dorsal root ganglia. We demonstrate that neither acute nor long-term antiallodynic effect of pregabalin in a context of neuropathic pain is mediated by the endogenous opioid system, which differs from opioid treatment of pain and antidepressant treatment of neuropathic pain. Our data are also supportive of an impact of gabapentinoid treatment on the neuroimmune aspect of neuropathic pain. © The Author(s) 2016.

TREATMENT SUCCESS IN THREE ANDEAN BEARS (TREMARCTOS ORNATUS) WITH ALOPECIA SYNDROME USING OCLACITINIB MALEATE (APOQUEL®).

PubMed

Drake, Gabby J; Nuttall, Tim; López, Javier; Magnone, William; Leclerc, Antoine; Potier, Romain; Lécu, Alexis; Guézénec, Maëlle; Kolter, Lydia; Nicolau, Amélie; Lemberger, Karin; Pin, Didier; Cosgrove, Sallie B

2017-09-01

Andean bear (Tremarctos ornatus) alopecia syndrome (ABAS) commonly affects captive bears, particularly sexually mature females. ABAS is characterized by bilaterally symmetrical predominantly flank alopecia with or without profound pruritus and secondary bacterial and Malassezia infections. There is no effective treatment and severely affected bears have been euthanized. This paper describes the successful management of ABAS in three female Andean bears. Skin biopsies and cytology revealed a mixed dermal inflammatory infiltrate, alopecia, hyperkeratosis, and Malassezia dermatitis. Allergen specific serology was positive for environmental allergens in one case. Hematology, serum biochemistry, and thyroid and adrenal function were normal in all cases. There was no consistent response to novel diet trials, antifungals, antihistamines, allergen specific immunotherapy, or topical antimicrobials. There was a partial response to ciclosporin (Atopica® cat, Novartis Animal Health; 5 mg/kg po, sid) in one case and oral glucocorticoids in all cases (dexamethasone sodium phosphate, [Colvasone 0.2%, Norbrook], 0.15 mg/kg po, sid or prednisolone [Deltacortene, Bruno Farmaceutici, and Megasolone 20, Coophavet], 0.3-1.2 mg/kg po, sid), but treatment was withdrawn following adverse effects. Treatment with oclacitinib maleate (Apoquel®, Zoetis; 0.46-0.5 mg/kg po, bid) resulted in rapid and complete resolution of the pruritus with subsequent improvement in demeanor and fur regrowth. After 5 mo, the bears were almost fully furred and off all other medication. Treatment was tapered to the lowest dose that prevented relapse of the pruritus (0.23-0.4 mg/kg po, sid). No adverse effects have been noted. ABAS is usually an intractable condition, and, to our knowledge, oclacitinib is the first treatment shown to result in sustained clinical improvement. Further studies on the etiology of ABAS, and on efficacy and long-term safety of oclacitinib are needed.

The current use of patient-centered/reported outcomes in implant dentistry: a systematic review.

PubMed

De Bruyn, Hugo; Raes, Stefanie; Matthys, Carine; Cosyn, Jan

2015-09-01

To provide an update on the use of Patient-Reported Outcome Measures (PROMs) in the field of implant dentistry (1); to compare PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition (2). The dental literature was searched on PubMed until December 31, 2014, using a general search algorithm. An overall quantitative analysis was performed, and a qualitative appraisal was made on the output of the last 6 years. Per type of edentulism and prosthetic treatment, the general search algorithm was refined in order to select controlled studies comparing PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition. With nearly half of the output (300 of 635) published in the last 6 years, there is a growing interest in PROMs by the scientific community. When scrutinizing the 300 most recent publications, only 84 controlled studies could be identified among which 38 RCTs and 31 cohort studies. An "ad hoc" approach is commonly employed using non-standardized questions and different scoring methods, which may compromise validity and reliability. Overall, 39 eligible papers related to fully edentulous patients treated with an implant overdenture (IOD) and 9 to fully edentulous patients treated with a fixed implant prosthesis (FIP). There is plenty of evidence from well-controlled studies showing that fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a conventional denture (CD). This may not hold true for fully edentulous patients in the maxilla. In general, fully edentulous patients seem to opt for a fixed or removable rehabilitation on implants for specific reasons. Data pertaining to partially edentulous patients were limited (FIP: n = 6; single implants: n = 16). In these patients, the timing of implant placement does not seem to affect patient satisfaction. Patients seem to prefer straightforward implant surgery over complex surgery that includes bone grafting. There is an urgent need for standardized reporting of PROMs in the field of implant dentistry. Fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a CD. All other types of prostheses have been underexposed to research. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bezlotoxumab: A Review in Preventing Clostridium difficile Infection Recurrence.

PubMed

Deeks, Emma D

2017-10-01

Bezlotoxumab (Zinplava™) is a fully human monoclonal antibody against Clostridium difficile toxin B indicated for the prevention of C. difficile infection (CDI) recurrence in patients with a high recurrence risk. It is the first agent approved for recurrence prevention and is administered as a single intravenous infusion in conjunction with standard-of-care (SoC) antibacterial treatment for CDI. In well-designed, placebo-controlled, phase 3 trials (MODIFY 1 and 2), a single infusion of bezlotoxumab, given in combination with SoC antibacterial therapy for CDI in adults, was effective in reducing CDI recurrence in the 12 weeks post-treatment, with this benefit being seen mainly in the patients at high recurrence risk. Bezlotoxumab did not impact the efficacy of the antibacterials being used to treat the CDI and, consistent with its benefits on CDI recurrence, appeared to reduce the need for subsequent antibacterials, thus minimizing further gut microbiota disruption. Longer term, there were no further CDI recurrences over 12 months' follow-up among patients who had received bezlotoxumab in MODIFY 2 and entered an extension substudy. Bezlotoxumab has low immunogenicity and is generally well tolerated, although the potential for heart failure in some patients requires consideration; cost-effectiveness data for bezlotoxumab are awaited with interest. Thus, a single intravenous infusion of bezlotoxumab during SoC antibacterial treatment for CDI is an emerging option for reducing CDI recurrence in adults at high risk of recurrence.

Posttranscriptional Upregulation of IDH1 by HuR Establishes a Powerful Survival Phenotype in Pancreatic Cancer Cells

PubMed Central

Zarei, Mahsa; Lal, Shruti; Parker, Seth J.; Nevler, Avinoam; Vaziri-Gohar, Ali; Dukleska, Katerina; Mambelli-Lisboa, Nicole C.; Moffat, Cynthia; Blanco, Fernando F.; Chand, Saswati N.; Jimbo, Masaya; Cozzitorto, Joseph A.; Jiang, Wei; Yeo, Charles J.; Londin, Eric R.; Seifert, Erin L.; Metallo, Christian M.; Brody, Jonathan R.; Winter, Jordan M.

2018-01-01

Cancer aggressiveness may result from the selective pressure of a harsh nutrient-deprived microenvironment. Here we illustrate how such conditions promote chemotherapy resistance in pancreatic ductal adenocarcinoma (PDAC). Glucose or glutamine withdrawal resulted in a 5- to 10-fold protective effect with chemotherapy treatment. PDAC xenografts were less sensitive to gemcitabine in hypoglycemic mice compared with hyperglycemic mice. Consistent with this observation, patients receiving adjuvant gemcitabine (n = 107) with elevated serum glucose levels (HgbA1C > 6.5%) exhibited improved survival. We identified enhanced antioxidant defense as a driver of chemoresistance in this setting. ROS levels were doubled in vitro by either nutrient withdrawal or gemcitabine treatment, but depriving PDAC cells of nutrients before gemcitabine treatment attenuated this effect. Mechanistic investigations based on RNAi or CRISPR approaches implicated the RNA binding protein HuR in preserving survival under nutrient withdrawal, with or without gemcitabine. Notably, RNA deep sequencing and functional analyses in HuR-deficient PDAC cell lines identified isocitrate dehydrogenase 1 (IDH1) as the sole antioxidant enzyme under HuR regulation. HuR-deficient PDAC cells lacked the ability to engraft successfully in immunocompromised mice, but IDH1 overexpression in these cells was sufficient to fully restore chemoresistance under low nutrient conditions. Overall, our findings highlight the HuR–IDH1 regulatory axis as a critical, actionable therapeutic target in pancreatic cancer. PMID:28652247

Chronic treatment with ginsenoside Rg1 promotes memory and hippocampal long-term potentiation in middle-aged mice.

PubMed

Zhu, G; Wang, Y; Li, J; Wang, J

2015-04-30

Ginseng serves as a potential candidate for the treatment of aging-related memory decline or memory loss. However, the related mechanism is not fully understood. In this study, we applied an intraperitoneal injection of ginsenoside Rg1, an active compound from ginseng in middle-aged mice and detected memory improvement and the underlying mechanisms. Our results showed that a period of 30-day administration of ginsenoside Rg1 enhanced long-term memory in the middle-aged animals. Consistent with the memory improvement, ginsenoside Rg1 administration facilitated weak theta-burst stimulation (TBS)-induced long-term potentiation (LTP) in acute hippocampal slices from middle-aged animals. Ginsenoside Rg1 administration increased the dendritic apical spine numbers and area in the CA1 region. In addition, ginsenoside Rg1 administration up-regulated the expression of hippocampal p-AKT, brain-derived neurotrophic factor (BDNF), proBDNF and glutamate receptor 1 (GluR1), but not p-ERK. Interestingly, the phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibitor (bpV) mimicked the ginsenoside Rg1 effects, including increasing p-AKT expression, promoting hippocampal basal synaptic transmission, LTP and memory. Taken together, our data suggest that ginsenoside Rg1 treatment improves memory in middle-aged mice possibly through regulating the PI3K/AKT pathway, altering apical spines and facilitating hippocampal LTP. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Structural and mechanical modifications induced on Zr-based bulk metallic glass by laser shock peening

NASA Astrophysics Data System (ADS)

Zhu, Yunhu; Fu, Jie; Zheng, Chao; Ji, Zhong

2016-12-01

In this study, surface modification of a Zr41.2Ti13.8Cu12.5Ni10Be22.5 (vit1) bulk metallic glass (BMG) has been studied in an effort to improve the mechanical properties by laser shock peening (LSP) treatment. The phase structure, mechanical properties, and microstructural evolution of the as-cast and LSP treated specimens were systematically investigated. It was found that the vit1 BMG still consisted of fully amorphous structure after LSP treatment. Measurements of the heat relaxation indicate that a large amount of free volume is introduced into vit1 BMG during LSP process. LSP treatment causes a decrease of hardness attributable to generation of free volume. The plastic deformation ability of vit1 BMG was investigated under three-point bending conditions. The results demonstrate that the plastic strain of LSP treated specimen is 1.83 times as large as that of the as-cast specimen. The effect of LSP technology on the hardness and plastic deformation ability of vit1 BMG is discussed on the basis of free volume theory. The high dense shear bands on the side surface, the increase of striations and critical shear displacement on the tensile fracture region, and more uniform dimples structure on the compressive fracture region also demonstrate that the plasticity of vit1 BMG can be enhanced by LSP.

Membrane treatment of Aqueous Film Forming Foam (AFFF) wastes for recovery of its active ingredients. Final report, Mar 79-Sep 80

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

Chian, E.S.K.; Wu, T.P.; Rowland, R.W.

1980-10-01

Ultrafiltration (UF) and Reverse Osmosis (RO) treatment of Aqueous Film Forming Foam (AFFF) solutions was investigated to determine the feasibility of employing membrane processes to separate and recover AFFF active ingredients for reuse. Studies were performed on both 6% AFFF in tap-water solutions and on actual wastewaters spiked with 3% or 6% AFFF. The AFFF materials used in this study consisted of Ansul, 3M FC-206, and 3M FC-780. Membrane employed for these studies included Abcor HFD, HFF, HFJ, and HFK tubular ultrafiltration (UF) membranes and a DuPont B-10 reverse osmosis (RO) module. Parameters monitored to represent AFFF ingredients were TOC,more » dissolved solids, surfactants, and % glycol. An attempt was also made to determine fluorocarbons as fluoride. Membrane fluxes were also determined. Results of this study demonstrate the feasibility of employing UF-RO processes to separate and recover the AFFF active ingredients for reuse. Approximately 75% recovery of the AFFF active ingredients as represented by the foam test was attained. An economic analysis of the membrane treatment processes indicates that it is extremely favorable in recovering the AFFF wastewater for reuse. Pilot-scale studies are, however, necessary to fully establish the process feasibilities and economics of the AFFF recovery system.« less

Particle swarm optimizer for weighting factor selection in intensity-modulated radiation therapy optimization algorithms.

PubMed

Yang, Jie; Zhang, Pengcheng; Zhang, Liyuan; Shu, Huazhong; Li, Baosheng; Gui, Zhiguo

2017-01-01

In inverse treatment planning of intensity-modulated radiation therapy (IMRT), the objective function is typically the sum of the weighted sub-scores, where the weights indicate the importance of the sub-scores. To obtain a high-quality treatment plan, the planner manually adjusts the objective weights using a trial-and-error procedure until an acceptable plan is reached. In this work, a new particle swarm optimization (PSO) method which can adjust the weighting factors automatically was investigated to overcome the requirement of manual adjustment, thereby reducing the workload of the human planner and contributing to the development of a fully automated planning process. The proposed optimization method consists of three steps. (i) First, a swarm of weighting factors (i.e., particles) is initialized randomly in the search space, where each particle corresponds to a global objective function. (ii) Then, a plan optimization solver is employed to obtain the optimal solution for each particle, and the values of the evaluation functions used to determine the particle's location and the population global location for the PSO are calculated based on these results. (iii) Next, the weighting factors are updated based on the particle's location and the population global location. Step (ii) is performed alternately with step (iii) until the termination condition is reached. In this method, the evaluation function is a combination of several key points on the dose volume histograms. Furthermore, a perturbation strategy - the crossover and mutation operator hybrid approach - is employed to enhance the population diversity, and two arguments are applied to the evaluation function to improve the flexibility of the algorithm. In this study, the proposed method was used to develop IMRT treatment plans involving five unequally spaced 6MV photon beams for 10 prostate cancer cases. The proposed optimization algorithm yielded high-quality plans for all of the cases, without human planner intervention. A comparison of the results with the optimized solution obtained using a similar optimization model but with human planner intervention revealed that the proposed algorithm produced optimized plans superior to that developed using the manual plan. The proposed algorithm can generate admissible solutions within reasonable computational times and can be used to develop fully automated IMRT treatment planning methods, thus reducing human planners' workloads during iterative processes. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Endotherapy for bile leaks from isolated ducts after hepatic resection: A long awaited challenge.

PubMed

Mutignani, Massimiliano; Forti, Edoardo; Dokas, Stefanos; Pugliese, Francesco; Fontana, Paola; Tringali, Alberto; Dioscoridi, Lorenzo

2017-08-01

Bile leakage is a common complication after hepatic resection [1-4] (Donadon et al., 2016; Dechene et al., 2014; Zimmitti et al., 2013; Yabe et al., 2016). Endotherapy is the treatment of choice for this complication except for bile leaks originating from isolated ducts; a condition resembling the post laparoscopic cholecystectomy Strasberg type C lesions [5-9] (Lillemo et al., 2000; Gupta and Chandra, 2011; Park et al., 2005; Colovic, 2009; Mutignani et al., 2002). In such cases, surgical repair is complex, often of uncertain result and with a high morbidity and mortality [1] (Donadon et al., 2016). On the other hand, percutaneous interventions (i.e. plugging the isolated duct with glue) are technically difficult and risky [7,8] (Park et al., 2005; Colovic, 2009). Endoscopy, thus far, was not considered amongst treatment options. That is because the isolated duct cannot be opacified during cholangiography and is not accessible with the usual endoscopic methods [5,6] (Lillemo et al., 2000; Gupta and Chandra, 2011). Considering the pathophysiology of this type of bile leaks, it is possible to change the pressure gradient endoscopically in order to direct bile flow from the isolated duct towards the duodenal lumen, thus creating an internal biliary fistula to restore bile flow. In order to achieve this goal, we have to perforate the biliary tree into the abdomen. The key element of endoscopic treatment is to create a direct connection between the abdominal cavity and the duodenal lumen by-passing the residual biliary tree with a new technique fully explained in the paper. Our case series (from 2011 to 2016) consists of 13 patients (eight male, five female, mean age 58 years) with fistulas from isolated ducts after various types of hepatic resection. We performed sphincterotomy and placed a biliary stent with the proximal edge inside the intra-abdominal bile collection in 11 patients (eight biliary fully-covered self-expandable metal stents; three plastic stents). In the remaining two patients we successfully cannulated the involved isolated biliary duct and we placed a bridging stent (one fully covered self-expandable metal stent; one plastic stent). Technical and clinical success (considered as fistula healing) was achieved in all 13 patients (mean fistula healing time was four days). Biliary stents were removed three to six months after atrophy of the involved duct in nine cases. In two patients the stent is still in situ. Two patients died with stent in situ due to advanced cancer at 8 and 42 months respectively. Mean follow up was 18 months (range: 8-42 months). The described endoscopic treatment is innovative, safe and effective. It is applicable in tertiary level endoscopic centers and requires considerable expertise. This minimally invasive procedure can increase the rate of fistula healing and will eventually reduce the need for more aggressive and risky surgical procedures. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Fully implicit moving mesh adaptive algorithm

NASA Astrophysics Data System (ADS)

Serazio, C.; Chacon, L.; Lapenta, G.

2006-10-01

In many problems of interest, the numerical modeler is faced with the challenge of dealing with multiple time and length scales. The former is best dealt with with fully implicit methods, which are able to step over fast frequencies to resolve the dynamical time scale of interest. The latter requires grid adaptivity for efficiency. Moving-mesh grid adaptive methods are attractive because they can be designed to minimize the numerical error for a given resolution. However, the required grid governing equations are typically very nonlinear and stiff, and of considerably difficult numerical treatment. Not surprisingly, fully coupled, implicit approaches where the grid and the physics equations are solved simultaneously are rare in the literature, and circumscribed to 1D geometries. In this study, we present a fully implicit algorithm for moving mesh methods that is feasible for multidimensional geometries. Crucial elements are the development of an effective multilevel treatment of the grid equation, and a robust, rigorous error estimator. For the latter, we explore the effectiveness of a coarse grid correction error estimator, which faithfully reproduces spatial truncation errors for conservative equations. We will show that the moving mesh approach is competitive vs. uniform grids both in accuracy (due to adaptivity) and efficiency. Results for a variety of models 1D and 2D geometries will be presented. L. Chac'on, G. Lapenta, J. Comput. Phys., 212 (2), 703 (2006) G. Lapenta, L. Chac'on, J. Comput. Phys., accepted (2006)

Inexact adaptive Newton methods

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

Bertiger, W.I.; Kelsey, F.J.

1985-02-01

The Inexact Adaptive Newton method (IAN) is a modification of the Adaptive Implicit Method/sup 1/ (AIM) with improved Newton convergence. Both methods simplify the Jacobian at each time step by zeroing coefficients in regions where saturations are changing slowly. The methods differ in how the diagonal block terms are treated. On test problems with up to 3,000 cells, IAN consistently saves approximately 30% of the CPU time when compared to the fully implicit method. AIM shows similar savings on some problems, but takes as much CPU time as fully implicit on other test problems due to poor Newton convergence.

Radiotherapy in pediatric medulloblastoma: Quality assessment of Pediatric Oncology Group Trial 9031

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

Miralbell, Raymond; Fitzgerald, T.J.; Laurie, Fran

2006-04-01

Purpose: To evaluate the potential influence of radiotherapy quality on survival in high-risk pediatric medulloblastoma patients. Methods and Materials: Trial 9031 of the Pediatric Oncology Group (POG) aimed to study the relative benefit of cisplatin and etoposide randomization of high-risk patients with medulloblastoma to preradiotherapy vs. postradiotherapy treatment. Two-hundred and ten patients were treated according to protocol guidelines and were eligible for the present analysis. Treatment volume (whole brain, spine, posterior fossa, and primary tumor bed) and dose prescription deviations were assessed for each patient. An analysis of first site of failure was undertaken. Event-free and overall survival rates weremore » calculated. A log-rank test was used to determine the significance of potential survival differences between patients with and without major deviations in the radiotherapy procedure. Results: Of 160 patients who were fully evaluable for all treatment quality parameters, 91 (57%) had 1 or more major deviations in their treatment schedule. Major deviations by treatment site were brain (26%), spinal (7%), posterior fossa (40%), and primary tumor bed (17%). Major treatment volume or total dose deviations did not significantly influence overall and event-free survival. Conclusions: Despite major treatment deviations in more than half of fully evaluable patients, underdosage or treatment volume misses were not associated with a worse event-free or overall survival.« less

Settlement of Clean Water Act Violations

EPA Pesticide Factsheets

Fully executed copy of the Administrative Order for Compliance on Consent (AOCC) between EPA and Fluid Recovery Services, Inc., Hart Resource Technologies, Inc., and Pennsylvania Brine Treatment, Inc.

Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion.

PubMed

2016-11-01

This opinion addresses the ethics of providing fertility treatment to women at elevated risk from fertility treatment or pregnancy. Providers ethically may treat women at elevated risk provided that they are carefully assessed; that specialists in their medical condition are consulted as appropriate; and that patients are fully informed about risks, benefits, and alternatives, including oocyte and embryo donation, use of a gestational surrogate, not undergoing fertility care, and adoption. Providers also may conclude that the risks are too high for them to treat particular patients ethically; such determinations must be made in a medically objective and unbiased manner and patients must be fully informed of the decision. Counseling of women who wish to initiate fertility treatment with underlying medical conditions that confer increased risk during treatment or pregnancy should incorporate the most current knowledge available, being cognizant of the woman's personal determinants in relation to her reproductive desires. In such a way, both physician and patient will optimize decision making in an ethically sound, patient-supportive context. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

Yee, Cristal S.; Xie, LiQin; Hatsell, Sarah

Type 1 diabetes mellitus (T1DM) patients have osteopenia and impaired fracture healing due to decreased osteoblast activity. Further, no adequate treatments are currently available that can restore impaired healing in T1DM; hence a significant need exists to investigate new therapeutics for treatment of orthopedic complications. Sclerostin (SOST), a WNT antagonist, negatively regulates bone formation, and SostAb is a potent bone anabolic agent. To determine whether SOST antibody (SostAb) treatment improves fracture healing in streptozotocin (STZ) induced T1DM mice, we administered SostAb twice weekly for up to 21 days post-fracture, and examined bone quality and callus outcomes at 21 days andmore » 42 days post-fracture (11 and 14 weeks of age, respectively). Here we show that SostAb treatment improves bone parameters; these improvements persist after cessation of antibody treatment. Markers of osteoblast differentiation such as Runx2, collagen I, osteocalcin, and DMP1 were reduced, while an abundant number of SP7/osterix-positive early osteoblasts were observed on the bone surface of STZ calluses. These results suggest that STZ calluses have poor osteogenesis resulting from failure of osteoblasts to fully differentiate and produce mineralized matrix, which produces a less mineralized callus. SostAb treatment enhanced fracture healing in both normal and STZ groups, and in STZ + SostAb mice, also reversed the lower mineralization seen in STZ calluses. Micro-CT analysis of calluses revealed improved bone parameters with SostAb treatment, and the mineralized bone was comparable to Controls. Additionally, we found sclerostin levels to be elevated in STZ mice and β-catenin activity to be reduced. Consistent with its function as a WNT antagonist, SostAb treatment enhanced β-catenin activity, but also increased the levels of SOST in the callus and in circulation. Lastly, our results indicate that SostAb treatment rescues the impaired osteogenesis seen in the STZ induced T1DM fracture model by facilitating osteoblast differentiation and mineralization of bone.« less

Variation in herbaceous vegetation and soil moisture under treated and untreated oneseed juniper trees

Treesearch

Hector Ramirez; Alexander Fernald; Andres Cibils; Michelle Morris; Shad Cox; Michael Rubio

2008-01-01

Clearing oneseed juniper (Juniperus monosperma) may make more water available for aquifer recharge or herbaceous vegetation growth, but the effects of tree treatment on soil moisture dynamics are not fully understood. This study investigated juniper treatment effects on understory herbaceous vegetation concurrently with soil moisture dynamics using vegetation sampling...

Role of endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures: What’s new?

PubMed Central

Ferreira, Rosa; Loureiro, Rui; Nunes, Nuno; Santos, António Alberto; Maio, Rui; Cravo, Marília; Duarte, Maria Antónia

2016-01-01

Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cholangitis and to chronic pancreatitis. Endoscopic treatment of benign biliary strictures is widely used as first line therapy, since it is effective, safe, noninvasive and repeatable. Endoscopic techniques currently used are dilation, multiple plastic stents insertion and fully covered self-expandable metal stents. The main indication for dilation alone is primary sclerosing cholangitis related strictures. In the vast majority of the remaining cases, temporary placement of multiple plastic stents with/without dilation is considered the treatment of choice. Although this approach is effective, it requires multiple endoscopic sessions due to the short duration of stent patency. Fully covered self-expandable metal stents appear as a good alternative to plastic stents, since they have an increased radial diameter, longer stent patency, easier insertion technique and similar efficacy. Recent advances in endoscopic technique and various devices have allowed successful treatment in most cases. The development of novel endoscopic techniques and devices is still ongoing. PMID:26962404

Fourier rebinning and consistency equations for time-of-flight PET planograms

PubMed Central

Li, Yusheng; Defrise, Michel; Matej, Samuel; Metzler, Scott D

2016-01-01

Due to the unique geometry, dual-panel PET scanners have many advantages in dedicated breast imaging and on-board imaging applications since the compact scanners can be combined with other imaging and treatment modalities. The major challenges of dual-panel PET imaging are the limited-angle problem and data truncation, which can cause artifacts due to incomplete data sampling. The time-of-flight (TOF) information can be a promising solution to reduce these artifacts. The TOF planogram is the native data format for dual-panel TOF PET scanners, and the non-TOF planogram is the 3D extension of linogram. The TOF planograms is five-dimensional while the objects are three-dimensional, and there are two degrees of redundancy. In this paper, we derive consistency equations and Fourier-based rebinning algorithms to provide a complete understanding of the rich structure of the fully 3D TOF planograms. We first derive two consistency equations and John's equation for 3D TOF planograms. By taking the Fourier transforms, we obtain two Fourier consistency equations and the Fourier-John equation, which are the duals of the consistency equations and John's equation, respectively. We then solve the Fourier consistency equations and Fourier-John equation using the method of characteristics. The two degrees of entangled redundancy of the 3D TOF data can be explicitly elicited and exploited by the solutions along the characteristic curves. As the special cases of the general solutions, we obtain Fourier rebinning and consistency equations (FORCEs), and thus we obtain a complete scheme to convert among different types of PET planograms: 3D TOF, 3D non-TOF, 2D TOF and 2D non-TOF planograms. The FORCEs can be used as Fourier-based rebinning algorithms for TOF-PET data reduction, inverse rebinnings for designing fast projectors, or consistency conditions for estimating missing data. As a byproduct, we show the two consistency equations are necessary and sufficient for 3D TOF planograms. Finally, we give numerical examples of implementation of a fast 2D TOF planogram projector and Fourier-based rebinning for a 2D TOF planograms using the FORCEs to show the efficacy of the Fourier-based solutions. PMID:28255191

Fourier rebinning and consistency equations for time-of-flight PET planograms.

PubMed

Li, Yusheng; Defrise, Michel; Matej, Samuel; Metzler, Scott D

2016-01-01

Due to the unique geometry, dual-panel PET scanners have many advantages in dedicated breast imaging and on-board imaging applications since the compact scanners can be combined with other imaging and treatment modalities. The major challenges of dual-panel PET imaging are the limited-angle problem and data truncation, which can cause artifacts due to incomplete data sampling. The time-of-flight (TOF) information can be a promising solution to reduce these artifacts. The TOF planogram is the native data format for dual-panel TOF PET scanners, and the non-TOF planogram is the 3D extension of linogram. The TOF planograms is five-dimensional while the objects are three-dimensional, and there are two degrees of redundancy. In this paper, we derive consistency equations and Fourier-based rebinning algorithms to provide a complete understanding of the rich structure of the fully 3D TOF planograms. We first derive two consistency equations and John's equation for 3D TOF planograms. By taking the Fourier transforms, we obtain two Fourier consistency equations and the Fourier-John equation, which are the duals of the consistency equations and John's equation, respectively. We then solve the Fourier consistency equations and Fourier-John equation using the method of characteristics. The two degrees of entangled redundancy of the 3D TOF data can be explicitly elicited and exploited by the solutions along the characteristic curves. As the special cases of the general solutions, we obtain Fourier rebinning and consistency equations (FORCEs), and thus we obtain a complete scheme to convert among different types of PET planograms: 3D TOF, 3D non-TOF, 2D TOF and 2D non-TOF planograms. The FORCEs can be used as Fourier-based rebinning algorithms for TOF-PET data reduction, inverse rebinnings for designing fast projectors, or consistency conditions for estimating missing data. As a byproduct, we show the two consistency equations are necessary and sufficient for 3D TOF planograms. Finally, we give numerical examples of implementation of a fast 2D TOF planogram projector and Fourier-based rebinning for a 2D TOF planograms using the FORCEs to show the efficacy of the Fourier-based solutions.

Characterization of Inclusion Populations in Mn-Si Deoxidized Steel

NASA Astrophysics Data System (ADS)

García-Carbajal, Alfonso; Herrera-Trejo, Martín; Castro-Cedeño, Edgar-Ivan; Castro-Román, Manuel; Martinez-Enriquez, Arturo-Isaias

2017-12-01

Four plant heats of Mn-Si deoxidized steel were conducted to follow the evolution of the inclusion population through ladle furnace (LF) treatment and subsequent vacuum treatment (VT). The liquid steel was sampled, and the chemical composition and size distribution of the inclusion populations were characterized. The Gumbel generalized extreme-value (GEV) and generalized Pareto (GP) distributions were used for the statistical analysis of the inclusion size distributions. The inclusions found at the beginning of the LF treatment were mostly fully liquid SiO2-Al2O3-MnO inclusions, which then evolved into fully liquid SiO2-Al2O3-CaO-MgO and partly liquid SiO2-CaO-MgO-(Al2O3-MgO) inclusions detected at the end of the VT. The final fully liquid inclusions had a desirable chemical composition for plastic behavior in subsequent metallurgical operations. The GP distribution was found to be undesirable for statistical analysis. The GEV distribution approach led to shape parameter values different from the zero value hypothesized from the Gumbel distribution. According to the GEV approach, some of the final inclusion size distributions had statistically significant differences, whereas the Gumbel approach predicted no statistically significant differences. The heats were organized according to indicators of inclusion cleanliness and a statistical comparison of the size distributions.

Stream ecosystem response to limestone treatment in acid impacted watersheds of the allegheny plateau

USGS Publications Warehouse

McClurg, S.E.; Petty, J.T.; Mazik, P.M.; Clayton, J.L.

2007-01-01

Restoration programs are expanding worldwide, but assessments of restoration effectiveness are rare. The objectives of our study were to assess current acid-precipitation remediation programs in streams of the Allegheny Plateau ecoregion of West Virginia (USA), identify specific attributes that could and could not be fully restored, and quantify temporal trends in ecosystem recovery. We sampled water chemistry, physical habitat, periphyton biomass, and benthic macroinvertebrate and fish community structure in three stream types: acidic (four streams), naturally circumneutral (eight streams), and acidic streams treated with limestone sand (eight streams). We observed no temporal trends in ecosystem recovery in treated streams despite sampling streams that ranged from 2 to 20 years since initial treatment. Our results indicated that the application of limestone sand to acidic streams was effective in fully recovering some characteristics, such as pH, alkalinity, Ca2+, Ca:H ratios, trout biomass and density, and trout reproductive success. However, recovery of many other characteristics was strongly dependent upon spatial proximity to treatment, and still others were never fully recovered. For example, limestone treatment did not restore dissolved aluminum concentrations, macroinvertebrate taxon richness, and total fish biomass to circumneutral reference conditions. Full recovery may not be occurring because treated streams continue to drain acidic watersheds and remain isolated in a network of acidic streams. We propose a revised stream restoration plan for the Allegheny Plateau that includes restoring stream ecosystems as connected networks rather than isolated reaches and recognizes that full recovery of acidified watersheds may not be possible. ?? 2007 by the Ecological Society of America.

Hemangiomas

MedlinePlus

... to 18 months, and then slowly shrink. Port wine stains and other true birthmarks are fully formed ... left alone, but as medicine has progressed the benefits to early treatment are outweighing the risks more ...

Sparse matrix beamforming and image reconstruction for real-time 2D HIFU monitoring using Harmonic Motion Imaging for Focused Ultrasound (HMIFU) with in vitro validation

PubMed Central

Hou, Gary Y.; Provost, Jean; Grondin, Julien; Wang, Shutao; Marquet, Fabrice; Bunting, Ethan; Konofagou, Elisa E.

2015-01-01

Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a recently developed High-Intensity Focused Ultrasound (HIFU) treatment monitoring method. HMIFU utilizes an Amplitude-Modulated (fAM = 25 Hz) HIFU beam to induce a localized focal oscillatory motion, which is simultaneously estimated and imaged by confocally-aligned imaging transducer. HMIFU feasibilities have been previously shown in silico, in vitro, and in vivo in 1-D or 2-D monitoring of HIFU treatment. The objective of this study is to develop and show the feasibility of a novel fast beamforming algorithm for image reconstruction using GPU-based sparse-matrix operation with real-time feedback. In this study, the algorithm was implemented onto a fully integrated, clinically relevant HMIFU system composed of a 93-element HIFU transducer (fcenter = 4.5MHz) and coaxially-aligned 64-element phased array (fcenter = 2.5MHz) for displacement excitation and motion estimation, respectively. A single transmit beam with divergent beam transmit was used while fast beamforming was implemented using a GPU-based delay-and-sum method and a sparse-matrix operation. Axial HMI displacements were then estimated from the RF signals using a 1-D normalized cross-correlation method and streamed to a graphic user interface. The present work developed and implemented a sparse matrix beamforming onto a fully-integrated, clinically relevant system, which can stream displacement images up to 15 Hz using a GPU-based processing, an increase of 100 fold in rate of streaming displacement images compared to conventional CPU-based conventional beamforming and reconstruction processing. The achieved feedback rate is also currently the fastest and only approach that does not require interrupting the HIFU treatment amongst the acoustic radiation force based HIFU imaging techniques. Results in phantom experiments showed reproducible displacement imaging, and monitoring of twenty two in vitro HIFU treatments using the new 2D system showed a consistent average focal displacement decrease of 46.7±14.6% during lesion formation. Complementary focal temperature monitoring also indicated an average rate of displacement increase and decrease with focal temperature at 0.84±1.15 %/ °C, and 2.03± 0.93%/ °C, respectively. These results reinforce the HMIFU capability of estimating and monitoring stiffness related changes in real time. Current ongoing studies include clinical translation of the presented system for monitoring of HIFU treatment for breast and pancreatic tumor applications. PMID:24960528

Beyond "Hitting the Books"

ERIC Educational Resources Information Center

Entress, Cole; Wagner, Aimee

2014-01-01

Scientists, science teachers, and serious students recognize that success in science classes requires consistent practice--including study at home. Whether balancing chemical equations, calculating angular momentum, or memorizing the steps of cell division, students must review material repeatedly to fully understand new ideas--and must practice…

Passive Polarimetric Microwave Signatures Observed Over Antarctica

USDA-ARS?s Scientific Manuscript database

WindSat satellite-based fully polarimetric passive microwave observations, expressed in the form of the Stokes vector, were analyzed over the Antarctic ice sheet. The vertically and horizontally polarized brightness temperatures (first two Stokes components) from WindSat are shown to be consistent w...

Molybdenum disilicide composites reinforced with zirconia and silicon carbide

DOEpatents

Petrovic, John J.

1995-01-01

Compositions consisting essentially of molybdenum disilicide, silicon carbide, and a zirconium oxide component. The silicon carbide used in the compositions is in whisker or powder form. The zirconium oxide component is pure zirconia or partially stabilized zirconia or fully stabilized zirconia.

Handling incomplete correlated continuous and binary outcomes in meta-analysis of individual participant data.

PubMed

Gomes, Manuel; Hatfield, Laura; Normand, Sharon-Lise

2016-09-20

Meta-analysis of individual participant data (IPD) is increasingly utilised to improve the estimation of treatment effects, particularly among different participant subgroups. An important concern in IPD meta-analysis relates to partially or completely missing outcomes for some studies, a problem exacerbated when interest is on multiple discrete and continuous outcomes. When leveraging information from incomplete correlated outcomes across studies, the fully observed outcomes may provide important information about the incompleteness of the other outcomes. In this paper, we compare two models for handling incomplete continuous and binary outcomes in IPD meta-analysis: a joint hierarchical model and a sequence of full conditional mixed models. We illustrate how these approaches incorporate the correlation across the multiple outcomes and the between-study heterogeneity when addressing the missing data. Simulations characterise the performance of the methods across a range of scenarios which differ according to the proportion and type of missingness, strength of correlation between outcomes and the number of studies. The joint model provided confidence interval coverage consistently closer to nominal levels and lower mean squared error compared with the fully conditional approach across the scenarios considered. Methods are illustrated in a meta-analysis of randomised controlled trials comparing the effectiveness of implantable cardioverter-defibrillator devices alone to implantable cardioverter-defibrillator combined with cardiac resynchronisation therapy for treating patients with chronic heart failure. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

The First Flight of ATIC: Preliminary Results on Li, Be, B Nuclei

NASA Technical Reports Server (NTRS)

Zatsepin, V. I.; Adams, J. H.; Ahn, H.; Ampe, J.; Bashindzhagyan, G.; Case, G.; Whitaker, Ann F. (Technical Monitor)

2001-01-01

The ATIC (Advanced Thin Ionization Calorimeter) balloon experiment had its first test flight which lasted for 16 days and brought it around Antarctica. The ATIC spectrometer consists of a fully active BGO (Bismuth Germanate) calorimeter, scintillator hodoscopes and a silicon matrix. The silicon matrix consisted of 4480 pixels was used as a charge detector in the experiment. We discuss a possibility of the ATIC to measure individual energy spectra of Li, Be and B.

Ethics of medical and nonmedical oocyte cryopreservation.

PubMed

Patrizio, Pasquale; Molinari, Emanuela; Caplan, Arthur

2016-12-01

To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical and social indications. As more women are postponing motherhood for a variety of reasons, including lack of partner, for completing career plans and reaching financial stability, they are resorting to oocyte cryopreservation. To make informed choices, women rely on their primary care physicians (PCPs) for initial advice, but PCPs are not always fully prepared to discuss oocyte cryopreservation. Interestingly, there are mixed feelings among obstetricians/gynecologists on whether oocyte cryopreservation should be used for elective reasons, whereas it is fully supported for medical indications. Oocyte vitrification has become an established procedure for safeguarding future reproductive chances for medical reasons, and its use is progressively expanding. There is an urgent need in preparing future PCPs and obstetricians/gynecologists as to how to initiate discussions with their patients about elective oocyte banking consistent with fully respecting patient autonomy so as to facilitate informed decisions.

New developments in endoscopic treatment of chronic pancreatitis.

PubMed

Didden, P; Bruno, M; Poley, J W

2012-12-01

The aim of endoscopic therapy of chronic pancreatitis (CP) is to treat pain by draining the pancreatic duct or managing loco-regional complications. Recent decennia were characterized by continuous improvement of endoscopic techniques and devices, resulting in a better clinical outcome. Novel developments now also provide the opportunity to endoscopically treat refractory CP-related complications. Especially suboptimal surgical candidates could potentially benefit from these new developments, consequently avoiding invasive surgery. The use of fully covered self-expandable metal stents (SEMS) has been explored in pancreatic and CP-related biliary duct strictures, resistant to conventional treatment with plastic endoprotheses. Furthermore, endosonography-guided transmural drainage of the main pancreatic duct via duct-gastrostomy is an alternative treatment option in selected cases. Pancreatic pseudocysts represent an excellent indication for endoscopic therapy with some recent case series demonstrating effective drainage with the use of a fully covered SEMS. Although results of these new endoscopic developments are promising, high quality randomized trials are required to determine their definite role in the management of chronic pancreatitis.

Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

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

Purdie, Thomas G., E-mail: Tom.Purdie@rmp.uhn.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Techna Institute, University Health Network, Toronto, Ontario

Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to definemore » and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented improvements in care for breast cancer patients, using technologies that are widely available and already in clinical use.« less

[RECOMMENDATION FOR EVALUATION AND TREATMENT OF CHRONIC URTICARIA - THE ISRAELI ASSOCIATION FOR ALLERGY AND CLINICAL IMMUNOLOGY].

