Evaluating a policing strategy intended to disrupt an illicit street-level drug market.

PubMed

Corsaro, Nicholas; Brunson, Rod K; McGarrell, Edmund F

2010-12-01

The authors examined a strategic policing initiative that was implemented in a high crime Nashville, Tennessee neighborhood by utilizing a mixed-methodological evaluation approach in order to provide (a) a descriptive process assessment of program fidelity; (b) an interrupted time-series analysis relying upon generalized linear models; (c) in-depth resident interviews. Results revealed that the initiative corresponded with a statistically significant reduction in drug and narcotics incidents as well as perceived changes in neighborhood disorder within the target community. There was less-clear evidence, however, of a significant impact on other outcomes examined. The implications that an intensive crime prevention strategy corresponded with a reduction in specific forms of neighborhood crime illustrates the complex considerations that law enforcement officials face when deciding to implement this type of crime prevention initiative.

Histopathological, immunohistochemical, and ultrastructural evidence of spontaneous Senecavirus A-induced lesions at the choroid plexus of newborn piglets.

PubMed

Oliveira, Thalita E S; Michelazzo, Mariana M Z; Fernandes, Thiago; de Oliveira, Admilton G; Leme, Raquel A; Alfieri, Alice F; Alfieri, Amauri A; Headley, Selwyn A

2017-11-29

Epidemic Transient Neonatal Losses (ETNL) is a disease of piglets caused by Senecavirus A (SVA) in which the method of dissemination and associated lesions are not well-defined. This study investigated the possible SVA-induced lesions by examining spontaneous infections in newborn piglets. Histopathology revealed ballooning degeneration of transitional epithelium, nonsuppurative meningoencephalitis, plexus choroiditis, and atrophic enteritis. RT-PCR identified SVA in all tissues evaluated and sequencing confirmed these results. Positive immunoreactivity to SVA was observed in endothelial and epithelial tissues of all organs evaluated. Semithin analysis revealed vacuolization of apical enterocytes of the small intestine, balloon degeneration and necrosis of endothelial cells of the choroid plexus (CP) and nonsuppurative choroid plexitis. Ultrathin evaluation demonstrated hydropic degeneration of apical enterocytes, degeneration and necrosis of endothelium of CP fenestrated capillaries, degeneration of ependymocytes associated with intralesional viral particles. It is proposed that SVA initially infects apical enterocytes of newborn piglets and probably enters the circulatory system with entry to the brain via the CP, by first producing an initial inflammatory reaction, with subsequent encephalitic dissemination. Consequently, SVA probably uses an enteric-neurological method of dissemination.

Counter-intuitive experimental evidence on the initiation of radical crack in ceramic thin films at the atomic scale

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

Zhuang, Chunqiang, E-mail: chunqiang.zhuang@bjut.edu.cn; Li, Zhipeng; Lin, Songsheng

2015-10-15

The basic issue related to radial crack in ceramic thin films has received considerable attention due to the fact that the radial crack plays an important role in evaluating the toughness properties of ceramic materials. In this work, an atomic-scale new experimental evidence is clearly presented to reveal the counter-intuitive initiation, the nucleation and the propagation mechanism of the radial crack in Al-Cr-N ceramic thin films.

Effect of Systematic Desensitization on the Training of Counselors

ERIC Educational Resources Information Center

Monke, Robert H.

1971-01-01

In determining whether the technique of desensitization would reduce the initial anxiety experienced by the beginning counselor trainee, analyses of the data revealed significantly less self-reported anxiety in the experimental group. No differences were found in heart rate, skin resistance, and tape-evaluation measures. (Author/CG(

Genetic evaluation of gestation length as a trait of the service sire

USDA-ARS?s Scientific Manuscript database

Predicted transmitting abilities (PTA) for gestation length (GL) were developed for all dairy breeds and crossbreds. Initial GL edits gave 20.5 million records of 10.8 million cows and included GL after either heifer or cow inseminations. Preliminary analysis revealed a very negative genetic trend i...

Policy Issues in the Administration of Higher Education in Nigeria

ERIC Educational Resources Information Center

Ogbogu, Christiana O.

2013-01-01

This paper evaluates policy initiatives in the Nigerian higher educational system with a view to bringing it in line with good practices. Issues of gender, management/governance, teaching, research and funding were discussed. The study revealed that government's funding is insufficient to maintain institutional performance because of the policy…

Implementation and evaluation of the HEROES initiative: a tri-state coordinated school health program to reduce childhood obesity.

PubMed

King, Mindy H; Lederer, Alyssa M; Sovinski, Danielle; Knoblock, Heidi M; Meade, Rhonda K; Seo, Dong-Chul; Kim, Nayoung

2014-05-01

This article describes the design, implementation, and evaluative findings of the HEROES (Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools) Initiative, a school-based multilevel childhood obesity prevention intervention. Based on the Centers for Disease Control and Prevention's recommended coordinated school health approach, the HEROES Initiative works to alleviate the burden of childhood obesity in Southern Indiana, Northwestern Kentucky, and Southeastern Illinois in the United States. Process evaluation was conducted with the 17 participating schools in spring 2012 based on interviews with school personnel and observation of the school environment. Findings showed that despite some variability, schools were generally able to implement the intervention with fidelity. School-level outcome evaluation was also based on observation of the school environment, and revealed that schools had implemented a number of new practices to encourage physical activity and healthy eating. Assessment of student-level outcomes was based on professionally collected physiological measurements and self-reported behavioral data collected over an 18-month period of time, last collected in spring 2012. Findings demonstrated that the HEROES Initiative has been successful in reducing the percentage of overweight children in participating schools and healthfully modifying their dietary, physical activity, and sedentary behaviors. Strategies that have facilitated success and challenges related to the intervention are discussed.

Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

PubMed

Gotovac, Sandra; Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

2018-04-01

The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.

Unilateral external and internal ophthalmoplegia caused by intracranial meningioma in a dog.

PubMed

Larocca, R.D.

2000-01-01

Unilateral internal and external ophthalmoplegia caused by an intracranial meningioma occurred in a 15-year-old Belgian Sheepdog. The dog initially presented with ventro-lateral strabismus of the left eye, and ptosis of the left upper eyelid. Anisocoria was present with the left pupil fixed and dilated. Both eyes were visual. Neuro-ophthalmic evaluation revealed a lesion located in the left oculomotor nerve. Pharmacological testing with dilute pilocarpine (0.1% in artificial tears) revealed evidence of parasympathetic denervation of the left eye. Further evaluation via magnetic resonance imaging (MRI) revealed a well-defined mass to the left of midline and lateral to the sella turcica. An attempt was made to excise/debulk the mass due to worsening conditions and the dog died the following day. Necropsy revealed a mass of randomly arranged bundles and streams of spindle cells. Immunohistochemistry demonstrated a strong avidity for vimentin and a negative response for S-100 protein. These findings suggest a diagnosis of meningioma.

Evaluation of the Risk Factors for a Rotator Cuff Retear After Repair Surgery.

PubMed

Lee, Yeong Seok; Jeong, Jeung Yeol; Park, Chan-Deok; Kang, Seung Gyoon; Yoo, Jae Chul

2017-07-01

A retear is a significant clinical problem after rotator cuff repair. However, no study has evaluated the retear rate with regard to the extent of footprint coverage. To evaluate the preoperative and intraoperative factors for a retear after rotator cuff repair, and to confirm the relationship with the extent of footprint coverage. Cohort study; Level of evidence, 3. Data were retrospectively collected from 693 patients who underwent arthroscopic rotator cuff repair between January 2006 and December 2014. All repairs were classified into 4 types of completeness of repair according to the amount of footprint coverage at the end of surgery. All patients underwent magnetic resonance imaging (MRI) after a mean postoperative duration of 5.4 months. Preoperative demographic data, functional scores, range of motion, and global fatty degeneration on preoperative MRI and intraoperative variables including the tear size, completeness of rotator cuff repair, concomitant subscapularis repair, number of suture anchors used, repair technique (single-row or transosseous-equivalent double-row repair), and surgical duration were evaluated. Furthermore, the factors associated with failure using the single-row technique and transosseous-equivalent double-row technique were analyzed separately. The retear rate was 7.22%. Univariate analysis revealed that rotator cuff retears were affected by age; the presence of inflammatory arthritis; the completeness of rotator cuff repair; the initial tear size; the number of suture anchors; mean operative time; functional visual analog scale scores; Simple Shoulder Test findings; American Shoulder and Elbow Surgeons scores; and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis. Multivariate logistic regression analysis revealed patient age, initial tear size, and fatty degeneration of the supraspinatus as independent risk factors for a rotator cuff retear. Multivariate logistic regression analysis of the single-row group revealed patient age and fatty degeneration of the supraspinatus as independent risk factors for a rotator cuff retear. Multivariate logistic regression analysis of the transosseous-equivalent double-row group revealed a frozen shoulder as an independent risk factor for a rotator cuff retear. Our results suggest that patient age, initial tear size, and fatty degeneration of the supraspinatus are independent risk factors for a rotator cuff retear, whereas the completeness of rotator cuff repair based on the extent of footprint coverage and repair technique are not.

Development and Assessment of the Social Issues Advocacy Scale

ERIC Educational Resources Information Center

Nilsson, Johanna E.; Marszalek, Jacob M.; Linnemeyer, Rachel M.; Bahner, Angela D.; Misialek, Leah Hanson

2011-01-01

This article describes the development and the initial psychometric evaluation of the Social Issues Advocacy Scale in two studies. In the first study, an exploratory factor analysis (n = 278) revealed a four-factor scale, accounting for 71.4% of the variance, measuring different aspects of social issue advocacy: Political and Social Advocacy,…

An International Schools Perspective on Diagnosis and Treatment of Reading Disabilities.

ERIC Educational Resources Information Center

Balajthy, Ernest

A diagnostic evaluation was conducted on Thomas, a fifth-grade student, to identify levels of reading and major word identification strategies. Initial testing conducted at Thomas' home revealed that he appeared to have an unusually positive attitude toward reading, considering the difficulties it had presented him since kindergarten. Learning…

Initial Teacher Certification Testing in Massachusetts: A Case of the Tail Wagging the Dog.

ERIC Educational Resources Information Center

Flippo, Rona F.; Riccards, Michael P.

2000-01-01

An evaluation of the Massachusetts Educator Certification Test has revealed unforeseen, counterproductive consequences. Teacher preparation colleges are adjusting curricular emphases to teach to a test of dubious validity and are inadvertently excluding substantial portions of enrollees to boost test scores. Minorities are failing at higher rates.…

Can We Reduce Our Implicit Prejudice toward Persons with Disability? The Challenge of Meditation

ERIC Educational Resources Information Center

Schimchowitsch, Sarah; Rohmer, Odile

2016-01-01

The present research further extends recent data revealing implicit attitude towards persons with disability, with the aim to explore if meditation practice can reduce automatic mental processes initiating prejudice. Forty adult experienced meditators and 34 meditation-naïve individuals performed an evaluative priming task. None of them presented…

Effect of eccentric exercise program for early tibialis posterior tendinopathy.

PubMed

Kulig, Kornelia; Lederhaus, Eric S; Reischl, Steve; Arya, Shruti; Bashford, Greg

2009-09-01

Morphology and vascularization of painful tibialis posterior (TP) tendons before and after an intervention targeting the degenerated tendon were examined. Functional status and pain level were also assessed. A10-week twice daily, progressive eccentric tendon loading, calf stretching program with orthoses was implemented with ten, early stage TP tendinopathy subjects. TP tendons were imaged by grayscale and Doppler ultrasound at INITIAL and POST evaluations to assess the tendon's morphology and signs of neovascularization. The Foot Functional Index (FFI), Physical Activity Scale (PAS), 5-Minute Walk Test, and single heel raise (SHR) test were completed at INITIAL and POST evaluations. The Global Rating Scale (GRS) was completed at 6 months followup. One-way ANOVA was used to compare the FFI at INITIAL, POST, and 6-MONTH time points. Paired t-tests were used to compare means between the remaining variables. The level of significance was p = 0.05. There was a significant difference in FFI total, pain, and disability at the three time-points. Post-hoc paired t-tests revealed that the FFI scores were lower for the total score and pain and disability subcategories when comparing from INITIAL to POST and INITIAL to 6-MONTH evaluations (p < 0.05 for all). The number of SHR increased significantly on the involved side from INITIAL to POST evaluation (p = 0.041). The GRS demonstrated minimum clinically important differences for improvements in symptoms at 6-MONTH. Tendon morphology and vascularization remained abnormal following the intervention. A 10-week tendon specific eccentric program resulted in improvements in symptoms and function without changes in tendon morphology or neovascularization.

Thrombophilia-Related Complications in the Treatment of a Left Atrial Appendage Thrombus: A Case Report

PubMed Central

Parato, Vito Maurizio; Scarano, Michele; Labanti, Benedetto

2014-01-01

Trans-esophageal echocardiography (TEE) revealed a left atrial appendage (LAA) thrombus in an 84-year-old woman with nonvalvular atrial fibrillation not known before our evaluation. In her medical history, there were hypertension, dyslipidemia and a previous pulmonary embolism. She was taking warfarin at time of our evaluation and presented signs and symptoms of heart failure. Together with heart failure treatment, intravenous anticoagulation with unfractionated heparin was initiated. Treatment was complicated by additional right lower limb embolic event and the LAA thrombus remained unchanged. Testing revealed heterozygosity for both the factor V Leiden and the methylenetetrahydrofolate reductase C677T mutations inducing resistance to activated protein C. The patient refused transcatheter closure of the left atrial appendage. PMID:28465906

Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure.

PubMed

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Masaoka, Yoshihisa; Tanaka, Takashi; Sato, Takuya; Gobara, Hideo; Toyooka, Shinichi; Kanazawa, Susumu

2018-05-01

To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429-43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631-0.996; p = 0.046). The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.

Superselective Wada test for ruptured spontaneous fusiform middle cerebral artery aneurysm: a technical case report.

PubMed

Rajpal, Sharad; Moftakhar, Roham; Bauer, Andrew M; Turk, Aquilla S; Niemann, David B

2011-09-01

Spontaneous fusiform aneurysms of the middle cerebral artery (sfaMCA) are quite uncommon and tend to occur in young adults. The use of superselective angiography for ruptured and unruptured aneurysms can help delineate vital angioarchitecture and assist with perioperative planning and treatment modality. The use of superselective Wada testing (SWT) for treatment of a ruptured sfaMCA involving the dominant hemisphere, however, has never been described in the English literature. We report a case of a ruptured sfaMCA involving the dominant hemisphere where superselective angiography and SWT were utilized to predict the ability to occlude a major vessel without adverse neurological sequelae. A healthy young patient presented with subarachnoid hemorrhage. Initial CT-angiogram of the head identified a left-sided fusiform MCA aneurysm measuring 1.3 cm by 0.5 cm in maximum dimensions. Diagnostic angiography evaluation demonstrated an irregular, fusiform aneurysm involving the central (Rolandic) trunk of the left MCA. An SWT was then performed through an SL 10 microcatheter with injection of sodium amytal. Verbal, motor and cognitive testing were performed twice and revealed no neurological defects. The patient underwent subsequent coil embolization of the aneurysm. Formal post-procedure evaluation revealed no speech, language or cognitive deficits. She was eventually discharged home and remained without neurological deficits at her follow-up appointment 12 months after her initial presentation. Intraoperative SWT can be performed as part of the initial evaluation for patients with sfaMCA of the dominant cerebral hemisphere to help choose the appropriate treatment algorithm and predict post-treatment neurological deficits.

Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review

PubMed Central

Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

2018-01-01

Introduction The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. PMID:29662521

Ten-year growth comparison between rooted cuttings and seedlings of loblolly pine

Treesearch

H.E. Stelzer; G. Sam Foster; D.V. Shaw; J.B. McRae

1997-01-01

Rooted cuttings and seedlings of loblolly pine (Pinus taeda L.) were established in a central Alabama field trial. Five, full-sib families, with an average number of six clones per family, were evaluated. Mean cutting/seedling height ratios revealed that despite initial differences in size, relative growth rates of both propagule types stabilized and...

Assessment of the Forensic Sciences Profession. A Survey of Educational Offerings in the Forensic Sciences. Volume I.

ERIC Educational Resources Information Center

Field, Kenneth S.; And Others

This survey of the educational offerings in the Forensic Sciences was initiated to identify institutions and agencies offering educational courses and/or programs in the forensic sciences and to evaluate the availability of these programs. The information gathered by surveying members of the American Academy of Forensic Sciences reveals that…

Misstaging of ovarian cancer.

PubMed

McGowan, L; Lesher, L P; Norris, H J; Barnett, M

1985-04-01

The thoroughness of intraoperative evaluation of the extent of disease in 291 women with primary ovarian cancer was investigated. Notable differences among physician specialties but not types of hospitals where initial surgery was performed were observed. A review of medical record documentation revealed that 97% of the cases operated on by gynecologic oncologists had complete staging evaluations performed intraoperatively, but only 52 and 35% of cases operated on by obstetricians/gynecologists and general surgeons, respectfully, were adequately evaluated. Roughly one-half of the cases diagnosed in community hospitals and in hospitals with teaching affiliations were found to be completely studied, and 66% of those operated on in university hospitals received complete intraoperative evaluations.

Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia.

PubMed

Hor, Esther Sl; Subramaniam, Sivasangari; Koay, Jun Min; Bharathy, Arokiamary; Vasudevan, Umadevi; Panickulam, Joseph J; Ng, InnTiong; Arif, Nor Hayati; Russell, Vincent

2016-02-01

To evaluate the monitoring of metabolic parameters among outpatients maintained on antipsychotic medications in a general hospital setting in Malaysia and to assess the impact of a local monitoring protocol. By performing a baseline audit of files from a random sample of 300 patients prescribed antipsychotic medications for at least 1 year; we determined the frequency of metabolic monitoring. The findings informed the design of a new local protocol, on which clinical staff was briefed. We re-evaluated metabolic monitoring immediately after implementation, in a small sample of new referrals and current patients. We explored staff perceptions of the initiative with a follow-up focus group, 6 months post-implementation. The baseline audit revealed a sub-optimal frequency of metabolic parameter recording. Re-audit, following implementation of the new protocol, revealed improved monitoring but persisting deficits. Dialogue with the clinical staff led to further protocol modification, clearer definition of staff roles and use of a standard recording template. Focus group findings revealed positive perceptions of the initiative, but persisting implementation barriers, including cultural issues surrounding waist circumference measurement. Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns. © The Royal Australian and New Zealand College of Psychiatrists 2015.

A Statistical Study on the Effect of Hydrostatic Pressure on Metastable Pitting Corrosion of X70 Pipeline Steel.

PubMed

Yang, Zixuan; Kan, Bo; Li, Jinxu; Qiao, Lijie; Volinsky, Alex A; Su, Yanjing

2017-11-14

Hydrostatic pressure effects on pitting initiation and propagation in X70 steel are investigated by evaluating metastable pitting probability using electrochemical methods and immersion corrosion tests in containing chlorine ion solution. Potentiodynamic tests indicated that hydrostatic pressure can decrease the breakdown potential and lead to a reduced transpassivity region. Metastable test results revealed that hydrostatic pressure can increase metastable pitting formation frequency and promote stabilization of metastable pitting growth. Electrochemical impedance spectroscopy (EIS) results indicate that Hydrostatic pressure decreases the charge transfer resistance and increases the dissolution rate within the cavities. Corrosion test results also indicated that pitting initiation and propagation are accelerated by hydrostatic pressure. Result validity was verified by evaluating metastable pitting to predict pitting corrosion resistance.

A Statistical Study on the Effect of Hydrostatic Pressure on Metastable Pitting Corrosion of X70 Pipeline Steel

PubMed Central

Yang, Zixuan; Kan, Bo; Li, Jinxu; Su, Yanjing; Qiao, Lijie; Volinsky, Alex A.

2017-01-01

Hydrostatic pressure effects on pitting initiation and propagation in X70 steel are investigated by evaluating metastable pitting probability using electrochemical methods and immersion corrosion tests in containing chlorine ion solution. Potentiodynamic tests indicated that hydrostatic pressure can decrease the breakdown potential and lead to a reduced transpassivity region. Metastable test results revealed that hydrostatic pressure can increase metastable pitting formation frequency and promote stabilization of metastable pitting growth. Electrochemical impedance spectroscopy (EIS) results indicate that Hydrostatic pressure decreases the charge transfer resistance and increases the dissolution rate within the cavities. Corrosion test results also indicated that pitting initiation and propagation are accelerated by hydrostatic pressure. Result validity was verified by evaluating metastable pitting to predict pitting corrosion resistance. PMID:29135912

Harnessing Technology to Improve Formative Assessment of Student Conceptions in STEM: Forging a National Network

PubMed Central

Haudek, Kevin C.; Kaplan, Jennifer J.; Knight, Jennifer; Long, Tammy; Merrill, John; Munn, Alan; Nehm, Ross; Smith, Michelle; Urban-Lurain, Mark

2011-01-01

Concept inventories, consisting of multiple-choice questions designed around common student misconceptions, are designed to reveal student thinking. However, students often have complex, heterogeneous ideas about scientific concepts. Constructed-response assessments, in which students must create their own answer, may better reveal students’ thinking, but are time- and resource-intensive to evaluate. This report describes the initial meeting of a National Science Foundation–funded cross-institutional collaboration of interdisciplinary science, technology, engineering, and mathematics (STEM) education researchers interested in exploring the use of automated text analysis to evaluate constructed-response assessments. Participants at the meeting shared existing work on lexical analysis and concept inventories, participated in technology demonstrations and workshops, and discussed research goals. We are seeking interested collaborators to join our research community. PMID:21633063

Harnessing technology to improve formative assessment of student conceptions in STEM: forging a national network.

PubMed

Haudek, Kevin C; Kaplan, Jennifer J; Knight, Jennifer; Long, Tammy; Merrill, John; Munn, Alan; Nehm, Ross; Smith, Michelle; Urban-Lurain, Mark

2011-01-01

Concept inventories, consisting of multiple-choice questions designed around common student misconceptions, are designed to reveal student thinking. However, students often have complex, heterogeneous ideas about scientific concepts. Constructed-response assessments, in which students must create their own answer, may better reveal students' thinking, but are time- and resource-intensive to evaluate. This report describes the initial meeting of a National Science Foundation-funded cross-institutional collaboration of interdisciplinary science, technology, engineering, and mathematics (STEM) education researchers interested in exploring the use of automated text analysis to evaluate constructed-response assessments. Participants at the meeting shared existing work on lexical analysis and concept inventories, participated in technology demonstrations and workshops, and discussed research goals. We are seeking interested collaborators to join our research community.

DIAGNOSIS AND SUCCESSFUL TREATMENT OF A POTENTIALLY ZOONOTIC DERMATOPHYTOSIS CAUSED BY MICROSPORUM GYPSEUM IN A ZOO-HOUSED NORTH AMERICAN PORCUPINE (ERETHIZON DORSATUM).

PubMed

Hackworth, Christine E; Eshar, David; Nau, Melissa; Bagladi-Swanson, Mary; Andrews, Gordon A; Carpenter, James W

2017-06-01

A female North American porcupine ( Erethizon dorsatum ) was evaluated for a unilateral pedal crusting and alopecic dermatopathy. Fungal culture and histopathology testing revealed Microsporum gypseum dermatophytosis. Treatment with topical miconazole was initiated and then discontinued after 9 days and changed to oral terbinafine. Twenty-eight days after initial examination, clinical signs were improving, and fungal cultures of the front foot, muzzle, and noninfected area along the dorsum were negative for M. gypseum. Visual exams were conducted on a regular basis. Eighty-three days after initial evaluation, clinical signs had completely resolved and repeat fungal cultures were negative. One of the animal's keepers was suspected to have acquired a dermal fungal infection 3 days after contact with this porcupine, and lesions had resolved after treatment with topical ketoconazole. To the authors' knowledge, this is the first report of M. gypseum diagnosed and treated in a captive North American porcupine. Veterinary staff and zookeepers should be aware of this potentially zoonotic infection.

Breast mass as the initial presentation of esophageal carcinoma: a case report

PubMed Central

Norooz, Mohammad Tayefeh; Ahmadi, Hamed; Zavarei, Mansour Jamali; Daryaei, Parviz

2009-01-01

Introduction Esophageal cancer is considered as a fatal malignancy. It mostly metastasizes to lung, liver, and bone while breast metastasis has been rarely reported. This is the fifth report of metastatic breast cancer from esophageal cancer, which differs from previous reported cases in terms of initial presentation with metastatic breast mass and no metastatic involvement of other organs. Case presentation We present a 35-year-old Caucasian woman who initially complained of a painful breast mass. Squamous pearls on cytologic evaluation suggested a metastatic lesion. Two months history of dysphagia was extracted through detailed interview with patient and further investigation revealed a stage IV esophageal squamous cell carcinoma. Conclusion In this case, breast lesion as an unusual presentation of esophageal carcinoma emphasizes the great role of thorough medical history taking and cytologic study in evaluating an accidentally detected breast mass. The increasing reports of breast metastasis in patients with esophageal carcinoma necessitate the careful breast examination in visits after treatment of the primary tumor. PMID:19829901

Synchronous occurrence of neuroendocrine colon carcinoma and hairy cell leukemia.

PubMed

Salemis, Nikolaos S; Pinialidis, Dionisios; Tsiambas, Evangelos; Gakis, Christos; Nakos, Georgios; Sambaziotis, Dimitrios; Christofyllakis, Charalambos

2011-09-01

BACKGROUND-PURPOSE: The risk of secondary malignancy development in patients with hairy cell leukemia has been evaluated in several studies with varying results. The aim of this study is to describe a case of synchronous occurrence of neuroendocrine colon carcinoma and hairy cell leukemia. A 69-year-old man presented with rectal bleeding. Colonoscopy revealed a rectal tumor, whereas biopsy specimens revealed a poorly differentiated carcinoma. During the preoperative evaluation, pancytopenia was detected. At laparotomy, a mass was detected 16 cm from the anal verge and an anterior resection of the rectum was performed. Detailed histological and immunohistochemical analyses revealed a poorly differentiated neuroendocrine carcinoma of the rectum. Postoperative evaluation of pancytopenia revealed hairy cell leukemia. The patient was initially treated with chemotherapy for hairy cell leukemia followed by chemotherapy for neuroendocrine colon carcinoma. Survival was 44 months. To our knowledge, synchronous occurrence of neuroendocrine colon carcinoma and hairy cell leukemia has not been previously reported in the literature. Given the rare incidence of both entities in the general population, it is highly unlikely that they occurred together by chance. Further research is needed to determine what would be the optimal management options of patients with simultaneous hairy cell leukemia and a neuroendocrine colon cancer.

Fatigue Crack Topography.

DTIC Science & Technology

1984-01-01

nominal cycle frequency of 15 Hz. Buckling of the specimens during compression loading was prevented by felt-lined aluminium alloy antibuckling guides...evaluating ciack initiation time and crack propagation, prgram I was used for performing the major fatigue test with the aircraft structure. In...direction of the notch to prevent scratches in the through-the-thickness direction. Prior to testing, the notch surfaces were lightly etched to reveal

Breaking Down the Stigma of Mental Illness through an Adventure Camp: A Collaborative Education Initiative.

ERIC Educational Resources Information Center

Stuhlmiller, Cynthia M.

2003-01-01

Describes an outdoor adventure camp to help mental health consumers and nursing students explore the issues of mental health and illness through experiential and perceived risk challenges. Evaluation data reveals a breakdown in the stigma of mental illness as consumers and students came to know, trust, and count on each other in order to succeed…

The role of fundus autofluorescence in late-onset retinitis pigmentosa (LORP) diagnosis.

PubMed

Lee, Tamara J; Hwang, John C; Chen, Royce W S; Lima, Luiz H; Wang, Nan-Kai; Tosi, Joaquin; Freund, K Bailey; Yannuzzi, Lawrence A; Tsang, Stephen H

2014-09-01

To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa. Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed. All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing. Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis.

Perceptual learning in Williams syndrome: looking beyond averages.

PubMed

Gervan, Patricia; Gombos, Ferenc; Kovacs, Ilona

2012-01-01

Williams Syndrome is a genetically determined neurodevelopmental disorder characterized by an uneven cognitive profile and surprisingly large neurobehavioral differences among individuals. Previous studies have already shown different forms of memory deficiencies and learning difficulties in WS. Here we studied the capacity of WS subjects to improve their performance in a basic visual task. We employed a contour integration paradigm that addresses occipital visual function, and analyzed the initial (i.e. baseline) and after-learning performance of WS individuals. Instead of pooling the very inhomogeneous results of WS subjects together, we evaluated individual performance by expressing it in terms of the deviation from the average performance of the group of typically developing subjects of similar age. This approach helped us to reveal information about the possible origins of poor performance of WS subjects in contour integration. Although the majority of WS individuals showed both reduced baseline and reduced learning performance, individual analysis also revealed a dissociation between baseline and learning capacity in several WS subjects. In spite of impaired initial contour integration performance, some WS individuals presented learning capacity comparable to learning in the typically developing population, and vice versa, poor learning was also observed in subjects with high initial performance levels. These data indicate a dissociation between factors determining initial performance and perceptual learning.

Assessing Management Support for Worksite Health Promotion: Psychometric Analysis of the Leading by Example (LBE) Instrument

PubMed Central

Della, Lindsay J.; DeJoy, David M.; Goetzel, Ron Z.; Ozminkowski, Ronald J.; Wilson, Mark G.

2009-01-01

Objective This paper describes the development of the Leading by Example (LBE) instrument. Methods Exploratory factor analysis was used to obtain an initial factor structure. Factor validity was evaluated using confirmatory factor analysis methods. Cronbach’s alpha and item-total correlations provided information on the reliability of the factor subscales. Results Four subscales were identified: business alignment with health promotion objectives; awareness of the health-productivity link; worksite support for health promotion; leadership support for health promotion. Factor by group comparisons revealed that the initial factor structure is effective in detecting differences in organizational support for health promotion across different employee groups Conclusions Management support for health promotion can be assessed using the LBE, a brief, self-report questionnaire. Researchers can use the LBE to diagnose, track, and evaluate worksite health promotion programs. PMID:18517097

Discussing Occupy Wall Street on Twitter: longitudinal network analysis of equality, emotion, and stability of public discussion.

PubMed

Wang, Cheng-Jun; Wang, Pian-Pian; Zhu, Jonathan J H

2013-09-01

To evaluate the quality of public discussion about social movements on Twitter and to understand the structural features and evolution of longitudinal discussion networks, we analyze tweets about the Occupy Wall Street movement posted over the course of 16 days by investigating the relationship between inequality, emotion, and the stability of online discussion. The results reveal that (1) the discussion is highly unequal for both initiating discussions and receiving conversations; (2) the stability of the discussion is much higher for receivers than for initiators; (3) the inequality of online discussions moderates the stability of online discussions; and (4) on an individual level, there is no significant relationship between emotion and political discussion. The implications help evaluate the quality of public discussion, and to understand the relationship between online discussion and social movements.

DUE (drug usage evaluation) of ticarcillin and clavulanate potassium: determining appropriate and cost-effective therapeutic options.

PubMed

Lomaestro, B M; Lesar, T S

1988-11-01

The initial 46 patients who were prescribed the combination drug ticarcillin disodium and clavulanate potassium in a 640-bed teaching hospital were evaluated to determine the potential usefulness of the drug in the institution. The review revealed frequent use of the drug for inappropriate indications and in situations for which less expensive antimicrobials were appropriate. The results demonstrate that an increase in costs can occur when an agent that is being considered for formulary addition--because of its cost-saving potential--is not used as expected. In order to optimally utilize the clinical or cost advantages of newer antimicrobials, a program of prescriber education, drug use controls or guidelines, and a concurrent monitoring program may be required and should be implemented at the time of initial drug use within an institution.

Follow-Up Review of the 1982 Analysis of Operation, University of Mississippi School of Dentistry. Report to the Mississippi Legislature.

ERIC Educational Resources Information Center

Neasman, G. E., Comp.; And Others

Results of a followup legislative review of the operation of the University of Mississippi School of Dentistry are summarized. An initial 1982 evaluation of the dental school revealed numerous deficiencies in financial and operational management. Among other things, the 1982 report concluded the the dental school, the third smallest in the United…

Nondestructive evaluation of loading and fatigue effects in Haynes(R) 230(R) alloy

NASA Astrophysics Data System (ADS)

Saleh, Tarik Adel

Nondestructive evaluation is a useful method for studying the effects of deformation and fatigue. In this dissertation I employed neutron and X-ray diffraction, nonlinear resonant ultrasound spectroscopy (NRUS), and infrared thermography to study the effects of deformation and fatigue on two different nickel based superalloys. The alloys studied were HAYNES 230, a solid solution strengthened alloy with 4% M6C carbides, and secondarily HASTELLOY C-2000 a similar single phase alloy. Using neutron and X-ray diffraction, the deformation behavior of HAYNES 230 was revealed to be composite-like during compression, but unusual in tension, where the carbides provide strengthening until just after the macroscopic yield strength and then they begin to debond and crack, creating a tension-compression asymmetry that is revealed clearly by in situ diffraction. In fatigue of HAYNES 230, the hkl elastic strains changed very little in tension-tension fatigue. However, in situ tension-compression studies showed large changes over the initial stages of fatigue. The HAYNES 230 samples studies had two distinct starting textures, measured by neutron diffraction. Some samples were texture free initially and deformed in tension and compression to fiber textures. Other samples started with a bimodal texture due to cross-rolling and incomplete annealing. The final texture of these bimodal samples is shown through modeling to be a superposition of the initial texture and typical FCC deformation mechanisms. The texture-free samples deformed significantly more macroscopically and in internal elastic strains than the samples with the cross-rolled texture. In contrast to the relative insensitivity of neutron diffraction to the effects of tension-tension fatigue, NRUS revealed large differences between as-received and progressively fatigued samples. This showed that microcracking and void formation are the primary mechanisms responsible for fatigue damage in tension-tension fatigue. NRUS is shown to be a useful complimentary technique to neutron diffraction to evaluate fatigue damage. Finally, infrared thermography is used to show temperature changes over the course of fatigue in HASTELLOY C-2000. Four stages of temperature are shown over the course of a single fatigue test. Both empirical and theoretical relationships between steady state temperature and fatigue life are developed and presented.

A non-pregnant woman with elevated beta-HCG: A case of para-neoplastic syndrome in ovarian cancer.

PubMed

Goldstein, Jennifer; Pandey, Prasamsa; Fleming, Nicole; Westin, Shannon; Piha-Paul, Sarina

2016-08-01

There is a broad range of possible diagnoses for an elevated beta human chorionic gonadotropin (β-hCG) in the absence of intrauterine or ectopic pregnancy. When women of child bearing potential undergo evaluation for clinical trial, it is often unclear what course of evaluation to take when a pregnancy test is positive. We describe the clinical course of a patient with widely metastatic mucinous ovarian carcinoma with metastasis to the peritoneum, lymph nodes and liver. The patient was found to have a mildly elevated β-hCG during initial evaluation for clinical trial. Extensive work up for ectopic pregnancy, trophoblastic disease, and phantom β-hCG were negative. The patient's β-hCG levels continued to rise until initiation of therapy. She was treated on a phase I protocol with restaging scans revealing a partial response. The β-hCG was retested and declined in conjunction with her response, consistent with paraneoplastic β-hCG. Here, we propose a decision making algorithm to evaluate a patient with an elevated β-hCG undergoing assessment for clinical trial.

A case of unilateral phthiriasis palpebrarum infestation involving the left eye.

PubMed

Ashraf, Mohammad; Waris, Abdul; Kumar, Ashwini; Akhtar, Nahid

2014-06-06

Phthiriasis palpebrarum is a rare cause of eyelid infestation. We report a case of unilateral phthiriasis palpebrarum. A 28-year-old man presented with moderate itching associated with lacrimation and irritation in the left eye. The initial evaluation of the patient revealed multiple white dots on the left upper eyelashes. Slit-lamp examination revealed multiple nits attached to the base and shaft of the cilia. There was no hyperaemia or discharge present in the conjunctiva and the cornea was clear and shiny. The right eye was perfectly normal. The patient was treated with moxifloxacin eye ointment and was completely cured in 1 week. 2014 BMJ Publishing Group Ltd.

Successful Resection of a Growing Distal Medial Lenticulostriate Artery Pseudoaneurysm Presenting with Isolated Intraventricular Hemorrhage.

PubMed

Sato, Yosuke; Ando, Kazuhiro; Kawaguchi, Makoto; Kakinuma, Kenichi

2017-10-01

Distal medial lenticulostriate artery (LSA) aneurysms associated with isolated intraventricular hemorrhage (IVH) are extremely rare. We report a very rare case of the isolated IVH due to the rupture of the distal medial LSA pseudoaneurysm that was not visible at the initial angiography but later emerged and grew. A 61-year-old woman with a history of hypertension had sudden onset of severe headache and mild consciousness disturbance. The computed tomography scan revealed the IVH, but the initial angiographies showed no evidence of aneurysm. The follow-up magnetic resonance imaging revealed that an intraventricular mass, arising from the right distal medial LSA, emerged and grew into the right anterior horn. Considering the risk of rebleeding, we resected the mass lesion via the transsulcal transventricular approach. The postoperative imaging showed complete obliteration of the mass lesion. Histopathological analysis indicated the pseudoaneurysm. The patient was discharged without any neurological deficit. The careful and repetitive follow-up imaging should be done in the cases with isolated IVH even if the initial image evaluations are unrevealing. The transsulcal transventricular approach can be the most minimally invasive surgical option for intraventricular lesion. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

On the Automaticity of the Evaluative Priming Effect in the Valent/Non-Valent Categorization Task

PubMed Central

Spruyt, Adriaan; Tibboel, Helen

2015-01-01

It has previously been argued (a) that automatic evaluative stimulus processing is critically dependent upon feature-specific attention allocation and (b) that evaluative priming effects can arise in the absence of dimensional overlap between the prime set and the response set. In line with both claims, research conducted at our lab revealed that the evaluative priming effect replicates in the valent/non-valent categorization task. This research was criticized, however, because non-automatic, strategic processes may have contributed to the emergence of this effect. We now report the results of a replication study in which the operation of non-automatic, strategic processes was controlled for. A clear-cut evaluative priming effect emerged, thus supporting initial claims concerning feature-specific attention allocation and dimensional overlap. PMID:25803444

On the automaticity of the evaluative priming effect in the valent/non-valent categorization task.

PubMed

Spruyt, Adriaan; Tibboel, Helen

2015-01-01

It has previously been argued (a) that automatic evaluative stimulus processing is critically dependent upon feature-specific attention allocation and (b) that evaluative priming effects can arise in the absence of dimensional overlap between the prime set and the response set. In line with both claims, research conducted at our lab revealed that the evaluative priming effect replicates in the valent/non-valent categorization task. This research was criticized, however, because non-automatic, strategic processes may have contributed to the emergence of this effect. We now report the results of a replication study in which the operation of non-automatic, strategic processes was controlled for. A clear-cut evaluative priming effect emerged, thus supporting initial claims concerning feature-specific attention allocation and dimensional overlap.

Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

PubMed

Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

2010-05-01

This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

Salicylanilide Inhibitors of Toxoplasma gondii

PubMed Central

Fomovska, Alina; Wood, Richard D.; Mui, Ernest; Dubey, Jitenter P.; Ferriera, Leandra R.; Hickman, Mark R.; Lee, Patricia J.; Leed, Susan E.; Auschwitz, Jennifer M.; Welsh, William J.; Sommerville, Caroline; Woods, Stuart; Roberts, Craig; McLeod, Rima

2012-01-01

Toxoplasma gondii(T. gondii) is an apicomplexan parasite that can cause eye disease, brain disease, and death, especially in congenitally infected and immune-compromised people. Novel medicines effective against both active and latent forms of the parasite are greatly needed. The current study focused on the discovery of such medicines by exploring a family of potential inhibitors whose anti-apicomplexan activity has not been previously reported. Initial screening efforts revealed that niclosamide, a drug approved for anthelmintic use, possessed promising activity in vitro against T. gondii. This observation inspired the evaluation of the activity of a series of salicylanilides and derivatives. Several inhibitors with activities in the nanomolar range with no appreciable in vitro toxicity to human cells were identified. An initial structure-activity relationship was explored. Four compounds were selected for evaluation in an in vivo model of infection, and two derivatives with potentially enhanced pharmacological parameters demonstrated the best activity profiles. PMID:22970937

Discussing Occupy Wall Street on Twitter: Longitudinal Network Analysis of Equality, Emotion, and Stability of Public Discussion

PubMed Central

Wang, Pian-Pian; Zhu, Jonathan J.H.

2013-01-01

Abstract To evaluate the quality of public discussion about social movements on Twitter and to understand the structural features and evolution of longitudinal discussion networks, we analyze tweets about the Occupy Wall Street movement posted over the course of 16 days by investigating the relationship between inequality, emotion, and the stability of online discussion. The results reveal that (1) the discussion is highly unequal for both initiating discussions and receiving conversations; (2) the stability of the discussion is much higher for receivers than for initiators; (3) the inequality of online discussions moderates the stability of online discussions; and (4) on an individual level, there is no significant relationship between emotion and political discussion. The implications help evaluate the quality of public discussion, and to understand the relationship between online discussion and social movements. PMID:23656222

Brain Activity and Human Unilateral Chewing

PubMed Central

Quintero, A.; Ichesco, E.; Myers, C.; Schutt, R.; Gerstner, G.E.

2012-01-01

Brain mechanisms underlying mastication have been studied in non-human mammals but less so in humans. We used functional magnetic resonance imaging (fMRI) to evaluate brain activity in humans during gum chewing. Chewing was associated with activations in the cerebellum, motor cortex and caudate, cingulate, and brainstem. We also divided the 25-second chew-blocks into 5 segments of equal 5-second durations and evaluated activations within and between each of the 5 segments. This analysis revealed activation clusters unique to the initial segment, which may indicate brain regions involved with initiating chewing. Several clusters were uniquely activated during the last segment as well, which may represent brain regions involved with anticipatory or motor events associated with the end of the chew-block. In conclusion, this study provided evidence for specific brain areas associated with chewing in humans and demonstrated that brain activation patterns may dynamically change over the course of chewing sequences. PMID:23103631

Non-destructive and non-invasive observation of friction and wear of human joints and of fracture initiation by acoustic emission.

PubMed

Schwalbe, H J; Bamfaste, G; Franke, R P

1999-01-01

Quality control in orthopaedic diagnostics according to DIN EN ISO 9000ff requires methods of non-destructive process control, which do not harm the patient by radiation or by invasive examinations. To obtain an improvement in health economy, quality-controlled and non-destructive measurements have to be introduced into the diagnostics and therapy of human joints and bones. A non-invasive evaluation of the state of wear of human joints and of the cracking tendency of bones is, as of today's point of knowledge, not established. The analysis of acoustic emission signals allows the prediction of bone rupture far below the fracture load. The evaluation of dry and wet bone samples revealed that it is possible to conclude from crack initiation to the bone strength and thus to predict the probability of bone rupture.

Influence of cow breed type, age and previous lactation status on cow height, calf growth, and patterns of body weight, condition, and blood metabolites for cows grazing bahiagrass pastures

USDA-ARS?s Scientific Manuscript database

Economic analysis has revealed that in most parts of the country, the largest economic costs for cattle production are for winter feed. This study was initiated to evaluate the effect of two winter nutrition programs on three breeds of cows grazing bahiagrass pastures in central Florida. Data on 4...

The Role of Fundus Autofluorescence in Late-Onset Retinitis Pigmentosa (LORP) Diagnosis

PubMed Central

Lee, Tamara J.; Hwang, John C.; Chen, Royce W. S.; Lima, Luiz H.; Wang, Nan-Kai; Tosi, Joaquin; Freund, K. Bailey; Yannuzzi, Lawrence A.; Tsang, Stephen H.

2015-01-01

Purpose To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa. Methods Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed. Results All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing. Conclusion Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis. PMID:23899229

Monomorphous Plurihormonal Pituitary Adenoma of Pit-1 Lineage in a Giant Adolescent with Central Hyperthyroidism.

PubMed

Pereira, Bernardo Dias; Raimundo, Luísa; Mete, Ozgur; Oliveira, Ana; Portugal, Jorge; Asa, Sylvia L

2016-03-01

Thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare at the pediatric age and no cases of co-secretion with other pituitary hormones in these tumors have been described in this age range. We present a case of a monomorphous plurihormonal pituitary adenoma that co-secreted TSH and GH in a pediatric patient. A 13-year-old male presented with increasing height velocity (17.75 cm/year, 9.55SD), weight loss, and visual impairment. Initial biochemical evaluations revealed secondary hyperthyroidism. A giant pituitary tumor compressing the surrounding structures was detected by magnetic resonance, and a transsphenoidal surgery was initially performed. Pathological examinations revealed an atypical, monomorphous plurihormonal Pit-1 lineage tumor with mixed features of silent subtype 3 adenoma and acidophil stem cell adenoma. In the postoperative period, secondary hyperthyroidism recurred with high levels of both GH and IGF1. In addition, due to tumor re-growth, a multimodality treatment plan was undertaken including surgery, somatostatin analogs, and radiotherapy. We report the first pediatric case of a plurihormonal TSH- and GH-secreting pituitary adenoma, further expanding the clinical manifestations of pediatric pituitary tumors. Comprehensive pathological evaluation and close follow-up surveillance are crucial to the prompt delivery of the best therapeutic options in the context of this particularly aggressive pituitary tumor.

The development of a screening tool to evaluate gross motor function in HIV-infected infants.

PubMed

Hilburn, Nicole; Potterton, Joanne; Stewart, Aimee; Becker, Piet

2011-12-01

Neurodevelopmental delay or HIV encephalopathy is a stage four disease indicator for paediatric HIV/AIDS according to the World Health Organisation (WHO), and may be used as a criterion for initiation of highly active antiretroviral therapy (HAART). To date, the only means of prevention of this condition is early initiation of HAART. Studies which have been carried out in South African clinics have revealed the high prevalence of this condition. In developing countries, commencement of HAART is based on declining virologic and immunologic status, as standardised neurodevelopmental assessment tools are not widely available. A standardised developmental screening tool which is suitable for use in a developing country is therefore necessary in order to screen for neurodevelopmental delay to allow for further assessment and referral to rehabilitation services, as well as providing an additional assessment criterion for initiation of HAART. The infant gross motor screening test (IGMST) was developed for this purpose. The standardisation sample of the IGMST consisted of 112 HIV-infected infants between six and 18 months of age. Item selection for the IGMST was based on the Gross Motor scale of the Bayley Scales of Infant Development (BSID)-III. Content validity was assessed by a panel of experts using a nominal group technique (NGT; agreement >80%). Concurrent validity (n=60) of the IGMST was carried out against the BSID-III, and agreement was excellent (K=0.85). The diagnostic properties of the IGMST were evaluated and revealed: sensitivity 97.4%, specificity 85.7%, positive predictive value (PPV) 92.7%, and negative predictive value (NPV) 94.7%. Reliability testing (n=30) revealed inter-rater reliability as: r=1, test-retest reliability: r=0.98 and intra-rater reliability: r=0.98. The results indicate that the statistical properties of the IGMST are excellent, and the tool is suitable for use within the paediatric HIV setting.

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

Kimelman, Aya; Levy, Asaf; Sberro, Hila

In the process of clone-based genome sequencing, initial assemblies frequently contain cloning gaps that can be resolved using cloning-independent methods, but the reason for their occurrence is largely unknown. By analyzing 9,328,693 sequencing clones from 393 microbial genomes we systematically mapped more than 15,000 genes residing in cloning gaps and experimentally showed that their expression products are toxic to the Escherichia coli host. A subset of these toxic sequences was further evaluated through a series of functional assays exploring the mechanisms of their toxicity. Among these genes our assays revealed novel toxins and restriction enzymes, and new classes of smallmore » non-coding toxic RNAs that reproducibly inhibit E. coli growth. Further analyses also revealed abundant, short toxic DNA fragments that were predicted to suppress E. coli growth by interacting with the replication initiator dnaA. Our results show that cloning gaps, once considered the result of technical problems, actually serve as a rich source for the discovery of biotechnologically valuable functions, and suggest new modes of antimicrobial interventions.« less

Bilateral Proliferative Retinopathy as the Initial Presentation of Chronic Myeloid Leukemia

PubMed Central

Macedo, Mafalda S. F.; Figueiredo, Ana R. M.; Ferreira, Natália N.; Barbosa, Irene M. A.; Furtado, Maria João F. B. S.; Correia, Nuno F. C. B. A.; Gomes, Miguel P.; Lume, Miguel R. B.; Menéres, Maria João S.; Santos, Marinho M. N.; Meireles S., M. Angelina C.