PubMed

Levin Agmon, Nancy; Kessel, Aharon; Maoz Segal, Ramit; Rottem, Menachem; Tal, Yuval; Confino-Cohen, Ronit; Tobi, Elias

2017-06-01

Chronic urticaria is a disease manifested by a pruritic rash lasting longer than 6 weeks that may severely affect quality of life and daily function. Chronic urticaria can be further divided into chronic spontaneous urticaria which appears without a trigger and chronic inducible urticaria which evolves following distinct physical triggers. These two clinical manifestations could coexist in the same patient. The pathogenesis of chronic urticaria is not fully elucidated, although it is considered an autoimmune disease in at least 50% patients that produce auto- IgG antibodies targeted against the high affinity Fc receptor and to a lesser extent against IgE itself. Auto-antibodies associated with different autoimmune diseases can be detected such as those directed at thyroid proteins. Urticaria tends to spontaneously resolve in 50% of patients within the first year while others will suffer from it for a much longer period of time. The treatment of chronic urticaria has dramatically progressed in the last decade, enabling reduction of systemic corticosteroid use which has been the cornerstone of treatment in the past. The recommended treatment for chronic urticaria is currently based on a stepwise approach that enables achieving disease control with a reasonably good quality of life. The first step of the treatment ladder consists of selective, new generation, anti-H1 histamine blockers, which do not cross the blood brain barrier, starting from the recommended dose (first line) and increasing up to four-fold (second line). The third line of treatment is the addition of immune modulators such as leukotriene receptor blockers (Singulair), anti-IgE biological therapy (Xolair), or cyclosporine. In this review we present the updates and considerations arising during evaluation and treatment of chronic urticaria. The need for specific tests, immunologist/allergologist evaluation, as well as treatment modalities taking into consideration the large body of evidence that has accumulated in the last few years, the new international guidelines as well as their application in Israel have been addressed.

Automation and intensity modulated radiation therapy for individualized high-quality tangent breast treatment plans.

PubMed

Purdie, Thomas G; Dinniwell, Robert E; Fyles, Anthony; Sharpe, Michael B

2014-11-01

To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented improvements in care for breast cancer patients, using technologies that are widely available and already in clinical use. Copyright © 2014 Elsevier Inc. All rights reserved.

Decline in infection-related morbidities following drug-mediated reductions in the intensity of Schistosoma infection: A systematic review and meta-analysis

PubMed Central

Andrade, Gisele; Bertsch, David J.; Gazzinelli, Andrea

2017-01-01

Background Since 1984, WHO has endorsed drug treatment to reduce Schistosoma infection and its consequent morbidity. Cross-sectional studies suggest pre-treatment correlation between infection intensity and risk for Schistosoma-related pathology. However, evidence also suggests that post-treatment reduction in intensity may not reverse morbidity because some morbidities occur at all levels of infection, and some reflect permanent tissue damage. The aim of this project was to systematically review evidence on drug-based control of schistosomiasis and to develop a quantitative estimate of the impact of post-treatment reductions in infection intensity on prevalence of infection-associated morbidity. Methodology/Principal findings This review was registered at inception with PROSPERO (CRD42015026080). Studies that evaluated morbidity before and after treatment were identified by online searches and searches of private archives. Post-treatment odds ratios or standardized mean differences were calculated for each outcome, and these were correlated to treatment-related egg count reduction ratios (ERRs) by meta-regression. A greater ERR correlated with greater reduction in odds of most morbidities. Random effects meta-analysis was used to derive summary estimates: after treatment of S. mansoni and S. japonicum, left-sided hepatomegaly was reduced by 54%, right-sided hepatomegaly by 47%, splenomegaly by 37%, periportal fibrosis by 52%, diarrhea by 53%, and blood in stools by 75%. For S. haematobium, hematuria was reduced by 92%, proteinuria by 90%, bladder lesions by 86%, and upper urinary tract lesions by 72%. There were no consistent changes in portal dilation or hemoglobin levels. In sub-group analysis, age, infection status, region, parasite species, and interval to follow-up were associated with meaningful differences in outcome. Conclusion/Significance While there are challenges to implementing therapy for schistosomiasis, and praziquantel therapy is not fully curative, reductions in egg output are significantly correlated with decreased morbidity and can be used to project diminution in disease burden when contemplating more aggressive strategies to minimize infection intensity. PMID:28212414

20 CFR 404.1545 - Your residual functional capacity.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Your residual functional capacity. 404.1545 Section 404.1545 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... fully capable of the physical demands consistent with those of sustained medium work activity, but...

20 CFR 404.1545 - Your residual functional capacity.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Your residual functional capacity. 404.1545 Section 404.1545 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... fully capable of the physical demands consistent with those of sustained medium work activity, but...

Molybdenum disilicide composites reinforced with zirconia and silicon carbide

DOEpatents

Petrovic, J.J.

1995-01-17

Compositions are disclosed consisting essentially of molybdenum disilicide, silicon carbide, and a zirconium oxide component. The silicon carbide used in the compositions is in whisker or powder form. The zirconium oxide component is pure zirconia or partially stabilized zirconia or fully stabilized zirconia.

Global Properties of Fully Convective Accretion Disks from Local Simulations

NASA Astrophysics Data System (ADS)

Bodo, G.; Cattaneo, F.; Mignone, A.; Ponzo, F.; Rossi, P.

2015-08-01

We present an approach to deriving global properties of accretion disks from the knowledge of local solutions derived from numerical simulations based on the shearing box approximation. The approach consists of a two-step procedure. First, a local solution valid for all values of the disk height is constructed by piecing together an interior solution obtained numerically with an analytical exterior radiative solution. The matching is obtained by assuming hydrostatic balance and radiative equilibrium. Although in principle the procedure can be carried out in general, it simplifies considerably when the interior solution is fully convective. In these cases, the construction is analogous to the derivation of the Hayashi tracks for protostars. The second step consists of piecing together the local solutions at different radii to obtain a global solution. Here we use the symmetry of the solutions with respect to the defining dimensionless numbers—in a way similar to the use of homology relations in stellar structure theory—to obtain the scaling properties of the various disk quantities with radius.

Comparison of $$\

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

Adams, C.; et al.

We measure a large set of observables in inclusive charged current muon neutrino scattering on argon with the MicroBooNE liquid argon time projection chamber operating at Fermilab. We evaluate three neutrino interaction models based on the widely used GENIE event generator using these observables. The measurement uses a data set consisting of neutrino interactions with a final state muon candidate fully contained within the MicroBooNE detector. These data were collected in 2016 with the Fermilab Booster Neutrino Beam, which has an average neutrino energy of 800 MeV, using an exposure corresponding to 5e19 protons-on-target. The analysis employs fully automatic eventmore » selection and charged particle track reconstruction and uses a data-driven technique to separate neutrino interactions from cosmic ray background events. We find that GENIE models consistently describe the shapes of a large number of kinematic distributions for fixed observed multiplicity, but we show an indication that the observed multiplicity fractions deviate from GENIE expectations.« less

Convergence of quasiparticle self-consistent GW calculations of transition metal monoxides

NASA Astrophysics Data System (ADS)

Das, Suvadip; Coulter, John E.; Manousakis, Efstratios

2015-03-01

We have investigated the electronic structure of the transition metal monoxides MnO, CoO, and NiO in their undistorted rock-salt structure within a fully iterated quasiparticle self-consistent GW (QPscGW) scheme. We have studied the convergence of the QPscGW method, i.e., how the quasiparticle energy eigenvalues and wavefunctions converge as a function of the QPscGW iterations, and compared the converged outputs obtained from different starting wavefunctions. We found that the convergence is slow and that a one-shot G0W0 calculation does not significantly improve the initial eigenvalues and states. In some cases the ``path'' to convergence may go through energy band reordering which cannot be captured by the simple initial unperturbed Hamiltonian. When a fully iterated solution is reached, the converged density of states, band-gaps and magnetic moments of these oxides are found to be only weakly dependent on the choice of the starting wavefunctions and in reasonable agreement with the experiment. National High Magnetic Field Laboratory.

Tests of neutrino interaction models with the MicroBooNE detector

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

Rafique, Aleena

2018-01-01

I measure a large set of observables in inclusive charged current muon neutrino scattering on argon with the MicroBooNE liquid argon time projection chamber operating at Fermilab. I evaluate three neutrino interaction models based on the widely used GENIE event generator using these observables. The measurement uses a data set consisting of neutrino interactions with a final state muon candidate fully contained within the MicroBooNE detector. These data were collected in 2016 with the Fermilab Booster Neutrino Beam, which has an average neutrino energy ofmore » $800$ MeV, using an exposure corresponding to $$5.0\\times10^{19}$$ protons-on-target. The analysis employs fully automatic event selection and charged particle track reconstruction and uses a data-driven technique to separate neutrino interactions from cosmic ray background events. I find that GENIE models consistently describe the shapes of a large number of kinematic distributions for fixed observed multiplicity, but I show an indication that the observed multiplicity fractions deviate from GENIE expectations.« less

Developing management options for longleaf communities of the gulf coastal plain

Treesearch

Kenneth W. Outcalt

2003-01-01

Choosing treatments to reduce fuel loads and readjust structure and composition in longleaf communities of the Gulf Coastal Plains region is difficult because benefits and costs of possible treatment combinations are not fully known. The objective of this research project is to develop management options to reduce fuels and restore the ecosystem that are economically...

Novel integrative genomic tool for interrogating lithium response in bipolar disorder

PubMed Central

Hunsberger, J G; Chibane, F L; Elkahloun, A G; Henderson, R; Singh, R; Lawson, J; Cruceanu, C; Nagarajan, V; Turecki, G; Squassina, A; Medeiros, C D; Del Zompo, M; Rouleau, G A; Alda, M; Chuang, D-M

2015-01-01

We developed a novel integrative genomic tool called GRANITE (Genetic Regulatory Analysis of Networks Investigational Tool Environment) that can effectively analyze large complex data sets to generate interactive networks. GRANITE is an open-source tool and invaluable resource for a variety of genomic fields. Although our analysis is confined to static expression data, GRANITE has the capability of evaluating time-course data and generating interactive networks that may shed light on acute versus chronic treatment, as well as evaluating dose response and providing insight into mechanisms that underlie therapeutic versus sub-therapeutic doses or toxic doses. As a proof-of-concept study, we investigated lithium (Li) response in bipolar disorder (BD). BD is a severe mood disorder marked by cycles of mania and depression. Li is one of the most commonly prescribed and decidedly effective treatments for many patients (responders), although its mode of action is not yet fully understood, nor is it effective in every patient (non-responders). In an in vitro study, we compared vehicle versus chronic Li treatment in patient-derived lymphoblastoid cells (LCLs) (derived from either responders or non-responders) using both microRNA (miRNA) and messenger RNA gene expression profiling. We present both Li responder and non-responder network visualizations created by our GRANITE analysis in BD. We identified by network visualization that the Let-7 family is consistently downregulated by Li in both groups where this miRNA family has been implicated in neurodegeneration, cell survival and synaptic development. We discuss the potential of this analysis for investigating treatment response and even providing clinicians with a tool for predicting treatment response in their patients, as well as for providing the industry with a tool for identifying network nodes as targets for novel drug discovery. PMID:25646593

Novel integrative genomic tool for interrogating lithium response in bipolar disorder.

PubMed

Hunsberger, J G; Chibane, F L; Elkahloun, A G; Henderson, R; Singh, R; Lawson, J; Cruceanu, C; Nagarajan, V; Turecki, G; Squassina, A; Medeiros, C D; Del Zompo, M; Rouleau, G A; Alda, M; Chuang, D-M

2015-02-03

We developed a novel integrative genomic tool called GRANITE (Genetic Regulatory Analysis of Networks Investigational Tool Environment) that can effectively analyze large complex data sets to generate interactive networks. GRANITE is an open-source tool and invaluable resource for a variety of genomic fields. Although our analysis is confined to static expression data, GRANITE has the capability of evaluating time-course data and generating interactive networks that may shed light on acute versus chronic treatment, as well as evaluating dose response and providing insight into mechanisms that underlie therapeutic versus sub-therapeutic doses or toxic doses. As a proof-of-concept study, we investigated lithium (Li) response in bipolar disorder (BD). BD is a severe mood disorder marked by cycles of mania and depression. Li is one of the most commonly prescribed and decidedly effective treatments for many patients (responders), although its mode of action is not yet fully understood, nor is it effective in every patient (non-responders). In an in vitro study, we compared vehicle versus chronic Li treatment in patient-derived lymphoblastoid cells (LCLs) (derived from either responders or non-responders) using both microRNA (miRNA) and messenger RNA gene expression profiling. We present both Li responder and non-responder network visualizations created by our GRANITE analysis in BD. We identified by network visualization that the Let-7 family is consistently downregulated by Li in both groups where this miRNA family has been implicated in neurodegeneration, cell survival and synaptic development. We discuss the potential of this analysis for investigating treatment response and even providing clinicians with a tool for predicting treatment response in their patients, as well as for providing the industry with a tool for identifying network nodes as targets for novel drug discovery.

Cognitive restructuring and imagery modification for posttraumatic stress disorder (CRIM-PTSD): A pilot study.

PubMed

Müller-Engelmann, Meike; Steil, Regina

2017-03-01

Cognitive restructuring and imagery modification for PTSD (CRIM-PTSD) is a new short intervention. It consists of the cognitive restructuring of core trauma-related dysfunctional beliefs about the self and the use of imagery to encourage more functional beliefs. A randomized controlled trial showed that CRIM was effective for reducing posttraumatic stress disorder (PTSD) in survivors of childhood sexual abuse (CSA) when it focused on the feeling of being contaminated. For this study, CRIM was adapted to treat PTSD symptoms more generally and after various types of trauma by addressing the patients' negative self-concept. Ten patients with PTSD received two assessment sessions, two treatment sessions, and a booster session. The Clinician-Administered PTSD Scale (CAPS) was administered prior to and four weeks after treatment. Self-ratings, e.g., the Posttraumatic Diagnostic Scale (PDS) and the Posttraumatic Cognitions Inventory (PTCI), were administered at baseline, immediately posttreatment, and four weeks after treatment. The participants showed significant improvements in both clinician-rated (d = 2.55; p < 0.01) and self-reported PTSD symptoms (d = 1.47; p < 0.01). One month after treatment, 9 patients no longer fully met the diagnostic criteria for PTSD. The results are limited by the small sample size and the lack of a control group. This pilot study suggests that addressing the negative self-concept of PTSD patients using a combination of cognitive techniques and imagery modification can effectively reduce PTSD symptoms. Further research is needed to assess the treatment's effects and stability in a randomized controlled trial. Copyright © 2016 Elsevier Ltd. All rights reserved.

Why the Eurocontrol Safety Regulation Commission Policy on Safety Nets and Risk Assessment is Wrong

NASA Astrophysics Data System (ADS)

Brooker, Peter

2004-05-01

Current Eurocontrol Safety Regulation Commission (SRC) policy says that the Air Traffic Management (ATM) system (including safety minima) must be demonstrated through risk assessments to meet the Target Level of Safety (TLS) without needing to take safety nets (such as Short Term Conflict Alert) into account. This policy is wrong. The policy is invalid because it does not build rationally and consistently from ATM's firm foundations of TLS and hazard analysis. The policy is bad because it would tend to retard safety improvements. Safety net policy must rest on a clear and rational treatment of integrated ATM system safety defences. A new safety net policy, appropriate to safe ATM system improvements, is needed, which recognizes that safety nets are an integrated part of ATM system defences. The effects of safety nets in reducing deaths from mid-air collisions should be fully included in hazard analysis and safety audits in the context of the TLS for total system design.

Transition in Electron Physics of Magnetic Reconnection in Weakly Collisional Plasma

NASA Astrophysics Data System (ADS)

Le, A.; Roytershteyn, V.; Karimabadi, H.; Daughton, W. S.; Egedal, J.; Forest, C.

2013-12-01

Using self-consistent fully kinetic simulations with a Monte-Carlo treatment of the Coulomb collision operator, we explore the transition between collisional and kinetic regimes of magnetic reconnection in high-Lundquist-number current sheets. Recent research in collisionless reconnection has shown that electron kinetic physics plays a key role in the evolution. Large-scale electron current sheets may form, leading to secondary island formation and turbulent flux rope interactions in 3D. The new collisional simulations demonstrate how increasing collisionality modifies or eliminates these electron structures in the kinetic regimes. Additional basic questions that are addressed include how the reconnection rate and the release of magnetic energy into electrons and ions vary with collisionality. The numerical study provides insight into reconnection in dense regions of the solar corona, the solar wind, and upcoming laboratory experiments at MRX (Princeton) and MPDX (UW-Madison). The implications of these results for studies of turbulence dissipation in weakly collisional plasmas are discussed.

Three-cluster dynamics within an ab initio framework

DOE PAGES

Quaglioni, Sofia; Romero-Redondo, Carolina; Navratil, Petr

2013-09-26

In this study, we introduce a fully antisymmetrized treatment of three-cluster dynamics within the ab initio framework of the no-core shell model/resonating-group method. Energy-independent nonlocal interactions among the three nuclear fragments are obtained from realistic nucleon-nucleon interactions and consistent ab initio many-body wave functions of the clusters. The three-cluster Schrödinger equation is solved with bound-state boundary conditions by means of the hyperspherical-harmonic method on a Lagrange mesh. We discuss the formalism in detail and give algebraic expressions for systems of two single nucleons plus a nucleus. Using a soft similarity-renormalization-group evolved chiral nucleon-nucleon potential, we apply the method to amore » 4He+n+n description of 6He and compare the results to experiment and to a six-body diagonalization of the Hamiltonian performed within the harmonic-oscillator expansions of the no-core shell model. Differences between the two calculations provide a measure of core ( 4He) polarization effects.« less

Equilibrium models of coronal loops that involve curvature and buoyancy

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

Hindman, Bradley W.; Jain, Rekha, E-mail: hindman@solarz.colorado.edu

2013-12-01

We construct magnetostatic models of coronal loops in which the thermodynamics of the loop is fully consistent with the shape and geometry of the loop. This is achieved by treating the loop as a thin, compact, magnetic fibril that is a small departure from a force-free state. The density along the loop is related to the loop's curvature by requiring that the Lorentz force arising from this deviation is balanced by buoyancy. This equilibrium, coupled with hydrostatic balance and the ideal gas law, then connects the temperature of the loop with the curvature of the loop without resorting to amore » detailed treatment of heating and cooling. We present two example solutions: one with a spatially invariant magnetic Bond number (the dimensionless ratio of buoyancy to Lorentz forces) and the other with a constant radius of the curvature of the loop's axis. We find that the density and temperature profiles are quite sensitive to curvature variations along the loop, even for loops with similar aspect ratios.« less

Peripheral Neuropathy Due to Recreational Use of Nitrous Oxide Presenting After an Ankle Sprain With Foot Drop.

PubMed

Middleton, Jackson A; Roffers, John A

2018-05-01

A 22-year-old man was referred for orthopedic follow-up after an ankle injury. Initial evaluation in urgent care included radiographs with negative findings. After a delayed presentation, a course of functional treatment was recommended. Subsequently, he developed a deep venous thrombosis and pulmonary emboli. He was found to be factor V Leiden deficient and was fully anticoagulated on warfarin. Later reevaluation revealed a steppage gait and foot drop. Electrodiagnostic studies (ie, electromyography and nerve conduction studies) revealed a severe peripheral polyneuropathy. The patient admitted to engaging in high-volume recreational use of nitrous oxide. Neurological evaluation confirmed vitamin B12 deficiency consistent with the toxic effects of nitrous oxide. The patient's condition improved with vitamin B supplementation, bracing, and avoidance of nitrous oxide and similar neurotoxins. He participated in a 3-month physical rehabilitation program, and he displayed partial recovery at most recent follow-up. [Orthopedics. 2018; 41(3):e432-e433.]. Copyright 2017, SLACK Incorporated.

The frequency, characteristics and aetiology of stroke mimic presentations: a narrative review.

PubMed

McClelland, Graham; Rodgers, Helen; Flynn, Darren; Price, Christopher I

2018-05-01

A significant proportion of patients with acute stroke symptoms have an alternative 'mimic' diagnosis. A narrative review was carried out to explore the frequency, characteristics and aetiology of stroke mimics. Prehospital and thrombolysis-treated patients were described separately. Overall, 9972 studies were identified from the initial search and 79 studies were included with a median stroke mimic rate of 19% (range: 1-64%). The prehospital median was 27% (range: 4-43%) and the thrombolysis median 10% (range: 1-25%). Seizures, migraines and psychiatric disorders are the most frequently reported causes of stroke mimics. Several characteristics are consistently associated with stroke mimics; however, they do not fully exclude the possibility of stroke. Nineteen per cent of suspected stroke patients had a mimic condition. Stroke mimics were more common with younger age and female sex. The range of mimic diagnoses, a lack of clear differentiating characteristics and the short treatment window for ischaemic stroke create challenges for early identification.

The microstructural evolution, crystallography, and thermal processing of ultrahigh carbon Fe-1.85 pct C melt-spun ribbon

NASA Technical Reports Server (NTRS)

Spanos, G.; Ayers, J. D.; Vold, C. L.; Locci, I. E.

1993-01-01

A study is presented to determine if fine microstructures could be achieved using rapid solidification to produce a fine-grained fully austenitic starting structure and then using thermal processing cycles to produce an even finer ferrite-cementite structure. The evolution, mechanisms of grain refinement, and crystallography of the resultant microstructures were examined by TEM. A thermal processing cycle consisted of quenching the ribbon in liquid nitrogen, tempering at 600 C for 10 sec, 'upquenching' to 750 C for 10 sec, and subsequently quenching again in liquid nitrogen. The heat-treatment resulted in martensite grains with sizes of about 1 micron or less in both length and thickness and cementite particles of 0.4 micron or less. It is concluded that these microstructures could be used for producing fine-grained ultrahigh carbon steels of very high strength without the brittleness associated with the formation of coarse carbide particles of the loss of strength due to graphite formation.

Status and future of the 3D MAFIA group of codes

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

Ebeling, F.; Klatt, R.; Krawzcyk, F.

1988-12-01

The group of fully three dimensional computer codes for solving Maxwell's equations for a wide range of applications, MAFIA, is already well established. Extensive comparisons with measurements have demonstrated the accuracy of the computations. A large numer of components have been designed for accelerators, such as kicker magnets, non cyclindrical cavities, ferrite loaded cavities, vacuum chambers with slots and transitions, etc. The latest additions to the system include a new static solver that can calculate 3D magneto- and electrostatic fields, and a self consistent version of the 2D-BCI that solves the field equations and the equations of motion in parallel.more » Work on new eddy current modules has started, which will allow treatment of laminated and/or solid iron cores excited by low frequency currents. Based on our experience with the present releases 1 and 2, we have started a complete revision of the whole user interface and data structure, which will make the codes even more user-friendly and flexible.« less

Development of a gravity-independent wastewater bioprocessor for advanced life support in space

NASA Technical Reports Server (NTRS)

Nashashibi-Rabah, Majda; Christodoulatos, Christos; Korfiatis, George P.; Janes, H. W. (Principal Investigator)

2005-01-01

Operation of aerobic biological reactors in space is controlled by a number of challenging constraints, mainly stemming from mass transfer limitations and phase separation. Immobilized-cell packed-bed bioreactors, specially designed to function in the absence of gravity, offer a viable solution for the treatment of gray water generated in space stations and spacecrafts. A novel gravity-independent wastewater biological processor, capable of carbon oxidation and nitrification of high-strength aqueous waste streams, is presented. The system, consisting of a fully saturated pressurized packed bed and a membrane oxygenation module attached to an external recirculation loop, operated continuously for over one year. The system attained high carbon oxidation efficiencies often exceeding 90% and ammonia oxidation reaching approximately 60%. The oxygen supply module relies on hydrophobic, nonporous, oxygen selective membranes, in a shell and tube configuration, for transferring oxygen to the packed bed, while keeping the gaseous and liquid phases separated. This reactor configuration and operating mode render the system gravity-independent and suitable for space applications.

An Electron Microscopy Study of Graphite Growth in Nodular Cast Irons

NASA Astrophysics Data System (ADS)

Laffont, L.; Jday, R.; Lacaze, J.

2018-04-01

Growth of graphite during solidification and high-temperature solid-state transformation has been investigated in samples cut out from a thin-wall casting which solidified partly in the stable (iron-graphite) and partly in the metastable (iron-cementite) systems. Transmission electron microscopy has been used to characterize graphite nodules in as-cast state and in samples having been fully graphitized at various temperatures in the austenite field. Nodules in the as-cast material show a twofold structure characterized by an inner zone where graphite is disoriented and an outer zone where it is well crystallized. In heat-treated samples, graphite nodules consist of well-crystallized sectors radiating from the nucleus. These observations suggest that the disoriented zone appears because of mechanical deformation when the liquid contracts during its solidification in the metastable system. During heat-treatment, the graphite in this zone recrystallizes. In turn, it can be concluded that nodular graphite growth mechanism is the same during solidification and solid-state transformation.

Fixing the Problem With Empathy: Development and Validation of the Affective and Cognitive Measure of Empathy.

PubMed

Vachon, David D; Lynam, Donald R

2016-04-01

Low empathy is a criterion for most externalizing disorders, and empathy training is a regular component of treatment for aggressive people, from school bullies to sex offenders. However, recent meta-analytic evidence suggests that current measures of empathy explain only 1% of the variance in aggressive behavior. A new assessment of empathy was developed to more fully represent the empathy construct and better predict important outcomes--particularly aggressive behavior and externalizing psychopathology. Across three independent samples (N = 210-708), the 36-item Affective and Cognitive measure of Empathy (ACME) was internally consistent, structurally reliable, and invariant across sex. The ACME bore significant associations to important outcomes, which were incremental relative to other measures of empathy and generalizable across sex. Importantly, the affective scales of the ACME-particularly a new "Affective Dissonance" scale--yielded moderate to strong associations with aggressive behavior and externalizing disorders. The ACME is a short, reliable, and useful measure of empathy. © The Author(s) 2015.

Information processing speed in obstructive sleep apnea syndrome: a review.

PubMed

Kilpinen, R; Saunamäki, T; Jehkonen, M

2014-04-01

To provide a comprehensive review of studies on information processing speed in patients with obstructive sleep apnea syndrome (OSAS) as compared to healthy controls and normative data, and to determine whether continuous positive airway pressure (CPAP) treatment improves information processing speed. A systematic review was performed on studies drawn from Medline and PsycINFO (January 1990-December 2011) and identified from lists of references in these studies. After inclusion criteria, 159 articles were left for abstract review, and after exclusion criteria 44 articles were fully reviewed. The number of patients in the studies reviewed ranged from 10 to 157 and the study samples consisted mainly of men. Half of the studies reported that patients with OSAS showed reduced information processing speed when compared to healthy controls. Reduced information processing speed was seen more often (75%) when compared to norm-referenced data. Psychomotor speed seemed to be particularly liable to change. CPAP treatment improved processing speed, but the improvement was marginal when compared to placebo or conservative treatment. Patients with OSAS are affected by reduced information processing speed, which may persist despite CPAP treatment. Information processing is usually assessed as part of other cognitive functioning, not as a cognitive domain per se. However, it is important to take account of information processing speed when assessing other aspects of cognitive functioning. This will make it possible to determine whether cognitive decline in patients with OSAS is based on lower-level or higher-level cognitive processes or both. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Jet Fuel-Associated Occupational Contact Dermatitis.

PubMed

Contestable, James J

2017-03-01

Occupational contact dermatitis is a ubiquitous problem. Sailors onboard U.S. Navy vessels are at high risk given the multitude of potential workplace exposures. Solvents, petrochemicals, and fuels are abundant and can cause irritant or allergic contact dermatitis. Symptoms of contact dermatitis can cause inability to work and, if chronic, may require a change in rating or job. Prevention of this issue requires patient education about the risks and correct personnel protective equipment. Even with preventative strategies in place, exposures and cases of contact dermatitis will occur. Treatment consists of topical steroids and immunomodulators, as well as barrier creams and emollients. The goal of treatment is to fully restore the skin's natural barrier and prevent further exposure. A classic case of jet fuel-associated contact dermatitis is reviewed. A literature review utilizing PubMed, Google Scholar, and Google Search was conducted to elucidate our understanding of this issue, current occupational health guidelines, preventative approaches, and treatments. This case report provides guidance and recommendations for providers who encounter contact dermatitis related to petrochemicals, such as jet fuel. The literature review revealed limited knowledge surrounding in vivo human skin effects of jet fuel, specifically JP-5. Even larger gaps were found in our understanding of, and guidelines for, protective modalities against jet fuel exposure and dermatitis. A case is presented to facilitate recognition of jet fuel contact dermatitis and guidance for treatment and prevention. Given our current limited knowledge and guidelines concerning protective equipment and skin protectants, multiple proposals for future studies are suggested. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Inverse association between urbanicity and treatment resistance in schizophrenia.

PubMed

Wimberley, Theresa; Pedersen, Carsten B; MacCabe, James H; Støvring, Henrik; Astrup, Aske; Sørensen, Holger J; Horsdal, Henriette T; Mortensen, Preben B; Gasse, Christiane

2016-07-01

Living in a larger city is associated with increased risk of schizophrenia; and world-wide, consistent evidence shows that the higher the degree of urbanicity the higher the risk of schizophrenia. However, the association between urbanicity and treatment-resistant schizophrenia (TRS) as a more severe form of schizophrenia or separate entity of schizophrenia has not been fully explored yet. We aimed to investigate the association between urbanicity and incidence of TRS. A large Danish population-based cohort of all individuals with a first schizophrenia diagnosis after 1996 was followed until 2013 applying survival analysis techniques. TRS was assessed using a treatment-based proxy, defined as the earliest observed instance of either clozapine initiation or hospital admission due to schizophrenia after having received two prior antipsychotic monotherapy trials of adequate duration. Among the 13,349 schizophrenia patients, 17.3% experienced TRS during follow-up (median follow-up: 7years, inter-quartile range: 3-12years). The 5-year risk of TRS ranged from 10.5% in the capital area to 17.6% in the rural areas. Compared with individuals with schizophrenia residing in the capital area, hazard ratios were 1.44 (1.31-1.59) for provincial areas and 1.60 (1.43-1.79) for rural areas. Higher rates of TRS were found in less urbanized areas. The different direction of urban-rural differences regarding TRS and schizophrenia risk may indicate urban-rural systematic differences in treatment practices, or different urban-rural aetiologic types of schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention.

PubMed

Brendryen, Håvar; Kraft, Pål

2008-03-01

To assess the long-term efficacy of a fully automated digital multi-media smoking cessation intervention. Two-arm randomized control trial (RCT). Setting World Wide Web (WWW) study based in Norway. Subjects (n = 396) were recruited via internet advertisements and assigned randomly to conditions. Inclusion criteria were willingness to quit smoking and being aged 18 years or older. The treatment group received the internet- and cell-phone-based Happy Ending intervention. The intervention programme lasted 54 weeks and consisted of more than 400 contacts by e-mail, web-pages, interactive voice response (IVR) and short message service (SMS) technology. The control group received a self-help booklet. Additionally, both groups were offered free nicotine replacement therapy (NRT). Abstinence was defined as 'not even a puff of smoke, for the last 7 days', and assessed by means of internet surveys or telephone interviews. The main outcome was repeated point abstinence at 1, 3, 6 and 12 months following cessation. Participants in the treatment group reported clinically and statistically significantly higher repeated point abstinence rates than control participants [22.3% versus 13.1%; odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.12-3.26, P = 0.02; intent-to-treat). Improved adherence to NRT and a higher level of post-cessation self-efficacy were observed in the treatment group compared with the control group. As the first RCT documenting the long-term treatment effects of such an intervention, this study adds to the promise of digital media in supporting behaviour change.

Chronic blockade or constitutive deletion of the serotonin transporter reduces operant responding for food reward.

PubMed

Sanders, Amy Cecilia; Hussain, Ali J; Hen, René; Zhuang, Xiaoxi

2007-11-01

The therapeutic effects of chronic selective serotonin reuptake inhibitors (SSRIs) are well documented, yet the elementary behavioral processes that are affected by such treatment have not been fully investigated. We report here the effects of chronic fluoxetine treatment and genetic deletion of the serotonin transporter (SERT) on food reinforced behavior in three paradigms: the progressive ratio operant task, the concurrent choice operant task, and the Pavlovian-to-Instrumental transfer task. We consistently find that chronic pharmacological blockade or genetic deletion of SERT result in similar behavioral consequences: reduced operant responding for natural reward. This is in line with previous studies reporting declines in operant responding for drugs and intracranial self-stimulation with fluoxetine treatment, suggesting that the effect of SERT blockade can be generalized to different reward types. Detailed analyses of behavioral parameters indicate that this reduction in operant responding affect both goal-directed and non-goal-directed behaviors without affecting the Pavlovian cue-triggered excessive operant responding. In addition, both pharmacological and genetic manipulations reduce locomotor activity in the open field novel environment. Our data contrast with the effect of dopamine in increasing operant responding for natural reward specifically in goal-directed behaviors and in increasing Pavlovian cue-triggered excessive operant responding. Serotonin and dopamine have been proposed to serve opposing functions in motivational processes. Our data suggest that their interactions do not result in simple opponency. The fact that pharmacological blockade and genetic deletion of SERT have similar behavioral consequences reinforces the utility of the SERT null mice for investigation of the mechanisms underlying chronic SSRIs treatment.

Effect of Post-spray Shot Peening Treatment on the Corrosion Behavior of NiCr-Mo Coating by Plasma Spraying of the Shell-Core-Structured Powders

NASA Astrophysics Data System (ADS)

Tian, Jia-Jia; Wei, Ying-Kang; Li, Cheng-Xin; Yang, Guan-Jun; Li, Chang-Jiu

2018-01-01

Corrosion of metal plays a detrimental role in service lifetime of parts or systems. Therefore, coating a protective film which is fully dense and defects free on the base metal is an effective approach to protect the base metal from corrosion. In this study, a dense NiCr-20Mo coating with excellent lamellar interface bonding was deposited by plasma spraying of the novel shell-core-structured Mo-clad-NiCr powders, and then post-spray shot peening treatment by cold spraying of steel shots was applied to the plasma-sprayed NiCr-20Mo coating to obtain a fully dense coating through eliminating possibly existed pores and un-bonded interfaces within the NiCr-20Mo coating. Corrosion behaviors of the NiCr-20Mo coatings before and after shot peening were tested to investigate the effect of the post-spray shot peening on the corrosion behavior of the NiCr-20Mo coating. Results showed that a much dense and uniform plasma-sprayed NiCr-20Mo coating with perfect lamellar bonding at most of interfaces was deposited. However, the electrochemical tests revealed the existence of through-thickness pores in the as-plasma-sprayed NiCr-20Mo coating. Through the post-spray shot peening treatment, a completely dense top layer in the coating was formed, and with the increase in the shot peening intensity from one pass to three passes, the dense top layer became thicker from 100 μm to reach 300 μm of the whole coating thickness. Thus, a fully dense bulk-like coating was obtained. Corrosion test results showed that the dense coating layer resulting from densification of shot peening can act as an effective barrier coating to prevent the penetration of the corrosive medium and consequently protect the substrate from corrosion effectively. Therefore, a fully dense bulk-like NiCr-20Mo coating with excellent corrosion resistance can be achieved through the plasma spraying of Mo-clad-NiCr powders followed by appropriate post-spray shot peening treatment.

Caveolin Contributes to the Modulation of Basal and β-Adrenoceptor Stimulated Function of the Adult Rat Ventricular Myocyte by Simvastatin: A Novel Pleiotropic Effect

PubMed Central

Agarwal, Shailesh R.; Harvey, Robert D.; Porter, Karen E.; Calaghan, Sarah

2014-01-01

The number of people taking statins is increasing across the globe, highlighting the importance of fully understanding statins' effects on the cardiovascular system. The beneficial impact of statins extends well beyond regression of atherosclerosis to include direct effects on tissues of the cardiovascular system (‘pleiotropic effects’). Pleiotropic effects on the cardiac myocyte are often overlooked. Here we consider the contribution of the caveolin protein, whose expression and cellular distribution is dependent on cholesterol, to statin effects on the cardiac myocyte. Caveolin is a structural and regulatory component of caveolae, and is a key regulator of cardiac contractile function and adrenergic responsiveness. We employed an experimental model in which inhibition of myocyte HMG CoA reductase could be studied in the absence of paracrine influences from non-myocyte cells. Adult rat ventricular myocytes were treated with 10 µM simvastatin for 2 days. Simvastatin treatment reduced myocyte cholesterol, caveolin 3 and caveolar density. Negative inotropic and positive lusitropic effects (with corresponding changes in [Ca2+]i) were seen in statin-treated cells. Simvastatin significantly potentiated the inotropic response to β2-, but not β1-, adrenoceptor stimulation. Under conditions of β2-adrenoceptor stimulation, phosphorylation of phospholamban at Ser16 and troponin I at Ser23/24 was enhanced with statin treatment. Simvastatin increased NO production without significant effects on eNOS expression or phosphorylation (Ser1177), consistent with the reduced expression of caveolin 3, its constitutive inhibitor. In conclusion, statin treatment can reduce caveolin 3 expression, with functional consequences consistent with the known role of caveolae in the cardiac cell. These data are likely to be of significance, particularly during the early phases of statin treatment, and in patients with heart failure who have altered β-adrenoceptor signalling. In addition, as caveolin is ubiquitously expressed and has myriad tissue-specific functions, the impact of statin-dependent changes in caveolin is likely to have many other functional sequelae. PMID:25211146

High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI).

PubMed

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-08-07

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R(2) = 0.821 at p < 0.002 in the 2D HMI system. We demonstrated the feasibility of using this HMI-based technique to localize the HIFU focal spot without inducing thermal changes during the planning phase. The focal spot localization method has also been applied on ex vivo human breast tissue ablation and can be fully integrated into any HMI system for planning purposes.

High Intensity Focused Ultrasound (HIFU) Focal Spot Localization Using Harmonic Motion Imaging (HMI)

PubMed Central

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-01-01

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of High-Intensity Focused Ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the −3 dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p<0.002 in the 2D HMI system. We demonstrated the feasibility of using this HMI-based technique to localize the HIFU focal spot without inducing thermal changes during the planning phase. The focal spot localization method has also been applied on ex vivo human breast tissue ablation and can be fully integrated into any HMI system for planning purposes. PMID:26184846

High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI)

NASA Astrophysics Data System (ADS)

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-08-01

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the  -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p  <  0.002 in the 2D HMI system. We demonstrated the feasibility of using this HMI-based technique to localize the HIFU focal spot without inducing thermal changes during the planning phase. The focal spot localization method has also been applied on ex vivo human breast tissue ablation and can be fully integrated into any HMI system for planning purposes.

Indium Hybridization of Large Format TES Bolometer Arrays to Readout Multiplexers for Far-Infrared Astronomy

NASA Technical Reports Server (NTRS)

Miller, Timothy M.; Costen, Nick; Allen, Christine

2007-01-01

This conference poster reviews the Indium hybridization of the large format TES bolometer arrays. We are developing a key technology to enable the next generation of detectors. That is the Hybridization of Large Format Arrays using Indium bonded detector arrays containing 32x40 elements which conforms to the NIST multiplexer readout architecture of 1135 micron pitch. We have fabricated and hybridized mechanical models with the detector chips bonded after being fully back-etched. The mechanical support consists of 30 micron walls between elements Demonstrated electrical continuity for each element. The goal is to hybridize fully functional array of TES detectors to NIST readout.

Development and Application of Agglomerated Multigrid Methods for Complex Geometries

NASA Technical Reports Server (NTRS)

Nishikawa, Hiroaki; Diskin, Boris; Thomas, James L.

2010-01-01

We report progress in the development of agglomerated multigrid techniques for fully un- structured grids in three dimensions, building upon two previous studies focused on efficiently solving a model diffusion equation. We demonstrate a robust fully-coarsened agglomerated multigrid technique for 3D complex geometries, incorporating the following key developments: consistent and stable coarse-grid discretizations, a hierarchical agglomeration scheme, and line-agglomeration/relaxation using prismatic-cell discretizations in the highly-stretched grid regions. A signi cant speed-up in computer time is demonstrated for a model diffusion problem, the Euler equations, and the Reynolds-averaged Navier-Stokes equations for 3D realistic complex geometries.

Treatment of Anemia in Heart Failure: Potential Risks and Benefits of Intravenous Iron Therapy in Cardiovascular Disease

PubMed Central

Jelani, Qurat-ul-ain; Katz, Stuart D.

2010-01-01

Iron-deficiency anemia is common is patients with heart failure (HF), but the optimum diagnostic tests to detect iron deficiency and the treatment options to replete iron have not been fully characterized. Recent studies in patients with HF indicate that intravenous iron can rapidly replenish iron stores in patients having iron-deficiency anemia, with resultant increased hemoglobin levels and improved functional capacity. Preliminary data from a sub-group analysis also suggests that supplemental intravenous iron therapy can improve functional capacity even in those subjects without anemia. The mechanisms responsible for this observation are not fully characterized, but may be related to beneficial effects of iron supplementation on mitochondrial respiration in skeletal muscle. The long-term safety of using intravenous iron supplementation in HF populations is not known. Iron is a known pro-oxidant factor that can inhibit nitric oxide signaling and irreversibly injury cells. Increased iron stores are associated with vascular endothelial dysfunction and increased risk of coronary heart disease events. Additional clinical trials are needed to more fully characterize the therapeutic potential and safety of intravenous iron in HF patients. PMID:20699672

20 CFR 416.945 - Your residual functional capacity.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Your residual functional capacity. 416.945 Section 416.945 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... disorder may be fully capable of the physical demands consistent with those of sustained medium work...

20 CFR 416.945 - Your residual functional capacity.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Your residual functional capacity. 416.945 Section 416.945 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... disorder may be fully capable of the physical demands consistent with those of sustained medium work...

Can Bose condensation of alpha particles be observed in heavy ion collisions?

NASA Technical Reports Server (NTRS)

Tripathi, Ram K.; Townsend, Lawrence W.

1993-01-01

Using a fully self-consistent quantum statistical model, we demonstrate the possibility of Bose condensation of alpha particles with a concomitant phase transition in heavy ion collisions. Suggestions for the experimental observation of the signature of the onset of this phenomenon are made.

Parenting Styles and Adjustment Outcomes among College Students

ERIC Educational Resources Information Center

Love, Keisha M.; Thomas, Deneia M.

2014-01-01

Research has demonstrated that parenting styles partially explain college students' academic adjustment. However, to account for academic adjustment more fully, additional contributors should be identified and tested. We examined the fit of a hypothesized model consisting of parenting styles, indicators of well-being, and academic adjustment…

Critically Reflective Dialogues in Learning Communities of Professionals

ERIC Educational Resources Information Center

de Groot, Esther; Endedijk, Maaike D.; Jaarsma, A. Debbie C.; Simons, P. Robert-Jan; van Beukelen, Peter

2014-01-01

Communities in which professionals share and create knowledge potentially support their continued learning. To realise this potential more fully, members are required to reflect critically. For learning at work such behaviour has been described as critically reflective work behaviour, consisting of six aspects: challenging groupthink, critical…

Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer.

PubMed

Ross, Kaile M; Ranby, Krista W; Wooldridge, Jennalee S; Robertson, Cary; Lipkus, Isaac M

2016-08-01

Prostate cancer may affect quality of life in men diagnosed as well as their spouses. Changes in health may disrupt the couple's relationship functioning which disrupts recovery. This study examined how mental and physical health relates to relationship satisfaction for couples at diagnosis through the year following treatment. Patients with stage I-II prostate cancer and their spouses (N = 159 couples) were recruited from a urology clinic and completed questionnaires at diagnosis, 1 month, 6 months, and 12 months post prostatectomy on demographics, mental and physical health quality of life, and relationship satisfaction. The Actor-Partner Interdependence Model was employed to examine effects of each partners' mental and physical health on their own and their partner's relationship satisfaction. Patients and spouses had declined mental and physical health at 1 month post-surgery. Health improved at 6 and 12 months but did not fully return to pre-surgery levels. Actor effects showed that patient's physical health consistently predicted own relationship satisfaction. Both patient's and spouse's mental health consistently related to their own relationship satisfaction. Partner effects showed that patient's and spouse's physical health had an effect on each other's relationship satisfaction at 1 month. Spouse's mental health predicted patient's relationship satisfaction throughout the year following treatment. The effects of patient and spouse mental and physical health quality of life on their own as well as their partner's relationship satisfaction differed across time which will inform psychosocial interventions for couples with prostate cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of serum vitamins A and E and zinc levels according to the severity of acne vulgaris.

PubMed

Ozuguz, Pinar; Dogruk Kacar, Seval; Ekiz, Ozlem; Takci, Zennure; Balta, Ilknur; Kalkan, Göknur

2014-06-01

Although hyperseborrhea, follicular hyperkeratinization, Propionibacterium acnes colonization and inflammation are found to be responsible in the pathogenesis of acne, the exact mechanisms are unknown. Vitamin A and E are basic antioxidants vital for health. Zinc is also an essential element for human. But these parameters of the effects on skin are not fully understood. We aimed to evaluate plasma levels of vitamin A, E and zinc in acne patients in relation to the severity of the disease. There were 94 acne patients who were referred to our clinic, all new diagnosed, and 56 age and sex matched healthy volunteers as control group. All patients are assessed according to Global Acne Grading System and grouped as mild, moderate, severe and very severe. Acne patients further grouped as group 1 consist of patients with mild to moderate disease; and group 2 consist of patients with severe to very severe acne. The patients with the controls and group 1 with group 2 was compared. The level of vitamin E, vitamin A and zinc were significantly lower than the control group (Table 1,p < 0.001). When the patient group is compared among each other there was no statistically significant difference for plasma vitamin A levels between group 1 and 2 whereas vitamin E and zinc levels were significantly low in group 2 than group 1. Thus there was a negative correlation between acne severity and vitamin E and zinc levels. Our study marks the importance of diet in patients with acne. We offer supportive dietary measures with foods rich in vitamin A and E and zinc in the acne prophylaxis and treatment. Supportive treatment with these vitamins and zinc in severe acne may lead to satisfactory results.

Syndrome of fixed dystonia in adolescents--short term outcome in 4 cases.

PubMed

Majumdar, Anirban; López-Casas, Jesús; Poo, Pilar; Colomer, Jaume; Galvan, Marta; Lingappa, Lokesh; Short, Clare; Jardine, Philip E; Fernández-Alvarez, Emilio

2009-09-01

We describe the clinical features, investigations and outcome of 4 adolescents aged 13, 16, 17 and 19 years, with fixed dystonia. The diagnosis was made within 6 months of the onset of symptoms. One patient had an identifiable traumatic precipitant. All the affected extremities had pain, sudomotor and vascular changes which were consistent with complex regional pain syndrome. The extremities affected by dystonia were the foot and the hand. The dystonia spread to affect other extremities in one patient. One patient had hemifacial spasm. Examination of the central and peripheral nervous system and allied investigations failed to reveal an organic cause. Common genetic causes for dystonia were excluded. The response to physical treatments for the affected extremities, such as Botulinum Toxin and surgery was poor. In all our cases there were significant psychological and psychiatric factors. Three patients fully met the criteria for psychogenic dystonia and responded well to psychological intervention. Fixed dystonia in adolescents is an uncommon disorder of unknown aetiology, usually presenting in girls, which can be very disabling and difficult to treat. The affected parts of the body are usually painful and show vascular changes. The condition is allied to CRPS. Treatment with multidisciplinary approach including psychological measures and physiotherapy is more likely to be successful and may prevent unnecessary physical measures.

A concept to transfer a therapeutic splint position into permanent occlusion with a customized lingual appliance.

PubMed

Sachse, Tina; Schwestka-Polly, Rainer; Flieger, Stefanie; Wiechmann, Dirk

2012-05-21

The role of occlusion concerning temporomandibular disorder is still unclear but seems to be the only component of the stomathognathic system dentists are able to change morphologically. The aim of the paper is to describe the orthodontist's approach for transferring and maintaining a therapeutic splint position into permanent occlusion using a fully customized lingual appliance. Fixed acrylic bite planes on lower molars were used to maintain a symptom-free condyle position prior to orthodontic treatment. Silicone impressions of the arches including the fixed bite planes were used for the Incognito laboratory procedure. Two digital setups were made. One setup represents the target occlusion. A second setup including the bite planes was used to fabricate an additional set of lower molar brackets. In the leveling stage all teeth except the lower molars were settled to maintain the therapeutic condyle position. Finally, the fixed bite planes were stepwise removed and molar brackets were replaced to establish the permanent occlusion planned with the first setup. The advantage of an individual lingual appliance consists in the high level of congruence between the fabricated setups and the final clinical result. Both the individual scope for design and the precision of the appliance were vitally important in the treatment of a patient with a functional disorder of the masticatory system.

Examining the interplay between depression, motivation, and antiretroviral therapy adherence: a social cognitive approach.

PubMed

Tatum, A K; Houston, E

2017-03-01

A large body of research identifies depressive symptoms as a barrier to optimal antiretroviral therapy (ART) adherence, whereas treatment motivation has been characterized as a facilitator. There is evidence, however, that these patterns may not hold for some ART patients despite the widespread use of motivational techniques aimed at promoting adherence. Little is known about how the interplay between different levels of depressive symptoms and variations in the types and levels of motivation may influence ART adherence. The purpose of this study was to examine the relationship between depressive symptoms, two types of motivation, and adherence, with self-efficacy as a mediator. The sample consisted of 121 ART patients who reported various levels of depressive symptoms (mean age = 41 years; 84% African-American; and 68% female). Path analysis revealed that self-efficacy fully mediated the relationship between the three predictor variables (depressive symptoms, intrinsic motivation, and extrinsic motivation) and adherence, χ 2 (3, N = 121) = .78, RMSEA = .00, SRMR = .02, CFI = 1.00, NNFI = 1.06. Findings suggest that interventions using motivational techniques to build adherence among patients with varying levels of depressive symptoms should address the role of treatment self-efficacy to improve their effectiveness.

Brace related stress in scoliosis patients – Comparison of different concepts of bracing

PubMed Central

Weiss, Hans-Rudolf; Werkmann, Mario; Stephan, Carola

2007-01-01

Background The BSSQbrace questionnaire has been shown to be reliable with good internal consistency and reproducibility estimating the stress scoliosis patients have whilst wearing their brace. Eight questions are provided focussing on this topic. A max. score of 24 can be achieved (from 0 for most stress to 24 for no stress). The subdivision of the score values is: 0–8 (strong stress), 9–16 (medium stress) and 17–24 (little stress). Study design Two BSSQbrace questionnaires have been posted to 65 patients under brace treatment from our Cheneau light data base. All patients had another kind of brace prior to the Cheneau light. The patients have been asked to rate their stress level using one questionnaire for the current brace and the other for the previous one. Results 63 Patients (59 girls and 4 boys) returned their fully completed questionnaires (average age 13,6 years, average Cobb angle 43,7 degrees). Stress level in the previous brace was 11,04 and in the Cheneau light(r) 13,87. The differences were highly significant in the t-test; t = -4,67; p < 0,001. Conclusion The use of the Cheneau light® brace leads to reduced stress and/or impairment for the patients under treatment compared to heavier brace models used so far. PMID:17708766

Umbilical hernia alloplastic dual-mesh treatment in cirrhotic patients

PubMed Central

Guriță, RE; Popa, F; Bălălău, C; Scăunașu, RV

2013-01-01

Rationale. Abdominal wall hernias represent a pathology with an impressive prevalence among the population of patients with cirrhosis complicated by ascites. The aggressive surgical approach of umbilical hernia for patients with cirrhotic background remains a controversial problem, accompanied by anesthetic and surgical risk. Its indication remains fully justified in case of severe symptoms or life threatening complications: strangulation, incarceration, evisceration. Objective. This article evaluates results obtained by using dual-mesh alloplastic materials for surgical treatment of umbilical hernias affecting cirrhotic patients with incipient liver injury. Methods and Results. Our lot consists of twelve patients with ages between 45 and 65 years, diagnosed with hepatic cirrhosis, without other associated comorbidities. All patients were admitted for strangulated umbilical hernia. Among the analyzed lot, no decease was encountered, the morbidity being limited to two cases of parietal suppuration, solved conservatively, without the mesh removal. There were no ascitic fistulas. No recurrences were registered for a 12 months tracking period. Discussion. The presence of cirrhosis implies a high anesthetic and surgical risk, the intervention being grafted by a substantial increase of mortality and morbidity in an emergency setting. The development of new alloplastic materials, together with the modern anesthetic techniques, allows superior results for patients with incipient hepatic injury. PMID:23599831

Impact of ozonation on particle aggregation in mature fine tailings.

PubMed

Liang, Jiaming; Tumpa, Fahmida; Pérez Estrada, Leonidas; Gamal El-Din, Mohamed; Liu, Yang

2014-12-15

The extraction of bitumen from the oil sands in Canada generates tonnes of mature fine tailings (MFT), consisting of a mineral matrix of sand, clay, and water, which without treatment requires thousands of years to fully consolidate. We assessed the performance of a novel ozonation method designed to enhance the settling of MFT and explored the mechanisms involved. The solid content of MFT obtained from oil sands tailings was adjusted to 1, 3, 5 wt % with water before applying 15, 30, and 60 min of ozonation. MFT settled after a short (15 min) ozonation treatment, resulting in a sample with clear released water on the top and condensed sludge at the bottom. The water chemistry characteristics, particles' surface charge and chemical bonding were measured. Ozonation led to the increased organic acids concentrations in MFT suspension through converting of organic matter from high to low molecular weight, and detaching organic coating on MFT particles. The pH and the concentrations of ions in the MFT suspension were changed significantly, an association of metal ions with MFT particles was promoted, and the surface charges of MFT particles were neutralized. Consequently, the MFT suspension was destabilized and MFT particle precipitation was observed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adherence in children with growth hormone deficiency treated with r-hGH and the easypod™ device.

PubMed

Loche, S; Salerno, M; Garofalo, P; Cardinale, G M; Licenziati, M R; Citro, G; Caruso Nicoletti, M; Cappa, M; Longobardi, S; Maghnie, M; Perrone, R

2016-12-01

Poor adherence to recombinant human growth hormone (r-hGH) therapy is associated with reduced growth velocity in children with growth hormone deficiency (GHD). This twelve-month observational study was to assess adherence in r-hGH patients treated with the easypod ™ , an electronic, fully automated injection device designed to track the time, date and dose administered. Ninety-seven prepubertal patients receiving r-hGH therapy were included in the study from ten Italian clinical sites and 88 completed the study. To avoid possible confounding effects, only GHD patients (79/88; 89.7 % of the overall study population) were considered in the final analysis. The primary endpoint-adherence to treatment-was calculated as the proportion of injections correctly administered during the observational period out of the expected total number of injections. The relevant information, tracked by the easypod ™ , was collected at months 6 (V1) and 12 (V2) after baseline (V0). At study termination, adherence data were partially available from 16 patients and fully available from 53 patients. As secondary endpoints, serum IGF-1 levels, fasting serum glucose and insulin levels and key anthropometric characteristics (height, waist circumference and BMI) were also determined. The easypod ™ data showed that 56.7 % of the patients were considered to be fully (≥92 %) adherent to their treatment throughout the period V0-V2. Treatment improved stature, significantly increased IGF-1 and produced a non-significant increase in blood glucose and insulin levels. The injection-recording system and other characteristics of easypod ™ could enhance the ability of physicians to monitor adherence to r-hGH treatment.

Structure, morphology, and photoluminescence of porous Si nanowires: effect of different chemical treatments

PubMed Central

2013-01-01

The structure and light-emitting properties of Si nanowires (SiNWs) fabricated by a single-step metal-assisted chemical etching (MACE) process on highly boron-doped Si were investigated after different chemical treatments. The Si nanowires that result from the etching of a highly doped p-type Si wafer by MACE are fully porous, and as a result, they show intense photoluminescence (PL) at room temperature, the characteristics of which depend on the surface passivation of the Si nanocrystals composing the nanowires. SiNWs with a hydrogen-terminated nanostructured surface resulting from a chemical treatment with a hydrofluoric acid (HF) solution show red PL, the maximum of which is blueshifted when the samples are further chemically oxidized in a piranha solution. This blueshift of PL is attributed to localized states at the Si/SiO2 interface at the shell of Si nanocrystals composing the porous SiNWs, which induce an important pinning of the electronic bandgap of the Si material and are involved in the recombination mechanism. After a sequence of HF/piranha/HF treatment, the SiNWs are almost fully dissolved in the chemical solution, which is indicative of their fully porous structure, verified also by transmission electron microscopy investigations. It was also found that a continuous porous Si layer is formed underneath the SiNWs during the MACE process, the thickness of which increases with the increase of etching time. This supports the idea that porous Si formation precedes nanowire formation. The origin of this effect is the increased etching rate at sites with high dopant concentration in the highly doped Si material. PMID:24025542

Profiling bacterial communities associated with sediment-based aquaculture bioremediation systems under contrasting redox regimes

NASA Astrophysics Data System (ADS)

Robinson, Georgina; Caldwell, Gary S.; Wade, Matthew J.; Free, Andrew; Jones, Clifford L. W.; Stead, Selina M.

2016-12-01

Deposit-feeding invertebrates are proposed bioremediators in microbial-driven sediment-based aquaculture effluent treatment systems. We elucidate the role of the sediment reduction-oxidation (redox) regime in structuring benthic bacterial communities, having direct implications for bioremediation potential and deposit-feeder nutrition. The sea cucumber Holothuria scabra was cultured on sediments under contrasting redox regimes; fully oxygenated (oxic) and redox stratified (oxic-anoxic). Taxonomically, metabolically and functionally distinct bacterial communities developed between the redox treatments with the oxic treatment supporting the greater diversity; redox regime and dissolved oxygen levels were the main environmental drivers. Oxic sediments were colonised by nitrifying bacteria with the potential to remediate nitrogenous wastes. Percolation of oxygenated water prevented the proliferation of anaerobic sulphate-reducing bacteria, which were prevalent in the oxic-anoxic sediments. At the predictive functional level, bacteria within the oxic treatment were enriched with genes associated with xenobiotics metabolism. Oxic sediments showed the greater bioremediation potential; however, the oxic-anoxic sediments supported a greater sea cucumber biomass. Overall, the results indicate that bacterial communities present in fully oxic sediments may enhance the metabolic capacity and bioremediation potential of deposit-feeder microbial systems. This study highlights the benefits of incorporating deposit-feeding invertebrates into effluent treatment systems, particularly when the sediment is oxygenated.

Profiling bacterial communities associated with sediment-based aquaculture bioremediation systems under contrasting redox regimes

PubMed Central

Robinson, Georgina; Caldwell, Gary S.; Wade, Matthew J.; Free, Andrew; Jones, Clifford L. W.; Stead, Selina M.

2016-01-01

Deposit-feeding invertebrates are proposed bioremediators in microbial-driven sediment-based aquaculture effluent treatment systems. We elucidate the role of the sediment reduction-oxidation (redox) regime in structuring benthic bacterial communities, having direct implications for bioremediation potential and deposit-feeder nutrition. The sea cucumber Holothuria scabra was cultured on sediments under contrasting redox regimes; fully oxygenated (oxic) and redox stratified (oxic-anoxic). Taxonomically, metabolically and functionally distinct bacterial communities developed between the redox treatments with the oxic treatment supporting the greater diversity; redox regime and dissolved oxygen levels were the main environmental drivers. Oxic sediments were colonised by nitrifying bacteria with the potential to remediate nitrogenous wastes. Percolation of oxygenated water prevented the proliferation of anaerobic sulphate-reducing bacteria, which were prevalent in the oxic-anoxic sediments. At the predictive functional level, bacteria within the oxic treatment were enriched with genes associated with xenobiotics metabolism. Oxic sediments showed the greater bioremediation potential; however, the oxic-anoxic sediments supported a greater sea cucumber biomass. Overall, the results indicate that bacterial communities present in fully oxic sediments may enhance the metabolic capacity and bioremediation potential of deposit-feeder microbial systems. This study highlights the benefits of incorporating deposit-feeding invertebrates into effluent treatment systems, particularly when the sediment is oxygenated. PMID:27941918

Opioid Addiction: Social Problems Associated and Implications of Both Current and Possible Future Treatments, including Polymeric Therapeutics for Giving Up the Habit of Opioid Consumption.

PubMed

Benéitez, M Cristina; Gil-Alegre, M Esther

2017-01-01

Detoxification programmes seek to implement the most secure and compassionate ways of withdrawing from opiates so that the inevitable withdrawal symptoms and other complications are minimized. Once detoxification has been achieved, the next stage is to enable the patient to overcome his or her drug addiction by ensuring consumption is permanently and completely abandoned, only after which can the subject be regarded as fully recovered. A systematic search on the common databases of relevant papers published until 2016 inclusive. Our study of the available oral treatments for opioid dependence has revealed that no current treatment can actually claim to be fully effective. These treatments require daily oral administration and, consequently, regular visits to dispensaries, which in most cases results in a lack of patient compliance, which causes fluctuations in drug plasma levels. We then reviewed alternative treatments in the available scientific literature on polymeric sustained release formulations. Research has been done not only on release systems for detoxification but also on release systems for giving up the habit of taking opioids. These efforts have obtained the recent authorization of polymeric systems for use in patients that could help them to reduce their craving for drugs.

Training development for pavement preservation.

DOT National Transportation Integrated Search

2013-05-01

This research project strives to help the Iowa Department of Transportation (DOT) fully achieve the full benefits of pavement : preservation through training on proper selection, design, and application of pavement preservation treatments. In some ca...

A fully analytic treatment of resonant inductive coupling in the far field

NASA Astrophysics Data System (ADS)

Sedwick, Raymond J.

2012-02-01

For the application of resonant inductive coupling for wireless power transfer, fabrication of flat spiral coils using ribbon wire allows for analytic expressions of the capacitance and inductance of the coils and therefore the resonant frequency. The expressions can also be used in an approximate way for the analysis of coils constructed from cylindrical wire. Ribbon wire constructed from both standard metals as well as high temperature superconducting material is commercially available, so using these derived expressions as a basis, a fully analytic treatment is presented that allows for design trades to be made for hybrid designs incorporating either technology. The model is then extended to analyze the performance of the technology as applied to inductively coupled communications, which has been demonstrated as having an advantage in circumstances where radiated signals would suffer unacceptable levels of attenuation.

Text categorization models for identifying unproven cancer treatments on the web.

PubMed

Aphinyanaphongs, Yin; Aliferis, Constantin

2007-01-01

The nature of the internet as a non-peer-reviewed (and largely unregulated) publication medium has allowed wide-spread promotion of inaccurate and unproven medical claims in unprecedented scale. Patients with conditions that are not currently fully treatable are particularly susceptible to unproven and dangerous promises about miracle treatments. In extreme cases, fatal adverse outcomes have been documented. Most commonly, the cost is financial, psychological, and delayed application of imperfect but proven scientific modalities. To help protect patients, who may be desperately ill and thus prone to exploitation, we explored the use of machine learning techniques to identify web pages that make unproven claims. This feasibility study shows that the resulting models can identify web pages that make unproven claims in a fully automatic manner, and substantially better than previous web tools and state-of-the-art search engine technology.

Microbial Community Composition of Polyhydroxyalkanoate-Accumulating Organisms in Full-Scale Wastewater Treatment Plants Operated in Fully Aerobic Mode

PubMed Central

Oshiki, Mamoru; Onuki, Motoharu; Satoh, Hiroyasu; Mino, Takashi

2013-01-01

The removal of biodegradable organic matter is one of the most important objectives in biological wastewater treatments. Polyhydroxyalkanoate (PHA)-accumulating organisms (PHAAOs) significantly contribute to the removal of biodegradable organic matter; however, their microbial community composition is mostly unknown. In the present study, the microbial community composition of PHAAOs was investigated at 8 full-scale wastewater treatment plants (WWTPs), operated in fully aerobic mode, by fluorescence in situ hybridization (FISH) analysis and post-FISH Nile blue A (NBA) staining techniques. Our results demonstrated that 1) PHAAOs were in the range of 11–18% in the total number of cells, and 2) the microbial community composition of PHAAOs was similar at the bacterial domain/phylum/class/order level among the 8 full-scale WWTPs, and dominant PHAAOs were members of the class Alphaproteobacteria and Betaproteobacteria. The microbial community composition of α- and β-proteobacterial PHAAOs was examined by 16S rRNA gene clone library analysis and further by applying a set of newly designed oligonucleotide probes targeting 16S rRNA gene sequences of α- or β-proteobacterial PHAAOs. The results demonstrated that the microbial community composition of PHAAOs differed in the class Alphaproteobacteria and Betaproteobacteria, which possibly resulted in a different PHA accumulation capacity among the WWTPs (8.5–38.2 mg-C g-VSS−1 h−1). The present study extended the knowledge of the microbial diversity of PHAAOs in full-scale WWTPs operated in fully aerobic mode. PMID:23257912

Spatial variation of electrode position in bioelectrochemical treatment system: Design consideration for azo dye remediation.

PubMed

Yeruva, Dileep Kumar; Shanthi Sravan, J; Butti, Sai Kishore; Annie Modestra, J; Venkata Mohan, S

2018-05-01

In the present study, three bio-electrochemical treatment systems (BET) were designed with variations in cathode electrode placement [air exposed (BET1), partially submerged (BET2) and fully submerged (BET3)] to evaluate azo-dye based wastewater treatment at three dye loading concentrations (50, 250 and 500 mg L -1 ). Highest dye decolorization (94.5 ± 0.4%) and COD removal (62.2 ± 0.8%) efficiencies were observed in BET3 (fully submerged electrodes) followed by BET1 and BET2, while bioelectrogenic activity was highest in BET1 followed by BET2 and BET3. It was observed that competition among electron acceptors (electrode, dye molecules and intermediates) critically regulated the fate of bio-electrogenesis to be higher in BET1 and dye removal higher in BET3. Maximum half-cell potentials in BET3 depict higher electron acceptance by electrodes utilized for dye degradation. Study infers that spatial positioning of electrodes in BET3 is more suitable towards dye remediation, which can be considered for scaling-up/designing a treatment plant for large-scale industrial applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of social relationships and culture in the cognitive representation of emotions.

PubMed

Koh, Sharon; Napa Scollon, Christie; Wirtz, Derrick

2014-04-01

There are individual and cultural differences in how memories of our emotions are cognitively represented. This article examines the cognitive representation of emotions in different cultures, as a result of emotional (in)consistency in different cultures. Using a continuous semantic priming task, we showed in two studies that individuals who were less emotionally consistent across relationships have stronger associations of their emotions within those relationships. Further, we found (in Study 2) that in a culture characterised by higher levels of emotional inconsistency across relationships (Singapore), stronger associations between emotions within relationships were found than in a culture characterised by emotional consistency (USA). This cultural difference in cognitive representation was fully mediated by individual differences in cross-situational consistency levels.

Estimating the uncertainty of calculated out-of-field organ dose from a commercial treatment planning system.

PubMed

Wang, Lilie; Ding, George X

2018-06-12

Therapeutic radiation to cancer patients is accompanied by unintended radiation to organs outside the treatment field. It is known that the model-based dose algorithm has limitation in calculating the out-of-field doses. This study evaluated the out-of-field dose calculated by the Varian Eclipse treatment planning system (v.11 with AAA algorithm) in realistic treatment plans with the goal of estimating the uncertainties of calculated organ doses. Photon beam phase-space files for TrueBeam linear accelerator were provided by Varian. These were used as incident sources in EGSnrc Monte Carlo simulations of radiation transport through the downstream jaws and MLC. Dynamic movements of the MLC leaves were fully modeled based on treatment plans using IMRT or VMAT techniques. The Monte Carlo calculated out-of-field doses were then compared with those calculated by Eclipse. The dose comparisons were performed for different beam energies and treatment sites, including head-and-neck, lung, and pelvis. For 6 MV (FF/FFF), 10 MV (FF/FFF), and 15 MV (FF) beams, Eclipse underestimated out-of-field local doses by 30%-50% compared with Monte Carlo calculations when the local dose was <1% of prescribed dose. The accuracy of out-of-field dose calculations using Eclipse is improved when collimator jaws were set at the smallest possible aperture for MLC openings. The Eclipse system consistently underestimates out-of-field dose by a factor of 2 for all beam energies studied at the local dose level of less than 1% of prescribed dose. These findings are useful in providing information on the uncertainties of out-of-field organ doses calculated by Eclipse treatment planning system. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Therapeutic implications of Epstein–Barr virus infection for the treatment of nasopharyngeal carcinoma

PubMed Central

Hutajulu, Susanna Hilda; Kurnianda, Johan; Tan, I Bing; Middeldorp, Jaap M

2014-01-01

Nasopharyngeal carcinoma (NPC) is highly endemic in certain regions including the People’s Republic of China and Southeast Asia. Its etiology is unique and multifactorial, involving genetic background, epigenetic, and environment factors, including Epstein–Barr virus (EBV) infection. The presence of EBV in all tumor cells, aberrant pattern of antibodies against EBV antigens in patient sera, and elevated viral DNA in patient circulation as well as nasopharyngeal site underline the role of EBV during NPC development. In NPC tumors, EBV expresses latency type II, where three EBV-encoded proteins, Epstein–Barr nuclear antigen 1, latent membrane protein 1 and 2 (LMP1, 2), are expressed along with BamH1-A rightward reading frame 1, Epstein–Barr virus-encoded small nuclear RNAs, and BamH1-A rightward transcripts. Among all encoded proteins, LMP1 plays a central role in the propagation of NPC. Standard treatment of NPC consists of radiotherapy with or without chemotherapy for early stage, concurrent chemoradiotherapy in locally advanced tumors, and palliative systemic chemotherapy in metastatic disease. However, this standard care has limitations, allowing recurrences and disease progression in a certain proportion of cases. Although the pathophysiological link and molecular process of EBV-induced oncogenesis are not fully understood, therapeutic approaches targeting the virus may increase the cure rate and add clinical benefit. The promising results of early phase clinical trials on EBV-specific immunotherapy, epigenetic therapy, and treatment with viral lytic induction offer new options for treating NPC. PMID:25228810

Polish universal neonatal hearing screening program-4-year experience (2003-2006).

PubMed

Szyfter, Witold; Wróbel, Maciej; Radziszewska-Konopka, Marzanna; Szyfter-Harris, Joanna; Karlik, Michał

2008-12-01

The aim of this paper is to share our experience and observations in running the Universal Neonatal Hearing Screening Program on a national level, present results and indicate some problems that have arisen during these 4 years. Polish Universal Neonatal Hearing Screening Program started back in 2002 in all neonatal units in Poland. Implemented testing methods consisted of test of transient evoked otoacoustic emission (TEOAE) performed in all new born children in their first 2-3 days of life and auditory brainstem response testing (ABR) conducted on children, who did not meet the TEOAE pass criteria. Additional questionnaire registered information on ototoxic drugs and family history of hearing impairment in every newborn. Diagnosed children were further referred for treatment and rehabilitation. After 4 years of running the program (between 2003 and 2006) a total number of 1,392,427 children were screened for hearing impairment, what stands for 96.3% of all delivered babies, registered in Poland. The screening program enabled to identify and refer for further treatment 2485 children with various types of hearing loss, 312 with profound (0.02% of population) and 145 with severe sensorineural hearing loss (0.11% of population). Our results indicate the accuracy of newborn hearing screening which remain an issue. Although improvement is needed in both intervention systems and diagnostic follow-up of hospitals, the Polish Universal Neonatal Hearing Program fully has achieved the main goal, the identification and treatment of hearing impaired children.

Phenformin Enhances the Efficacy of ERK Inhibition in NF1-Mutant Melanoma.

PubMed

Trousil, Sebastian; Chen, Shuang; Mu, Chan; Shaw, Fiona M; Yao, Zhan; Ran, Yuping; Shakuntala, Tiwari; Merghoub, Taha; Manstein, Dieter; Rosen, Neal; Cantley, Lewis C; Zippin, Jonathan H; Zheng, Bin

2017-05-01

Inactivation of the tumor suppressor neurofibromin 1 (NF1) presents a newly characterized melanoma subtype, for which currently no targeted therapies are clinically available. Preclinical studies suggest that extracellular signal-regulated kinase (ERK) inhibitors are likely to provide benefit, albeit with limited efficacy as a single agent; therefore, there is a need for rationally designed combination therapies. Here, we evaluate the combination of the ERK inhibitor SCH772984 and the biguanide phenformin. A combination of both compounds showed potent synergy in cell viability assays and cooperatively induced apoptosis. Treatment with both drugs was required to fully suppress mechanistic target of rapamycin signaling, a known effector of NF1 loss. Mechanistically, SCH772984 increased the oxygen consumption rate, indicating that these cells relied more on oxidative phosphorylation upon treatment. Consistently, SCH772984 increased expression of the mitochondrial transcriptional coactivator peroxisome proliferator-activated receptor gamma, coactivator 1-α. In contrast, cotreatment with phenformin, an inhibitor of complex I of the respiratory chain, decreased the oxygen consumption rate. SCH772984 also promoted the expansion of the H3K4 demethylase KDM5B (also known as JARID1B)-positive subpopulation of melanoma cells, which are slow-cycling and treatment-resistant. Importantly, phenformin suppressed this KDM5B-positive population, which reduced the emergence of SCH772984-resistant clones in long-term cultures. Our results warrant the clinical investigation of this combination therapy in patients with NF1 mutant melanoma. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Case Report: The Effects of Massage Therapy on a Woman with Thoracic Outlet Syndrome

PubMed Central

Wakefield, Mary Lillias

2014-01-01

Introduction Thoracic outlet syndrome (TOS) refers to a group of conditions resulting from compression of the neurovascular structures of the thoracic outlet. The parameters for physical therapy include myofascial release (MFR), neuromuscular therapy (NMT), muscle strengthening, and stretching. This case study examined the effects of neuromuscular therapy, massage, and other manual therapies on a 56-year-old female presenting with bilateral numbness over the forearms and hands on waking. Numbness occurred most days, progressing to “dead rubbery” forearms and hands once or twice a month. Methods The treatment plan was implemented over eight weeks and consisted of six, 50-minute bodywork sessions. Several nonbodywork strategies were also employed to address potential contributing factors to the TOS symptomology experienced by the client. Objective measurements included posture analysis (PA), range of movement (ROM), and Roos and Adson’s tests. The Measure Your Own Medical Outcome Profile (MYMOP2), a client-generated measure of clinical outcome, was used to measure clinical change. Results MYMOP2 overall profile score results demonstrated an improvement of 2.25 from pretreatment to post-treatment measurement. Clinically meaningful change was measured by the individual and was indicative of substantial symptom improvement where a score change of over one was considered as meaningful. Conclusions A course of massage was effective for numbness symptoms in an individual with TOS, and results lasted over a year without additional treatments. Further research is needed to fully understand the effects of massage for TOS symptoms. PMID:25452819

Young breast cancer patients' involvement in treatment decisions: the major role played by decision-making about surgery.

PubMed

Seror, Valérie; Cortaredona, Sébastien; Bouhnik, Anne-Deborah; Meresse, Mégane; Cluze, Camille; Viens, Patrice; Rey, Dominique; Peretti-Watel, Patrick

2013-11-01

The objective of this study is to investigate young breast cancer patients' preferred and actual involvement in decision-making about surgery, chemotherapy, and adjuvant endocrine therapy (AET). A total of 442 women aged 18-40 years at the time of the diagnosis participated in the region-wide ELIPPSE40 cohort study (southeastern France). Logistic regression analyses were performed on various factors possibly affecting patients' preferred and perceived involvement in the decisions about their cancer treatment. The women's mean age was 36.8 years at enrollment. Preference for a fully passive role in decision-making was stated by 20.7% of them. It was favored by regular breast surveillance (p = 0.04) and positive experience of being informed about cancer diagnosis (p = 0.02). Patients' preferences were independently associated with their reported involvement in decision-making about surgery (p = 0.01). A fully passive role in decision-making about chemotherapy and AET was more likely to be reported by patients who perceived their involvement in decision-making about surgery as having been fully passive (adjusted odds ratio = 4.8, CI95% [2.7-8.7], and adjusted odds ratio = 9.8, CI95% [3.3-29.2], respectively). This study shows a significant relationship between the use of antidepressants and involvement in decision-making about surgery, and confirms the relationship between impaired quality of life (in the psychological domain) and a fully passive role in decisions about cancer treatment. Patients' involvement in decision-making about chemotherapy and AET was strongly influenced by their experience of decision-making about surgery, regardless of their tumor stage and history of breast or ovarian cancer. When decisions are being made about surgery, special attention should be paid to facilitating breast cancer patients' involvement in the decision-making. Copyright © 2013 John Wiley & Sons, Ltd.

26 CFR 1.1250-3 - Exceptions and limitations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... following examples: Example 1. (i) Green transfers section 1250 property on March 1, 1968, to a corporation... subparagraph may be illustrated by the following example: Example: (a) Green owns property consisting of land and a fully equipped factory building thereon. The property is condemned and proceeds of $100,000 are...

Cavitation in liquid cryogens. 1: Venturi

NASA Technical Reports Server (NTRS)

Hord, J.; Anderson, L. M.; Hall, W. J.

1972-01-01

The results of continuing cavitation studies are reported. The cavitation characteristics of liquid hydrogen and liquid nitrogen flowing in a transparent plastic Venturi are discussed. Thermodynamic data, consisting of pressure and temperature measurements within fully developed hydrogen cavities, are reported. Details concerning test apparatus, test procedure, and data correlation techniques are given.

DEMONSTRATION BULLETIN: X*TRAX MODEL 200 THERMAL DESORPTION SYSTEMS - CHEMICAL WASTE MANAGEMENT, INC.

EPA Science Inventory

The X*TRAX™ Mode! 200 Thermal Desorption System developed by Chemical Waste Management, Inc. (CWM), is a low-temperature process designed to separate organic contaminants from soils, sludges, and other solid media. The X*TRAX™ Model 200 is fully transportable and consists of thre...

The Role of Construct Maps in Standard Setting

ERIC Educational Resources Information Center

Kane, Michael T.; Tannenbaum, Richard J.

2013-01-01

The authors observe in this commentary that construct maps can help standard-setting panels to make realistic and internally consistent recommendations for performance-level descriptions (PLDs) and cut-scores, but the benefits may not be realized if policymakers do not fully understand the rationale for the recommendations provided by the…

76 FR 63833 - Commission Approval of Divestiture Agreements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... example, ``immaterial'' may have a specific meaning under contract law that is not fully consistent with... process for approval of ministerial and other minor contract modifications that will not diminish the... competition laws and any other provisions in the order. This evaluation includes review of the purchase and...

Fully dynamical simulation of central nuclear collisions.

PubMed

van der Schee, Wilke; Romatschke, Paul; Pratt, Scott

2013-11-27

We present a fully dynamical simulation of central nuclear collisions around midrapidity at LHC energies. Unlike previous treatments, we simulate all phases of the collision, including the equilibration of the system. For the simulation, we use numerical relativity solutions to anti-de Sitter space/conformal field theory for the preequilibrium stage, viscous hydrodynamics for the plasma equilibrium stage, and kinetic theory for the low-density hadronic stage. Our preequilibrium stage provides initial conditions for hydrodynamics, resulting in sizable radial flow. The resulting light particle spectra reproduce the measurements from the ALICE experiment at all transverse momenta.

An eddy-viscosity treatment of the unsteady turbulent boundary layer on a flat plate in an expansion tube

NASA Technical Reports Server (NTRS)

Gupta, R. N.; Trimpi, R. L.

1974-01-01

An analysis is presented for the relaxation of a turbulent boundary layer on a semiinfinite flat plate after passage of a shock wave and a trailing driver gas-driven gas interface. The problem has special application to expansion tube flows. The flow-governing equations have been transformed into the Lamcrocco variables. The numerical results indicate that a fully turbulent boundary layer relaxes faster to the final steady-state values of heat transfer and skin-friction than a fully laminar boundary layer.

Fully developed turbulence in slugs of pipe flows

NASA Astrophysics Data System (ADS)

Cerbus, Rory; Liu, Chien-Chia; Sakakibara, Jun; Gioia, Gustavo; Chakraborty, Pinaki

2015-11-01

Despite over a century of research, transition to turbulence in pipe flows remains a mystery. In theory the flow remains laminar for arbitrarily large Reynolds number, Re. In practice, however, the flow transitions to turbulence at a finite Re whose value depends on the disturbance, natural or artificial, in the experimental setup. The flow remains in the transition state for a range of Re ~ 0 (1000) ; for larger Re the flow becomes fully developed. The transition state for Re > 3000 consists of axially segregated regions of laminar and turbulent patches. These turbulent patches, known as slugs, grow as they move downstream. Their lengths span anywhere between a few pipe diameters to the whole length of the pipe. Here we report Stereo Particle Image Velocimetry measurements in the cross-section of the slugs. Notwithstanding the continuous growth of the slugs, we find that the mean velocity and stress profiles in the slugs are indistinguishable from that of statistically-stationary fully-developed turbulent flows. Our results are independent of the length of the slugs. We contrast our results with the well-known work of Wygnanski & Champagne (1973), whose measurements, we argue, are insufficient to draw a clear conclusion regarding fully developed turbulence in slugs.

Validation of the Fully-Coupled Air-Sea-Wave COAMPS System

NASA Astrophysics Data System (ADS)

Smith, T.; Campbell, T. J.; Chen, S.; Gabersek, S.; Tsu, J.; Allard, R. A.

2017-12-01

A fully-coupled, air-sea-wave numerical model, COAMPS®, has been developed by the Naval Research Laboratory to further enhance understanding of oceanic, atmospheric, and wave interactions. The fully-coupled air-sea-wave system consists of an atmospheric component with full physics parameterizations, an ocean model, NCOM (Navy Coastal Ocean Model), and two wave components, SWAN (Simulating Waves Nearshore) and WaveWatch III. Air-sea interactions between the atmosphere and ocean components are accomplished through bulk flux formulations of wind stress and sensible and latent heat fluxes. Wave interactions with the ocean include the Stokes' drift, surface radiation stresses, and enhancement of the bottom drag coefficient in shallow water due to the wave orbital velocities at the bottom. In addition, NCOM surface currents are provided to SWAN and WaveWatch III to simulate wave-current interaction. The fully-coupled COAMPS system was executed for several regions at both regional and coastal scales for the entire year of 2015, including the U.S. East Coast, Western Pacific, and Hawaii. Validation of COAMPS® includes observational data comparisons and evaluating operational performance on the High Performance Computing (HPC) system for each of these regions.

JEM spotlight: Monitoring the treatment efficiency of a full scale ozonation on a sewage treatment plant with a mode-of-action based test battery.