2013-01-01

The authors report a rare case of a 48-year-old male with chronic myeloid leukemia (CML) who initially presented with a bilateral proliferative retinopathy. The patient complained of recent visual loss and floaters in both eyes (BE). Ophthalmologic evaluation revealed a best corrected visual acuity (BCVA) of 20/50 in the right eye and 20/200 in the left eye (LE). Fundoscopy showed the presence of bilateral peripheral capillary dropout with multiple retinal sea fan neovascularisations, which were confirmed on fluorescein angiography. Full blood count revealed hyperleukocytosis, thrombocytosis, anemia, and hyperuricemia. Bone marrow aspiration and biopsy showed the reciprocal chromosomal translocation t (9;22), diagnostic of CML. The patient was started on hydroxyurea, allopurinol and imatinib mesylate. He received bilateral panretinal laser photocoagulation and a vitrectomy was performed in the LE. The patient has been in complete hematologic, cytogenetic, and major molecular remission while on imatinib and his BCVA is 20/25 in BE. PMID:24339689

Long-term survival in a dog with meningoencephalitis and epidural abscessation due to Actinomyces species.

PubMed

Song, Rachel B; Vitullo, Carina A; da Costa, Ronaldo C; Daniels, Joshua B

2015-07-01

A 2-year-old, female spayed Golden Retriever dog was presented to The Ohio State University Veterinary Medical Center for evaluation of ataxia, cervical pain, 1 episode of acute collapse, dull mentation, and inappetence. Physical examination revealed an elevated temperature of 39.7°C and severe cervical pain. Blood work revealed a mature neutrophilia. Cerebrospinal fluid (CSF) analysis revealed nondegenerative neutrophilic pleocytosis with no infectious agents. A presumptive diagnosis of steroid-responsive meningitis-arteritis was made, and corticosteroid therapy was started. The patient improved initially but experienced a vestibular episode characterized by falling and vertical nystagmus. A magnetic resonance imaging of the brain revealed an epidural abscess in the cervical vertebral canal and diffuse meningeal enhancement in the brain and cranial cervical spine. Abscess drainage revealed degenerate neutrophils and several filamentous, branching organisms. Culture of the initial CSF using an enrichment broth revealed growth of a Gram-positive organism 5 days after fluid collection. The isolate was identified by partial 16S ribosomal DNA sequencing as Actinomyces spp. The patient was successfully treated with long-term antibiotics. Our study reports the long-term survival after medical treatment of bacterial meningoencephalitis and epidural abscessation due to Actinomyces sp. infection in a dog. Bacterial meningoencephalitis should be included as a differential diagnosis in patients with cervical pain and fever, even when a nondegenerative neutrophilic pleocytosis is found on CSF analysis. Culture of the CSF with use of an enrichment broth should be considered in all cases of neutrophilic pleocytosis to rule out infections of the central nervous system. © 2015 The Author(s).

Septic abortion presenting as a right lower trapezius abscess secondary to Bacteroides fragilis bacteraemia.

PubMed

Yamanaka, Yusuke; Shimabukuro, Akira

2017-08-21

A 43-year-old Japanese woman was evaluated in the outpatient department for right shoulder pain and fever, which began 5 days earlier. MRI of the right shoulder revealed a high-intensity area deep in the right trapezius muscle. Aspiration revealed purulent fluid, and Gram staining of the fluid showed Gram-negative bacilli. The patient was also found to be profoundly anaemic and to have a positive urine pregnancy test. On admission, we initiated intravenous ampicillin-sulbactam and aztreonam. She underwent dilatation and curettage for septic abortion and surgical drainage of the right shoulder abscess. Bacteroides fragilis was isolated from the blood, uterine aspiration and abscess samples. On hospital day 4, a whole-body CT scan revealed no other abscesses, and ampicillin-sulbactam was continued for 28 days. The patient was discharged on hospital day 29. Gram staining is an important tool for evaluating infectious aetiologies. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical management of maxillary and premaxillary osteomyelitis in a reticulated python (Python reticulatus).

PubMed

Latney, La'Toya V; McDermott, Colin; Scott, Gregory; Soltero-Rivera, Maria M; Beguesse, Kyla; Sánchez, Melissa D; Lewis, John R

2016-05-01

CASE DESCRIPTION A 1-year-old reticulated python (Python reticulatus) was evaluated because of a 2-week history of wheezing and hissing. CLINICAL FINDINGS Rostral facial cellulitis and deep gingival pockets associated with missing rostral maxillary teeth were evident. Tissues of the nares were swollen, resulting in an audible wheeze during respiration. Multiple scars and superficial facial wounds attributed to biting by live prey were apparent. Radiographic examination revealed bilateral, focal, rostral maxillary osteomyelitis. TREATMENT AND OUTCOME Wound irrigation, antimicrobials, and anti-inflammatory drug treatment resulted in reduced cellulitis. A 3-week regimen that included empirical antimicrobial treatment and improved husbandry resulted in resolution of the respiratory sounds and partial healing of bite wounds, but radiographic evaluation revealed progressive maxillary osteomyelitis. Microbial culture of blood yielded scant gram-positive cocci and Bacillus spp, which were suspected sample contaminants. Bilateral partial maxillectomies were performed; microbial culture and histologic examination of resected bone confirmed osteomyelitis with gram-positive cocci. Treatment with trimethoprim-sulfamethoxazole was initiated on the basis of microbial susceptibility tests. Four months later, follow-up radiography revealed premaxillary osteomyelitis; surgery was declined, and treatment with trimethoprim-sulfamethoxazole was reinstituted. Eight months after surgery, the patient was reevaluated because of recurrent clinical signs; premaxillectomy was performed, and treatment with trimethoprim-sulfamethoxazole was prescribed on the basis of microbial culture of bone and microbial susceptibility testing. Resolution of osteomyelitis was confirmed by CT 11 months after the initial surgery. CONCLUSIONS AND CLINICAL RELEVANCE Focal maxillectomies and premaxillectomy were successfully performed in a large python. Surgical management and appropriate antimicrobial treatment resulted in a good outcome.

Mate Choice in Adult Female Bengalese Finches: Females Express Consistent Preferences for Individual Males and Prefer Female-Directed Song Performances

PubMed Central

Dunning, Jeffery L.; Pant, Santosh; Bass, Aaron; Coburn, Zachary; Prather, Jonathan F.

2014-01-01

In the process of mate selection by female songbirds, male suitors advertise their quality through reproductive displays in which song plays an important role. Females evaluate the quality of each signal and the associated male, and the results of that evaluation guide expression of selective courtship displays. Some studies reveal broad agreement among females in their preferences for specific signal characteristics, indicating that those features are especially salient in female mate choice. Other studies reveal that females differ in their preference for specific characteristics, indicating that in those cases female evaluation of signal quality is influenced by factors other than simply the physical properties of the signal. Thus, both the physical properties of male signals and specific traits of female signal evaluation can impact female mate choice. Here, we characterized the mate preferences of female Bengalese finches. We found that calls and copulation solicitation displays are equally reliable indicators of female preference. In response to songs from an array of males, each female expressed an individual-specific song preference, and those preferences were consistent across tests spanning many months. Across a population of females, songs of some males were more commonly preferred than others, and females preferred female-directed songs more than undirected songs, suggesting that some song features are broadly attractive. Preferences were indistinguishable for females that did or did not have social experience with the singers, indicating that female preference is strongly directed by song features rather than experiences associated with the singer. Analysis of song properties revealed several candidate parameters that may influence female evaluation. In an initial investigation of those parameters, females could be very selective for one song feature yet not selective for another. Therefore, multiple song parameters are evaluated independently. Together these findings reveal the nature of signal evaluation and mate choice in this species. PMID:24558501

Probability distributions of continuous measurement results for conditioned quantum evolution

NASA Astrophysics Data System (ADS)

Franquet, A.; Nazarov, Yuli V.

2017-02-01

We address the statistics of continuous weak linear measurement on a few-state quantum system that is subject to a conditioned quantum evolution. For a conditioned evolution, both the initial and final states of the system are fixed: the latter is achieved by the postselection in the end of the evolution. The statistics may drastically differ from the nonconditioned case, and the interference between initial and final states can be observed in the probability distributions of measurement outcomes as well as in the average values exceeding the conventional range of nonconditioned averages. We develop a proper formalism to compute the distributions of measurement outcomes, and evaluate and discuss the distributions in experimentally relevant setups. We demonstrate the manifestations of the interference between initial and final states in various regimes. We consider analytically simple examples of nontrivial probability distributions. We reveal peaks (or dips) at half-quantized values of the measurement outputs. We discuss in detail the case of zero overlap between initial and final states demonstrating anomalously big average outputs and sudden jump in time-integrated output. We present and discuss the numerical evaluation of the probability distribution aiming at extending the analytical results and describing a realistic experimental situation of a qubit in the regime of resonant fluorescence.

Continued development of mature field: west Cameron Block 45 field, Gulf of Mexico

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

Brand, S.R.; Fox, J.F.

Initial acreage acquisition and exploration of the West Cameron Block 45 field, located offshore Louisiana, were based on reconnaissance gravity surveys that revealed an anomalous high across the area. Several phases of development drilling activity have been conducted in the field since its discovery in March 1949. Nearly four decades after initial exploration began, an integrated field study incorporating all available geological, geophysical, petrophysical, and engineering data was undertaken to evaluate the remaining potential of the field. As a result of this study, a detailed structural and stratigraphic framework was developed, the controls on reservoir production performance were established, andmore » additional drillable prospects were delineated.« less

Development and validation of the simulation-based learning evaluation scale.

PubMed

Hung, Chang-Chiao; Liu, Hsiu-Chen; Lin, Chun-Chih; Lee, Bih-O

2016-05-01

The instruments that evaluate a student's perception of receiving simulated training are English versions and have not been tested for reliability or validity. The aim of this study was to develop and validate a Chinese version Simulation-Based Learning Evaluation Scale (SBLES). Four stages were conducted to develop and validate the SBLES. First, specific desired competencies were identified according to the National League for Nursing and Taiwan Nursing Accreditation Council core competencies. Next, the initial item pool was comprised of 50 items related to simulation that were drawn from the literature of core competencies. Content validity was established by use of an expert panel. Finally, exploratory factor analysis and confirmatory factor analysis were conducted for construct validity, and Cronbach's coefficient alpha determined the scale's internal consistency reliability. Two hundred and fifty students who had experienced simulation-based learning were invited to participate in this study. Two hundred and twenty-five students completed and returned questionnaires (response rate=90%). Six items were deleted from the initial item pool and one was added after an expert panel review. Exploratory factor analysis with varimax rotation revealed 37 items remaining in five factors which accounted for 67% of the variance. The construct validity of SBLES was substantiated in a confirmatory factor analysis that revealed a good fit of the hypothesized factor structure. The findings tally with the criterion of convergent and discriminant validity. The range of internal consistency for five subscales was .90 to .93. Items were rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree). The results of this study indicate that the SBLES is valid and reliable. The authors recommend that the scale could be applied in the nursing school to evaluate the effectiveness of simulation-based learning curricula. Copyright © 2016 Elsevier Ltd. All rights reserved.

A telemedicine instrument for remote evaluation of tremor: design and initial applications in fatigue and patients with Parkinson's Disease

PubMed Central

2011-01-01

Introduction A novel system that combines a compact mobile instrument and Internet communications is presented in this paper for remote evaluation of tremors. The system presents a high potential application in Parkinson's disease and connects to the Internet through a TCP/IP protocol. Tremor transduction is carried out by accelerometers, and the data processing, presentation and storage were obtained by a virtual instrument. The system supplies the peak frequency (fp), the amplitude (Afp) and power in this frequency (Pfp), the total power (Ptot), and the power in low (1-4 Hz) and high (4-7 Hz) frequencies (Plf and Phf, respectively). Methods The ability of the proposed system to detect abnormal tremors was initially demonstrated by a fatigue study in normal subjects. In close agreement with physiological fundamentals, the presence of fatigue increased fp, Afp, Pfp and Pt (p < 0.05), while the removal of fatigue reduced all the mentioned parameters (p < 0.05). The system was also evaluated in a preliminary in vivo test in parkinsonian patients. Afp, Pfp, Ptot, Plf and Phf were the most accurate parameters in the detection of the adverse effects of this disease (Se = 100%, Sp = 100%), followed by fp (Se = 100%, Sp = 80%). Tests for Internet transmission that realistically simulated clinical conditions revealed adequate acquisition and analysis of tremor signals and also revealed that the user could adequately receive medical recommendations. Conclusions The proposed system can be used in a wide spectrum of telemedicine scenarios, enabling the home evaluation of tremor occurrence under specific medical treatments and contributing to reduce the costs of the assistance offered to these patients. PMID:21306628

Vertebral sarcoidosis: demonstration of bone involvement by computerized axial tomography

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

Dinerstein, S.L.; Kovarsky, J.

1984-08-01

A report is given of a rare case of vertebral sarcoidosis with negative conventional spinal x-ray films, yet with typical cystic lesions of the spine found incidentally during abdominal computerized axial tomography (CAT). The patient was a 28-year-old black man, who was admitted for evaluation of a 1 1/2-year history of diffuse myalgias, intermittent fever to 102 F orally, bilateral hilar adenopathy, and leukopenia. A technetium polyphosphate bone scan revealed diffuse areas of increased uptake over the sternum, entire vertebral column, and pelvis. Conventional x-ray films of the cervical, thoracic, and lumbar spine, and an AP view of the pelvismore » were all normal. Chest x-ray film revealed only bilateral hilar adenopathy. During the course of an extensive negative evaluation for infection, an abdominal CAT scan was done, showing multiple, small, sclerotic-rimmed cysts at multiple levels of the lower thoracic and lumbar spine. Bone marrow biopsy revealed only changes consistent with anemia of chronic disease. Mediastinal lymph node biopsy revealed noncaseating granulomas. A tentative diagnosis of sarcoidosis was made, and treatment with prednisone, isoniazid and rifampin was begun. Within two weeks of initiation of prednisone therapy, the patient was symptom-free. A repeat technetium polyphosphate bone scan revealed only a small residual area of mildly increased uptake over the upper thoracic vertebrae.« less

Association of reversible splenial lesion syndrome (RESLES) with Anti-VGKC autoantibody syndrome: a case report.

PubMed

Gilder, Thomas R; Hawley, Jason S; Theeler, Brett J

2016-05-01

A 50-year-old male presented with complaints of fatigue, confusion, and memory problems. Neurological evaluation revealed altered cognition, unsteady gait, ataxia, dysmetria, and weakness. MRI of the brain was initially unremarkable. Over several days, the patient experienced improvement of symptoms and a follow-up MRI revealed a small lesion in the splenium of the corpus callosum seen on diffusion weighted and T2 sequences. The patient was discovered to have elevated anti-voltage gated potassium channel serum autoantibodies. Follow-up MRI revealed resolution of the splenial lesion. The patient was treated with intravenous immune globulin, and improved back to his pre-treatment baseline. We believe this to be the first case of a reversible splenial lesion syndrome as a manifestation of the anti-voltage gated potassium channel autoantibody syndrome, and propose a pathophysiologic mechanism.

Incremental clinical value of ultrasound in men with mammographically confirmed gynecomastia.

PubMed

Chen, Po-Hao; Slanetz, Priscilla J

2014-01-01

To determine whether ultrasound is of any value in male patients presenting with focal symptoms who have classic features of gynecomastia but no concerning findings on mammography. Over a 3-year period, all male patients who underwent mammographic evaluation were identified in this retrospective study. Patients with a mammographic diagnosis of gynecomastia and subsequent breast ultrasound at a large tertiary academic medical center comprised the study cohort. Men whose ultrasound diagnosis differed from the initial mammographic evaluation were analyzed for both additional benign findings as well as findings that warranted biopsy. A total of 353 mammograms were obtained from 327 unique patients (ages 18-95, mean 51 years). Of all mammographic examinations, gynecomastia was the sole finding in 73% (259). In those 259 studies, 85% were further evaluated with ultrasound, in which 6 (2.7%) showed additional benign findings, and 4 (1.8%) showed suspicious findings for which biopsy was recommended. No malignancies were detected in those patients. Furthermore, no malignancies were detected in patients whose mammogram revealed only normal fatty parenchyma or only gynecomastia. In all cases of cancer, mammography revealed visible masses. Judicious use of breast ultrasound in men improves outcome. Our data suggest that targeted ultrasound is of limited value in symptomatic male patients where mammography is negative or reveals only gynecomastia and leads to unnecessary benign biopsies in these patients. When mammography reveals concerning findings, ultrasound adds positively to clinical management. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Hypokalemic Periodic Paralysis: a case report and review of the literature

PubMed Central

Soule, Benjamin R; Simone, Nicole L

2008-01-01

Hypokalemic Periodic Paralysis is one form of Periodic Paralysis, a rare group of disorders that can cause of sudden onset weakness. A case of a 29 year old male is presented here. The patient presented with sudden onset paralysis of his extremities. Laboratory evaluation revealed a markedly low potassium level. The patient's paralysis resolved upon repletion of his low potassium and he was discharged with no neurologic deficits. An association with thyroid disease is well established and further workup revealed Grave's disease in this patient. Although rare, Periodic Paralysis must differentiated from other causes of weakness and paralysis so that the proper treatment can be initiated quickly. PMID:18939979

Well-differentiated neuroendocrine tumor of the stomach

PubMed Central

Gumuscu, Burak; Norwood, Kevin; Parker, George A.; Bridges, C. Lee; Rountree, Carl B.

2016-01-01

Abstract Introduction: A 13-year-old African–American female presented to her primary care physician's office with fatigue, syncope, and hematemesis. After initial evaluation, the patient was referred to pediatric gastroenterology clinic for further evaluation. Main concerns, important findings: An upper gastrointestinal endoscopy was performed to evaluate the source of her bleeding. Endoscopy revealed a 3-cm mass in the lesser curvature of the stomach, and a biopsy of the mass revealed a concern for carcinoid (neuroendocrine) features. Diagnosis: She underwent an open gastrectomy. Post-surgical pathology reports confirmed a well-differentiated neuroendocrine tumor of the stomach. Conclusion: Neuroendocrine tumors of the stomach in children are rare and we presently do not have pediatric-specific diagnostic and treatment guidelines. Although adult-based The North American Neuroendocrine Tumor Society (NANETS) guidelines are helpful, they are clearly not geared toward pediatric patients. To establish pediatric guidelines and to assess effectiveness of treatments, multicenter data collection is essential. In the long run, accumulation of clinically useful treatment information and long-term follow-up guidelines should enable clinicians to improve standard of care given to children with neuroendocrine tumors. PMID:27442656

Preclinical Evaluation of 18F-JNJ64349311, a Novel PET Tracer for Tau Imaging.

PubMed

Declercq, Lieven; Rombouts, Frederik; Koole, Michel; Fierens, Katleen; Mariën, Jonas; Langlois, Xavier; Andrés, José Ignacio; Schmidt, Mark; Macdonald, Gregor; Moechars, Diederik; Vanduffel, Wim; Tousseyn, Thomas; Vandenberghe, Rik; Van Laere, Koen; Verbruggen, Alfons; Bormans, Guy

2017-06-01

In this study, we have synthesized and evaluated 18 F-JNJ64349311, a tracer with high affinity for aggregated tau (inhibition constant value, 8 nM) and high (≥500×) in vitro selectivity for tau over β-amyloid, in comparison with the benchmark compound 18 F-AV1451 ( 18 F-T807) in mice, rats, and a rhesus monkey. Methods: In vitro binding characteristics were determined for Alzheimer's disease, progressive supranuclear palsy, and corticobasal degeneration patient brain tissue slices using autoradiography studies. Ex vivo biodistribution studies were performed in mice. Radiometabolites were quantified in the brain and plasma of mice and in the plasma of a rhesus monkey using high-performance liquid chromatography. Dynamic small-animal PET studies were performed in rats and a rhesus monkey to evaluate tracer pharmacokinetics in the brain. Results: Mouse biodistribution studies showed moderate initial brain uptake and rapid brain washout. Radiometabolite analyses after injection of 18 F-JNJ64349311 in mice showed the presence of a polar radiometabolite in plasma, but not in the brain. Semiquantitative autoradiography studies on postmortem tissue sections of human Alzheimer's disease brains showed highly displaceable binding to tau-rich regions. No specific binding was, however, found on human progressive supranuclear palsy and corticobasal degeneration brain slices. Small-animal PET scans of Wistar rats revealed moderate initial brain uptake (SUV, ∼1.5 at 1 min after injection) and rapid brain washout. Gradual bone uptake was, however, also observed. Blocking and displacement did not affect brain time-activity curves, suggesting no off-target specific binding of the tracer in the healthy rat brain. A small-animal PET scan of a rhesus monkey revealed moderate initial brain uptake (SUV, 1.9 at 1 min after injection) with a rapid washout. In the monkey, no bone uptake was detected during the 120-min scan. Conclusion: This biologic evaluation suggests that 18 F-JNJ64349311 is a promising tau PET tracer candidate, with a favorable pharmacokinetic profile, as compared with 18 F-AV1451. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

68Ga-PSMA Expression in Pseudoangiomatous Stromal Hyperplasia of the Breast.

PubMed

Malik, Dharmender; Basher, Rajender K; Mittal, Bhagwant Rai; Jain, Tarun Kumar; Bal, Amanjit; Singh, Shrawan Kumar

2017-01-01

Ga-labeled prostate-specific membrane antigen ligand PET-CT has emerged as a promising technique to evaluate the extent of disease in patients with prostate carcinoma. We are reporting a 63-year-old man with prostatic carcinoma subjected to Ga-prostate-specific membrane antigen ligand PET-CT for initial staging. In addition to the radiotracer uptake in known primary site (prostate), focal increased radiotracer uptake was also noticed in the left breast. Subsequent biopsy of the breast lesion revealed PASH (pseudoangiomatous stromal hyperplasia), which is a benign mesenchymal proliferative lesion that may present clinically as palpable mass requiring further evaluation to rule out malignancy.

The enquiry-based learning experience: An evaluation project.

PubMed

Ashby, Jayne; Hubbert, Vanessa; Cotrel-Gibbons, Liz; Cox, Karen; Digan, John; Lewis, Kerry; Langmack, Gill; Matiti, Milika; McCormick, Damion; Roberts, Lorraine; Taylor, Derek; Thom, Natasha; Wiggs, Mary; Wilson, Linda

2006-01-01

A research and nursing development initiative group consisting of health lecturers and lecturer practitioners set out to evaluate how learners and teachers felt about the introduction of an enquiry based learning (EBL) approach to education. Five focus groups, teachers (1 group) post-registration students (1 group) and pre-registration diploma students (3 groups) were interviewed. Discussions were tape recorded, transcribed, and analysed. The results revealed that students and teachers held disparative views on the efficiency of EBL. Teachers, surprisingly, felt more doubtful and discouraged than learners. Several concerns were raised over the ability of EBL to establish a foothold in a curriculum more noted for a pedagogical stance on learning.

Structural Determination of a Transcribing RNA Polymerase II Complex

DTIC Science & Technology

2000-05-01

A be extended and evaluated by the solution of pol II cocrystal structures, with the use of the pol II model for molecular replacement. Co- crystals...with TFIIB and TFIIE (78) should reveal the trajectory of DNA in the initial pol - II-promoter complex. Cocrystals containing pol II in the act of...transcription (79) will show the locations of nucleic acids in an elongation complex. Cocrystals with TFIIS (80) may indicate the proposed exit pathway

The Evaluation of Post-Exposure Prophylaxis Models for Use in the Event of an Aerosolized Anthrax Attack

DTIC Science & Technology

2014-09-01

exercise conducted in the Chicago metropolitan area revealed that the initiation of PEP on Day 5 after an attack, as opposed to on Day 2, resulted in an...Scale Anthrax Attack on the Chicago Metropolitan Area: Impact of Timing and Surge Capacity,” Biosecurity and Bioterrorism: Biodefense Strategy, Practice... Chicago Metropolitan Area, also concluded that the optimal cost effective response strategy is to provide antibiotic prophylaxis and vaccination for all

Local government units initiatives on coastal resource management in adjacent municipalities in Camarines Sur, Philippines

NASA Astrophysics Data System (ADS)

Faustino, A. Z.; Madela, H. L.

2018-03-01

This research was conducted to determine the local government units (LGUs) initiatives on coastal resource management (CRM) in adjacent municipalities in Camarines Sur, Philippines. The respondents of this study are 100 fisherfolk leaders in the municipalities of Calabanga, Tinambac and Siruma. Descriptive, comparative and evaluative methods of research were employed and a survey questionnaire was used as the primary tool in data gathering. On the test of difference, the computed F-value of 12.038 and p-value of .001 revealed a very high difference in the implementation of CRM initiatives in the adjacent municipalities. The respondents in this study live below the poverty threshold. The intrusion of commercial fishers and the use of active fishing gears inside the 15-km municipal waters significantly affect the marine habitat while fishpond conversion kills the natural cycle in the mangrove forests. However, the FOs membership in the Municipal Fisheries and Aquatic Resources Management Council empower them to engage in governance which can be a venue for them to recommend policies related to CRM. As a result of this study, a CRM monitoring and evaluation model was crafted to guide the LGUs in the review, revision and crafting of CRM programs.

Suspected synthetic cannabinoid toxicosis in a dog.

PubMed

Williams, Keysa; Wells, Raegan J; McLean, Mary Kay

2015-01-01

To describe the effects of suspected synthetic cannabinoid (SC) toxicosis and the response to intravenous lipid emulsion (ILE) therapy in a dog. A 2-year-8-month-old male Boxer dog was evaluated at an emergency hospital for progressive ataxia and inappropriate mentation. The initial physical examination identified marked hypothermia (32.7°C [90.9°F]), intermittent sinus bradycardia (60/min), stuporous mentation with intermittent aggression, and severe ataxia. Neurologic status deteriorated to comatose mentation within 2 hours of presentation. The initial diagnostic evaluation (eg, CBC, serum biochemistry profile, venous blood gas, and electrolyte determination) revealed a respiratory acidosis and thrombocytopenia. The owner reported that the dog was exposed to an SC containing Damiana leaf, Marshmallow leaf, and Athaea leaves. Initial treatment included IV fluids and supplemental oxygen. Mechanical ventilation was provided due to hypoventilation and periods of apnea. Intravenous lipid emulsion therapy was administered as a bolus (1.5 mL/kg) and continued as a continuous rate infusion (0.5 mL/kg/h) for a total of 6 hours. The dog became rousable and was weaned from mechanical ventilation approximately 15 hours following presentation. The dog was eating and walking with no ataxia, had a normal mentation at approximately 33 hours following presentation, and was discharged home at that time. Communication with the owners 5 days following discharge revealed that the dog was apparently normal. Based on this case and other reports in the literature regarding human exposures, SC ingestion may result in more severe clinical signs than marijuana ingestion in dogs. Significant clinical intervention may be necessary. Intravenous lipid emulsion treatment may be beneficial due to the lipophilicity of SC. © Veterinary Emergency and Critical Care Society 2015.

Prevalence, cause, and location of palatal fistula in operated complete unilateral cleft lip and palate: retrospective study.

PubMed

de Agostino Biella Passos, Vivian; de Carvalho Carrara, Cleide Felício; da Silva Dalben, Gisele; Costa, Beatriz; Gomide, Marcia Ribeiro

2014-03-01

To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. Retrospective analysis of patient records and evaluation of preoperative initial photographs. Tertiary craniofacial center. Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.

Initiation of follicular atresia: gene networks during early atresia in pig ovaries.

PubMed

Zhang, Jinbi; Liu, Yang; Yao, Wang; Li, Qifa; Liu, Hong-Lin; Pan, Zengxiang

2018-05-09

In mammals, more than 99% of ovarian follicles undergo a degenerative process known as atresia. The molecular events involve in atresia initiation remain incompletely understood. The objective of this study was to analyze differential gene expression profiles of medium antral ovarian follicles during early atresia in pig. The transcriptome evaluation was performed on cDNA microarrays using healthy and early atretic follicle samples and was validated by quantitative PCR. Annotation analysis applying current database (sus scrofa 11.1) revealed 450 significantly differential expressed genes between healthy and early atretic follicles. Among them, 142 were significantly up-regulated in early atretic with respect to healthy group and 308 were down-regulated. Similar expression trends were observed between microarray data and qRT-PCR confirmation, which indicated the reliability of the microarray analysis. Further analysis of the differential expressed genes revealed the most significantly affected biological functions during early atresia including blood vessel development, regulation of DNA-templated transcription in response to stress and negative regulation of cell adhesion. The pathway and interaction analysis suggested that atresia initiation associates with 1) a crosstalk of cell apoptosis, autophagy, and ferroptosis rather than change of typical apoptosis markers, 2) dramatic shift of steroidogenic enzymes, 3) deficient glutathione metabolism, and 4) vascular degeneration. The novel gene candidates and pathways identified in the current study will lead to a comprehensive view of the molecular regulation of ovarian follicular atresia and a new understanding of atresia initiation.

Antibiofilm potential of flavonoids extracted from Moringa oleifera seed coat against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans.

PubMed

Onsare, J G; Arora, D S

2015-02-01

The increased microbial drug resistance due to biofilms and the side effects associated with the use of conventional drugs is still a major concern in the medical fraternity. This work evaluates the antibiofilm potential of flavonoids extracted from Moringa oleifera seed coat (SC) in search for green and effective alternatives for overcoming menace of biofilms. The study evaluated the minimum inhibitory concentration (MIC) of flavonoids against respective test organisms, inhibition of initial cell attachment as well as disruption of preformed biofilms and metabolic activity of treated biofilms. Mutagenicity and cytotoxicity as well as characterization of the active component were also carried out. Although Pseudomonas aeruginosa showed the lowest MIC of 0.05 mg ml(-1), the action of flavonoids and gentamicin on initial cell attachment revealed a comparable effect against bacterial biofilms, i.e. Staphylococcus aureus and Pseudomonas aeruginosa with approx. 80% inhibition compared to Candida albicans. Disruption of the preformed biofilms revealed that susceptibility of P. aeruginosa began as early as 4 h of exposure to flavonoids with 88% growth inhibition at the end of 24-h incubation. Encouragingly, t-test analysis on the effect of the extract and the standard antibiotic against each organism indicated no significant variance at P < 0.05. A drastic low metabolic activity exhibited by the treated biofilms as compared to the untreated ones was further supportive of the antibiofilm potential of seed coat flavonoids. The bioactive component from M. oleifera seed coat has exhibited antibiofilm potential against the test organisms belonging to Gram positive, Gram negative and yeast. Antibiofilm potential and biosafety of plant-based flavonoids from M. oleifera seed coat reveal a prospective active principle that could be of use in biofilm-associated menace. © 2014 The Society for Applied Microbiology.

Choosing Wisely Canada Students and Trainees Advocating for Resource Stewardship (STARS) campaign: a descriptive evaluation

PubMed Central

Cardone, Franco; Cheung, Daphne; Han, Angela; Born, Karen B.; Alexander, Lisa; Levinson, Wendy; Wong, Brian M.

2017-01-01

Background: Resource stewardship is being increasingly recognized as an essential competency for physicians, but medical schools are just beginning to integrate this into education. We describe the evaluation of Choosing Wisely Canada's Students and Trainees Advocating for Resource Stewardship (STARS) campaign, a student-led campaign to advance resource stewardship education in medical schools across Canada. Methods: We evaluated the campaign 6 months after its launch, in November 2015. STARS students were administered a telephone survey eliciting a description of the initiatives that they had implemented or planned to implement at their schools to promote resource stewardship, and exploring their perceptions of facilitators of and barriers to successful implementation of their initiatives. We used a mixed-methods approach to analyze and summarize the data. Results: Twenty-seven (82%) of the 33 eligible students representing all 17 medical schools responded. In 14 schools (82%), students led various local activities (e.g., interest groups, campaign weeks) to raise awareness about resource stewardship among medical students and faculty. Students contributed to curriculum change (both planned and implemented) at 10 schools (59%). Thematic analysis revealed key program characteristics that facilitated success (e.g., pan-Canadian student network, local faculty champion) as well as barriers to implementing change (e.g., complex processes to change curriculum, hierarchical nature of medical school). Interpretation: This student-led campaign, with support from local faculty and Choosing Wisely Canada staff, led to awareness-building activities and early curricula change at medical schools across Canada. Future plans will build on the initial momentum created by the STARS campaign to sustain and spread local initiatives. PMID:29263153

Difficulties in prenatal diagnosis of tumour in the fetal sacrococcygeal area

PubMed Central

Krekora, Michał; Blitek, Marek; Kęsiak, Marcin; Piaseczna-Piotrowska, Anna; Łukaszek, Stanisław; Krasomski, Grzegorz; Słodki, Maciej; Szaflik, Krzysztof; Respondek-Liberska, Maria

2016-01-01

Prenatal ultrasound at the 20th week of gestation revealed a 3-cm tumour in the sacrococcygeal area. Initially, a sacrococcygeal teratoma was suspected on the basis of fetal ultrasonography, which revealed normal heart anatomy and an increasing tumour mass. The diagnosis was then changed to fetus in fetu or teratoma. Prenatal magnetic resonance imaging at the 34th week of pregnancy confirmed the ultrasound diagnosis. No other anomalies were found. Elective caesarean section was performed at term. The care team included a paediatric surgeon, obstetricians, neonatologists, midwives, and an anesthesiologist. A female newborn was delivered in good condition. The tumour was resected in the operating room and mature teratoma was established by histopathological evaluation. Surprisingly, agenesis of the right forearm was revealed which had not been detected prenatally, despite many examinations (both in our hospital and earlier at a primary care obstetrician office). PMID:27482281

Reduction of bulimia nervosa symptoms after psychostimulant initiation in patients with comorbid ADHD: five case reports.

PubMed

Keshen, Aaron; Ivanova, Iryna

2013-01-01

Studies reveal a higher occurrence of bulimia nervosa (BN) in patients with attention deficit/hyperactivity disorder (ADHD) compared to controls. Due to this high degree of comorbidity, some clinicians have used psychostimulants in this population. The goal of this article is to describe five patients with comorbid BN and ADHD and their responses to a course of psychostimulants. After medication initiation, all five patients experienced a decrease in binge/purging and an improvement in ADHD symptoms. Overall, the medications were well tolerated. Possible mechanisms underlying the relationship between ADHD and BN, and words of caution are discussed. The need for clinical trials to further evaluate the efficacy of psychostimulants in this population is warranted.

[Clinical thinking and decision making in practice. A 7-year old boy with rapid growth and pubic hair].

PubMed

Berents-Oosterhof, M Y; Noordam, C; Otten, B J

2000-12-16

A 7-year-old boy was tall, with a developing penis and initial growth of pubic hair. Due to the accelerated growth there was no premature adrenarche and due to the increased testicular volume there must have been a central cause for the production of androgens. Further specific investigations revealed an astrocytoma of the hypothalamus. After radiotherapy, the tumour exhibited no growth. The pubertal development was inhibited and the growth later stimulated by means of medication. In the case of pubertas praecox the growth chart and pubertal stages including testicular volume can help to differentiate between central and peripheral precocious puberty, narrow the diagnostic evaluation and reduce the time of the initial therapy.

Cyclopropenimine superbases: Competitive initiation processes in lactide polymerization

DOE PAGES

Stukenbroeker, Tyler S.; Bandar, Jeffrey S.; Zhang, Xiangyi; ...

2015-07-30

Cyclopropenimine superbases were employed in this study to catalyze the ring-opening polymerization of lactide. Polymerization occurred readily in the presence and absence of alcohol initiators. Polymerizations in the absence of alcohol initiators revealed a competitive initiation mechanism involving deprotonation of lactide by the cyclopropenimine to generate an enolate. NMR and MALDI-TOF analysis of the poly(lactides) generated from cyclopropenimines in the absence of alcohol initiators showed acylated lactide and hydroxyl end groups. Finally, model studies and comparative experiments with guanidine and phosphazene catalysts revealed the subtle influence of the nature of the superbase on competitive initiation processes.

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.

Primary Gastric Lymphoma Presenting as Acute Pancreatitis: A Case Report.

PubMed

Raj, Mithun; Ghoshal, Uday C; Choudhuri, Gourdas; Mohindra, Samir

2013-07-10

Diffuse large B-cell lymphoma is the commonest form of non-Hodgkin lymphoma. Gastro-intestinal tract and bone marrow are common extra-nodal sites of lymphomatous involvement. A 54-year-old woman presented with acute onset epigastric pain. On evaluation, raised serum amylase and radiological features of acute pancreatitis were detected. Gastroscopy revealed thickened folds in distal stomach, which on histopathology revealed large B-cell lymphoma. Subsequently, the patient developed extra-hepatic biliary obstruction due to peripancreatic lymph nodal mass that was relieved with plastic biliary stenting. Subsequent chemotherapy regime directed against lymphoma led to resolution of lymphoma. In this patient , pancreatitis was the initial presentation of primary gastric lymphoma, which has not been commonly reported and therefore should be considered in the etiological workup.

Disseminated, histologically confirmed Cryptococcus spp infection in a domestic ferret.

PubMed

Eshar, David; Mayer, Jörg; Parry, Nicola M; Williams-Fritze, Misty J; Bradway, Daniel S

2010-04-01

A 4-year-old castrated male domestic ferret from central Massachusetts was evaluated for weight loss over a 1.5-month period and for 2 days of retching, diarrhea, and signs of lethargy. It had been housed indoors, with 2 other ferrets, 2 cats, and humans that lacked signs or symptoms of disease. Physical examination revealed a thin body condition, tachypnea, an increase in respiratory effort, and retching. Splenomegaly was detected during abdominal palpation. Clinicopathologic analysis revealed lymphopenia, lactic acidosis, hypoglycemia, hypocalcemia, hypoalbuminemia, and hyperglobulinemia. A pulmonary bronchointerstitial pattern was evident on radiographs, and abdominal ultrasonography revealed a suspected pancreatic mass and mesenteric lymphadenopathy. After 2 weeks of medical treatment and once clinical signs resolved, an exploratory laparotomy was performed and a lymph node biopsy specimen was collected. Histologic evaluation of the specimen revealed Cryptococcus-like organisms. Antifungal treatment was initiated with itraconazole (PO) and amphotericin B (IV). The ferret died after 2 days of treatment. A full necropsy was performed, revealing multicentric cryptococcosis affecting the lungs, brain, spleen, and multiple lymph nodes. Paraffin-embedded, formalin-fixed lung tissue was submitted for DNA extraction, and the organism was identified as Cryptococcus neoformans var grubii. To the authors' knowledge, this is the first report of disseminated cryptococcosis in a North American ferret. This case is unique in that the ferret lived indoors, in a geographic region in which reports of cryptococcosis are rare. The genotyping technique used to identify the Cryptococcus strain can aid in better understanding the epidemiology of cryptococcosis.

[Rapid resolution of acute subdural haematoma with significant impact on clinical outcome].

PubMed

Capion, Tenna; Lilja-Cyron, Alexander; Kelsen, Jesper

2017-09-04

A 73-year-old woman was admitted to hospital due to anaemia. She suffered a minor head trauma and deteriorated to deep unconsciousness. A CT revealed an acute subdural haematoma (ASDH). Initially, she was not found to be a candidate for neurosurgical intervention, but within 24 hours her level of consciousness improved dramatically, and a renewed CT showed resolution of the ASDH. She underwent acute craniotomy with good outcome. This illustrates the importance of re-evaluation of patients with intracranial haemorrhage.

Severe Cardiomyopathy after Huffing Dust-Off™

PubMed Central

Cates, Alexis L.; Cook, Matthew D.

2016-01-01

A 34-year-old man was found down in a parking lot after huffing fifteen cans of Dust-Off. Though lucid during the initial hospital evaluation, the patient experienced a generalized seizure followed by a torsades de pointes arrhythmia and was resuscitated. An echocardiogram revealed left and right ventricular dysfunction with an ejection fraction of 25%. This unique outcome of inhalant abuse has scarcely been reported in similar cases. The patient fully recovered and had a normal ejection fraction prior to discharge. PMID:27313914

Infertility in a Ram Associated with a Knobbed Acrosome Abnormality of the Spermatozoa

PubMed Central

Savage, N. C.

1984-01-01

A yearling Rambouillet ram with an asymmetrical scrotum was examined for potential breeding soundness prior to use in a synchronized mating program in a purebred flock of 20 ewes. Initial sperm cell evaluation revealed 78% knobbed acrosomes associated with few other abnormalities of the head and midpiece. Use of the ram resulted in no conception in one group of ten synchronized ewes. One month later, the proportion of sperm cells with knobbed acrosomes was 80%. ImagesFigure 1.Figure 2. PMID:17422370

Initiating Event Analysis of a Lithium Fluoride Thorium Reactor

NASA Astrophysics Data System (ADS)

Geraci, Nicholas Charles

The primary purpose of this study is to perform an Initiating Event Analysis for a Lithium Fluoride Thorium Reactor (LFTR) as the first step of a Probabilistic Safety Assessment (PSA). The major objective of the research is to compile a list of key initiating events capable of resulting in failure of safety systems and release of radioactive material from the LFTR. Due to the complex interactions between engineering design, component reliability and human reliability, probabilistic safety assessments are most useful when the scope is limited to a single reactor plant. Thus, this thesis will study the LFTR design proposed by Flibe Energy. An October 2015 Electric Power Research Institute report on the Flibe Energy LFTR asked "what-if?" questions of subject matter experts and compiled a list of key hazards with the most significant consequences to the safety or integrity of the LFTR. The potential exists for unforeseen hazards to pose additional risk for the LFTR, but the scope of this thesis is limited to evaluation of those key hazards already identified by Flibe Energy. These key hazards are the starting point for the Initiating Event Analysis performed in this thesis. Engineering evaluation and technical study of the plant using a literature review and comparison to reference technology revealed four hazards with high potential to cause reactor core damage. To determine the initiating events resulting in realization of these four hazards, reference was made to previous PSAs and existing NRC and EPRI initiating event lists. Finally, fault tree and event tree analyses were conducted, completing the logical classification of initiating events. Results are qualitative as opposed to quantitative due to the early stages of system design descriptions and lack of operating experience or data for the LFTR. In summary, this thesis analyzes initiating events using previous research and inductive and deductive reasoning through traditional risk management techniques to arrive at a list of key initiating events that can be used to address vulnerabilities during the design phases of LFTR development.

Neuropsychological profile and social cognition in congenital central hypoventilation syndrome (CCHS): Correlation with neuroimaging in a clinical case.

PubMed

Esteso Orduña, Borja; Seijas Gómez, Raquel; García Esparza, Elena; Briceño, Emily M; Melero Llorente, Javier; Fournier Del Castillo, María de la Concepción

2018-02-01

Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder due to paired-like homeobox gene (PHOX2B) mutations. CCHS patients suffer from dysregulation of the autonomic nervous system characterized by the absence of or extremely reduced response to hypercapnia and hypoxia, with neuropsychological deficits. The aim of this exploratory study is to describe the longitudinal neuropsychological profile and its correlations with magnetic resonance imaging (MRI) of a child with CCHS with a PHOX2B mutation. A comprehensive neuropsychological evaluation was conducted serially at age 7 years 4 months and 10 years 3 months, including assessment of intellectual functioning (IQ), motor functioning, perception, attention, executive functions, language, memory, social cognition, academic skills, and psychopathology. Reliable change index (RCI) scores were used to assess changes between assessments. We collected spin lattice relaxation time (T1)-weighted, fluid-attenuated inversion recovery (FLAIR), and spin spin lattice relaxation time (T2)-weighted images from the child at age 10 years 3 months using a 1.5-tesla MRI scanner. IQ, processing speed index (PSI), social cognition (theory of mind and facial emotion recognition), selective attention, naming, academic skills (reading/comprehension), and manual speed with right hand declined in the second evaluation relative to the initial evaluation, while visuoconstructional praxis, receptive vocabulary, working memory, and arithmetic skill improved. The patient showed a remarkable global deterioration in executive functions (planning, task flexibility, behavioral regulation, and metacognition) as revealed by parental report and clinical evaluation. MRI revealed gliosis from the head to tail of the hippocampus and thinning of parahippocampal gyri. In a clinical case of CCHS, serial evaluation revealed deterioration of executive functions and social cognition over a 3-year interval. These changes corresponded to hippocampal damage as revealed in MRI, which may have affected social cognition through its role in the default mode network. Serial neuropsychological assessment is clinically useful in managing the needs of these patients.

[Theoretical and conceptual contribution to evaluative research in health surveillance context].

PubMed

Arreaza, Antônio Luis Vicente; de Moraes, José Cássio

2010-08-01

Initially this article revises some of the conceptual and operational elements on evaluative research by gathering knowledge and action fields on public health practices. Such concepts are taken according to a wider conception of quality. Then, the article intends to arrange a theoretical model design considering the proposition for implementation of health surveillance actionsAn image-objective definition of organization and integration of health polices and practices based on hierarchic and local logic also take place. Finally, becomings and challenges around the theory in the health evaluation field turn to be the aim of our reflection in order to enable the production of knowledge and approaches to construct logic models which reveals the complexity of interventionist objects as well as its transforming nature of social practices.

Digital tomosynthesis for evaluating metastatic lung nodules: nodule visibility, learning curves, and reading times.

PubMed

Lee, Kyung Hee; Goo, Jin Mo; Lee, Sang Min; Park, Chang Min; Bahn, Young Eun; Kim, Hyungjin; Song, Yong Sub; Hwang, Eui Jin

2015-01-01

To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, ≤ 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p < 0.001). Area under the curve (AUC) values at the initial session were > 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.

Initial 12-h operative fluid volume is an independent risk factor for pleural effusion after hepatectomy.

PubMed

Cheng, Xiang; Wu, Jia-Wei; Sun, Ping; Song, Zi-Fang; Zheng, Qi-Chang

2016-12-01

Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.

Is there an ideal way to initiate antiplatelet therapy with aspirin? A crossover study on healthy volunteers evaluating different dosing schemes with whole blood aggregometry

PubMed Central

2011-01-01

Background Guidelines recommend an early initiation of aspirin treatment in patients with acute cerebral ischemia. Comparative studies on the best starting dose for initiating aspirin therapy to achieve a rapid antiplatelet effect do not exist. This study evaluated the platelet inhibitory effect in healthy volunteers by using three different aspirin loading doses to gain a model for initiating antiplatelet treatment in acute strokes patients. Methods Using whole blood aggregometry, this study with a prospective, uncontrolled, open, crossover design examined 12 healthy volunteers treated with three different aspirin loading doses: intravenous 500 mg aspirin, oral 500 mg aspirin, and a course of 200 mg aspirin on two subsequent days followed by a five-day course of 100 mg aspirin. Aspirin low response was defined as change of impedance exceeding 0 Ω after stimulation with arachidonic acid. Results Sufficient antiplatelet effectiveness was gained within 30 seconds when intravenous 500 mg aspirin was used. The mean time until antiplatelet effect was 74 minutes for 500 mg aspirin taken orally and 662 minutes (11.2 hours) for the dose scheme with 200 mg aspirin with a high inter- and intraindividual variability in those two regimes. Platelet aggregation returned to the baseline range during the wash-out phase within 4 days. Conclusion Our study reveals that the antiplatelet effect differs significantly between the three different aspirin starting dosages with a high inter- and intraindividual variability of antiplatelet response in our healthy volunteers. To ensure an early platelet inhibitory effect in acute stroke patients, it could be advantageous to initiate the therapy with an intravenous loading dose of 500 mg aspirin. However, clinical outcome studies must still define the best way to initiate antiplatelet treatment with aspirin. PMID:21466682

Bladder cancer discussed on the internet: a systematic analysis of gender differences of initial posters on an online discussion board.

PubMed

Lippka, Yannick; Patschan, Oliver; Todenhöfer, Tilmann; Schwentner, Christian; Gutzeit, Andreas; Merseburger, Axel S; Horstmann, Marcus

2013-01-01

To evaluate gender differences of initial posters in threads dealing with bladder cancer on an online discussion board. 529 threads opened between 09/2005 and 03/2012 were screened on the largest German speaking bladder cancer online discussion board. 366 threads fulfilled the requirements for this study. Gender, age, number, status of concern and oncological situation of initiating posters as well as their motives and language style were analyzed following a standardized protocol. Threads were initiated in 45% (164/366) by men and in 55% (202/366) by women. Mean age of male initiating posters was 50 years and of female posters 44 years (p < 0.001). Of males 80% (132/164) were concerned patients and 20% (32/164) relatives or friends. Of females they were 39% (78/202) and 61% (124/202), respectively (p < 0.001). In general motives for initial posting were focused on medical information and did not differ between both genders. 81% of the posters asked for medical information or therapeutic recommendations regarding diagnosis, treatment and prognosis. However, women significantly more often expressed their wish for emotional support (p = 0.034) and in tendency wanted to share their experiences with others (p = 0.057). Language analysis revealed that women significantly more often used a tentative language style than men (p = 0.003). Even though women are less often affected by bladder cancer, they are more active -especially for their concerned family members - on the evaluated discussion board than men. Whereas both genders equally often ask for medical information, women more often want to share their experiences and look for emotional support.

Evaluation of an intervention program for head lice infestation in school children.

PubMed

Sarov, B; Neumann, L; Herman, Y; Naggan, L

1988-03-01

In order to investigate the point prevalence rate of pediculosis capitis (human head lice) among children in the southern region of Israel, 1431 elementary school children (6 to 15 years old), representing rural and urban environments, were examined and characterized by sociodemographic variables. An intervention program was initiated immediately after the first examination, which included "health education" for children and parents and free medicated shampoo (with pediculocides) provided for each child detected as "positive." The intervention program was evaluated by a second examination performed on the same population after an interval of 1 month. Fifty-five percent of the children (793 of 1431) were found to be infested with one of the markers of head lice, with the highest rate in kibbutz children (80%) and the lowest rate (37%) among children who live in an urban neighborhood of high socioeconomic status. Analysis of various characteristics (related to the children screened in this study) revealed that crowding was the main factor contributing to the variation in the rates of infestation. Evaluation of the intervention program revealed a significant success in reducing head lice infestation that was not influenced by variation in socioeconomic status or place of residence.

Diagnosis and Management of Polycythemia Vera in a Ferret (Mustela putorius furo).

PubMed

Le, Kim; Beaufrère, Hugues; Bassel, Laura L; Wills, Sarah; Laniesse, Delphine; Blois, Shauna L; Smith, Dale A

2016-12-01

A 5-y-old female ferret (Mustela putorius furo) was evaluated for diarrhea, anorexia, and lethargy for 1 wk. Only mild dehydration was detected on physical examination. CBC analysis revealed marked erythrocytosis with an unremarkable plasma biochemistry panel; follow-up CBC analyses revealed a consistent primary erythrocytosis. Whole-body radiographs and abdominal ultrasonography were unremarkable except for a small nephrolith in the right kidney and a small cyst in the left kidney. The plasma erythropoietin level was 17.0 mIU/mL and considered normal. In light of the diagnostic work-up and consistent erythrocytosis, a diagnosis of polycythemia vera (primary erythrocytosis) was made. The initial presentation of diarrhea resolved after treatment with oral metronidazole (20 mg/kg PO BID for 7 d). Treatment for the polycythemia consisted of a phlebotomy initially followed by chemotherapy with hydroxyurea (10 mg/kg PO BID). During the subsequent 12 mo, the hydroxyurea dose adjusted according to follow-up CBC results, and finding an optimal dosage regimen proved to be challenging. One year after the initial diagnosis, the ferret presented to an emergency clinic for acute and severe hemorrhagic diarrhea and died shortly thereafter. The postmortem diagnosis was acute venous infarction of the small and large intestine. To our knowledge, this report is the first to describe the diagnosis and long-term management of polycythemia vera in a ferret and the use of hydroxyurea for this purpose.

Provision of pandemic disease information by health sciences librarians: a multisite comparative case series.

PubMed

Featherstone, Robin M; Boldt, R Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

2012-04-01

The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Comparison of the four cases revealed a distinct difference between "client-initiated" and "librarian-initiated" provision of pandemic information. Librarian-initiated projects utilized social software to "push" information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease.

Evaluation of constipation by abdominal radiographs correlated with treatment outcome in children with dysfunctional elimination.

PubMed

Allen, Heidi A; Austin, J Christopher; Boyt, Margaret A; Hawtrey, Charles E; Cooper, Christopher S

2007-05-01

To analyze the utility of assessing degree of constipation by abdominal radiograph (KUB) in relation to symptoms and urodynamic data in children with dysfunctional elimination. A retrospective review of children with concomitant constipation and daytime incontinence was performed. Inclusion required at least two consecutive visits with KUB and noninvasive uroflowmetry. Patients were excluded for anticholinergic medication use or neurogenic or anatomic abnormalities. Rectal fecal quantification and presence of stool throughout the colon was assessed on KUB and categorized as "empty," "normal amount of stool," or "fecal distention of rectum (FDR)." Twenty-six patients met inclusion requirements (6 boys, 20 girls; average age, 7.7 +/- 2.2 years). The average time between the initial and subsequent visit was 12.5 +/- 7.8 weeks. Initial KUB revealed FDR in 17. No statistical significance was found between FDR on initial or final KUB and outcome of wetting symptoms, nor could a relationship between FDR uroflow parameters at either visit be demonstrated. No correlation between any uroflowmetry parameter and the presence of FDR at the initial or final visits could be demonstrated. Similarly, no statistical significance between FDR on final or initial KUB and outcome of wetting symptoms was established.

NASA industry education initiative. Education programs report, 1991

NASA Technical Reports Server (NTRS)

1991-01-01

Findings from the initial inventory of education programs show that support for the NASA-Industry Education Initiative (NIEI) appears to be strong among the organizations surveyed. In addition, the range, depth and historical baselines of NIEI education programs are encouraging. It is also apparent that there is a significant level of cooperation between NIEI members and other organizations. Heavily focused towards science, engineering, mathematics and technology achievement, NIEI activities appear to be aligned with national education goals. Three criticisms are revealed: (1) the majority of programs are targeted fairly late in the education cycle; (2) the number of initiatives geared towards adult literacy and adult skills-enhancement appears to be relatively low; (3) the majority of NIEI activities involve traditional education-assistance programs, but the number of critical assessment and systematic reform initiatives is low. Four Working Group recommendations resulted from this activity: (1) NIEI Working Group operations should continue for an indefinite period, with participation open to other like-minded private-sector organization; (2) the report should be periodically updated; (3) an analysis of ongoing education programs should be conducted; (4) American corporations should continue to support education and evaluate in-house programs periodically.

Test and evaluation of Apollo 14 composite casting demonstration specimens 6, 9, and 12, phase 1

NASA Technical Reports Server (NTRS)

Reger, J. L.

1971-01-01

Flight and control specimens 6, 9, and 12 from the Apollo 14 composite casting demonstration were evaluated with respect to the degree of dispersion achieved for mixtures of immiscible materials under one-gravity and low gravity environments. The flight and control capsules 6, 9, and 12 contained paraffin and sodium acetate; paraffin, sodium acetate and argon; and paraffin, sodium acetate and 100 micrometer diameter tungsten microspheres, respectively. The evaluation and documentation utilized photographic and microstructure examinations, density measurements, and droplet size and distribution determinations. In addition, theoretical analyses were performed in order to aid in the understanding of the fluid behavior of the specimens during processing and subsequent solidification. A comparison of evaluated data with the theoretical analyses reveals that although the immiscible materials were uniquely dispersed in a low gravity environment, nonuniform dispersions were obtained primarily due to insufficient initial mixing and an essentially unidirectional thermal gradient during cooldown.

Confirmatory Factor Analysis of the System for Evaluation of Teaching Qualities (SETQ) in Graduate Medical Training.

PubMed

Boerebach, Benjamin C M; Lombarts, Kiki M J M H; Arah, Onyebuchi A

2016-03-01

The System for Evaluation of Teaching Qualities (SETQ) was developed as a formative system for the continuous evaluation and development of physicians' teaching performance in graduate medical training. It has been seven years since the introduction and initial exploratory psychometric analysis of the SETQ questionnaires. This study investigates the validity and reliability of the SETQ questionnaires across hospitals and medical specialties using confirmatory factor analyses (CFAs), reliability analysis, and generalizability analysis. The SETQ questionnaires were tested in a sample of 3,025 physicians and 2,848 trainees in 46 hospitals. The CFA revealed acceptable fit of the data to the previously identified five-factor model. The high internal consistency estimates suggest satisfactory reliability of the subscales. These results provide robust evidence for the validity and reliability of the SETQ questionnaires for evaluating physicians' teaching performance. © The Author(s) 2014.

Application of Organosilane Monolayer Template to Quantitative Evaluation of Cancer Cell Adhesive Ability

NASA Astrophysics Data System (ADS)

Tanii, Takashi; Sasaki, Kosuke; Ichisawa, Kota; Demura, Takanori; Beppu, Yuichi; Vu, Hoan Anh; Thanh Chi, Hoan; Yamamoto, Hideaki; Sato, Yuko

2011-06-01

The adhesive ability of two human pancreatic cancer cell lines was evaluated using organosilane monolayer templates (OMTs). Using the OMT, the spreading area of adhered cells can be limited, and this enables us to focus on the initial attachment process of adhesion. Moreover, it becomes possible to arrange the cells in an array and to quantitatively evaluate the number of attached cells. The adhesive ability of the cancer cells cultured on the OMT was controlled by adding (-)-epigallocatechin-3-gallate (EGCG), which blocks a receptor that mediates cell adhesion and is overexpressed in cancer cells. Measurement of the relative ability of the cancer cells to attach to the OMT revealed that the ability for attachment decreased with increasing EGCG concentration. The results agreed well with the western blot analysis, indicating that the OMT can potentially be employed to evaluate the adhesive ability of various cancer cells.

Photo-elastic stress analysis of initial alignment archwires.

PubMed

Badran, Serene A; Orr, John F; Stevenson, Mike; Burden, Donald J

2003-04-01

Photo-elastic models replicating a lower arch with a moderate degree of lower incisor crowding and a palatally displaced maxillary canine were used to evaluate the stresses transmitted to the roots of the teeth by initial alignment archwires. Six initial alignment archwires were compared, two multi-strand stainless steel wires, two non-super-elastic (stabilized martensitic form) nickel titanium wires, and two stress-induced super-elastic (austenitic active) nickel titanium wires. Three specimens of each archwire type were tested. Analysis of the photo-elastic fringe patterns, in the medium supporting the teeth, revealed that the non-super-elastic nickel titanium archwires produced the highest shear stresses (P = 0.001). However, the shear stresses generated by the super-elastic alignment archwires and the multi-strand stainless steel archwires were very similar (P = 1.00). These results show that even in situations where large deflections of initial alignment archwires are required, super-elastic archwires do not appear to have any marked advantage over multi-strand stainless steel alignment archwires in terms of the stresses transferred to the roots of the teeth.

Diethylnitrosamine initiation does not alter clofibric acid-induced hepatocarcinogenesis in the rat.

PubMed

Michel, Cecile; Desdouets, Chantal; Slaoui, Mohamed; Isaacs, Kevin Robert; Roberts, Ruth Angela; Boitier, Eric

2007-09-01

Clofibric acid (CLO) is a nongenotoxic hepatocarcinogen in rodents that causes altered hepatocellular foci and/or neoplasms. Initiation by DNA-damaging agents such as diethylnitrosamine (DEN) accelerates focus and tumor appearance and could therefore significantly contribute to shortening of the regulatory 2-year rodent carcinogenicity bioassays. However, it is crucial to evaluate the histological and molecular impact of initiation with DEN on hepatocarcinogenesis promoted by CLO. Male F344 rats were given a single nonnecrogenic injection of DEN (0 or 30 mg/kg) followed by Control diet or CLO (5000 ppm) in diet for up to 20 months. Histopathology and gene expression profiling were performed in liver tumors and surrounding nontumoral liver tissues. The molecular signature of DEN was characterized and its histopathological and immunohistopathological effects on focus and tumor types were also determined. Although foci and tumors appeared earlier in the DEN+CLO-treated group compared to the group treated with CLO alone, DEN had little impact on gene expression in nontumoral tissues since the gene expression profiles were highly similar between Control and DEN-treated rats, and DEN+CLO- and CLO-treated rats. Finally, tumors obtained from DEN+CLO and CLO-treated groups displayed highly correlated gene expression profiles (r>0.83, independently of the time-point). The pathways involved in tumor development revealed by Gene Ontology functional analysis are similar when driven either by spontaneous initiation or by a chemically induced initiation step. Our work described here may contribute to the design optimization of shorter preclinical tests for the evaluation of the nongenotoxic hepatocarcinogenic potential of drugs under development.

Dehydration and Stabilization of a Reactive Tertiary Hydroxyl Group in Solid Oral Dosage Forms of BMS-779788.

PubMed

Adams, Monica L; Sharma, Vijayata; Gokhale, Madhushree; Huang, Yande; Stefanski, Kevin; Su, Ching; Hussain, Munir A

2016-04-01

BMS-779788 contains a reactive tertiary hydroxyl attached to a weakly basic imidazole ring. Propensity of the carbinol toward dehydration to yield the corresponding alkene, BMS-779788-ALK, was evaluated. Elevated levels of BMS-779788-ALK were observed in excipient compatibility samples. Stability studies revealed that BMS-779788 degrades to BMS-779788-ALK in capsules and tablets prepared by both dry and wet granulation processes. An acid-catalyzed dehydration mechanism, in which the heterocyclic core contributes resonance stability to the cationic intermediate via charge transfer to the imidazole ring, was proposed. Therefore, neutralization via a buffered (pH 7.0) granulating solution was used to mitigate dehydration. Solution studies revealed degradation of BMS-779788 to BMS-779788-ALK over the pH range of 1-7.5. Reversibility was confirmed by initiating reactions with BMS-779788-ALK over the same pH range. Accordingly, a simple reversible scheme can be used to describe reactions initiated with either BMS-779788 or BMS-779788-ALK. To eliminate potential for charge delocalization across the heterocycle and probe the degradation mechanism, the imidazole ring of BMS-779788 was methylated (BMS-779788-Me). The propensity for acid-catalyzed dehydration was then evaluated. The acid stability of BMS-779788-Me confirmed that the heterocyclic core contributes to reactivity liability of the tertiary hydroxyl. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Hepatic manifestations of telomere biology disorders.

PubMed

Patnaik, Mrinal M; Kamath, Patrick S; Simonetto, Douglas A

2018-06-07

A 51-year-old Caucasian male was referred for evaluation of variceal bleeding. Laboratory tests were remarkable for mild thrombocytopenia and moderate alkaline phosphatase elevation. Synthetic liver function was well preserved. Abdominal computed tomography scan revealed moderate splenomegaly, gastric varices, and normal hepatic contour. A transjugular liver biopsy was performed revealing findings of nodular regenerative hyperplasia with no significant fibrosis or necroinflammatory activity. Hepatic venous pressure gradient was elevated at 31 mmHg, consistent with clinically significant portal hypertension. The clinical course was complicated by refractory gastric variceal bleeding requiring a surgical portosystemic shunt. Approximately seven years after the initial presentation, the patient developed progressive dyspnoea and a diagnosis of idiopathic pulmonary fibrosis was made. Contrast-enhanced echocardiogram was not suggestive of hepatopulmonary syndrome or portopulmonary hypertension. Given this new diagnosis a telomere biology disorder was suspected. A flow-fluorescence in situ hybridisation analysis for telomere length assessment revealed telomere lengths below the first percentile in both lymphocytes and granulocytes. Next generation sequencing analysis identified a heterozygous mutation involving the hTERT gene (Histidine983Threonine). The lung disease unfortunately progressed in the subsequent two years, leading to the patient's death nine years after his initial presentation with portal hypertension. During those nine years two brothers also developed idiopathic pulmonary fibrosis. The questions that arise from this case include. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Periodontist-Dental Hygienist Collaboration in Periodontal Care for Chronic Periodontitis: An 11-year Case Report.

PubMed

Tomita, Sachiyo; Uekusa, Tomomi; Hosono, Meiko; Kigure, Takashi; Sugito, Hiroki; Saito, Atsushi

2016-01-01

We report a case of severe chronic periodontitis treated and longitudinally maintained by a periodontist and dental hygienists. The patient was a 45-year-old woman who presented with the chief complaint of gingival bleeding and tooth mobility. An initial examination revealed generalized gingival inflammation and subgingival calculus in the premolar and molar regions. Premature contact was observed in #14 and 45. Clinical examination revealed 42% of sites with a probing depth (PD) of ≥4 mm and 44% of sites with bleeding on probing. Radiographic examination revealed vertical bone resorption in #35, 36, and 45, and horizontal bone resorption in other regions. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, and removal of an ill-fitting prosthesis was performed. Following suppression of inflammation, occlusal adjustment of premature contact sites was performed. Open flap debridement was performed for teeth with a PD of ≥5 mm. After confirming the stability of the periodontal tissue, final prostheses were placed on #16, 35-37, and 46. Following re-evaluation, the patient was placed on supportive periodontal therapy. It has been 11 years since the patient's first visit, and the periodontal conditions have remained stable. Meticulous periodontal care maintained over a number of years by a periodontist and dental hygienist have yielded a clinically favorable outcome.

Hydrophobic Coatings on Cotton Obtained by in Situ Plasma Polymerization of a Fluorinated Monomer in Ethanol Solutions.

PubMed

Molina, Ricardo; Teixidó, Josep Maria; Kan, Chi-Wai; Jovančić, Petar

2017-02-15

Plasma polymerization using hydrophobic monomers in the gas phase is a well-known technology to generate hydrophobic coatings. However, synthesis of functional hydrophobic coatings using plasma technology in liquids has not yet been accomplished. This work is consequently focused on polymerization of a liquid fluorinated monomer on cotton fabric initiated by atmospheric plasma in a dielectric barrier discharge configuration. Functional hydrophobic coatings on cotton were successfully achieved using in situ atmospheric plasma-initiated polymerization of fluorinated monomer dissolved in ethanol. Gravimetric measurements reveal that the amount of polymer deposited on cotton substrates can be modulated with the concentration of monomer in ethanol solution, and cross-linking reactions occur during plasma polymerization of a fluorinated monomer even without the presence of a cross-linking agent. FTIR and XPS analysis were used to study the chemical composition of hydrophobic coatings and to get insights into the physicochemical processes involved in plasma treatment. SEM analysis reveals that at high monomer concentration, coatings possess a three-dimensional pattern with a characteristic interconnected porous network structure. EDX analysis reveals that plasma polymerization of fluorinated monomers takes place preferentially at the surface of cotton fabric and negligible polymerization takes place inside the cotton fabric. Wetting time measurements confirm the hydrophobicity of cotton coatings obtained although equilibrium moisture content was slightly decreased. Additionally, the abrasion behavior and resistance to washing of plasma-coated cotton has been evaluated.

Assessing the initial adaptability and impact of a mobile dictation and reporting system in the radiology department of an academic hospital

NASA Astrophysics Data System (ADS)

Gali, Raja L.; Dave, Jaydev K.

2017-03-01

Mobile Radiologist 360, rolled out as part of the voice dictation system upgrade from Nuance Powerscribe 5.0 to PS360 allows an attending radiologist to edit and sign-off a report assigned by a trainee or that has been started by the radiologist on a workstation. The purpose of this study was to evaluate the adoptability and impact of this application. Report turnaround time data was extracted from the RIS (GE-Centricity RIS-IC) for 60 days before- (period-1) and 60 days after- (period-2) the application implementation and then, for 60 days after end of period-2 (period-3). Adoptability of the application was evaluated using two metrics; first, the number of attending radiologists who signed-off reports using the application in periods 2 and 3, and second, the proportion of reports signed-off by the top five users of the mobile application using the application. Impact of the application was evaluated by comparing the time from initial dictation to final sign-off (time_PF) for the top five users of the mobile application to the time_PF by other five radiologists who did not use the application. 41% radiologists used the mobile application at least once during the study period; the proportion of cases signed-off using the mobile application ranged from 1% to 20%. ANOVA revealed no statistically significant effect of the mobile application system on time_PF (p=0.842). In conclusion, there was low initial adoptability and no impact of the mobile dictation and reporting system in reducing the time from initial dictation to final sign-off on a radiology report.

Reactivity of vinyl ethers and vinyl ribosides in UV-initiated free radical copolymerization with acceptor monomers.

PubMed

Pichavant, Loic; Guillermain, Céline; Coqueret, Xavier

2010-09-13

The reactivity of various vinyl ethers and vinyloxy derivatives of ribose in the presence of diethyl fumarate or diethyl maleate was investigated for evaluating the potential of donor-acceptor-type copolymerization applied to unsaturated monomers derived from renewable feedstock. The photochemically induced polymerization of model monomer blends in the bulk state was monitored by infrared spectroscopy. The method allowed us to examine the influence of monomer pair structure on the kinetic profiles. The simultaneous consumption of both monomers was observed, supporting an alternating copolymerization mechanism. A lower reactivity of the blends containing maleates compared with fumarates was confirmed. The obtained kinetic data revealed a general correlation between the initial polymerization rate and the Hansen parameter δ(H) associated with the H-bonding aptitude of the donor monomer.

Evaluation of initial posttrauma cardiovascular levels in association with acute PTSD symptoms following a serious motor vehicle accident.

PubMed

Buckley, Beth; Nugent, Nicole; Sledjeski, Eve; Raimonde, A Jay; Spoonster, Eileen; Bogart, Laura M; Delahanty, Douglas L

2004-08-01

The present study examined the relationship between heart rate (HR) and blood pressure (BP) levels assessed at multiple time points posttrauma and subsequent acute posttraumatic stress disorder (PTSD) symptoms present at a 1-month follow-up. HR and BP levels were measured in 65 motor vehicle accident (MVA) survivors during Emergency Medical Service transport, upon admission to the trauma unit, for the first 20 min postadmission and on the day of discharge. Hierarchical linear modeling analyses revealed no significant relationships between cardiovascular levels and acute PTSD symptoms. Given the small sample size, these results should be interpreted with caution. However, the present results question the use of initial cardiovascular levels as predictors of subsequent acute PTSD in seriously injured MVA victims.

Gastric choriocarcinoma admixed with an α-fetoprotein-producing adenocarcinoma and separated adenocarcinoma

PubMed Central

Eom, Bang Wool; Jung, So-Youn; Yoon, Hongman; Kook, Myeong-Cherl; Ryu, Keun Won; Lee, Jun Ho; Kim, Young-Woo

2009-01-01

We report a case of gastric choriocarcinoma admixed with an α-fetoprotein (AFP)-producing adenocarcinoma. A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum. The patient underwent radical subtotal gastrectomy with D2 lymph node dissection and Billroth II gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively. PMID:19860007

Cerebral venous hypertension and blindness: a reversible complication.

PubMed

Cuadra, Salvador A; Padberg, Frank T; Turbin, Roger E; Farkas, Jeffrey; Frohman, Larry P

2005-10-01

A 57-year-old woman developed blindness during treatment for sarcoidosis-induced end-stage renal disease. An initial renal transplantation failed, and hemoaccess was maintained with multiple central catheters and upper extremity prosthetic arteriovenous grafts. A successful second transplantation eliminated her need for hemodialysis, but a right brachial to internal jugular graft remained patent. Progressive visual loss 2 years after transplantation prompted ophthalmic evaluation which initially revealed unilateral left optic nerve edema and visual loss, ultimately worsening over several months to no light perception in the left eye, 20/60 vision in the right eye, and bilateral papilledema. Arteriography demonstrated cerebral venous hypertension attributed to the functioning hemoaccess graft. Permanent graft occlusion normalized the papilledema, and visual field defects in the right eye and visual acuity returned to 20/20 in the right eye.

[Support of the nursing process through electronic nursing documentation systems (UEPD) – Initial validation of an instrument].

PubMed

Hediger, Hannele; Müller-Staub, Maria; Petry, Heidi

2016-01-01

Electronic nursing documentation systems, with standardized nursing terminology, are IT-based systems for recording the nursing processes. These systems have the potential to improve the documentation of the nursing process and to support nurses in care delivery. This article describes the development and initial validation of an instrument (known by its German acronym UEPD) to measure the subjectively-perceived benefits of an electronic nursing documentation system in care delivery. The validity of the UEPD was examined by means of an evaluation study carried out in an acute care hospital (n = 94 nurses) in German-speaking Switzerland. Construct validity was analyzed by principal components analysis. Initial references of validity of the UEPD could be verified. The analysis showed a stable four factor model (FS = 0.89) scoring in 25 items. All factors loaded ≥ 0.50 and the scales demonstrated high internal consistency (Cronbach's α = 0.73 – 0.90). Principal component analysis revealed four dimensions of support: establishing nursing diagnosis and goals; recording a case history/an assessment and documenting the nursing process; implementation and evaluation as well as information exchange. Further testing with larger control samples and with different electronic documentation systems are needed. Another potential direction would be to employ the UEPD in a comparison of various electronic documentation systems.

The mere exposure effect depends on an odor's initial pleasantness.

PubMed

Delplanque, Sylvain; Coppin, Géraldine; Bloesch, Laurène; Cayeux, Isabelle; Sander, David

2015-01-01

The mere exposure phenomenon refers to improvement of one's attitude toward an a priori neutral stimulus after its repeated exposure. The extent to which such a phenomenon influences evaluation of a priori emotional stimuli remains under-investigated. Here we investigated this question by presenting participants with different odors varying in a priori pleasantness during different sessions spaced over time. Participants were requested to report each odor's pleasantness, intensity, and familiarity. As expected, participants became more familiar with all stimuli after the repetition procedure. However, while neutral and mildly pleasant odors showed an increase in pleasantness ratings, unpleasant and very pleasant odors remained unaffected. Correlational analyses revealed an inverse U-shape between the magnitude of the mere exposure effect and the initial pleasantness of the odor. Consequently, the initial pleasantness of the stimuli appears to modulate the impact of repeated exposures on an individual's attitude. These data underline the limits of mere exposure effect and are discussed in light of the biological relevance of odors for individual survival.

The mere exposure effect depends on an odor’s initial pleasantness

PubMed Central

Delplanque, Sylvain; Coppin, Géraldine; Bloesch, Laurène; Cayeux, Isabelle; Sander, David

2015-01-01

The mere exposure phenomenon refers to improvement of one’s attitude toward an a priori neutral stimulus after its repeated exposure. The extent to which such a phenomenon influences evaluation of a priori emotional stimuli remains under-investigated. Here we investigated this question by presenting participants with different odors varying in a priori pleasantness during different sessions spaced over time. Participants were requested to report each odor’s pleasantness, intensity, and familiarity. As expected, participants became more familiar with all stimuli after the repetition procedure. However, while neutral and mildly pleasant odors showed an increase in pleasantness ratings, unpleasant and very pleasant odors remained unaffected. Correlational analyses revealed an inverse U-shape between the magnitude of the mere exposure effect and the initial pleasantness of the odor. Consequently, the initial pleasantness of the stimuli appears to modulate the impact of repeated exposures on an individual’s attitude. These data underline the limits of mere exposure effect and are discussed in light of the biological relevance of odors for individual survival. PMID:26191021

Evaluation of a community health representative program among the Cree of northern Quebec.

PubMed

Lavallée, C; James, C A; Robinson, E J

1991-01-01

The James Bay Cree Community Health Representative (CHR) program was implemented in 1984 to train persons from the Cree population of northern Quebec to act as health care advocates and educators, as intermediaries between the Cree population, health services and local organizations, and as participants in assessing health needs. A formative evaluation was initiated which included quantitative analysis of the daily tasks of CHRs and a qualitative component based on documentary research, observation and semi-structured interviews. The evaluation revealed that CHRs actively participated in the ongoing community health programs mainly through health education; the people interviewed showed a high level of satisfaction. However, direct supervision, sufficient continuing education for the CHRs and better integration into health care teams are long-term goals which need to be emphasized in the program.

Evidence-based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in Ghana.

PubMed

Brantuo, Mary N A; Cristofalo, Elizabeth; Meheš, Mira M; Ameh, Juliana; Brako, Nana Okai; Boahene, Frederick; Adjei, Stella B; Opoku, Ernest; Banda, Harriet; Wang, Yu T; Forgor, Abdulai A; Punguire, Damien; Brightson, Kennedy; Sottie, Cynthia; Owusu-Agyei, Seth; Williams, John E; Sulemana, Abubakari; Oduro, Abraham R; Gyampong, Margaret; Sarpong, Doris; Andrews, Edith; Gyansa-Lutterodt, Martha; Hodgson, Abraham; Bannerman, Cynthia; Abdullah, Fizan

2014-04-01

To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity. The neonatal quality improvement initiative was launched at two intervention referral district hospitals in Ghana. Local Health and Demographic Surveillance Systems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on-site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices. In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre- and post-training test results demonstrates significant improvement in provider knowledge (73% vs. 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs. 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence. Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on-site training, mentorship and enhanced demographic surveillance. © 2014 John Wiley & Sons Ltd.

Gemifloxacin-associated neurotoxicity presenting as encephalopathy.

PubMed

Barrett, Matthew J; Login, Ivan S

2009-04-01

To report a case of acute encephalopathy associated with ingestion of gemifloxacin, a fluoroquinolone. A 67-year-old woman presented to the emergency department with an acute alteration in mental status. Twenty-four hours earlier she had taken one 320-mg tablet of her husband's gemifloxacin prescription to treat symptoms of a mild upper respiratory infection. During her initial evaluation at our institution, the woman was dysphasic, unable to follow commands, and agitated, suggesting encephalopathy. A thorough diagnostic investigation did not reveal any structural, metabolic, or infectious etiology. Her mental status returned to normal within 2 days without any definitive treatment. Fluoroquinolone-associated neurotoxicity may manifest as encephalopathy, seizures, confusion, or toxic psychosis. To date, none of these adverse effects, specifically encephalopathy, has been reported with gemifloxacin. An objective causality assessment revealed that encephalopathy was probably associated with gemifloxacin use. Seizures, either convulsive or nonconvulsive, may have contributed to our patient's presentation, but she denied seizures prior to this event and did not suffer a seizure in the 18 months following her discharge. However, her second electroencephalograph revealed an underlying predisposition to seizures, which gemifloxacin may have unmasked. This report illustrates that severe central nervous system adverse effects associated with some fluoroquinolones may also occur with gemifloxacin. Gemifloxacin and other fluoroquinolones should be considered in the etiologic evaluation of patients with acute encephalopathy.

An Investigation to Improve Quality Evaluations of Primers and Propellant for 20mm Munitions

NASA Technical Reports Server (NTRS)

Bement, L. J.; Holmes, C.; McGrory, J.; Schimmel, M. L.

1997-01-01

To reduce the frequency of electrically initiated, 20mm munition hangfires (delayed ignitions), a joint Army/NASA investigation was conducted to recommend quality evaluation improvements for acceptance of both primers and gun propellant. This effort focused only on evaluating ignition and combustion performance as potential causes of hangfires: poor electrical initiation of the primer, low output performance of the primer, low ignition sensitivity of the gun propellant, and the effects of cold temperature. The goal was to determine the "best" of the Army and NASA test methods to assess the functional performance of primers and gun propellants. The approach was to evaluate the performance of both high-quality and deliberately defective primers to challenge the sensitivity of test methods. In addition, the ignition sensitivity of different manufacturing batches of gun propellants was evaluated. The results of the investigation revealed that improvements can be made in functional evaluations that can assist in identifying and reducing ignition and performance variations. The "best" functional evaluation of primers and propellant is achieved through a combination of both Army and NASA test methods. Incorporating the recommendations offered in this report may provide for considerable savings in reducing the number of cartridge firings, while significantly lowering the rejection rate of primer, propellant and cartridge lots. The most probable causes for ignition and combustion-related hangfires were the lack of calcium silicide in the primer mix, a low output performance of primers, and finally, poor ignition sensitivity of gun propellant. Cold temperatures further reduce propellant ignition sensitivity, as well as reducing burn rate and chamber pressures.

Assessment of an outreach program for eighth-grade science students: Measurement of affective and cognitive gains

NASA Astrophysics Data System (ADS)

Hauge, James Brian

1998-12-01

The College of Sciences and Mathematics Science Outreach Initiative was a program designed to attract students with the interest and ability to succeed in science and to keep them interested until they entered college. In this way, the Initiative sought to address the problem of a projected shortfall of scientists and engineers in the future. This study was conducted to evaluate the goals of the eighth grade component of the COSAM Initiative. These goals included: increased interest in and self-efficacy relating to science, increased achievement in science and mathematics, and increased enrollment in science and mathematics classes. Data were collected from 48 participants and 43 non-participants with surveys and from student records. Pre-treatment Chi-Square tests revealed that the groups did not differ in ethnicity, race, family income, parents' education, or parents' occupation. The surveys used were a total battery interest survey including (1) the Learning Science Things Survey (to measure interest in science topics), the Activities Interest Survey (to measure interest in science activities), the Career Orientation Survey (to measure interest in science careers) and the Learning Methods Survey (to measure interest in learning by experiential methods), (2) the Saturday Academy Survey (to measure self-efficacy concerning science activities), (3) the Saturday Academy Electronics/Eye Quiz (to test ability relating to science activities), and (4) the Summer Science Camp Survey (to measure interest in and self-efficacy concerning science activities). Student grades, SAT, and OLSAT scores, and the kinds of science and mathematics courses enrolled in during seventh and eighth grades were obtained from school records. Analysis of data using a mixed ANOVA design revealed that participation in the COSAM Initiative had no significant effect on interest in science as measured by the total battery survey. Similar analysis of Saturday Academy Survey data revealed that the participant group showed significantly greater gains in self-efficacy regarding science activities than did the non-participant group. No correlation was found between self-efficacy and ability as measured by the Electronics/Eye Quiz. Analysis of Summer Science Camp Survey data with paired samples tests revealed that interest and self-efficacy significantly increased after treatment. Interest and self-efficacy relating to Summer Science Camp activities were positively correlated after treatment. No significant effects were detected to indicate that participation in the COSAM Initiative positively affected school grades, standardized test scores, or increased the number of science and mathematics courses in which students enrolled.

Toxicosis associated with ingestion of quick-dissolve granulated chlorine in a dog.

PubMed

Hofmeister, Aaron S; Heseltine, Johanna C; Sharp, Claire R

2006-10-15

A dog was referred for treatment after ingestion of quick-dissolve chlorine granules intended for use in a swimming pool. At evaluation 18 hours after ingestion of the granules, the dog had tachypnea, signs of depression, approximately 5% dehydration, oral mucositis, and a productive cough. Increased respiratory tract sounds and wheezes were ausculted in all lung fields. Complete blood count revealed erythrocytosis and lymphopenia. Serum biochemical analyses revealed mildly high activities of hepatic enzymes and creatine kinase. Arterial blood gas concentrations were consistent with hypoxemia and hyperventilation. Thoracic radiography revealed widespread pulmonary alveolar infiltrates predominantly affecting the ventral portions of both lungs, consistent with noncardiogenic pulmonary edema secondary to aspiration of the granulated chlorine. Initial treatment included IV administration of an electrolyte solution with supplemental KCl, ranitidine, furosemide, cefotaxime, buprenorphine, and supplemental oxygen. Subsequent treatment included administration of meloxicam and an endoscopically placed percutaneous gastrostomy tube. Endoscopic examination revealed esophagitis and mild gastritis; therefore, metoclopramide and sucralfate were also administered. Fifteen days later, the gastrostomy tube was removed prior to discharge; endoscopic examination revealed grossly normal esophageal and gastric mucosa, and thoracic radiography revealed complete resolution of the lung lesions. Although ingestion of granulated chlorine is rare in veterinary patients, the resulting disease processes are common and can be treated successfully.

Successful Treatment of Suspected Pulmonary Arterial Hypertension in a Mealy Amazon Parrot (Amazona farinose).

PubMed

Brady, Sean M; Burgdorf-Moisuk, Anne; Silverman, Sarah; Wack, Raymund F

2016-12-01

A 25-year-old, male mealy Amazon parrot (Amazona farinose) with a history of polycythemia, hepatomegaly, and epistaxis was evaluated for progressive lethargy and anorexia. Clinical laboratory testing revealed severe polycythemia (71%), hypophosphatemia (1.6 mg/dL), and mild hypokalemia (2.8 mEq/L). Radiographs showed marked hepatomegaly and loss of air sac space. Despite supportive treatments, the bird's condition deteriorated, and it developed ataxia, was unable to fly, and became oxygen dependent. An echocardiogram, including an air bubble study, revealed a right-to-left atrial shunt and presumed pulmonary arterial hypertension. The bird was started on periodic phlebotomy (5-10 mL/kg q6wk) to reduce packed cell volume and sildenafil citrate (2.5 mg/kg PO q8h) for treatment of suspected pulmonary arterial hypertension. One week later, the patient was weaned off oxygen, and 24 days after initial presentation, the parrot was returned to its outdoor exhibit. Intermittent periods of increased respiratory rate and effort have been reported but have resolved without additional treatments. Epistaxis, once common in this bird, has not been noted since initiating treatment with sildenafil citrate 15 months ago.

Disseminated protothecosis associated with diskospondylitis in a dog.

PubMed

Manino, Paul M; Oliveira, Fabiano; Ficken, Martin; Swinford, Amy; Burney, Derek

2014-01-01

A 6 yr old female Labrador retriever was evaluated for an acute onset of difficulty walking and a head tilt. Initial physical examination revealed bilateral retinal detachment, a left-sided head tilt, positional rotary nystagmus, and lumbar hyperpathia. Pertinent preliminary diagnostic findings included systemic hypertension, bony lysis and adjacent sclerosis of the vertebral endplates of the first and second lumbar vertebrae, and positive urine and blood cultures for a yeast identified as Candida spp. Concerned about disseminated candidiasis after subsequent subretinal aspirates confirmed the presence of a yeast-like organism, therapy with voriconazole was initiated. Because of progressive clinical deterioration and the poor prognosis for recovery, the dog was eventually euthanized. Postmortem histological examination of tissues, including the affected vertebral endplates, revealed numerous intralesional algae compatible with Prototheca spp. To the authors' knowledge, this report is the first to document a case of protothecal diskospondylitis with possible concurrent candidiasis in a dog. Although typically associated with signs referable to the gastrointestinal tract, this report underscores the importance of not excluding protothecosis as a differential diagnosis when such signs are absent. Lastly, the use of voriconazole appears ineffective for reversing the clinical course of late-stage disseminated protothecosis.

Disorders of the neonatal nasal cavity: Fundamentals for practice.

PubMed

Sohal, Maheep; Schoem, Scott R

2016-08-01

Neonatal nasal obstruction is a well-known clinical entity. Fortunately, it is rarely life-threatening and usually resolves with conservative management. As with most conditions, a systematic history and thorough physical examination are crucial for correct diagnosis and management. The initial diagnosis may be elusive and require either serial or more in-depth evaluations. Occasionally, examination may reveal structural abnormalities necessitating surgical intervention. Fortunately most of these abnormalities are amenable to surgery; however, a select few are notoriously difficult to treat. Copyright © 2016. Published by Elsevier Ltd.

Information systems analysis approach in hospitals: a national survey.

PubMed

Wong, B K; Sellaro, C L; Monaco, J A

1995-03-01

A survey of 216 hospitals reveals that some hospitals do not conduct cost-benefit analyses or analyze possible adverse effects in feasibility studies. In determining and analyzing system requirements, external factors that initiate the transaction are not examined, and computer-aided software engineering (CASE) tools are seldom used. Some hospitals do not investigate the advantages and disadvantages of using in-house-developed software versus purchased software packages in the evaluation of alternatives. The survey finds that, overall, most hospitals follow the traditional systems development life cycle (SDLC) approach in analyzing information systems.

Clinical and prognostic aspects of adrenocortical neoplasms in childhood.

PubMed

Teinturier, C; Pauchard, M S; Brugières, L; Landais, P; Chaussain, J L; Bougnères, P F

1999-02-01

A retrospective study of 54 children was undertaken to define the clinical presentation and secretory patterns of adrenal tumors and to evaluate the outcome of surgical resection and medical therapy. Different factors were studied in univariate and multivariate analysis by using the Cox proportional hazard model. Median age at diagnosis was 4 years. Boys and girls were affected equally. The disease was revealed by virilization (61%) or by a palpable mass (39%) with a 0.1-5.5 year delay from initial symptoms. At initial examination, we found that 76% of children were virilized. Ninety-four percent of the tested tumors secreted androgens, which were associated with glucocorticoids in 36%. Adrenal tumors in children were smaller than in adults. Half of them measured less than 10 cm. There were recurrences in 40% of children. The survival rate at 5 years was 49%, 70% if resection was microscopically complete and 7% if not (P < 0.001). In children, rare adrenal tumors have different diagnostic and prognostic characteristics than in adults; however, recurrences remain frequent. The efficacy of chemotherapy, mainly o,p'-DDD (Mitotane), remains to be evaluated in comparative trials.

A case of central retinal artery occlusion following embolization procedure for juvenile nasopharyngeal angiofibroma

PubMed Central

Ramezani, Alireza; Haghighatkhah, Hamidreza; Moghadasi, Habibollah; Taheri, Morteza S; Parsafar, Hiva

2010-01-01

A 23-year-old male patient with right nasal Juvenile Nasopharyngeal Angiofibroma (JNA) developed Central Retinal Artery Occlusion (CRAO) during embolization of the tumor using polyvinyl alcohol particles before endoscopic excision. Classic CRAO management was initiated by an ophthalmologist after 12 h. Retrospective evaluation of the angiograms revealed a tiny communication between the external carotid and ophthalmic arteries which had not been noticed before embolization. During endoscopic excision, the tumor was found to originate extraordinarily from midline structures. It was concluded that CRAO might be a rare complication of JNA embolization. Careful preoperative angiographic evaluations to detect communicating arteries and immediate ophthalmologic consultation in case of developing visual symptoms during the procedure are necessary. PMID:20689199

An approach to the patient with late-onset cerebellar ataxia.

PubMed

Fogel, Brent L; Perlman, Susan

2006-11-01

An 83-year-old man presented with hypertension, hyperlipidemia, and a previous basal cell carcinoma, having developed progressive worsening of his balance and difficulty walking at the age of 78 years. He was initially diagnosed with stroke, but MRI revealed only isolated cerebellar atrophy. The patient then underwent multiple evaluations for an underlying paraneoplastic process, all of which were negative, but his symptoms progressed and he remained undiagnosed for several years. Neurological examination, laboratory blood tests, MRI, and directed genetic testing. Five years after becoming symptomatic, the patient was re-evaluated for a possible genetic ataxia syndrome, which was subsequently confirmed by gene testing as spinocerebellar ataxia type 6 (SCA6). Symptomatic medical treatment and physical, occupational, and speech therapy.

Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations.

PubMed

Chaniotis, Antonis

2018-03-01

Although regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the suggested therapeutic endodontic spectrum, little is known about the effect of orthodontic movement in the tissue that has been regenerated. Furthermore, as the number of adults undergoing orthodontic treatment increases, there is an increasing need to investigate the changes that these tissues may undergo during orthodontic movement. Here we describe the alterations observed after the application of orthodontic forces in a case of an apically root-fractured necrotic immature root that had been managed with regenerative endodontic procedures in the past. A 9-year-old male patient was referred after suffering the third incidence of trauma in the anterior maxilla. Radiographic evaluation revealed a periapical rarefaction associated with an apically root-fractured immature central incisor. Clinical evaluation revealed a buccal abscess and grade 3 tooth mobility. Periodontal probing was within normal limits. The tooth was accessed and disinfected by using apical negative pressure irrigation of 6% NaOCl. Intracanal dentin conditioning was achieved by using 17% EDTA for 5 minutes. A blood clot was induced from the periapical area, and calcium silicate-based cement was placed in direct contact with the blood clot at the same visit. The composite resin restoration was accomplished in the same appointment. Recall radiographic examination after 24 months revealed healing of the periapical lesion and signs of continuous root development despite the apical root fracture. Clinical evaluation revealed normal tooth development, normal mobility, and a resolving buccal infection. The tooth was subjected to orthodontic treatment because of Class II division 1 malocclusion with an overjet of 11 mm. After completion of the orthodontic treatment, 5.5 years after the initial intervention, the radiographic image revealed marked remodeling of the periapical tissues and repair of the apical fractures, and the buccal infection had resolved completely. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endometrioid adenocarcinoma arising in adenomyosis: elucidation by periodic magnetic resonance imaging evaluations.

PubMed

Motohara, Kenichi; Tashiro, Hironori; Ohtake, Hideyuki; Saito, Fumitaka; Ohba, Takashi; Katabuchi, Hidetaka

2008-06-01

There are several case reports of adenocarcinomas developing within adenomyosis. However, there is no report demonstrating the natural course from adenomyosis to adenocarcinoma. We report a patient (a 41-year-old Japanese woman) who was observed every 6 months after being diagnosed with adenomyosis at our University Hospital. Although she went through menopause at age 51, she occasionally complained subsequently of abnormal genital bleeding. Eleven years after the initial diagnosis, endometrial cytology revealed the presence of malignant cells. Pelvic magnetic resonance imaging (MRI) demonstrated replacement of the adenomyotic lesion by a poorly demarcated lesion, compared to the findings on prior MRI. Consequently, we performed a modified radical hysterectomy and pelvic lymph node dissection, under a presumptive diagnosis of adenocarcinoma arising in adenomyosis. Histological diagnosis revealed an endometrioid adenocarcinoma (G3) transformed from adenomyotic epithelium, which was classified, according to the International Federation of Gynecology and Obstetrics, as stage Ic, pT1cN0M0. In this patient, periodic MRI evaluations, in conjunction with pathological examination, identified the transformation from adenomyosis to adenocarcinoma.

Tracking hand movements captures the response dynamics of the evaluative priming effect.

PubMed

Kawakami, Naoaki; Miura, Emi

2018-06-08

We tested the response dynamics of the evaluative priming effect (i.e. facilitation of target responses following evaluatively congruent compared with evaluatively incongruent primes) using a mouse tracking procedure that records hand movements during the execution of categorisation tasks. In Experiment 1, when participants performed the evaluative categorisation task but not the non-evaluative semantic categorisation task, their mouse trajectories for evaluatively incongruent trials curved more toward the opposite response than those for evaluatively congruent trials, indicating the emergence of evaluative priming effects based on response competition. In Experiment 2, implementing a task-switching procedure in which evaluative and non-evaluative categorisation tasks were intermixed, we obtained reliable evaluative priming effects in the non-evaluative semantic categorisation task as well as in the evaluative categorisation task when participants assigned attention to the evaluative stimulus dimension. Analyses of hand movements revealed that the evaluative priming effects in the evaluative categorisation task were reflected in the mouse trajectories, while evaluative priming effects in the non-evaluative categorisation tasks were reflected in initiation times (i.e. the time elapsed between target onset and first mouse movement). Based on these findings, we discuss the methodological benefits of the mouse tracking procedure and the underlying processes of evaluative priming effects.

Effect of Warfarin Treatment on Survival of Patients With Pulmonary Arterial Hypertension (PAH) in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL)

PubMed Central

Preston, Ioana R.; Roberts, Kari E.; Miller, Dave P.; Sen, Ginny P.; Selej, Mona; Benton, Wade W.; Hill, Nicholas S.