PubMed

Escher, Beate I; Bramaz, Nadine; Ort, Christoph

2009-10-01

Tertiary treatment of wastewater with ozone is a promising technique for removing residual micropollutants that remain after secondary biological treatment. We monitored the performance of a full-scale ozonation reactor on a sewage treatment plant in Switzerland with a screening battery of bioassays. Six toxicity endpoints were selected that covered non-specific toxicity, as well as selected receptor-mediated modes of action and reactive toxicity. Non-specific toxicity was assessed with two bioassays, the bioluminescence inhibition of the marine luminescent bacterium Vibrio Fischeri and the growth inhibition of the green algae Pseudokirchneriella subcapitata. Treatment efficiency was around 90% for the secondary treatment, but only 65% and 76% for the ozonation step in the two non-specific endpoints, respectively. This finding is consistent with this type of oxidation reaction because ozone only modifies the organic molecules but does not mineralize them fully leaving residual toxicity of the transformation products. In contrast, the specific receptor-mediated endpoints of inhibition of photosystem II in algae and estrogenicity were largely reduced by ozonation. While compounds inhibiting photosynthesis proved to be rather recalcitrant toward biological treatment with only 47% removal, an additional 86% removal by ozonation yielded an overall treatment efficiency in the entire treatment chain of 89%. The effect on estrogenicity, quantified with the yeast estrogen screen, was even more significant: A treatment efficiency of 95% in the secondary treatment, 86% during ozonation plus a small effect by biological sand filtration yielded an overall treatment efficiency of 99.5%. Insecticides that inhibit acetylcholinesterase were fairly resistant to degradation, but an overall treatment efficiency of 91% was achieved in two steps: 72% in biological treatment and 60% during ozonation. Finally, no significant genotoxicity was observed with the umuC test after ozonation, while the influent showed a genotoxic response when it was enriched by a factor of 15 to 60. Treatment efficiency increased with the ozone dose and remained virtually unchanged over ozone doses above 500 g ozone per kg dissolved organic carbon. The reduction of toxicity can be rationalized by the chemical oxidation processes likely to occur for each group of chemicals that are typical for a given mode of toxic action. For comparison, tertiary treatment with powdered activated carbon was also evaluated, which poses a viable alternative to ozonation with respect to removal of micropollutants.

Partial validation of a French version of the ADHD-rating scale IV on a French population of children with ADHD and epilepsy. Factorial structure, reliability, and responsiveness.

PubMed

Mercier, Catherine; Roche, Sylvain; Gaillard, Ségolène; Kassai, Behrouz; Arzimanoglou, Alexis; Herbillon, Vania; Roy, Pascal; Rheims, Sylvain

2016-05-01

Attention deficit hyperactivity disorder (ADHD) is a well-known comorbidity in children with epilepsy. In English-speaking countries, the scores of the original ADHD-rating scale IV are currently used as main outcomes in various clinical trials in children with epilepsy. In French-speaking countries, several French versions are in use though none has been fully validated yet. We sought here for a partial validation of a French version of the ADHD-RS IV regarding construct validity, internal consistency (i.e., scale reliability), item reliability, and responsiveness in a group of French children with ADHD and epilepsy. The study involved 167 children aged 6-15years in 10 French neuropediatric units. The factorial structure and item reliability were assessed with a confirmatory factorial analysis for ordered categorical variables. The dimensions' internal consistency was assessed with Guttman's lambda 6 coefficient. The responsiveness was assessed by the change in score under methylphenidate and in comparison with a control group. The results confirmed the original two-dimensional factorial structure (inattention, hyperactivity/impulsivity) and showed a satisfactory reliability of most items, a good dimension internal consistency, and a good responsiveness of the total score and the two subscores. The studied French version of the ADHD-RS IV is thus validated regarding construct validity, reliability, and responsiveness. It can now be used in French-speaking countries in clinical trials of treatments involving children with ADHD and epilepsy. The full validation requires further investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

Sclerostin antibody treatment improves fracture outcomes in a Type I diabetic mouse model

DOE PAGES

Yee, Cristal S.; Xie, LiQin; Hatsell, Sarah; ...

2015-05-04

Type 1 diabetes mellitus (T1DM) patients have osteopenia and impaired fracture healing due to decreased osteoblast activity. Further, no adequate treatments are currently available that can restore impaired healing in T1DM; hence a significant need exists to investigate new therapeutics for treatment of orthopedic complications. Sclerostin (SOST), a WNT antagonist, negatively regulates bone formation, and SostAb is a potent bone anabolic agent. To determine whether SOST antibody (SostAb) treatment improves fracture healing in streptozotocin (STZ) induced T1DM mice, we administered SostAb twice weekly for up to 21 days post-fracture, and examined bone quality and callus outcomes at 21 days andmore » 42 days post-fracture (11 and 14 weeks of age, respectively). Here we show that SostAb treatment improves bone parameters; these improvements persist after cessation of antibody treatment. Markers of osteoblast differentiation such as Runx2, collagen I, osteocalcin, and DMP1 were reduced, while an abundant number of SP7/osterix-positive early osteoblasts were observed on the bone surface of STZ calluses. These results suggest that STZ calluses have poor osteogenesis resulting from failure of osteoblasts to fully differentiate and produce mineralized matrix, which produces a less mineralized callus. SostAb treatment enhanced fracture healing in both normal and STZ groups, and in STZ + SostAb mice, also reversed the lower mineralization seen in STZ calluses. Micro-CT analysis of calluses revealed improved bone parameters with SostAb treatment, and the mineralized bone was comparable to Controls. Additionally, we found sclerostin levels to be elevated in STZ mice and β-catenin activity to be reduced. Consistent with its function as a WNT antagonist, SostAb treatment enhanced β-catenin activity, but also increased the levels of SOST in the callus and in circulation. Lastly, our results indicate that SostAb treatment rescues the impaired osteogenesis seen in the STZ induced T1DM fracture model by facilitating osteoblast differentiation and mineralization of bone.« less

Psychostimulant addiction treatment

PubMed Central

Phillips, Karran A.; Epstein, David H.; Preston, Kenzie L.

2014-01-01

Treatment of psychostimulant addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications. For psychostimulants, there is no corresponding form of agonist maintenance that has met criteria for regulatory approval or generally accepted use. Stimulant-use disorders remain prevalent and can result in both short-term and long-term adverse consequences. The mainstay of treatment remains behavioral interventions. In this paper, we discuss those interventions and some promising candidates in the search for pharmacological interventions. PMID:24727297

Hydrocephalus in a patient with an unruptured pial arteriovenous fistula: hydrodynamic considerations, endovascular treatment, and clinical course.

PubMed

Morales-Gómez, Jesús A; Garza-Oyervides, Vicente V; Arenas-Ruiz, José A; Mercado-Flores, Mariana; Elizondo-Riojas, C Guillermo; Boop, Frederick A; de León, Ángel Martínez-Ponce

2017-03-01

Intracranial pial arteriovenous fistulas, also known as nongalenic fistulas, are rare vascular malformations affecting predominantly the pediatric population. Hydrocephalus is an unusual presentation in which the exact pathophysiology is not fully understood. The aim of treatment in these cases is occlusion of the fistula prior to considering ventricular shunting. Here, the authors describe the hydrodynamic considerations of the paravascular pathway and the resolution of hydrocephalus with endovascular treatment of the fistula.

Gyrokinetic neoclassical study of the bootstrap current in the tokamak edge pedestal with fully non-linear Coulomb collisions

DOE PAGES

Hager, Robert; Chang, C. S.

2016-04-08

As a follow-up on the drift-kinetic study of the non-local bootstrap current in the steep edge pedestal of tokamak plasma by Koh et al. [Phys. Plasmas 19, 072505 (2012)], a gyrokinetic neoclassical study is performed with gyrokinetic ions and drift-kinetic electrons. Besides the gyrokinetic improvement of ion physics from the drift-kinetic treatment, a fully non-linear Fokker-Planck collision operator—that conserves mass, momentum, and energy—is used instead of Koh et al.'s linearized collision operator in consideration of the possibility that the ion distribution function is non-Maxwellian in the steep pedestal. An inaccuracy in Koh et al.'s result is found in the steepmore » edge pedestal that originated from a small error in the collisional momentum conservation. The present study concludes that (1) the bootstrap current in the steep edge pedestal is generally smaller than what has been predicted from the small banana-width (local) approximation [e.g., Sauter et al., Phys. Plasmas 6, 2834 (1999) and Belli et al., Plasma Phys. Controlled Fusion 50, 095010 (2008)], (2) the plasma flow evaluated from the local approximation can significantly deviate from the non-local results, and (3) the bootstrap current in the edge pedestal, where the passing particle region is small, can be dominantly carried by the trapped particles in a broad trapped boundary layer. In conclusion, a new analytic formula based on numerous gyrokinetic simulations using various magnetic equilibria and plasma profiles with self-consistent Grad-Shafranov solutions is constructed.« less

Gap-free segmentation of vascular networks with automatic image processing pipeline.

PubMed

Hsu, Chih-Yang; Ghaffari, Mahsa; Alaraj, Ali; Flannery, Michael; Zhou, Xiaohong Joe; Linninger, Andreas

2017-03-01

Current image processing techniques capture large vessels reliably but often fail to preserve connectivity in bifurcations and small vessels. Imaging artifacts and noise can create gaps and discontinuity of intensity that hinders segmentation of vascular trees. However, topological analysis of vascular trees require proper connectivity without gaps, loops or dangling segments. Proper tree connectivity is also important for high quality rendering of surface meshes for scientific visualization or 3D printing. We present a fully automated vessel enhancement pipeline with automated parameter settings for vessel enhancement of tree-like structures from customary imaging sources, including 3D rotational angiography, magnetic resonance angiography, magnetic resonance venography, and computed tomography angiography. The output of the filter pipeline is a vessel-enhanced image which is ideal for generating anatomical consistent network representations of the cerebral angioarchitecture for further topological or statistical analysis. The filter pipeline combined with computational modeling can potentially improve computer-aided diagnosis of cerebrovascular diseases by delivering biometrics and anatomy of the vasculature. It may serve as the first step in fully automatic epidemiological analysis of large clinical datasets. The automatic analysis would enable rigorous statistical comparison of biometrics in subject-specific vascular trees. The robust and accurate image segmentation using a validated filter pipeline would also eliminate operator dependency that has been observed in manual segmentation. Moreover, manual segmentation is time prohibitive given that vascular trees have more than thousands of segments and bifurcations so that interactive segmentation consumes excessive human resources. Subject-specific trees are a first step toward patient-specific hemodynamic simulations for assessing treatment outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gyrokinetic neoclassical study of the bootstrap current in the tokamak edge pedestal with fully non-linear Coulomb collisions

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

Hager, Robert; Chang, C. S.

As a follow-up on the drift-kinetic study of the non-local bootstrap current in the steep edge pedestal of tokamak plasma by Koh et al. [Phys. Plasmas 19, 072505 (2012)], a gyrokinetic neoclassical study is performed with gyrokinetic ions and drift-kinetic electrons. Besides the gyrokinetic improvement of ion physics from the drift-kinetic treatment, a fully non-linear Fokker-Planck collision operator—that conserves mass, momentum, and energy—is used instead of Koh et al.'s linearized collision operator in consideration of the possibility that the ion distribution function is non-Maxwellian in the steep pedestal. An inaccuracy in Koh et al.'s result is found in the steepmore » edge pedestal that originated from a small error in the collisional momentum conservation. The present study concludes that (1) the bootstrap current in the steep edge pedestal is generally smaller than what has been predicted from the small banana-width (local) approximation [e.g., Sauter et al., Phys. Plasmas 6, 2834 (1999) and Belli et al., Plasma Phys. Controlled Fusion 50, 095010 (2008)], (2) the plasma flow evaluated from the local approximation can significantly deviate from the non-local results, and (3) the bootstrap current in the edge pedestal, where the passing particle region is small, can be dominantly carried by the trapped particles in a broad trapped boundary layer. In conclusion, a new analytic formula based on numerous gyrokinetic simulations using various magnetic equilibria and plasma profiles with self-consistent Grad-Shafranov solutions is constructed.« less

Gyrokinetic neoclassical study of the bootstrap current in the tokamak edge pedestal with fully non-linear Coulomb collisions

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

Hager, Robert, E-mail: rhager@pppl.gov; Chang, C. S., E-mail: cschang@pppl.gov

As a follow-up on the drift-kinetic study of the non-local bootstrap current in the steep edge pedestal of tokamak plasma by Koh et al. [Phys. Plasmas 19, 072505 (2012)], a gyrokinetic neoclassical study is performed with gyrokinetic ions and drift-kinetic electrons. Besides the gyrokinetic improvement of ion physics from the drift-kinetic treatment, a fully non-linear Fokker-Planck collision operator—that conserves mass, momentum, and energy—is used instead of Koh et al.'s linearized collision operator in consideration of the possibility that the ion distribution function is non-Maxwellian in the steep pedestal. An inaccuracy in Koh et al.'s result is found in the steepmore » edge pedestal that originated from a small error in the collisional momentum conservation. The present study concludes that (1) the bootstrap current in the steep edge pedestal is generally smaller than what has been predicted from the small banana-width (local) approximation [e.g., Sauter et al., Phys. Plasmas 6, 2834 (1999) and Belli et al., Plasma Phys. Controlled Fusion 50, 095010 (2008)], (2) the plasma flow evaluated from the local approximation can significantly deviate from the non-local results, and (3) the bootstrap current in the edge pedestal, where the passing particle region is small, can be dominantly carried by the trapped particles in a broad trapped boundary layer. A new analytic formula based on numerous gyrokinetic simulations using various magnetic equilibria and plasma profiles with self-consistent Grad-Shafranov solutions is constructed.« less

Top-pair production and decay at NLO matched with parton showers

DOE PAGES

Campbell, John M.; Ellis, R. Keith; Nason, Paolo; ...

2015-04-21

We present a next-to-leading order (NLO) calculation of tt¯ production in hadronic collisions interfaced to shower generators according to the POWHEG method. We start from an NLO result from previous work, obtained in the zero width limit, where radiative corrections to both production and decays are included. The POWHEG interface required an extension of the POWHEG BOX framework, in order to deal with radiation from the decay of resonances. This extension is fully general (i.e. it can be applied in principle to any process considered in the zero width limit), and is here applied for the first time. In ordermore » to perform a realistic simulation, we introduce finite width effects using different approximations, that we validated by comparing with published exact NLO results. We have interfaced our POWHEG code to the PYTHIA8 shower Monte Carlo generator. At this stage, we dealt with novel issues related to the treatment of resonances, especially with regard to the initial scale for the shower that needs to be set appropriately. This procedure affects, for example, the fragmentation function of the b quark, that we have studied with particular attention. We believe that the tool presented here improves over previous generators for all aspects that have to do with top decays, and especially for the study of issues related to top mass measurements that involve B hadrons or b jets. As a result, the work presented here also constitutes a first step towards a fully consistent matching of NLO calculations involving intermediate resonances decaying into coloured particles, with parton showers.« less

ADHD and risky sexual behavior in adolescents: Conduct problems and substance use as mediators of risk

PubMed Central

Sarver, Dustin E.; McCart, Michael R.; Sheidow, Ashli J.; Letourneau, Elizabeth J.

2015-01-01

Background Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. Methods ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N=115; mean age=14.9 years) involved in the juvenile justice system. Results Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive but not inattentive symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. Conclusions The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD. PMID:24813803

Optically transparent microwave screens based on engineered graphene layers.

PubMed

Grande, M; Bianco, G V; Vincenti, M A; de Ceglia, D; Capezzuto, P; Petruzzelli, V; Scalora, M; Bruno, G; D'Orazio, A

2016-10-03

We propose an innovative approach for the realization of a microwave absorber fully transparent in the optical regime. This device is based on the Salisbury screen configuration, which consists of a lossless spacer, sandwiched between two graphene sheets whose sheet resistances are different and properly engineered. Experimental results show that it is possible to achieve near-perfect electromagnetic absorption in the microwave X-band. These findings are fully supported by an analytical approach based on an equivalent circuital model. Engineering and integration of graphene sheets could facilitate the realization of innovative microwave absorbers with additional electromagnetic and optical functionalities that could circumvent some of the major limitations of opaque microwave absorbers.

Spectral-element simulation of two-dimensional elastic wave propagation in fully heterogeneous media on a GPU cluster

NASA Astrophysics Data System (ADS)

Rudianto, Indra; Sudarmaji

2018-04-01

We present an implementation of the spectral-element method for simulation of two-dimensional elastic wave propagation in fully heterogeneous media. We have incorporated most of realistic geological features in the model, including surface topography, curved layer interfaces, and 2-D wave-speed heterogeneity. To accommodate such complexity, we use an unstructured quadrilateral meshing technique. Simulation was performed on a GPU cluster, which consists of 24 core processors Intel Xeon CPU and 4 NVIDIA Quadro graphics cards using CUDA and MPI implementation. We speed up the computation by a factor of about 5 compared to MPI only, and by a factor of about 40 compared to Serial implementation.

3D fully convolutional networks for subcortical segmentation in MRI: A large-scale study.

PubMed

Dolz, Jose; Desrosiers, Christian; Ben Ayed, Ismail

2018-04-15

This study investigates a 3D and fully convolutional neural network (CNN) for subcortical brain structure segmentation in MRI. 3D CNN architectures have been generally avoided due to their computational and memory requirements during inference. We address the problem via small kernels, allowing deeper architectures. We further model both local and global context by embedding intermediate-layer outputs in the final prediction, which encourages consistency between features extracted at different scales and embeds fine-grained information directly in the segmentation process. Our model is efficiently trained end-to-end on a graphics processing unit (GPU), in a single stage, exploiting the dense inference capabilities of fully CNNs. We performed comprehensive experiments over two publicly available datasets. First, we demonstrate a state-of-the-art performance on the ISBR dataset. Then, we report a large-scale multi-site evaluation over 1112 unregistered subject datasets acquired from 17 different sites (ABIDE dataset), with ages ranging from 7 to 64 years, showing that our method is robust to various acquisition protocols, demographics and clinical factors. Our method yielded segmentations that are highly consistent with a standard atlas-based approach, while running in a fraction of the time needed by atlas-based methods and avoiding registration/normalization steps. This makes it convenient for massive multi-site neuroanatomical imaging studies. To the best of our knowledge, our work is the first to study subcortical structure segmentation on such large-scale and heterogeneous data. Copyright © 2017 Elsevier Inc. All rights reserved.

[Complications and the management of fully covered retrievable metal stent placement in benign tracheal stenosis].

PubMed

Wang, Zheng-yu; Wang, Yong-li; Chen, Guang-li; Liang, Xi-hong; Wang, Zhen-chang; Ma, Jian-zhong; Wu, Guang-zhong; Zhang, Xiao-ping

2012-11-01

To study complications and the management of the use of covered retrievable expandable metallic stents in the treatment of benign tracheal stenosis. Fully covered retrievable metal stents were placed in 21 patients with benign tracheal stenosis. Stent-related complications and the management were reviewed and analysed. Twenty-eight fully covered retrievable metallic stents were successfully placed fluoroscopically in 21 patients. Stents were removed 4 - 12 months [mean (5.5 ± 2.2) mouths] after placement in all patients. Stent-related complications included granulation tissue (n = 18), stent migration (n = 4), stent expectoration (n = 2), halitosis (n = 8), mucous retention (n = 21) and mucus plugging (n = 1). Granulation tissue was removed with a carbon dioxide laser in 2 patients. Stents were replaced for 2 times and 3 times respectively in 2 patients after stent migration and stent expectoration. An additional stent was placed in 2 patients after stent migration. Symptom of halitosis was relieved after prolonged course of systemic antibiotics treatment in 8 patients. Symptom of mucous retention was relieved with nebulized saline and N-acetylcysteine saline inhalation. Mucous plug was expelled after severe coughing after suctioning using an aspirator in one patient. There were statistically significant differences in stricture diameter, rank of tachypnea and pulmonary function (FEV(1)) in all 21 patients before stent insertion and after stents removal. No patient has experienced recurrence during the follow-up period of 1 - 36 months [mean (23.2 ± 8.0) months]. Fully covered retrievable metallic stent may be a safe and effective in benign tracheal stenosis. Stent-related complications may be effectively managed.

Post-fire mulching for runoff and erosion mitigation; Part II: Effectiveness in reducing runoff and sediment yields from small catchments

Treesearch

Peter R. Robichaud; Joseph W. Wagenbrenner; Sarah A. Lewis; Louise E. Ashmun; Robert E. Brown; Peter M. Wohlgemuth

2013-01-01

Agricultural straw, hydromulch, and wood shred or wood strand mulches increasingly are being used as post-fire hillslope treatments, but the differences in effectiveness among these mulch treatments are not fully understood. Following the 2002 Hayman fire in central Colorado and the 2003 Cedar fire in southern California, matched catchments were monitored for five to...

Chemotherapy and treatment scheduling: the Johns Hopkins Oncology Center Outpatient Department.

PubMed Central

Majidi, F.; Enterline, J. P.; Ashley, B.; Fowler, M. E.; Ogorzalek, L. L.; Gaudette, R.; Stuart, G. J.; Fulton, M.; Ettinger, D. S.

1993-01-01

The Chemotherapy and Treatment Scheduling System provides integrated appointment and facility scheduling for very complex procedures. It is fully integrated with other scheduling systems at The Johns Hopkins Oncology Center and is supported by the Oncology Clinical Information System (OCIS). It provides a combined visual and textual environment for the scheduling of events that have multiple dimensions and dependencies on other scheduled events. It is also fully integrated with other clinical decision support and ancillary systems within OCIS. The system has resulted in better patient flow through the ambulatory care areas of the Center. Implementing the system required changes in behavior among physicians, staff, and patients. This system provides a working example of building a sophisticated rule-based scheduling system using a relatively simple paradigm. It also is an example of what can be achieved when there is total integration between the operational and clinical components of patient care automation. PMID:8130453

Infrared detection of (H 2O) 20 isomers of exceptional stability: A drop-like and a face-sharing pentagonal prism cluster

DOE PAGES

Pradzynski, Christoph C.; Dierking, Christoph W.; Zurheide, Florian; ...

2014-09-01

Water clusters containing fully coordinated water molecules are model systems that mimic the local environment of the condensed phase. Present knowledge about the water cluster size regime in which the transition from the allsurface to the fully solvated water molecules occurs is mainly based on theoretical predictions in lieu of the absence of precisely size resolved experimental measurements. Here, we report size and isomer selective infrared (IR) spectra of (H 2O) 20 clusters tagged with a sodium atom by employing IR excitation modulated photoionization spectroscopy. The observed absorption patterns in the OH stretching ”fingerprint” region are consistent with the theoreticallymore » predicted spectra of two structurally distinct isomers: A drop-like cluster with a fully coordinated (interior) water and an edge-sharing pentagonal prism cluster in which all atoms are on the surface. The observed isomers show exceptional stability and are predicted to be nearly isoenergetic.« less

Conformational Heterogeneity in a Fully Complementary DNA Three-Way Junction with a GC-Rich Branchpoint.

PubMed

Toulmin, Anita; Baltierra-Jasso, Laura E; Morten, Michael J; Sabir, Tara; McGlynn, Peter; Schröder, Gunnar F; Smith, Brian O; Magennis, Steven W

2017-09-19

DNA three-way junctions (3WJs) are branched structures that serve as important biological intermediates and as components in DNA nanostructures. We recently derived the global structure of a fully complementary 3WJ and found that it contained unpaired bases at the branchpoint, which is consistent with previous observations of branch flexibility and branchpoint reactivity. By combining high-resolution single-molecule Förster resonance energy transfer, molecular modeling, time-resolved ensemble fluorescence spectroscopy, and the first 19 F nuclear magnetic resonance observations of fully complementary 3WJs, we now show that the 3WJ structure can adopt multiple distinct conformations depending upon the sequence at the branchpoint. A 3WJ with a GC-rich branchpoint adopts an open conformation with unpaired bases at the branch and at least one additional conformation with an increased number of base interactions at the branchpoint. This structural diversity has implications for branch interactions and processing in vivo and for technological applications.

A novel fully-humanised 3D skin equivalent to model early melanoma invasion

PubMed Central

Hill, David S; Robinson, Neil D P; Caley, Matthew P; Chen, Mei; O’Toole, Edel A; Armstrong, Jane L; Przyborski, Stefan; Lovat, Penny E

2015-01-01

Metastatic melanoma remains incurable, emphasising the acute need for improved research models to investigate the underlying biological mechanisms mediating tumour invasion and metastasis, and to develop more effective targeted therapies to improve clinical outcome. Available animal models of melanoma do not accurately reflect human disease and current in vitro human skin equivalent models incorporating melanoma cells are not fully representative of the human skin microenvironment. We have developed a robust and reproducible, fully-humanised 3D skin equivalent comprising a stratified, terminally differentiated epidermis and a dermal compartment consisting of fibroblast-generated extracellular matrix. Melanoma cells incorporated into the epidermis were able to invade through the basement membrane and into the dermis, mirroring early tumour invasion in vivo. Comparison of our novel 3D melanoma skin equivalent with melanoma in situ and metastatic melanoma indicates this model accurately recreates features of disease pathology, making it a physiologically representative model of early radial and vertical growth phase melanoma invasion. PMID:26330548

A random-walk/giant-loop model for interphase chromosomes.

PubMed Central

Sachs, R K; van den Engh, G; Trask, B; Yokota, H; Hearst, J E

1995-01-01

Fluorescence in situ hybridization data on distances between defined genomic sequences are used to construct a quantitative model for the overall geometric structure of a human chromosome. We suggest that the large-scale geometry during the G0/G1 part of the cell cycle may consist of flexible chromatin loops, averaging approximately 3 million bp, with a random-walk backbone. A fully explicit, three-parametric polymer model of this random-walk/giant-loop structure can account well for the data. More general models consistent with the data are briefly discussed. PMID:7708711

Acetylcholine contributes to the integration of self-movement cues in head direction cells.

PubMed

Yoder, Ryan M; Chan, Jeremy H M; Taube, Jeffrey S

2017-08-01

Acetylcholine contributes to accurate performance on some navigational tasks, but details of its contribution to the underlying brain signals are not fully understood. The medial septal area provides widespread cholinergic input to various brain regions, but selective damage to medial septal cholinergic neurons generally has little effect on landmark-based navigation, or the underlying neural representations of location and directional heading in visual environments. In contrast, the loss of medial septal cholinergic neurons disrupts navigation based on path integration, but no studies have tested whether these path integration deficits are associated with disrupted head direction (HD) cell activity. Therefore, we evaluated HD cell responses to visual cue rotations in a familiar arena, and during navigation between familiar and novel arenas, after muscarinic receptor blockade with systemic atropine. Atropine treatment reduced the peak firing rate of HD cells, but failed to significantly affect other HD cell firing properties. Atropine also failed to significantly disrupt the dominant landmark control of the HD signal, even though we used a procedure that challenged this landmark control. In contrast, atropine disrupted HD cell stability during navigation between familiar and novel arenas, where path integration normally maintains a consistent HD cell signal across arenas. These results suggest that acetylcholine contributes to path integration, in part, by facilitating the use of idiothetic cues to maintain a consistent representation of directional heading. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Last Deglacial Sea Level: A Curated Database of Indicators of Past Sea Levels from Biological and Geomorphological Archives

NASA Astrophysics Data System (ADS)

Hibbert, F. D.; Williams, F. H.; Fallon, S.; Rohling, E. J.

2017-12-01

The last deglacial was an interval of rapid climate and sea-level change, including the collapse of large continental ice sheets. This database collates carefully assessed sea-level data from peer-reviewed sources for the interval 0 to 25 thousand years ago (ka), from the last glacial maximum to the present interglacial conditions. In addition to facilitating site-specific reconstructions of past sea levels, the database provides a suite of data beyond the range of modern/instrumental variability that may help hone future sea-level projections. The database is global in scope, internally consistent, and contains U-series and radiocarbon dated indicators from both biological and geomorpohological archives. We focus on far-field data (i.e., away from the sites of the former continental ice sheets), but some key intermediate (i.e., from the Caribbean) data are also included. All primary fields (i.e., sample location, elevation, age and context) possess quantified uncertainties, which - in conjunction with available metadata - allows the reconstructed sea levels to be interpreted within both their uncertainties and geological context. Consistent treatment of each of the individual records in the database, and incorporation of fully expressed uncertainties, allows datasets to be easily compared. The compilation contains 145 studies from 40 locations (>2,000 data points) and includes all raw information and metadata.

A Cost Element Structure for Defense Training. Final Report.

ERIC Educational Resources Information Center

Knapp, Mark I.; Orlansky, Jesse

This paper identifies, structures, and defines a list of cost elements that is intended to describe fully the life-cycle cost of any formal program, course, or device for individual training of Department of Defense personnel. It was developed to provide consistent, comparable, and credible evaluations of the cost-effectiveness of alternative…

Assessing Global Perspectives at a Hispanic and Minority Serving Institution: A University-Wide Effort

ERIC Educational Resources Information Center

Durodoye, Beth A.; Coryell, Joellen E.; Redmon Wright, Robin; Pate, P. Elizabeth

2011-01-01

Across the United States, colleges and universities are increasingly giving voice to campus internationalization. However, the benefits of this endeavor cannot be fully realized if institutions do not balance their efforts with deliberate and consistent assessment practices. This study examined the global worldviews of students, faculty, and…

Working against the Grain: Researching School Leadership

ERIC Educational Resources Information Center

Niesche, Richard

2012-01-01

Criticisms of the field of educational leadership and management have consisted of the arguments that scholarship is generally lacking in theoretical and methodological rigour. While it is beyond the scope of this Review Essay to fully examine the terrain of critical approaches to leadership, what is important to note is what little headway much…

Elementary Pre-Service Teachers' Response-Shift Bias: Self-Efficacy and Attitudes toward Science

ERIC Educational Resources Information Center

Cartwright, Tina J.; Atwood, Jon

2014-01-01

Response-shift bias occurs when participants' initial constructs, such as self-efficacy in teaching science, are incomplete because they do not fully conceptualize something they have yet to experience. This study examines whether elementary pre-service teachers can consistently evaluate constructs such as self-efficacy and attitudes toward…

Analysis of windsat 3rd and 4th stokes components over Arct Sea ice

USDA-ARS?s Scientific Manuscript database

WindSat has provided an opportunity to investigate the first spaceborne passive fully polarimetric observations of the Earth’s surface. In the present study, we investigated the Arctic sea ice. The passive polarimetric data is provided in the form of the modified Stokes vector consisting of four par...

Nested Neural Networks

NASA Technical Reports Server (NTRS)

Baram, Yoram

1992-01-01

Report presents analysis of nested neural networks, consisting of interconnected subnetworks. Analysis based on simplified mathematical models more appropriate for artificial electronic neural networks, partly applicable to biological neural networks. Nested structure allows for retrieval of individual subpatterns. Requires fewer wires and connection devices than fully connected networks, and allows for local reconstruction of damaged subnetworks without rewiring entire network.

GLOBAL PROPERTIES OF FULLY CONVECTIVE ACCRETION DISKS FROM LOCAL SIMULATIONS

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

Bodo, G.; Ponzo, F.; Rossi, P.

2015-08-01

We present an approach to deriving global properties of accretion disks from the knowledge of local solutions derived from numerical simulations based on the shearing box approximation. The approach consists of a two-step procedure. First, a local solution valid for all values of the disk height is constructed by piecing together an interior solution obtained numerically with an analytical exterior radiative solution. The matching is obtained by assuming hydrostatic balance and radiative equilibrium. Although in principle the procedure can be carried out in general, it simplifies considerably when the interior solution is fully convective. In these cases, the construction ismore » analogous to the derivation of the Hayashi tracks for protostars. The second step consists of piecing together the local solutions at different radii to obtain a global solution. Here we use the symmetry of the solutions with respect to the defining dimensionless numbers—in a way similar to the use of homology relations in stellar structure theory—to obtain the scaling properties of the various disk quantities with radius.« less

Fels-Rand: an Xlisp-Stat program for the comparative analysis of data under phylogenetic uncertainty.

PubMed

Blomberg, S

2000-11-01

Currently available programs for the comparative analysis of phylogenetic data do not perform optimally when the phylogeny is not completely specified (i.e. the phylogeny contains polytomies). Recent literature suggests that a better way to analyse the data would be to create random trees from the known phylogeny that are fully-resolved but consistent with the known tree. A computer program is presented, Fels-Rand, that performs such analyses. A randomisation procedure is used to generate trees that are fully resolved but whose structure is consistent with the original tree. Statistics are then calculated on a large number of these randomly-generated trees. Fels-Rand uses the object-oriented features of Xlisp-Stat to manipulate internal tree representations. Xlisp-Stat's dynamic graphing features are used to provide heuristic tools to aid in analysis, particularly outlier analysis. The usefulness of Xlisp-Stat as a system for phylogenetic computation is discussed. Available from the author or at http://www.uq.edu.au/~ansblomb/Fels-Rand.sit.hqx. Xlisp-Stat is available from http://stat.umn.edu/~luke/xls/xlsinfo/xlsinfo.html. s.blomberg@abdn.ac.uk

Classic-Ada(TM)

NASA Technical Reports Server (NTRS)

Valley, Lois

1989-01-01

The SPS product, Classic-Ada, is a software tool that supports object-oriented Ada programming with powerful inheritance and dynamic binding. Object Oriented Design (OOD) is an easy, natural development paradigm, but it is not supported by Ada. Following the DOD Ada mandate, SPS developed Classic-Ada to provide a tool which supports OOD and implements code in Ada. It consists of a design language, a code generator and a toolset. As a design language, Classic-Ada supports the object-oriented principles of information hiding, data abstraction, dynamic binding, and inheritance. It also supports natural reuse and incremental development through inheritance, code factoring, and Ada, Classic-Ada, dynamic binding and static binding in the same program. Only nine new constructs were added to Ada to provide object-oriented design capabilities. The Classic-Ada code generator translates user application code into fully compliant, ready-to-run, standard Ada. The Classic-Ada toolset is fully supported by SPS and consists of an object generator, a builder, a dictionary manager, and a reporter. Demonstrations of Classic-Ada and the Classic-Ada Browser were given at the workshop.

A fusion network for semantic segmentation using RGB-D data

NASA Astrophysics Data System (ADS)

Yuan, Jiahui; Zhang, Kun; Xia, Yifan; Qi, Lin; Dong, Junyu

2018-04-01

Semantic scene parsing is considerable in many intelligent field, including perceptual robotics. For the past few years, pixel-wise prediction tasks like semantic segmentation with RGB images has been extensively studied and has reached very remarkable parsing levels, thanks to convolutional neural networks (CNNs) and large scene datasets. With the development of stereo cameras and RGBD sensors, it is expected that additional depth information will help improving accuracy. In this paper, we propose a semantic segmentation framework incorporating RGB and complementary depth information. Motivated by the success of fully convolutional networks (FCN) in semantic segmentation field, we design a fully convolutional networks consists of two branches which extract features from both RGB and depth data simultaneously and fuse them as the network goes deeper. Instead of aggregating multiple model, our goal is to utilize RGB data and depth data more effectively in a single model. We evaluate our approach on the NYU-Depth V2 dataset, which consists of 1449 cluttered indoor scenes, and achieve competitive results with the state-of-the-art methods.

Fully automated tumor segmentation based on improved fuzzy connectedness algorithm in brain MR images.

PubMed

Harati, Vida; Khayati, Rasoul; Farzan, Abdolreza

2011-07-01

Uncontrollable and unlimited cell growth leads to tumor genesis in the brain. If brain tumors are not diagnosed early and cured properly, they could cause permanent brain damage or even death to patients. As in all methods of treatments, any information about tumor position and size is important for successful treatment; hence, finding an accurate and a fully automated method to give information to physicians is necessary. A fully automatic and accurate method for tumor region detection and segmentation in brain magnetic resonance (MR) images is suggested. The presented approach is an improved fuzzy connectedness (FC) algorithm based on a scale in which the seed point is selected automatically. This algorithm is independent of the tumor type in terms of its pixels intensity. Tumor segmentation evaluation results based on similarity criteria (similarity index (SI), overlap fraction (OF), and extra fraction (EF) are 92.89%, 91.75%, and 3.95%, respectively) indicate a higher performance of the proposed approach compared to the conventional methods, especially in MR images, in tumor regions with low contrast. Thus, the suggested method is useful for increasing the ability of automatic estimation of tumor size and position in brain tissues, which provides more accurate investigation of the required surgery, chemotherapy, and radiotherapy procedures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Vegetative growth and cluster development in Shiraz grapevines subjected to partial root-zone cooling

PubMed Central

Rogiers, Suzy Y.; Clarke, Simon J.

2013-01-01

Heterogeneity in root-zone temperature both vertically and horizontally may contribute to the uneven vegetative and reproductive growth often observed across vineyards. An experiment was designed to assess whether the warmed half of a grapevine root zone could compensate for the cooled half in terms of vegetative growth and reproductive development. We divided the root system of potted Shiraz grapevines bilaterally and applied either a cool or a warm treatment to each half from budburst to fruit set. Shoot growth and inflorescence development were monitored over the season. Simultaneous cooling and warming of parts of the root system decreased shoot elongation, leaf emergence and leaf expansion below that of plants with a fully warmed root zone, but not to the same extent as those with a fully cooled root zone. Inflorescence rachis length, flower number and berry number after fertilization were smaller only in those vines exposed to fully cooled root zones. After terminating the treatments, berry enlargement and the onset of veraison were slowed in those vines that had been exposed to complete or partial root-zone cooling. Grapevines exposed to partial root-zone cooling were thus delayed in vegetative and reproductive development, but the inhibition was greater in those plants whose entire root system had been cooled. PMID:24244839

A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial.

PubMed

Brendryen, Håvar; Drozd, Filip; Kraft, Pål

2008-11-28

Happy Ending (HE) is an intense 1-year smoking cessation program delivered via the Internet and cell phone. HE consists of more than 400 contacts by email, Web pages, interactive voice response, and short message service technology. HE includes a craving helpline and a relapse prevention system, providing just-in-time therapy. All the components of the program are fully automated. The objectives were to describe the rationale for the design of HE, to assess the 12-month efficacy of HE in a sample of smokers willing to attempt to quit without the use of nicotine replacement therapy, and to explore the potential effect of HE on coping planning and self-efficacy (prior to quitting) and whether coping planning and self-efficacy mediate treatment effect. A two-arm randomized controlled trial was used. Subjects were recruited via Internet advertisements and randomly assigned to condition. Inclusion criteria were willingness to quit on a prescribed day without using nicotine replacement and being aged 18 years or older. The intervention group received HE, and the control group received a 44-page self-help booklet. Abstinence was defined as "not even a puff of smoke, for the last seven days" and was assessed by means of Internet surveys or telephone interviews 1, 3, 6, and 12 months postcessation. The main outcome was repeated point abstinence (ie, abstinence at all four time points). Coping planning and self-efficacy were measured at baseline and at the end of the preparation phase (ie, after 2 weeks of treatment, but prior to cessation day). A total of 290 participants received either the HE intervention (n=144) or the control booklet (n=146). Using intent-to-treat analysis, participants in the intervention group reported clinically and statistically significantly higher repeated point abstinence rates than control participants (20% versus 7%, odds ratio [OR] = 3.43, 95% CI = 1.60-7.34, P = .002). Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group. However, neither coping planning nor self-efficacy mediated long-term treatment effect. For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect. This 12-month trial documents a long-term treatment effect of a fully automated smoking cessation intervention without the use of nicotine replacement therapy. The study adds to the promise of using digital media in supporting behavior change.

Short course chemotherapy for tuberculous lymphadenitis in children.

PubMed Central

Jawahar, M S; Sivasubramanian, S; Vijayan, V K; Ramakrishnan, C V; Paramasivan, C N; Selvakumar, V; Paul, S; Tripathy, S P; Prabhakar, R

1990-01-01

OBJECTIVE--To assess the efficacy of a short course chemotherapy regimen for treating tuberculosis of the lymph nodes in children. DESIGN--Open, collaborative, outpatient clinical trial. SETTING--Outpatient department of the Tuberculosis Research Centre, paediatric surgery departments of the Institute of Child Health and Hospital for Children and the Government Stanley Hospital, Madras, South India. PATIENTS--Children aged 1-12 years with extensive, multiple site, superficial tuberculous lymphadenitis confirmed by biopsy (histopathology or culture). INTERVENTIONS--Patients were treated with a fully supervised intermittent chemotherapy regimen consisting of streptomycin, rifampicin, isoniazid, and pyrazinamide three times a week for two months followed by streptomycin and isoniazid twice a week for four months on an outpatient basis. Surgery was limited to biopsy of nodes for diagnosis and assessment. MAIN OUTCOME MEASURES--Response to chemotherapy was assessed by regression of lymph nodes and healing of sinuses and abscesses during treatment and follow up. Compliance with treatment and frequency of adverse reactions were also estimated. RESULTS--197 Patients were admitted to the study and 168 into the analysis. The regimen was well tolerated and compliance was good with 101 (60%) patients receiving the prescribed chemotherapy within 15 days of the stipulated period of six months. Those whose chemotherapy extended beyond that period received the same total number of doses. Clinical response was favourable in most patients at the end of treatment. Sinuses and abscesses healed rapidly. Residual lymphadenopathy (exceeding 10 mm diameter) was present in 50 (30%) patients at the end of treatment; these nodes were biopsied. Fresh nodes, increase in size of nodes, and sinuses and abscesses occurred both during treatment and follow up. After 36 months of follow up after treatment only 5 (3%) patients required retreatment for tuberculosis. CONCLUSION--Tuberculous lymphadenitis in children can be successfully treated with a short course chemotherapy regimen of six months. PMID:2205318

The effect of dilution and the use of a post-extraction nucleic acid purification column on the accuracy, precision, and inhibition of environmental DNA samples

USGS Publications Warehouse

Mckee, Anna M.; Spear, Stephen F.; Pierson, Todd W.