2015-01-01

Background— Long-term anticoagulation is recommended in idiopathic pulmonary arterial hypertension (IPAH). In contrast, limited data support anticoagulation in pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc-PAH). We assessed the effect of warfarin anticoagulation on survival in IPAH and SSc-PAH patients enrolled in Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL), a longitudinal registry of group I PAH. Methods and Results— Patients who initiated warfarin on study (n=187) were matched 1:1 with patients never on warfarin, by enrollment site, etiology, and diagnosis status. Descriptive analyses were conducted to compare warfarin users and nonusers by etiology. Survival analyses with and without risk adjustment were performed from the time of warfarin initiation or a corresponding quarterly update in matched pairs to avoid immortal time bias. Time-varying covariate models were used as sensitivity analyses. Mean warfarin treatment was 1 year; mean international normalized ratios were 1.9 (IPAH) and 2.0 (SSc-PAH). Two-thirds of patients initiating warfarin discontinued treatment before the last study assessment. There was no survival difference with warfarin in IPAH patients (adjusted hazard ratio, 1.37; P=0.21) or in SSc-PAH patients (adjusted hazard ratio, 1.60; P=0.15) in comparison with matched controls. However, SSc-PAH patients receiving warfarin within the previous year (hazard ratio, 1.57; P=0.031) or any time postbaseline (hazard ratio, 1.49; P=0.046) had increased mortality in comparison with warfarin-naïve patients. Conclusions— No significant survival advantage was observed in IPAH patients who started warfarin. In SSc-PAH patients, long-term warfarin was associated with poorer survival than in patients not receiving warfarin, even after adjusting for confounders. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00370214. PMID:26510696

Effect of Warfarin Treatment on Survival of Patients With Pulmonary Arterial Hypertension (PAH) in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL).

PubMed

Preston, Ioana R; Roberts, Kari E; Miller, Dave P; Sen, Ginny P; Selej, Mona; Benton, Wade W; Hill, Nicholas S; Farber, Harrison W

2015-12-22

Long-term anticoagulation is recommended in idiopathic pulmonary arterial hypertension (IPAH). In contrast, limited data support anticoagulation in pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc-PAH). We assessed the effect of warfarin anticoagulation on survival in IPAH and SSc-PAH patients enrolled in Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL), a longitudinal registry of group I PAH. Patients who initiated warfarin on study (n=187) were matched 1:1 with patients never on warfarin, by enrollment site, etiology, and diagnosis status. Descriptive analyses were conducted to compare warfarin users and nonusers by etiology. Survival analyses with and without risk adjustment were performed from the time of warfarin initiation or a corresponding quarterly update in matched pairs to avoid immortal time bias. Time-varying covariate models were used as sensitivity analyses. Mean warfarin treatment was 1 year; mean international normalized ratios were 1.9 (IPAH) and 2.0 (SSc-PAH). Two-thirds of patients initiating warfarin discontinued treatment before the last study assessment. There was no survival difference with warfarin in IPAH patients (adjusted hazard ratio, 1.37; P=0.21) or in SSc-PAH patients (adjusted hazard ratio, 1.60; P=0.15) in comparison with matched controls. However, SSc-PAH patients receiving warfarin within the previous year (hazard ratio, 1.57; P=0.031) or any time postbaseline (hazard ratio, 1.49; P=0.046) had increased mortality in comparison with warfarin-naïve patients. No significant survival advantage was observed in IPAH patients who started warfarin. In SSc-PAH patients, long-term warfarin was associated with poorer survival than in patients not receiving warfarin, even after adjusting for confounders. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00370214. © 2015 The Authors.

Identification of corrosion and damage mechanisms by using scanning electron microscopy and energy-dispersive X-ray microanalysis: contribution to failure analysis case histories

NASA Astrophysics Data System (ADS)

Pantazopoulos, G.; Vazdirvanidis, A.

2014-03-01

Emphasis is placed on the evaluation of corrosion failures of copper and machineable brass alloys during service. Typical corrosion failures of the presented case histories mainly focussed on stress corrosion cracking and dezincification that acted as the major degradation mechanisms in components used in piping and water supply systems. SEM assessment, coupled with EDS spectroscopy, revealed the main cracking modes together with the root-source(s) that are responsible for the damage initiation and evolution. In addition, fracture surface observations contributed to the identification of the incurred fracture mechanisms and potential environmental issues that stimulated crack initiation and propagation. Very frequently, the detection of chlorides among the corrosion products served as a suggestive evidence of the influence of working environment on passive layer destabilisation and metal dissolution.

The effect of the baby-friendly hospital initiative on long-term breast feeding.

PubMed

Duyan Camurdan, A; Ozkan, S; Yüksel, D; Pasli, F; Sahin, F; Beyazova, U

2007-08-01

The aim of this study was to evaluate the effects of 'baby-friendly hospital initiative' (BFHI) on breast feeding. In the four consecutive months after BFHI in Gazi University Hospital (November 2002-February 2003), breast feeding status until the second year of life in 297 babies, born in the same hospital was compared with the values of 258 babies born before BFHI (November 2001-February 2002). The exclusive breast feeding rate in the first 6 months was higher in the babies born after BFHI. Cox regression analysis revealed that BFHI increases the duration of breast feeding 1.5 times. At the end of the second year, cumulative rate of breast feeding was higher in the group after-BFHI (p=0.0036). The rate of breast feeding was increased by BFHI implementation.

The Emergency Medical Care of Patients With Acute Myocardial Infarction.

PubMed

Stockburger, Martin; Maier, Birga; Fröhlich, Georg; Rutsch, Wolfgang; Behrens, Steffen; Schoeller, Ralph; Theres, Heinz; Poloczek, Stefan; Plock, Gerd; Schühlen, Helmut

2016-07-25

Optimizing the emergency medical care chain might shorten the time to treatment of patients with ST-elevation myocardial infarction (STEMI). The initial care by a physician, and, in particular, correct ECG interpretation, are critically important factors. From 1999 onward, data on the care of patients with myocardial infarction have been recorded and analyzed in the Berlin Myocardial Infarction Registry. In the First Medical Contact Study, data on initial emergency medical care were obtained on 1038 patients who had been initially treated by emergency physicians in 2012. Their pre-hospital ECGs were re-evaluated in a blinded fashion according to the criteria of the European Society of Cardiology. The retrospective re-evaluation of pre-hospital ECGs revealed that 756 of the 1038 patients had sustained a STEMI. The emergency physicians had correctly diagnosed STEMI in 472 patients (62.4%), and they had correctly diagnosed ventricular fibrillation in 85 patients (11.2%); in 199 patients (26.3%), the ECG interpretation was unclear. The pre-hospital ECG interpretation was significantly associated with the site of initial hospitalization and the ensuing times to treatment. In particular, the time from hospital admission to cardiac catheterization was longer in patients with an unclear initial ECG interpretation than in those with correctly diagnosed STEMI (121 [54; 705] vs. 36 [19; 60] minutes, p <0.001). After multivariate adjustment, this corresponded to a hazard ratio* of 2.67 [2.21; 3.24]. Pre-hospital ECG interpretation in patients with STEMI was a trigger factor with a major influence on the time to treatment in the hospital. The considerable percentage of pre-hospital ECGs whose interpretation was unclear implies that there is much room for improvement.

Batch and fixed-bed adsorption of tartrazine azo-dye onto activated carbon prepared from apricot stones

NASA Astrophysics Data System (ADS)

Albroomi, H. I.; Elsayed, M. A.; Baraka, A.; Abdelmaged, M. A.

2017-07-01

This work describes the potential of utilizing prepared activated carbon from apricot stones as an efficient adsorbent material for tartrazine (TZ) azo-dye removal in a batch and dynamic adsorption system. The results revealed that activated carbons with well-developed surface area (774 m2/g) and pore volume (1.26 cm3/g) can be manufactured from apricot stones by H3PO4 activation. In batch experiments, effects of the parameters such as initial dye concentration and temperature on the removal of the dye were studied. Equilibrium was achieved in 120 min. Adsorption capacity was found to be dependent on the initial concentration of dye solution, and maximum adsorption was found to be 76 mg/g at 100 mg/L of TZ. The adsorption capacity at equilibrium ( q e) increased from 22.6 to 76 mg/g with an increase in the initial dye concentrations from 25 to 100 mg/L. The thermodynamic parameters such as change in free energy (Δ G 0), enthalpy (Δ H 0) and entropy (Δ S 0) were determined and the positive value of (Δ H) 78.1 (K J mol-1) revealed that adsorption efficiency increased with an increase in the process temperature. In fixed-bed column experiments, the effect of selected operating parameters such as bed depth, flow rate and initial dye concentration on the adsorption capacity was evaluated. Increase in bed height of adsorption columns leads to an extension of breakthrough point as well as the exhaustion time of adsorbent. However, the maximum adsorption capacities decrease with increases of flow rate. The breakthrough data fitted well to bed depth service time and Thomas models with high coefficient of determination, R 2 ≥ 94.

Effect of resin infiltration on white spot lesions after debonding orthodontic brackets.

PubMed

Hammad, Shaza M; El Banna, Mai; El Zayat, Inas; Mohsen, Mohamed Abdel

2012-02-01

To evaluate the effect of application of a resin infiltration material on masking the white spot lesions (WSLs) after bracket removal. 18 patients participated in this study and were divided into two groups of nine patients each; by a visual score based on the extent of demineralization, according to the classification of the WSLs. Group 1: Visible WSLs without surface disruption and Group 2: WSLs showed a roughened surface but not requiring restoration. Three successive photographs were taken for every patient; immediately after bracket removal, 1 week after oral hygiene measures and after Icon material application. The JPEG images were imported into image analysis software (Image J version 1.33u for Windows XP, US National Institutes of Health) which presented the images into histograms of gray scale from (0 to 255). Initial and final images were compared for percentage of WSLs masking area. For both groups, a statistically significant difference at P<0.05 was obtained as follows; for WSLs in Group 1, the means at gray scale for the initial and the final photographs were 126.091 +/- 13.452 and 221.268 +/- 9.350 respectively and they revealed significance by Wilcoxon's signed rank test = 0.038, P<0.05. For WSLs in Group 2, the means at gray scale for the initial and the final photographs were 95.585 +/- 20.973 and 155.612 +/- 31.203 respectively and they revealed significance by Wilcoxon's signed rank test = 0.029, P<0.05.

Primary Orbital Chondromyxoid Fibroma: A Rare Case.

PubMed

Mullen, Martin G; Somogyi, Marie; Maxwell, Sean P; Prabhu, Vikram; Yoo, David K

A 56-year-old male with history of chronic sinusitis was found to have a 3 cm left orbital lesion on CT. Subsequent MRI demonstrated a multilobulated enhancing soft tissue lesion at the superotemporal region of the left orbit. Initial biopsy was reported as a low-grade sarcoma. On further evaluation, a consensus was made that the lesion was likely a benign mixed mesenchymal type tumor but should nonetheless be surgically removed. Left lateral orbitotomy was performed which revealed a tumor originating in the lateral orbital bone with segments eroding through the wall of the orbit. Intraoperative frozen sections revealed myoepitheliod tissue with locally aggressive features and the tumor was completely removed. The final histopathologic analysis of the tissue was consistent with a chondromyxoid fibroma. Chondomyxoid fibroma is a rare entity in the orbital bones and is more commonly seen in long bones.

A longitudinal study on deep brain stimulation of the medial forebrain bundle for treatment-resistant depression.

PubMed

Fenoy, Albert J; Schulz, Paul E; Selvaraj, Sudhakar; Burrows, Christina L; Zunta-Soares, Giovanna; Durkin, Kathryn; Zanotti-Fregonara, Paolo; Quevedo, Joao; Soares, Jair C

2018-06-04

Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB) has been reported to lead to rapid antidepressant effects. In this longitudinal study, we expand upon the initial results we reported at 26 weeks (Fenoy et al., 2016), showing sustained antidepressant effects of MFB DBS on six patients with treatment-resistant depression (TRD) over 1 year. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary assessment tool. Deterministic fiber tracking was used to individually map the target area; analysis was performed to compare modulated fiber tracts between patients. Intraoperatively, upon stimulation at target, responders reported immediate increases in energy and motivation. An insertional effect was seen during the 4-week sham stimulation phase from baseline (28% mean MADRS reduction, p = 0.02). However, after 1 week of initiating stimulation, three of six patients had a > 50% decrease in MADRS scores relative to baseline (43% mean MADRS reduction, p = 0.005). One patient withdrew from study participation. At 52 weeks, four of remaining five patients have > 70% decrease in MADRS scores relative to baseline (73% mean MADRS reduction, p = 0.007). Evaluation of modulated fiber tracts reveals significant common orbitofrontal connectivity to the target region in all responders. Neuropsychological testing and 18 F-fluoro-deoxyglucose-positron emission tomography cerebral metabolism evaluations performed at baseline and at 52 weeks showed minimal changes and verified safety. This longitudinal evaluation of MFB DBS demonstrated rapid antidepressant effects, as initially reported by Schlaepfer et al. (2013), and supports the use of DBS for TRD.

Critical evaluation and modeling of algal harvesting using dissolved air flotation. DAF Algal Harvesting Modeling

DOE PAGES

Zhang, Xuezhi; Hewson, John C.; Amendola, Pasquale; ...

2014-07-14

In our study, Chlorella zofingiensis harvesting by dissolved air flotation (DAF) was critically evaluated with regard to algal concentration, culture conditions, type and dosage of coagulants, and recycle ratio. Harvesting efficiency increased with coagulant dosage and leveled off at 81%, 86%, 91%, and 87% when chitosan, Al 3+, Fe 3+, and cetyl trimethylammonium bromide (CTAB) were used at dosages of 70, 180, 250, and 500 mg g -1, respectively. The DAF efficiency-coagulant dosage relationship changed with algal culture conditions. In evaluating the influence of the initial algal concentration and recycle ratio revealed that, under conditions typical for algal harvesting, wemore » found that it is possible that the number of bubbles is insufficient. A DAF algal harvesting model was developed to explain this observation by introducing mass-based floc size distributions and a bubble limitation into the white water blanket model. Moreover, the model revealed the importance of coagulation to increase floc-bubble collision and attachment, and the preferential interaction of bubbles with larger flocs, which limited the availability of bubbles to the smaller sized flocs. The harvesting efficiencies predicted by the model agree reasonably with experimental data obtained at different Al 3+ dosages, algal concentrations, and recycle ratios. Based on this modeling, critical parameters for efficient algal harvesting were identified.« less

Critical evaluation and modeling of algal harvesting using dissolved air flotation. DAF Algal Harvesting Modeling

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

Zhang, Xuezhi; Hewson, John C.; Amendola, Pasquale

In our study, Chlorella zofingiensis harvesting by dissolved air flotation (DAF) was critically evaluated with regard to algal concentration, culture conditions, type and dosage of coagulants, and recycle ratio. Harvesting efficiency increased with coagulant dosage and leveled off at 81%, 86%, 91%, and 87% when chitosan, Al 3+, Fe 3+, and cetyl trimethylammonium bromide (CTAB) were used at dosages of 70, 180, 250, and 500 mg g -1, respectively. The DAF efficiency-coagulant dosage relationship changed with algal culture conditions. In evaluating the influence of the initial algal concentration and recycle ratio revealed that, under conditions typical for algal harvesting, wemore » found that it is possible that the number of bubbles is insufficient. A DAF algal harvesting model was developed to explain this observation by introducing mass-based floc size distributions and a bubble limitation into the white water blanket model. Moreover, the model revealed the importance of coagulation to increase floc-bubble collision and attachment, and the preferential interaction of bubbles with larger flocs, which limited the availability of bubbles to the smaller sized flocs. The harvesting efficiencies predicted by the model agree reasonably with experimental data obtained at different Al 3+ dosages, algal concentrations, and recycle ratios. Based on this modeling, critical parameters for efficient algal harvesting were identified.« less

Biomechanical aspects of initial intraosseous stability and implant design: a quantitative micro-morphometric analysis.

PubMed

Akça, Kivanç; Chang, Ting-Ling; Tekdemir, Ibrahim; Fanuscu, Mete I

2006-08-01

The objective of this biomechanical study was to explore the effect of bone micro-morphology on initial intraosseous stability of implants with different designs. Straumann and Astra Tech dental implants were placed into anterior and posterior regions of completely edentulous maxilla and mandible of a human cadaver. Experiments were undertaken to quantify initial implant stability and bone micro-morphology. Installation torque values (ITVs) and implant stability quotients (ISQs) were measured to determine initial intraosseous implant stability. For quantification of relative bone volume and micro-architecture, sectioned implant-bone and bone core specimens of each implant placement site were consecutively scanned and trabecular bone was analyzed in a micro-computed tomography (micro-CT) unit. Experimental outcomes were evaluated for correlations among implant designs, initial intraosseous implant stability and bone micro-structural parameters. ITVs correlated higher with bone volume fraction (BV/TV) than ISQs, at 88.1% and 68.9% levels, respectively. Correlations between ITVs and micro-morphometric parameters were significant at the 95% confidence level (P<0.05) while ISQs were not. Differences in ITVs, ISQs and BV/TV data in regards to implant designs used were not significant at the 95% confidence level (P>0.05). Bone micro-morphology has a prevailing effect over implant design on intraosseus initial implant stability, and ITV is more sensitive in terms of revealing biomechanical properties at the bone-implant interface in comparison with ISQ.

Paradoxical response to dexamethasone and spontaneous hypocortisolism in Cushing's disease

PubMed Central

Lila, Anurag R; Sarathi, Vijaya; Bandgar, Tushar R; Shah, Nalini S

2013-01-01

Paradoxical response to dexamethasone and spontaneous development of hypocortisolism are rare features of Cushing's disease. We report a 13-year-old boy with Cushing's disease owing to a pituitary macroadenoma. On initial evaluation, he had partial suppression of serum cortisol by dexamethasone. He developed transient hypocortisolism after first adenomectomy, but the disease recurred after 1 year. Repeat evaluation showed recurrent hypercortisolism and paradoxical response to dexamethasone. He underwent second surgery and, postoperatively, hypercostisolism persisted even after 2 years of surgery. Repeat evaluations after 8 years of second surgery revealed persistent hypocortisolism despite residual tumour of same size and similar plasma adrenocorticotropic hormone (ACTH) levels. We have also shown that the paradoxical increase in serum cortisol was preceded by a paradoxical increase in ACTH. The paradoxical response persisted despite hypocortisolism. This patient with Cushing's disease had two very rare features: paradoxical response to dexamethasone and spontaneous development of hypocortisolism. PMID:23365169

One thousand words: evaluating an interdisciplinary art education program.

PubMed

Klugman, Craig M; Beckmann-Mendez, Diana

2015-04-01

Art Rounds, an innovative interdisciplinary program, began as a pilot project to determine if use of fine arts instructional strategies would be of benefit in health professional education. Specifically, students were exposed to fine art and taught to use visual thinking strategies (VTS). The initial evaluation of the pilot program revealed improved physical observation skills, increased tolerance for ambiguity, and increased interest in communication skills. More recently, the Art Rounds program has been expanded to an interdisciplinary elective course open to both nursing student and medical students at all levels. An evaluation of Art Rounds as a semester- long course was conducted by course faculty and compared to the original pilot program for differences and similarities. Outcomes have demonstrated that the use of visual arts and humanities continues to be highly effective in improving students' physical observation skills and a powerful tool for teaching nursing students how to be skilled clinicians. Copyright 2015, SLACK Incorporated.

Movement initiation-locked activity of the anterior putamen predicts future movement instability in periodic bimanual movement.

PubMed

Aramaki, Yu; Haruno, Masahiko; Osu, Rieko; Sadato, Norihiro

2011-07-06

In periodic bimanual movements, anti-phase-coordinated patterns often change into in-phase patterns suddenly and involuntarily. Because behavior in the initial period of a sequence of cycles often does not show any obvious errors, it is difficult to predict subsequent movement errors in the later period of the cyclical sequence. Here, we evaluated performance in the later period of the cyclical sequence of bimanual periodic movements using human brain activity measured with functional magnetic resonance imaging as well as using initial movement features. Eighteen subjects performed a 30 s bimanual finger-tapping task. We calculated differences in initiation-locked transient brain activity between antiphase and in-phase tapping conditions. Correlation analysis revealed that the difference in the anterior putamen activity during antiphase compared within-phase tapping conditions was strongly correlated with future instability as measured by the mean absolute deviation of the left-hand intertap interval during antiphase movements relative to in-phase movements (r = 0.81). Among the initial movement features we measured, only the number of taps to establish the antiphase movement pattern exhibited a significant correlation. However, the correlation efficient of 0.60 was not high enough to predict the characteristics of subsequent movement. There was no significant correlation between putamen activity and initial movement features. It is likely that initiating unskilled difficult movements requires increased anterior putamen activity, and this activity increase may facilitate the initiation of movement via the basal ganglia-thalamocortical circuit. Our results suggest that initiation-locked transient activity of the anterior putamen can be used to predict future motor performance.

Direct visualization reveals kinetics of meiotic chromosome synapsis

DOE PAGES

Rog, Ofer; Dernburg, Abby  F.

2015-03-17

The synaptonemal complex (SC) is a conserved protein complex that stabilizes interactions along homologous chromosomes (homologs) during meiosis. The SC regulates genetic exchanges between homologs, thereby enabling reductional division and the production of haploid gametes. Here, we directly observe SC assembly (synapsis) by optimizing methods for long-term fluorescence recording in C. elegans. We report that synapsis initiates independently on each chromosome pair at or near pairing centers—specialized regions required for homolog associations. Once initiated, the SC extends rapidly and mostly irreversibly to chromosome ends. Quantitation of SC initiation frequencies and extension rates reveals that initiation is a rate-limiting step inmore » homolog interactions. Eliminating the dynein-driven chromosome movements that accompany synapsis severely retards SC extension, revealing a new role for these conserved motions. This work provides the first opportunity to directly observe and quantify key aspects of meiotic chromosome interactions and will enable future in vivo analysis of germline processes.« less

Disseminated histoplasmosis in an African pygmy hedgehog.

PubMed

Snider, Timothy A; Joyner, Priscilla H; Clinkenbeard, Kenneth D

2008-01-01

A 2-year-old captive-bred sexually intact female African pygmy hedgehog (Atelerix albiventris) was evaluated because of vague signs of illness including inappetence, weakness, lethargy, and weight loss over a 20-day period. Abnormalities detected via initial clinicopathologic analyses included anemia, thrombocytopenia, leukopenia, hypoproteinemia, and hypoglycemia. Results of a fecal flotation test were negative. Three weeks after the initial evaluation, splenomegaly was detected via palpation and ultrasonography. The hedgehog was treated with broad-spectrum antibacterial agents, resulting in an initially favorable response. Fenbendazole was also administered against possible occult parasitic infestation. After 3 weeks of illness, the hedgehog's condition had worsened and supportive care and administration of additional antibacterial agents were instituted. The hedgehog died, and pathologic examinations revealed severe splenomegaly; granulomatous infiltrates were evident in multiple organs, and Histoplasma capsulatum yeasts were detected intralesionally. Histoplasmosis can develop in a wide range of mammalian species. African pygmy hedgehogs are becoming increasingly popular as exotic pets, and vague signs of illness and splenomegaly are often attributed to hemolymphatic malignancies, which are somewhat common in this species. Practitioners should be aware that similar clinical signs may be associated with histoplasmosis in these animals. Although the hedgehog of this report was confined indoors, it originated from an area where histoplasmosis was endemic; this indicates that the disease should be included as a differential diagnosis for hedgehogs that develop vague signs of illness and are known to originate from such geographic regions.

38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

Code of Federal Regulations, 2013 CFR

2013-07-01

... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

Code of Federal Regulations, 2012 CFR

2012-07-01

... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

Code of Federal Regulations, 2011 CFR

2011-07-01

... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

Code of Federal Regulations, 2010 CFR

2010-07-01

... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

Code of Federal Regulations, 2014 CFR

2014-07-01

... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

Practical recommendations for the evaluation of improvement initiatives

PubMed Central

Parry, Gareth; Coly, Astou; Goldmann, Don; Rowe, Alexander K; Chattu, Vijay; Logiudice, Deneil; Rabrenovic, Mihajlo; Nambiar, Bejoy

2018-01-01

Abstract A lack of clear guidance for funders, evaluators and improvers on what to include in evaluation proposals can lead to evaluation designs that do not answer the questions stakeholders want to know. These evaluation designs may not match the iterative nature of improvement and may be imposed onto an initiative in a way that is impractical from the perspective of improvers and the communities with whom they work. Consequently, the results of evaluations are often controversial, and attribution remains poorly understood. Improvement initiatives are iterative, adaptive and context-specific. Evaluation approaches and designs must align with these features, specifically in their ability to consider complexity, to evolve as the initiative adapts over time and to understand the interaction with local context. Improvement initiatives often identify broadly defined change concepts and provide tools for care teams to tailor these in more detail to local conditions. Correspondingly, recommendations for evaluation are best provided as broad guidance, to be tailored to the specifics of the initiative. In this paper, we provide practical guidance and recommendations that funders and evaluators can use when developing an evaluation plan for improvement initiatives that seeks to: identify the questions stakeholders want to address; develop the initial program theory of the initiative; identify high-priority areas to measure progress over time; describe the context the initiative will be applied within; and identify experimental or observational designs that will address attribution. PMID:29447410

Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.

PubMed

Böttche, Maria; Kuwert, Philipp; Pietrzak, Robert H; Knaevelsrud, Christine

2016-03-01

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth. © 2015 The British Psychological Society.

Training and capacity building evaluation: Maximizing resources and results with Success Case Method.

PubMed

Medina, L; Acosta-Pérez, E; Velez, C; Martínez, G; Rivera, M; Sardiñas, L; Pattatucci, A

2015-10-01

This article describes the use of Success Case Method (Brinkerhoff, 2003) to evaluate health promotion and public health training programs. The goal of the Office Community Research and Engagement (OCRE) of the Puerto Rico Clinical and Translational Research Consortium (PRCTRC) is to establish a stable and sustainable translational research capacity. Early efforts toward achieving this goal included sponsoring two independent research training programs. A description of the implementation of the five step Success Case Method is presented. Results reveal that SCM would deem both trainings as highly successful, based upon the overall impact of a low number of success cases. However, a traditional summative evaluation would consider this disappointing. Strengths of SCM are discussed. It was concluded that the Success Case Method is a useful and valuable evaluative method for measuring the success of health promotion and public health training initiatives and provides sufficient information for decision-making processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Increasing the rate of return of resident rotation evaluations by their attending physicians in an in-patient psychiatric facility.

PubMed

Shah, Nurun; Thompson, Britta; Averill, Patricia; Searle, Nancy

2007-01-01

Psychiatrist's evaluations of residents are the primary means of determining whether the residents are ready to be promoted. However, the return rate for evaluations is quite low. The purpose of this study was to increase the return rates. Feedback from two surveys and open discussion was utilized to develop and implement a system for increasing completion rates. Completion rates before and after the intervention were compared. The survey revealed that the initial evaluation form was too complex and not readily available. In addition, participants indicated that reminders would be helpful for increasing compliance. Completion rates were 48% and 80% for the 4 months prior and after the intervention, respectively. Addressing the problem and implementing suggested strategies increased completion rates significantly. However, it is unclear which strategy was most associated with the change. Future directions will focus on determining whether gains will be maintained and what would be necessary to obtain 100% compliance rates.

Sarcoidosis and multiple myeloma: Concurrent presentation of an unusual association

PubMed Central

Nair, Vidya; Prajapat, Deepak; Talwar, Deepak

2016-01-01

Literature on concurrent association of sarcoidosis with lymphoproliferative malignancies other than lymphoma e.g. multiple myeloma is meager. The rarity of the situation prompted us to report this patient who was a 51-year-old woman with a 2-years history of breathlessness, cough with expectoration, chest pain and backache. Initial evaluation revealed mild anemia, increased alkaline phosphatase with chest skiagram showing both lower zone non homogenous opacities with calcified hilar lymph nodes. CECT chest showed mediastinal with bilateral hilar lymphadenopathy, parenchymal fibrosis, traction bronchiectasis, ground glass opacities, septal and peribronchovascular thickening affecting mid and lower lung zones bilaterally. MRI Dorsolumbar spine was suggestive of marrow infiltrative disorder. EBUS FNA of intrathoracic nodes, EBB and TBLB confirmed sarcoidosis. PET CT revealed hyper metabolic activity in lung, multiple lymph nodes and lytic bone lesions. Serum protein electrophoresis and immunofixation revealed a monoclonal paraprotein, immunoglobulin IgG kappa type. Bone marrow biopsy revealed an increase in plasma cells (15%), but no granulomas. Diagnosis of Indolent or multiple myeloma with sarcoidosis was established. 12 cases of sarcoidosis and multiple myeloma have been reported in literature, and mostly preceding the onset of multiple myeloma by many years, in our case both were diagnosed concurrently. PMID:26933313

Development and Psychometric Evaluation of a Self-Administered Questionnaire to Assess Parental Attitudes Toward Firearms and Related Parenting Decisions.

PubMed

Davis, Amy B; White, Marney A

2016-01-01

The study sought to develop and evaluate the psychometric properties of the Parental Attitudes Toward Firearms Survey (PATFS), a self-report measure of parental attitudes about firearms and parenting behavior. The initial item pool was generated based on a literature review and discussion with experts in violence reduction, psychometrics, and public health. Data were collected online from 362 volunteers and subjected to exploratory factor analysis which revealed a 13-item, 3-factor solution accounting for 59.7% of the variance. The 3 conceptual factors (subscales) were interpreted as Firearms Exposure, Parental Control, and Violent Play. The PATFS demonstrated good internal consistency and content and construct validity. The PATFS can be used to investigate parenting attitudes and behaviors specific to firearms and violent play.

Headache due to an osteochondroma of the axis.

PubMed

Kouwenhoven, J W M; Wuisman, P I J M; Ploegmakers, J F

2004-12-01

We reported a case of a 42-year-old man with a 3-year history of headache due to a spinal osteochondroma. Repeated neurological evaluation, including EEG studies and CT of the cerebrum, revealed no pathology. More recently the patient presented with persistent headache and a slight limitation of neck motion. MRI studies of the cerebrum including the cervical spine showed a high cervical extradural tumor. Additional CT angiography showed a bony tumor suspected of being a spinal osteochondroma. An en bloc resection of the tumor was performed; histological evaluation confirmed the diagnosis. Immediately after intervention, all symptoms disappeared. In most patients with a spinal osteochondroma, the lesion causes no symptoms, or symptoms are aspecific. Therefore, there is often a significant delay between initial complaints and the diagnosis, as in the current case.

Struma Ovarii With Hyperthyroidism.

PubMed

Ang, Lynn P; Avram, Anca M; Lieberman, Richard W; Esfandiari, Nazanene H

2017-06-01

We report the case of a 61-year-old woman with persistent thyrotoxicosis for 7 years despite low thyroidal radioiodine uptake and methimazole treatment. Her initial I whole-body scan (WBS) was read as negative. Upon evaluation in our institution, she remained hyperthyroid after discontinuation of methimazole. Repeat WBS with SPECT/CT revealed low 24-hour thyroidal uptake (RAIU = 2%) and intensely focal radioiodine uptake in a large heterogeneous left pelvic mass, consistent with left adnexal struma ovarii. Resection of this mass confirmed benign struma ovarii. This case illustrates the advantage of fusion SPECT/CT imaging with planar I-WBS for diagnosis of extrathyroidal thyrotoxicosis.

Neuralgia associated with transcutaneous electrical nerve stimulation therapy in a patient initially diagnosed with temporomandibular disorder.

PubMed

Omolehinwa, Temitope T; Musbah, Thamer; Desai, Bhavik; O'Malley, Bert W; Stoopler, Eric T

2015-03-01

Head and neck neoplasms may be difficult to detect because of wide-ranging symptoms and the presence of overlapping anatomic structures in the region. This case report describes a patient with chronic otalgia and temporomandibular disorder, who developed sudden-onset neuralgia while receiving transcutaneous electrical nerve stimulation (TENS) therapy. Further diagnostic evaluation revealed a skull base tumor consistent with adenoid cystic carcinoma. To our knowledge, this is the first report of TENS-associated neuralgia leading to a diagnosis of primary intracranial adenoid cystic carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

A Smart Unconscious? Procedural Origins of Automatic Partner Attitudes in Marriage

PubMed Central

Murray, Sandra L.; Holmes, John G.; Pinkus, Rebecca T.

2010-01-01

The paper examines potential origins of automatic (i.e., unconscious) attitudes toward one’s marital partner. It tests the hypothesis that early experiences in conflict-of-interest situations predict one’s later automatic inclination to approach (or avoid) the partner. A longitudinal study linked daily experiences in conflict-of-interest situations in the initial months of new marriages to automatic evaluations of the partner assessed four years later using the Implicit Associations Test. The results revealed that partners who were initially (1) treated less responsively and (2) evidenced more self-protective and less connectedness-promoting “if-then” contingencies in their thoughts and behavior later evidenced less positive automatic partner attitudes. However, these factors did not predict changes in love, satisfaction, or explicit beliefs about the partner. The findings hint at the existence of a “smart” relationship unconscious that captures behavioral realities conscious reflection can miss. PMID:20526450

Promoting ergonomics in Algeria: activities of "the research and training laboratory" in the University of Oran.

PubMed

Mebarki, Bouhafs; El-Bachir, Tebboune Cheikh

2012-01-01

The growing need in Algeria to develop ergonomics knowledge and practice in industry was behind the initiative to develop a training and research project within the ergonomics laboratory at Oran University. Since 2005 the laboratory team is running an academic option master in work design and ergonomics. The evaluation of the academic master in 2010 revealed the acute need of the local industry for professional competences in ergonomic and work psychology. A professional training master program in "ergonomics & work psychology" was then developed in partnership with local industry, five European Universities and six Universities from three Maghreb countries. Research projects were initiated around the two training programs, in conjunction with a number of ergonomics dissemination and promotion activities. Preliminary results of the project are presented and discussed in relation to the local context, and in the light of similar cases in Industrially Developing Countries.

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

Deibler, Lisa Anne; Brown, Arthur; Puskar, Joseph D.

Drawn 304L stainless steel tubing was subjected to 42 different annealing heat treatments with the goal of initializing a microstructural model to select a heat treatment to soften the tubing from a hardness of 305 Knoop to 225–275 Knoop. The amount of recrystallization and grain size caused by 18 heat treatments were analyzed via optical microscopy and image analysis, revealing the full range of recrystallization from 0 to 100%. The formation of carbides during the longer duration and higher-temperature heat treatments was monitored via transmission electron microscope evaluation. The experimental results informed a model which includes recovery, recrystallization, and grainmore » growth to predict microstructure and hardness. After initialization of the model, it was able to predict hardness with a R 2 value of 0.95 and recrystallization with an R 2 value of 0.99. As a result, the model was then utilized in the design and testing of a heat treatment to soften the tubing.« less

Performance improvement of planar dielectric elastomer actuators by magnetic modulating mechanism

NASA Astrophysics Data System (ADS)

Zhao, Yun-Hua; Li, Wen-Bo; Zhang, Wen-Ming; Yan, Han; Peng, Zhi-Ke; Meng, Guang

2018-06-01

In this paper, a novel planar dielectric elastomer actuator (DEA) with magnetic modulating mechanism is proposed. This design can provide the availability of wider actuation range and larger output force, which are significant indicators to evaluate the performance of DEAs. The DEA tends to be a compact and simple design, and an analytical model is developed to characterize the mechanical behavior. The result shows that the output force induced by the DEA can be improved by 76.90% under a certain applied voltage and initial magnet distance. Moreover, experiments are carried out to reveal the performance of the proposed DEA and validate the theoretical model. It demonstrates that the DEA using magnetic modulating mechanism can enlarge the actuation range and has more remarkable effect with decreasing initial magnet distance within the stable range. It can be useful to promote the applications of DEAs to soft robots and haptic feedback.

TiO2-V2O5 nanocomposites as alternative energy storage substances for photocatalysts.

PubMed

Ngaotrakanwiwat, Pailin; Meeyoo, Vissanu

2012-01-01

TiO2-V2O5 was prepared and evaluated as an energy storage material for photocatalysts with high capacity and initial charging rate. The compound was successfully obtained by sol-gel technique and effects of compound composition and calcination temperature on the energy storage ability were investigated. The synthesized compounds were characterized by means of X-ray powder diffraction (XRD), scanning electron microscopy equipped with energy-dispersive X-ray analysis (SEM-EDX) and transmission electron microscopy (TEM). The results reveals that the compound of Ti:V molar ratio equal to 1:0.11 calcined at 550 degrees C exhibited superior energy storage ability than parent substances and 1.7-times higher capacity and 2.3-times higher initial charging rate compared to WO3, indicating that the compound is a remarkable alternative to conventional energy storage substances.

Scalp Metastasis as the First Sign of Small-Cell Lung Cancer: Management and Literature Review

PubMed Central

Salemis, Nikolaos S.; Veloudis, Georgios; Spiliopoulos, Kyriakos; Nakos, Georgios; Vrizidis, Nikolaos; Gourgiotis, Stavros

2014-01-01

Cutaneous metastasis from primary visceral malignancy is a relatively uncommon clinical entity, with a reported incidence ranging from 0.22% to 10% among various series. However, the presence of cutaneous metastasis as the first sign of a clinically silent visceral cancer is exceedingly rare. We describe here a case of an asymptomatic male patient who presented with a solitary scalp metastasis as the initial manifestation of an underlying small-cell lung cancer. Diagnostic evaluation revealed advanced disease. We conclude that the possibility of metastatic skin disease should always be considered in the differential diagnosis in patients with a history of smoking or lung cancer presenting with cutaneous nodules. Physicians should be aware of this rare clinical entity, and appropriate investigation should be arranged for early diagnosis and initiation of the appropriate treatment. The prognosis for most patients remains poor. PMID:25058760

Scalp metastasis as the first sign of small-cell lung cancer: management and literature review.

PubMed

Salemis, Nikolaos S; Veloudis, Georgios; Spiliopoulos, Kyriakos; Nakos, Georgios; Vrizidis, Nikolaos; Gourgiotis, Stavros

2014-01-01

Cutaneous metastasis from primary visceral malignancy is a relatively uncommon clinical entity, with a reported incidence ranging from 0.22% to 10% among various series. However, the presence of cutaneous metastasis as the first sign of a clinically silent visceral cancer is exceedingly rare. We describe here a case of an asymptomatic male patient who presented with a solitary scalp metastasis as the initial manifestation of an underlying small-cell lung cancer. Diagnostic evaluation revealed advanced disease. We conclude that the possibility of metastatic skin disease should always be considered in the differential diagnosis in patients with a history of smoking or lung cancer presenting with cutaneous nodules. Physicians should be aware of this rare clinical entity, and appropriate investigation should be arranged for early diagnosis and initiation of the appropriate treatment. The prognosis for most patients remains poor.

Biodegradation and environmental behavior of biodiesel mixtures in the sea: An initial study.

PubMed

DeMello, Jared A; Carmichael, Catherine A; Peacock, Emily E; Nelson, Robert K; Samuel Arey, J; Reddy, Christopher M

2007-07-01

Biodiesel, a mixture of fatty acid methyl esters (FAMEs) derived from animal fats or vegetable oils, is rapidly moving towards the mainstream as an alternative source of energy. However, the behavior of biodiesel, or blends of biodiesel with fossil diesel, in the marine environment have yet to be fully understood. Hence, we performed a series of initial laboratory experiments and simple calculations to evaluate the microbial and environmental fate of FAMEs. Aerobic seawater microcosms spiked with biodiesel or mixtures of biodiesel and fossil diesel revealed that the FAMEs were degraded at roughly the same rate as n-alkanes, and more rapidly than other hydrocarbon components. The residues extracted from these different microcosms became indistinguishable within weeks. Preliminary results from physical-chemical calculations suggest that FAMEs in biodiesel mixtures will not affect the evaporation rates of spilled petroleum hydrocarbons but may stabilize oil droplets in the water column and thereby facilitate transport.

[Initial clinical experience of proton therapy at Shizuoka Cancer Center].

PubMed

Murayama, Shigeyuki; Fuji, Hiroshi; Yamashita, Haruo; Futami, Yasuyuki; Numano, Masumi; Harada, Hideyuki; Kamata, Minoru; Nishimura, Tetsuo

2005-10-01

To present the initial experience and preliminary clinical results of patients treated mainly with proton irradiation at the newly developed proton therapy facility at Shizuoka Cancer Center. We reviewed 125 patients who underwent proton therapy between July 2003 and December 2004. Of these 125 patients, 11 had head and neck malignancies, 15 non-small cell lung cancers, 22 hepatocellular carcinomas, 62 prostate cancers, and 15 other malignant tumors. Most patients experienced Grade 0-1 acute morbidities (NCI-CTC) in skin or mucosa, while a temporary Grade 2-3 reaction was observed in a high dose area. Response rates were 73% for H & N malignancies, 100% for NSCLC, and 77% for HCC. PSA evaluation for patients with prostate cancer revealed a high rate of complete response. The efficacy and safety of proton therapy at Shizuoka Cancer Center was demonstrated for patients with early-stage cancer or locally advanced disease.

Driving and sustaining culture change in Olympic sport performance teams: a first exploration and grounded theory.

PubMed

Cruickshank, Andrew; Collins, Dave; Minten, Sue

2014-02-01

Stimulated by growing interest in the organizational and performance leadership components of Olympic success, sport psychology researchers have identified performance director-led culture change as a process of particular theoretical and applied significance. To build on initial work in this area and develop practically meaningful understanding, a pragmatic research philosophy and grounded theory methodology were engaged to uncover culture change best practice from the perspective of newly appointed performance directors. Delivered in complex and contested settings, results revealed that the optimal change process consisted of an initial evaluation, planning, and impact phase adjoined to the immediate and enduring management of a multidirectional perception- and power-based social system. As the first inquiry of its kind, these findings provide a foundation for the continued theoretical development of culture change in Olympic sport performance teams and a first model on which applied practice can be based.

Parametric and energy consumption optimization of Basic Red 2 removal by electrocoagulation/egg shell adsorption coupling using response surface methodology in a batch system.

PubMed

de Carvalho, Helder Pereira; Huang, Jiguo; Zhao, Meixia; Liu, Gang; Yang, Xinyu; Dong, Lili; Liu, Xingjuan

2016-01-01

In this study, response surface methodology (RSM) model was applied for optimization of Basic Red 2 (BR2) removal using electrocoagulation/eggshell (ES) coupling process in a batch system. Central composite design was used to evaluate the effects and interactions of process parameters including current density, reaction time, initial pH and ES dosage on the BR2 removal efficiency and energy consumption. The analysis of variance revealed high R(2) values (≥85%) indicating that the predictions of RSM models are adequately applicable for both responses. The optimum conditions when the dye removal efficiency of 93.18% and energy consumption of 0.840 kWh/kg were observed were 11.40 mA/cm(2) current density, 5 min and 3 s reaction time, 6.5 initial pH and 10.91 g/L ES dosage.

[Rare differential diagnosis of hyperthyroidism].

PubMed

Besemer, Britta; Müssig, Karsten

2016-06-01

A 54-year-old female patient is admitted for evaluation of her thyroid function after two cycles of ipilimumab therapy. The decision for the anti-cytotoxic-T-lymphocyte-antigen-4-therapy (anti-CTLA-4) was made two months earlier because of malignant melanoma with pulmonary metastases. The patient was euthyroid before initiation of treatment and without known thyroid disease. The laboratory reveals thyrotoxicosis with elevated anti-thyroid peroxidase and anti-thyroglobulin antibody levels. The anti-thyroid stimulating hormone receptor antibody levels are within the normal range. Thyroid ultrasound shows a normal-sized, inhomogenous, hypoechogenic thyroid gland, consistent with autoimmune thyroiditis. Diagnosis of hyperthyroidism due to ipilimumab-induced autoimmune thyroiditis is made. The patient does not receive any thyroid-specific medication, with regular control of the thyroid hormone levels. When the patient becomes euthyroid, the ipilimumab therapy is continued. Three weeks later, the patient develops hypothyroidism and a supplementation with L-thyroxine is initiated. An anti-CTLA-4 therapy may cause thyroid dysfunction. Therefore, before initiation and in the course of the treatment, regular controls of the thyroid hormone levels are required. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery.

PubMed

von Arx, Thomas; Jensen, Simon Storgård; Hänni, Stefan

2007-02-01

This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

Dryout-type critical heat flux in vertical upward annular flow: effects of entrainment rate, initial entrained fraction and diameter

NASA Astrophysics Data System (ADS)

Wu, Zan; Wadekar, Vishwas; Wang, Chenglong; Sunden, Bengt

2018-01-01

This study aims to reveal the effects of liquid entrainment, initial entrained fraction and tube diameter on liquid film dryout in vertical upward annular flow for flow boiling. Entrainment and deposition rates of droplets were included in mass conservation equations to estimate the local liquid film mass flux in annular flow, and the critical vapor quality at dryout conditions. Different entrainment rate correlations were evaluated using flow boiling data of water and organic liquids including n-pentane, iso-octane and R134a. Effect of the initial entrained fraction (IEF) at the churn-to-annular flow transition was also investigated. A transitional Boiling number was proposed to separate the IEF-sensitive region at high Boiling numbers and the IEF-insensitive region at low Boiling numbers. Besides, the diameter effect on dryout vapor quality was studied. The dryout vapor quality increases with decreasing tube diameter. It needs to be pointed out that the dryout characteristics of submillimeter channels might be different because of different mechanisms of dryout, i.e., drying of liquid film underneath long vapor slugs and flow boiling instabilities.

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

Mimura, Hidefumi, E-mail: mimura@marianna-u.ac.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp; Yamakado, Koichiro, E-mail: yama@clin.medic.mie-u.ac.jp

PurposeThis multicenter phase I/II study evaluated the safety, feasibility, and initial efficacy of radiofrequency ablation (RFA) for small malignant renal tumors.MethodsThirty-three patients were enrolled in the study. A single session of RFA was performed in patients with a renal tumor of 1–3 cm in greatest diameter, with the exception of lesions adjacent to the renal hilum. The primary endpoint was the safety of renal RFA, and the secondary endpoints were its feasibility and initial efficacy for local control, as well as the incidence and grade of adverse events. Clinical efficacy was evaluated by CT scans within 1 week and at a furthermore » 4 weeks after the procedure using the criteria adapted from the Response Evaluation Criteria in Solid Tumors.ResultsThe RFA procedure was completed in 100 % (95 % confidence interval [CI] 89–100 %) of all 33 patients. There were no severe adverse events (0 % [95 % CI 0–11 %]). Among the 33 patients, a complete response, partial response, progressive disease, and stable disease were seen in 28 (85 %), 0 (0 %), one (3 %), and one (3 %) patient(s), respectively, with a tumor response rate of 85 % [95 % CI 68–95 %]). Three patients (9 %), including one ineligible patient (3 %), were not evaluable. Out of 30 evaluable patients, a complete response was achieved in 28 (93 %).ConclusionThe current multicenter trial revealed that RFA is a safe, feasible, and effective treatment for small malignant renal tumors in patients who are not candidates for surgery.« less

Cough in Ambulatory Immunocompromised Adults: CHEST Expert Panel Report.

PubMed

Rosen, Mark J; Ireland, Belinda; Narasimhan, Mangala; French, Cynthia; Irwin, Richard S

2017-11-01

Cough is a common symptom prompting patients to seek medical care. Like patients in the general population, patients with compromised immune systems also seek care for cough. However, it is unclear whether the causes of cough in immunocompromised patients who are deemed unlikely to have a life-threating condition and a normal or unchanged chest radiograph are similar to those in persons with cough and normal immune systems. We conducted a systematic review to answer the question: What are the most common causes of cough in ambulatory immunodeficient adults with normal chest radiographs? Studies of patients ≥ 18 years of age with immune deficiency, cough of any duration, and normal or unchanged chest radiographs were included and assessed for relevance and quality. Based on the systematic review, suggestions were developed and voted on using the American College of Chest Physicians (CHEST) methodology framework. The results of the systematic review revealed no high-quality evidence to guide the clinician in determining the likely causes of cough specifically in immunocompromised ambulatory patients with normal chest radiographs. Based on a systematic review, we found no evidence to assess whether or not the proper initial evaluation of cough in immunocompromised patients is different from that in immunocompetent persons. A consensus of the panel suggested that the initial diagnostic algorithm should be similar to that for immunocompetent persons but that the context of the type and severity of the immune defect, geographic location, and social determinants be considered. The major modifications to the 2006 CHEST Cough Guidelines are the suggestions that TB should be part of the initial evaluation of patients with cough and HIV infection who reside in regions with a high prevalence of TB, regardless of the radiographic findings, and that specific causes and immune defects be considered in all patients in whom the initial evaluation is unrevealing. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Case 252: Acute Hyperammonemic Encephalopathy Resulting from Late-Onset Ornithine Transcarbamylase Deficiency.

PubMed

Hershman, Michelle; Carmody, Raymond; Udayasankar, Unni K

2018-04-01

History A 19-year-old woman with no pertinent medical history was brought to the emergency department after being found unconscious on her bathroom floor by her roommate. In the preceding weeks, she had reported intractable nausea and vomiting, for which she had been taking ondansetron. No other medications had been prescribed. The day prior to presentation, she had contacted her mother and described increasing confusion. Glasgow coma scale score on arrival in the emergency department was 4. Intravenous naloxone was administered, without immediate response. Initial blood glucose level was 232 mg/dL (12.8 mmol/L) (normal range, 79-140 mg/dL [4.4- 7.7 mmol/L]), and other routine laboratory test results were normal. Urine toxicology results were negative. Cerebrospinal fluid evaluation revealed levels were within normal limits. Neurologic examination revealed dilated pupils, which showed a sluggish response to light, and left lower extremity rigidity with intermittent tremors. Initial unenhanced cranial computed tomographic (CT) findings were negative. Magnetic resonance (MR) imaging of the brain was performed. The patient's condition deteriorated, with increasing cerebral edema over the next week, and she was declared brain dead. Her liver was transplanted into an adult recipient, who subsequently developed cerebral edema and elevated plasma ammonia levels, resulting in death in the immediate postoperative period.

Change of Retinal Nerve Layer Thickness in Non-Arteritic Anterior Ischemic Optic Neuropathy Revealed by Fourier Domain Optical Coherence Tomography.

PubMed

Han, Mei; Zhao, Chen; Han, Quan-Hong; Xie, Shiyong; Li, Yan

2016-08-01

To examine the changes of non-arteritic anterior ischemic optic neuropathy (NAION) by serial morphometry using Fourier domain optical coherence tomography (FD-OCT). Retrospective study in patients with newly diagnosed NAION (n=33, all unilateral) and controls (n=75 unilateral NAION patients with full contralateral eye vision) who underwent FD-OCT of the optic disk, optic nerve head (ONH), and macula within 1 week of onset and again 1, 3, 6, and 12 months later. The patients showed no improvement in vision during follow-up. Within 1 week of onset, all NAION eyes exhibited severe ONH fiber crowding and peripapillary retinal nerve fiber layer (RNFL) edema. Four had subretinal fluid accumulation and 12 had posterior vitreous detachment (PVD) at the optic disc surface. Ganglion cell complex (GCC) and RNFL thicknesses were reduced at 1 and 3 months (p < 0.05), with no deterioration thereafter. Initial RNFL/GCC contraction magnitude in the superior hemisphere correlated with the severity of inferior visual field deficits. NAION progression is characterized by an initial phase of accelerated RNFL and GCC deterioration. These results reveal that the kinetic change of neural retina in NAION and may have implication on the time window for treatment of NAION. FD-OCT is useful in the evaluation of NAION.

Detection of skeletal muscle metastases on initial staging of lung cancer: a retrospective case series.

PubMed

Bocchino, Marialuisa; Valente, Tullio; Somma, Francesco; de Rosa, Ilaria; Bifulco, Marco; Rea, Gaetano

2014-03-01

Estimation of skeletal muscle metastases (SMMs) at the time of diagnosis and/or initial staging of lung cancer. Retrospective evaluation of clinical charts and imaging data suggestive of SMMs of patients with histology-proved lung cancer over a 5-year period. SMMs were identified in 46 out of 1,754 patients. Single and multiple (62.9% of cases) SMMs were detected by total body multi-detector computed tomography (MDCT). They were associated with poorly differentiated (43%) and advanced adenocarcinomas (52%) without clinically relevant symptoms and/or signs. Psoas and buttock muscles were most frequently involved (33.3%). MDCT findings consisted of well-defined homogeneously hyperdense oval masses (31%), lesions with ring-like enhancement and central hypoattenuation (68%), or large abscess-like necrotic lesions (24%). Sonography revealed well-defined hypoechoic masses (41.6%), ill-defined hypoechoic lesions (33.3%), or anechoic areas with a necrotic centre (25%). Positron emission tomography revealed that all SMMs were metabolically active. SMMs are uncommon but not negligible in lung cancer, with an estimated prevalence of 2.62% in our series. Although histology remains the recommended method, use of high-performance imaging techniques and increased clinical suspicion may improve their early detection. Efforts addressing their effect on the natural history of lung cancer are needed.

[Two Cases of Laparoscopic Resection of Colon Cancer Manifested by Liver Abscess].

PubMed

Ohashi, Motonari; Iwama, Masahiro; Ikenaga, Shojirokazunori; Yokoyama, Makoto

2017-11-01

We report 2 cases of laparoscopic surgery for patients who had liver abscess as the initial manifestation of underlying colon cancer. The first case was in an 80-year-old woman who presented to our hospital with a diagnosis ofliver abscess. Percutaneous transhepatic abscess drainage(PTAD)was performed as initial treatment. Subsequent colonoscopy revealed a type 1 tumor in the cecum, and biopsy results ofthe mass indicated adenocarcinoma. The patient underwent laparoscopic right hemicolectomy as curative treatment. The pathological findings were as follows: tub1, T2, N0, M0 and Stage I . Two years later, she remains disease free. The second case was in a 59-year-old man with liver abscess. Colonoscopy also revealed a type 2 tumor in the sigmoid colon. After treatment of the liver abscess with PTAD, laparoscopic sigmoidectomy was performed with a preoperative diagnosis of sigmoid colon cancer. The pathological findings were as follows: tub2, T3, N0, M0 and Stage II . Lung metastases appeared 10 months after surgery, and systemic chemotherapy was administered. In conclusion, liver abscess is occasionally caused by malignancy, and complete gastrointestinal evaluation should be conducted. Laparoscopic radical surgery can be safely performed in cases in which the liver abscesses are controlled.

Appearance of acute gouty arthritis on indium-111-labeled leukocyte scintigraphy

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

Palestro, C.J.; Vega, A.; Kim, C.K.

1990-05-01

Indium-111-labeled leukocyte scintigraphy was performed on a 66-yr-old male with polyarticular acute gouty arthritis. Images revealed intense labeled leukocyte accumulation in a pattern indistinguishable from septic arthritis, in both knees and ankles, and the metatarsophalangeal joint of both great toes, all of which were involved in the acute gouty attack. Joint aspirate as well as blood cultures were reported as no growth; the patient was treated with intravenous colchicine and ACTH for 10 days with dramatic improvement noted. Labeled leukocyte imaging, repeated 12 days after the initial study, revealed near total resolution of joint abnormalities, concordant with the patient's clinicalmore » improvement. This case demonstrates that while acute gouty arthritis is a potential pitfall in labeled leukocyte imaging, in the presence of known gout, it may provide a simple, objective, noninvasive method of evaluating patient response to therapy.« less

Developmental Trajectories of Anxiety Symptoms Among Boys Across Early and Middle Childhood

PubMed Central

Feng, Xin; Shaw, Daniel S.; Silk, Jennifer S.

2009-01-01

This study examined the developmental trajectory of anxiety symptoms among 290 boys and evaluated the association of trajectory groups with child and family risk factors and children’s internalizing disorders. Anxiety symptoms were measured using maternal reports from the Child Behavior Checklist (T. M. Achenbach, 1991, 1992) for boys between the ages of 2 and 10. A group-based trajectory analysis revealed 4 distinct trajectories in the development of anxiety symptoms: low, low increasing, high declining, and high-increasing trajectories. Child shy temperament tended to differentiate between initial high and low groups, whereas maternal negative control and maternal depression were associated with increasing trajectories and elevated anxiety symptoms in middle childhood. Follow-up analyses to diagnoses of preadolescent depression and/or anxiety disorders revealed different patterns on the basis of trajectory group membership. The results are discussed in terms of the mechanisms of risk factors and implications for early identification and prevention. PMID:18266484

Fear and loathing: undergraduate nursing students' experiences of a mandatory course in applied statistics.

PubMed

Hagen, Brad; Awosoga, Oluwagbohunmi A; Kellett, Peter; Damgaard, Marie

2013-04-23

This article describes the results of a qualitative research study evaluating nursing students' experiences of a mandatory course in applied statistics, and the perceived effectiveness of teaching methods implemented during the course. Fifteen nursing students in the third year of a four-year baccalaureate program in nursing participated in focus groups before and after taking the mandatory course in statistics. The interviews were transcribed and analyzed using content analysis to reveal four major themes: (i) "one of those courses you throw out?," (ii) "numbers and terrifying equations," (iii) "first aid for statistics casualties," and (iv) "re-thinking curriculum." Overall, the data revealed that although nursing students initially enter statistics courses with considerable skepticism, fear, and anxiety, there are a number of concrete actions statistics instructors can take to reduce student fear and increase the perceived relevance of courses in statistics.

Novel PNKP mutation in siblings with ataxia-oculomotor apraxia type 4.

PubMed

Schiess, Nicoline; Zee, David S; Siddiqui, Khurram A; Szolics, Miklos; El-Hattab, Ayman W

The phenotypic and genetic spectrum of ataxia with oculomotor apraxia (AOA) disorders is rapidly evolving and new technologies such as genetic mapping using whole exome sequencing reveal subtle distinctions among the various subtypes. We report a novel PNKP mutation in two siblings with progressive ataxia, abnormal saccades, sensorimotor neuropathy and dystonia consistent with the AOA type 4 phenotype. Laboratory evaluation revealed hypoalbuminemia, hypercholesterolemia with elevated LDL, elevated IgE levels and normal α fetoprotein levels. Eye movement examination demonstrated a marked saccade initiation defect with profound hypometric horizontal saccades. Vertical saccades were also affected but less so. Also present were conspicuous thrusting head movements when attempting to change gaze, but rather than an apraxia these were an adaptive strategy to take advantage of an intact vestibulo-ocular reflex to carry the eyes to a new target of interest. This is demonstrated in accompanying videos.

Rapidly Progressive Quadriplegia and Encephalopathy.

PubMed

Wynn, DonRaphael; McCorquodale, Donald; Peters, Angela; Juster-Switlyk, Kelsey; Smith, Gordon; Ansari, Safdar

2016-11-01

A woman aged 77 years was transferred to our neurocritical care unit for evaluation and treatment of rapidly progressive motor weakness and encephalopathy. Examination revealed an ability to follow simple commands only and abnormal movements, including myoclonus, tongue and orofacial dyskinesias, and opsoclonus. Imaging study findings were initially unremarkable, but when repeated, they demonstrated enhancement of the cauda equina nerve roots, trigeminal nerve, and pachymeninges. Cerebrospinal fluid examination revealed mildly elevated white blood cell count and protein levels. Serial electrodiagnostic testing demonstrated a rapidly progressive diffuse sensory motor axonopathy, and electroencephalogram findings progressed from generalized slowing to bilateral periodic lateralized epileptiform discharges. Critical details of her recent history prompted a diagnostic biopsy. Over time, the patient became completely unresponsive with no further abnormal movements and ultimately died. The differential diagnosis, pathological findings, and diagnosis are discussed with a brief review of a well-known yet rare diagnosis.

[Woman with type 1 diabetes mellitus and rapidly progressive edema].

PubMed

Ehren, M; Dietrich, J W

2013-05-01

A 47-year-old woman with type 1 diabetes mellitus was presented for evaluation of progressive oedema, fatigue and weight gain. Her medical history was significant for arterial hypertension and autoimmune thyroiditis requiring substitution therapy with levothyroxine. Physical examination revealed bilateral malleolar and crural oedema, swelling of the eyelids and two-sided pleural effusions. DIAGNOSTIC, TREATMENT AND COURSE: The blood level of albumin was very low, urine analysis showed proteinuria of > 8 g/day. The kidney biopsy revealed only slight changes. This led in combination with the blood and urine results to the diagnosis of minimal change glomerulopathy. After initiation of high dose prednisolone the patient achieved near total remission within four weeks. Prednisolone therapy was tapered over several months. In patients with diabetes mellitus and suddenly occurring nephrotic syndrome other diseases than diabetic nephropathy have to be considered. In most cases a kidney biopsy is mandatory. © Georg Thieme Verlag KG Stuttgart · New York.

Reflectance measurements for the detection and mapping of soil limitations

NASA Technical Reports Server (NTRS)

Benson, L. A.; Frazee, C. J.

1973-01-01

During 1971 and 1972 research was conducted on two fallow fields in the proposed Oahe Irrigation Project to investigate the relationship between the tonal variations observed on aerial photographs and the principal soil limitations of the area. A grid sampling procedure was used to collected detailed field data during the 1972 growing season. The field data was compared to imagery collected on May 14, 1971 at 3050 meters altitude. The imagery and field data were initially evaluated by a visual analysis. Correlation and regression analysis revealed a highly significant correlation and regression analysis revealed a highly significant correlation between the digitized color infrared film data and soil properties such as organic matter content, color, depth to carbonates, bulk density and reflectivity. Computer classification of the multiemulsion film data resulted in maps delineating the areas containing claypan and erosion limitations. Reflectance data from the red spectral band provided the best results.

Assembling the evidence jigsaw: insights from a systematic review of UK studies of individual-focused return to work initiatives for disabled and long-term ill people

PubMed Central

2011-01-01

Background Employment rates of long-term ill and disabled people in the UK are low and 2.63 million are on disability-related state benefits. Since the mid-1990 s, UK governments have experimented with a range of active labour market policies aimed to move disabled people off benefits and into work to reduce the risk of poverty and social exclusion. This systematic review asks what employment impact have these interventions had and how might they work better? Methods A systematic review of observational and qualitative empirical studies and systematic reviews published between 2002 and mid-2008 reporting employment effects and/or process evaluations of national UK government interventions focused on helping long-term sick or disabled people (aged 16-64) into the open labour market. This built on our previous systematic review which covered the years 1970 to 2001. Results Searches identified 42 studies, 31 of which evaluated initiatives with an individual focus (improving an individual's employability or providing financial support in returning to work) while 11 evaluated initiatives with an environmental focus (directed at the employment environment or changing the behaviour of employers). This paper synthesises evidence from the 31 studies with an individual focus. The use of personal advisors and individual case management in these schemes helped some participants back to work. Qualitative studies, however, revealed that time pressures and job outcome targets influenced advisors to select 'easier-to-place' claimants into programmes and also inhibited the development of mutual trust, which was needed for individual case management to work effectively. Financial incentives can help with lasting transitions into work, but the incentives were often set too low or were too short-term to have an effect. Many of the studies suffered from selection bias into these programmes of more work-ready claimants. Even though these were national programmes, they had very low awareness and take-up rates, making it unlikely that a population-level impact would be achieved even if effective for participants. Conclusions The evidence reveals barriers and facilitators for the effective implementation of these types of interventions that could inform the continuing welfare reforms. The evidence points towards the need for more long-term, sustained and staged support for those furthest from the labour market. PMID:21418621

Characterization of Fatigue Damage for Bonded Composite Skin/Stringer Configurations

NASA Technical Reports Server (NTRS)

Paris, Isabelle; Cvitkovich, Michael; Krueger, Ronald

2008-01-01

The fatigue damage was characterized in specimens which consisted of a tapered composite flange bonded onto a composite skin. Quasi-static tension tests were performed first to determine the failure load. Subsequently, tension fatigue tests were performed at 40%, 50%, 60% and 70% of the failure load to evaluate the debonding mechanisms. For four specimens, the cycling loading was stopped at intervals. Photographs of the polished specimen edges were taken under a light microscope to document the damage. At two diagonally opposite corners of the flange, a delamination appeared to initiate at the flange tip from a matrix crack in the top 45deg skin ply and propagated at the top 45deg/-45deg skin ply interface. At the other two diagonally opposite corners, a delamination running in the bondline initiated from a matrix crack in the adhesive pocket. In addition, two specimens were cut longitudinally into several sections. Micrographs revealed a more complex pattern inside the specimen where the two delamination patterns observed at the edges are present simultaneously across most of the width of the specimen. The observations suggest that a more sophisticated nondestructive evaluation technique is required to capture the complex damage pattern of matrix cracking and multi-level delaminations.

Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand

PubMed Central

Lovelock, Kirsten; Martin, Greg; Gauld, Robin; MacRae, Jayden

2017-01-01

Objectives: This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. Methods: The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Results: Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. Conclusion: The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were encountered because of inadequate attention to organisational culture; competing additional areas of focus within the same timeframe; and consequent overloading of front-line staff which led to workload stress, fatigue and disillusionment. Where success was achieved, this largely hinged on the enthusiasm of a small pool of front-line workers and their initial buy-into the idea of integrated care. PMID:28491307

Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand.

PubMed

Lovelock, Kirsten; Martin, Greg; Gauld, Robin; MacRae, Jayden

2017-01-01

This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were encountered because of inadequate attention to organisational culture; competing additional areas of focus within the same timeframe; and consequent overloading of front-line staff which led to workload stress, fatigue and disillusionment. Where success was achieved, this largely hinged on the enthusiasm of a small pool of front-line workers and their initial buy-into the idea of integrated care.

Tailored Behavioral Intervention Among Blacks With Metabolic Syndrome and Sleep Apnea: Results of the MetSO Trial.

PubMed

Jean-Louis, Girardin; Newsome, Valerie; Williams, Natasha J; Zizi, Ferdinand; Ravenell, Joseph; Ogedegbe, Gbenga

2017-01-01

To assess effectiveness of a culturally and linguistically tailored telephone-delivered intervention to increase adherence to physician-recommended evaluation and treatment of obstructive sleep apnea (OSA) among blacks. In a two-arm randomized controlled trial, we evaluated effectiveness of the tailored intervention among blacks with metabolic syndrome, relative to those in an attention control arm (n = 380; mean age = 58 ± 13; female = 71%). The intervention was designed to enhance adherence using culturally and linguistically tailored OSA health messages delivered by a trained health educator based on patients' readiness to change and unique barriers preventing desired behavior changes. Analysis showed 69.4% of the patients in the intervention arm attended initial consultation with a sleep specialist, compared to 36.7% in the control arm; 74.7% of those in the intervention arm and 66.7% in the control arm completed diagnostic evaluation; and 86.4% in the intervention arm and 88.9% in the control arm adhered to PAP treatment based on subjective report. Logistic regression analyses adjusting for sociodemographic factors indicated patients in the intervention arm were 3.17 times more likely to attend initial consultation, compared to those in the control arm. Adjusted models revealed no significant differences between the two arms regarding adherence to OSA evaluation or treatment. The intervention was successful in promoting importance of sleep consultation and evaluation of OSA among blacks, while there was no significant group difference in laboratory-based evaluation and treatment adherence rates. It seems that the fundamental barrier to OSA care in that population may be the importance of seeking OSA care. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The Relationship Between Early Sexual Debut and Psychosocial Outcomes: A Longitudinal Study of Dutch Adolescents

PubMed Central

Sandfort, Theo; Reitz, Ellen; Bos, Henny; Dekovic, Maja

2010-01-01

In a longitudinal dataset of 470 Dutch adolescents, the current study examined the ways in which early sexual initiation was related to subsequent attachment, self-perception, internalizing problems, and externalizing problems. For male adolescents, analyses revealed general attachment to mother and externalizing problems at Wave 1 to predict to early transition at Wave 2. However, there was no differential change in these psychosocial factors over time for early initiators of sexual intercourse and their non-initiating peers. For female adolescents, the model including psychosocial factors at Wave 1 did not predict to sexual initiation at Wave 2. However, univariate repeated measures analyses revealed early initiators to have significantly larger increases in self-concept and externalizing problems than their non-initiating female peers. While the difference between female early initiators and non-initiators were statistically significant, the mean levels of problem behaviors were very low. The findings suggest that, contrary to previous research, early sexual initiation does not seem to be clustered with problem behaviors for this sample of Dutch adolescents. PMID:20119696

Clinical, Morphological, and Molecular Characterization of Penicillium canis sp. nov., Isolated from a Dog with Osteomyelitis

PubMed Central

Sutton, Deanna A.; Swenson, Cheryl L.; Bailey, Chris J.; Wiederhold, Nathan P.; Nelson, Nathan C.; Thompson, Elizabeth H.; Wickes, Brian L.; French, Stephanie; Fu, Jianmin; Vilar-Saavedra, Paulo

2014-01-01

Infections caused by Penicillium species are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resolution of lameness and clinical stability of disease were achieved with intravenous phospholipid-complexed amphotericin B initially, followed by long-term combination therapy with terbinafine and ketoconazole. A detailed morphological and molecular characterization of the mold was undertaken. Sequence analysis of the internal transcribed spacer revealed the isolate to be closely related to Penicillium menonorum and Penicillium pimiteouiense. Additional sequence analysis of β-tubulin, calmodulin, minichromosome maintenance factor, DNA-dependent RNA polymerase, and pre-rRNA processing protein revealed the isolate to be a novel species; the name Penicillium canis sp. nov. is proposed. Morphologically, smooth, ovoid conidia, a greenish gray colony color, slow growth on all media, and a failure to form ascomata distinguish this species from closely related Penicillium species. PMID:24789186

Clinical, morphological, and molecular characterization of Penicillium canis sp. nov., isolated from a dog with osteomyelitis.

PubMed

Langlois, Daniel K; Sutton, Deanna A; Swenson, Cheryl L; Bailey, Chris J; Wiederhold, Nathan P; Nelson, Nathan C; Thompson, Elizabeth H; Wickes, Brian L; French, Stephanie; Fu, Jianmin; Vilar-Saavedra, Paulo; Peterson, Stephen W

2014-07-01

Infections caused by Penicillium species are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resolution of lameness and clinical stability of disease were achieved with intravenous phospholipid-complexed amphotericin B initially, followed by long-term combination therapy with terbinafine and ketoconazole. A detailed morphological and molecular characterization of the mold was undertaken. Sequence analysis of the internal transcribed spacer revealed the isolate to be closely related to Penicillium menonorum and Penicillium pimiteouiense. Additional sequence analysis of β-tubulin, calmodulin, minichromosome maintenance factor, DNA-dependent RNA polymerase, and pre-rRNA processing protein revealed the isolate to be a novel species; the name Penicillium canis sp. nov. is proposed. Morphologically, smooth, ovoid conidia, a greenish gray colony color, slow growth on all media, and a failure to form ascomata distinguish this species from closely related Penicillium species. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Ranolazine, tacrolimus, and diltiazem might be a hazardous combination in a transplant patient.

PubMed

Patni, Hitesh; Gitman, Michael; Hazzan, Azzour; Jhaveri, Kenar D

2012-01-01

We report a case of a renal transplant patient who was maintained on tacrolimus and diltiazem therapy and developed tacrolimus toxicity leading to reversible acute kidney injury when started on ranolazine. A 62-year-old Caucasian male status post renal transplant in 2009 (on prednisone and tacrolimus) was evaluated for ischemic heart disease and was initiated on ranolazine 500 mg tablets twice daily, which was later increased to 1000 mg twice daily. After 2 weeks, he developed fatigue, loss of appetite, tremors, and decreased urine output and was admitted to our hospital. His other significant medications included enalapril 2.5 mg and diltiazem 240 mg daily. The patient was awake and alert, but lethargic. He was found to be bradycardic with a heart rate of 42/min. The rest of his physical examination was benign. His electrocardiogram revealed sinus bradycardia. Laboratory studies revealed serum creatinine of 2.4 mg/dL from a baseline of 1.5 mg/dL (stable for the past 2 years). The tacrolimus trough was elevated at 14 ng/mL, which decreased after stopping ranolazine, reaching 7 ng/mL after 3 days, while continuing the same dose of tacrolimus. His creatinine trended downward and reached his baseline of 1.5 mg/dL over the next 2 days. His bradycardia and other symptoms resolved after cessation of ranolazine. He was discharged to follow up, to initiate an alternate agent for ischemic heart disease. Specific pharmacokinetic studies are warranted to study these drug interactions, and tacrolimus levels should be closely monitored in transplant patients who initiate ranolazine treatment.

Evaluation of the Susceptibility to SCC Initiation of Alloy 690 in Simulated PWR Primary Water

NASA Astrophysics Data System (ADS)

Tsutsumi, Kazuya; Couvant, Thierry

Alloy 690 has been widely used in fabricating components of LWR plants as an alternative material to Alloy 600 which has exhibited a significant susceptibility to PWSCC. However, some authors have reported that Alloy 690 can suffer a significant susceptibility to SCC crack growth when highly cold worked. While most of the recent studies emphasize SCC propagation phase, EDF and its partners are focusing on the material's resistance to SCC initiation. This paper summarizes the current work carried out at EDF MAI on the SCC initiation. By means of constant elongation rate tests (CERTs) and constant displacement tests, experimental investigation of the susceptibility to PWSCC were performed. No SCC was observed on either an extruded bar or on two plates, even after 24%-1D cold rolling, confirming the superior PWSCC resistance of Alloy 690 independent of a amount of intergranular precipitation of carbides, and also revealing that such cold rolling does not necessarily decrease the resistance to SCC. On the other hand, a experimental steam generator tube that has a degraded microstructure due to specific heat-treatment revealed its susceptibility to SCC, probably because of the interactive effect of microstructure with heavy intragranular carbide precipitations and the cold worked superficial layer. This phenomenon is in good agreement with results previously published. In this study, the maximal crack depth slightly increased when DH increased from 5 to 60 cc.kg-1H2O. No significant prior ageing effect on the crack depth was observed, even when ageing was combined with high DH.

Deep Brain Stimulation of the Internal Globus Pallidus Improves Response Initiation and Proactive Inhibition in Patients With Parkinson’s Disease

PubMed Central

Pan, Yixin; Wang, Linbin; Zhang, Yingying; Zhang, Chencheng; Qiu, Xian; Tan, Yuyan; Zhou, Haiyan; Sun, Bomin; Li, Dianyou

2018-01-01

Background: Impulse control disorder is not uncommon in patients with Parkinson’s disease (PD) who are treated with dopamine replacement therapy and subthalamic deep brain stimulation (DBS). Internal globus pallidus (GPi)-DBS is increasingly used, but its role in inhibitory control has rarely been explored. In this study, we evaluated the effect of GPi-DBS on inhibitory control in PD patients. Methods: A stop-signal paradigm was used to test response initiation, proactive inhibition, and reactive inhibition. The subjects enrolled in the experiment were 27 patients with PD, of whom 13 had received only drug treatment and 14 had received bilateral GPi-DBS in addition to conventional medical treatment and 15 healthy individuals. Results: Our results revealed that with GPi-DBS on, patients with PD showed significantly faster responses than the other groups in trials where it was certain that no stop signal would be presented. Proactive inhibition was significantly different in the surgical patients with GPi-DBS on versus when GPi-DBS was off, in surgical patients with GPi-DBS on versus drug-treated patients, and in healthy controls versus drug-treated patients. Correlation analyses revealed that when GPi-DBS was on, there was a statistically significant moderate positive relationship between proactive inhibition and dopaminergic medication. Conclusion: GPi-DBS may lead to an increase in response initiation speed and improve the dysfunctional proactive inhibitory control observed in PD patients. Our results may help us to understand the role of the GPi in cortical-basal ganglia circuits. PMID:29681869

The interaction of rhinal cortex and hippocampus in human declarative memory formation.

PubMed

Fell, Jürgen; Klaver, Peter; Elger, Christian E; Fernández, Guillén

2002-01-01

Human declarative memory formation crucially depends on processes within the medial temporal lobe (MTL). These processes can be monitored in real-time by recordings from depth electrodes implanted in the MTL of patients with epilepsy who undergo presurgical evaluation. In our studies, patients performed a word memorization task during depth EEG recording. Afterwards, the difference between event-related potentials (ERPs) corresponding to subsequently remembered versus forgotten words was analyzed. These kind of studies revealed that successful memory encoding is characterized by an early process generated by the rhinal cortex within 300 ms following stimulus onset. This rhinal process precedes a hippocampal process, which starts about 200 ms later. Further investigation revealed that the rhinal process seems to be a correlate of semantic preprocessing which supports memory formation, whereas the hippocampal process appears to be a correlate of an exclusively mnemonic operation. These studies yielded only indirect evidence for an interaction of rhinal cortex and hippocampus. Direct evidence for a memory related cooperation between both structures, however, has been found in a study analyzing so called gamma activity, EEG oscillations of around 40 Hz. This investigation showed that successful as opposed to unsuccessful memory formation is accompanied by an initial enhancement of rhinal-hippocampal phase synchronization, which is followed by a later desynchronization. Present knowledge about the function of phase synchronized gamma activity suggests that this phase coupling and decoupling initiates and later terminates communication between the two MTL structures. Phase synchronized rhinal-hippocampal gamma activity may, moreover, accomplish Hebbian synaptic modifications and thus provide an initial step of declarative memory formation on the synaptic level.

Design and development of sustainable remediation process for mitigation of fluoride contamination in ground water and field application for domestic use.

PubMed

Gwala, Poonam; Andey, Subhash; Nagarnaik, Pranav; Ghosh, Sarika Pimpalkar; Pal, Prashant; Deshmukh, Prashant; Labhasetwar, Pawan

2014-08-01

Decentralised household chemo defluoridation unit (CDU) was developed and designed based on a combination of coagulation and sorption processes. Chemo-defluoridation process was optimised to reduce use of chemicals and increase acceptability among beneficiaries without affecting palatability of water. Chemical dose optimization undertaken in the laboratory using jar test revealed the optimum calcium salt to initial fluoride ratio of 60 for fluoride removal. Performance of CDU was evaluated in the laboratory for removal efficiency, water quality parameters, filter bed cleaning cycle and desorption of fluoride. CDU evaluation in the laboratory with spiked water (5 mg/L) and field water (~4.2 mg/L) revealed treated water fluoride concentration of less than 1mg/L. Seventy five CDUs were installed in households at Sakhara Village, Yavatmal District in Maharashtra State of India. Monthly monitoring of CDUs for one year indicated reduction of the raw water fluoride concentration from around 4 mg/L to less than 1mg/L. Post implementation survey after regular consumption of treated drinking water by the users for one year indicated user satisfaction and technological sustainability. Copyright © 2014 Elsevier B.V. All rights reserved.

Posttraumatic Intracranial Tuberculous Subdural Empyema in a Patient with Skull Fracture

PubMed Central

Kim, Jiha; Kim, Choonghyo; Ryu, Young-Joon

2016-01-01

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M. tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema. PMID:27226867

[Comparative evaluation of the sensitivity of Acinetobacter to colistin, using the prediffusion and minimum inhibitory concentration methods: detection of heteroresistant isolates].

PubMed

Herrera, Melina E; Mobilia, Liliana N; Posse, Graciela R

2011-01-01

The objective of this study is to perform a comparative evaluation of the prediffusion and minimum inhibitory concentration (MIC) methods for the detection of sensitivity to colistin, and to detect Acinetobacter baumanii-calcoaceticus complex (ABC) heteroresistant isolates to colistin. We studied 75 isolates of ABC recovered from clinically significant samples obtained from various centers. Sensitivity to colistin was determined by prediffusion as well as by MIC. All the isolates were sensitive to colistin, with MIC = 2µg/ml. The results were analyzed by dispersion graph and linear regression analysis, revealing that the prediffusion method did not correlate with the MIC values for isolates sensitive to colistin (r² = 0.2017). Detection of heteroresistance to colistin was determined by plaque efficiency of all the isolates with the same initial MICs of 2, 1, and 0.5 µg/ml, which resulted in 14 of them with a greater than 8-fold increase in the MIC in some cases. When the sensitivity of these resistant colonies was determined by prediffusion, the resulting dispersion graph and linear regression analysis yielded an r² = 0.604, which revealed a correlation between the methodologies used.

Delayed diagnosis in a house of correction: Smith-Magenis syndrome due to a de novo nonsense RAI1 variant.

PubMed

Yeetong, Patra; Vilboux, Thierry; Ciccone, Carla; Boulier, Kristin; Schnur, Rhonda E; Gahl, William A; Huizing, Marjan; Laje, Gonzalo; Smith, Ann C M

2016-09-01

We report a 25-year-old female confirmed to have Smith-Magenis syndrome (SMS) due to a de novo RAI1 variant. Her past history is significant for developmental and intellectual delay, early and escalating maladaptive behaviors, and features consistent with significant sleep disturbance, the etiology of which was not confirmed for over two decades. The diagnosis of SMS was initially suspected in 1998 (at age 12 years), but that was 5 years before the initial report of RAI1 variants as causative of the SMS phenotype; cytogenetic fluorescence in situ hybridization studies failed to confirm an interstitial deletion of 17p11.2. Re-evaluation for suspected SMS was pursued with RAI1 sequencing analysis in response to urgent parental concerns of escalating behaviors and aggression with subsequent incarceration of the subject for assault of a health professional. Genetic analysis revealed a de novo RAI1 (NM_030665.3) nonsense variant, c.5536C>T; p.Q1846X. This case illustrates the importance of confirming the SMS diagnosis, which is associated with cognitive and functional impairment, as well as significant psychiatric co-morbidities and behavioral problems. The diagnosis was particularly relevant to the legal discussion and determination of her competence to stand trial. As other similar cases may exist, this report will help to increase awareness of the possibility of a very late diagnosis of SMS, with the need for re-evaluation of individuals suspected to have SMS who were initially evaluated prior to the identification of the RAI1 gene. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma.

PubMed

Gebb, Juliana S; Khalek, Nahla; Qamar, Huma; Johnson, Mark P; Oliver, Edward R; Coleman, Beverly G; Peranteau, William H; Hedrick, Holly L; Flake, Alan W; Adzick, N Scott; Moldenhauer, Julie S

2018-03-01

Tumor volume to fetal weight ratio (TFR) > 0.12 before 24 weeks has been associated with poor outcome in fetuses with sacrococcygeal teratoma (SCT). We evaluated TFR in predicting poor fetal outcome and increased maternal operative risk in our cohort of SCT pregnancies. This is a retrospective, single-center review of fetuses seen with SCT from 1997 to 2015. Patients who chose termination of pregnancy (TOP), delivered elsewhere, or had initial evaluation at > 24 weeks were excluded. Receiver operating characteristic (ROC) analysis determined the optimal TFR to predict poor fetal outcome and increased maternal operative risk. Poor fetal outcome included fetal demise, neonatal demise, or fetal deterioration warranting open fetal surgery or delivery < 32 weeks. Increased maternal operative risk included cases necessitating open fetal surgery, classical cesarean delivery, or ex utero intrapartum treatment (EXIT). Of 139 pregnancies with SCT, 27 chose TOP, 14 delivered elsewhere, and 40 had initial evaluation at > 24 weeks. Thus, 58 fetuses were reviewed. ROC analysis revealed that at ≤24 weeks, TFR > 0.095 was predictive of poor fetal outcome and TFR > 0.12 was predictive of increased maternal operative risk. This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT. © 2018 S. Karger AG, Basel.

Utility of Cardiac Troponin to Predict Drug Overdose Mortality

PubMed Central

Stimmel, Barry; Hoffman, Robert S.; Vlahov, David

2016-01-01

Drug overdose is now the leading cause of injury-related mortality in the USA, but the prognostic utility of cardiac biomarkers is unknown. We investigated whether serum cardiac troponin I (cTnI) was associated with overdose mortality. This prospective observational cohort studied adults with suspected acute drug overdose at two university hospital emergency departments (ED) over 3 years. The endpoint was in-hospital mortality, which was used to determine test characteristics of initial/peak cTnI. There were 437 overdoses analyzed, of whom there were 20 (4.6 %) deaths. Mean initial cTnI was significantly associated with mortality (1.2 vs. 0.06 ng/mL, p <0.001), and the ROC curve revealed excellent cTnI prediction of mortality (AUC 0.87, CI 0.76–0.98). Test characteristics for initial cTnI (90 % specificity, 99 % negative predictive value) were better than peak cTnI (88.2 % specificity, 99.2 % negative predictive value), and initial cTnI was normal in only one death out of the entire cohort (1/437, CI 0.1–1.4 %). Initial cTnI results were highly associated with drug overdose mortality. Future research should focus on high-risk overdose features to optimize strategies for utilization of cTnI as part of the routine ED evaluation for acute drug overdose. PMID:26541348

Changing climate, challenging choices: identifying and evaluating climate change adaptation options for protected areas management in Ontario, Canada.

PubMed

Lemieux, Christopher J; Scott, Daniel J

2011-10-01

Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for any protected area agency or organization. In this study, a panel of protected area experts applied a Policy Delphi methodology to identify and evaluate climate change adaptation options across the primary management areas of a protected area agency in Canada. The panel identified and evaluated one hundred and sixty five (165) adaptation options for their perceived desirability and feasibility. While the results revealed a high level of agreement with respect to the desirability of adaptation options and a moderate level of capacity pertaining to policy formulation and management direction, a perception of low capacity for implementation in most other program areas was identified. A separate panel of senior park agency decision-makers used a multiple criterion decision-facilitation matrix to further evaluate the institutional feasibility of the 56 most desirable adaptation options identified by the initial expert panel and to prioritize them for consideration in a climate change action plan. Critically, only two of the 56 adaptation options evaluated by senior decision-makers were deemed definitely implementable, due largely to fiscal and internal capacity limitations. These challenges are common to protected area agencies in developed countries and pervade those in developing countries, revealing that limited adaptive capacity represents a substantive barrier to biodiversity conservation and other protected area management objectives in an era of rapid climate change.

Changing Climate, Challenging Choices: Identifying and Evaluating Climate Change Adaptation Options for Protected Areas Management in Ontario, Canada

NASA Astrophysics Data System (ADS)

Lemieux, Christopher J.; Scott, Daniel J.

2011-10-01

Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for any protected area agency or organization. In this study, a panel of protected area experts applied a Policy Delphi methodology to identify and evaluate climate change adaptation options across the primary management areas of a protected area agency in Canada. The panel identified and evaluated one hundred and sixty five (165) adaptation options for their perceived desirability and feasibility. While the results revealed a high level of agreement with respect to the desirability of adaptation options and a moderate level of capacity pertaining to policy formulation and management direction, a perception of low capacity for implementation in most other program areas was identified. A separate panel of senior park agency decision-makers used a multiple criterion decision-facilitation matrix to further evaluate the institutional feasibility of the 56 most desirable adaptation options identified by the initial expert panel and to prioritize them for consideration in a climate change action plan. Critically, only two of the 56 adaptation options evaluated by senior decision-makers were deemed definitely implementable, due largely to fiscal and internal capacity limitations. These challenges are common to protected area agencies in developed countries and pervade those in developing countries, revealing that limited adaptive capacity represents a substantive barrier to biodiversity conservation and other protected area management objectives in an era of rapid climate change.

Fears, Uncertainties, and Hopes: Patient-Initiated Actions and Doctors’ Responses During Oncology Interviews*

PubMed Central

Beach, Wayne A.; Dozier, David M.

2015-01-01

New cancer patients frequently raise concerns about fears, uncertainties, and hopes during oncology interviews. This study sought to understand when and how patients raise their concerns, how doctors responded to these patient-initiated actions, and implications for communication satisfaction. A sub-sampling of video recorded and transcribed encounters was investigated involving 44 new patients and 14 oncologists. Patients completed pre-post self-report measures about fears, uncertainties, and hopes as well as post-evaluations of interview satisfaction. Conversation Analysis (CA) was employed to initially identify pairs of patient-initiated and doctor-responsive actions. A coding scheme was subsequently developed, and two independent coding teams, comprised of two coders each, reliably identified patient-initiated and doctor-responsive social actions. Interactional findings reveal that new cancer patients initiate actions much more frequently than previous research had identified, concerns are usually raised indirectly, and with minimal emotion. Doctors tend to respond to these concerns immediately, but with even less affect, and rarely partner with patients. From pre-post results it was determined that the higher patients’ reported fears, the higher their post-visit fears and lower their satisfaction. Patients with high uncertainty were highly proactive (e.g., asked more questions), yet reported even greater uncertainties following encounters. Hopeful patients also exited interviews with high hopes. Overall, new patients were very satisfied: Oncology interviews significantly decreased patients’ fears and uncertainties, while increasing hopes. Discussion raises key issues for improving communication and managing quality cancer care. PMID:26134261

Developmental Exposure to Estrogen Alters Differentiation and Epigenetic Programming in a Human Fetal Prostate Xenograft Model

PubMed Central

Saffarini, Camelia M.; McDonnell-Clark, Elizabeth V.; Amin, Ali; Huse, Susan M.; Boekelheide, Kim

2015-01-01

Prostate cancer is the most frequent non-cutaneous malignancy in men. There is strong evidence in rodents that neonatal estrogen exposure plays a role in the development of this disease. However, there is little information regarding the effects of estrogen in human fetal prostate tissue. This study explored early life estrogen exposure, with and without a secondary estrogen and testosterone treatment in a human fetal prostate xenograft model. Histopathological lesions, proliferation, and serum hormone levels were evaluated at 7, 30, 90, and 200-day time-points after xenografting. The expression of 40 key genes involved in prostatic glandular and stromal growth, cell-cycle progression, apoptosis, hormone receptors and tumor suppressors was evaluated using a custom PCR array. Epigenome-wide analysis of DNA methylation was performed on whole tissue, and laser capture-microdissection (LCM) isolated epithelial and stromal compartments of 200-day prostate xenografts. Combined initial plus secondary estrogenic exposures had the most severe tissue changes as revealed by the presence of hyperplastic glands at day 200. Gene expression changes corresponded with the cellular events in the KEGG prostate cancer pathway, indicating that initial plus secondary exposure to estrogen altered the PI3K-Akt signaling pathway, ultimately resulting in apoptosis inhibition and an increase in cell cycle progression. DNA methylation revealed that differentially methylated CpG sites significantly predominate in the stromal compartment as a result of estrogen-treatment, thereby providing new targets for future investigation. By using human fetal prostate tissue and eliminating the need for species extrapolation, this study provides novel insights into the gene expression and epigenetic effects related to prostate carcinogenesis following early life estrogen exposure. PMID:25799167

Toward Evaluating the Predictability of Arctic-related Climate Variations: Initial Results from ArCS Project Theme 5

NASA Astrophysics Data System (ADS)

Hasumi, H.

2016-12-01

We present initial results from the theme 5 of the project ArCS, which is a national flagship project for Arctic research in Japan. The goal of theme 5 is to evaluate the predictability of Arctic-related climate variations, wherein we aim to: (1) establish the scientific basis of climate predictability; and (2) develop a method for predicting/projecting medium- and long-term climate variations. Variability in the Arctic environment remotely influences middle and low latitudes. Since some of the processes specific to the Arctic environment function as a long memory of the state of the climate, understanding of the process of remote connections would lead to higher-precision and longer-term prediction of global climate variations. Conventional climate models have large uncertainty in the Arctic region. By making Arctic processes in climate models more sophisticated, we aim to clarify the role of multi-sphere interaction in the Arctic environment. In this regard, our newly developed high resolution ice-ocean model has revealed the relationship between the oceanic heat transport into the Arctic Ocean and the synoptic scale atmospheric variability. We also aim to reveal the mechanism of remote connections by conducting climate simulations and analyzing various types of climate datasets. Our atmospheric model experiments under possible future situations of Arctic sea ice cover indicate that reduction of sea ice qualitatively alters the basic mechanism of remote connection. Also, our analyses of climate data have identified the cause of recent more frequent heat waves at Eurasian mid-to-high latitudes and clarified the dynamical process which forms the West Pacific pattern, a dominant mode of the atmospheric anomalous circulation in the West Pacific region which also exhibits a significant signal in the Arctic stratosphere.

Genes related to antioxidant metabolism are involved in Methylobacterium mesophilicum-soybean interaction.

PubMed

Araújo, Welington Luiz; Santos, Daiene Souza; Dini-Andreote, Francisco; Salgueiro-Londoño, Jennifer Katherine; Camargo-Neves, Aline Aparecida; Andreote, Fernando Dini; Dourado, Manuella Nóbrega

2015-10-01

The genus Methylobacterium is composed of pink-pigmented methylotrophic bacterial species that are widespread in natural environments, such as soils, stream water and plants. When in association with plants, this genus colonizes the host plant epiphytically and/or endophytically. This association is known to promote plant growth, induce plant systemic resistance and inhibit plant infection by phytopathogens. In the present study, we focused on evaluating the colonization of soybean seedling-roots by Methylobacterium mesophilicum strain SR1.6/6. We focused on the identification of the key genes involved in the initial step of soybean colonization by methylotrophic bacteria, which includes the plant exudate recognition and adaptation by planktonic bacteria. Visualization by scanning electron microscopy revealed that M. mesophilicum SR1.6/6 colonizes soybean roots surface effectively at 48 h after inoculation, suggesting a mechanism for root recognition and adaptation before this period. The colonization proceeds by the development of a mature biofilm on roots at 96 h after inoculation. Transcriptomic analysis of the planktonic bacteria (with plant) revealed the expression of several genes involved in membrane transport, thus confirming an initial metabolic activation of bacterial responses when in the presence of plant root exudates. Moreover, antioxidant genes were mostly expressed during the interaction with the plant exudates. Further evaluation of stress- and methylotrophic-related genes expression by qPCR showed that glutathione peroxidase and glutathione synthetase genes were up-regulated during the Methylobacterium-soybean interaction. These findings support that glutathione (GSH) is potentially a key molecule involved in cellular detoxification during plant root colonization. In addition to methylotrophic metabolism, antioxidant genes, mainly glutathione-related genes, play a key role during soybean exudate recognition and adaptation, the first step in bacterial colonization.

Rostral mandibular fracture repair in a pet bearded dragon (Pogona vitticeps).

PubMed

Nau, Melissa R; Eshar, David

2018-04-15

CASE DESCRIPTION A 2-year-old male bearded dragon (Pogona vitticeps) was evaluated because of a traumatic mandibular fracture. CLINICAL FINDINGS An open comminuted fracture of the rostral aspect of the right mandible was evident, with a fragment of bone exposed and dorsally displaced. Whole-body radiography revealed no evidence of additional injury. Other findings were unremarkable, except for moderate anemia (PCV, 19%). TREATMENT AND OUTCOME The fracture fragments were stabilized with 2 crossed 36-gauge interfragmentary wire loops. An external fixator device was fashioned from four 25-gauge needles inserted at alternating angles through the fracture fragments; plastic IV fluid line tubing filled with dental acrylic was used as a connecting bar. One day after surgery, the lizard had regained its typical activity level and appetite. Body weight was measured and the external fixator was inspected 1 week after surgery and monthly thereafter. Three months after initial injury, the fracture was stable, radiography revealed bony callus formation at the fracture site, and the external fixator was removed. Recheck radiography performed 5.5 months after initial injury revealed complete osseous union of the fracture fragments, and the interfragmentary wires were removed. CLINICAL RELEVANCE Surgical management of the traumatic comminuted mandibular fracture in this bearded dragon by means of a combination of internal and external fixation resulted in complete healing of the mandible and restoration of function. Management of this complicated fracture was achieved with the aid of readily available and inexpensive supplies in a clinical setting, which may be useful to other clinicians in the management of similar cases.