2015-01-01

Isolation of environmental DNA (eDNA) is an increasingly common method for detecting presence and assessing relative abundance of rare or elusive species in aquatic systems via the isolation of DNA from environmental samples and the amplification of species-specific sequences using quantitative PCR (qPCR). Co-extracted substances that inhibit qPCR can lead to inaccurate results and subsequent misinterpretation about a species’ status in the tested system. We tested three treatments (5-fold and 10-fold dilutions, and spin-column purification) for reducing qPCR inhibition from 21 partially and fully inhibited eDNA samples collected from coastal plain wetlands and mountain headwater streams in the southeastern USA. All treatments reduced the concentration of DNA in the samples. However, column purified samples retained the greatest sensitivity. For stream samples, all three treatments effectively reduced qPCR inhibition. However, for wetland samples, the 5-fold dilution was less effective than other treatments. Quantitative PCR results for column purified samples were more precise than the 5-fold and 10-fold dilutions by 2.2× and 3.7×, respectively. Column purified samples consistently underestimated qPCR-based DNA concentrations by approximately 25%, whereas the directional bias in qPCR-based DNA concentration estimates differed between stream and wetland samples for both dilution treatments. While the directional bias of qPCR-based DNA concentration estimates differed among treatments and locations, the magnitude of inaccuracy did not. Our results suggest that 10-fold dilution and column purification effectively reduce qPCR inhibition in mountain headwater stream and coastal plain wetland eDNA samples, and if applied to all samples in a study, column purification may provide the most accurate relative qPCR-based DNA concentrations estimates while retaining the greatest assay sensitivity.

TPS(PET)-A TPS-based approach for in vivo dose verification with PET in proton therapy.

PubMed

Frey, K; Bauer, J; Unholtz, D; Kurz, C; Krämer, M; Bortfeld, T; Parodi, K

2014-01-06

Since the interest in ion-irradiation for tumour therapy has significantly increased over the last few decades, intensive investigations are performed to improve the accuracy of this form of patient treatment. One major goal is the development of methods for in vivo dose verification. In proton therapy, a PET (positron emission tomography)-based approach measuring the irradiation-induced tissue activation inside the patient has been already clinically implemented. The acquired PET images can be compared to an expectation, derived under the assumption of a correct treatment application, to validate the particle range and the lateral field position in vivo. In the context of this work, TPSPET is introduced as a new approach to predict proton-irradiation induced three-dimensional positron emitter distributions by means of the same algorithms of the clinical treatment planning system (TPS). In order to perform additional activity calculations, reaction-channel-dependent input positron emitter depth distributions are necessary, which are determined from the application of a modified filtering approach to the TPS reference depth dose profiles in water. This paper presents the implementation of TPSPET on the basis of the research treatment planning software treatment planning for particles. The results are validated in phantom and patient studies against Monte Carlo simulations, and compared to β(+)-emitter distributions obtained from a slightly modified version of the originally proposed one-dimensional filtering approach applied to three-dimensional dose distributions. In contrast to previously introduced methods, TPSPET provides a faster implementation, the results show no sensitivity to lateral field extension and the predicted β(+)-emitter densities are fully consistent to the planned treatment dose as they are calculated by the same pencil beam algorithms. These findings suggest a large potential of the application of TPSPET for in vivo dose verification in the daily clinical routine.

Dietary high oleic canola oil supplemented with docosahexaenoic acid attenuates plasma proprotein convertase subtilisin kexin type 9 (PCSK9) levels in participants with cardiovascular disease risk: A randomized control trial.

PubMed

Pu, Shuaihua; Rodríguez-Pérez, Celia; Ramprasath, Vanu Ramkumar; Segura-Carretero, Antonio; Jones, Peter J H

2016-12-01

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a novel circulating protein which plays an important role in regulation of cholesterol metabolism by promoting hepatic LDL receptor degradation. However, the action of dietary fat composition on PCSK9 levels remains to be fully elucidated. The objective was to investigate the action of different dietary oils on circulating PCSK9 levels in the Canola Oil Multicenter Intervention Trial (COMIT). COMIT employed a double-blinded crossover randomized control design, consisting of five 30-d treatment periods. Diets were provided based on a 3000Kcal/d intake, including a 60g/d treatment of conventional canola oil (Canola), a high oleic canola/DHA oil blend (CanolaDHA), a corn/safflower oil blend (CornSaff), a flax/safflower oil blend (FlaxSaff) or a high oleic canola oil (CanolaOleic). Plasma PCSK9 levels were assessed using ELISA at the end of each phase. Lipid profiles (n=84) showed that CanolaDHA feeding resulted in the highest (P<0.05) serum total cholesterol (TC, 5.06±0.09mmol/L) and LDL-cholesterol levels (3.15±0.08mmol/L) across all five treatments. CanolaDHA feeding also produced the lowest (P<0.05) plasma PCSK9 concentrations (216.42±8.77ng/mL) compared to other dietary oil treatments. Plasma PCSK9 levels positively correlated (P<0.05) with serum TC, LDL-cholesterol, apolipoprotein A, and apolipoprotein B levels but did not correlate to HDL-cholesterol levels. Results indicate that post-treatment response in PCSK9 may be altered with the CanolaDHA diet. In conclusion, the elevated LDL-C levels from a DHA oil treatment may not be relevant for the observed decline in PCSK9 levels. Copyright © 2016 Elsevier Inc. All rights reserved.

When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation.

PubMed

Djulbegovic, Benjamin; van den Ende, Jef; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Pauker, Stephen G

2015-05-01

The threshold model represents an important advance in the field of medical decision-making. It is a linchpin between evidence (which exists on the continuum of credibility) and decision-making (which is a categorical exercise - we decide to act or not act). The threshold concept is closely related to the question of rational decision-making. When should the physician act, that is order a diagnostic test, or prescribe treatment? The threshold model embodies the decision theoretic rationality that says the most rational decision is to prescribe treatment when the expected treatment benefit outweighs its expected harms. However, the well-documented large variation in the way physicians order diagnostic tests or decide to administer treatments is consistent with a notion that physicians' individual action thresholds vary. We present a narrative review summarizing the existing literature on physicians' use of a threshold strategy for decision-making. We found that the observed variation in decision action thresholds is partially due to the way people integrate benefits and harms. That is, explanation of variation in clinical practice can be reduced to a consideration of thresholds. Limited evidence suggests that non-expected utility threshold (non-EUT) models, such as regret-based and dual-processing models, may explain current medical practice better. However, inclusion of costs and recognition of risk attitudes towards uncertain treatment effects and comorbidities may improve the explanatory and predictive value of the EUT-based threshold models. The decision when to act is closely related to the question of rational choice. We conclude that the medical community has not yet fully defined criteria for rational clinical decision-making. The traditional notion of rationality rooted in EUT may need to be supplemented by reflective rationality, which strives to integrate all aspects of medical practice - medical, humanistic and socio-economic - within a coherent reasoning system. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Impact of involved field radiotherapy in partial response after doxorubicin-based chemotherapy for advanced aggressive non-Hodgkin's lymphoma

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

Moser, Elizabeth C.; Kluin-Nelemans, Hanneke C.; Carde, Patrice

2006-11-15

Purpose: Whether salvage therapy in patients with advanced aggressive non-Hodgkin's lymphoma (NHL) in partial remission (PR) should consist of radiotherapy or autologous stem-cell transplantation (ASCT) is debatable. We evaluated the impact of radiotherapy on outcome in PR patients treated in four successive European Organization for Research and Treatment of Cancer trials for aggressive NHL. Patients and Methods: Records of 974 patients (1980-1999) were reviewed regarding initial response, final outcome, and type and timing of salvage treatment. After 8 cycles of doxorubicin-based chemotherapy, 227 NHL patients were in PR and treated: 114 received involved field radiotherapy, 16 ASCT, 93 second-line chemotherapy,more » and 4 were operated. Overall survival (OS) and progression-free survival (PFS) after radiotherapy were estimated (Kaplan-Meier method) and compared with other treatments (log-rank). Impact on survival was evaluated by multivariate analysis (Cox proportional hazards model). Results: The median PFS in PR patients was 4.2 years and 48% remained progression-free at 5 years. Half of the PR patients converted to a complete remission. After conversion, survival was comparable to patients directly in complete remission. Radiotherapy resulted in better OS and PFS compared with other treatments, especially in patients with low to intermediate International Prognostic Index score, bulky disease, or nodal disease only. Correction by multivariate analysis for prognostic factors such as stage, bulky disease, and number of extranodal locations showed that radiotherapy was clearly the most significant factor affecting both OS and PFS. Conclusion: This retrospective analysis demonstrates that radiotherapy can be effective for patients in PR after fully dosed chemotherapy; assessment in a randomized trial (radiotherapy vs. ASCT) is justified.« less

Randomized study of adjunctive belimumab in participants with generalized myasthenia gravis

PubMed Central

Hewett, Karen; Sanders, Donald B.; Grove, Richard A.; Broderick, Christine L.; Rudo, Todd J.; Bassiri, Ashlyn; Zvartau-Hind, Marina

2018-01-01

Objective To investigate the efficacy and safety of belimumab, a fully human immunoglobulin G1λ monoclonal antibody against B-lymphocyte stimulator, in participants with generalized myasthenia gravis (MG) who remained symptomatic despite standard of care (SoC) therapy. Methods Eligible participants with MG were randomized 1:1 to receive IV belimumab 10 mg/kg or placebo in this phase II, placebo-controlled, multicenter, double-blind study (NCT01480596; BEL115123). Participants received SoC therapies throughout the 24-week treatment phase and 12-week follow-up period. The primary efficacy endpoint was mean change from baseline in the Quantitative Myasthenia Gravis (QMG) scale at week 24; safety assessments included the frequency and severity of adverse events (AEs) and serious AEs. Results Forty participants were randomized (placebo n = 22; belimumab n = 18). The mean change in QMG score from baseline at week 24 was not significantly different for belimumab vs placebo (p = 0.256). There were no statistically significant differences between treatment groups for secondary endpoints, including the MG Composite and MG–Activity of Daily Living scores. Acetylcholine receptor antibody levels decreased over time in both treatment groups. No unexpected AEs were identified and occurrence was similar in the belimumab (78%) and placebo (91%) groups. One participant receiving placebo died (severe sepsis) during the treatment phase. Conclusions The primary endpoint was not met for belimumab in participants with generalized MG receiving SoC. There was no significant difference in mean change in the QMG score at week 24 for belimumab vs placebo. The safety profile of belimumab was consistent with previous systemic lupus erythematosus studies. Classification of evidence This study provides Class I evidence that for participants with generalized MG, belimumab did not significantly improve QMG score compared with placebo. PMID:29661905

Investigations of seborrheic dermatitis. Part II. Influence of itraconazole on the clinical condition and the level of selected cytokines in seborrheic dermatitis.

PubMed

Trznadel-Grodzka, Ewa; Błaszkowski, Marcin; Rotsztejn, Helena

2012-11-14

The pathogenesis of seborrheic dermatitis has not been fully elucidated. A number of anascogenic yeasts of Malassezia spp. appear to be involved in the intensity of the symptoms. The purpose of the study is to evaluate the levels of selected inflammatory cytokines, IL-2, IL-4, IFN-γ and TNF-α, in the serum after treatment with itraconazole. Sixty-six subjects were enrolled in the study. The control group consisted of 30 participants (23 females and 7 males) without any clinical disorders, aged 24-65 (37.41±6.08 years). Thirty-six patients with seborrheic dermatitis (16 females and 20 males), aged 19-76 (38.61±13.77), constituted the study group. The measurement of IL-2, IL-4, IFN-γ and TNF-α levels was performed by ELISA using a Human High Sensitivity kit (Diaclone, France). After six-week treatment with itraconazole administered daily at a dose of 200 mg using pulse therapy, there was remission of the disease or at least substantial clinical improvement in the patients with seborrheic dermatitis. The levels of IL-2 and IFN-γ cytokines in the study group were higher than in the control group. After the treatment the level of IFN-γ secretion in the male patients with seborrheic dermatitis significantly increased. The levels of the other studied cytokines did not significantly differ. The treatment with itraconazole had a beneficial effect on the clinical condition of the skin of the patients. IFN-γ is a cytokine whose secretion might affect the condition of the skin in seborrheic dermatitis.

Sparse matrix beamforming and image reconstruction for 2-D HIFU monitoring using harmonic motion imaging for focused ultrasound (HMIFU) with in vitro validation.

PubMed

Hou, Gary Y; Provost, Jean; Grondin, Julien; Wang, Shutao; Marquet, Fabrice; Bunting, Ethan; Konofagou, Elisa E

2014-11-01

Harmonic motion imaging for focused ultrasound (HMIFU) utilizes an amplitude-modulated HIFU beam to induce a localized focal oscillatory motion simultaneously estimated. The objective of this study is to develop and show the feasibility of a novel fast beamforming algorithm for image reconstruction using GPU-based sparse-matrix operation with real-time feedback. In this study, the algorithm was implemented onto a fully integrated, clinically relevant HMIFU system. A single divergent transmit beam was used while fast beamforming was implemented using a GPU-based delay-and-sum method and a sparse-matrix operation. Axial HMI displacements were then estimated from the RF signals using a 1-D normalized cross-correlation method and streamed to a graphic user interface with frame rates up to 15 Hz, a 100-fold increase compared to conventional CPU-based processing. The real-time feedback rate does not require interrupting the HIFU treatment. Results in phantom experiments showed reproducible HMI images and monitoring of 22 in vitro HIFU treatments using the new 2-D system demonstrated reproducible displacement imaging, and monitoring of 22 in vitro HIFU treatments using the new 2-D system showed a consistent average focal displacement decrease of 46.7 ±14.6% during lesion formation. Complementary focal temperature monitoring also indicated an average rate of displacement increase and decrease with focal temperature at 0.84±1.15%/(°)C, and 2.03±0.93%/(°)C , respectively. These results reinforce the HMIFU capability of estimating and monitoring stiffness related changes in real time. Current ongoing studies include clinical translation of the presented system for monitoring of HIFU treatment for breast and pancreatic tumor applications.

The Clonic Phase of Seizures in Patients Treated with Electroconvulsive Therapy is Related to Age and Stimulus Intensity.

PubMed

Wang, Chao-Chih; Lin, Ching-Hung; Chiu, Yao-Chu; Tseng, Chih-Chieh

2013-01-01

Electroconvulsive therapy (ECT) is effective in the treatment of major depressive disorder and schizophrenia in patients who are drug-naïve or less-receptive to antipsychotic drugs. Several studies have discussed the correlation between patient characteristics, input-current volume, and seizure duration. According to the present principle of ECT guidelines, the therapeutic effect of ECT mostly correlates with seizure duration. As the tonic phase is different from the clonic phase with respect to brain function and activity, it is informative to analyze both the tonic and clonic phases. Thus, this study sought to clarify the relationship between the features of the two phases, and to re-examine and refine guidelines regarding ECT treatment. ECT-course data from 44 schizophrenia or bipolar I patients were recollected, including the number of treatments that they had received, their gender, age, and the association of these characteristics with motor seizure duration was analyzed. A two-factor correlation was employed to test the relationship between each of the two factors. The post-analysis results indicate that seizure duration and age are significantly correlated. Older patients had relatively short seizure durations after ECT-treatment. Notably, a negative correlation was only found between age and the clonic phase of the seizure, not between age and the tonic phase. Furthermore, this study also found an inverse relationship between ECT-intensity and the clonic phase, but not between ECT-intensity and the tonic phase. This study demonstrated that age and ECT-intensity are negatively correlated with seizure duration, particularly in the clonic phase. The present observations are not fully consistent with the basic guidelines of the APA-ECT practical manual. Accordingly, the predictions regarding the therapeutic effect of ECT can be based on both the seizure duration and the clonic phase.

Disease Progression and Resolution in Rodent Models of Clostridium difficile Infection and Impact of Antitoxin Antibodies and Vancomycin.

PubMed

Warn, Peter; Thommes, Pia; Sattar, Abdul; Corbett, David; Flattery, Amy; Zhang, Zuo; Black, Todd; Hernandez, Lorraine D; Therien, Alex G

2016-11-01

Clostridium difficile causes infections of the colon in susceptible patients. Specifically, gut dysbiosis induced by treatment with broad-spectrum antibiotics facilitates germination of ingested C. difficile spores, expansion of vegetative cells, and production of symptom-causing toxins TcdA and TcdB. The current standard of care for C. difficile infections (CDI) consists of administration of antibiotics such as vancomycin that target the bacterium but also perpetuate gut dysbiosis, often leading to disease recurrence. The monoclonal antitoxin antibodies actoxumab (anti-TcdA) and bezlotoxumab (anti-TcdB) are currently in development for the prevention of recurrent CDI. In this study, the effects of vancomycin or actoxumab/bezlotoxumab treatment on progression and resolution of CDI were assessed in mice and hamsters. Rodent models of CDI are characterized by an early severe phase of symptomatic disease, associated with high rates of morbidity and mortality; high intestinal C. difficile burden; and a disrupted intestinal microbiota. This is followed in surviving animals by gradual recovery of the gut microbiota, associated with clearance of C. difficile and resolution of disease symptoms over time. Treatment with vancomycin prevents disease initially by inhibiting outgrowth of C. difficile but also delays microbiota recovery, leading to disease relapse following discontinuation of therapy. In contrast, actoxumab/bezlotoxumab treatment does not impact the C. difficile burden but rather prevents the appearance of toxin-dependent symptoms during the early severe phase of disease, effectively preventing disease until the microbiota (the body's natural defense against C. difficile) has fully recovered. These data provide insight into the mechanism of recurrence following vancomycin administration and into the mechanism of recurrence prevention observed clinically with actoxumab/bezlotoxumab. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system

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

Karagounis, Ilias V.; Koukourakis, Michael I., E-mail: targ@her.forthnet.gr, E-mail: mkoukour@med.duth.gr; Abatzoglou, Ioannis M., E-mail: abadzoglou@yahoo.gr

Purpose: In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. Methods: The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housingmore » an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. Results: Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. Conclusions: The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.« less

Assessing and addressing cognitive impairment in bipolar disorder: the International Society for Bipolar Disorders Targeting Cognition Task Force recommendations for clinicians.

PubMed

Miskowiak, K W; Burdick, K E; Martinez-Aran, A; Bonnin, C M; Bowie, C R; Carvalho, A F; Gallagher, P; Lafer, B; López-Jaramillo, C; Sumiyoshi, T; McIntyre, R S; Schaffer, A; Porter, R J; Purdon, S; Torres, I J; Yatham, L N; Young, A H; Kessing, L V; Vieta, E

2018-05-01

Cognition is a new treatment target to aid functional recovery and enhance quality of life for patients with bipolar disorder. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force aimed to develop consensus-based clinical recommendations on whether, when and how to assess and address cognitive impairment. The task force, consisting of 19 international experts from nine countries, discussed the challenges and recommendations in a face-to-face meeting, telephone conference call and email exchanges. Consensus-based recommendations were achieved through these exchanges with no need for formal consensus methods. The identified questions were: (I) Should cognitive screening assessments be routinely conducted in clinical settings? (II) What are the most feasible screening tools? (III) What are the implications if cognitive impairment is detected? (IV) What are the treatment perspectives? Key recommendations are that clinicians: (I) formally screen cognition in partially or fully remitted patients whenever possible, (II) use brief, easy-to-administer tools such as the Screen for Cognitive Impairment in Psychiatry and Cognitive Complaints in Bipolar Disorder Rating Assessment, and (III) evaluate the impact of medication and comorbidity, refer patients for comprehensive neuropsychological evaluation when clinically indicated, and encourage patients to build cognitive reserve. Regarding question (IV), there is limited evidence for current evidence-based treatments but intense research efforts are underway to identify new pharmacological and/or psychological cognition treatments. This task force paper provides the first consensus-based recommendations for clinicians on whether, when, and how to assess and address cognition, which may aid patients' functional recovery and improve their quality of life. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system.

PubMed

Karagounis, Ilias V; Abatzoglou, Ioannis M; Koukourakis, Michael I

2016-05-01

In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housing an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.

Severe myositis of the hip flexors after pre-operative chemoradiation therapy for locally advanced rectal cancer: case report.

PubMed

Florczynski, Matthew M; Sanatani, Michael S; Mai, Lauren; Fisher, Barbara; Moulin, Dwight E; Cao, Jeffrey; Louie, Alexander V; Pope, Janet E; Leung, Eric

2016-03-22

The use of neoadjuvant radiation therapy and chemotherapy in the treatment of locally advanced rectal adenocarcinoma has been shown to reduce disease recurrence when combined with surgery and adjuvant chemotherapy. We report a case of a patient who developed a debilitating bilateral myopathy of the hip flexors after successful treatment for rectal cancer. To the best of our knowledge, this is the first such complication from radiation therapy reported in a patient with colorectal cancer. The disproportionate severity of our patient's myopathy relative to the dose of radiation used also makes this case unique among reports of neuromuscular complications from radiation therapy. The patient is a 65-year-old male with node negative, high-grade adenocarcinoma of the rectum penetrating through the distal rectal wall. He underwent neoadjuvant concurrent pelvic radiation therapy and capecitabine-based chemotherapy, followed by abdominoperineal resection and post-operative FOLFOX chemotherapy. Five months post-completion of pelvic radiotherapy and 2 months after the completion of adjuvant chemotherapy, he presented with bilateral weakness of the iliopsoas muscles and severe pain radiating to the groin. The patient improved with 40 mg/d of prednisone, which was gradually tapered to 2 mg/d over 6 months, with substantial recovery of muscle strength and elimination of pain. The timing, presentation and response of our patient's symptoms to corticosteroids are most consistent with a radiation recall reaction. Radiation recall is a phenomenon whereby previously irradiated tissue becomes vulnerable to toxicity by subsequent systemic therapy and is rarely associated with myopathies. Radiation recall should be considered a potential complication of neoadjuvant radiation therapy for rectal cancer, and for ongoing research into the optimization of treatment for these patients. Severe myopathies caused by radiation recall may be fully reversible with corticosteroid treatment.

SECOND-STAGE TREATMENTS FOR RELATIVE NONRESPONDERS TO COGNITIVE BEHAVIORAL THERAPY (CBT) FOR PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA-CONTINUED CBT VERSUS SSRI: A RANDOMIZED CONTROLLED TRIAL.

PubMed

Payne, Laura A; White, Kamila S; Gallagher, Matthew W; Woods, Scott W; Shear, M Katherine; Gorman, Jack M; Farchione, Todd J; Barlow, David H

2016-05-01

Cognitive behavioral therapy (CBT) and pharmacotherapy are efficacious for the short-term treatment of panic disorder. Less is known about the efficacy of these therapies for individuals who do not respond fully to short-term CBT. The current trial is a second-step stratified randomized design comparing two treatment conditions-selective serotonin reuptake inhibitor (SSRI; paroxetine or citalopram; n = 34) and continued CBT (n = 24)-in a sample of individuals classified as treatment nonresponders to an initial course of CBT for panic disorder. Participants were randomized to 3 months of treatment and then followed for an additional 9 months. Only treatment responders after 3 months were maintained on the treatment until 12-month follow-up. Data analysis focused on panic disorder symptoms and achievement of response status across the first 3 months of treatment. Final follow-up data are presented descriptively. Participants in the SSRI condition showed significantly lower panic disorder symptoms as compared to continued CBT at 3 months. Results were similar when excluding individuals with comorbid major depression or analyzing the entire intent-to-treat sample. Group differences disappeared during 9-month naturalistic follow-up, although there was significant attrition and use of nonstudy therapies in both arms. These data suggest greater improvement in panic disorder symptoms when switching to SSRI after failure to fully respond to an initial course of CBT. Future studies should further investigate relapse following treatment discontinuation for nonresponders who became responders. Clinicaltrials.gov Identifier: NCT00000368; https://clinicaltrials.gov/show/NCT00000368. © 2015 Wiley Periodicals, Inc.

Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

PubMed

Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

2015-04-01

Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P < 0.001). Multidisciplinary clinical hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

Rethinking responsibility in offenders with acquired paedophilia: punishment or treatment?

PubMed

Gilbert, Frédéric; Focquaert, Farah

2015-01-01

This article reviews the current neurobiological literature on the aetiology of developmental and acquired paedophilia and examines what the consequences could be in terms of responsibility and treatment for the latter. Addressing the question of responsibility and punishment of offenders with acquired paedophilia from a neurobiological perspective is controversial. Consequently it is essential to avoid hasty conclusions based strictly on neurobiological abnormality justifications. This study establishes a distinction between developmental and acquired paedophilia. The article investigates whether offenders who fulfil the diagnosis of acquired paedophilia should be held fully responsible, particularly in cases where the offender's conduct appears to result from volitionally controlled behaviour that is seemingly incompatible with a neurological cause. Moreover, the article explores how responsibility can be compromised when offenders with acquired paedophilia have (partially) preserved moral knowledge despite their sexual disorder. The article then examines the option of offering mandatory treatment as an alternative to imprisonment for offenders with acquired paedophilia. Furthermore, the article addresses the ethical issues related to offering any form of quasi-coercive treatment as a condition of release. This study concludes that decisions to fully or partially excuse an individual who fulfil the diagnosis of acquired paedophilia should take all relevant information into account, both neurobiological and other environmental evidence, and should proceed on a careful case by case analysis before sentencing or offering treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Side-by-side placement of bilateral endoscopic metal stents for the treatment of postoperative biliary stricture.

PubMed

Kaino, Seiji; Sen-Yo, Manabu; Shinoda, Shuhei; Kawano, Michitaka; Harima, Hirofumi; Suenaga, Shigeyuki; Sakaida, Isao

2017-02-01

Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture. Temporally fully covered metal stents with dilated diameters of 6 mm were placed in a side-by-side fashion in the left and right hepatic ducts, respectively. We removed the stents 2 months after their placement. Subsequent cholangiography revealed an improvement in the biliary strictures. Although we were apprehensive about the fully covered metal stents obstructing the biliary side branches, we noted that careful placement of the bilateral metal stents did not cause any complications. Side-by-side deployment of bilateral endoscopic fully covered metal stents can be one of the safe and effective therapies for postoperative biliary stricture.

Psychological aspects of dentofacial esthetics and orthognathic surgery.

PubMed

Jacobson, A

1984-01-01

The literature and the results of the survey clearly confirm that physical attractiveness plays a major role in the social life and interaction among individuals. Cosmetic improvement is a powerful motivating factor leading people to seek treatment. Those who believe that the rewards of facial improvement will enable them to lead more satisfying and comfortable lives should be encouraged to proceed with the treatment. However, it is absolutely essential that those contemplating treatment be counseled before-hand and fully informed on the prognosis, risks and hazards, advantages and disadvantages of such procedures before embarking on treatment.

Comparison of semi-automated center-dot and fully automated endothelial cell analyses from specular microscopy images.

PubMed

Maruoka, Sachiko; Nakakura, Shunsuke; Matsuo, Naoko; Yoshitomi, Kayo; Katakami, Chikako; Tabuchi, Hitoshi; Chikama, Taiichiro; Kiuchi, Yoshiaki

2017-10-30

To evaluate two specular microscopy analysis methods across different endothelial cell densities (ECDs). Endothelial images of one eye from each of 45 patients were taken by using three different specular microscopes (three replicates each). To determine the consistency of the center-dot method, we compared SP-6000 and SP-2000P images. CME-530 and SP-6000 images were compared to assess the consistency of the fully automated method. The SP-6000 images from the two methods were compared. Intraclass correlation coefficients (ICCs) for the three measurements were calculated, and parametric multiple comparisons tests and Bland-Altman analysis were performed. The ECD mean value was 2425 ± 883 (range 516-3707) cells/mm 2 . ICC values were > 0.9 for all three microscopes for ECD, but the coefficients of variation (CVs) were 0.3-0.6. For ECD measurements, Bland-Altman analysis revealed that the mean difference was 42 cells/mm 2 between the SP-2000P and SP-6000 for the center-dot method; 57 cells/mm 2 between the SP-6000 measurements from both methods; and -5 cells/mm 2 between the SP-6000 and CME-530 for the fully automated method (95% limits of agreement: - 201 to 284 cell/mm 2 , - 410 to 522 cells/mm 2 , and - 327 to 318 cells/mm 2 , respectively). For CV measurements, the mean differences were - 3, - 12, and 13% (95% limits of agreement - 18 to 11, - 26 to 2, and - 5 to 32%, respectively). Despite using three replicate measurements, the precision of the center-dot method with the SP-2000P and SP-6000 software was only ± 10% for ECD data and was even worse for the fully automated method. Japan Clinical Trials Register ( http://www.umin.ac.jp/ctr/index/htm9 ) number UMIN 000015236.

The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form.

PubMed

Hickman, Susan E; Nelson, Christine A; Moss, Alvin H; Tolle, Susan W; Perrin, Nancy A; Hammes, Bernard J

2011-11-01

To evaluate the consistency between treatments provided and Physician Orders for Life-Sustaining Treatment (POLST) orders. Retrospective chart abstraction. Stratified, random sample of 90 nursing facilities in Oregon, Wisconsin, and West Virginia. Eight hundred seventy living and deceased nursing facility residents aged 65 and older with a minimum 60-day stay. Chart data about POLST form orders and related treatments over a 60-day period were abstracted. Decision rules were created to determine whether the rationale for each treatment was consistent with POLST orders. Most residents (85.2%) had the same POLST form in place during the review period. A majority of treatments provided to residents with orders for comfort measures only (74.3%) and limited antibiotics (83.3%) were consistent with POLST orders because they were primarily comfort focused rather than life-prolonging, but antibiotics were provided to 32.1% of residents with orders for no antibiotics. Overall consistency rates between treatments and POLST orders were high for resuscitation (98%), medical interventions (91.1%), and antibiotics (92.9%) and modest for feeding tubes (63.6%). In all, POLST orders were consistent with treatments provided 94.0% of the time. With the exception of feeding tubes and antibiotic use in residents with orders for no antibiotics, the use of medical treatments was nearly always consistent with POLST orders to provide or withhold life-sustaining interventions. The POLST program is a useful tool for ensuring that the treatment preferences of nursing facility residents are honored. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Quasi-Dynamic Versus Fully-Dynamic Simulations of Slip Accumulation on Faults with Enhanced Dynamic Weakening

NASA Astrophysics Data System (ADS)

Lapusta, N.; Thomas, M.; Noda, H.; Avouac, J.

2012-12-01

Long-term simulations that incorporate both seismic events and aseismic slip are quite important for studies of earthquake physics but challenging computationally. To study long deformation histories, most simulation methods do not incorporate full inertial effects (wave propagation) during simulated earthquakes, using quasi-dynamic approximations instead. Here we compare the results of quasi-dynamic simulations to the fully dynamic ones for a range of problems to determine the applicability of the quasi-dynamic approach. Intuitively, the quasi-dynamic approach should do relatively well in problems where wave-mediated effects are relatively simple but should have substantially different (and hence wrong) response when the wave-mediated stress transfers dominate the character of the seismic events. This is exactly what we observe in our simulations. We consider a 2D model of a rate-and-state fault with a seismogenic (steady-state velocity-weakening) zone surrounded by creeping (steady-state velocity-strengthening) areas. If the seismogenic zone is described by the standard Dieterich-Ruina rate-and-state friction, the resulting earthquake sequences consist of relatively simple crack-like ruptures, and the inclusion of true wave-propagation effects mostly serves to concentrate stress more efficiently at the rupture front. Hence, in such models, rupture speeds and slip rates are significantly (several times) lower in the quasi-dynamic simulations compared to the fully dynamic ones, but the total slip, the crack-like nature of seismic events, and the overall pattern of earthquake sequences is comparable, consistently with prior studies. Such behavior can be classified as qualitatively similar but quantitatively different, and it motivates the popularity of the quasi-dynamic methods in simulations. However, the comparison changes dramatically once we consider a model with enhanced dynamic weakening in the seismogenic zone in the form of flash heating. In this case, the fully dynamic simulations produce seismic ruptures in the form of short-duration slip pulses, where the pulses form due to a combination of enhanced weakening and wave effects. The quasi-dynamic simulations in the same model produce completely different results, with large crack-like ruptures, different total slips, different rupture patterns, and different prestress state before large, model-spanning events. Such qualitative differences between the quasi-dynamic and fully-dynamic simulation should result in any model where inertial effects lead to qualitative differences, such as cases with supershear transition or fault with different materials on the two sides. We will present results on our current work on how the quasi-dynamic and fully dynamic simulations compare for the cases with heterogeneous fault properties.

Fully automated MR liver volumetry using watershed segmentation coupled with active contouring.

PubMed

Huynh, Hieu Trung; Le-Trong, Ngoc; Bao, Pham The; Oto, Aytek; Suzuki, Kenji

2017-02-01

Our purpose is to develop a fully automated scheme for liver volume measurement in abdominal MR images, without requiring any user input or interaction. The proposed scheme is fully automatic for liver volumetry from 3D abdominal MR images, and it consists of three main stages: preprocessing, rough liver shape generation, and liver extraction. The preprocessing stage reduced noise and enhanced the liver boundaries in 3D abdominal MR images. The rough liver shape was revealed fully automatically by using the watershed segmentation, thresholding transform, morphological operations, and statistical properties of the liver. An active contour model was applied to refine the rough liver shape to precisely obtain the liver boundaries. The liver volumes calculated by the proposed scheme were compared to the "gold standard" references which were estimated by an expert abdominal radiologist. The liver volumes computed by using our developed scheme excellently agreed (Intra-class correlation coefficient was 0.94) with the "gold standard" manual volumes by the radiologist in the evaluation with 27 cases from multiple medical centers. The running time was 8.4 min per case on average. We developed a fully automated liver volumetry scheme in MR, which does not require any interaction by users. It was evaluated with cases from multiple medical centers. The liver volumetry performance of our developed system was comparable to that of the gold standard manual volumetry, and it saved radiologists' time for manual liver volumetry of 24.7 min per case.

Legal implications of employee assistance programs.

PubMed

Lehr, R I; Middlebrooks, D J

1986-01-01

Employers who offer EAPs should be aware of their rights as well as the rights of employees. Appropriate steps should be taken to assure that employees are fully informed of the conditions of participating in a program prior to volunteering for treatment. An issue that must be considered is the confidentiality of information arising during the course of treatment. Several court cases involving the physician-patient relationship offer guidelines in this area.

Cancer treatment scheduling and dynamic heterogeneity in social dilemmas of tumour acidity and vasculature.

PubMed

Kaznatcheev, Artem; Vander Velde, Robert; Scott, Jacob G; Basanta, David

2017-03-14

Tumours are diverse ecosystems with persistent heterogeneity in various cancer hallmarks like self-sufficiency of growth factor production for angiogenesis and reprogramming of energy metabolism for aerobic glycolysis. This heterogeneity has consequences for diagnosis, treatment and disease progression. We introduce the double goods game to study the dynamics of these traits using evolutionary game theory. We model glycolytic acid production as a public good for all tumour cells and oxygen from vascularisation via vascular endothelial growth factor production as a club good benefiting non-glycolytic tumour cells. This results in three viable phenotypic strategies: glycolytic, angiogenic and aerobic non-angiogenic. We classify the dynamics into three qualitatively distinct regimes: (1) fully glycolytic; (2) fully angiogenic; or (3) polyclonal in all three cell types. The third regime allows for dynamic heterogeneity even with linear goods, something that was not possible in prior public good models that considered glycolysis or growth factor production in isolation. The cyclic dynamics of the polyclonal regime stress the importance of timing for anti-glycolysis treatments like lonidamine. The existence of qualitatively different dynamic regimes highlights the order effects of treatments. In particular, we consider the potential of vascular normalisation as a neoadjuvant therapy before follow-up with interventions like buffer therapy.

Multiple imputation for handling missing outcome data when estimating the relative risk.

PubMed

Sullivan, Thomas R; Lee, Katherine J; Ryan, Philip; Salter, Amy B

2017-09-06

Multiple imputation is a popular approach to handling missing data in medical research, yet little is known about its applicability for estimating the relative risk. Standard methods for imputing incomplete binary outcomes involve logistic regression or an assumption of multivariate normality, whereas relative risks are typically estimated using log binomial models. It is unclear whether misspecification of the imputation model in this setting could lead to biased parameter estimates. Using simulated data, we evaluated the performance of multiple imputation for handling missing data prior to estimating adjusted relative risks from a correctly specified multivariable log binomial model. We considered an arbitrary pattern of missing data in both outcome and exposure variables, with missing data induced under missing at random mechanisms. Focusing on standard model-based methods of multiple imputation, missing data were imputed using multivariate normal imputation or fully conditional specification with a logistic imputation model for the outcome. Multivariate normal imputation performed poorly in the simulation study, consistently producing estimates of the relative risk that were biased towards the null. Despite outperforming multivariate normal imputation, fully conditional specification also produced somewhat biased estimates, with greater bias observed for higher outcome prevalences and larger relative risks. Deleting imputed outcomes from analysis datasets did not improve the performance of fully conditional specification. Both multivariate normal imputation and fully conditional specification produced biased estimates of the relative risk, presumably since both use a misspecified imputation model. Based on simulation results, we recommend researchers use fully conditional specification rather than multivariate normal imputation and retain imputed outcomes in the analysis when estimating relative risks. However fully conditional specification is not without its shortcomings, and so further research is needed to identify optimal approaches for relative risk estimation within the multiple imputation framework.

Uniform spatial distribution of collagen fibril radii within tendon implies local activation of pC-collagen at individual fibrils

NASA Astrophysics Data System (ADS)

Rutenberg, Andrew D.; Brown, Aidan I.; Kreplak, Laurent

2016-08-01

Collagen fibril cross-sectional radii show no systematic variation between the interior and the periphery of fibril bundles, indicating an effectively constant rate of collagen incorporation into fibrils throughout the bundle. Such spatially homogeneous incorporation constrains the extracellular diffusion of collagen precursors from sources at the bundle boundary to sinks at the growing fibrils. With a coarse-grained diffusion equation we determine stringent bounds, using parameters extracted from published experimental measurements of tendon development. From the lack of new fibril formation after birth, we further require that the concentration of diffusing precursors stays below the critical concentration for fibril nucleation. We find that the combination of the diffusive bound, which requires larger concentrations to ensure homogeneous fibril radii, and lack of nucleation, which requires lower concentrations, is only marginally consistent with fully processed collagen using conservative bounds. More realistic bounds may leave no consistent concentrations. Therefore, we propose that unprocessed pC-collagen diffuses from the bundle periphery followed by local C-proteinase activity and subsequent collagen incorporation at each fibril. We suggest that C-proteinase is localized within bundles, at fibril surfaces, during radial fibrillar growth. The much greater critical concentration of pC-collagen, as compared to fully processed collagen, then provides broad consistency between homogeneous fibril radii and the lack of fibril nucleation during fibril growth.

Defining Recovery from an Eating Disorder: Conceptualization, Validation, and Examination of Psychosocial Functioning and Psychiatric Comorbidity

PubMed Central

Bardone-Cone, Anna M.; Harney, Megan B.; Maldonado, Christine R.; Lawson, Melissa A.; Robinson, D. Paul; Smith, Roma; Tosh, Aneesh

2009-01-01

Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a “fully recovered” group (n=20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n=15), active eating disorder (n=53), and healthy controls (n=67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed. PMID:19945094

The initial instability and finite-amplitude stability of alternate bars in straight channels

USGS Publications Warehouse

Nelson, J.M.

1990-01-01

The initial instability and fully developed stability of alternate bars in straight channels are investigated using linearized and nonlinear analyses. The fundamental instability leading to these features is identified through a linear stability analysis of the equations governing the flow and sediment transport fields. This instability is explained in terms of topographically induced steering of the flow and the associated pattern of erosion and deposition on the bed. While the linear theory is useful for examining the instability mechanism, this approach is shown to yield relatively little information about well-developed alternate bars and, specifically, the linear analysis is shown to yield poor predictions of the fully developed bar wavelength. A fully nonlinear approach is presented that permits computation of the evolution of these bed features from an initial perturbation to their fully developed morphology. This analysis indicates that there is typically substantial elongation of the bar wavelength during the evolution process, a result that is consistent with observations of bar development in flumes and natural channels. The nonlinear approach demonstrates that the eventual stability of these features is a result of the interplay between topographic steering effects, secondary flow production as a result of streamline curvature, and gravitationally induced modifications of sediment fluxes over a sloping bed. ?? 1990.

Three dimensional intensity modulated brachytherapy (IMBT): dosimetry algorithm and inverse treatment planning.