Debromoaplysiatoxin as the Causative Agent of Dermatitis in a Dog after Exposure to Freshwater in California

PubMed Central

Puschner, Birgit; Bautista, Adrienne C.; Wong, Chris

2017-01-01

Contamination of recreational waters with cyanobacterial toxins continues to increase and presents a risk to animals and humans. Although cases of acute hepato- and neurotoxicoses in dogs following cyanotoxin exposure exist, no reports of skin-related reactions in dogs exist. A 5-year-old female spayed 34 kg Bracco Italiano was initially presented for rapid onset of severe pruritus and urticaria. Marked excoriation and erythema were noted over the chest and neck, while urticaria was noted in the inguinal regions and ventral abdomen. Initial basic dermatology work-up excluded parasitic, fungal, and bacterial organisms. Due to the severity and progression of urticaria, the dog received IV dexamethasone and IM diphenhydramine. Improvement of the urticaria and the dog’s clinical status was noted over the next 45 min. Assessment of the dog’s environment revealed access to a lake on the property with visible algal bloom. Water from the lake was submitted for toxicology testing and revealed the presence of debromoaplysiatoxin. Access to the lake was discontinued and follow-up evaluation over the next few weeks revealed a complete resolution of the skin irritation. To the authors’ knowledge, this is the first case report of debromoaplysiatoxin exposure in a dog after swimming in cyanobacteria-contaminated water. Veterinarians should recognize the potential harm that contaminated waters may cause in terms of dermal, hepatic, and neurological conditions. In addition, more prudent oversight of contaminated recreational waters is recommended for animals and humans to prevent adverse events and intoxications. PMID:28428958

Orthopedic surgery postgraduate year 1 intern curriculum improves initial orthopedic in-training examination performance.

PubMed

Roberts, Craig S; Nyland, John; Broome, Brandon

2012-04-01

To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one residency training program (n = 55) during 7-year periods before (1996-2002) and after structured curriculum implementation (2003-2009). Linear regression analysis revealed insignificant changes in median PGY-1 intern OITE percentile rank during the precurriculum period (R = 0.08, P = 0.53). Postcurriculum period comparisons revealed significantly improving PGY-1 intern OITE percentile rank (R = 0.46, P = 0.048). Pre- and postcurriculum median US Medical Licensing Examination (USMLE) Step I scores did not display statistically significant differences (218.2 ± 6.6 vs 229.1 ± 13.8, Mann-Whitney U test, z = -1.5, P = 0.10). Spearman rho correlations revealed a moderate relation (r = 0.61) between postcurriculum PGY-1 intern OITE percentile rank and USMLE Step I score, but not during the precurriculum period. A moderate relation (r = 0.50) also was observed between postcurriculum USMLE Step I score and average OITE percentile rank during the 5-year residency program, but not during the precurriculum period. PGY-1 intern OITE percentile rank improved significantly with the addition of a specially designed educational curriculum. The stronger USMLE Step I score and PGY-1 intern OITE percentile rank relation observed during the postcurriculum period suggests that interns who participated in the educational curriculum were better prepared to translate general medical and patient care knowledge into orthopedic surgery knowledge.

Restrictive orbital myofibroblastic sarcoma in a cat--cross-sectional imaging (MRI & CT) appearance, treatment, and outcome.

PubMed

Thomasy, Sara M; Cissell, Derek D; Arzi, Boaz; Vilches-Moure, Jose G; Lo, Winnie Y; Wisner, Erik R; Dubielzig, Richard R; Maggs, David J

2013-07-01

A 16-year-old spayed female cat was evaluated for lagophthalmos and chronic exposure keratitis in both eyes. Ophthalmic examination revealed upper and lower eyelid entropion of the left eye (OS) and markedly decreased retropulsion, restricted eye movement, marked episcleral congestion, and severe keratitis of both eyes (OU). Magnetic resonance imaging of both orbits revealed extensive, irregular, contrast-enhancing tissue without evidence of osteolysis considered compatible with diffuse inflammatory tissue. Feline herpesvirus DNA was not detected in conjunctival samples. Partial temporary tarsorrhaphies were placed OU, and the cat was treated with topically administered erythromycin ointment OU, orally administered famciclovir and prednisolone, and sublingually administered buprenorphine. Little improvement was noted after 2 weeks. Six weeks after initial presentation, a left exenteration was performed and histopathology was consistent with idiopathic sclerosing orbital pseudotumor (ISOP). Ten weeks after initial presentation, the patient represented for weight loss and jaw pain. Computed tomography demonstrated disease progression in the right orbit and the patient was euthanized. Histopathology of the decalcified skull revealed an aggressive and highly infiltrative mass involving the right orbit with extension to the maxilla, hard palate, nasal cavity and gingiva most consistent with feline restrictive orbital myofibroblastic sarcoma (FROMS). Clinical data from this patient support the reclassification of ISOP as FROMS. MRI and CT may provide supportive evidence for FROMS, but histopathology is necessary for definitive diagnosis. Aggressive and early surgical treatment, including bilateral exenteration, with adjunctive radiotherapy and/or chemotherapy should be considered for patients with FROMS. © 2013 American College of Veterinary Ophthalmologists.

Demonstration of GTG as an endogenous initiation codon for a human mRNA transcript revealed by molecular cloning of the serpin endopin 2B.

PubMed

Hwang, Shin-Rong; Garza, Christina Z; Wegrzyn, Jill; Hook, Vivian Y H

2004-08-16

This study demonstrates utilization of the novel GTG initiation codon for translation of a human mRNA transcript that encodes the serpin endopin 2B, a protease inhibitor. Molecular cloning revealed the nucleotide sequence of the human endopin 2B cDNA. Its deduced primary sequence shows high homology to bovine endopin 2A that possesses cross-class protease inhibition of elastase and papain. Notably, the human endopin 2B cDNA sequence revealed GTG as the predicted translation initiation codon; the predicted translation product of 46 kDa endopin 2B was produced by in vitro translation of 35S-endopin 2B with mammalian (rabbit) protein translation components. Importantly, bioinformatic studies demonstrated the presence of the entire human endopin 2B cDNA sequence with GTG as initiation codon within the human genome on chromosome 14. Further evidence for GTG as a functional initiation codon was illustrated by GTG-mediated in vitro translation of the heterologous protein EGFP, and by GTG-mediated expression of EGFP in mammalian PC12 cells. Mutagenesis of GTG to GTC resulted in the absence of EGFP expression in PC12 cells, indicating the function of GTG as an initiation codon. In addition, it was apparent that the GTG initiation codon produces lower levels of translated protein compared to ATG as initiation codon. Significantly, GTG-mediated translation of endopin 2B demonstrates a functional human gene product not previously predicted from initial analyses of the human genome. Further analyses based on GTG as an alternative initiation codon may predict new candidate genes of the human genome.

Prolactinoma presenting as chronic anaemia with osteoporosis: a case report

PubMed Central

2010-01-01

Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man, with chronic anaemia ascribed to old age. Six years later, he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tiredness. His anaemia was investigated and ascribed to senescence. Endocrine causes were not considered or tested for. Six years later, he was again referred. Reassessment and direct questioning revealed long-standing sexual dysfunction. It was also discovered that our patient had fractured his radius twice, with minor trauma, during the preceding year. His serum prolactin was massively increased and a magnetic resonance imaging (MRI) scan of the head demonstrated a pituitary mass consistent with a prolactinoma. Dual X-ray absorptiometry revealed osteoporosis. Treatment of the prolactinoma led to a reduction in his serum prolactin with a rise in his haemoglobin to normal levels. This suggested that the prolactinoma was present during the initial presentation and was the cause of his anaemia. Conclusion This case highlights the importance of fully evaluating and investigating unexplained anaemia in older people and that endocrine causes should be considered. Osteoporosis also requires evaluation with secondary causes considered. PMID:20205855

RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

PubMed

Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

2011-12-01

Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p < 0.0001). There were also significant improvements (p < 0.05) in stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data.

Synthesis and Initial in Vivo Studies with [11C]SB-216763: The First Radiolabeled Brain Penetrative Inhibitor of GSK-3

PubMed Central

2015-01-01

Quantifying glycogen synthase kinase-3 (GSK-3) activity in vivo using positron emission tomography (PET) imaging is of interest because dysregulation of GSK-3 is implicated in numerous diseases and neurological disorders for which GSK-3 inhibitors are being considered as therapeutic strategies. Previous PET radiotracers for GSK-3 have been reported, but none of the published examples cross the blood–brain barrier. Therefore, we have an ongoing interest in developing a brain penetrating radiotracer for GSK-3. To this end, we were interested in synthesis and preclinical evaluation of [11C]SB-216763, a high-affinity inhibitor of GSK-3 (Ki = 9 nM; IC50 = 34 nM). Initial radiosyntheses of [11C]SB-216763 proved ineffective in our hands because of competing [3 + 3] sigmatropic shifts. Therefore, we have developed a novel one-pot two-step synthesis of [11C]SB-216763 from a 2,4-dimethoxybenzyl-protected maleimide precursor, which provided high specific activity [11C]SB-216763 in 1% noncorrected radiochemical yield (based upon [11C]CH3I) and 97–100% radiochemical purity (n = 7). Initial preclinical evaluation in rodent and nonhuman primate PET imaging studies revealed high initial brain uptake (peak rodent SUV = 2.5 @ 3 min postinjection; peak nonhuman primate SUV = 1.9 @ 5 min postinjection) followed by washout. Brain uptake was highest in thalamus, striatum, cortex, and cerebellum, areas known to be rich in GSK-3. These results make the arylindolemaleimide skeleton our lead scaffold for developing a PET radiotracer for quantification of GSK-3 density in vivo and ultimately translating it into clinical use. PMID:26005531

Subjective and objective outcome after revision arthroscopic stabilization for recurrent anterior instability versus initial shoulder stabilization.

PubMed

Krueger, David; Kraus, Natascha; Pauly, Stephan; Chen, Jianhai; Scheibel, Markus

2011-01-01

The value of arthroscopic revision shoulder stabilization after failed instability repair is still a matter of debate. Arthroscopic revision shoulder stabilization using suture anchors provides equivalent subjective and objective results compared with initial arthroscopic instability repair. Cohort study; Level of evidence, 3. Twenty consecutive patients who underwent arthroscopic revision shoulder stabilization using suture anchors (group 2) were matched for age, gender, and handedness (dominant or nondominant) with 20 patients who had initial arthroscopic instability repair using the same technique (group 1). At the time of follow-up, a complete physical examination of both shoulders and evaluation with the Rowe score, Walch-Duplay score, Melbourne Instability Shoulder Score, Western Ontario Shoulder Instability Index, and the Subjective Shoulder Value were performed. In addition, standard radiographs (true AP and axillary views) were taken to evaluate signs of osteoarthritis. After a minimum follow-up of 24 months, no recurrent dislocations were observed in either group. The apprehension sign was positive in 2 cases of revision surgery (0 vs 2; P > .05). No significant differences in the Rowe score (89 vs 81.8 points) were found between groups 1 and 2 (P > .05). However, group 2 revealed significantly lower scores in the Walch-Duplay score (85.3 vs 75.5 points), Melbourne Instability Shoulder Score (90.2 vs 73.7 points), Western Ontario Shoulder Instability Index (89.8% vs 68.9%), and Subjective Shoulder Value (91.8% vs 69.2%) (P < .05). Signs of instability arthropathy were found more often in patients with arthroscopic revision surgery (2 vs 5; P > .05). Arthroscopic revision shoulder stabilization is associated with a lower subjective outcome compared with initial arthroscopic stabilization. The objective results found in this study may overestimate the clinical outcome in this patient population.

An elective course in personal finance for health care professionals.

PubMed

Chui, Michelle A

2009-02-19

To create, implement, and assess an elective course on the principles and applications of personal finance. A 1.5 unit (15 hours total) elective course was designed using active-learning pedagogy, lecture, and group discussion. Homework assignments were designed to provide practical tools and materials that students could individualize and apply to their personal financial goals. Student satisfaction, using a standard course evaluation form, revealed consistent high ratings. Student enrollment increased from 19 students in its initial year to 90 students in its fourth year. Student knowledge, assessed using the Jump$tart Financial Literacy Survey, indicated significant knowledge acquisition. Many pharmacy students are ill equipped to effectively handle the complex financial decisions they face after graduation. This course provides students with practical tools to identify appropriate ways to achieve their financial goals and critically evaluate financial advice and advisors.

Neural correlates of strategic processes underlying episodic memory in women with major depression: A 15O-PET study.

PubMed

Ottowitz, William E; Deckersbach, Thilo; Savage, Cary R; Lindquist, Martin A; Dougherty, Darin D

2010-01-01

To evaluate the functional integrity of brain regions underlying strategic mnemonic processing in patients with major depressive disorder, the authors administered a modified version of the California Verbal Learning Test to depressed patients during presentation of lists of unrelated words and, conversely, during presentation of lists of related words with and without orientation regarding the relatedness of the words (eight healthy females, IQ=122, and eight depressed females, IQ=107). Brain function evaluated across all three conditions showed that patients with major depressive disorder revealed activation of the right anterior cingulate cortex, left ventrolateral prefrontal cortex, both hippocampi, and the left orbitofrontal cortex. Further analysis showed that patients with major depressive disorder had greater activation of the right anterior cingulate cortex during semantic organization and the right ventrolateral prefrontal cortex during strategy initiation.

Are health science faculty interested in medical history? An evaluative case study.

PubMed Central

Bowman, I A; Eaton, E K; Mahan, J M

1978-01-01

This paper deals with the efforts of a medical library to stimulate interest in the history of medicine by utilizing its historical resources. It is based on a survey designed to evaluate the monthly publication of the library, the Bookman, and to determine the response of health science faculty to historical essays as well as to other sections of the publication. The results show that a large percentage of the faculty reads historical essays either regularly or occasionally, and reveal a trend contrary to the common belief that the teaching staff in health science centers is not interested in medical history. The authors suggest that a library with historical resources can contribute to the educational process in a medical community by actively publicizing its collections and providing opportunities for informal and self-initiated reading. PMID:656659

Organogenesis in plants: initiation and elaboration of leaves

USDA-ARS?s Scientific Manuscript database

Plant organs initiate from meristems and grow into diverse forms. After initiation, organs enter a morphological phase where they develop their shape, followed by differentiation into mature tissue. Investigations into these processes have revealed numerous factors necessary for proper development, ...

Prognostic implications of serial risk score assessments in patients with pulmonary arterial hypertension: a Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) analysis.

PubMed

Benza, Raymond L; Miller, Dave P; Foreman, Aimee J; Frost, Adaani E; Badesch, David B; Benton, Wade W; McGoon, Michael D

2015-03-01

Data from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) were used previously to develop a risk score calculator to predict 1-year survival. We evaluated prognostic implications of changes in the risk score and individual risk-score parameters over 12 months. Patients were grouped by decreased, unchanged, or increased risk score from enrollment to 12 months. Kaplan-Meier estimates of subsequent 1-year survival were made based on change in the risk score during the initial 12 months of follow-up. Cox regression was used for multivariable analysis. Of 2,529 patients in the analysis cohort, the risk score was decreased in 800, unchanged in 959, and increased in 770 at 12 months post-enrollment. Six parameters (functional class, systolic blood pressure, heart rate, 6-minute walk distance, brain natriuretic peptide levels, and pericardial effusion) each changed sufficiently over time to improve or worsen risk scores in ≥5% of patients. One-year survival estimates in the subsequent year were 93.7%, 90.3%, and 84.6% in patients with a decreased, unchanged, and increased risk score at 12 months, respectively. Change in risk score significantly predicted future survival, adjusting for risk at enrollment. Considering follow-up risk concurrently with risk at enrollment, follow-up risk was a much stronger predictor, although risk at enrollment maintained a significant effect on future survival. Changes in REVEAL risk scores occur in most patients with pulmonary arterial hypertension over a 12-month period and are predictive of survival. Thus, serial risk score assessments can identify changes in disease trajectory that may warrant treatment modifications. Copyright © 2015 International Society for Heart and Lung Transplantation. All rights reserved.

Insights into the equilibrium, kinetic and thermodynamics of nickel removal by environmental friendly Lansium domesticum peel biosorbent.

PubMed

Lam, Yun Fung; Lee, Lai Yee; Chua, Song Jun; Lim, Siew Shee; Gan, Suyin

2016-05-01

Lansium domesticum peel (LDP), a waste material generated from the fruit consumption, was evaluated as a biosorbent for nickel removal from aqueous media. The effects of dosage, contact time, initial pH, initial concentration and temperature on the biosorption process were investigated in batch experiments. Equilibrium data were fitted by the Langmuir, Freundlich, Temkin and Dubinin-Radushkevich models using nonlinear regression method with the best-fit model evaluated based on coefficient of determination (R(2)) and Chi-square (χ(2)). The best-fit isotherm was found to be the Langmuir model exhibiting R(2) very close to unity (0.997-0.999), smallest χ(2) (0.0138-0.0562) and largest biosorption capacity (10.1mg/g) at 30°C. Kinetic studies showed that the initial nickel removal was rapid with the equilibrium state established within 30min. Pseudo-second-order model was the best-fit kinetic model indicating the chemisorption nature of the biosorption process. Further data analysis by the intraparticle diffusion model revealed the involvement of several rate-controlling steps such as boundary layer and intraparticle diffusion. Thermodynamically, the process was exothermic, spontaneous and feasible. Regeneration studies indicated that LDP biosorbent could be regenerated using hydrochloric acid solution with up to 85% efficiency. The present investigation proved that LDP having no economic value can be used as an alternative eco-friendly biosorbent for remediation of nickel contaminated water. Copyright © 2016 Elsevier Inc. All rights reserved.

Kinetic evaluation of chromium(VI) sorption by water lettuce (Pistia).

PubMed

Chakraborty, Rupa; Karmakar, Sukalpa; Mukherjee, Somnath; Kumar, Sunil

2014-01-01

An investigation was performed to evaluate the uptake capacity of Pistia in living condition for adsorptive removal of chromium(VI) from spiked solution for examining a remedial measure for disposal of chrome-laden wastewater in an urban wetland system. Kinetics results show about 78% removal was achieved for 3 mg/L initial concentration of Cr(VI). Experimental data showed that the root portion absorbed more Cr(VI) (28.54 μg/g) compared to accumulation in leaf (5.73 μg/g). It was also noted that the plant could effectively remove Cr(VI) from the solution with minor damage up to an initial Cr(VI) concentration of 3 mg/L, for which the adsorption isotherm studies were conducted. The maximum uptake capacity of the plant was recorded as 0.05 mg/g of Cr(VI) at the equilibrium level after a contact period of 7 days for an initial concentration of 8 mg /L, although severe physiological damage occurred. The experimental results were plotted in Langmuir and Freundlich isotherm models and both were found to be well fitted (r(2) = 0.979 and r(2) = 0.974 respectively). The high value of n (2.16) reveals a strong bond between the plant root and dissolved Cr(VI), which favours the adsorption process. The order of the reaction was also examined on the basis of uptake capacity and it was found that the second order model fitted best.

Futility of fluorodeoxyglucose F 18 positron emission tomography in initial evaluation of patients with T2 to T4 melanoma.

PubMed

Clark, Paige B; Soo, Victoria; Kraas, Jonathan; Shen, Perry; Levine, Edward A

2006-03-01

Evaluation of newly diagnosed patients with melanoma for metastasis is requisite to treatment planning. The reported diagnostic yield of whole-body conventional radiological imaging in initial staging of patients with melanoma is low. However, the diagnostic yield of positron emission tomography (PET) for distant metastases is unclear. There is no utility of PET as part of a routine metastatic survey in patients with T2 to T4 melanoma. Retrospective review of a cohort study between December 1998 and July 2004. University hospital tertiary care center. There were 64 patients with T2 to T4 melanomas who underwent PET for detection of occult metastases at our institution. All patients underwent surgical excision of the primary lesion and sentinel lymph node dissection. Data included were pathologic findings of the primary lesion and sentinel lymph nodes, laboratory data, and radiological reports. None of the patients had clinically suspected regional or distant metastases prior to PET. The diagnostic yield of PET was evaluated through retrospective analysis. Positive scans were then correlated for accuracy with follow-up imaging, biopsy, and clinical information when available. Positron emission tomography did not reveal occult distant metastases in any of the patients. Positron emission tomographic scans showed no abnormalities in 94% of these patients. In 2 patients (3%), false-positive findings were reported on PET (muscular activity and intranodal melanocytic nevocellular inclusion). Further, PET was not useful in predicting regional lymph node metastases. Nineteen of 64 patients had positive sentinel lymph nodes, and only 2 (11%) were identified on PET. Overall, PET did not change clinical management in any of the patients. This study suggests no utility for PET in the detection of occult metastases in patients at initial diagnosis of melanoma. Omission of PET imaging from preoperative evaluations for patients with melanoma is recommended.

Vaginal Epithelial Cell-Derived S100 Alarmins Induced by Candida albicans via Pattern Recognition Receptor Interactions Are Sufficient but Not Necessary for the Acute Neutrophil Response during Experimental Vaginal Candidiasis

PubMed Central

Yano, Junko; Palmer, Glen E.; Eberle, Karen E.; Peters, Brian M.; Vogl, Thomas; McKenzie, Andrew N.

2014-01-01

Vulvovaginal candidiasis (VVC), caused by Candida albicans, affects women worldwide. Animal and clinical studies suggest that the immunopathogenic inflammatory condition of VVC is initiated by S100 alarmins in response to C. albicans, which stimulate polymorphonuclear neutrophil (PMN) migration to the vagina. The purpose of this study was to extend previous in vitro data and determine the requirement for the alarmin S100A8 in the PMN response and to evaluate pattern recognition receptors (PRRs) that initiate the response. For the former, PMN migration was evaluated in vitro or in vivo in the presence or absence of S100 alarmins initiated by several approaches. For the latter, vaginal epithelial cells were evaluated for PRR expression and C. albicans-induced S100A8 and S100A9 mRNAs, followed by evaluation of the PMN response in inoculated PRR-deficient mice. Results revealed that, consistent with previously reported in vitro data, eukaryote-derived S100A8, but not prokaryote-derived recombinant S100A8, induced significant PMN chemotaxis in vivo. Conversely, a lack of biologically active S100A8 alarmin, achieved by antibody neutralization or by using S100A9−/− mice, had no effect on the PMN response in vivo. In PRR analyses, whereas Toll-like receptor 4 (TLR4)- and SIGNR1-deficient vaginal epithelial cells showed a dramatic reduction in C. albicans-induced S100A8/S100A9 mRNAs in vitro, inoculated mice deficient in these PRRs showed PMN migration similar to that in wild-type controls. These results suggest that S100A8 alarmin is sufficient, but not necessary, to induce PMN migration during VVC and that the vaginal PMN response to C. albicans involves PRRs in addition to SIGNR1 and TLR4, or other induction pathways. PMID:24478092

Vaginal epithelial cell-derived S100 alarmins induced by Candida albicans via pattern recognition receptor interactions are sufficient but not necessary for the acute neutrophil response during experimental vaginal candidiasis.

PubMed

Yano, Junko; Palmer, Glen E; Eberle, Karen E; Peters, Brian M; Vogl, Thomas; McKenzie, Andrew N; Fidel, Paul L

2014-02-01

Vulvovaginal candidiasis (VVC), caused by Candida albicans, affects women worldwide. Animal and clinical studies suggest that the immunopathogenic inflammatory condition of VVC is initiated by S100 alarmins in response to C. albicans, which stimulate polymorphonuclear neutrophil (PMN) migration to the vagina. The purpose of this study was to extend previous in vitro data and determine the requirement for the alarmin S100A8 in the PMN response and to evaluate pattern recognition receptors (PRRs) that initiate the response. For the former, PMN migration was evaluated in vitro or in vivo in the presence or absence of S100 alarmins initiated by several approaches. For the latter, vaginal epithelial cells were evaluated for PRR expression and C. albicans-induced S100A8 and S100A9 mRNAs, followed by evaluation of the PMN response in inoculated PRR-deficient mice. Results revealed that, consistent with previously reported in vitro data, eukaryote-derived S100A8, but not prokaryote-derived recombinant S100A8, induced significant PMN chemotaxis in vivo. Conversely, a lack of biologically active S100A8 alarmin, achieved by antibody neutralization or by using S100A9(-/-) mice, had no effect on the PMN response in vivo. In PRR analyses, whereas Toll-like receptor 4 (TLR4)- and SIGNR1-deficient vaginal epithelial cells showed a dramatic reduction in C. albicans-induced S100A8/S100A9 mRNAs in vitro, inoculated mice deficient in these PRRs showed PMN migration similar to that in wild-type controls. These results suggest that S100A8 alarmin is sufficient, but not necessary, to induce PMN migration during VVC and that the vaginal PMN response to C. albicans involves PRRs in addition to SIGNR1 and TLR4, or other induction pathways.

Combining wet etching and real-time damage event imaging to reveal the most dangerous laser damage initiator in fused silica.

PubMed

Hu, Guohang; Zhao, Yuanan; Liu, Xiaofeng; Li, Dawei; Xiao, Qiling; Yi, Kui; Shao, Jianda

2013-08-01

A reliable method, combining a wet etch process and real-time damage event imaging during a raster scan laser damage test, has been developed to directly determine the most dangerous precursor inducing low-density laser damage at 355 nm in fused silica. It is revealed that ~16% of laser damage sites were initiated at the place of the scratches, ~49% initiated at the digs, and ~35% initiated at invisible defects. The morphologies of dangerous scratches and digs were compared with those of moderate ones. It is found that local sharp variation at the edge, twist, or inside of a subsurface defect is the most dangerous laser damage precursor.

Using learning analytics to evaluate a video-based lecture series.

PubMed

Lau, K H Vincent; Farooque, Pue; Leydon, Gary; Schwartz, Michael L; Sadler, R Mark; Moeller, Jeremy J

2018-01-01

The video-based lecture (VBL), an important component of the flipped classroom (FC) and massive open online course (MOOC) approaches to medical education, has primarily been evaluated through direct learner feedback. Evaluation may be enhanced through learner analytics (LA) - analysis of quantitative audience usage data generated by video-sharing platforms. We applied LA to an experimental series of ten VBLs on electroencephalography (EEG) interpretation, uploaded to YouTube in the model of a publicly accessible MOOC. Trends in view count; total percentage of video viewed and audience retention (AR) (percentage of viewers watching at a time point compared to the initial total) were examined. The pattern of average AR decline was characterized using regression analysis, revealing a uniform linear decline in viewership for each video, with no evidence of an optimal VBL length. Segments with transient increases in AR corresponded to those focused on core concepts, indicative of content requiring more detailed evaluation. We propose a model for applying LA at four levels: global, series, video, and feedback. LA may be a useful tool in evaluating a VBL series. Our proposed model combines analytics data and learner self-report for comprehensive evaluation.

Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients.

PubMed

Ford, Diana C; Schroeder, Mary C; Ince, Dilek; Ernst, Erika J

2018-06-14

The cost-effectiveness of initial treatment strategies for mild-to-moderate Clostridium difficile infection (CDI) in hospitalized patients was evaluated. Decision-analytic models were constructed to compare initial treatment with metronidazole, vancomycin, and fidaxomicin. The primary model included 1 recurrence, and the secondary model included up to 3 recurrences. Model variables were extracted from published literature with costs based on a healthcare system perspective. The primary outcome was the incremental cost-effective ratio (ICER) between initial treatment strategies. In the primary model, the overall percentage of patients cured was 94.23%, 95.19%, and 96.53% with metronidazole, vancomycin, and fidaxomicin, respectively. Expected costs per case were $1,553.01, $1,306.62, and $5,095.70, respectively. In both models, vancomycin was more effective and less costly than metronidazole, resulting in negative ICERs. The ICERs for fidaxomicin compared with those for metronidazole and vancomycin in the primary model were $1,540.23 and $2,828.69 per 1% gain in cure, respectively. Using these models, a hospital currently treating initial episodes of mild-to-moderate CDI with metronidazole could expect to save $246.39-$388.37 per case treated by using vancomycin for initial therapy. A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate CDI in adult inpatients. From the hospital perspective, initial treatment with vancomycin resulted in a higher probability of cure and a lower probability of colectomy, recurrence, persistent recurrence, and cost per case treated, compared with metronidazole. Use of fidaxomicin was associated with an increased probability of cure compared with metronidazole and vancomycin, but at a substantially increased cost. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Use of intravenous lipid emulsion to treat ivermectin toxicosis in a Border Collie.

PubMed

Clarke, Dana L; Lee, Justine A; Murphy, Lisa A; Reineke, Erica L

2011-11-15

A 2-year-old spayed female Border Collie was treated with IV lipid emulsion (ILE) after ingesting 6 mg/kg (2.73 mg/lb) of an equine ivermectin anthelmintic paste 8 hours prior to examination. On initial examination, the dog had stable cardiovascular signs but had diffuse muscle tremors and was hyperthermic. Neurologic evaluation revealed that the dog was ataxic and had mydriasis with bilaterally absent menace responses and pupillary light reflexes. The remaining physical examination findings were unremarkable. Results of CBC, serum biochemical analysis, venous blood gas analysis, and measurement of plasma lactate concentration were also within reference limits. The dog was treated with ILE in addition to supportive care with IV fluid therapy and cardiovascular, respiratory, and neurologic monitoring. The use of ILE treatment was initiated in this patient on the basis of previous clinical and experimental evidence supporting its use for toxicosis resulting from lipid-soluble agents. An initial bolus of 1.5 mL/kg (0.68 mL/lb) of a 20% sterile lipid solution was administered IV over 10 minutes, followed by a constant rate infusion of 0.25 mL/kg/min (0.11 mL/lb/min) over 60 minutes that was administered twice to treat clinical signs of ivermectin toxicosis. The dog was discharged from the hospital 48 hours after admission and was clinically normal within 4 days after ivermectin ingestion. Further diagnostic evaluation subsequently revealed that this dog was unaffected by the multidrug resistance gene (MDR-1) deletion, known as the ATP-binding cassette polymorphism. Ivermectin toxicosis in veterinary patients can result in death without aggressive treatment, and severe toxicosis often requires mechanical ventilation and intensive supportive care. This is particularly true in dogs affected by the ATP-binding cassette polymorphism. Novel ILE treatment has been shown to be effective in human patients with lipid-soluble drug toxicoses, although the exact mechanism is unknown. In the patient in the present report, ILE was used successfully to treat ivermectin toxicosis, and results of serial measurement of serum ivermectin concentration supported the proposed lipid sink mechanism of action.

Computed tomography-magnetic resonance image fusion: a clinical evaluation of an innovative approach for improved tumor localization in primary central nervous system lesions.

PubMed

Lattanzi, J P; Fein, D A; McNeeley, S W; Shaer, A H; Movsas, B; Hanks, G E

1997-01-01

We describe our initial experience with the AcQSim (Picker International, St. David, PA) computed tomography-magnetic resonance imaging (CT-MRI) fusion software in eight patients with intracranial lesions. MRI data are electronically integrated into the CT-based treatment planning system. Since MRI is superior to CT in identifying intracranial abnormalities, we evaluated the precision and feasibility of this new localization method. Patients initially underwent CT simulation from C2 to the most superior portion of the scalp. T2 and post-contrast T1-weighted MRI of this area was then performed. Patient positioning was duplicated utilizing a head cup and bridge of nose to forehead angle measurements. First, a gross tumor volume (GTV) was identified utilizing the CT (CT/GTV). The CT and MRI scans were subsequently fused utilizing a point pair matching method and a second GTV (CT-MRI/GTV) was contoured with the aid of both studies. The fusion process was uncomplicated and completed in a timely manner. Volumetric analysis revealed the CT-MRI/GTV to be larger than the CT/GTV in all eight cases. The mean CT-MRI/GTV was 28.7 cm3 compared to 16.7 cm3 by CT alone. This translated into a 72% increase in the radiographic tumor volume by CT-MRI. A simulated dose-volume histogram in two patients revealed that marginal portions of the lesion, as identified by CT and MRI, were not included in the high dose treatment volume as contoured with the use of CT alone. Our initial experience with the fusion software demonstrated an improvement in tumor localization with this technique. Based on these patients the use of CT alone for treatment planning purposes in central nervous system (CNS) lesions is inadequate and would result in an unacceptable rate of marginal misses. The importation of MRI data into three-dimensional treatment planning is therefore crucial to accurate tumor localization. The fusion process simplifies and improves precision of this task.

Triceps tendon tear in a middle-aged weightlifter.

PubMed

Molloy, Joseph M; Aberle, Curtis J; Escobar, Eduardo

2013-11-01

The patient was a 47-year-old man who was evaluated by a physical therapist for a chief complaint of posterior right elbow pain. The patient routinely participated in weightlifting activities and reported a sudden onset of triceps weakness and posterior elbow pain while performing clap push-ups 3 days prior. A physician assistant ordered radiographs, which were initially interpreted as normal, and routine magnetic resonance imaging for the right elbow. Following examination by a physical therapist, due to concern for a triceps tendon tear, the previously ordered magnetic resonance imaging was expedited, which revealed a partial triceps tendon tear with partial tendon retraction medially.

Sertraline alleviated osmophobia caused by partial hypopituitarism with isolated ACTH deficiency.

PubMed

Kuo, Yu-Heng; Chang, Yun; Chen, Hsi-Chung; Liao, Shih-Cheng

2013-01-01

Hyperosmia may be an early manifestation of hypocortisolism and may be mistakenly diagnosed as osmophobia. However, sertraline therapy incidentally alleviated the phobic symptoms and hindered accurate diagnosis. A 41-year-old man was diagnosed as having osmophobia. Initial sertraline treatment relieved the symptoms, but its cessation resulted in recurrence of osmophobia. Endocrinological examinations revealed severe hypocortisolism and partial hypopituitarism with isolated adrenocorticotropic hormone deficiency. After prednisolone supplementation, his condition dramatically improved. We recommend that, before intervention with selective serotonin reuptake inhibitors is performed, the hypothalamic-pituitary-adrenal axis be evaluated in psychiatric patients presenting with co-occurring olfactory change. Copyright © 2013 Elsevier Inc. All rights reserved.

Synthesis and preliminary biological evaluation of potent and selective 2-(3-alkoxy-1-azetidinyl) quinolines as novel PDE10A inhibitors with improved solubility.

PubMed

Rzasa, Robert M; Frohn, Michael J; Andrews, Kristin L; Chmait, Samer; Chen, Ning; Clarine, Jeffrey G; Davis, Carl; Eastwood, Heather A; Horne, Daniel B; Hu, Essa; Jones, Adrie D; Kaller, Matthew R; Kunz, Roxanne K; Miller, Silke; Monenschein, Holger; Nguyen, Thomas; Pickrell, Alexander J; Porter, Amy; Reichelt, Andreas; Zhao, Xiaoning; Treanor, James J S; Allen, Jennifer R

2014-12-01

We report the discovery of a novel series of 2-(3-alkoxy-1-azetidinyl) quinolines as potent and selective PDE10A inhibitors. Structure-activity studies improved the solubility (pH 7.4) and maintained high PDE10A activity compared to initial lead compound 3, with select compounds demonstrating good oral bioavailability. X-ray crystallographic studies revealed two distinct binding modes to the catalytic site of the PDE10A enzyme. An ex vivo receptor occupancy assay in rats demonstrated that this series of compounds covered the target within the striatum.

Diagnosis and treatment of chronic lymphocytic leukemia in a bat-eared fox (Otocyon megalotis).

PubMed

Nevitt, Benjamin N; Langan, Jennifer N; Adkesson, Michael J; Landolfi, Jennifer A; Wilson, Rand

2014-12-15

Severe lymphocytosis and leukocytosis were detected during examination of a 10-year-old sexually intact male bat-eared fox (Otocyon megalotis) with regionally extensive alopecia. A CBC revealed severe leukocytosis (39,100 leukocytes/μL) and marked lymphocytosis (90%). A blood smear consisted predominantly of intermediate-sized lymphocytes and few large lymphocytes, with mild to moderate nuclear atypia. These findings were highly suggestive of chronic lymphocytic leukemia (CLL). Cytologic evaluation of bone marrow aspirates revealed no evidence of overt malignancy, with 10% of all cells identified as small to intermediate-sized mature lymphocytes. Treatment with chlorambucil and prednisone administered orally over a 1.8-year period decreased the leukocyte and lymphocyte counts to within reference intervals with no adverse effects. Although repeated flow cytometry revealed evidence of residual disease, the fox remained free of clinical disease, and WBC counts were within reference intervals for this species. At 22 months after initial evaluation, the fox was euthanized because of debilitating arthritis. No evidence of CLL was detected grossly or histologically during necropsy. To the authors' knowledge, this was the first report of CLL in a bat-eared fox and first successful treatment in a nondomestic carnivore. Treatment in accordance with a chemotherapeutic protocol successfully resolved the leukocytosis and lymphocytosis with no serious adverse effects. Description of this fox and the treatment protocol should provide a valuable reference for future cases in this and other nondomestic canine species.

Perspective taking combats automatic expressions of racial bias.

PubMed

Todd, Andrew R; Bodenhausen, Galen V; Richeson, Jennifer A; Galinsky, Adam D

2011-06-01

Five experiments investigated the hypothesis that perspective taking--actively contemplating others' psychological experiences--attenuates automatic expressions of racial bias. Across the first 3 experiments, participants who adopted the perspective of a Black target in an initial context subsequently exhibited more positive automatic interracial evaluations, with changes in automatic evaluations mediating the effect of perspective taking on more deliberate interracial evaluations. Furthermore, unlike other bias-reduction strategies, the interracial positivity resulting from perspective taking was accompanied by increased salience of racial inequalities (Experiment 3). Perspective taking also produced stronger approach-oriented action tendencies toward Blacks (but not Whites; Experiment 4). A final experiment revealed that face-to-face interactions with perspective takers were rated more positively by Black interaction partners than were interactions with nonperspective takers--a relationship that was mediated by perspective takers' increased approach-oriented nonverbal behaviors (as rated by objective, third-party observers). These findings indicate that perspective taking can combat automatic expressions of racial biases without simultaneously decreasing sensitivity to ongoing racial disparities. 2011 APA, all rights reserved

Healthy Cities: facilitating the active participation and empowerment of local people.

PubMed

Dooris, Mark; Heritage, Zoe

2013-10-01

Community participation and empowerment are key values underpinning the European WHO Healthy Cities initiative, now in its fifth phase. This paper provides a brief overview of the history, policy context, and theory relating to community participation and empowerment. Drawing on Phase IV evaluation data, it presents the findings in relation to the four quadrants of Davidson's Wheel of Participation--information, consultation, participation in decision making, and empowerment. The large majority of European Healthy Cities have mechanisms in place to provide information for and to consult with local people. Most also demonstrate a commitment to enabling community participation in decision-making and to empowering citizens. Within this context, the evaluation highlighted a diversity of approaches and revealed varied perspectives on how participation and empowerment can be integrated within city leadership and governance processes. The paper concludes by suggesting that there is a need to strengthen future evaluative research to better understand how and why the Healthy Cities approach makes a difference.

Development of an Evaluation Methodology for Triple Bottom Line Reports Using International Standards on Reporting

NASA Astrophysics Data System (ADS)

Skouloudis, Antonis; Evangelinos, Konstantinos; Kourmousis, Fotis

2009-08-01

The purpose of this article is twofold. First, evaluation scoring systems for triple bottom line (TBL) reports to date are examined and potential methodological weaknesses and problems are highlighted. In this context, a new assessment methodology is presented based explicitly on the most widely acknowledged standard on non-financial reporting worldwide, the Global Reporting Initiative (GRI) guidelines. The set of GRI topics and performance indicators was converted into scoring criteria while the generic scoring devise was set from 0 to 4 points. Secondly, the proposed benchmark tool was applied to the TBL reports published by Greek companies. Results reveal major gaps in reporting practices, stressing the need for the further development of internal systems and processes in order to collect essential non-financial performance data. A critical overview of the structure and rationale of the evaluation tool in conjunction with the Greek case study is discussed while recommendations for future research on the field of this relatively new form of reporting are suggested.

Development of an evaluation methodology for triple bottom line reports using international standards on reporting.

PubMed

Skouloudis, Antonis; Evangelinos, Konstantinos; Kourmousis, Fotis

2009-08-01

The purpose of this article is twofold. First, evaluation scoring systems for triple bottom line (TBL) reports to date are examined and potential methodological weaknesses and problems are highlighted. In this context, a new assessment methodology is presented based explicitly on the most widely acknowledged standard on non-financial reporting worldwide, the Global Reporting Initiative (GRI) guidelines. The set of GRI topics and performance indicators was converted into scoring criteria while the generic scoring devise was set from 0 to 4 points. Secondly, the proposed benchmark tool was applied to the TBL reports published by Greek companies. Results reveal major gaps in reporting practices, stressing the need for the further development of internal systems and processes in order to collect essential non-financial performance data. A critical overview of the structure and rationale of the evaluation tool in conjunction with the Greek case study is discussed while recommendations for future research on the field of this relatively new form of reporting are suggested.

Muscle strength and fatigue in newly diagnosed patients with myasthenia gravis.

PubMed

Vinge, Lotte; Andersen, Henning

2016-10-01

Dynamometry is increasingly used as an objective measurement of muscle strength in neurological diseases. No study has applied dynamometry in untreated newly diagnosed patients with myasthenia gravis (MG). Isometric muscle strength at the shoulder, knee, and ankle was determined in 21 MG patients before and after initial anti-myasthenic treatment. Isometric strength was compared with MG evaluation scales. Muscle strength was reduced for knee extensors and shoulder abductors but normal for ankle extensors. Isometric muscle strength did not correlate significantly with manual muscle testing (MG Composite). Dynamometry revealed improved muscle strength of up to 50% (median 17%; range -1.8-49.8) despite no change in the MG Composite score. Dynamometry appears to be a more sensitive method of identifying changes in limb strength than MG evaluation scales. This supports the use of dynamometry in MG patients, especially for evaluation of the effect of anti-myasthenic treatment. Muscle Nerve 54: 709-714, 2016. © 2016 Wiley Periodicals, Inc.

RASA1 analysis guides management in a family with capillary malformation-arteriovenous malformation

PubMed Central

Flore, Leigh Anne; Leon, Eyby; Maher, Tom A.; Milunsky, Jeff M.

2012-01-01

Capillary malformation-arteriovenous malformation (CM-AVM; MIM 60354) is an autosomal dominant disorder characterized by multifocal cutaneous capillary malformations, often in association with fast-flow vascular lesions, which may be cutaneous, subcutaneous, intramuscular, intraosseus, or cerebral arteriovenous malformations or arteriovenous fistulas. CM-AVM results from heterozygous mutations in the RASA1 gene. Capillary malformations of the skin are common, and clinical examination alone may not be able to definitively diagnose-or exclude- CM-AVM. We report a family in which the proband was initially referred for a genetic evaluation in the neonatal period because of the presence of a cardiac murmur and minor dysmorphic features. Both he and his mother were noted to have multiple capillary malformations on the face, head, and extremities. Echocardiography revealed dilated head and neck vessels and magnetic resonance imaging and angiography of the brain revealed a large infratentorial arteriovenous fistula, for which he has had two embolization procedures. RASA1 sequence analysis revealed a heterozygous mutation, confirming his diagnosis of CM-AVM. We established targeted mutation analysis for the proband's mother and sister, the latter of whom is a healthy 3-year-old whose only cutaneous finding is a facial capillary malformation. This revealed that the proband's mother is also heterozygous for the RASA1 mutation, but his sister is negative. Consequently, his mother will undergo magnetic resonance imaging and angiography screening for intracranial and spinal fast-flow lesions, while his sister will require no imaging or serial evaluations. Targeted mutation analysis has been offered to additional maternal family members. This case illustrates the benefit of molecular testing in diagnosis and making screening recommendations for families with CM-AVM. PMID:27625812

RASA1 analysis guides management in a family with capillary malformation-arteriovenous malformation.

PubMed

Flore, Leigh Anne; Leon, Eyby; Maher, Tom A; Milunsky, Jeff M

2012-06-01

Capillary malformation-arteriovenous malformation (CM-AVM; MIM 60354) is an autosomal dominant disorder characterized by multifocal cutaneous capillary malformations, often in association with fast-flow vascular lesions, which may be cutaneous, subcutaneous, intramuscular, intraosseus, or cerebral arteriovenous malformations or arteriovenous fistulas. CM-AVM results from heterozygous mutations in the RASA1 gene. Capillary malformations of the skin are common, and clinical examination alone may not be able to definitively diagnose-or exclude- CM-AVM. We report a family in which the proband was initially referred for a genetic evaluation in the neonatal period because of the presence of a cardiac murmur and minor dysmorphic features. Both he and his mother were noted to have multiple capillary malformations on the face, head, and extremities. Echocardiography revealed dilated head and neck vessels and magnetic resonance imaging and angiography of the brain revealed a large infratentorial arteriovenous fistula, for which he has had two embolization procedures. RASA1 sequence analysis revealed a heterozygous mutation, confirming his diagnosis of CM-AVM. We established targeted mutation analysis for the proband's mother and sister, the latter of whom is a healthy 3-year-old whose only cutaneous finding is a facial capillary malformation. This revealed that the proband's mother is also heterozygous for the RASA1 mutation, but his sister is negative. Consequently, his mother will undergo magnetic resonance imaging and angiography screening for intracranial and spinal fast-flow lesions, while his sister will require no imaging or serial evaluations. Targeted mutation analysis has been offered to additional maternal family members. This case illustrates the benefit of molecular testing in diagnosis and making screening recommendations for families with CM-AVM.

A quantitative evaluation of the public response to climate engineering

NASA Astrophysics Data System (ADS)

Wright, Malcolm J.; Teagle, Damon A. H.; Feetham, Pamela M.

2014-02-01

Atmospheric greenhouse gas concentrations continue to increase, with CO2 passing 400 parts per million in May 2013. To avoid severe climate change and the attendant economic and social dislocation, existing energy efficiency and emissions control initiatives may need support from some form of climate engineering. As climate engineering will be controversial, there is a pressing need to inform the public and understand their concerns before policy decisions are taken. So far, engagement has been exploratory, small-scale or technique-specific. We depart from past research to draw on the associative methods used by corporations to evaluate brands. A systematic, quantitative and comparative approach for evaluating public reaction to climate engineering is developed. Its application reveals that the overall public evaluation of climate engineering is negative. Where there are positive associations they favour carbon dioxide removal (CDR) over solar radiation management (SRM) techniques. Therefore, as SRM techniques become more widely known they are more likely to elicit negative reactions. Two climate engineering techniques, enhanced weathering and cloud brightening, have indistinct concept images and so are less likely to draw public attention than other CDR or SRM techniques.

Evaluation of Radiation-induced Class V Dental Caries in Patients with Head and Neck Cancers Undergoing Radiotherapy.

PubMed

Mohammadi, Narmin; Seyednejad, Farshad; Oskoee, Parnian Alizadeh; Savadi Oskoee, Siavash; Ebrahimi Chaharom, Mohammad Esmaeil

2008-01-01

Salivary glands are very susceptible to radiation and any disturbances in their function are detrimental to the hard tissues in the oral cavity. The aim of this study was to evaluate posterior class V dental caries in patients with head and neck cancers undergoing radiotherapy. In this study, twenty seven patients undergoing conventional radiotherapy were included. Class V dental caries of posterior teeth in these patients were evaluated in three intervals: before treatment, 3 weeks after the initiation of the treatment, and at the end of the treatment. Differences of mean caries activity between intervals were evaluated using paired sample t-test. There were no class V decays prior to radiotherapy. Mean percentage of class V caries three weeks after radiotherapy and at the end of radiotherapy were 28.42% ± 14.41 and 67.05% ± 19.02, respectively. There were statistically signifi-cant differences in mean values among three stages (P = 0.00025). The results of the present study re-vealed that radiotherapy in patients with head and neck cancers causes class V dental caries on posteri-or teeth.

Metformin-induced lactic acidosis: a case series.