PubMed

Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko

2010-07-01

The feasibility of intensity modulated brachytherapy (IMBT) to improve dose conformity for irregularly shaped targets has been previously investigated by researchers by means of using partially shielded sources. However, partial shielding does not fully explore the potential of IMBT. The goal of this study is to introduce the concept of three dimensional (3D) intensity modulated brachytherapy and solve two fundamental issues regarding the application of 3D IMBT treatment planning: The dose calculation algorithm and the inverse treatment planning method. A 3D IMBT treatment planning system prototype was developed using the MATLAB platform. This system consists of three major components: (1) A comprehensive IMBT source calibration method with dosimetric inputs from Monte Carlo (EGSnrc) simulations; (2) a "modified TG-43" (mTG-43) dose calculation formalism for IMBT dosimetry; and (3) a physical constraint based inverse IMBT treatment planning platform utilizing a simulated annealing optimization algorithm. The model S700 Axxent electronic brachytherapy source developed by Xoft, Inc. (Fremont, CA), was simulated in this application. Ten intracavitary accelerated partial breast irradiation (APBI) cases were studied. For each case, an "isotropic plan" with only optimized source dwell time and a fully optimized IMBT plan were generated and compared to the original plan in various dosimetric aspects, such as the plan quality, planning, and delivery time. The issue of the mechanical complexity of the IMBT applicator is not addressed in this study. IMBT approaches showed superior plan quality compared to the original plans and tht isotropic plans to different extents in all studied cases. An extremely difficult case with a small breast and a small distance to the ribs and skin, the IMBT plan minimized the high dose volume V200 by 16.1% and 4.8%, respectively, compared to the original and the isotropic plans. The conformity index for the target was increased by 0.13 and 0.04, respectively. The maximum dose to the skin was reduced by 56 and 28 cGy, respectively, per fraction. Also, the maximum dose to the ribs was reduced by 104 and 96 cGy, respectively, per fraction. The mean dose to the ipsilateral and contralateral breasts and lungs were also slightly reduced by the IMBT plan. The limitations of IMBT are the longer planning and delivery time. The IMBT plan took around 2 h to optimize, while the isotropic plan optimization could reach the global minimum within 5 min. The delivery time for the IMBT plan is typically four to six times longer than the corresponding isotropic plan. In this study, a dosimetry method for IMBT sources was proposed and an inverse treatment planning system prototype for IMBT was developed. The improvement of plan quality by 3D IMBT was demonstrated using ten APBI case studies. Faster computers and higher output of the source can further reduce plan optimization and delivery time, respectively.

A fully organic retinal prosthesis restores vision in a rat model of degenerative blindness

NASA Astrophysics Data System (ADS)

Maya-Vetencourt, José Fernando; Ghezzi, Diego; Antognazza, Maria Rosa; Colombo, Elisabetta; Mete, Maurizio; Feyen, Paul; Desii, Andrea; Buschiazzo, Ambra; di Paolo, Mattia; di Marco, Stefano; Ticconi, Flavia; Emionite, Laura; Shmal, Dmytro; Marini, Cecilia; Donelli, Ilaria; Freddi, Giuliano; Maccarone, Rita; Bisti, Silvia; Sambuceti, Gianmario; Pertile, Grazia; Lanzani, Guglielmo; Benfenati, Fabio

2017-06-01

The degeneration of photoreceptors in the retina is one of the major causes of adult blindness in humans. Unfortunately, no effective clinical treatments exist for the majority of retinal degenerative disorders. Here we report on the fabrication and functional validation of a fully organic prosthesis for long-term in vivo subretinal implantation in the eye of Royal College of Surgeons rats, a widely recognized model of retinitis pigmentosa. Electrophysiological and behavioural analyses reveal a prosthesis-dependent recovery of light sensitivity and visual acuity that persists up to 6-10 months after surgery. The rescue of the visual function is accompanied by an increase in the basal metabolic activity of the primary visual cortex, as demonstrated by positron emission tomography imaging. Our results highlight the possibility of developing a new generation of fully organic, highly biocompatible and functionally autonomous photovoltaic prostheses for subretinal implants to treat degenerative blindness.

A fully organic retinal prosthesis restores vision in a rat model of degenerative blindness

PubMed Central

Antognazza, Maria Rosa; Colombo, Elisabetta; Mete, Maurizio; Feyen, Paul; Desii, Andrea; Buschiazzo, Ambra; Di Paolo, Mattia; Di Marco, Stefano; Ticconi, Flavia; Emionite, Laura; Shmal, Dmytro; Marini, Cecilia; Donelli, Ilaria; Freddi, Giuliano; Maccarone, Rita; Bisti, Silvia; Sambuceti, Gianmario; Pertile, Grazia; Lanzani, Guglielmo; Benfenati, Fabio

2017-01-01

The degeneration of photoreceptors in the retina is one of the major causes of adult blindness in humans. Unfortunately, no effective clinical treatments exist for the majority of retinal degenerative disorders. Here we report on the fabrication and functional validation of a fully organic prosthesis for long-term in vivo subretinal implantation in the eye of Royal College of Surgeons rats, a widely recognized model of Retinitis pigmentosa. Electrophysiological and behavioral analyses reveal a prosthesis-dependent recovery of light-sensitivity and visual acuity that persists up to 6-10 months after surgery. The rescue of the visual function is accompanied by an increase in the basal metabolic activity of the primary visual cortex, as demonstrated by positron emission tomography imaging. Our results highlight the possibility of developing a new generation of fully organic, highly biocompatible and functionally autonomous photovoltaic prostheses for subretinal implants to treat degenerative blindness. PMID:28250420

NOVEL CERAMIC MEMBRANE BIOREACTOR FOR LOW-FLOW SYSTEMS - PHASE I

EPA Science Inventory

Improved low-flow (50,000 gallons per day) sanitary wastewater treatment systems are needed. CeraMem Corporation's proposed approach includes a membrane bioreactor (MBR) using fully proven biological processes for biological oxygen demand oxidation and (optionally) fo...

Treatment of HIV in the Central Nervous System.

PubMed

Yilmaz, Aylin; Gisslén, Magnus

2014-02-01

Central nervous system (CNS) infection is an important part of systemic human immunodeficiency disease (HIV) infection. It is most often asymptomatic, but can sometimes lead to severe neurologic disease, particularly in advanced stages of immunosuppression. CNS HIV infection usually responds well to antiretroviral treatment, but there are concerns that treatment may not always be fully effective in treating or preventing milder CNS disease and that it, under certain circumstances, might be important to consider antiretroviral drug distribution and effects within the CNS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Consensus in chronic ankle instability: aetiology, assessment, surgical indications and place for arthroscopy.

PubMed

Guillo, S; Bauer, T; Lee, J W; Takao, M; Kong, S W; Stone, J W; Mangone, P G; Molloy, A; Perera, A; Pearce, C J; Michels, F; Tourné, Y; Ghorbani, A; Calder, J

2013-12-01

Ankle sprains are the most common injuries sustained during sports activities. Most ankle sprains recover fully with non-operative treatment but 20-30% develop chronic ankle instability. Predicting which patients who sustain an ankle sprain will develop instability is difficult. This paper summarises a consensus on identifying which patients may require surgery, the optimal surgical intervention along with treatment of concomitant pathology given the evidence available today. It also discusses the role of arthroscopic treatment and the anatomical basis for individual procedures. Copyright © 2013. Published by Elsevier Masson SAS.

Fully automated adipose tissue measurement on abdominal CT

NASA Astrophysics Data System (ADS)

Yao, Jianhua; Sussman, Daniel L.; Summers, Ronald M.

2011-03-01

Obesity has become widespread in America and has been associated as a risk factor for many illnesses. Adipose tissue (AT) content, especially visceral AT (VAT), is an important indicator for risks of many disorders, including heart disease and diabetes. Measuring adipose tissue (AT) with traditional means is often unreliable and inaccurate. CT provides a means to measure AT accurately and consistently. We present a fully automated method to segment and measure abdominal AT in CT. Our method integrates image preprocessing which attempts to correct for image artifacts and inhomogeneities. We use fuzzy cmeans to cluster AT regions and active contour models to separate subcutaneous and visceral AT. We tested our method on 50 abdominal CT scans and evaluated the correlations between several measurements.

O+OH-->O(2)+H: A key reaction for interstellar chemistry. New theoretical results and comparison with experiment.

PubMed

Lique, F; Jorfi, M; Honvault, P; Halvick, P; Lin, S Y; Guo, H; Xie, D Q; Dagdigian, P J; Kłos, J; Alexander, M H

2009-12-14

We report extensive, fully quantum, time-independent (TID) calculations of cross sections at low collision energies and rate constants at low temperatures for the O+OH reaction, of key importance in the production of molecular oxygen in cold, dark, interstellar clouds and in the chemistry of the Earth's atmosphere. Our calculations are compared with TID calculations within the J-shifting approximation, with wave-packet calculations, and with quasiclassical trajectory calculations. The fully quantum TID calculations yield rate constants higher than those from the more approximate methods and are qualitatively consistent with a low-temperature extrapolation of earlier experimental values but not with the most recent experiments at the lowest temperatures.

μ SR study of the noncentrosymmetric superconductor PbTaSe2

NASA Astrophysics Data System (ADS)

Wilson, M. N.; Hallas, A. M.; Cai, Y.; Guo, S.; Gong, Z.; Sankar, R.; Chou, F. C.; Uemura, Y. J.; Luke, G. M.

2017-06-01

We present muon spin rotation and relaxation (μ SR ) measurements on the noncentrosymmetric superconductor PbTaSe2. From measurements in an applied transverse field between Hc 1 and Hc 2, we extract the superfluid density as a function of temperature in the vortex state. These data can be fit with a fully gapped two-band model, consistent with previous evidence from ARPES, thermal conductivity, and resistivity. Furthermore, zero-field measurements show no evidence for a time-reversal symmetry-breaking field greater than 0.05 G in the superconducting state. This makes exotic fully gapped spin-triplet states unlikely, and hence we contend that PbTaSe2 is characterized by conventional BCS s -wave superconductivity in multiple bands.

Fully automated detection of diabetic macular edema and dry age-related macular degeneration from optical coherence tomography images

PubMed Central

Srinivasan, Pratul P.; Kim, Leo A.; Mettu, Priyatham S.; Cousins, Scott W.; Comer, Grant M.; Izatt, Joseph A.; Farsiu, Sina

2014-01-01

We present a novel fully automated algorithm for the detection of retinal diseases via optical coherence tomography (OCT) imaging. Our algorithm utilizes multiscale histograms of oriented gradient descriptors as feature vectors of a support vector machine based classifier. The spectral domain OCT data sets used for cross-validation consisted of volumetric scans acquired from 45 subjects: 15 normal subjects, 15 patients with dry age-related macular degeneration (AMD), and 15 patients with diabetic macular edema (DME). Our classifier correctly identified 100% of cases with AMD, 100% cases with DME, and 86.67% cases of normal subjects. This algorithm is a potentially impactful tool for the remote diagnosis of ophthalmic diseases. PMID:25360373

Electromagnetic Scattering by Fully Ordered and Quasi-Random Rigid Particulate Samples

NASA Technical Reports Server (NTRS)

Mishchenko, Michael I.; Dlugach, Janna M.; Mackowski, Daniel W.

2016-01-01

In this paper we have analyzed circumstances under which a rigid particulate sample can behave optically as a true discrete random medium consisting of particles randomly moving relative to each other during measurement. To this end, we applied the numerically exact superposition T-matrix method to model far-field scattering characteristics of fully ordered and quasi-randomly arranged rigid multiparticle groups in fixed and random orientations. We have shown that, in and of itself, averaging optical observables over movements of a rigid sample as a whole is insufficient unless it is combined with a quasi-random arrangement of the constituent particles in the sample. Otherwise, certain scattering effects typical of discrete random media (including some manifestations of coherent backscattering) may not be accurately replicated.

Knowledge enabled plan of care and documentation prototype.

PubMed

DaDamio, Rebecca; Gugerty, Brian; Kennedy, Rosemary

2006-01-01

There exist significant challenges in integrating the plan of care into documentation and point of care operational processes. A plan of care is often a static artifact that meets regulatory standards with limited influence on supporting goal-directed care delivery processes. Although this prototype is applicable to many clinical disciplines, we will highlight nursing processes in demonstrating a knowledge-driven computerized solution that fully integrates the plan of care within documentation. The knowledge-driven solution reflects evidenced-based practice; is an effective tool for managing problems, orders/interventions, and the patient's progress towards expected outcomes; meets regulatory standards; and drives quality and process improvement. The knowledge infrastructure consists of fully represented terminology, structured clinical expressions utilizing the controlled terminology and clinical knowledge representing evidence-based practice.

Resilient Nodeless d -Wave Superconductivity in Monolayer FeSe

NASA Astrophysics Data System (ADS)

Agterberg, D. F.; Shishidou, T.; O'Halloran, J.; Brydon, P. M. R.; Weinert, M.

2017-12-01

Monolayer FeSe exhibits the highest transition temperature among the iron based superconductors and appears to be fully gapped, seemingly consistent with s -wave superconductivity. Here, we develop a theory for the superconductivity based on coupling to fluctuations of checkerboard magnetic order (which has the same translation symmetry as the lattice). The electronic states are described by a symmetry based k .p -like theory and naturally account for the states observed by angle resolved photoemission spectroscopy. We show that a prediction of this theory is that the resultant superconducting state is a fully gapped, nodeless, d -wave state. This state, which would usually have nodes, stays nodeless because, as seen experimentally, the relevant spin-orbit coupling has an energy scale smaller than the superconducting gap.

47 CFR 73.1211 - Broadcast of lottery information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... consisting of money or other thing of value is awarded to any person whose selection is dependent in whole or... winners are required to furnish any money or other thing of value or are required to have in their... profit, i.e., all receipts fully consumed in defraying the actual costs of operation). (3) Any gaming...

47 CFR 73.1211 - Broadcast of lottery information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... consisting of money or other thing of value is awarded to any person whose selection is dependent in whole or... winners are required to furnish any money or other thing of value or are required to have in their... profit, i.e., all receipts fully consumed in defraying the actual costs of operation). (3) Any gaming...

47 CFR 73.1211 - Broadcast of lottery information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... consisting of money or other thing of value is awarded to any person whose selection is dependent in whole or... winners are required to furnish any money or other thing of value or are required to have in their... profit, i.e., all receipts fully consumed in defraying the actual costs of operation). (3) Any gaming...

47 CFR 73.1211 - Broadcast of lottery information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... consisting of money or other thing of value is awarded to any person whose selection is dependent in whole or... winners are required to furnish any money or other thing of value or are required to have in their... profit, i.e., all receipts fully consumed in defraying the actual costs of operation). (3) Any gaming...

47 CFR 73.1211 - Broadcast of lottery information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... consisting of money or other thing of value is awarded to any person whose selection is dependent in whole or... winners are required to furnish any money or other thing of value or are required to have in their... profit, i.e., all receipts fully consumed in defraying the actual costs of operation). (3) Any gaming...

An Inclusive Definition of Spirituality for Social Work Education and Practice

ERIC Educational Resources Information Center

Senreich, Evan

2013-01-01

A formidable body of recent literature advocates the incorporation of spirituality into the bio-psycho-social framework of social work education and practice. No consistent conceptualization of spirituality has been developed, however, that can be used with all clients and that is fully consonant with social work values as taught in schools of…

A computational study of pyrolysis reactions of lignin model compounds

Treesearch

Thomas Elder

2010-01-01

Enthalpies of reaction for the initial steps in the pyrolysis of lignin have been evaluated at the CBS-4m level of theory using fully substituted b-O-4 dilignols. Values for competing unimolecular decomposition reactions are consistent with results previously published for phenethyl phenyl ether models, but with lowered selectivity. Chain propagating reactions of free...

78 FR 63435 - Approval and Promulgation of Air Quality Implementation Plans; Rhode Island: Prevention of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

... also proposing to fully approve the State's definition of ``PM 2.5 '' (fine particulate matter) which is specific only to permitting. Certain of the State's SIP revisions consist of definitions that also... pollutants other than GHGs. EPA is proposing to conditionally approve those definitions as they relate to the...

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

PAQUETTE,D.E.; BENNETT,D.B.; DORSCH,W.R.

THE DEPARTMENT OF ENERGY ORDER 5400.1, GENERAL ENVIRONMENTAL PROTECTION PROGRAM, REQUIRES THE DEVELOPMENT AND IMPLEMENTATION OF A GROUNDWATER PROTECTION PROGRAM. THE BNL GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION PROVIDES AN OVERVIEW OF HOW THE LABORATORY ENSURES THAT PLANS FOR GROUNDWATER PROTECTION, MONITORING, AND RESTORATION ARE FULLY DEFINED, INTEGRATED, AND MANAGED IN A COST EFFECTIVE MANNER THAT IS CONSISTENT WITH FEDERAL, STATE, AND LOCAL REGULATIONS.

Slow-motion scattering and coalescence of maximally charged black holes

NASA Technical Reports Server (NTRS)

Ferrell, Robert C.; Eardley, Douglas M.

1987-01-01

Systems consisting of several maximally charged, nonrotating black holes ('Reissner-Nordstrom' black holes) interacting with one another are studied. An effective action for the system in the slow-motion, fully strong-field regime is presented. An exact calculation of black-hole-black-hole scattering and coalescence in the slow-motion (but strong-field) limit is given.

Workplace Training Programs: Instruments for Human Capital Improvements or Screening Devices?

ERIC Educational Resources Information Center

Brunetti, Irene; Corsini, Lorenzo

2017-01-01

Purpose: The purpose of this paper is to analyse the effect of an Italian training program on the re-employment probability of young unemployed workers. The program consists exclusively of workplace training and is coordinated by employment centers, even if it is fully implemented by firms. Design/Methodology/Approach: The authors develop a…

A Collaborative Capstone to Develop a Mobile Hospital Clinic Application through a Student Team Competition

ERIC Educational Resources Information Center

Wong, Wilson; Pepe, James; Stahl, James; Englander, Irv

2013-01-01

A new collaborative capstone model is presented that consists of three synergistic elements: (1) a capstone course component; (2) a business component; and (3) an advanced technical course component geared towards enhancing the student capstone learning experience. The model was fully implemented at Bentley University in spring 2012 with…

Elements of a modern turbomachinery design system

NASA Astrophysics Data System (ADS)

Jennions, Ian K.

1994-05-01

The aerodynamic design system at GE Aircraft Engines (GEAE) consists of many parts: throughflow, secondary flow, geometry generators, blade-to-blade and fully three-dimensional (3D) analysis. This paper describes each of these elements and discusses optimization and computer architecture issues. Emphasis is placed on those areas in which the company is thought to have special capability.

40 CFR 93.113 - Criteria and procedures: Timely implementation of TCMs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... funding source(s) needed to fully implement each TCM indicates that TCMs which are eligible for funding... implementation plan which are eligible for funding under title 23 U.S.C. or the Federal Transit Laws, consistent... approvals or funding for TCMs are giving maximum priority to approval or funding of TCMs over other projects...

Tier 2 Interventions in Positive Behavior Support: A Survey of School Implementation

ERIC Educational Resources Information Center

Rodriguez, Billie Jo; Loman, Sheldon L.; Borgmeier, Christopher

2016-01-01

As increasing numbers of schools implement Multi-Tiered Systems of Support (MTSS), schools are looking for and implementing evidence-based practices for students whose needs are not fully met by Tier 1 supports. Although there is relative consistency and clarity in what constitutes Tier 1 behavior support within MTSS, Tier 2 supports may be more…

Religiousness and Infidelity: Attendance, but not Faith and Prayer, Predict Marital Fidelity

ERIC Educational Resources Information Center

Atkins, David C.; Kessel, Deborah E.

2008-01-01

High religiousness has been consistently linked with a decreased likelihood of past infidelity but has been solely defined by religious service attendance, a limited assessment of a complex facet of life. The current study developed nine religiousness subscales using items from the 1998 General Social Survey to more fully explore the association…

Attenuating the mortality risk of high serum uric acid: the role of physical activity underused.

PubMed

Chen, Jiunn-Horng; Wen, Chi Pang; Wu, Shiuan Bei; Lan, Joung-Liang; Tsai, Min Kuang; Tai, Ya-Ping; Lee, June Han; Hsu, Chih Cheng; Tsao, Chwen Keng; Wai, Jackson Pui Man; Chiang, Po Huang; Pan, Wen Han; Hsiung, Chao Agnes

2015-11-01

High serum uric acid (sUA) has been associated with increased mortality risks, but its clinical treatment varied with potential side effects. The role of physical activity has received limited attention. A cohort, consisting of 467 976 adults, who went through a standard health screening programme, with questionnaire and fasting blood samples, was successively recruited between 1996 and 2008. High sUA is defined as uric acid above 7.0 mg/dL. Leisure time physical activity level was self-reported, with fully active defined as those with 30 min per day for at least 5 days a week. National death file identified 12 228 deaths with a median follow-up of 8.5 years. Cox proportional model was used to analyse HRs, and 12 variables were controlled, including medical history, life style and risk factors. High sUA constituted one quarter of the cohort (25.6%). Their all-cause mortality was significantly increased [HR: 1.22 (1.15-1.29)], with much of the increase contributed to by the inactive (HR: 1.27 (1.17-1.37)), relative to the reference group with sUA level of 5-6 mg/dL. When they were fully active, mortality risks did not increase, but decreased by 11% (HR: 0.89 (0.82-0.97)), reflecting the benefits of being active was able to overcome the adverse effects of high sUA. Given the same high sUA, a 4-6 years difference in life expectancy was found between the active and the inactive. Physical activity is a valuable alternative to pharmacotherapy in its ability to reduce the increases in mortality risks from high sUA. By being fully active, exercise can extend life span by 4-6 years, a level greater than the 1-4 years of life-shortening effect from high sUA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevention of gross setup errors in radiotherapy with an efficient automatic patient safety system.

PubMed

Yan, Guanghua; Mittauer, Kathryn; Huang, Yin; Lu, Bo; Liu, Chihray; Li, Jonathan G

2013-11-04

Treatment of the wrong body part due to incorrect setup is among the leading types of errors in radiotherapy. The purpose of this paper is to report an efficient automatic patient safety system (PSS) to prevent gross setup errors. The system consists of a pair of charge-coupled device (CCD) cameras mounted in treatment room, a single infrared reflective marker (IRRM) affixed on patient or immobilization device, and a set of in-house developed software. Patients are CT scanned with a CT BB placed over their surface close to intended treatment site. Coordinates of the CT BB relative to treatment isocenter are used as reference for tracking. The CT BB is replaced with an IRRM before treatment starts. PSS evaluates setup accuracy by comparing real-time IRRM position with reference position. To automate system workflow, PSS synchronizes with the record-and-verify (R&V) system in real time and automatically loads in reference data for patient under treatment. Special IRRMs, which can permanently stick to patient face mask or body mold throughout the course of treatment, were designed to minimize therapist's workload. Accuracy of the system was examined on an anthropomorphic phantom with a designed end-to-end test. Its performance was also evaluated on head and neck as well as abdominalpelvic patients using cone-beam CT (CBCT) as standard. The PSS system achieved a seamless clinic workflow by synchronizing with the R&V system. By permanently mounting specially designed IRRMs on patient immobilization devices, therapist intervention is eliminated or minimized. Overall results showed that the PSS system has sufficient accuracy to catch gross setup errors greater than 1 cm in real time. An efficient automatic PSS with sufficient accuracy has been developed to prevent gross setup errors in radiotherapy. The system can be applied to all treatment sites for independent positioning verification. It can be an ideal complement to complex image-guidance systems due to its advantages of continuous tracking ability, no radiation dose, and fully automated clinic workflow.

Serelaxin as a novel therapeutic opposing fibrosis and contraction in lung diseases.

PubMed

Lam, Maggie; Royce, Simon G; Samuel, Chrishan S; Bourke, Jane E

2018-07-01

The most common therapies for asthma and other chronic lung diseases are anti-inflammatory agents and bronchodilators. While these drugs oppose disease symptoms, they do not reverse established structural changes in the airways and their therapeutic efficacy is reduced with increasing disease severity. The peptide hormone, relaxin, is a Relaxin Family Peptide Receptor 1 (RXFP1) receptor agonist with unique combined effects in the lung that differentiates it from these existing therapies. Relaxin has previously been reported to have cardioprotective effects in acute heart failure as well anti-fibrotic actions in several organs. This review focuses on recent experimental evidence of the beneficial effects of chronic relaxin treatment in animal models of airways disease demonstrating inhibition of airway hyperresponsiveness and reversal of established fibrosis, consistent with potential therapeutic benefit. Of particular interest, accumulating evidence demonstrates that relaxin can also acutely oppose contraction by reducing the release of mast cell-derived bronchoconstrictors and by directly eliciting bronchodilation. When used in combination, chronic and acute treatment with relaxin has been shown to enhance responsiveness to both glucocorticoids and β 2 -adrenoceptor agonists respectively. While the mechanisms underlying these beneficial actions remain to be fully elucidated, translation of these promising combined preclinical findings is critical in the development of relaxin as a novel alternative or adjunct therapeutic opposing multiple aspects of airway pathology in lung diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

Peroxisome proliferator-activated receptor β/δ (PPARβ/δ) activates promyogenic signaling pathways, thereby promoting myoblast differentiation

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

Lee, Sang-Jin; Go, Ga-Yeon; Yoo, Miran

Peroxisome proliferator-activated receptor β/δ (PPARβ/δ) regulates postnatal myogenesis by alleviating myostatin activity, but the molecular mechanisms by which it regulates myogenesis are not fully understood. In this study, we investigate molecular mechanisms of PPARβ/δ in myoblast differentiation. C2C12 myoblasts treated with a PPARβ/δ agonist, GW0742 exhibit enhanced myotube formation and muscle-specific gene expression. GW0742 treatment dramatically activates promyogenic kinases, p38MAPK and Akt, in a dose-dependent manner. GW0742-stimulated myoblast differentiation is mediated by p38MAPK and Akt, since it failed to restore myoblast differentiation repressed by inhibition of p38MAPK and Akt. In addition, GW0742 treatment enhances MyoD-reporter activities. Consistently, overexpression of PPARβ/δmore » enhances myoblast differentiation accompanied by elevated activation of p38MAPK and Akt. Collectively, these results suggest that PPARβ/δ enhances myoblast differentiation through activation of promyogenic signaling pathways. - Highlights: • A PPARβ/δ agonist, GW0742 promotes myoblast differentiation. • GW0742 activates both p38MAPK and Akt activation in myogenic differentiation. • GW0742 enhances MyoD activity for myogenic differentiation. • Overexpression of PPARβ/δ enhances myoblast differentiation via activating promyogenic signaling pathways. • This is the first finding for agonistic mechanism of PPARβ/δ in myogenesis.« less

Does Plant Biomass Manipulation in Static Chambers Affect Nitrous Oxide Emissions from Soils?

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

Collier, Sarah M.; Dean, Andrew P.; Oates, Lawrence G.

One of the most widespread approaches for measurement of greenhouse gas emissions from soils involves the use of static chambers. This method is relatively inexpensive, is easily replicated, and is ideally suited to plot-based experimental systems. Among its limitations is the loss of detection sensitivity with increasing chamber height, which creates challenges for deployment in systems including tall vegetation. It is not always possible to avoid inclusion of plants within chambers or to extend chamber height to fully accommodate plant growth. Thus, in many systems, such as perennial forages and biomass crops, plants growing within static chambers must either bemore » trimmed or folded during lid closure. Currently, data on how different types of biomass manipulation affect measured results is limited. For this study, we compare the effects of cutting vs. folding of biomass on nitrous oxide measurements in switchgrass (Panicum virgatum L.) and alfalfa (Medicago sativa L.) systems. We report only limited evidence of treatment effects during discrete sampling events and little basis for concern that effects may intensify over time as biomass manipulation is repeatedly imposed. However, nonsignificant treatment effects that were consistently present amounted to significant overall trends in three out of the four systems studied. Such minor disparities in flux could amount to considerable quantities over time, suggesting that caution should be exercised when comparing cumulative emission values from studies using different biomass manipulation strategies.« less

Nutritional Interventions for Cancer-induced Cachexia

PubMed Central

Gullett, Norleena P.; Mazurak, Vera; Hebbar, Gautam; Ziegler, Thomas R.

2011-01-01

Cancer-induced cachexia remains a significant cause of morbidity and mortality in cancer treatment. Cancer research and development continues at an aggressive pace and yet a degree of cancer-induced cachexia is experienced by up to 80% of advanced stage cancer patients. Unfortunately, there are no established treatment regimens for this condition. Weight loss and fatigue consistently appear in patient oncologic histories and progress notes. However, few oncologists fully understand the pathologic mechanisms causing cachexia resulting in well-meaning advice to increase caloric intake with minimal results. Our goal is to describe the pathologic basis of cancer-induced cachexia and to detail accompanying metabolic derangements. Understanding the causes of cachexia sheds light on the subsequent need for multi-modality therapy including clinical intervention with specialized nutrition support, drug therapy, lifestyle and diet changes. In addition to nutrition support modalities, practicing oncologists may prescribe medical therapies designed to increase body weight and lean body mass, including megestrol acetate, tetrahydrocannibinol, oxandrolone, and non-steroidal anti-inflammatory drugs. A variety of experimental therapies are also being investigated for cancer-induced cachexia including tumor necrosis factor-alpha inhibitors and ghrelin infusions. We review the available data to support nutrition-oriented interventions in cancer-induced cachexia, including omega-3 fatty acids, amino-acid loading/protein supplementation, parenteral and enteral nutrition support, and food-derived compounds such as curcumin, reservatrol, and pomegranate. PMID:21420558

Does Plant Biomass Manipulation in Static Chambers Affect Nitrous Oxide Emissions from Soils?

DOE PAGES

Collier, Sarah M.; Dean, Andrew P.; Oates, Lawrence G.; ...

2016-01-22

One of the most widespread approaches for measurement of greenhouse gas emissions from soils involves the use of static chambers. This method is relatively inexpensive, is easily replicated, and is ideally suited to plot-based experimental systems. Among its limitations is the loss of detection sensitivity with increasing chamber height, which creates challenges for deployment in systems including tall vegetation. It is not always possible to avoid inclusion of plants within chambers or to extend chamber height to fully accommodate plant growth. Thus, in many systems, such as perennial forages and biomass crops, plants growing within static chambers must either bemore » trimmed or folded during lid closure. Currently, data on how different types of biomass manipulation affect measured results is limited. For this study, we compare the effects of cutting vs. folding of biomass on nitrous oxide measurements in switchgrass (Panicum virgatum L.) and alfalfa (Medicago sativa L.) systems. We report only limited evidence of treatment effects during discrete sampling events and little basis for concern that effects may intensify over time as biomass manipulation is repeatedly imposed. However, nonsignificant treatment effects that were consistently present amounted to significant overall trends in three out of the four systems studied. Such minor disparities in flux could amount to considerable quantities over time, suggesting that caution should be exercised when comparing cumulative emission values from studies using different biomass manipulation strategies.« less

Role of microstructure in caustic stress corrosion cracking of Alloy 690

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

Mertz, D.A.; Duda, P.T.; Pica, P.N.

1995-12-31

Alloy 690 has been selected for nuclear heat transport system tubing application in recent commercial reactor plants due to its resistance to multiple types of corrosion attack. Typical corn final heat treatments for this material are a mill-anneal (MA, approximately 1,070 C) to completely dissolve the carbides and develop the final grain structure plus a thermal treatment (TT, approximately 700 C) to precipitate carbides at the grain boundaries. Tubing with grain boundary carbides and no or few intragranular carbides has been found resistant to intergranular stress corrosion cracking (IGSCC) in caustic environments. In this work, first, Alloy 690 plate wasmore » subjected to a variety of MA and MA-TT heat treatments to create microstructures of carbide-decorated grain boundaries and undecorated boundaries. Caustic IGSCC test results were consistent with tubing data. Second, experiments were conducted to understand the mechanism by which caustic-corrosion resistance is imparted to Alloy 690 by grain boundary carbides. Tubing with a fully-developed MA-TT carbide microstructure was strained and heat-treated to create a mixed microstructure of new grain boundaries with no carbide precipitate decoration, intermixed with intragranular carbide strings from prior grain boundaries. Caustic SCC performance of this material was identical to that of material with the MA-TT carbide-decorated grain boundaries. This work suggests that the fundamental cause of good IGSCC resistance of MA-TT Alloy 690 in caustic does not derive solely from grain boundary carbides. It is suggested that matrix strength, as measured by yield stress, could be a controlling factor.« less

Establishing conditions for simulating hydrophobic solutes in electric fields by molecular dynamics: effects of the long-range van der Waals treatment on the apparent particle mobility.

PubMed

Miličević, Zoran; Marrink, Siewert J; Smith, Ana-Sunčana; Smith, David M

2014-08-01

Despite considerable effort over the last decade, the interactions between solutes and solvents in the presence of electric fields have not yet been fully understood. A very useful manner in which to study these systems is through the application of molecular dynamics (MD) simulations. However, a number of MD studies have shown a tremendous sensitivity of the migration rate of a hydrophobic solute to the treatment of the long range part of the van der Waals interactions. While the origin of this sensitivity was never explained, the mobility is currently regarded as an artifact of an improper simulation setup. We explain the spread in observed mobilites by performing extensive molecular dynamics simulations using the GROMACS software package on a system consisting of a model hydrophobic object (Lennard-Jones particle) immersed in water both in the presence and absence of a static electric field. We retrieve a unidirectional field-induced mobility of the hydrophobic object when the forces are simply truncated. Careful analysis of the data shows that, only in the specific case of truncated forces, a non-zero van der Waals force acts, on average, on the Lennard-Jones particle. Using the Stokes law we demonstrate that this force yields quantitative agreement with the field-induced mobility found within this setup. In contrast, when the treatment of forces is continuous, no net force is observed. In this manner, we provide a simple explanation for the previously controversial reports.

Antibody-based targeted delivery of interleukin-4 synergizes with dexamethasone for the reduction of inflammation in arthritis.

PubMed

Schmid, Anja Sophie; Hemmerle, Teresa; Pretto, Francesca; Kipar, Anja; Neri, Dario

2018-04-01

We have previously reported that F8-IL4, a fusion protein consisting of the F8 antibody specific to the alternatively-spliced extra domain A of fibronectin and of murine IL-4, cures mice with established arthritis, when used in combination with dexamethasone (DXM). The goal of this study was to assess whether other therapeutic agents, besides DXM, could induce cures in combination with F8-IL4 and to elucidate which leucocytes are most affected by the pharmacological treatment. We performed therapy experiments in mice with CIA, using intravenous administrations of F8-IL4 in combination with DXM, MTX, murine cytotoxic T-lymphocyte-associated protein 4 fused to the fragment crystallizable portion of murine IgG2a, as well as mAbs to murine IL17A or the p40 subunit of murine IL12/IL23. Histology and immunohistochemistry for the identification of the various leucocytes were performed on the paws of mice euthanized at different therapy time points. Only the use of F8-IL4 in combination with DXM induced complete remissions, while all other combinations did not lead to cures. The light microscopical evaluation of paws with arthritis revealed a predominant infiltration of neutrophils, which substantially decreased 24 h after treatment with F8-IL4 and DXM. The combination of F8-IL4 with DXM promotes a rapid anti-arthritic action by potently inhibiting neutrophil activity. A fully human analogue of F8-IL4 may find clinical utility for the treatment of neutrophil-driven chronic inflammatory conditions.

A high-performance protocol for extraction of microplastics in fish.

PubMed

Karami, Ali; Golieskardi, Abolfazl; Choo, Cheng Keong; Romano, Nicholas; Ho, Yu Bin; Salamatinia, Babak

2017-02-01

So far, several classes of digesting solutions have been employed to extract microplastics (MPs) from biological matrices. However, the performance of digesting solutions across different temperatures has never been systematically investigated. In the first phase of the present study, we measured the efficiency of different oxidative agents (NaClO or H 2 O 2 ), bases (NaOH or KOH), and acids [HCl or HNO 3 ; concentrated and diluted (5%)] in digesting fish tissues at room temperature (RT, 25°C), 40, 50, or 60°C. In the second phase, the treatments that were efficient in digesting the biological materials (>95%) were evaluated for their compatibility with eight major plastic polymers (assessed through recovery rate, Raman spectroscopy analysis, and morphological changes). Among the tested solutions, NaClO, NaOH, and diluted acids did not result in a satisfactory digestion efficiency at any of the temperatures. The H 2 O 2 treatment at 50°C efficiently digested the biological materials, although it decreased the recovery rate of nylon-6 (NY6) and nylon-66 (NY66) and altered the colour of polyethylene terephthalate (PET) fragments. Similarly, concentrated HCl and HNO 3 treatments at RT fully digested the fish tissues, but also fully dissolved NY6 and NY66, and reduced the recovery rate of most or all of the polymers, respectively. Potassium hydroxide solution fully eliminated the biological matrices at all temperatures. However, at 50 and 60°C, it degraded PET, reduced the recovery rate of PET and polyvinyl chloride (PVC), and changed the colour of NY66. According to our results, treating biological materials with a 10% KOH solution and incubating at 40°C was both time and cost-effective, efficient in digesting biological materials, and had no impact on the integrity of the plastic polymers. Furthermore, coupling this treatment with NaI extraction created a promising protocol to isolate MPs from whole fish samples. Copyright © 2016 Elsevier B.V. All rights reserved.

Optimization and validation of a fully automated silica-coated magnetic beads purification technology in forensics.

PubMed

Nagy, M; Otremba, P; Krüger, C; Bergner-Greiner, S; Anders, P; Henske, B; Prinz, M; Roewer, L

2005-08-11

Automated procedures for forensic DNA analyses are essential not only for large-throughput sample preparation, but are also needed to avoid errors during routine sample preparation. The most critical stage in PCR-based forensic analysis is DNA isolation, which should yield as much highly purified DNA as possible. The extraction method used consists of pre-treatment of stains and samples, cell lysis using chaotropic reagents, binding of the DNA to silica-coated magnetic particles, followed by elution of the DNA. Our work focuses mainly on sample preparation, obtaining the maximum possible amount of biological material from forensic samples, and the following cell lysis, to create a simple standardized lysis protocol suitable for nearly all forensic material. After optimization and validation, the M-48 BioRobot((R)) workstation has been used for more than 20,000 routine lab samples. There has been no evidence of cross contamination. Resulting DNA from as small as three nuclear cells yield reliable complete STR amplification profiles. The DNA remains stable after 2 years of storage.

Rapid analytical procedure for determination of mineral oils in edible oil by GC-FID.

PubMed

Wrona, Magdalena; Pezo, Davinson; Nerin, Cristina

2013-12-15

A procedure for the determination of mineral oils in edible oil has been fully developed. The procedure consists of using a sulphuric acid-impregnated silica gel (SAISG) glass column to eliminate the fat matter. A chemical combustion of the fatty acids takes place, while the mineral oils are not affected by the sulphuric acid. The column is eluted with hexane using a vacuum pump and the final extract is concentrated and analysed by gas chromatography (GC) with flame ionisation detector (FID). The detection limit (LOD) and the quantification limit (LOQ) in hexane were 0.07 and 0.21 μg g(-1) respectively and the LOQ in vegetable oil was 1 μg g(-1). Only a few minutes were necessary for sample treatment to have a clean extract. The efficiency of the process, measured through the recoveries from spiked samples of edible oil was higher than 95%. The procedure has been applied to determine mineral oil in olive oil from the retailed market. Copyright © 2013 Elsevier Ltd. All rights reserved.

Phase equilibria in polymer-blend thin films

NASA Astrophysics Data System (ADS)

Clarke, Nigel; Souche, Mireille

2010-03-01

To describe equilibrium concentration profiles in thin films of polymer mixtures, we propose a Hamiltonian formulation of the Flory-Huggins-de Gennes theory describing a polymer blend thin film. We first focus on the case of 50:50 polymer blends confined between anti-symmetric walls. The different phases of the system and the transitions between them, including finite size effects, are systematically studied through their relation with the geometry of the Hamiltonian flow in phase space. This method provides an easy and efficient way, with strong graphical insight, to infer the qualitative physical behavior of polymer blend thin films. The addition of a further degree of freedom in the system, namely a solvent, may result in a chaotic behavior of the system, characterized by the existence of solutions with exponential sensitivity to initial conditions. Such solutions and there subsequent contribution to the out-of-equilibrium dynamics of the system are well described in Hamiltonian formalism. A fully consistent treatment of the Flory-Huggins-de Gennes theory of thin film polymer blend solutions, in the spirit of the Hamiltonian approach will be presented. 1. M. Souche and N. Clarke, J. Chem. Phys., submitted.

A truncated Wnt7a retains full biological activity in skeletal muscle

NASA Astrophysics Data System (ADS)

von Maltzahn, Julia; Zinoviev, Radoslav; Chang, Natasha C.; Bentzinger, C. Florian; Rudnicki, Michael A.

2013-11-01

Wnt signaling has essential roles during embryonic development and tissue homoeostasis. Wnt proteins are post-translationally modified and the attachment of a palmitate moiety at two conserved residues is believed to be a prerequisite for the secretion and function of Wnt proteins. Here we demonstrate that a mammalian Wnt protein can be fully functional without palmitoylation. We generate a truncated Wnt7a variant, consisting of the C-terminal 137 amino acids lacking the conserved palmitoylation sites and show that it retains full biological activity in skeletal muscle. This includes binding to and signaling through its receptor Fzd7 to stimulate symmetric expansion of satellite stem cells by activating the planar-cell polarity pathway and inducing myofibre hypertrophy by signaling through the AKT/mTOR pathway. Furthermore, this truncated Wnt7a shows enhanced secretion and dispersion compared with the full-length protein. Together, these findings open important new avenues for the development of Wnt7a as a treatment for muscle-wasting diseases and have broad implications for the therapeutic use of Wnts as biologics.

A Review of Alprazolam Use, Misuse, and Withdrawal

PubMed Central

Ait-Daoud, Nassima; Hamby, Allan Scott; Sharma, Sana; Blevins, Derek

2018-01-01

Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its “abuse liability,” yet it is one of the most frequently prescribed benzodiazepines. “Abuse liability” is the degree to which a psychoactive drug has properties that facilitate people misusing it, or becoming addicted to it, and is commonly used in the literature. We have replaced it in our manuscript with “misuse liability” as it reflects a more updated terminology consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this paper, we have reviewed alprazolam’s indications for use, its effect on pregnant women, misuse liability, withdrawal syndrome, pharmacodynamic properties, and suggest better clinical prescription practice of alprazolam by presenting an indepth theory of its clinical effects with use and withdrawal. PMID:28777203

The role of the non-collagenous matrix in tendon function.

PubMed

Thorpe, Chavaunne T; Birch, Helen L; Clegg, Peter D; Screen, Hazel R C

2013-08-01

Tendon consists of highly ordered type I collagen molecules that are grouped together to form subunits of increasing diameter. At each hierarchical level, the type I collagen is interspersed with a predominantly non-collagenous matrix (NCM) (Connect. Tissue Res., 6, 1978, 11). Whilst many studies have investigated the structure, organization and function of the collagenous matrix within tendon, relatively few have studied the non-collagenous components. However, there is a growing body of research suggesting the NCM plays an important role within tendon; adaptations to this matrix may confer the specific properties required by tendons with different functions. Furthermore, age-related alterations to non-collagenous proteins have been identified, which may affect tendon resistance to injury. This review focuses on the NCM within the tensional region of developing and mature tendon, discussing the current knowledge and identifying areas that require further study to fully understand structure-function relationships within tendon. This information will aid in the development of appropriate techniques for tendon injury prevention and treatment. © 2013 The Authors. International Journal of Experimental Pathology © 2013 International Journal of Experimental Pathology.

Status of MAPA (Modular Accelerator Physics Analysis) and the Tech-X Object-Oriented Accelerator Library

NASA Astrophysics Data System (ADS)

Cary, J. R.; Shasharina, S.; Bruhwiler, D. L.

1998-04-01

The MAPA code is a fully interactive accelerator modeling and design tool consisting of a GUI and two object-oriented C++ libraries: a general library suitable for treatment of any dynamical system, and an accelerator library including many element types plus an accelerator class. The accelerator library inherits directly from the system library, which uses hash tables to store any relevant parameters or strings. The GUI can access these hash tables in a general way, allowing the user to invoke a window displaying all relevant parameters for a particular element type or for the accelerator class, with the option to change those parameters. The system library can advance an arbitrary number of dynamical variables through an arbitrary mapping. The accelerator class inherits this capability and overloads the relevant functions to advance the phase space variables of a charged particle through a string of elements. Among other things, the GUI makes phase space plots and finds fixed points of the map. We discuss the object hierarchy of the two libraries and use of the code.

Beliefs and attitudes about endemic dental fluorosis among adolescents in rural Brazil.

PubMed

Castilho, Lia Silva de; Ferreira, Efigênia Ferreira E; Velásquez, Leila Nunes Menegasse; Fantinel, Lucia Maria; Perini, Edson

2010-04-01

OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.

Inhibition of Cell Survival by Curcumin Is Associated with Downregulation of Cell Division Cycle 20 (Cdc20) in Pancreatic Cancer Cells

PubMed Central

Zhang, Yu; Xue, Ying-bo; Li, Hang; Qiu, Dong; Wang, Zhi-wei; Tan, Shi-sheng

2017-01-01

Pancreatic cancer is one of the most aggressive human tumors in the United States. Curcumin, a polyphenol derived from the Curcuma longa plant, has been reported to exert its antitumor activity in pancreatic cancer. However, the molecular mechanisms of curcumin-mediated tumor suppressive function have not been fully elucidated. In the current study, we explore whether curcumin exhibits its anti-cancer function through inhibition of oncoprotein cell division cycle 20 (Cdc20) in pancreatic cancer cells. We found that curcumin inhibited cell growth, enhanced apoptosis, induced cell cycle arrest and retarded cell invasion in pancreatic cancer cells. Moreover, we observed that curcumin significantly inhibited the expression of Cdc20 in pancreatic cancer cells. Furthermore, our results demonstrated that overexpression of Cdc20 enhanced cell proliferation and invasion, and abrogated the cytotoxic effects induced by curcumin in pancreatic cancer cells. Consistently, downregulation of Cdc20 promoted curcumin-mediated anti-tumor activity. Therefore, our findings indicated that inhibition of Cdc20 by curcumin could be useful for the treatment of pancreatic cancer patients. PMID:28165402

Methylene blue induces macroautophagy through 5′ adenosine monophosphate-activated protein kinase pathway to protect neurons from serum deprivation

PubMed Central

Xie, Luokun; Li, Wenjun; Winters, Ali; Yuan, Fang; Jin, Kunlin; Yang, Shaohua

2013-01-01

Methylene blue has been shown to be neuroprotective in multiple experimental neurodegenerative disease models. However, the mechanisms underlying the neuroprotective effects have not been fully elucidated. Previous studies have shown that macroautophagy has multiple beneficial roles for maintaining normal cellular homeostasis and that induction of macroautophagy after myocardial ischemia is protective. In the present study we demonstrated that methylene blue could protect HT22 hippocampal cell death induced by serum deprivation, companied by induction of macroautophagy. We also found that methylene blue-mediated neuroprotection was abolished by macroautophagy inhibition. Interestingly, 5′ adenosine monophosphate-activated protein kinase (AMPK) signaling, but not inhibition of mammalian target of rapamycin signaling, was activated at 12 and 24 h after methylene blue treatment in a dose-dependent manner. Methylene blue-induced macroautophagy was blocked by AMPK inhibitor. Consistent with in vitro data, macroautophagy was induced in the cortex and hippocampus of mouse brains treated with methylene blue. Our findings suggest that methylene blue-induced neuroprotection is mediated, at least in part, by macroautophagy though activation of AMPK signaling. PMID:23653592

Inhibition of Cell Survival by Curcumin Is Associated with Downregulation of Cell Division Cycle 20 (Cdc20) in Pancreatic Cancer Cells.

PubMed

Zhang, Yu; Xue, Ying-Bo; Li, Hang; Qiu, Dong; Wang, Zhi-Wei; Tan, Shi-Sheng

2017-02-04

Pancreatic cancer is one of the most aggressive human tumors in the United States. Curcumin, a polyphenol derived from the Curcuma longa plant, has been reported to exert its antitumor activity in pancreatic cancer. However, the molecular mechanisms of curcumin-mediated tumor suppressive function have not been fully elucidated. In the current study, we explore whether curcumin exhibits its anti-cancer function through inhibition of oncoprotein cell division cycle 20 (Cdc20) in pancreatic cancer cells. We found that curcumin inhibited cell growth, enhanced apoptosis, induced cell cycle arrest and retarded cell invasion in pancreatic cancer cells. Moreover, we observed that curcumin significantly inhibited the expression of Cdc20 in pancreatic cancer cells. Furthermore, our results demonstrated that overexpression of Cdc20 enhanced cell proliferation and invasion, and abrogated the cytotoxic effects induced by curcumin in pancreatic cancer cells. Consistently, downregulation of Cdc20 promoted curcumin-mediated anti-tumor activity. Therefore, our findings indicated that inhibition of Cdc20 by curcumin could be useful for the treatment of pancreatic cancer patients.

The child in hospital*

PubMed Central

1955-01-01

In 1951 the WHO Regional Office for Europe as a part of its long-term activities in child health initiated plans for a meeting between paediatricians and child psychiatrists, at which they could discuss their respective roles and the co-ordination of their work. Early in 1953 an ad hoc committee was called together to discuss the possibility of holding a conference which would delineate the role of the paediatrician in the management of psychosomatic and behaviour disorders in young children. This committee, consisting of leading specialists in paediatrics and child psychiatry, under the chairmanship of Professor R. Debré (France), felt that any wider conference should be devoted to considering more fully the inter-relation of somatic and psychological processes in sick children, the respective roles of paediatricians and child psychiatrists in their treatment, and the working relations between the different disciplines responsible for the care of children. In order to avoid diffusion of effort, and to arrive as far as possible at practical conclusions, the study group that was subsequently convened in Stockholm concentrated on one important aspect of child care—the child in hospital. PMID:14364192

Progress towards biocompatible intracortical microelectrodes for neural interfacing applications

NASA Astrophysics Data System (ADS)

Jorfi, Mehdi; Skousen, John L.; Weder, Christoph; Capadona, Jeffrey R.

2015-02-01

To ensure long-term consistent neural recordings, next-generation intracortical microelectrodes are being developed with an increased emphasis on reducing the neuro-inflammatory response. The increased emphasis stems from the improved understanding of the multifaceted role that inflammation may play in disrupting both biologic and abiologic components of the overall neural interface circuit. To combat neuro-inflammation and improve recording quality, the field is actively progressing from traditional inorganic materials towards approaches that either minimizes the microelectrode footprint or that incorporate compliant materials, bioactive molecules, conducting polymers or nanomaterials. However, the immune-privileged cortical tissue introduces an added complexity compared to other biomedical applications that remains to be fully understood. This review provides a comprehensive reflection on the current understanding of the key failure modes that may impact intracortical microelectrode performance. In addition, a detailed overview of the current status of various materials-based approaches that have gained interest for neural interfacing applications is presented, and key challenges that remain to be overcome are discussed. Finally, we present our vision on the future directions of materials-based treatments to improve intracortical microelectrodes for neural interfacing.

Progress Towards Biocompatible Intracortical Microelectrodes for Neural Interfacing Applications

PubMed Central

Jorfi, Mehdi; Skousen, John L.; Weder, Christoph; Capadona, Jeffrey R.

2015-01-01

To ensure long-term consistent neural recordings, next-generation intracortical microelectrodes are being developed with an increased emphasis on reducing the neuro-inflammatory response. The increased emphasis stems from the improved understanding of the multifaceted role that inflammation may play in disrupting both biologic and abiologic components of the overall neural interface circuit. To combat neuro-inflammation and improve recording quality, the field is actively progressing from traditional inorganic materials towards approaches that either minimizes the microelectrode footprint or that incorporate compliant materials, bioactive molecules, conducting polymers or nanomaterials. However, the immune-privileged cortical tissue introduces an added complexity compared to other biomedical applications that remains to be fully understood. This review provides a comprehensive reflection on the current understanding of the key failure modes that may impact intracortical microelectrode performance. In addition, a detailed overview of the current status of various materials-based approaches that have gained interest for neural interfacing applications is presented, and key challenges that remain to be overcome are discussed. Finally, we present our vision on the future directions of materials-based treatments to improve intracortical microelectrodes for neural interfacing. PMID:25460808

Methylene blue induces macroautophagy through 5' adenosine monophosphate-activated protein kinase pathway to protect neurons from serum deprivation.

PubMed

Xie, Luokun; Li, Wenjun; Winters, Ali; Yuan, Fang; Jin, Kunlin; Yang, Shaohua

2013-01-01

Methylene blue has been shown to be neuroprotective in multiple experimental neurodegenerative disease models. However, the mechanisms underlying the neuroprotective effects have not been fully elucidated. Previous studies have shown that macroautophagy has multiple beneficial roles for maintaining normal cellular homeostasis and that induction of macroautophagy after myocardial ischemia is protective. In the present study we demonstrated that methylene blue could protect HT22 hippocampal cell death induced by serum deprivation, companied by induction of macroautophagy. We also found that methylene blue-mediated neuroprotection was abolished by macroautophagy inhibition. Interestingly, 5' adenosine monophosphate-activated protein kinase (AMPK) signaling, but not inhibition of mammalian target of rapamycin signaling, was activated at 12 and 24 h after methylene blue treatment in a dose-dependent manner. Methylene blue-induced macroautophagy was blocked by AMPK inhibitor. Consistent with in vitro data, macroautophagy was induced in the cortex and hippocampus of mouse brains treated with methylene blue. Our findings suggest that methylene blue-induced neuroprotection is mediated, at least in part, by macroautophagy though activation of AMPK signaling.

Fibroblast growth factor 21 corrects obesity in mice.

PubMed

Coskun, Tamer; Bina, Holly A; Schneider, Michael A; Dunbar, James D; Hu, Charlie C; Chen, Yanyun; Moller, David E; Kharitonenkov, Alexei

2008-12-01

Fibroblast growth factor 21 (FGF21) is a metabolic regulator that provides efficient and durable glycemic and lipid control in various animal models. However, its potential to treat obesity, a major health concern affecting over 30% of the population, has not been fully explored. Here we report that systemic administration of FGF21 for 2 wk in diet-induced obese and ob/ob mice lowered their mean body weight by 20% predominantly via a reduction in adiposity. Although no decrease in total caloric intake or effect on physical activity was observed, FGF21-treated animals exhibited increased energy expenditure, fat utilization, and lipid excretion, reduced hepatosteatosis, and ameliorated glycemia. Transcriptional and blood cytokine profiling studies revealed effects consistent with the ability of FGF21 to ameliorate insulin and leptin resistance, enhance fat oxidation and suppress de novo lipogenesis in liver as well as to activate futile cycling in adipose. Overall, these data suggest that FGF21 exhibits the therapeutic characteristics necessary for an effective treatment of obesity and fatty liver disease and provides novel insights into the metabolic determinants of these activities.

Simulation of dissolved oxygen and biochemical oxygen demand, Plantation Canal, Broward County, Florida with an evaluation of the QUAL-I model for use in south Florida

USGS Publications Warehouse

Russo, Thomas N.; McQuivey, Raul S.

1975-01-01

A mathematical model; QUAL-I, developed by the Texas Water Development Board, was evaluated as a management tool in predicting the spatial and temporal distribution of dissolved oxygen and biochemical oxygen demand in Plantation Canal. Predictions based on the QUAL-I model, which was verified only against midday summer-flow conditions, showed that improvement of quality of inflows from sewage treatment plants and use of at least 130 cubic feet per second of dilution water would improve water quality in the canal significantly. The model was not fully amenable to use on Plantation Canal because: (1) it did not consider photosynthetic production, nitrification, and benthic oxygen demand as sources and sinks of oxygen; (2) the model assumptions of complete mixing, transport, and steady state were not met; and (3) the data base was inadequate because it consisted of only one set of data for each case. However, it was felt that meaningful results could be obtained for some sets of conditions. (Woodard-USGS)

Vibrational self-consistent field theory using optimized curvilinear coordinates.

PubMed

Bulik, Ireneusz W; Frisch, Michael J; Vaccaro, Patrick H

2017-07-28

A vibrational SCF model is presented in which the functions forming the single-mode functions in the product wavefunction are expressed in terms of internal coordinates and the coordinates used for each mode are optimized variationally. This model involves no approximations to the kinetic energy operator and does not require a Taylor-series expansion of the potential. The non-linear optimization of coordinates is found to give much better product wavefunctions than the limited variations considered in most previous applications of SCF methods to vibrational problems. The approach is tested using published potential energy surfaces for water, ammonia, and formaldehyde. Variational flexibility allowed in the current ansätze results in excellent zero-point energies expressed through single-product states and accurate fundamental transition frequencies realized by short configuration-interaction expansions. Fully variational optimization of single-product states for excited vibrational levels also is discussed. The highlighted methodology constitutes an excellent starting point for more sophisticated treatments, as the bulk characteristics of many-mode coupling are accounted for efficiently in terms of compact wavefunctions (as evident from the accurate prediction of transition frequencies).

A system for saccular intracranial aneurysm analysis and virtual stent planning

NASA Astrophysics Data System (ADS)

Baloch, Sajjad; Sudarsky, Sandra; Zhu, Ying; Mohamed, Ashraf; Geiger, Berhard; Dutta, Komal; Namburu, Durga; Nias, Puthenveettil; Martucci, Gary; Redel, Thomas

2012-02-01

Recent studies have found correlation between the risk of rupture of saccular aneurysms and their morphological characteristics, such as volume, surface area, neck length, among others. For reliably exploiting these parameters in endovascular treatment planning, it is crucial that they are accurately quantified. In this paper, we present a novel framework to assist physicians in accurately assessing saccular aneurysms and efficiently planning for endovascular intervention. The approach consists of automatically segmenting the pathological vessel, followed by the construction of its surface representation. The aneurysm is then separated from the vessel surface through a graph-cut based algorithm that is driven by local geometry as well as strong prior information. The corresponding healthy vessel is subsequently reconstructed and measurements representing the patient-specific geometric parameters of pathological vessel are computed. To better support clinical decisions on stenting and device type selection, the placement of virtual stent is eventually carried out in conformity with the shape of the diseased vessel using the patient-specific measurements. We have implemented the proposed methodology as a fully functional system, and extensively tested it with phantom and real datasets.

Non-linear structure formation in the `Running FLRW' cosmological model

NASA Astrophysics Data System (ADS)

Bibiano, Antonio; Croton, Darren J.

2016-07-01

We present a suite of cosmological N-body simulations describing the `Running Friedmann-Lemaïtre-Robertson-Walker' (R-FLRW) cosmological model. This model is based on quantum field theory in a curved space-time and extends Lambda cold dark matter (ΛCDM) with a time-evolving vacuum density, Λ(z), and time-evolving gravitational Newton's coupling, G(z). In this paper, we review the model and introduce the necessary analytical treatment needed to adapt a reference N-body code. Our resulting simulations represent the first realization of the full growth history of structure in the R-FLRW cosmology into the non-linear regime, and our normalization choice makes them fully consistent with the latest cosmic microwave background data. The post-processing data products also allow, for the first time, an analysis of the properties of the halo and sub-halo populations. We explore the degeneracies of many statistical observables and discuss the steps needed to break them. Furthermore, we provide a quantitative description of the deviations of R-FLRW from ΛCDM, which could be readily exploited by future cosmological observations to test and further constrain the model.

Quantum plasmons with optical-range frequencies in doped few-layer graphene

NASA Astrophysics Data System (ADS)

Shirodkar, Sharmila N.; Mattheakis, Marios; Cazeaux, Paul; Narang, Prineha; Soljačić, Marin; Kaxiras, Efthimios

2018-05-01

Although plasmon modes exist in doped graphene, the limited range of doping achieved by gating restricts the plasmon frequencies to a range that does not include the visible and infrared. Here we show, through the use of first-principles calculations, that the high levels of doping achieved by lithium intercalation in bilayer and trilayer graphene shift the plasmon frequencies into the visible range. To obtain physically meaningful results, we introduce a correction of the effect of plasmon interaction across the vacuum separating periodic images of the doped graphene layers, consisting of transparent boundary conditions in the direction perpendicular to the layers; this represents a significant improvement over the exact Coulomb cutoff technique employed in earlier works. The resulting plasmon modes are due to local field effects and the nonlocal response of the material to external electromagnetic fields, requiring a fully quantum mechanical treatment. We describe the features of these quantum plasmons, including the dispersion relation, losses, and field localization. Our findings point to a strategy for fine-tuning the plasmon frequencies in graphene and other two-dimensional materials.

Managing Sports-related Concussions From Time of Injury Through Return to Play.

PubMed

Shirley, Eric; Hudspeth, L Jared; Maynard, Jennifer R

2018-06-01

Sports-related concussions continue to generate widespread interest. A concussion is a complex pathophysiologic process, with or without loss of consciousness, that results in a disturbance of brain function. Risk factors include age <18 years, female sex, and history of a previous concussion. A sideline physical examination with standardized assessment tools can assist diagnosis. Management for suspected concussion begins with immediate removal from play and requires clinical follow-up. Symptoms are usually self-limited and resolve within 2 to 3 weeks. Initial treatment consists of a reduction in cognitive activity and physical rest. A stepwise return-to-play protocol, taking into consideration state laws, with a gradual increase in activity until the athlete is able to perform full activity without symptoms should be followed. Neuropsychologic testing may be used as a tool in management. For prolonged concussion, physical rehabilitation or medications for headaches, mood, or sleep disturbance may be required. Education, rule changes, and equipment improvements may assist in prevention. The long-term consequences of concussions are not fully understood and merit additional research.

Determination of flubendiamide in honey at trace levels by using solid phase extraction and liquid chromatography coupled to quadrupole time-of-flight mass spectrometry.

PubMed

Ares, Ana M; Valverde, Silvia; Bernal, José L; Toribio, Laura; Nozal, María J; Bernal, José

2017-10-01

In this study, a new method has been developed to determine flubendiamide in honey using liquid chromatography coupled to a selective mass spectrometry detector (quadrupole-time-of-flight). An efficient sample treatment involving a solid phase extraction with a C 18 sorbent was proposed (average analyte recoveries were between 94 and 104%). Chromatographic analysis (9min) was performed on a C 18 column (Gemini C 18 , 50×2.0mm, 3µm, 110Å). The mobile phase consisted of water and acetonitrile, with a flow rate of 0.5mL/min in gradient elution mode. The method was fully validated in terms of selectivity, limits of detection and quantification, matrix effect, linearity, trueness and precision. Low limits of detection and quantification were obtained, ranging from 0.1 to 0.2µg/kg and 0.4 to 0.6µg/kg, respectively. The method was applied to analyze flubendiamide in honey from different botanic origins (multifloral, rosemary and heather). Copyright © 2017 Elsevier Ltd. All rights reserved.

Variation in Protein Origin and Utilization: Research and Clinical Application.

PubMed

Paddon-Jones, Douglas; Coss-Bu, Jorge A; Morris, Claudia R; Phillips, Stuart M; Wernerman, Jan

2017-04-01

Muscle health can be rapidly compromised in clinical environments. Modifiable strategies to preserve metabolic homeostasis in adult patient populations include physical activity and pharmacologic support; however, optimizing dietary practices, or more specifically protein intake, is a necessary prerequisite for any other treatment strategy to be fully effective. Simply increasing protein intake is a well-intentioned but often unfocused strategy to protect muscle health in an intensive care setting. Protein quality is a frequently overlooked factor with the potential to differentially influence health outcomes. Quality can be assessed by a variety of techniques, with digestible indispensable amino acid score being the current and most comprehensive technique endorsed by the Food and Agriculture Organization. In practical terms, animal-based proteins are consistently scored higher in quality compared with incomplete proteins, regardless of the assessment method. Consequently, choosing parenteral and/or enteral feeding options that contain high-quality proteins, rich in the branched-chain amino acid leucine, may help establish a dietary framework with the potential to support clinical practice and improve health outcomes in critically ill patients.

Development of a dry, stable and inhalable acyl-homoserine-lactone-acylase powder formulation for the treatment of pulmonary Pseudomonas aeruginosa infections.

PubMed

Wahjudi, Mariana; Murugappan, Senthil; van Merkerk, Ronald; Eissens, Anko C; Visser, Marinella R; Hinrichs, Wouter L J; Quax, Wim J

2013-03-12

In the lungs of cystic fibrosis (CF) patients, Pseudomonas aeruginosa commonly causes chronic infections. It has been shown that the P. aeruginosa quorum sensing (QS) system controls the expression of virulence factors during invasion and infection to host cells. PvdQ is an acyl-homoserine lactone (AHL) acylase able to degrade the signal molecule of P. aeruginosa QS. The role of PvdQ in inhibiting the QS and its successive virulence determinants has been established in in vitro as well as in in vivo, the latter in a Caenorabdhitis elegans model. For the treatment of pulmonary P. aeruginosa infections, we propose that PvdQ can be best administered directly to the lungs of the patients as a dry powder because this is expected to give specific advantages in delivery as compared to nebulizing. Therefore in this study we investigated the production of a PvdQ powder by spray-freeze drying using mannitol, trehalose and inulin as excipient. The activity of PvdQ in the powder was determined immediately after production and after subsequent storage during 4 weeks at 20°C and 55°C. We found that the enzymatic activity of PvdQ is fully maintained during spray-freeze drying using mannitol, trehalose or inulin as excipient. However, mannitol was not able to stabilize the protein during storage, while PvdQ incorporated in trehalose or inulin was fully stabilized even during storage at 55°C for at least 4 weeks. The poor stabilizing capacities of mannitol during storage could be related to its crystalline nature while the excellent stabilizing capacities of trehalose and inulin during storage could be related to their amorphous nature. The trehalose and inulin-based particles consisted of porous spheres with a volume average aerodynamical diameter of ∼1.8 μm implying that they are suitable for pulmonary delivery. This is the first study in which an AHL-degrading enzyme is processed into spray-freeze-dried powder suitable for inhalation. Copyright © 2013 Elsevier B.V. All rights reserved.

Substance abuse treatment for women who are under correctional supervision in the community: a systematic review of qualitative findings.

PubMed

Finfgeld-Connett, Deborah; Johnson, E Diane

2011-01-01

This systematic review was conducted to more fully analyze qualitative research findings relating to community-based court-supervised substance abuse treatment for women and to make recommendations regarding treatment enhancement. Five reports of qualitative research met the inclusion criteria. Findings from these reports were extracted and analyzed using constant comparative methods. Women who are referred to court-sanctioned substance abuse treatment programs may initially be reluctant to participate. Once engaged, however, they advocate for a full complement of well-financed comprehensive services. To optimize treatment effectiveness, women recommend gender-specific programs in which ambivalence is diminished, hope is instilled, and care is individualized.

Predominant antitumor effects by fully human anti-TRAIL-receptor2 (DR5) monoclonal antibodies in human glioma cells in vitro and in vivo

PubMed Central

Nagane, Motoo; Shimizu, Saki; Mori, Eiji; Kataoka, Shiro; Shiokawa, Yoshiaki

2010-01-01

Tumor necrosis factor–related apoptosis-inducing ligand (TRAIL/Apo2 L) preferentially induces apoptosis in human tumor cells through its cognate death receptors DR4 or DR5, thereby being investigated as a potential agent for cancer therapy. Here, we applied fully human anti-human TRAIL receptor monoclonal antibodies (mAbs) to specifically target one of death receptors for TRAIL in human glioma cells, which could also reduce potential TRAIL-induced toxicity in humans. Twelve human glioma cell lines treated with several fully human anti-human TRAIL receptor mAbs were sensitive to only anti-DR5 mAbs, whereas they were totally insensitive to anti-DR4 mAb. Treatment with anti-DR5 mAbs exerted rapid cytotoxicity and lead to apoptosis induction. The cellular sensitivity was closely associated with cell-surface expression of DR5. Expression of c-FLIPL, Akt, and Cyclin D1 significantly correlated with sensitivity to anti-DR5 mAbs. Primary cultures of glioma cells were also relatively resistant to anti-DR5 mAbs, exhibiting both lower DR5 and higher c-FLIPL expression. Downregulation of c-FLIPL expression resulted in the sensitization of human glioma cells to anti-DR5 mAbs, whereas overexpression of c-FLIPL conferred resistance to anti-DR5 mAb. Treatment of tumor-burden nude mice with the direct agonist anti-DR5 mAb KMTR2 significantly suppressed growth of subcutaneous glioma xenografts leading to complete regression. Similarly, treatment of nude mice bearing intracerebral glioma xenografts with KMTR2 significantly elongated lifespan without tumor recurrence. These results suggest that DR5 is the predominant TRAIL receptor mediating apoptotic signals in human glioma cells, and sensitivity to anti-DR5 mAbs was determined at least in part by the expression level of c-FLIPL and Akt. Specific targeting of death receptor pathway through DR5 using fully human mAbs might provide a novel therapeutic strategy for intractable malignant gliomas. PMID:20511188

TU-H-CAMPUS-JeP1-02: Fully Automatic Verification of Automatically Contoured Normal Tissues in the Head and Neck

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

McCarroll, R; UT Health Science Center, Graduate School of Biomedical Sciences, Houston, TX; Beadle, B

Purpose: To investigate and validate the use of an independent deformable-based contouring algorithm for automatic verification of auto-contoured structures in the head and neck towards fully automated treatment planning. Methods: Two independent automatic contouring algorithms [(1) Eclipse’s Smart Segmentation followed by pixel-wise majority voting, (2) an in-house multi-atlas based method] were used to create contours of 6 normal structures of 10 head-and-neck patients. After rating by a radiation oncologist, the higher performing algorithm was selected as the primary contouring method, the other used for automatic verification of the primary. To determine the ability of the verification algorithm to detect incorrectmore » contours, contours from the primary method were shifted from 0.5 to 2cm. Using a logit model the structure-specific minimum detectable shift was identified. The models were then applied to a set of twenty different patients and the sensitivity and specificity of the models verified. Results: Per physician rating, the multi-atlas method (4.8/5 point scale, with 3 rated as generally acceptable for planning purposes) was selected as primary and the Eclipse-based method (3.5/5) for verification. Mean distance to agreement and true positive rate were selected as covariates in an optimized logit model. These models, when applied to a group of twenty different patients, indicated that shifts could be detected at 0.5cm (brain), 0.75cm (mandible, cord), 1cm (brainstem, cochlea), or 1.25cm (parotid), with sensitivity and specificity greater than 0.95. If sensitivity and specificity constraints are reduced to 0.9, detectable shifts of mandible and brainstem were reduced by 0.25cm. These shifts represent additional safety margins which might be considered if auto-contours are used for automatic treatment planning without physician review. Conclusion: Automatically contoured structures can be automatically verified. This fully automated process could be used to flag auto-contours for special review or used with safety margins in a fully automatic treatment planning system.« less

Nonarteritic anterior ischemic optic neuropathy: cause, effect, and management.

PubMed

Berry, Shauna; Lin, Weijie V; Sadaka, Ama; Lee, Andrew G

2017-01-01

Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea). The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION.

REACTION PRODUCTS FROM THE CHLORINATION OF SEAWATER

EPA Science Inventory

Chemical treatment of natural waters, in particular the use of chlorine as a biocide, modifies the chemistry of these waters in ways that are not fully understood. The research described in this report examined both inorganic and organic reaction products from the chlorination of...

WEST AFRICAN TECHNOLOGY, EDUCATION AND RECIPROCITY (WATER) FOR BENIN

EPA Science Inventory

The Songhai Center has produced and tested over 300 fully functional point-of-use drinking water filters. The holistic approach of incorporated water treatment, waste reduction, economic development and promoted environmental and health awareness in the community.

The ...

A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol (ISRCTN: 93634563)

PubMed Central

2014-01-01

Background Exercise is consistently recommended for older adults with knee pain related to osteoarthritis. However, the effects from exercise are typically small and short-term, likely linked to insufficient individualisation of the exercise programme and limited attention to supporting exercise adherence over time. The BEEP randomised trial aims to improve patients’ short and long-term outcomes from exercise. It will test the overall effectiveness and cost-effectiveness of two physiotherapy-led exercise interventions (Individually Tailored Exercise and Targeted Exercise Adherence) to improve the individual tailoring of, and adherence to exercise, compared with usual physiotherapy care. Methods/design Based on the learning from a pilot study (ISRCTN 23294263), the BEEP trial is a multi-centre, pragmatic, parallel group, individually randomised controlled trial, with embedded longitudinal qualitative interviews. 500 adults in primary care, aged 45 years and over with knee pain will be randomised to 1 of 3 treatment groups delivered by fully trained physiotherapists in up to 6 NHS services. These are: Usual Physiotherapy Care (control group consisting of up to 4 treatment sessions of advice and exercise), Individually Tailored Exercise (an individualised, supervised and progressed lower-limb exercise programme) or Targeted Exercise Adherence (supporting patients to adhere to exercise and to engage in general physical activity over the longer-term). The primary outcomes are pain and function as measured by the Western Ontario and McMaster Osteoarthritis index. A comprehensive range of secondary outcomes are also included. Outcomes are measured at 3, 6 (primary outcome time-point), 9, 18 and 36 months. Data on adverse events will also be collected. Semi-structured, qualitative interviews with a subsample of 30 participants (10 from each treatment group) will be undertaken at two time-points (end of treatment and 12 to 18 months later) and analysed thematically. Discussion This trial will contribute to the evidence base for management of older adults with knee pain attributable to osteoarthritis in primary care. The findings will have important implications for healthcare commissioners, general practitioners and physiotherapy service providers and it will inform future education of healthcare practitioners. It may also serve to delay or prevent some individuals from becoming surgical candidates. Trial registration ISRCTN: ISRCTN93634563. PMID:25064573

A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol (ISRCTN: 93634563).

PubMed

Foster, Nadine E; Healey, Emma L; Holden, Melanie A; Nicholls, Elaine; Whitehurst, David Gt; Jowett, Susan; Jinks, Clare; Roddy, Edward; Hay, Elaine M

2014-07-27

Exercise is consistently recommended for older adults with knee pain related to osteoarthritis. However, the effects from exercise are typically small and short-term, likely linked to insufficient individualisation of the exercise programme and limited attention to supporting exercise adherence over time. The BEEP randomised trial aims to improve patients' short and long-term outcomes from exercise. It will test the overall effectiveness and cost-effectiveness of two physiotherapy-led exercise interventions (Individually Tailored Exercise and Targeted Exercise Adherence) to improve the individual tailoring of, and adherence to exercise, compared with usual physiotherapy care. Based on the learning from a pilot study (ISRCTN 23294263), the BEEP trial is a multi-centre, pragmatic, parallel group, individually randomised controlled trial, with embedded longitudinal qualitative interviews. 500 adults in primary care, aged 45 years and over with knee pain will be randomised to 1 of 3 treatment groups delivered by fully trained physiotherapists in up to 6 NHS services. These are: Usual Physiotherapy Care (control group consisting of up to 4 treatment sessions of advice and exercise), Individually Tailored Exercise (an individualised, supervised and progressed lower-limb exercise programme) or Targeted Exercise Adherence (supporting patients to adhere to exercise and to engage in general physical activity over the longer-term). The primary outcomes are pain and function as measured by the Western Ontario and McMaster Osteoarthritis index. A comprehensive range of secondary outcomes are also included. Outcomes are measured at 3, 6 (primary outcome time-point), 9, 18 and 36 months. Data on adverse events will also be collected. Semi-structured, qualitative interviews with a subsample of 30 participants (10 from each treatment group) will be undertaken at two time-points (end of treatment and 12 to 18 months later) and analysed thematically. This trial will contribute to the evidence base for management of older adults with knee pain attributable to osteoarthritis in primary care. The findings will have important implications for healthcare commissioners, general practitioners and physiotherapy service providers and it will inform future education of healthcare practitioners. It may also serve to delay or prevent some individuals from becoming surgical candidates. ISRCTN93634563.

Aerospace Technology Innovation. Volume 9

NASA Technical Reports Server (NTRS)

Turner, Janelle (Editor); Cousins, Liz (Editor)

2001-01-01

Commercializing technology is a daunting task. Of every 11 new product ideas, only one will successfully make it to the marketplace. Fully 46% of new product investment becomes sunk in cost. Yet, a few good companies consistently attain an 80% technology commercialization success rate and have lead the way in establishing best practices. The NASA Incubator program consists of nine incubators, each residing near a NASA research center. The purpose of the incubators is to use the best practices is to use the best practices of technology commercialization to help early stage businesses successfully launch new products that incorporate NASA technology.

The discrete one-sided Lipschitz condition for convex scalar conservation laws

NASA Technical Reports Server (NTRS)

Brenier, Yann; Osher, Stanley

1986-01-01

Physical solutions to convex scalar conservation laws satisfy a one-sided Lipschitz condition (OSLC) that enforces both the entropy condition and their variation boundedness. Consistency with this condition is therefore desirable for a numerical scheme and was proved for both the Godunov and the Lax-Friedrichs scheme--also, in a weakened version, for the Roe scheme, all of them being only first order accurate. A new, fully second order scheme is introduced here, which is consistent with the OSLC. The modified equation is considered and shows interesting features. Another second order scheme is then considered and numerical results are discussed.

High consistency cellulase treatment of hardwood prehydrolysis kraft based dissolving pulp.

PubMed

Wang, Qiang; Liu, Shanshan; Yang, Guihua; Chen, Jiachuan; Ni, Yonghao

2015-01-01

For enzymatic treatment of dissolving pulp, there is a need to improve the process to facilitate its commercialization. For this purpose, the high consistency cellulase treatment was conducted based on the hypothesis that a high cellulose concentration would favor the interactions of cellulase and cellulose, thus improves the cellulase efficiency while decreasing the water usage. The results showed that compared with a low consistency of 3%, the high consistency of 20% led to 24% increases of cellulase adsorption ratio. As a result, the viscosity decrease and Fock reactivity increase at consistency of 20% were enhanced from 510 mL/g and 70.3% to 471 mL/g and 77.6%, respectively, compared with low consistency of 3% at 24h. The results on other properties such as alpha cellulose, alkali solubility and molecular weight distribution also supported the conclusion that a high consistency of cellulase treatment was more effective than a low pulp consistency process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Too much ado about instrumental variable approach: is the cure worse than the disease?

PubMed

Baser, Onur

2009-01-01

To review the efficacy of instrumental variable (IV) models in addressing a variety of assumption violations to ensure standard ordinary least squares (OLS) estimates are consistent. IV models gained popularity in outcomes research because of their ability to consistently estimate the average causal effects even in the presence of unmeasured confounding. However, in order for this consistent estimation to be achieved, several conditions must hold. In this article, we provide an overview of the IV approach, examine possible tests to check the prerequisite conditions, and illustrate how weak instruments may produce inconsistent and inefficient results. We use two IVs and apply Shea's partial R-square method, the Anderson canonical correlation, and Cragg-Donald tests to check for weak instruments. Hall-Peixe tests are applied to see if any of these instruments are redundant in the analysis. A total of 14,952 asthma patients from the MarketScan Commercial Claims and Encounters Database were examined in this study. Patient health care was provided under a variety of fee-for-service, fully capitated, and partially capitated health plans, including preferred provider organizations, point of service plans, indemnity plans, and health maintenance organizations. We used controller-reliever copay ratio and physician practice/prescribing patterns as an instrument. We demonstrated that the former was a weak and redundant instrument producing inconsistent and inefficient estimates of the effect of treatment. The results were worse than the results from standard regression analysis. Despite the obvious benefit of IV models, the method should not be used blindly. Several strong conditions are required for these models to work, and each of them should be tested. Otherwise, bias and precision of the results will be statistically worse than the results achieved by simply using standard OLS.

Factors Associated with Correct and Consistent Insecticide Treated Curtain Use in Iquitos, Peru

PubMed Central

Scott, Thomas W.; Elder, John P.; Alexander, Neal; Halsey, Eric S.; McCall, Philip J.

2016-01-01

Dengue is an arthropod-borne virus of great public health importance, and control of its mosquito vectors is currently the only available method for prevention. Previous research has suggested that insecticide treated curtains (ITCs) can lower dengue vector infestations in houses. This observational study investigated individual and household-level socio-demographic factors associated with correct and consistent use of ITCs in Iquitos, Peru. A baseline knowledge, attitudes, and practices (KAP) survey was administered to 1,333 study participants, and ITCs were then distributed to 593 households as part of a cluster-randomized trial. Follow up KAP surveys and ITC-monitoring checklists were conducted at 9, 18, and 27 months post-ITC distribution. At 9 months post-distribution, almost 70% of ITCs were hanging properly (e.g. hanging fully extended or tied up), particularly those hung on walls compared to other locations. Proper ITC hanging dropped at 18 months to 45.7%. The odds of hanging ITCs correctly and consistently were significantly greater among those participants who were housewives, knew three or more correct symptoms of dengue and at least one correct treatment for dengue, knew a relative or close friend who had had dengue, had children sleeping under a mosquito net, or perceived a change in the amount of mosquitoes in the home. Additionally, the odds of recommending ITCs in the future were significantly greater among those who perceived a change in the amount of mosquitoes in the home (e.g. perceived the ITCs to be effective). Despite various challenges associated with the sustained effectiveness of the selected ITCs, almost half of the ITCs were still hanging at 18 months, suggesting a feasible vector control strategy for sustained community use. PMID:26967157

CE: Lyme Disease: Diagnosis, Treatment, and Prevention.

PubMed

Patton, Susan Kane; Phillips, Bailey

2018-04-01

: Lyme disease is recognized as the most common vector-borne disease in the United States. Surveillance data indicate both increasing numbers of Lyme disease cases and geographic expansion of areas where the causative spirochete, Borrelia burgdorferi, can be found. With prompt diagnosis and appropriate treatment in the acute stage, most patients will recover fully. Without treatment, however, the infecting pathogen remains within the body, often producing long-term complications, including musculoskeletal, neurologic, and cardiovascular effects. The authors describe early and late manifestations of Lyme disease, the appropriate use of diagnostic tests, the recommended treatment, and strategies for preventing tick-borne diseases nurses can share with patients.

Full covered self-expandable metal stents for the treatment of anastomotic leak using a silk thread

PubMed Central

Choi, Cheol Woong; Kang, Dae Hwan; Kim, Hyung Wook; Park, Su Bum; Kim, Su Jin; Hwang, Sun Hwi; Lee, Si Hak

2017-01-01

Abstract To evaluate the safety and effectiveness of fixation of the fully covered self-expandable metal stent (SEMS) placement using a silk thread for complete closure of an anastomotic leak. An anastomotic leak is a life-threatening complication after gastrectomy. Although the traditional treatment of choice was surgical re-intervention, an endoscopic SEMS can be used alternatively. During the study period, we retrospectively reviewed consecutive patients who received a modified covered SEMS capable of being fixed using a silk thread (Shim technique) due to an anastomotic leak after gastrectomy to prevent stent migration. Demographic data, stent placement and removal, clinical success, time to resolution, and complications were evaluated. A total of 7 patients underwent fully covered SEMS with a silk thread placement for an anastomotic leak after gastrectomy to treat gastric cancer. The patients’ mean age was 71.3 ± 8.0 years. Man sex was predominant (85.7%). All patients’ American Society of Anesthesiologists (ASA) scores were between I and III. Total gastrectomy was performed in 5 patients (71.4%) and proximal gastrectomy was performed in 2 patients (28.6%). The time between gastrectomy and stent insertion was 22.3 ± 11.1 days. The size of the leaks was 27.1 ± 11.1 mm. Technical success and complete leak closure were achieved in all patients. Stent migration was absent. All stents were removed between 4 and 6 weeks. Delayed esophageal stricture was found in 1 patient (14.2) and successfully resolved after endoscopic balloon dilation. For an anastomotic leak after gastrectomy, fully covered SEMS placement with a silk thread is an effective and safe treatment option without stent migration. The stent extraction time between 4 and 6 weeks was optimal without severe complications. PMID:28723752

Full covered self-expandable metal stents for the treatment of anastomotic leak using a silk thread.