PubMed

Silvestre, Joana; Carvalho, Susana; Mendes, Vitor; Coelho, Luis; Tapadinhas, Camila; Ferreira, Pedro; Povoa, Pedro; Ceia, Fatima

2007-10-31

Unlike other agents used in the treatment of type 2 diabetes mellitus, metformin has been shown to reduce mortality in obese patients. It is therefore being increasingly used in higher doses. The major concern of many physicians is a possible risk of lactic acidosis. The reported frequency of metformin related lactic acidosis is 0.05 per 1000 patient-years; some authors advocate that this rate is equal in those patients not taking metformin. We present two case reports of metformin-associated lactic acidosis. The first case is a 77 year old female with a past medical history of hypertension and type 2 diabetes mellitus who had recently been prescribed metformin (3 g/day), perindopril and acetylsalicylic acid. She was admitted to the emergency department two weeks later with abdominal pain and psychomotor agitation. Physical examination revealed only signs of poor perfusion. Laboratory evaluation revealed hyperkalemia, elevated creatinine and blood urea nitrogen and mild leukocytosis. Arterial blood gases showed severe lactic acidemia. She was admitted to the intensive care unit. Vasopressor and ventilatory support was initiated and continuous venovenous hemodiafiltration was instituted. Twenty-four hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the sixth day. The second patient is a 69 year old male with a past medical history of hypertension, type 2 diabetes mellitus and ischemic heart disease who was on metformin (4 g/day), glycazide, acetylsalicylic acid and isosorbide dinitrate. He was admitted to the emergency department in shock with extreme bradycardia. Initial evaluation revealed severe lactic acidosis and elevated creatinine and urea. The patient was admitted to the Intensive Care Unit and commenced on continuous venovenous hemodiafiltration in addition to other supportive measures. A progressive recovery was observed and he was discharged from the intensive care unit on the seventh day. We present two case reports of severe lactic acidosis most probably associated with high doses of metformin in patients with no known contraindications for metformin prescription. In both patients no other condition was identified to cause such severe lactic acidosis. Although controversial, lactic acidosis should be considered in patients taking metformin.

[Method for the evaluation of the stability and usability after opening packages of orally disintegrating tablets: case of amlodipine besilate products].

PubMed

Hori, Katsuhito; Yoshida, Naoko; Okumura, Tomonori; Okamura, Yasufumi; Kawakami, Junichi

2010-08-01

Orally disintegrating (OD) tablets are widely used in clinical practice. However, drug information on the choice and dispensing based on their stability after opening packages and usability in patients and dispensaries is not sufficient. The aim of this study was to investigate possible evaluation methods of the stability and usability of amlodipine OD tablets. Additives of the brand were changed in April 2009, and therefore the previous and current forms and two generics, current and newly marketed (in November 2009) products of different firms, were used. OD tablets were stored at 25 degrees C and 75% relative humidity for 3 months after opening the packages, and their physicochemical properties were evaluated. Their weight, diameter, thickness, and color difference increased slightly from the initial state. The extent of the change in their hardness, disintegration time, and friability was different among products. These physicochemical changes were acceptable in dispensary practice. Storage after opening the packages did not affect their dissolution rate. The dissolution rate at the initial state of the current brand was slower than that of the previous one. All products used were able to be dispensed by an automatic tablet-packing machine and applied to the so-called simple suspension method for intubational administration. Sensory evaluation tests revealed no major difference in the oral disintegration time, taste, impression, and preference among products. In conclusion, the stability and usability of amlodipine OD tablets used in this study were examined using several methods, and they can be used equivalently from the stability and usability viewpoints.

Malformations of cortical development: clinical spectrum in a series of 101 patients and review of the literature (Part I).

PubMed

Güngör, Serdal; Yalnizoğlu, Dilek; Turanli, Güzide; Saatçi, Işil; Erdoğan-Bakar, Emel; Topçu, Meral

2007-01-01

Patients with malformations of cortical development (MCD) present with a wide spectrum of clinical manifestations ranging from asymptomatic cases to those with epilepsy and neurodevelopmental problems. Thorough clinical delineation of patients with MCD may provide clues for future phenotype-genotype correlation studies. We studied clinical features of patients with MCD, including developmental risk factors and family history. We evaluated 10 patients with MCD at Hacettepe University Children's Hospital, Department of Pediatric Neurology. All patients underwent neurological evaluation with detailed medical and family history, and neuropsychological evaluation. Routine EEG and MRI were obtained. The patients were between 1 month and 19 years of age (mean: 6.1 +/- 4.4 years). Fifty-four patients were diagnosed with polymicrogyria (PMG), 23 patients with lissencephaly, 12 patients with schizencephaly, and 12 patients with heterotopia. Parents were relatives in 31.7% of the cases; consanguinity was most common in patients with lissencephaly and other MCDs with diffuse/bilateral involvement. Initial clinical presentation was seizures in 61.4% of the cases, developmental delays in 12.9%, and microcephaly in 9.9%. Neurological evaluation revealed most severe abnormalities in patients with lissencephaly, and relatively better outcome in patients with heterotopias. Cognitive functions were better in patients with heterotopias compared to other groups. Overall, 71.3% of patients ha epilepsy. In conclusion, initial presentation and clinical course of patients with MCD are variable and seem to be correlated with the extent of cortical involvement. Epilepsy and mental retardation are the most common problems. The most severe clinical outcome was seen in patients with lissencephaly.

Benefits of cardiac sonography performed by a non-expert sonographer in patients with non-traumatic cardiopulmonary arrest.

PubMed

Zengin, Suat; Yavuz, Erdal; Al, Behçet; Cindoruk, Şener; Altunbaş, Gökhan; Gümüşboğa, Hasan; Yıldırım, Cuma

2016-05-01

The purpose of this study was to evaluate a rapid cardiac ultrasound assessment performed by trained non-expert sonographers integrated into the advanced cardiac life support (ACLS). This study was prospectively performed in 179 patients (104 males and 75 females) who underwent cardiopulmonary resuscitation (CPR) in an emergency department (ED) during two calendar years (2013 and 2014). Two senior doctors, who had received emergency cardiac ultrasonography training, performed cardiac ultrasound through the apical, subxiphoid, or parasternal windows. Ultrasound evaluation and pulse controls were performed simultaneously. SPSS 18.0 was used for statistical analysis. A total of 63.7% (114) of the cardiopulmonary arrest incidents occurred out of the hospital. Only 13 patients had a femoral pulse during the initial evaluation, while 166 showed no femoral pulse. Initial monitoring showed a regular rhythm in 53 patients, ventricular fibrillation in 18 patients, and no rhythms in 108 patients. The first evaluation with ultrasound detected an effective heart rate in 26 patients and ventricular fibrillation in 14 patients, while no effective heart rate was observed in 139 patients. In addition, ultrasound revealed pericardial tamponade in seven patients and right ventricular enlargement in four cases. Global hypokinesia was detected in four patients and hypovolemia was observed in another four patients. The use of real-time ultrasonography during resuscitation with real-time femoral pulse check can help facilitate the distinguishing of pea-type arrest, ascertain the cause of the arrest, infer a suitable treatment, and optimize medical management decisions regarding CPR termination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Transcription closed and open complex dynamics studies reveal balance between genetic determinants and co-factors

NASA Astrophysics Data System (ADS)

Sala, Adrien; Shoaib, Muhammad; Anufrieva, Olga; Mutharasu, Gnanavel; Jahan Hoque, Rawnak; Yli-Harja, Olli; Kandhavelu, Meenakshisundaram

2015-05-01

In E. coli, promoter closed and open complexes are key steps in transcription initiation, where magnesium-dependent RNA polymerase catalyzes RNA synthesis. However, the exact mechanism of initiation remains to be fully elucidated. Here, using single mRNA detection and dual reporter studies, we show that increased intracellular magnesium concentration affects Plac initiation complex formation resulting in a highly dynamic process over the cell growth phases. Mg2+ regulates transcription transition, which modulates bimodality of mRNA distribution in the exponential phase. We reveal that Mg2+ regulates the size and frequency of the mRNA burst by changing the open complex duration. Moreover, increasing magnesium concentration leads to higher intrinsic and extrinsic noise in the exponential phase. RNAP-Mg2+ interaction simulation reveals critical movements creating a shorter contact distance between aspartic acid residues and Nucleotide Triphosphate residues and increasing electrostatic charges in the active site. Our findings provide unique biophysical insights into the balanced mechanism of genetic determinants and magnesium ion in transcription initiation regulation during cell growth.

Developing the protocol for the evaluation of the health foundation's 'engaging with quality initiative' – an emergent approach

PubMed Central

Soper, Bryony; Buxton, Martin; Hanney, Stephen; Oortwijn, Wija; Scoggins, Amanda; Steel, Nick; Ling, Tom

2008-01-01

In 2004 a UK charity, The Health Foundation, established the 'Engaging with Quality Initiative' to explore and evaluate the benefits of engaging clinicians in quality improvement in healthcare. Eight projects run by professional bodies or specialist societies were commissioned in various areas of acute care. A developmental approach to the initiative was adopted, accompanied by a two level evaluation: eight project self-evaluations and a related external evaluation. This paper describes how the protocol for the external evaluation was developed. The challenges faced included large variation between and within the projects (in approach, scope and context, and in understanding of quality improvement), the need to support the project teams in their self-evaluations while retaining a necessary objectivity, and the difficulty of evaluating the moving target created by the developmental approach adopted in the initiative. An initial period to develop the evaluation protocol proved invaluable in helping us to explore these issues. PMID:18973650

Process relevant screening of cellulolytic organisms for consolidated bioprocessing.

PubMed

Antonov, Elena; Schlembach, Ivan; Regestein, Lars; Rosenbaum, Miriam A; Büchs, Jochen

2017-01-01

Although the biocatalytic conversion of cellulosic biomass could replace fossil oil for the production of various compounds, it is often not economically viable due to the high costs of cellulolytic enzymes. One possibility to reduce costs is consolidated bioprocessing (CBP), integrating cellulase production, hydrolysis of cellulose, and the fermentation of the released sugars to the desired product into one process step. To establish such a process, the most suitable cellulase-producing organism has to be identified. Thereby, it is crucial to evaluate the candidates under target process conditions. In this work, the chosen model process was the conversion of cellulose to the platform chemical itaconic acid by a mixed culture of a cellulolytic fungus with Aspergillus terreus as itaconic acid producer. Various cellulase producers were analyzed by the introduced freeze assay that measures the initial carbon release rate, quantifying initial cellulase activity under target process conditions. Promising candidates were then characterized online by monitoring their respiration activity metabolizing cellulose to assess the growth and enzyme production dynamics. The screening of five different cellulase producers with the freeze assay identified Trichoderma   reesei and Penicillium   verruculosum as most promising. The measurement of the respiration activity revealed a retarded induction of cellulase production for P.   verruculosum but a similar cellulase production rate afterwards, compared to T.   reesei . The freeze assay measurement depicted that P.   verruculosum reaches the highest initial carbon release rate among all investigated cellulase producers. After a modification of the cultivation procedure, these results were confirmed by the respiration activity measurement. To compare both methods, a correlation between the measured respiration activity and the initial carbon release rate of the freeze assay was introduced. The analysis revealed that the different initial enzyme/cellulose ratios as well as a discrepancy in cellulose digestibility are the main differences between the two approaches. With two complementary methods to quantify cellulase activity and the dynamics of cellulase production for CBP applications, T.   reesei and P.   verruculosum were identified as compatible candidates for the chosen model process. The presented methods can easily be adapted to screen for suitable cellulose degrading organisms for various other applications.

Effects of chronic restraint stress on body weight, food intake, and hypothalamic gene expressions in mice.

PubMed

Jeong, Joo Yeon; Lee, Dong Hoon; Kang, Sang Soo

2013-12-01

Stress affects body weight and food intake, but the underlying mechanisms are not well understood. We evaluated the changes in body weight and food intake of ICR male mice subjected to daily 2 hours restraint stress for 15 days. Hypothalamic gene expression profiling was analyzed by cDNA microarray. Daily body weight and food intake measurements revealed that both parameters decreased rapidly after initiating daily restraint stress. Body weights of stressed mice then remained significantly lower than the control body weights, even though food intake slowly recovered to 90% of the control intake at the end of the experiment. cDNA microarray analysis revealed that chronic restraint stress affects the expression of hypothalamic genes possibly related to body weight control. Since decreases of daily food intake and body weight were remarkable in days 1 to 4 of restraint, we examined the expression of food intake-related genes in the hypothalamus. During these periods, the expressions of ghrelin and pro-opiomelanocortin mRNA were significantly changed in mice undergoing restraint stress. Moreover, daily serum corticosterone levels gradually increased, while leptin levels significantly decreased. The present study demonstrates that restraint stress affects body weight and food intake by initially modifying canonical food intake-related genes and then later modifying other genes involved in energy metabolism. These genetic changes appear to be mediated, at least in part, by corticosterone.

Secondary traumatization in parents following the disclosure of extrafamilial child sexual abuse: initial effects.

PubMed

Manion, I G; McIntyre, J; Firestone, P; Ligezinska, M; Ensom, R; Wells, G

1996-11-01

Disclosure or discovery of extrafamilial sexual abuse (ESA) has the potential to traumatize the entire family system. Little controlled research has examined the initial reactions of parents to this type of trauma. The present study evaluated the adjustment of 93 parents (63 mothers and 30 fathers) within 3 months of the disclosure of ESA. Parents' functioning was compared to that of a nonclinical comparison group of 136 parents (74 mothers, 62 fathers). Parent adjustment was assessed using self-report measures of psychological distress, parent competence, family functioning, marital functioning, life stressors, and environmental support. Results revealed that mothers of sexually abused children, in comparison to mothers of nonabused children, experienced greater overall emotional distress, poorer family functioning, and lower satisfaction in their parenting role. Fathers of sexually abused children also experienced greater overall emotional distress relative to comparison fathers but their level of distress remained below that of mothers. Standard and hierarchical multiple regressions on maternal self-reports revealed that mothers' satisfaction with their parenting role and their perceived level of environmental support predicted their emotional functioning. Abuse-related variables did not contribute to the prediction of emotional functioning. These results emphasize the need to expand our focus beyond the child victims to the traumatized families and to normalize the potential for all close family members to be vulnerable to experience adjustment difficulties following ESA.

Batch versus column modes for the adsorption of radioactive metal onto rice husk waste: conditions optimization through response surface methodology.

PubMed

Kausar, Abida; Bhatti, Haq Nawaz; Iqbal, Munawar; Ashraf, Aisha

2017-09-01

Batch and column adsorption modes were compared for the adsorption of U(VI) ions using rice husk waste biomass (RHWB). Response surface methodology was employed for the optimization of process variables, i.e., (pH (A), adsorbent dose (B), initial ion concentration (C)) in batch mode. The B, C and C 2 affected the U(VI) adsorption significantly in batch mode. The developed quadratic model was found to be validated on the basis of regression coefficient as well as analysis of variance. The predicted and actual values were found to be correlated well, with negligible residual value, and B, C and C 2 were significant terms. The column study was performed considering bed height, flow rate and initial metal ion concentration, and adsorption efficiency was evaluated through breakthrough curves and bed depth service time and Thomas models. Adsorption was found to be dependent on bed height and initial U(VI) ion concentration, and flow rate decreased the adsorption capacity. Thomas models fitted well to the U(VI) adsorption onto RHWB. Results revealed that RHWB has potential to remove U(VI) ions and batch adsorption was found to be efficient versus column mode.

Agent-based model of angiogenesis simulates capillary sprout initiation in multicellular networks

PubMed Central

Walpole, J.; Chappell, J.C.; Cluceru, J.G.; Mac Gabhann, F.; Bautch, V.L.; Peirce, S. M.

2015-01-01

Many biological processes are controlled by both deterministic and stochastic influences. However, efforts to model these systems often rely on either purely stochastic or purely rule-based methods. To better understand the balance between stochasticity and determinism in biological processes a computational approach that incorporates both influences may afford additional insight into underlying biological mechanisms that give rise to emergent system properties. We apply a combined approach to the simulation and study of angiogenesis, the growth of new blood vessels from existing networks. This complex multicellular process begins with selection of an initiating endothelial cell, or tip cell, which sprouts from the parent vessels in response to stimulation by exogenous cues. We have constructed an agent-based model of sprouting angiogenesis to evaluate endothelial cell sprout initiation frequency and location, and we have experimentally validated it using high-resolution time-lapse confocal microscopy. ABM simulations were then compared to a Monte Carlo model, revealing that purely stochastic simulations could not generate sprout locations as accurately as the rule-informed agent-based model. These findings support the use of rule-based approaches for modeling the complex mechanisms underlying sprouting angiogenesis over purely stochastic methods. PMID:26158406

Agent-based model of angiogenesis simulates capillary sprout initiation in multicellular networks.

PubMed

Walpole, J; Chappell, J C; Cluceru, J G; Mac Gabhann, F; Bautch, V L; Peirce, S M

2015-09-01

Many biological processes are controlled by both deterministic and stochastic influences. However, efforts to model these systems often rely on either purely stochastic or purely rule-based methods. To better understand the balance between stochasticity and determinism in biological processes a computational approach that incorporates both influences may afford additional insight into underlying biological mechanisms that give rise to emergent system properties. We apply a combined approach to the simulation and study of angiogenesis, the growth of new blood vessels from existing networks. This complex multicellular process begins with selection of an initiating endothelial cell, or tip cell, which sprouts from the parent vessels in response to stimulation by exogenous cues. We have constructed an agent-based model of sprouting angiogenesis to evaluate endothelial cell sprout initiation frequency and location, and we have experimentally validated it using high-resolution time-lapse confocal microscopy. ABM simulations were then compared to a Monte Carlo model, revealing that purely stochastic simulations could not generate sprout locations as accurately as the rule-informed agent-based model. These findings support the use of rule-based approaches for modeling the complex mechanisms underlying sprouting angiogenesis over purely stochastic methods.

A frequency-domain approach to improve ANNs generalization quality via proper initialization.

PubMed

Chaari, Majdi; Fekih, Afef; Seibi, Abdennour C; Hmida, Jalel Ben

2018-08-01

The ability to train a network without memorizing the input/output data, thereby allowing a good predictive performance when applied to unseen data, is paramount in ANN applications. In this paper, we propose a frequency-domain approach to evaluate the network initialization in terms of quality of training, i.e., generalization capabilities. As an alternative to the conventional time-domain methods, the proposed approach eliminates the approximate nature of network validation using an excess of unseen data. The benefits of the proposed approach are demonstrated using two numerical examples, where two trained networks performed similarly on the training and the validation data sets, yet they revealed a significant difference in prediction accuracy when tested using a different data set. This observation is of utmost importance in modeling applications requiring a high degree of accuracy. The efficiency of the proposed approach is further demonstrated on a real-world problem, where unlike other initialization methods, a more conclusive assessment of generalization is achieved. On the practical front, subtle methodological and implementational facets are addressed to ensure reproducibility and pinpoint the limitations of the proposed approach. Copyright © 2018 Elsevier Ltd. All rights reserved.

The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging.

PubMed

Šifrer, Robert; Urbančič, Jure; Strojan, Primož; Aničin, Aleksandar; Žargi, Miha

2017-07-01

The diagnostic gain of narrow band imaging in the definition of surgical margins in the treatment of head and neck cancer was evaluated. A prospective study, blinded to the pathologist, with historical comparison. The study group included 45 patients subjected to the intraoperative definition of margins by narrow band imaging. The control group included 55 patients who had undergone standard definition of margins. All patients underwent resection of the tumor and frozen section analysis of superficial margins. The rate of initial R 0 resection and the ratio of histologically negative margins for both groups were statistically compared. The rate of initial R 0 resection in the study group and in the control group was 88.9% and 70.9% (P = .047), and the ratio of histologically negative margins was 95.9% and 88.4% (P = .017), respectively. Narrow band imaging reveals a microscopic extension of the tumor that could be effectively used to better define superficial margins and to achieve a higher rate of initial R 0 resections. 4 Laryngoscope, 127:1577-1582, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Are mastery and ability goals both adaptive? Evaluation, initial goal construction and the quality of task engagement.

PubMed

Butler, Ruth

2006-09-01

The aims of this research were to examine the predictions that (a) the kind of evaluation pupils anticipate will influence their initial achievement goals and, as a result, the quality and consequences of task engagement; and (b) initial mastery goals will promote new learning and intrinsic motivation and initial ability goals will promote entity beliefs that ability is fixed. Participants were 312 secondary school pupils at ages 13-15. Pupils expected to receive normative evaluation, temporal evaluation (scores over time) or no evaluation. Mastery and ability goals were measured before pupils worked on challenging problems; intrinsic motivation and entity beliefs were measured after task completion. Anticipation of temporal evaluation enhanced initial mastery goals, anticipation of normative evaluation enhanced ability goals and the no-evaluation condition undermined both. Anticipation of temporal evaluation enhanced new learning (strategy acquisition and performance gains) and intrinsic motivation both directly and by enhancing initial mastery goals; anticipation of normative evaluation enhanced entity beliefs by enhancing ability goals. Results confirmed that evaluation conveys potent cues as to the goals of activity. They also challenged claims that both mastery and ability goals can be adaptive by demonstrating that these were differentially associated with positive versus negative processes and outcomes. Results have theoretical and applied implications for understanding and improving evaluative practices and student motivation.

Evaluating a community-based program to improve healthcare quality: research design for the Aligning Forces for Quality initiative.

PubMed

Scanlon, Dennis P; Alexander, Jeffrey A; Beich, Jeff; Christianson, Jon B; Hasnain-Wynia, Romana; McHugh, Megan C; Mittler, Jessica N; Shi, Yunfeng; Bodenschatz, Laura J

2012-09-01

The Aligning Forces for Quality (AF4Q) initiative is the Robert Wood Johnson Foundation's (RWJF's) signature effort to increase the overall quality of healthcare in targeted communities throughout the country. In addition to sponsoring this 16-site, complex program, the RWJF funds an independent scientific evaluation to support objective research on the initiative's effectiveness and contributions to basic knowledge in 5 core programmatic areas. The research design, data, and challenges faced in the evaluation of this 10-year initiative are discussed. A descriptive overview of the evaluation research design for a multi-site, community based, healthcare quality improvement initiative is provided. The multiphase research design employed by the evaluation team is discussed. Evaluation provides formative feedback to the RWJF, participants, and other interested audiences in real time; develops approaches to assess innovative and under-studied interventions; furthers the analysis and understanding of effective community-based collaborative work in healthcare; and helps to differentiate the various facilitators, barriers, and contextual dimensions that affect the implementation and outcomes of community-based health interventions. The AF4Q initiative is arguably the largest community-level healthcare improvement demonstration in the United States to date; it is being implemented at a time of rapid change in national healthcare policy. The implementation of large-scale, multi-site initiatives is becoming an increasingly common approach for addressing problems in healthcare. The evaluation research design for the AF4Q initiative, and the lessons learned from its approach, may be valuable to others tasked with evaluating similar community-based initiatives.

Effect of the human chorionic gonadotropin diet on patient outcomes.

PubMed

Goodbar, Nancy H; Foushee, Jaime A; Eagerton, David H; Haynes, Katie B; Johnson, Amanda A

2013-05-01

To report a case of left lower extremity deep vein thrombosis (DVT) and bilateral pulmonary embolisms in a patient who initiated the human chorionic gonadotropin (HCG) diet 2 weeks prior to presentation. A 64-year-old white female presented with leg swelling and shortness of breath. Lower extremity ultrasound revealed left leg DVT, and a computed tomography angiogram revealed bilateral pulmonary embolisms. A complete history and physical examination were unremarkable for any risk factors for acute thrombosis, with the exception of the initiation of the HCG diet approximately 2 weeks prior to presentation; the patient was taking 20 sublingual drops of HCG twice daily. Results of her hypercoagulable workup were negative. Upon admission, therapy was started with enoxaparin 120 mg subcutaneously twice daily and warfarin 5 mg orally once daily. According to the Naranjo probability scale, initiation of the HCG diet was a probable cause of our patient's adverse effects. The HCG diet has very few efficacy studies and no significant safety studies associated with its use. Six relevant studies were identified for assessment of efficacy, and only 1 was associated with a significant weight reduction in the HCG diet study population. All of these studies evaluated the use of the HCG diet via injections of the hormone and significant calorie restriction, which is known as the Simeons method. Currently marketed HCG products include sublingual drops, lozenges, and pellets, but none of these methods has an evidence-based efficacy and safety standard. As popularity of the HCG diet continues to increase, so do the potential adverse events associated with the management of weight loss via an unproven strategy. Patient safety information regarding this dieting strategy should be recognized by medical professionals.

Microbiological changes, shelf life and identification of initial and spoilage microbiota of sea bream fillets stored under various conditions using 16S rRNA gene analysis.

PubMed

Parlapani, Foteini F; Kormas, Konstantinos Ar; Boziaris, Ioannis S

2015-09-01

Sea bream fillets are one of the most important value-added products of the seafood market. Fresh seafood spoils mainly owing to bacterial action. In this study an exploration of initial and spoilage microbiota of sea bream fillets stored under air and commercial modified atmosphere packaging (MAP) at 0 and 5 °C was conducted by 16S rRNA gene sequence analysis of isolates grown on plates. Sensory evaluation and enumeration of total viable counts and spoilage microorganisms were also conducted to determine shelf life and bacterial growth respectively. Different temperatures and atmospheres affected growth and synthesis of spoilage microbiota as well as shelf life. Shelf life under air at 0 and 5 °C was 14 and 5 days respectively, while under MAP it was 20 and 8 days respectively. Initial microbiota were dominated by Pseudomonas fluorescens, Psychrobacter and Macrococcus caseolyticus. Different temperatures and atmospheres affected the synthesis of spoilage microbiota. At the end of shelf life, different phylotypes of Pseudomonas closely related to Pseudomonas fragi were found to dominate in most cases, while Pseudomonas veronii dominated in fillets under MAP at 0 °C. Furthermore, in fillets under MAP at 5 °C, new dominant species such as Carnobacterium maltaromaticum, Carnobacterium divergens and Vagococcus fluvialis were revealed. Different temperature and atmospheric conditions affected bacterial growth, shelf life and the synthesis of spoilage microbiota. Molecular identification revealed species and strains of microorganisms that have not been reported before for sea bream fillets stored under various conditions, thus providing valuable information regarding microbiological spoilage. © 2014 Society of Chemical Industry.

Biosorption of Cr(VI) by Ceratocystis paradoxa MSR2 Using Isotherm Modelling, Kinetic Study and Optimization of Batch Parameters Using Response Surface Methodology

PubMed Central

Ramalingam, Chidambaram

2015-01-01

This study is focused on the possible use of Ceratocystis paradoxa MSR2 native biomass for Cr(VI) biosorption. The influence of experimental parameters such as initial pH, temperature, biomass dosage, initial Cr(VI) concentration and contact time were optimized using batch systems as well as response surface methodology (RSM). Maximum Cr(VI) removal of 68.72% was achieved, at an optimal condition of biomass dosage 2g L−1, initial Cr(VI) concentration of 62.5 mg L−1 and contact time of 60 min. The closeness of the experimental and the predicted values exhibit the success of RSM. The biosorption mechanism of MSR2 biosorbent was well described by Langmuir isotherm and a pseudo second order kinetic model, with a high regression coefficient. The thermodynamic study also revealed the spontaneity and exothermic nature of the process. The surface characterization using FT-IR analysis revealed the involvement of amine, carbonyl and carboxyl groups in the biosorption process. Additionally, desorption efficiency of 92% was found with 0.1 M HNO3. The Cr(VI) removal efficiency, increased with increase in metal ion concentration, biomass concentration, temperature but with a decrease in pH. The size of the MSR2 biosorbent material was found to be 80 μm using particle size analyzer. Atomic force microscopy (AFM) visualizes the distribution of Cr(VI) on the biosorbent binding sites with alterations in the MSR2 surface structure. The SEM-EDAX analysis was also used to evaluate the binding characteristics of MSR2 strain with Cr(VI) metals. The mechanism of Cr(VI) removal of MSR2 biomass has also been proposed. PMID:25822726

Effect of Squareness of Initial γ' Precipitates on Creep-Rupture Life of a Ni-Base Single Crystal Superalloy at 760/982 °C

NASA Astrophysics Data System (ADS)

Shi, Zhenbin; Peng, Zhifang; Luo, Yushi; Xie, Hongji; Jin, Haipeng; Zhao, Yunsong; Mei, Qingsong

2018-05-01

An approach to determination of squareness of initial γ' precipitates (S 2D) is proposed to evaluate its effect on creep-rupture life (t r) of nickel-base single crystal (SC) superalloys. It is found that the 760/982 °C rupture life varied with the change in regional S 2D caused by redistribution of W when 1st-step aging temperature changed in full heat treatment on superalloy DD83 investigated. The longest creep-rupture life occurred at the highest value/the lowest difference in S 2D in the interdendritic regions/between the typical dendritic regions in DD83. It is also found that S 2D is a weighted function of the area fraction (F 2D), spacing (h), and size (d) of γ' precipitates and is closely related to t r in a series of SC superalloys. In addition, the variation of S 2D with F 2D (here, thermodynamic mole fraction is approximately expressed by F 2D) through lattice misfit (δ) in the SC superalloys with F 2D ranging from 60 to 75 pct is well correlated. Therefore, to reveal and to better understand these relationships and correlations may help to optimize the phase variables in order to achieve a long rupture life of SC superalloys. In addition, functions to reveal the interrelationships of F 2D, volume fraction (F 3D), S 2D, and cuboidness (S 3D) of initial γ' precipitates are derived considering their shape changes. All of these are hoped to be helpful in practical applications and in understanding the true meaning of the related variables.

Fully automatic detection of salient features in 3-d transesophageal images.

PubMed

Curiale, Ariel H; Haak, Alexander; Vegas-Sánchez-Ferrero, Gonzalo; Ren, Ben; Aja-Fernández, Santiago; Bosch, Johan G

2014-12-01

Most automated segmentation approaches to the mitral valve and left ventricle in 3-D echocardiography require a manual initialization. In this article, we propose a fully automatic scheme to initialize a multicavity segmentation approach in 3-D transesophageal echocardiography by detecting the left ventricle long axis, the mitral valve and the aortic valve location. Our approach uses a probabilistic and structural tissue classification to find structures such as the mitral and aortic valves; the Hough transform for circles to find the center of the left ventricle; and multidimensional dynamic programming to find the best position for the left ventricle long axis. For accuracy and agreement assessment, the proposed method was evaluated in 19 patients with respect to manual landmarks and as initialization of a multicavity segmentation approach for the left ventricle, the right ventricle, the left atrium, the right atrium and the aorta. The segmentation results revealed no statistically significant differences between manual and automated initialization in a paired t-test (p > 0.05). Additionally, small biases between manual and automated initialization were detected in the Bland-Altman analysis (bias, variance) for the left ventricle (-0.04, 0.10); right ventricle (-0.07, 0.18); left atrium (-0.01, 0.03); right atrium (-0.04, 0.13); and aorta (-0.05, 0.14). These results indicate that the proposed approach provides robust and accurate detection to initialize a multicavity segmentation approach without any user interaction. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Attenuation-emission alignment in cardiac PET∕CT based on consistency conditions

PubMed Central

Alessio, Adam M.; Kinahan, Paul E.; Champley, Kyle M.; Caldwell, James H.

2010-01-01

Purpose: In cardiac PET and PET∕CT imaging, misaligned transmission and emission images are a common problem due to respiratory and cardiac motion. This misalignment leads to erroneous attenuation correction and can cause errors in perfusion mapping and quantification. This study develops and tests a method for automated alignment of attenuation and emission data. Methods: The CT-based attenuation map is iteratively transformed until the attenuation corrected emission data minimize an objective function based on the Radon consistency conditions. The alignment process is derived from previous work by Welch et al. [“Attenuation correction in PET using consistency information,” IEEE Trans. Nucl. Sci. 45, 3134–3141 (1998)] for stand-alone PET imaging. The process was evaluated with the simulated data and measured patient data from multiple cardiac ammonia PET∕CT exams. The alignment procedure was applied to simulations of five different noise levels with three different initial attenuation maps. For the measured patient data, the alignment procedure was applied to eight attenuation-emission combinations with initially acceptable alignment and eight combinations with unacceptable alignment. The initially acceptable alignment studies were forced out of alignment a known amount and quantitatively evaluated for alignment and perfusion accuracy. The initially unacceptable studies were compared to the proposed aligned images in a blinded side-by-side review. Results: The proposed automatic alignment procedure reduced errors in the simulated data and iteratively approaches global minimum solutions with the patient data. In simulations, the alignment procedure reduced the root mean square error to less than 5 mm and reduces the axial translation error to less than 1 mm. In patient studies, the procedure reduced the translation error by >50% and resolved perfusion artifacts after a known misalignment for the eight initially acceptable patient combinations. The side-by-side review of the proposed aligned attenuation-emission maps and initially misaligned attenuation-emission maps revealed that reviewers preferred the proposed aligned maps in all cases, except one inconclusive case. Conclusions: The proposed alignment procedure offers an automatic method to reduce attenuation correction artifacts in cardiac PET∕CT and provides a viable supplement to subjective manual realignment tools. PMID:20384256

Minimally displaced clavicle fracture after high-energy injury: are they likely to displace?

PubMed

Riehl, John T; Athans, Bill J; Munro, Mark W; Langford, Joshua R; Kupiszewski, Stanley J; Haidukewych, George J; Koval, Kenneth J

2014-06-01

Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury.

Minimally displaced clavicle fracture after high-energy injury: Are they likely to displace?

PubMed Central

Riehl, John T.; Athans, Bill J.; Munro, Mark W.; Langford, Joshua R.; Kupiszewski, Stanley J.; Haidukewych, George J.; Koval, Kenneth J.

2014-01-01

Background Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. Methods We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Results Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Conclusion Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. PMID:24869608

Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates

PubMed Central

Israel, Tania; Willging, Cathleen; Ley, David

2016-01-01

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self-administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and post-test scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people. PMID:27516816

Iterative integral parameter identification of a respiratory mechanics model.

PubMed

Schranz, Christoph; Docherty, Paul D; Chiew, Yeong Shiong; Möller, Knut; Chase, J Geoffrey

2012-07-18

Patient-specific respiratory mechanics models can support the evaluation of optimal lung protective ventilator settings during ventilation therapy. Clinical application requires that the individual's model parameter values must be identified with information available at the bedside. Multiple linear regression or gradient-based parameter identification methods are highly sensitive to noise and initial parameter estimates. Thus, they are difficult to apply at the bedside to support therapeutic decisions. An iterative integral parameter identification method is applied to a second order respiratory mechanics model. The method is compared to the commonly used regression methods and error-mapping approaches using simulated and clinical data. The clinical potential of the method was evaluated on data from 13 Acute Respiratory Distress Syndrome (ARDS) patients. The iterative integral method converged to error minima 350 times faster than the Simplex Search Method using simulation data sets and 50 times faster using clinical data sets. Established regression methods reported erroneous results due to sensitivity to noise. In contrast, the iterative integral method was effective independent of initial parameter estimations, and converged successfully in each case tested. These investigations reveal that the iterative integral method is beneficial with respect to computing time, operator independence and robustness, and thus applicable at the bedside for this clinical application.

Evaluation of carbon-based nanosorbents synthesised by ethylene decomposition on stainless steel substrates as potential sequestrating materials for nickel ions in aqueous solution.

PubMed

Lee, X J; Lee, L Y; Foo, L P Y; Tan, K W; Hassell, D G

2012-01-01

The present work covers the preparation of carbon-based nanosorbents by ethylene decomposition on stainless steel mesh without the use of external catalyst for the treatment of water containing nickel ions (Ni2+). The reaction temperature was varied from 650 to 850 degrees C, while reaction time and ethylene to nitrogen flow ratio were maintained at 30 min and 1:1 cm3/min, respectively. Results show that nanosorbents synthesised at a reaction temperature of 650 degrees C had the smallest average diameter (75 nm), largest BET surface area (68.95 m2/g) and least amount of impurity (0.98 wt.% Fe). A series of batch-sorption tests were performed to evaluate the effects of initial pH, initial metal concentration and contact time on Ni2+ removal by the nanosorbents. The equilibrium data fitted well to Freundlich isotherm. The kinetic data were best correlated to a pseudo second-order model indicating that the process was of chemisorption type. Further analysis by the Boyd kinetic model revealed that boundary layer diffusion was the controlling step. This primary study suggests that the prepared material with Freundlich constants compared well with those in the literature, is a promising sorbent for the sequestration of Ni2+ in aqueous solutions.

Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates.

PubMed

Israel, Tania; Willging, Cathleen; Ley, David

2016-01-01

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self-administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and post-test scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people.

Can faith-based correctional programs work? An outcome evaluation of the innerchange freedom initiative in Minnesota.

PubMed

Duwe, Grant; King, Michelle

2013-07-01

This study evaluated the effectiveness of the InnerChange Freedom Initiative (InnerChange), a faith-based prisoner reentry program, by examining recidivism outcomes among 732 offenders released from Minnesota prisons between 2003 and 2009. Results from the Cox regression analyses revealed that participating in InnerChange significantly reduced reoffending (rearrest, reconviction, and new offense reincarceration), although it did not have a significant impact on reincarceration for a technical violation revocation. The findings further suggest that the beneficial recidivism outcomes for InnerChange participants may have been due, in part, to the continuum of mentoring support some offenders received in the institution and the community. The results imply that faith-based correctional programs can reduce recidivism, but only if they apply evidence-based practices that focus on providing a behavioral intervention within a therapeutic community, addressing the criminogenic needs of participants and delivering a continuum of care from the institution to the community. Given that InnerChange relies heavily on volunteers and program costs are privately funded, the program exacts no additional costs to the State of Minnesota. Yet, because InnerChange lowers recidivism, which includes reduced reincarceration and victimization costs, the program may be especially advantageous from a cost-benefit perspective.

Computer-aided detection of pulmonary embolism at CT pulmonary angiography: can it improve performance of inexperienced readers?

PubMed

Blackmon, Kevin N; Florin, Charles; Bogoni, Luca; McCain, Joshua W; Koonce, James D; Lee, Heon; Bastarrika, Gorka; Thilo, Christian; Costello, Philip; Salganicoff, Marcos; Joseph Schoepf, U

2011-06-01

To evaluate the effect of a computer-aided detection (CAD) algorithm on the performance of novice readers for detection of pulmonary embolism (PE) at CT pulmonary angiography (CTPA). We included CTPA examinations of 79 patients (50 female, 52 ± 18 years). Studies were evaluated by two independent inexperienced readers who marked all vessels containing PE. After 3 months all studies were reevaluated by the same two readers, this time aided by CAD prototype. A consensus read by three expert radiologists served as the reference standard. Statistical analysis used χ(2) and McNemar testing. Expert consensus revealed 119 PEs in 32 studies. For PE detection, the sensitivity of CAD alone was 78%. Inexperienced readers' initial interpretations had an average per-PE sensitivity of 50%, which improved to 71% (p < 0.001) with CAD as a second reader. False positives increased from 0.18 to 0.25 per study (p = 0.03). Per-study, the readers initially detected 27/32 positive studies (84%); with CAD this number increased to 29.5 studies (92%; p = 0.125). Our results suggest that CAD significantly improves the sensitivity of PE detection for inexperienced readers with a small but appreciable increase in the rate of false positives.

Study of methanogenesis during bioutilization of plant residuals

NASA Astrophysics Data System (ADS)

Ilyin, V. K.; Korniushenkova, I. N.; Starkova, L. V.; Lauriniavichius, K. S.

2005-02-01

The waste management strategy for the future should meet the benefits of human safety, respect principles of planet ecology, and compatibility with other habitability systems. For these purposes waste management technologies relevant to application of the biodegradation properties of bacteria are of great value. Biological treatment method is based on the biodegradation of organic substances by various microorganisms. The objectives of our study were: to evaluate the effectiveness of microbial biodegradation of vegetable non-edible residual, using artificial inoculum, and to study the peculiarities of biogas, and possibilities of optimizing or reducing the share of methane. The diminution rate of organic gained 76% from initial mass within 9 days of fermentation. The biogas production achieved 46 l/kg of substrate. The microbial studies of biodegradation process revealed the following peculiarities: (i) gradual quantitative increase of Lactobacillus sp. (from 103 to 105 colony-forming units (CFU) per ml); (ii) activation of Clostridia sp. (from 102 to 10 4 CFU/ml); and (iii) elimination of aerobic conventional pathogens (Enterobacteriaceae, Protea sp., Staphylococci). Chromatography analysis revealed the constant presence of carbon dioxide (up to 90.9%). The methane content measures revealed traces 0.1-0.4%. However, when we optimized the methane production in "boiling layer" using methanogenic granules, the amount of methane in biogas reached 80-90%. Based on the results obtained the artificial inoculum was created which was capable of initiating biodegradation of vegetable wastes. This inoculum consisted of active sludge adapted to wastes mixed with excretea of insects which consume plant wastes. Using this inoculum the biodegradation process takes less time than that using active sludge. Regulation of methane concentration from traces to 90% may be achieved by adding methane reactor to the plant digester.

Interstitial pneumonia associated to peginterferon alpha-2a: A focus on lung function

PubMed Central

Cortés-Telles, Arturo

2016-01-01

Pulmonary toxicity related to the use of pegylated interferon alpha-2a during treatment of hepatitis C infections is rare; nonetheless, some cases with fatal outcomes have been reported. Evaluating patients’ pulmonary function is a key to diagnosis, follow-up and prognosis of several respiratory diseases, but case reports of respiratory manifestations related to the use of pegylated interferon alpha-2a have limited their findings to only baseline measurements. This paper examines the case of a 65-year-old woman with chronic hepatitis C virus infection who developed interstitial pneumonitis associated with pegylated interferon alpha-2a. Initial lung function evaluation revealed a marked reduction compared to an earlier assessment; the results were consistent with a moderate restricted pattern. Fortunately, over the ensuing 8 weeks of follow-up after discontinuing the drug, the patient recovered her lung function and experienced an overall improvement in her respiratory symptoms. PMID:27051119

Novel ZBTB24 Mutation Associated with Immunodeficiency, Centromere Instability, and Facial Anomalies Type-2 Syndrome Identified in a Patient with Very Early Onset Inflammatory Bowel Disease.

PubMed

Conrad, Máire A; Dawany, Noor; Sullivan, Kathleen E; Devoto, Marcella; Kelsen, Judith R

2017-12-01

Very early onset inflammatory bowel disease, diagnosed in children ≤5 years old, can be the initial presentation of some primary immunodeficiencies. In this study, we describe a 17-month-old boy with recurrent infections, growth failure, facial anomalies, and inflammatory bowel disease. Immune evaluation, whole-exome sequencing, karyotyping, and methylation array were performed to evaluate the child's constellation of symptoms and examination findings. Whole-exome sequencing revealed that the child was homozygous for a novel variant in ZBTB24, the gene associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome. This describes the first case of inflammatory bowel disease associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome in a child with a novel disease-causing mutation in ZBTB24 found on whole-exome sequencing.

Issues related to line-oriented flight training

NASA Technical Reports Server (NTRS)

Lauber, J. K.

1981-01-01

The use of a training simulator along with carefully structured, detailed, line trip scenarios was envisioned by NASA as a means of providing a controllable, repeatable way to observe line crews in a highly realistic simulation of their working environment and obtain better understanding operationally significant human factors problems and issues. Relevant research done by the agency and the results of full-mission simulation scenarios revealed potential implications for flight training. Aspects to be considered in creating training programs closely related to the actual line environment with a total crew application in real world incident experiences include: (1) operational, environmental, equipment, and crew problems in scenario design; (2) real time line oriented flight training operation; (3) performance assessment and debriefing; (4) instructor qualification and training; and (5) other issues such as ub un initial, transition, and upgrade training; procedures developent and evaluation, and equipment evaluation.

Presumptive intraperitoneal envenomation resulting in hemoperitoneum and acute abdominal pain in a dog.

PubMed

Istvan, Stephanie A; Walker, Julie M; Hansen, Bernard D; Hanel, Rita M; Marks, Steven L

2015-01-01

To describe the clinical features, diagnostic findings, treatment, and outcome of a dog with acute abdominal pain and hemoperitoneum secondary to a presumptive intraperitoneal (IP) snakebite. A 10-month-old castrated male mixed-breed dog was evaluated for suspected snake envenomation. The dog presented recumbent and tachycardic with signs of severe abdominal pain. Two cutaneous puncture wounds and hemoperitoneum were discovered during evaluation. Ultrasonographic examination revealed communication of the wounds with the peritoneal cavity. The dog was treated with supportive care, parenteral analgesia, packed red blood cell and fresh frozen plasma transfusions, crotalid antivenom, and placement of an IP catheter to provide local analgesia. The dog recovered fully and was discharged 5 days after initial presentation. To our knowledge, this is the first report of IP envenomation accompanied by hemorrhage treated with continuous IP analgesia in the veterinary literature. © Veterinary Emergency and Critical Care Society 2015.

Insights into public export promotion programs in an emerging economy: the case of Malaysian SMEs.

PubMed

Ayob, Abu H; Freixanet, Joan

2014-10-01

This study evaluates the impact of public export promotion programs (EPPs) among small and medium-sized enterprises (SMEs) in Malaysia. Three indicators, level of awareness, frequency of use, and perception of usefulness, were examined according to a firm's export status. The global evaluation suggests that exporters are more frequent users of EPPs and perceive them to be more useful than non-exporters. Nonetheless, both groups demonstrate higher levels of awareness, are frequent users, and perceive the programs relating to export info/knowledge are more usefulness than programs relating to financial assistance. Further analysis also reveals that the frequency of use and the perception of usefulness for most programs are positively related to export experience, but not to export turnover. This study offers insights into the effectiveness of export programs for encouraging export initiation and expansion in an emerging economy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Covert video monitoring in the assessment of medically unexplained symptoms in children.

PubMed

Wallace, Dustin P; Sim, Leslie A; Harrison, Tracy E; Bruce, Barbara K; Harbeck-Weber, Cynthia

2012-04-01

Diagnosis of medically unexplained symptoms (MUS) occurs after thorough evaluations have failed to identify a physiological cause for symptoms. However, families and providers may wonder if something has been missed, leading to reduced confidence in behavioral treatment. Confidence may be improved through the use of technology such as covert video monitoring to better assess functioning across settings. A 12-year-old male presented with progressive neurological decline, precipitated by chronic pain. After thorough evaluation and the failure of standard treatments (medical, rehabilitative, and psychological) covert video monitoring revealed that the patient demonstrated greater abilities when alone in his room. Negative reinforcement was used to initiate recovery, accompanied by positive reinforcement and a rehabilitative approach. Covert video monitoring assisted in three subsequent cases over the following 3 years. In certain complex cases, video monitoring can inform the assessment and treatment of MUS. Discussion includes ethical and practical considerations.

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

Optimum employment of satellite indirect soundings as numerical model input

NASA Technical Reports Server (NTRS)

Horn, L. H.; Derber, J. C.; Koehler, T. L.; Schmidt, B. D.

1981-01-01

The characteristics of satellite-derived temperature soundings that would significantly affect their use as input for numerical weather prediction models were examined. Independent evaluations of satellite soundings were emphasized to better define error characteristics. Results of a Nimbus-6 sounding study reveal an underestimation of the strength of synoptic scale troughs and ridges, and associated gradients in isobaric height and temperature fields. The most significant errors occurred near the Earth's surface and the tropopause. Soundings from the TIROS-N and NOAA-6 satellites were also evaluated. Results again showed an underestimation of upper level trough amplitudes leading to weaker thermal gradient depictions in satellite-only fields. These errors show a definite correlation to the synoptic flow patterns. In a satellite-only analysis used to initialize a numerical model forecast, it was found that these synoptically correlated errors were retained in the forecast sequence.

An Elective Course in Personal Finance for Health Care Professionals

PubMed Central

2009-01-01

Objectives To create, implement, and assess an elective course on the principles and applications of personal finance. Design A 1.5 unit (15 hours total) elective course was designed using active-learning pedagogy, lecture, and group discussion. Homework assignments were designed to provide practical tools and materials that students could individualize and apply to their personal financial goals. Assessment Student satisfaction, using a standard course evaluation form, revealed consistent high ratings. Student enrollment increased from 19 students in its initial year to 90 students in its fourth year. Student knowledge, assessed using the Jump$tart Financial Literacy Survey, indicated significant knowledge acquisition. Conclusion Many pharmacy students are ill equipped to effectively handle the complex financial decisions they face after graduation. This course provides students with practical tools to identify appropriate ways to achieve their financial goals and critically evaluate financial advice and advisors. PMID:19513143

A study on the plasticity of soda-lime silica glass via molecular dynamics simulations.