PubMed

Choi, Cheol Woong; Kang, Dae Hwan; Kim, Hyung Wook; Park, Su Bum; Kim, Su Jin; Hwang, Sun Hwi; Lee, Si Hak

2017-07-01

To evaluate the safety and effectiveness of fixation of the fully covered self-expandable metal stent (SEMS) placement using a silk thread for complete closure of an anastomotic leak. An anastomotic leak is a life-threatening complication after gastrectomy. Although the traditional treatment of choice was surgical re-intervention, an endoscopic SEMS can be used alternatively.During the study period, we retrospectively reviewed consecutive patients who received a modified covered SEMS capable of being fixed using a silk thread (Shim technique) due to an anastomotic leak after gastrectomy to prevent stent migration. Demographic data, stent placement and removal, clinical success, time to resolution, and complications were evaluated.A total of 7 patients underwent fully covered SEMS with a silk thread placement for an anastomotic leak after gastrectomy to treat gastric cancer. The patients' mean age was 71.3 ± 8.0 years. Man sex was predominant (85.7%). All patients' American Society of Anesthesiologists (ASA) scores were between I and III. Total gastrectomy was performed in 5 patients (71.4%) and proximal gastrectomy was performed in 2 patients (28.6%). The time between gastrectomy and stent insertion was 22.3 ± 11.1 days. The size of the leaks was 27.1 ± 11.1 mm. Technical success and complete leak closure were achieved in all patients. Stent migration was absent. All stents were removed between 4 and 6 weeks. Delayed esophageal stricture was found in 1 patient (14.2) and successfully resolved after endoscopic balloon dilation.For an anastomotic leak after gastrectomy, fully covered SEMS placement with a silk thread is an effective and safe treatment option without stent migration. The stent extraction time between 4 and 6 weeks was optimal without severe complications.

Major depressive disorder: new clinical, neurobiological, and treatment perspectives

PubMed Central

Kupfer, David J; Frank, Ellen; Phillips, Mary L

2012-01-01

In this Seminar we discuss developments from the past 5 years in the diagnosis, neurobiology, and treatment of major depressive disorder. For diagnosis, psychiatric and medical comorbidity have been emphasised as important factors in improving the appropriate assessment and management of depression. Advances in neurobiology have also increased, and we aim to indicate genetic, molecular, and neuroimaging studies that are relevant for assessment and treatment selection of this disorder. Further studies of depression-specific psychotherapies, the continued application of antidepressants, the development of new treatment compounds, and the status of new somatic treatments are also discussed. We address two treatment-related issues: suicide risk with selective serotonin reuptake inhibitors, and the safety of antidepressants in pregnancy. Although clear advances have been made, no fully satisfactory treatments for major depression are available. PMID:22189047

Development of a fully automated network system for long-term health-care monitoring at home.

PubMed

Motoi, K; Kubota, S; Ikarashi, A; Nogawa, M; Tanaka, S; Nemoto, T; Yamakoshi, K

2007-01-01

Daily monitoring of health condition at home is very important not only as an effective scheme for early diagnosis and treatment of cardiovascular and other diseases, but also for prevention and control of such diseases. From this point of view, we have developed a prototype room for fully automated monitoring of various vital signs. From the results of preliminary experiments using this room, it was confirmed that (1) ECG and respiration during bathing, (2) excretion weight and blood pressure, and (3) respiration and cardiac beat during sleep could be monitored with reasonable accuracy by the sensor system installed in bathtub, toilet and bed, respectively.

A synopsis of short-term response to alternative restoration treatments in sagebrush-steppe: the SageSTEP project

USGS Publications Warehouse

McIver, James; Brunson, Mark; Bunting, Steve; Chambers, Jeanne; Doescher, Paul; Grace, James; Hulet, April; Johnson, Dale; Knick, Steven T.; Miller, Richard; Pellant, Mike; Pierson, Fred; Pyke, David; Rau, Benjamin; Rollins, Kim; Roundy, Bruce; Schupp, Eugene; Tausch, Robin; Williams, Jason

2014-01-01

The Sagebrush Steppe Treatment Evaluation Project (SageSTEP) is an integrated long-term study that evaluates ecological effects of alternative treatments designed to reduce woody fuels and to stimulate the herbaceous understory of sagebrush steppe communities of the Intermountain West. This synopsis summarizes results through 3 yr posttreatment. Woody vegetation reduction by prescribed fire, mechanical treatments, or herbicides initiated a cascade of effects, beginning with increased availability of nitrogen and soil water, followed by increased growth of herbaceous vegetation. Response of butterflies and magnitudes of runoff and erosion closely followed herbaceous vegetation recovery. Effects on shrubs, biological soil crust, tree cover, surface woody fuel loads, and sagebrush-obligate bird communities will take longer to be fully expressed. In the short term, cool wet sites were more resilient than warm dry sites, and resistance was mostly dependent on pretreatment herbaceous cover. At least 10 yr of posttreatment time will likely be necessary to determine outcomes for most sites. Mechanical treatments did not serve as surrogates for prescribed fire in how each influenced the fuel bed, the soil, erosion, and sage-obligate bird communities. Woody vegetation reduction by any means resulted in increased availability of soil water, higher herbaceous cover, and greater butterfly numbers. We identified several trade-offs (desirable outcomes for some variables, undesirable for others), involving most components of the study system. Trade-offs are inevitable when managing complex natural systems, and they underline the importance of asking questions about the whole system when developing management objectives. Substantial spatial and temporal heterogeneity in sagebrush steppe ecosystems emphasizes the point that there will rarely be a “recipe” for choosing management actions on any specific area. Use of a consistent evaluation process linked to monitoring may be the best chance managers have for arresting woodland expansion and cheatgrass invasion that may accelerate in a future warming climate.

A mixed methods feasibility study to evaluate the use of a low-intensity, nurse-delivered cognitive behavioural therapy for the treatment of irritable bowel syndrome.

PubMed

Dainty, Andrew David; Fox, Mark; Lewis, Nina; Hunt, Melissa; Holtham, Elizabeth; Timmons, Stephen; Kinsella, Philip; Wragg, Andrew; Callaghan, Patrick

2014-06-17

Irritable bowel syndrome (IBS) is characterised by symptoms such as abdominal pain, constipation, diarrhoea and bloating. These symptoms impact on health-related quality of life, result in excess service utilisation and are a significant burden to healthcare systems. Certain mechanisms which underpin IBS can be explained by a biopsychosocial model which is amenable to psychological treatment using techniques such as cognitive behavioural therapy (CBT). While current evidence supports CBT interventions for this group of patients, access to these treatments within the UK healthcare system remains problematic. A mixed methods feasibility randomised controlled trial will be used to assess the feasibility of a low-intensity, nurse-delivered guided self-help intervention within secondary care gastrointestinal clinics. A total of 60 participants will be allocated across four treatment conditions consisting of: high-intensity CBT delivered by a fully qualified cognitive behavioural therapist, low-intensity guided self-help delivered by a registered nurse, self-help only without therapist support and a treatment as usual control condition. Participants from each of the intervention arms of the study will be interviewed in order to identify potential barriers and facilitators to the implementation of CBT interventions within clinical practice settings. Quantitative data will be analysed using descriptive statistics only. Qualitative data will be analysed using a group thematic analysis. This study will provide essential information regarding the feasibility of nurse-delivered CBT interventions within secondary care gastrointestinal clinics. The data gathered during this study would also provide useful information when planning a substantive trial and will assist funding bodies when considering investment in substantive trial funding. A favourable opinion for this research was granted by the Nottingham 2 Research Ethics Committee. 83683687 (http://www.controlled-trials.com/ISRCTN83683687). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Endoscopic Treatment of Biliary Stenosis in Patients with Alveolar Echinococcosis--Report of 7 Consecutive Patients with Serial ERC Approach.

PubMed

Stojkovic, Marija; Junghanss, Thomas; Veeser, Mira; Weber, Tim F; Sauer, Peter

2016-02-01

Biliary vessel pathology due to alveolar echicococcosis (AE) results in variable combinations of stenosis, necrosis and inflammation. Modern management strategies for patients with cholestasis are desperately needed. The aim is proof of principle of serial ERC (endoscopic retrograde cholangiography) balloon dilation for AE biliary pathology. Retrospective case series of seven consecutive patients with AE-associated biliary pathology and ERC treatment in an interdisciplinary endoscopy unit at a University Hospital which hosts a national echinococcosis treatment center. The AE patient cohort consists of 106 patients with AE of the liver of which 13 presented with cholestasis. 6/13 received bilio-digestive anastomosis and 7/13 patients were treated by ERC and are reported here. Biliary stricture balloon dilation was performed with 18-Fr balloons at the initial and with 24-Fr balloons at subsequent interventions. If indicated 10 Fr plastic stents were placed. Six patients were treated by repeated balloon dilation and stenting, one by stenting only. After an acute phase of 6 months with repeated balloon dilation, three patients showed "sustained clinical success" and four patients "assisted therapeutic success," of which one has not yet reached the six month endpoint. In one patient, sustained success could not be achieved despite repeated insertion of plastic stents and balloon dilation, but with temporary insertion of a fully covered self-expanding metal stent (FCSEMS). There was no loss to follow up. No major complications were observed. Serial endoscopic dilation is a standard tool in the treatment of benign biliary strictures. Serial endoscopic intervention with balloon dilation combined with benzimidazole treatment can re-establish and maintain biliary duct patency in AE associated pathology and probably contributes to avoid or postpone bilio-digestive anastomosis. This approach is in accordance with current ERC guidelines and is minimally disruptive for patients.

Endoscopic Treatment of Biliary Stenosis in Patients with Alveolar Echinococcosis – Report of 7 Consecutive Patients with Serial ERC Approach

PubMed Central

Stojkovic, Marija; Junghanss, Thomas; Veeser, Mira; Weber, Tim F.; Sauer, Peter

2016-01-01

Background and Aims Biliary vessel pathology due to alveolar echicococcosis (AE) results in variable combinations of stenosis, necrosis and inflammation. Modern management strategies for patients with cholestasis are desperately needed. The aim is proof of principle of serial ERC (endoscopic retrograde cholangiography) balloon dilation for AE biliary pathology. Methods Retrospective case series of seven consecutive patients with AE-associated biliary pathology and ERC treatment in an interdisciplinary endoscopy unit at a University Hospital which hosts a national echinococcosis treatment center. The AE patient cohort consists of 106 patients with AE of the liver of which 13 presented with cholestasis. 6/13 received bilio-digestive anastomosis and 7/13 patients were treated by ERC and are reported here. Biliary stricture balloon dilation was performed with 18-Fr balloons at the initial and with 24-Fr balloons at subsequent interventions. If indicated 10 Fr plastic stents were placed. Results Six patients were treated by repeated balloon dilation and stenting, one by stenting only. After an acute phase of 6 months with repeated balloon dilation, three patients showed “sustained clinical success” and four patients “assisted therapeutic success,” of which one has not yet reached the six month endpoint. In one patient, sustained success could not be achieved despite repeated insertion of plastic stents and balloon dilation, but with temporary insertion of a fully covered self-expanding metal stent (FCSEMS). There was no loss to follow up. No major complications were observed. Conclusions Serial endoscopic dilation is a standard tool in the treatment of benign biliary strictures. Serial endoscopic intervention with balloon dilation combined with benzimidazole treatment can re-establish and maintain biliary duct patency in AE associated pathology and probably contributes to avoid or postpone bilio-digestive anastomosis. This approach is in accordance with current ERC guidelines and is minimally disruptive for patients. PMID:26910822

Economic evaluation in chronic pain: a systematic review and de novo flexible economic model.

PubMed

Sullivan, W; Hirst, M; Beard, S; Gladwell, D; Fagnani, F; López Bastida, J; Phillips, C; Dunlop, W C N

2016-07-01

There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and limitations in modelling approaches in the economic evaluation of treatments for chronic pain. The results of the literature review were then used to support the development of a fully flexible open-source economic model structure, designed to test structural and data assumptions and act as a reference for future modelling practice. The key model design themes identified from the systematic review included: time horizon; titration and stabilisation; number of treatment lines; choice/ordering of treatment; and the impact of parameter uncertainty (given reliance on expert opinion). Exploratory analyses using the model to compare a hypothetical novel therapy versus morphine as first-line treatments showed cost-effectiveness results to be sensitive to structural and data assumptions. Assumptions about the treatment pathway and choice of time horizon were key model drivers. Our results suggest structural model design and data assumptions may have driven previous cost-effectiveness results and ultimately decisions based on economic value. We therefore conclude that it is vital that future economic models in chronic pain are designed to be fully transparent and hope our open-source code is useful in order to aspire to a common approach to modelling pain that includes robust sensitivity analyses to test structural and parameter uncertainty.

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings.

PubMed

Nardell, E; Dharmadhikari, A

2010-10-01

Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated.

Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings

PubMed Central

Nardell, E.; Dharmadhikari, A.

2013-01-01

SUMMARY Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated. PMID:20843413

Tissue engineering-based cartilage repair with mesenchymal stem cells in a porcine model.

PubMed

Chang, Chih-Hung; Kuo, Tzong-Fu; Lin, Feng-Huei; Wang, Jyh-Horng; Hsu, Yuan-Ming; Huang, Huei-Ting; Loo, Shiao-Tung; Fang, Hsu-Wei; Liu, Hwa-Chang; Wang, Wen-Chih

2011-12-01

This in vivo pilot study explored the use of mesenchymal stem cell (MSC) containing tissue engineering constructs in repair of osteochondral defects. Osteochondral defects were created in the medial condyles of both knees of 16 miniature pigs. One joint received a cell/collagen tissue engineering construct with or without pretreatment with transforming growth factor β (TGF-β) and the other joint from the same pig received no treatment or the gel scaffold only. Six months after surgery, in knees with no treatment, all defects showed contracted craters; in those treated with the gel scaffold alone, six showed a smooth gross surface, one a hypertrophic surface, and one a contracted crater; in those with undifferentiated MSCs, five defects had smooth, fully repaired surfaces or partially repaired surfaces, and one defect poor repair; in those with TGF-β-induced differentiated MSCs, seven defects had smooth, fully repaired surfaces or partially repaired surfaces, and three defects showed poor repair. In Pineda score grading, the group with undifferentiated MSC, but not the group with TGF-β-induced differentiated MSCs, had significantly lower subchondral, cell morphology, and total scores than the groups with no or gel-only treatment. The compressive stiffness was larger in cartilage without surgical treatment than the treated area within each group. In conclusion, this preliminary pilot study suggests that using undifferentiated MSCs might be a better approach than using TGF-β-induced differentiated MSCs for in vivo tissue engineered treatment of osteochondral defects. Copyright © 2011 Orthopaedic Research Society.

THE TREATMENT OF DISRUPTIVE CLASSROOM BEHAVIOR PROBLEMS BY EMPLOYMENT OF A PARTIAL-MILIEU CONSISTENCY PROGRAM. FINAL REPORT.

ERIC Educational Resources Information Center

COLLINS, RONALD C.

THIS STUDY ATTEMPTED TO DEVELOP AND EVALUATE A TREATMENT PROCEDURE DESIGNED TO REDUCE THE INCIDENCE OF MALADAPTIVE BEHAVIORS IN PUBLIC SCHOOL CLASSROOMS. THE TREATMENT PROCEDURE ATTEMPTED TO PROVIDE ENVIRONMENTAL CONSISTENCY IN THE CHILD'S ENVIRONMENT. IT WAS HYPOTHESIZED THAT GIVEN A PROGRAM OF HOME-SCHOOL CONSISTENCY, UNYIELDING FOR COMPLIANCE…

Endoscopic treatment of benign biliary strictures using covered self-expandable metal stents (CSEMS).

PubMed

Irani, Shayan; Baron, Todd H; Akbar, Ali; Lin, Otto S; Gluck, Michael; Gan, Ian; Ross, Andrew S; Petersen, Bret T; Topazian, Mark; Kozarek, Richard A

2014-01-01

Traditional endoscopic management of benign biliary strictures (BBS) consists of placement of one or more plastic stents. Emerging data support the use of covered self-expandable metal stents (CSEMS). We sought to assess outcome of endoscopic temporary placement of CSEMS in patients with BBS. This was a retrospective study of CSEMS placement for BBS between May 2005 and July 2012 from two tertiary care centers. A total of 145 patients (81 males, median age 59 years) with BBS were identified; 73 of which were classified as extrinsic and were caused by chronic pancreatitis, and 70 were intrinsic. Main outcome measures were resolution of stricture and adverse events (AEs) due to self-expandable metal stents (SEMS)-related therapy. Fully covered and partially covered 8-10 mm diameter SEMS were placed and subsequently removed in 121/125 (97 %) attempts in BBS (failure to remove four partially covered stents). Stricture resolution occurred in 83/125 (66 %) patients after a median stent duration of 26 weeks (median follow-up 90 weeks). Resolution of extrinsic strictures was significantly lower compared to intrinsic strictures (31/65, 48 % vs. 52/60, 87 %, p = 0.004) despite longer median stent duration (30 vs. 20 weeks). Thirty-seven AEs occurred in 25 patients (17 %), with 12 developing multiple AEs including cholangitis (n = 17), pancreatitis (n = 5), proximal stent migration (n = 3), cholecystitis (n = 2), pain requiring SEMS removal and/or hospitalization (n = 3), inability to remove (n = 4), and new stricture formation (n = 3). Benign biliary strictures can be effectively treated with CSEMS. Successful resolution of biliary strictures due to extrinsic disease is seen significantly less often than those due to intrinsic disease. Removal is successful in all patients with fully covered SEMS.

Fully automated method for the liquid chromatographic determination of cyproterone acetate in plasma using restricted access material for sample pre-treatment.

PubMed

Christiaens, B; Chiap, P; Rbeida, O; Cello, D; Crommen, J; Hubert, Ph

2003-09-25

A new fully automated method for the quantitative analysis of an antiandrogenic substance, cyproterone acetate (CPA), in plasma samples has been developed using on-line solid-phase extraction (SPE) prior to the determination by reversed-phase liquid chromatography (LC). The automated method was based on the use of a precolumn packed with an internal-surface reversed-phase packing material (LiChrospher RP-4 ADS) for sample clean-up coupled to LC analysis on an octadecyl stationary phase using a column-switching system. A 200-microL volume of plasma sample was injected directly on the precolumn packed with restricted access material using a mixture of water-acetonitrile (90:10, v/v) as washing liquid. The analyte was then eluted in the back-flush mode with the LC mobile phase which consisted of a mixture of phosphate buffer, pH 7.0-acetonitrile (54:46, v/v). The elution profiles of CPA and blank plasma samples on the precolumn and the time needed for analyte transfer from the precolumn to the analytical column were determined. Different compositions of washing liquid and mobile phase were tested to reduce the interference of plasma endogenous components. UV detection was achieved at 280 nm. Finally, the developed method was validated using a new approach, namely the application of the accuracy profile based on the interval confidence at 90% of the total measurement error (bias+standard deviation). The limit of quantification of cyproterone acetate in plasma was determined at 15 ng mL(-1). The validated method should be applicable to the determination of CPA in patients treated by at least 50 mg day(-1).

Hydrological Modelling of The Guadiana Basin

NASA Astrophysics Data System (ADS)

Conan, C.; Bouraoui, F.; de Marsily, G.; Bidoglio, G.

Increased anthropogenic activities such as agriculture, irrigation, industry, mining, ur- ban water supply and sewage treatment, have created significant environmental prob- lems. To ensure sustainable development of water resources, water managers need new strategies and suitable tools. In particular it is often compulsory that surface wa- ter and groundwater be managed simultaneously both in terms of quantity and quality at catchment scales. To this purpose, a model coupling SWAT (Soil and Water As- sessment Tool) and MODFLOW (Modular 3-D Flow model) was developed. SWAT is a quasi-distributed watershed model with a GIS interface that outlines the sub-basins and stream networks from a Digital Elevation Model (DEM) and calculates daily wa- ter balances from meteorological data, soil and land-use characteristics. The particular advantage of this model, compared to other fully distributed physically based mod- els, is that it requires a small amount of readily available input data. MODFLOW is a fully distributed model that calculates groundwater flow from aquifer characteris- tics. We have adapted this new coupled model SWAT-MODFLOW to a Mediterranean catchment, the Guadiana basin, and present the first results of this work. Only wa- ter quantity results are available at this stage. The validation consisted in comparing measured and predicted daily flow at the catchment and sub-catchment outlets for the period 1970-1995. The model accurately reproduced the decrease of the piezometric level, due to increased water abstraction, and the exchanges between surface water and ground-water. The sensitivity of the model to irrigation practices was evaluated. The usefulness of this model as a management tool has been illustrated through the analysis of alternative scenarios of agricultural practices and climate change.

Patient Experience: A Critical Indicator of Healthcare Performance.

PubMed

Guler, Pamela H

2017-01-01

Patient experience has become a critical differentiator for healthcare organizations, and it will only grow in importance as transparency and consumerism dominate the healthcare landscape. Creating and sustaining a consistently exceptional experience that promotes patient engagement and the best outcomes is far more than just "satisfying" patients, going well beyond amenities that may be provided.Perception of care experience is often shaped by methods we use to address the biopsychosocial needs of patients. Building relationships and communicating well with our patients and families are primary approaches. In a complex healthcare situation, patients may not fully understand or remember the highly clinical nature of treatment. However, they always remember how we made them feel, how we communicated with them as a team, and what interactions they experienced while in our care.Patients who are fully informed and feel connected to their caregivers are often less anxious than those who are disengaged. Informed and engaged patients are enabled to participate in their healthcare. Organizations that focus on developing an accountable culture-one that inspires caregivers to communicate in a way that connects to patients' mind, body, and spirit while leveraging standard, evidence-based patient experience practices-find that patients' perception of care, or "the patient experience," is vastly improved.Adventist Health System has embarked on a journey to patient experience excellence with a commitment to whole-person care and standard patient experience practice across the system. Recognized with several national awards, we continue to strengthen our approach toward bringing all of our campuses and patient settings to sustained high-level performance. We have found that a combination of strong, accountable leadership; a focus on employee culture; engagement of physicians; standardized patient experience practices and education; and meaningful use of patient feedback are top contributors to excellence in patient experience.

Circulating Adipokines and Vascular Function: Cross-Sectional Associations in a Community-Based Cohort.

PubMed

Zachariah, Justin P; Hwang, Susan; Hamburg, Naomi M; Benjamin, Emelia J; Larson, Martin G; Levy, Daniel; Vita, Joseph A; Sullivan, Lisa M; Mitchell, Gary F; Vasan, Ramachandran S

2016-02-01

Adipokines may be potential mediators of the association between excess adiposity and vascular dysfunction. We assessed the cross-sectional associations of circulating adipokines with vascular stiffness in a community-based cohort of younger adults. We related circulating concentrations of leptin and leptin receptor, adiponectin, retinol-binding protein 4, and fatty acid-binding protein 4 to vascular stiffness measured by arterial tonometry in 3505 Framingham Third Generation cohort participants free of cardiovascular disease (mean age 40 years, 53% women). Separate regression models estimated the relations of each adipokine to mean arterial pressure and aortic stiffness, as carotid femoral pulse wave velocity, adjusting for age, sex, smoking, heart rate, height, antihypertensive treatment, total and high-density lipoprotein cholesterol, diabetes mellitus, alcohol consumption, estimated glomerular filtration rate, glucose, and C-reactive protein. Models evaluating aortic stiffness also were adjusted for mean arterial pressure. Mean arterial pressure was positively associated with blood retinol-binding protein 4, fatty acid-binding protein 4, and leptin concentrations (all P<0.001) and inversely with adiponectin (P=0.002). In fully adjusted models, mean arterial pressure was positively associated with retinol-binding protein 4 and leptin receptor levels (P<0.002 both). In fully adjusted models, aortic stiffness was positively associated with fatty acid-binding protein 4 concentrations (P=0.02), but inversely with leptin and leptin receptor levels (P≤0.03 both). In our large community-based sample, circulating concentrations of select adipokines were associated with vascular stiffness measures, consistent with the hypothesis that adipokines may influence vascular function and may contribute to the relation between obesity and hypertension. © 2015 American Heart Association, Inc.

Fully reprocessed ERS-1 altimeter data from 1992 to 1995: Feasibility of the detection of long term sea level change

NASA Astrophysics Data System (ADS)

Anzenhofer, M.; Gruber, T.

1998-04-01

Global mean sea level observations are necessary to answer the urgent questions about climate changes and their impact on socio-economy. At GeoForschungsZentrum/Geman Processing and Archiving Facility ERS altimeter data is used to systematically generate geophysical products such as sea surface topography, high-resolution geoid and short- and long-period sea surface height models. On the basis of this experience, fully reprocessed ERS-1 altimeter data is used to generated a time series of monthly sea surface height models from April 1992 to April 1995. The reprocessing consists of improved satellite ephemerides, merging of Grenoble tidal model, and application of range corrections due to timing errors. With the new data set the TOPEX/POSEIDON prelaunch accuracy requirements are fulfilled. The 3-year time series is taken to estimate the rate of change of global mean sea level. A careful treatment of seasonal effects is considered. A masking of continents, sea ice, and suspect sea surface heights is chosen that is common for all sea surface height models. The obtained rate of change is compared to external results from tide gauge records and TOPEX/POSEIDON data. The relation of sea level changes and sea surface temperature variations is examined by means of global monthly sea surface temperature maps. Both global wind speed and wave height maps are investigated and correlated with sea surface heights and sea surface temperatures in order to find other indicators of climate variations. The obtained rate of changes of the various global maps is compared to an atmospheric CO2 anomaly record, which is highly correlated to El Niño events. The relatively short period of 3 years, however, does not allow definite conclusions with respect to possible long-term climate changes.

ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk.

PubMed

Sarver, Dustin E; McCart, Michael R; Sheidow, Ashli J; Letourneau, Elizabeth J

2014-12-01

Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N = 115; mean age = 14.9 years) involved in the juvenile justice system. Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive, but not inattentive, symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Semantic annotation of consumer health questions.

PubMed

Kilicoglu, Halil; Ben Abacha, Asma; Mrabet, Yassine; Shooshan, Sonya E; Rodriguez, Laritza; Masterton, Kate; Demner-Fushman, Dina

2018-02-06

Consumers increasingly use online resources for their health information needs. While current search engines can address these needs to some extent, they generally do not take into account that most health information needs are complex and can only fully be expressed in natural language. Consumer health question answering (QA) systems aim to fill this gap. A major challenge in developing consumer health QA systems is extracting relevant semantic content from the natural language questions (question understanding). To develop effective question understanding tools, question corpora semantically annotated for relevant question elements are needed. In this paper, we present a two-part consumer health question corpus annotated with several semantic categories: named entities, question triggers/types, question frames, and question topic. The first part (CHQA-email) consists of relatively long email requests received by the U.S. National Library of Medicine (NLM) customer service, while the second part (CHQA-web) consists of shorter questions posed to MedlinePlus search engine as queries. Each question has been annotated by two annotators. The annotation methodology is largely the same between the two parts of the corpus; however, we also explain and justify the differences between them. Additionally, we provide information about corpus characteristics, inter-annotator agreement, and our attempts to measure annotation confidence in the absence of adjudication of annotations. The resulting corpus consists of 2614 questions (CHQA-email: 1740, CHQA-web: 874). Problems are the most frequent named entities, while treatment and general information questions are the most common question types. Inter-annotator agreement was generally modest: question types and topics yielded highest agreement, while the agreement for more complex frame annotations was lower. Agreement in CHQA-web was consistently higher than that in CHQA-email. Pairwise inter-annotator agreement proved most useful in estimating annotation confidence. To our knowledge, our corpus is the first focusing on annotation of uncurated consumer health questions. It is currently used to develop machine learning-based methods for question understanding. We make the corpus publicly available to stimulate further research on consumer health QA.

A 40 GHz fully integrated circuit with a vector network analyzer and a coplanar-line-based detection area for circulating tumor cell analysis using 65 nm CMOS technology

NASA Astrophysics Data System (ADS)

Nakanishi, Taiki; Matsunaga, Maya; Kobayashi, Atsuki; Nakazato, Kazuo; Niitsu, Kiichi

2018-03-01

A 40-GHz fully integrated CMOS-based circuit for circulating tumor cells (CTC) analysis, consisting of an on-chip vector network analyzer (VNA) and a highly sensitive coplanar-line-based detection area is presented in this paper. In this work, we introduce a fully integrated architecture that eliminates unwanted parasitic effects. The proposed analyzer was designed using 65 nm CMOS technology, and SPICE and MWS simulations were used to validate its operation. The simulation confirmed that the proposed circuit can measure S-parameter shifts resulting from the addition of various types of tumor cells to the detection area, the data of which are provided in a previous study: the |S 21| values for HepG2, A549, and HEC-1-A cells are -0.683, -0.580, and -0.623 dB, respectively. Additionally, the measurement demonstrated an S-parameters reduction of -25.7% when a silicone resin was put on the circuit. Hence, the proposed system is expected to contribute to cancer diagnosis.

On Flexible Tubes Conveying Fluid: Geometric Nonlinear Theory, Stability and Dynamics

NASA Astrophysics Data System (ADS)

Gay-Balmaz, François; Putkaradze, Vakhtang

2015-08-01

We derive a fully three-dimensional, geometrically exact theory for flexible tubes conveying fluid. The theory also incorporates the change of the cross section available to the fluid motion during the dynamics. Our approach is based on the symmetry-reduced, exact geometric description for elastic rods, coupled with the fluid transport and subject to the volume conservation constraint for the fluid. We first derive the equations of motion directly, by using an Euler-Poincaré variational principle. We then justify this derivation with a more general theory elucidating the interesting mathematical concepts appearing in this problem, such as partial left (elastic) and right (fluid) invariance of the system, with the added holonomic constraint (volume). We analyze the fully nonlinear behavior of the model when the axis of the tube remains straight. We then proceed to the linear stability analysis and show that our theory introduces important corrections to previously derived results, both in the consistency at all wavelength and in the effects arising from the dynamical change of the cross section. Finally, we derive and analyze several analytical, fully nonlinear solutions of traveling wave type in two dimensions.

A scalable, fully implicit algorithm for the reduced two-field low-β extended MHD model

DOE PAGES

Chacon, Luis; Stanier, Adam John

2016-12-01

Here, we demonstrate a scalable fully implicit algorithm for the two-field low-β extended MHD model. This reduced model describes plasma behavior in the presence of strong guide fields, and is of significant practical impact both in nature and in laboratory plasmas. The model displays strong hyperbolic behavior, as manifested by the presence of fast dispersive waves, which make a fully implicit treatment very challenging. In this study, we employ a Jacobian-free Newton–Krylov nonlinear solver, for which we propose a physics-based preconditioner that renders the linearized set of equations suitable for inversion with multigrid methods. As a result, the algorithm ismore » shown to scale both algorithmically (i.e., the iteration count is insensitive to grid refinement and timestep size) and in parallel in a weak-scaling sense, with the wall-clock time scaling weakly with the number of cores for up to 4096 cores. For a 4096 × 4096 mesh, we demonstrate a wall-clock-time speedup of ~6700 with respect to explicit algorithms. The model is validated linearly (against linear theory predictions) and nonlinearly (against fully kinetic simulations), demonstrating excellent agreement.« less

Fully Solution-Processed Flexible Organic Thin Film Transistor Arrays with High Mobility and Exceptional Uniformity

PubMed Central

Fukuda, Kenjiro; Takeda, Yasunori; Mizukami, Makoto; Kumaki, Daisuke; Tokito, Shizuo

2014-01-01

Printing fully solution-processed organic electronic devices may potentially revolutionize production of flexible electronics for various applications. However, difficulties in forming thin, flat, uniform films through printing techniques have been responsible for poor device performance and low yields. Here, we report on fully solution-processed organic thin-film transistor (TFT) arrays with greatly improved performance and yields, achieved by layering solution-processable materials such as silver nanoparticle inks, organic semiconductors, and insulating polymers on thin plastic films. A treatment layer improves carrier injection between the source/drain electrodes and the semiconducting layer and dramatically reduces contact resistance. Furthermore, an organic semiconductor with large-crystal grains results in TFT devices with shorter channel lengths and higher field-effect mobilities. We obtained mobilities of over 1.2 cm2 V−1 s−1 in TFT devices with channel lengths shorter than 20 μm. By combining these fabrication techniques, we built highly uniform organic TFT arrays with average mobility levels as high as 0.80 cm2 V−1 s−1 and ideal threshold voltages of 0 V. These results represent major progress in the fabrication of fully solution-processed organic TFT device arrays. PMID:24492785

Axion as a Cold Dark Matter Candidate: Proof to Fully Nonlinear Order

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

Noh, Hyerim; Hwang, Jai-chan; Park, Chan-Gyung

2017-09-01

We present proof of the axion as a cold dark matter (CDM) candidate to the fully nonlinear order perturbations based on Einstein’s gravity. We consider the axion as a coherently oscillating massive classical scalar field without interaction. We present the fully nonlinear and exact, except for ignoring the transverse-tracefree tensor-type perturbation, hydrodynamic equations for an axion fluid in Einstein’s gravity. We show that the axion has the characteristic pressure and anisotropic stress; the latter starts to appear from the second-order perturbation. But these terms do not directly affect the hydrodynamic equations in our axion treatment. Instead, what behaves as themore » effective pressure term in relativistic hydrodynamic equations is the perturbed lapse function and the relativistic result coincides exactly with the one known in the previous non-relativistic studies. The effective pressure term leads to a Jeans scale that is of the solar-system scale for conventional axion mass. As the fully nonlinear and relativistic hydrodynamic equations for an axion fluid coincide exactly with the ones of a zero-pressure fluid in the super-Jeans scale, we have proved the CDM nature of such an axion in that scale.« less

Autotransplantation of a maxillary third molar to replace a maxillary premolar with vertical root fracture.

PubMed

Tsurumachi, T; Kakehashi, Y

2007-12-01

To report the successful autotransplantation of a fully developed third molar that required nonsurgical and surgical interventions for tooth adaptation. This case report describes the autotransplantation of a third molar with complete root development after the loss of a fractured premolar in a 47-year-old male. To allow better adaptation of the donor tooth, the buccal roots of the third molar were removed using a diamond bur and the canal entrances were filled. Recall examination 6 years after completion of root-canal treatment showed normal periodontal healing with absence of infection, ankylosis or progressive resorption. The transplantation of a third molar is seen as a promising method to replace a lost permanent tooth, and to restore aesthetics and function. *Autotransplantation is a viable option for the treatment of a missing tooth or for replacement of traumatized tooth when there is a donor tooth available. *Fully developed third molars are potentially reliable candidates in the absence of other suitable donor teeth.

Waste collection subsystem study

NASA Technical Reports Server (NTRS)

1984-01-01

Practical ways were explored of improving waste compaction and of providing rapid turnaround between flights at essentially no cost for the space shuttle waste collection subsystem commode. Because of the possible application of a fully developed shuttle commode to the space station, means of providing waste treatment without overboard venting were also considered. Three basic schemes for compaction and rapid turnaround, each fully capable of meeting the objectives, were explored in sufficient depth to bring out the characteristic advantages and disadvantages of each. Tradeoff comparisons were very close between leading contenders and efforts were made to refine the design concepts sufficiently to justify a selection. The concept selected makes use of a sealed canister containing wastes that have been forcibly compacted, which is removable in flight. No selection was made between three superior non-venting treatment methods owing to the need for experimental evaluations of the processes involved. A system requirements definition document has been prepared to define the task for a test embodiment of the selected concept.

Evidence base for multimodal therapy in cachexia.

PubMed

Solheim, Tora S; Laird, Barry J A

2012-12-01

The lack of success of unimodal treatment studies in cachexia and the growing awareness that multiple components are responsible for the development of cachexia have led to the view that cachexia intervention should include multimodal treatment. The aim of this article is to examine the evidence for multimodal treatment in the management of cancer cachexia. There are some studies involving multimodal treatment that indicate significant effects on cachexia outcomes. There are, however, no randomized controlled trials to date that incorporate fully a structured exercise program, nutrition, good symptom treatment as well as drug treatment, to counteract the effects of altered metabolism. The effectiveness of any drug intervention for cancer cachexia probably will only be maximized if incorporated into multimodal treatment. Further, cachexia treatment trials should also aim to include patients at an early phase in their cachexia trajectory and use validated outcome measures.

Progress of plasma wakefield self-modulation experiments at FACET

NASA Astrophysics Data System (ADS)

Adli, E.; Berglyd Olsen, V. K.; Lindstrøm, C. A.; Muggli, P.; Reimann, O.; Vieira, J. M.; Amorim, L. D.; Clarke, C. I.; Gessner, S. J.; Green, S. Z.; Hogan, M. J.; Litos, M. D.; O`Shea, B. D.; Yakimenko, V.; Clayton, C.; Marsh, K. A.; Mori, W. B.; Joshi, C.; Vafaei-Najafabadi, N.; Williams, O.

2016-09-01

Simulations and theory predict that long electron and positron beams may under favorable conditions self-modulate in plasmas. We report on the progress of experiments studying the self-modulation instability in plasma wakefield experiments at FACET. The experimental results obtained so far, while not being fully conclusive, appear to be consistent with the presence of the self-modulation instability.

Taking an Attention-Grabbing "Headlines First!" Approach to Engage Students in a Lecture Setting

ERIC Educational Resources Information Center

Harris, G. Keith; Stevenson, Clint; Joyner, Helen

2015-01-01

Let's face it. Traditional lectures do not consistently capture our students' attention, especially when they are PowerPoint-driven and lack student/instructor interaction. Most of us have had the unfortunate feeling that our students were not fully engaged in our lectures, despite hours of preparation on our part. This sense of "wasted"…

Improving Synthetic Biology Communication: Recommended Practices for Visual Depiction and Digital Submission of Genetic Designs.

PubMed

Hillson, Nathan J; Plahar, Hector A; Beal, Jacob; Prithviraj, Ranjini

2016-06-17

Research is communicated more effectively and reproducibly when articles depict genetic designs consistently and fully disclose the complete sequences of all reported constructs. ACS Synthetic Biology is now providing authors with updated guidance and piloting a new tool and publication workflow that facilitate compliance with these recommended practices and standards for visual representation and data exchange.

The nature of turbulence in a triangular lattice gas automaton

NASA Astrophysics Data System (ADS)

Duong-Van, Minh; Feit, M. D.; Keller, P.; Pound, M.

1986-12-01

Power spectra calculated from the coarse-graining of a simple lattice gas automaton, and those of time averaging other stochastic times series that we have investigated, have exponents in the range -1.6 to -2, consistent with observation of fully developed turbulence. This power spectrum is a natural consequence of coarse-graining; the exponent -2 represents the continuum limit.

Motivational Regulatory Styles of Graduate Students Enrolled in Online Prescribed and Elective Courses

ERIC Educational Resources Information Center

Wasmanski, Stephanie Lynn

2018-01-01

The purpose of this study was to explore the regulatory styles, as identified in Ryan and Deci's Self-Determination Theory, of graduate students enrolled in prescribed and elective courses, in a fully online Master of Education degree program. A sample consisting of 53 participants, enrolled in a master's degree program in education at a state…

Bose condensation of nuclei in heavy ion collisions

NASA Technical Reports Server (NTRS)

Tripathi, Ram K.; Townsend, Lawrence W.

1994-01-01

Using a fully self-consistent quantum statistical model, we demonstrate the possibility of Bose condensation of nuclei in heavy ion collisions. The most favorable conditions of high densities and low temperatures are usually associated with astrophysical processes and may be difficult to achieve in heavy ion collisions. Nonetheless, some suggestions for the possible experimental verification of the existence of this phenomenon are made.

A Galilean Invariant Explicit Algebraic Reynolds Stress Model for Curved Flows

NASA Technical Reports Server (NTRS)

Girimaji, Sharath

1996-01-01

A Galilean invariant weak-equilbrium hypothesis that is sensitive to streamline curvature is proposed. The hypothesis leads to an algebraic Reynolds stress model for curved flows that is fully explicit and self-consistent. The model is tested in curved homogeneous shear flow: the agreement is excellent with Reynolds stress closure model and adequate with available experimental data.

A Comparison of Product Realization Frameworks

DTIC Science & Technology

1993-10-01

software (integrated FrameMaker ). Also included are BOLD for on-line documentation delivery, printer/plotter support, and 18 network licensing support. AMPLE...are built with DSS. Documentation tools include an on-line information system (BOLD), text editing (Notepad), word processing (integrated FrameMaker ...within an application. FrameMaker is fully integrated with the Falcon Framework to provide consistent documentation capabilities within engineering

Liberal Education and the Teleological Question; or Why Should a Dentist Read Chaucer?

ERIC Educational Resources Information Center

McIntyre, Kenneth B.

2013-01-01

This essay consists of an examination of the work of three thinkers who conceive of liberal education primarily in teleological terms, and, implicitly if not explicitly, attempt to offer some answer to the question: what does it mean to be fully human? John Henry Newman, T. S. Eliot, and Josef Pieper developed their understanding of liberal…