PubMed

Urata, Shingo; Sato, Yosuke

2017-11-07

Molecular dynamics (MD) simulations were applied to construct a plasticity model, which enables one to simulate deformations of soda-lime silica glass (SLSG) by using continuum methods. To model the plasticity, stress induced by uniaxial and a variety of biaxial deformations was measured by MD simulations. We found that the surfaces of yield and maximum stresses, which are evaluated from the equivalent stress-strain curves, are reasonably represented by the Mohr-Coulomb ellipsoid. Comparing a finite element model using the constructed plasticity model to a large scale atomistic model on a nanoindentation simulation of SLSG reveals that the empirical method is accurate enough to evaluate the SLSG mechanical responses. Furthermore, the effect of ion-exchange on the SLSG plasticity was examined by using MD simulations. As a result, it was demonstrated that the effects of the initial compressive stress on the yield and maximum stresses are anisotropic contrary to our expectations.

A study on the plasticity of soda-lime silica glass via molecular dynamics simulations

NASA Astrophysics Data System (ADS)

Urata, Shingo; Sato, Yosuke

2017-11-01

Molecular dynamics (MD) simulations were applied to construct a plasticity model, which enables one to simulate deformations of soda-lime silica glass (SLSG) by using continuum methods. To model the plasticity, stress induced by uniaxial and a variety of biaxial deformations was measured by MD simulations. We found that the surfaces of yield and maximum stresses, which are evaluated from the equivalent stress-strain curves, are reasonably represented by the Mohr-Coulomb ellipsoid. Comparing a finite element model using the constructed plasticity model to a large scale atomistic model on a nanoindentation simulation of SLSG reveals that the empirical method is accurate enough to evaluate the SLSG mechanical responses. Furthermore, the effect of ion-exchange on the SLSG plasticity was examined by using MD simulations. As a result, it was demonstrated that the effects of the initial compressive stress on the yield and maximum stresses are anisotropic contrary to our expectations.

Music therapy protocol development to enhance swallowing training for stroke patients with dysphagia.

PubMed

Kim, Soo Ji

2010-01-01

Considering the devastating condition of dysphagia, it is necessary to provide intensive therapeutic regimen based on interdisciplinary approach. In this aspect, music-enhanced swallowing protocol was developed through a pilot study. Then, the modified protocol from a pilot study was examined with 8 stroke patients in a local hospital. The protocol was designed to improve oral motor control, laryngeal elevation, breathing, and swallowing functions. The dependent variables measured included reflex, respiration, and laryngeal functions using the Frenchay Dysarthria assessment. Results from the initial to the midevaluation showed that pitch in the laryngeal category were statistically significant after 6th sessions. After the 12th session, when the final evaluation was compared with the initial assessment, additional categories revealed statistically significant changes. It is recommended that this study should be replicated with a control group and a larger sample using either FEES or video fluoroscopy for scientific data to further substantiate music therapy outcomes in stroke rehabilitation.

Poly(allyl methacrylate) functionalized hydroxyapatite nanocrystals via the combination of surface-initiated RAFT polymerization and thiol-ene protocol: a potential anticancer drug nanocarrier.

PubMed

Bach, Long Giang; Islam, Md Rafiqul; Vo, Thanh-Sang; Kim, Se-Kwon; Lim, Kwon Taek

2013-03-15

Hydroxyapatite nanocrystals (HAP NCs) were encapsulated by poly(allyl methacrylate) (PolyAMA) employing controlled surface-initiated reversible addition-fragmentation chain transfer (SI-RAFT) polymerization of allyl methacrylate to afford HAP-PolyAMA nanohybrids. The subsequent thiol-ene coupling of nanohybrids with 2-mercaptosuccinic acid resulted HAP-Poly(AMA-COOH) possessing multicarboxyl group. The formation of the nanohybrids was confirmed by FT-IR and EDS analyses. The TGA and FE-SEM investigation were further suggested the grafting of PolyAMA onto HAP NCs. The utility of the HAP-PolyAMA nanohybrid as drug carrier was also explored. The pendant carboxyl groups on the external layers of nanohybrids were conjugated with anticancer drug cisplatin to afford HAP-Poly(AMA-COOH)/Pt complex. The formation of the complex was confirmed by FT-IR, XPS, and FE-SEM. In vitro evaluation of the synthesized complex as nanomedicine revealed its potential chemotherapeutic efficacy against cancer cell lines. Copyright © 2012 Elsevier Inc. All rights reserved.

Kinetic Competition between Elongation Rate and Binding of NELF Controls Promoter Proximal Pausing

PubMed Central

Li, Jian; Liu, Yingyun; Rhee, Ho Sung; Ghosh, Saikat Kumar B.; Bai, Lu; Pugh, B. Franklin; Gilmour, David S.

2013-01-01

Summary Pausing of RNA polymerase II (Pol II) 20-60 bp downstream of transcription start sites is a major checkpoint during transcription in animal cells. Mechanisms that control pausing are largely unknown. We developed permanganate-ChIP-seq to evaluate the state of Pol II at promoters throughout the Drosophila genome, and a biochemical system that reconstitutes promoter-proximal pausing to define pausing mechanisms. Stable open complexes of Pol II are largely absent from the transcription start sites of most mRNA genes, but are present at snRNA genes and the highly transcribed heat shock genes following their induction. The location of the pause is influenced by the timing between when NELF loads onto Pol II and how fast Pol II escapes the promoter region. Our biochemical analysis reveals that the sequence-specific transcription factor, GAF, orchestrates efficient pausing by recruiting NELF to promoters before transcription initiation and by assisting in loading NELF onto Pol II after initiation. PMID:23746353

Uterine artery pseudoaneurysm in the setting of deep endometriosis: an uncommon cause of hemoperitoneum in pregnancy.

PubMed

Feld, Zoe; Rowen, Tami; Callen, Andrew; Goldstein, Ruth; Poder, Liina

2018-02-01

Uterine, ovarian, and placental pathologies are among the differential considerations for a pregnant woman presenting with abdominal and pelvic pain. Imaging plays a key role in the initial work-up of these patients. Sonography is often the first line test; however, evaluation of pelvic pathology can be limited in the gravid state, especially in mid- or late-term pregnancy. We present a case of a pregnant woman who came to the emergency room at 25 weeks with acute abdominal and pelvic pain. Both ultrasound and MR imaging findings revealed intraperitoneal hemorrhage, initially of unknown origin, as well as endometriomas and deep endometriosis. Only postpartum imaging confirmed a uterine artery pseudoaneurysm (PSA) presumably due to decidual reaction in deep endometriosis. We speculate the intraperitoneal hemorrhage was subsequently due to the PSA. This case demonstrates that if hemorrhage is not recognized promptly, it can lead to hemodynamic instability, as well as premature labor and delivery.

High-intensity ultrasound production of Maillard reaction flavor compounds in a cysteine-xylose model system.

PubMed

Ong, Olivia X H; Seow, Yi-Xin; Ong, Peter K C; Zhou, Weibiao

2015-09-01

Application of high intensity ultrasound has shown potential in the production of Maillard reaction odor-active flavor compounds in model systems. The impact of initial pH, sonication duration, and ultrasound intensity on the production of Maillard reaction products (MRPs) by ultrasound processing in a cysteine-xylose model system were evaluated using Response Surface Methodology (RSM) with a modified mathematical model. Generation of selected MRPs, 2-methylthiophene and tetramethyl pyrazine, was optimal at an initial pH of 6.00, accompanied with 78.1 min of processing at an ultrasound intensity of 19.8 W cm(-2). However, identification of volatiles using gas chromatography-mass spectrometry (GC/MS) revealed that ultrasound-assisted Maillard reactions generated fewer sulfur-containing volatile flavor compounds as compared to conventional heat treatment of the model system. Likely reasons for this difference in flavor profile include the expulsion of H2S due to ultrasonic degassing and inefficient transmission of ultrasonic energy. Copyright © 2015 Elsevier B.V. All rights reserved.

Experiments and modeling to characterize microstructure and hardness in 304L

DOE PAGES

Deibler, Lisa Anne; Brown, Arthur; Puskar, Joseph D.

2017-01-12

Drawn 304L stainless steel tubing was subjected to 42 different annealing heat treatments with the goal of initializing a microstructural model to select a heat treatment to soften the tubing from a hardness of 305 Knoop to 225–275 Knoop. The amount of recrystallization and grain size caused by 18 heat treatments were analyzed via optical microscopy and image analysis, revealing the full range of recrystallization from 0 to 100%. The formation of carbides during the longer duration and higher-temperature heat treatments was monitored via transmission electron microscope evaluation. The experimental results informed a model which includes recovery, recrystallization, and grainmore » growth to predict microstructure and hardness. After initialization of the model, it was able to predict hardness with a R 2 value of 0.95 and recrystallization with an R 2 value of 0.99. As a result, the model was then utilized in the design and testing of a heat treatment to soften the tubing.« less

The association of the metabolic profile in diabetes mellitus type 2 patients with obsessive-compulsive symptomatology and depressive symptomatology: new insights.

PubMed

Kontoangelos, Konstantinos; Raptis, Athanasios E; Papageorgiou, Charalabos C; Papadimitriou, George N; Rabavilas, Andreas D; Dimitriadis, George; Raptis, Sotirios A

2013-02-01

The aim of the present study was to explore the relationship between diabetes mellitus type 2, Obsessive- compulsive disorder (OCD) symptomatology and depressive symptomatology with the metabolic profile of diabetic patients. One hundred and thirty-one diabetic patients were randomly selected. In the first assessment all participants completed the Zung Self Rating Scale (ZUNG) and the Maudsley O-C Inventory Questionnaire (MOCI). After 1 year, diabetic patients that were initially uncontrolled (n = 31) (HbA1c > 7) were re-evaluated by the same psychometric tools. From those 31 patients, 10 had managed to control their metabolic profile. In the first evaluation MOCI and the sub-scale of slowness were statistically related with the diabetic profile (controlled, HbA1c ≤ 7; uncontrolled, HbA1c > 7), with uncontrolled patients scoring significantly higher on the overall MOCI score and the factor of slowness of MOCI scale (P = 0.028). The analysis revealed a positive association between depressive symptomatology (P = 0.004) and obsessive-compulsive disorder symptomatology (P < 0.001) and the metabolic profile of the patients. In the second evaluation the patients that managed to control their metabolic profile scored lower in both ZDRS and MOCI, although these differences in scores failed to reach significance levels were indicative of a tendency. The present results provide initial evidence that diabetes mellitus type 2 is associated with obsessive-compulsive disorder symptomatology and depressive symptomatology.

Genome-wide uniformity of human ‘open’ pre-initiation complexes

PubMed Central

Lai, William K.M.; Pugh, B. Franklin

2017-01-01

Transcription of protein-coding and noncoding DNA occurs pervasively throughout the mammalian genome. Their sites of initiation are generally inferred from transcript 5′ ends and are thought to be either locally dispersed or focused. How these two modes of initiation relate is unclear. Here, we apply permanganate treatment and chromatin immunoprecipitation (PIP-seq) of initiation factors to identify the precise location of melted DNA separately associated with the preinitiation complex (PIC) and the adjacent paused complex (PC). This approach revealed the two known modes of transcription initiation. However, in contrast to prevailing views, they co-occurred within the same promoter region: initiation originating from a focused PIC, and broad nucleosome-linked initiation. PIP-seq allowed transcriptional orientation of Pol II to be determined, which may be useful near promoters where sufficient sense/anti-sense transcript mapping information is lacking. PIP-seq detected divergently oriented Pol II at both coding and noncoding promoters, as well as at enhancers. Their occupancy levels were not necessarily coupled in the two orientations. DNA sequence and shape analysis of initiation complex sites suggest that both sequence and shape contribute to specificity, but in a context-restricted manner. That is, initiation sites have the locally “best” initiator (INR) sequence and/or shape. These findings reveal a common core to pervasive Pol II initiation throughout the human genome. PMID:27927716

Proteometabolomic response of Deinococcus radiodurans exposed to UVC and vacuum conditions: Initial studies prior to the Tanpopo space mission.

PubMed

Ott, Emanuel; Kawaguchi, Yuko; Kölbl, Denise; Chaturvedi, Palak; Nakagawa, Kazumichi; Yamagishi, Akihiko; Weckwerth, Wolfram; Milojevic, Tetyana

2017-01-01

The multiple extremes resistant bacterium Deinococcus radiodurans is able to withstand harsh conditions of simulated outer space environment. The Tanpopo orbital mission performs a long-term space exposure of D. radiodurans aiming to investigate the possibility of interplanetary transfer of life. The revealing of molecular machinery responsible for survivability of D. radiodurans in the outer space environment can improve our understanding of underlying stress response mechanisms. In this paper, we have evaluated the molecular response of D. radiodurans after the exposure to space-related conditions of UVC irradiation and vacuum. Notably, scanning electron microscopy investigations showed that neither morphology nor cellular integrity of irradiated cells was affected, while integrated proteomic and metabolomic analysis revealed numerous molecular alterations in metabolic and stress response pathways. Several molecular key mechanisms of D. radiodurans, including the tricarboxylic acid cycle, the DNA damage response systems, ROS scavenging systems and transcriptional regulators responded in order to cope with the stressful situation caused by UVC irradiation under vacuum conditions. These results reveal the effectiveness of the integrative proteometabolomic approach as a tool in molecular analysis of microbial stress response caused by space-related factors.

Proteometabolomic response of Deinococcus radiodurans exposed to UVC and vacuum conditions: Initial studies prior to the Tanpopo space mission

PubMed Central

Ott, Emanuel; Kawaguchi, Yuko; Kölbl, Denise; Chaturvedi, Palak; Nakagawa, Kazumichi; Yamagishi, Akihiko; Weckwerth, Wolfram

2017-01-01

The multiple extremes resistant bacterium Deinococcus radiodurans is able to withstand harsh conditions of simulated outer space environment. The Tanpopo orbital mission performs a long-term space exposure of D. radiodurans aiming to investigate the possibility of interplanetary transfer of life. The revealing of molecular machinery responsible for survivability of D. radiodurans in the outer space environment can improve our understanding of underlying stress response mechanisms. In this paper, we have evaluated the molecular response of D. radiodurans after the exposure to space-related conditions of UVC irradiation and vacuum. Notably, scanning electron microscopy investigations showed that neither morphology nor cellular integrity of irradiated cells was affected, while integrated proteomic and metabolomic analysis revealed numerous molecular alterations in metabolic and stress response pathways. Several molecular key mechanisms of D. radiodurans, including the tricarboxylic acid cycle, the DNA damage response systems, ROS scavenging systems and transcriptional regulators responded in order to cope with the stressful situation caused by UVC irradiation under vacuum conditions. These results reveal the effectiveness of the integrative proteometabolomic approach as a tool in molecular analysis of microbial stress response caused by space-related factors. PMID:29244852

Administrators’ Perspectives on Changing Practice in End-of-Life Care in a State Prison System

PubMed Central

Penrod, Janice; Loeb, Susan J.; Smith, Carol A.

2013-01-01

Objective Sentencing trends have created a demographic shift in prison populations. Greater numbers of inmates are aging and dying in prison, creating a demand for enhanced end-of-life care. Changing practice to meet escalating care demands in corrections settings is complicated by economic constraints, attitudinal barriers, and organizational features. This study explored perspectives of end-of-life care held by administrators in a state prison system to reveal challenges to changing practice to meet the needs of inmates suffering advanced illness and dying in prison. Design and Sample Qualitative interviews were conducted with 12 administrators from the central office of a state department of corrections. Results Key influences impacting end-of-life care services included: local prison culture; treatment versus security focus; case-by-case consideration; public sentiment; budget neutral approaches; and conflicting views of service targets. Conclusions These findings revealed the organizational structures, attitudes, and beliefs held by the administrative echelon of a state prison system and were used to guide the derivation of discrete approaches to changing practice in this complex system. Contextual evaluation permitted a much deeper understanding of the influences on changing practice in this hierarchical bureaucracy. This type of preliminary evaluation is crucial to infusing new practice initiatives in complex organizations caring for stigmatized, at-risk populations. PMID:24588128

Bursaphelenchus xylophilus and B. mucronatus secretomes: a comparative proteomic analysis

PubMed Central

Cardoso, Joana M. S.; Anjo, Sandra I.; Fonseca, Luís; Egas, Conceição; Manadas, Bruno; Abrantes, Isabel

2016-01-01

The pinewood nematode, Bursaphelenchus xylophilus, recognized as a worldwide major forest pest, is a migratory endoparasitic nematode with capacity to feed on pine tissues and also on fungi colonizing the trees. Bursaphelenchus mucronatus, the closest related species, differs from B. xylophilus on its pathogenicity, making this nematode a good candidate for comparative analyses. Secretome profiles of B. xylophilus and B. mucronatus were obtained and proteomic differences were evaluated by quantitative SWATH-MS. From the 681 proteins initially identified, 422 were quantified and compared between B. xylophilus and B. mucronatus secretomes and from these, 243 proteins were found differentially regulated: 158 and 85 proteins were increased in B. xylophilus and B. mucronatus secretomes, respectively. While increased proteins in B. xylophilus secretome revealed a strong enrichment in proteins with peptidase activity, the increased proteins in B. mucronatus secretome were mainly related to oxidative stress responses. The changes in peptidases were evaluated at the transcription level by RT-qPCR, revealing a correlation between the mRNA levels of four cysteine peptidases with secretion levels. The analysis presented expands our knowledge about molecular basis of B. xylophilus and B. mucronatus hosts interaction and supports the hypothesis of a key role of secreted peptidases in B. xylophilus pathogenicity. PMID:27941947

Invitro Evaluation of Fluoride Release from Hydroxyapatite Reinforced Glass Ionomer with or without Protective Coating.

PubMed

Tiwari, Shilpi; Nandlal, Bhojraj

2016-04-01

Glass Ionomer Cement (GIC) is well known for its fluoride releasing property but has its own drawbacks of poor mechanical properties, sensitivity to initial desiccation and moisture contamination. To overcome these, search led to the reinforcement of hydroxyapatite and application of surface coating agent but their effect on fluoride release is still not clear. To evaluate and compare the release of fluoride from Hydroxyapatite Reinforced Glass Ionomer (HA-GIC) with and without protective coating. Specimens were prepared as follows- Eight percent by weight conventional glass ionomer was replaced by hydroxyapatite powder (HA) and an indigenous product was prepared (HA-GIC). This powder was mixed with liquid of conventional GIC and allowed to set, then G coat plus coating agent was applied in surface coated group and light cured. Fluoride release of the sample was measured every 24 hrs for seven days and weekly from 7(th) to 21(st) day using combination ion selective electrode. Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both the groups. Results of repeated measure ANOVA revealed statistically significant difference between two groups (p <0.001). Coating the hydroxyapatite reinforced glass ionomer will allow for slow and steady release of fluoride for a long period of time into oral environment.

42 CFR 485.914 - Condition of participation: Admission, initial evaluation, comprehensive assessment, and...

Code of Federal Regulations, 2014 CFR

2014-10-01

...: Community Mental Health Centers (CMHCs) § 485.914 Condition of participation: Admission, initial evaluation...: Initial evaluation. (1) A licensed mental health professional employed by the CMHC and acting within his... assessment must be completed by licensed mental health professionals who are members of the interdisciplinary...

Trophic segregation of a fish assemblage along lateral depth gradients in a subtropical coastal lagoon revealed by stable isotope analyses.

PubMed

Mont'Alverne, R; Pereyra, P E R; Garcia, A M

2016-07-01

Stable isotopes were used to evaluate the hypothesis that fish assemblages occurring in shallow and deep areas of a large coastal lagoon are structured in partially segregated trophic modules with consumers showing contrasting reliance on benthic or pelagic food sources. The results revealed that fishes in deep areas were mainly dependent on particulate organic matter in the sediment (SOM), whereas emergent macrophytes were as important as SOM to fish consumers in shallow areas. Conceptual trophic diagrams depicting relationships among basal food sources and consumers in different regions of the lagoon highlighted the greater use of multiple basal food sources by more feeding mode functional guilds in shallow water compared with the use of predominantly benthic resources (SOM) in deep areas. The findings appear to corroborate the initial hypothesis and offer complementary perspectives in understanding the role of spatial ecology in structuring coastal ecosystem function and productivity. © 2016 The Fisheries Society of the British Isles.

MULTICENTRIC T-CELL LYMPHOMA AND CUTANEOUS HEMANGIOSARCOMA IN A CAPTIVE CHEETAH (ACINONYX JUBATUS).

PubMed

Lindemann, Dana M; Carpenter, James W; Nietfeld, Jerome C; Gonzalez, Estehela; Hallman, Mackenzie; Hause, Ben M

2015-12-01

A 13-yr-old intact male cheetah (Acinonyx jubatus) presented for evaluation after a 4-mo history of intermittent lethargy and increased expiratory effort. The clinical signs were initially noted after the diagnosis and death of its 13-yr-old male sibling with solitary hepatic T-cell lymphoma. Physical examination findings included thin body condition, harsh lung sounds, peripheral lymphadenopathy, and a cutaneous mass on the right medial tarsus and scrotum. Excisional biopsies diagnosed well-differentiated cutaneous hemangiosarcomas. Thoracic radiographs revealed a cranial mediastinal mass. Complete blood count and serum biochemical analyses showed a leukocytosis with persistent lymphocytosis, progressive azotemia, and markedly elevated alkaline phosphatase. Because of the cheetah's declining quality of life, euthanasia was elected. Postmortem examination, histopathology, and immunohistochemical staining revealed multicentric T-cell lymphoma. Feline leukemia virus (FeLV) enzyme-linked immunosorbent assay, FeLV polymerase chain reaction (whole blood), and viral metagenomic analysis were negative. This is the first case of cutaneous hemangiosarcoma and multicentric T-cell lymphoma reported in a FeLV-negative cheetah.

Endocarditis due to Lactobacillus jensenii in a Salvin's Amazon parrot (Amazona autumnalis salvini).

PubMed

Foldenauer, Ulrike; Rusch, Martina; Simova-Curd, Stefka; Nitzl, Dagmar; Hoop, Richard K; Hatt, Jean-Michel

2009-02-01

A 30-year-old Salvin's Amazon parrot (Amazona autumnalis salvini) with a history of a lifelong poor diet and inappropriate housing was presented in lateral recumbency to a veterinary teaching hospital for further evaluation. Radiological and ultrasonographic examination revealed a mild proventricular dilatation, mild hepatomegaly, signs of enteritis and airsacculitis. The main laboratory findings included a mild macrocytic hyperchromic anaemia, hypoglobulinaemia, decreased bile acids and increased alkaline phosphatase. In this bird a liver pathology was suspected because of the clinical, laboratory and ultrasonographic findings. The bird was treated with supportive care and metabolic aids. After initial improvement of the clinical signs, the bird's condition deteriorated and it died. Pathological findings revealed an endocarditis and myocarditis due to Lactobacillus jensenii and a bacteraemia. Endocarditis due to Lactobacillus sp. is a rare phenomenon in humans not yet described in animals. It is associated with severe underlying illnesses leading to translocation of otherwise non-pathogenic bacteria in the bloodstream. A similar pattern might be assumed in animals with compromised immunity.

Pediatric blunt carotid injury--case report.

PubMed

Oshiro, Shinya; Ohnishi, Hirokazu; Ohta, Mika; Tsuchimochi, Hirohito

2003-03-01

A 5-year-old boy was struck by a pickup truck, and admitted with Glasgow Coma Scale score of 14. Initial computed tomography (CT) showed no evidence of intracerebral lesions except for a skull fracture. Repeat CT 5 hours later showed hyperdense middle cerebral artery (MCA) sign, but he did not show any focal signs. Eighteen hours after the accident, he developed left hemiparesis. CT revealed a fresh infarction in the right MCA territory, associated with definite hyperdense MCA sign. He was immediately transferred to our hospital for further evaluation. Emergent angiography revealed a rat tail-shaped occlusion of the right internal carotid artery at the C-3 level. Cross-filling of the right MCA territory was insufficient for collateral circulation. He was treated conservatively because of the significant risk of hemorrhagic change from the established infarction. His hemiparesis improved gradually, and he was discharged on foot. Hyperdense MCA sign in a child is an important clinical sign for the early detection of cerebral ischemia after blunt carotid injury, before any focal signs appear.

Revealed Preference Methods for Studying Bicycle Route Choice-A Systematic Review.

PubMed

Pritchard, Ray

2018-03-07

One fundamental aspect of promoting utilitarian bicycle use involves making modifications to the built environment to improve the safety, efficiency and enjoyability of cycling. Revealed preference data on bicycle route choice can assist greatly in understanding the actual behaviour of a highly heterogeneous group of users, which in turn assists the prioritisation of infrastructure or other built environment initiatives. This systematic review seeks to compare the relative strengths and weaknesses of the empirical approaches for evaluating whole journey route choices of bicyclists. Two electronic databases were systematically searched for a selection of keywords pertaining to bicycle and route choice. In total seven families of methods are identified: GPS devices, smartphone applications, crowdsourcing, participant-recalled routes, accompanied journeys, egocentric cameras and virtual reality. The study illustrates a trade-off in the quality of data obtainable and the average number of participants. Future additional methods could include dockless bikeshare, multiple camera solutions using computer vision and immersive bicycle simulator environments.

Revealed Preference Methods for Studying Bicycle Route Choice—A Systematic Review

PubMed Central

2018-01-01

One fundamental aspect of promoting utilitarian bicycle use involves making modifications to the built environment to improve the safety, efficiency and enjoyability of cycling. Revealed preference data on bicycle route choice can assist greatly in understanding the actual behaviour of a highly heterogeneous group of users, which in turn assists the prioritisation of infrastructure or other built environment initiatives. This systematic review seeks to compare the relative strengths and weaknesses of the empirical approaches for evaluating whole journey route choices of bicyclists. Two electronic databases were systematically searched for a selection of keywords pertaining to bicycle and route choice. In total seven families of methods are identified: GPS devices, smartphone applications, crowdsourcing, participant-recalled routes, accompanied journeys, egocentric cameras and virtual reality. The study illustrates a trade-off in the quality of data obtainable and the average number of participants. Future additional methods could include dockless bikeshare, multiple camera solutions using computer vision and immersive bicycle simulator environments. PMID:29518991

Foreign Body in Vagina: An Uncommon Cause of Vaginitis in Children

PubMed Central

Chinawa, JM; Obu, HA; Uwaezuoke, SN

2013-01-01

Vaginal discharge in children may result from a variety of causes. A long-standing intra-vaginal foreign body can pose both diagnostic and therapeutic challenges in children. Treatment failure may occur because of alteration of the normal vaginal flora. A 6-year-old girl, who lived with her parents, presented with a foul-smelling, blood-stained vaginal discharge as well as dysuria for 2 years. There was no history of sexual abuse. Initial evaluation that excluded gynecologic examination revealed lower abdominal tenderness. Vaginal swab and urine cultures yielded Staphylococcus aureus sensitive to ceftriaxone only. She was commenced on this antibiotic for 2 weeks, but the discharge persisted, necessitating referral to the gynecologist. Examination under anesthesia by the gynecologist revealed shreds of toilet tissue paper extracted from the vagina and slight excoriations on the wall of the vagina. Vaginal foreign body can present with diverse symptoms. It should be considered in any young female patient presenting with recurrent or persistent vaginal discharge. PMID:23634340

Thermal stability and haemolytic effects of depolymerized guar gum derivatives.

PubMed

Hussain, Majid; Zahoor, Tahir; Akhtar, Saeed; Ismail, Amir; Hameed, Aneela

2018-03-01

The purpose of current study was to purify and partially depolymerize guar gum by β-mannanase, HCl, Ba(OH) 2 actions and subjected to inspect compositional, thermogravimetric analysis (TGA) and haemolytic activity. Chemical composition revealed mannose and galactose ratio remained un-altered even after process of purification and hydrolysis. TGA thermograms affirmed initial and final decomposition temperature in various zones. Major decomposition stages apparently revealed partially hydrolyzed guar gum (PHGG) exhibited better heat stable properties having more zones of degradation than crude one. Furthermore, all guar fractions (2.5-250 mg/mL) were subjected to haemolysis to evaluate toxic effects during process of hydrolysis. The crude and hydrolyzed guar galactomannans exhibited minor haemolytic activity (1.9 ± 0.03-7.24 ± 0.02%) when compared to 0.1% Triton-X 100 (100% haemolysis) showing no toxic effects to human RBC's. Conclusively, hydrolyzed guar-galactomannans are safe and can be used in food products with improved heat stability.

Verbal and non-verbal semantic impairment: From fluent primary progressive aphasia to semantic dementia

PubMed Central

Senaha, Mirna Lie Hosogi; Caramelli, Paulo; Porto, Claudia Sellitto; Nitrini, Ricardo

2007-01-01

Selective disturbances of semantic memory have attracted the interest of many investigators and the question of the existence of single or multiple semantic systems remains a very controversial theme in the literature. Objectives To discuss the question of multiple semantic systems based on a longitudinal study of a patient who presented semantic dementia from fluent primary progressive aphasia. Methods A 66 year-old woman with selective impairment of semantic memory was examined on two occasions, undergoing neuropsychological and language evaluations, the results of which were compared to those of three paired control individuals. Results In the first evaluation, physical examination was normal and the score on the Mini-Mental State Examination was 26. Language evaluation revealed fluent speech, anomia, disturbance in word comprehension, preservation of the syntactic and phonological aspects of the language, besides surface dyslexia and dysgraphia. Autobiographical and episodic memories were relatively preserved. In semantic memory tests, the following dissociation was found: disturbance of verbal semantic memory with preservation of non-verbal semantic memory. Magnetic resonance of the brain revealed marked atrophy of the left anterior temporal lobe. After 14 months, the difficulties in verbal semantic memory had become more severe and the semantic disturbance, limited initially to the linguistic sphere, had worsened to involve non-verbal domains. Conclusions Given the dissociation found in the first examination, we believe there is sufficient clinical evidence to refute the existence of a unitary semantic system. PMID:29213389

Functional and phenotypic evaluation of eosinophils from patients with the acute form of paracoccidioidomycosis.

PubMed

Braga, Fernanda Gambogi; Ruas, Luciana Pereira; Pereira, Ricardo Mendes; Lima, Xinaida Taligare; Antunes, Edson; Mamoni, Ronei Luciano; Blotta, Maria Heloisa Souza Lima

2017-05-01

Eosinophilia is a typical finding of the acute/juvenile form of paracoccidioidomycosis (PCM), a systemic mycosis endemic in Latin America. This clinical form is characterized by depressed cellular immune response and production of Th2 cytokines. Moreover, it has been shown that the increased number of eosinophils in peripheral blood of patients returns to normal values after antifungal treatment. However, the role of eosinophils in PCM has never been evaluated. This study aimed to assess the phenotypic and functional characteristics of eosinophils in PCM. In 15 patients with the acute form of the disease, we detected expression of MBP, CCL5 (RANTES) and CCL11 (eotaxin) in biopsies of lymph nodes and liver. In addition, there were higher levels of chemokines and granule proteins in the peripheral blood of patients compared to controls. Isolation of eosinophils from blood revealed a higher frequency of CD69+ and TLR2+ eosinophils in patients compared to controls, and a lower population of CD80+ cells. We also evaluated the fungicidal capacity of eosinophils in vitro. Our results revealed that eosinophils from PCM patients and controls exhibit similar ability to kill P. brasiliensis yeast cells, although eosinophils of patients were less responsive to IL-5 stimulation than controls. In conclusion, we suggest that eosinophils might play a role in the host response to fungi and in the pathophysiology of PCM by inducing an intense and systemic inflammatory response in the initial phase of the infection.

Evaluating patient care communication in integrated care settings: application of a mixed method approach in cerebral palsy programs.

PubMed

Gulmans, J; Vollenbroek-Hutten, M M R; Van Gemert-Pijnen, J E W C; Van Harten, W H

2009-02-01

In this study, we evaluated patient care communication in the integrated care setting of children with cerebral palsy in three Dutch regions in order to identify relevant communication gaps experienced by both parents and involved professionals. A three-step mixed method approach was used starting with a questionnaire to identify communication links in which parents experienced gaps. In subsequent in-depth interviews with parents and focus group meetings with professionals underlying factors were evaluated. In total, 197 parents completed the questionnaire (response 67%); 6% scored negative on parent-professional communication, whereas 17% scored negative on inter-professional communication, especially between the rehabilitation physician and primary care physiotherapy (16%) and (special) education/day care (15%). In-depth interviews among a subset of 20 parents revealed various sources of dissatisfaction such as lack of cooperation and patient centeredness, inappropriate amount of information exchange and professional use of parents as messenger of information. Focus group meetings revealed that professionals recognized these gaps. They attributed them to capacity problems, lack of interdisciplinary guidelines and clear definition of roles, but also a certain hesitance for contact due to unfamiliarity with involved professionals in the care network. Parents particularly identified gaps in inter-professional communication between (rehabilitation) hospitals and primary care settings. Involved professionals recognized these gaps and primarily attributed them to organizational factors. Improvement initiatives should focus on these factors as well as facilitation of low-threshold contact across the patient's care network.

Californium interrogation prompt neutron (CIPN) instrument for non-destructive assay of spent nuclear fuel – design concept and experimental demonstration

DOE PAGES

Henzlova, Daniela; Menlove, Howard Olsen; Rael, Carlos D.; ...

2015-10-09

Our paper presents results of the first experimental demonstration of the Californium Interrogation Prompt Neutron (CIPN) instrument developed within a multi-year effort launched by the Next Generation Safeguards Initiative Spent Fuel Project of the United States Department of Energy. The goals of this project focused on developing viable non-destructive assay techniques with capabilities to improve an independent verification of spent fuel assembly characteristics. For this purpose, the CIPN instrument combines active and passive neutron interrogation, along with passive gamma-ray measurements, to provide three independent observables. We describe the initial feasibility demonstration of the CIPN instrument, which involved measurements of fourmore » pressurized-water-reactor spent fuel assemblies with different levels of burnup and two initial enrichments. The measurements were performed at the Post-Irradiation Examination Facility at the Korea Atomic Energy Institute in the Republic of Korea. The key aim of the demonstration was to evaluate CIPN instrument performance under realistic deployment conditions, with the focus on a detailed assessment of systematic uncertainties that are best evaluated experimentally. The measurements revealed good positioning reproducibility, as well as a high degree of insensitivity of the CIPN instrument's response to irregularities in a radial burnup profile. Systematic uncertainty of individual CIPN instrument signals due to assembly rotation was found to be <4.5%, even for assemblies with fairly extreme gradients in the radial burnup profile. Lastly, these features suggest that the CIPN instrument is capable of providing a good representation of assembly average characteristics, independent of assembly orientation in the instrument.« less

Californium interrogation prompt neutron (CIPN) instrument for non-destructive assay of spent nuclear fuel – design concept and experimental demonstration

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

Henzlova, Daniela; Menlove, Howard Olsen; Rael, Carlos D.

Our paper presents results of the first experimental demonstration of the Californium Interrogation Prompt Neutron (CIPN) instrument developed within a multi-year effort launched by the Next Generation Safeguards Initiative Spent Fuel Project of the United States Department of Energy. The goals of this project focused on developing viable non-destructive assay techniques with capabilities to improve an independent verification of spent fuel assembly characteristics. For this purpose, the CIPN instrument combines active and passive neutron interrogation, along with passive gamma-ray measurements, to provide three independent observables. We describe the initial feasibility demonstration of the CIPN instrument, which involved measurements of fourmore » pressurized-water-reactor spent fuel assemblies with different levels of burnup and two initial enrichments. The measurements were performed at the Post-Irradiation Examination Facility at the Korea Atomic Energy Institute in the Republic of Korea. The key aim of the demonstration was to evaluate CIPN instrument performance under realistic deployment conditions, with the focus on a detailed assessment of systematic uncertainties that are best evaluated experimentally. The measurements revealed good positioning reproducibility, as well as a high degree of insensitivity of the CIPN instrument's response to irregularities in a radial burnup profile. Systematic uncertainty of individual CIPN instrument signals due to assembly rotation was found to be <4.5%, even for assemblies with fairly extreme gradients in the radial burnup profile. Lastly, these features suggest that the CIPN instrument is capable of providing a good representation of assembly average characteristics, independent of assembly orientation in the instrument.« less

Framework for Evaluating Educational Systemic Initiatives.

ERIC Educational Resources Information Center

Ikegulu, T. Nelson

This paper describes the implementation of the Holistic Systemic Evaluation (HSE), a component of an Education Systemic Initiative's strategic management. The HSE provides general guidance for the implementation and continual improvement of an Education Systemic Initiative Reform (ESIR). The implementation of the education system initiative plan:…

Association of a murine leukaemia stem cell gene signature based on nucleostemin promoter activity with prognosis of acute myeloid leukaemia in patients.

PubMed

Ali, Mohamed A E; Naka, Kazuhito; Yoshida, Akiyo; Fuse, Kyoko; Kasada, Atsuo; Hoshii, Takayuki; Tadokoro, Yuko; Ueno, Masaya; Ohta, Kumiko; Kobayashi, Masahiko; Takahashi, Chiaki; Hirao, Atsushi

2014-07-18

Acute myeloid leukaemia (AML) is a heterogeneous neoplastic disorder in which a subset of cells function as leukaemia-initiating cells (LICs). In this study, we prospectively evaluated the leukaemia-initiating capacity of AML cells fractionated according to the expression of a nucleolar GTP binding protein, nucleostemin (NS). To monitor NS expression in living AML cells, we generated a mouse AML model in which green fluorescent protein (GFP) is expressed under the control of a region of the NS promoter (NS-GFP). In AML cells, NS-GFP levels were correlated with endogenous NS mRNA. AML cells with the highest expression of NS-GFP were very immature blast-like cells, efficiently formed leukaemia colonies in vitro, and exhibited the highest leukaemia-initiating capacity in vivo. Gene expression profiling analysis revealed that cell cycle regulators and nucleotide metabolism-related genes were highly enriched in a gene set associated with leukaemia-initiating capacity that we termed the 'leukaemia stem cell gene signature'. This gene signature stratified human AML patients into distinct clusters that reflected prognosis, demonstrating that the mouse leukaemia stem cell gene signature is significantly associated with the malignant properties of human AML. Further analyses of gene regulation in leukaemia stem cells could provide novel insights into diagnostic and therapeutic approaches to AML. Copyright © 2014 Elsevier Inc. All rights reserved.

TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia.

PubMed

Rasouli, Omid; Stensdotter, Ann-Katrin; Van der Meer, Audrey L H

2016-08-01

Impaired postural control has been reported in static conditions in chronic fatigue syndrome and fibromyalgia, but postural control in dynamic tasks have not yet been investigated. Thus, we investigated measurements from a force plate to evaluate dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia compared to matched healthy controls. Thirty female participants (10 per group) performed five trials of gait initiation. Center of pressure (CoP) trajectory of the initial weight shift onto the supporting foot in the mediolateral direction (CoPX) was analyzed using General Tau Theory. We investigated the hypothesis that tau of the CoPX motion-gap (τCoPx) is coupled onto an intrinsic tauG-guide (τG) by keeping the relation τCoPx=KτG, where K is a scaling factor that determines the relevant kinematics of a movement. Mean K values were 0.57, 0.55, and 0.50 in fibromyalgia, chronic fatigue syndrome, and healthy controls, respectively. Both patient groups showed K values significantly higher than 0.50 (P<0.05), indicating that patients showed poorer dynamic balance control, CoPX colliding with the boundaries of the base of support (K>0.5). The findings revealed a lower level of dynamic postural control in both fibromyalgia and chronic fatigue syndrome compared to controls. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developmental evaluation and the 'Stronger Economies Together' initiative in the United States.

PubMed

Honadle, Beth Walter; Zapata, Marisa A; Auffrey, Christopher; vom Hofe, Rainer; Looye, Johanna

2014-04-01

This article describes a developmental evaluation and explains its impact on the Stronger Economies Together (SET) initiative of the U.S. Department of Agriculture in collaboration with the Nation's four Regional Rural Development Centers and Land-Grant universities. Through a dynamic process, this evaluation of the early phases of an initiative led to continuous program alterations based on feedback. The relationship of the evaluation team to the initiative's coordinating team enabled seamless transfer of observations, suggestions, and recommendations to decision makers. The multidisciplinary character of the evaluation team provided a diverse set of perspectives with a depth of subject matter and knowledge from relevant fields. One lesson is that developmental evaluators must be flexible, nimble, creative, and adaptive. When expected data are imperfect or nonexistent, the team must collect alternate information and make recommendations to improve data collection. As the initiative proceeded and modifications came about, the evaluation team had to recognize the changes in the program and focus on different questions. This experience with developmental evaluation provides insights into how interdisciplinary teams may need to change course and conduct a developmental evaluation when a formative evaluation was originally envisioned. Published by Elsevier Ltd.

Early Implementation of the Class Size Reduction Initiative.

ERIC Educational Resources Information Center

Illig, David C.

A survey of school districts was conducted to determine the initial progress and problems associated with the 1997 Class Size Reduction (CSR) Initiative. Data reveal that most school districts had enough space for smaller classes for at least two grade levels; small school districts were much less likely to report space constraints. The CSR did…

Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

PubMed

Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

2017-07-01

Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

The use of information and communications technologies in the delivery of interprofessional education: A review of evaluation outcome levels.

PubMed

Curran, Vernon; Reid, Adam; Reis, Pamela; Doucet, Shelley; Price, Sheri; Alcock, Lindsay; Fitzgerald, Shari

2015-01-01

Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current study's purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.

Gadd34 Requirement for Normal Hemoglobin Synthesis

PubMed Central

Patterson, Andrew D.; Hollander, M. Christine; Miller, Georgina F.; Fornace, Albert J.

2006-01-01

The protein encoded by growth arrest and DNA damage-inducible transcript 34 (Gadd34) is associated with translation initiation regulation following certain stress responses. Through interaction with the protein phosphatase 1 catalytic subunit (PP1c), Gadd34 recruits PP1c for the removal of an inhibitory phosphate group on the α subunit of elongation initiation factor 2, thereby reversing the shutoff of protein synthesis initiated by stress-inducible kinases. In the absence of stress, the physiologic consequences of Gadd34 function are not known. Initial analysis of Gadd34-null mice revealed several significant findings, including hypersplenism, decreased erythrocyte volume, increased numbers of circulating erythrocytes, and decreased hemoglobin content, resembling some thalassemia syndromes. Biochemical analysis of the hemoglobin-producing reticulocyte (an erythrocyte precursor) revealed that the decreased hemoglobin content in the Gadd34-null erythrocyte is due to the reduced initiation of the globin translation machinery. We propose that an equilibrium state exists between Gadd34/PP1c and the opposing heme-regulated inhibitor kinase during hemoglobin synthesis in the reticulocyte. PMID:16478986

Structure of a bacterial RNA polymerase holoenzyme open promoter complex

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

Bae, Brian; Feklistov, Andrey; Lass-Napiorkowska, Agnieszka

2015-09-08

Initiation of transcription is a primary means for controlling gene expression. In bacteria, the RNA polymerase (RNAP) holoenzyme binds and unwinds promoter DNA, forming the transcription bubble of the open promoter complex (RPo). We have determined crystal structures, refined to 4.14 Å-resolution, of RPo containing Thermus aquaticus RNAP holoenzyme and promoter DNA that includes the full transcription bubble. The structures, combined with biochemical analyses, reveal key features supporting the formation and maintenance of the double-strand/single-strand DNA junction at the upstream edge of the -10 element where bubble formation initiates. The results also reveal RNAP interactions with duplex DNA just upstreammore » of the -10 element and potential protein/DNA interactions that direct the DNA template strand into the RNAP active site. Addition of an RNA primer to yield a 4 base-pair post-translocated RNA:DNA hybrid mimics an initially transcribing complex at the point where steric clash initiates abortive initiation and σA dissociation.« less

Structure of a bacterial RNA polymerase holoenzyme open promoter complex

DOE PAGES

Bae, Brian; Feklistov, Andrey; Lass-Napiorkowska, Agnieszka; ...

2015-09-08

Initiation of transcription is a primary means for controlling gene expression. In bacteria, the RNA polymerase (RNAP) holoenzyme binds and unwinds promoter DNA, forming the transcription bubble of the open promoter complex (RPo). We have determined crystal structures, refined to 4.14 Å-resolution, of RPo containing Thermus aquaticus RNAP holoenzyme and promoter DNA that includes the full transcription bubble. The structures, combined with biochemical analyses, reveal key features supporting the formation and maintenance of the double-strand/single-strand DNA junction at the upstream edge of the -10 element where bubble formation initiates. The results also reveal RNAP interactions with duplex DNA just upstreammore » of the -10 element and potential protein/DNA interactions that direct the DNA template strand into the RNAP active site. Additionally a RNA primer to yield a 4 base-pair post-translocated RNA:DNA hybrid mimics an initially transcribing complex at the point where steric clash initiates abortive initiation and σ A dissociation.« less

Framework for Evaluation of Equity Initiatives

ERIC Educational Resources Information Center

Bexley, Emmaline; Harris, Kerri-Lee; James, Richard

2010-01-01

The Framework for Evaluation of Equity Initiatives has been prepared to support the Go8 Equity Strategy. Its purpose is to assist Group of Eight (Go8) universities to evaluate the effectiveness of their equity initiatives and interventions in the context of federal policies and the distinctive missions and responsibilities of the individual Go8…

76 FR 72423 - Bridging the Idea Development Evaluation Assessment and Long-Term Initiative and Total Product...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0780] Bridging the Idea Development Evaluation Assessment and Long-Term Initiative and Total Product Life Cycle... Idea Development Evaluation Assessment and Long-Term Initiative and Total Product Life Cycle Approaches...

Improving Beta Test Evaluation Response Rates: A Meta-Evaluation

ERIC Educational Resources Information Center

Russ-Eft, Darlene; Preskill, Hallie

2005-01-01

This study presents a meta-evaluation of a beta-test of a customer service training program. The initial evaluation showed a low response rate. Therefore, the meta-evaluation focused on issues related to the conduct of the initial evaluation and reasons for nonresponse. The meta-evaluation identified solutions to the nonresponse problem as related…

Revision by means of computer-mediated peer discussions

NASA Astrophysics Data System (ADS)

Soong, Benson; Mercer, Neil; Er, Siew Shin

2010-05-01

In this article, we provide a discussion on our revision method (termed prescriptive tutoring) aimed at revealing students' misconceptions and misunderstandings by getting them to solve physics problems with an anonymous partner via the computer. It is currently being implemented and evaluated in a public secondary school in Singapore, and statistical analysis of our initial small-scale study shows that students in the experimental group significantly outperformed students in both the control and alternative intervention groups. In addition, students in the experimental group perceived that they had gained improved understanding of the physics concepts covered during the intervention, and reported that they would like to continue revising physics concepts using the intervention methods.

Bone marrow hypoplasia associated with fenbendazole administration in a dog.

PubMed

Gary, Anthony T; Kerl, Marie E; Wiedmeyer, Charles E; Turnquist, Susan E; Cohn, Leah A

2004-01-01

A 1.5-year-old Doberman pinscher was presented with sudden-onset of fever and malaise. Twelve days prior to presentation, fenbendazole therapy was initiated for a suspected lungworm infection. Results of a complete blood count on presentation showed pancytopenia, while histopathological evaluation of a bone marrow core sample revealed bone marrow hypoplasia of undetermined etiology. Bactericidal antibiotics and fluid therapy, as well as discontinuation of fenbendazole administration, led to a complete resolution of clinical and hematological abnormalities within 15 days. An idiosyncratic reaction to fenbendazole was suspected based on the absence of infectious, neoplastic, autoimmune, and toxic etiologies, as well as resolution of clinical signs and pancytopenia upon drug withdrawal.

Caring for homeless persons with serious mental illness in general hospitals.

PubMed

Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

2013-01-01

The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

"This is public health: recycling counts!" Description of a pilot health communications campaign.

PubMed

L Chase, Nancy; Dominick, Gregory M; Trepal, Amy; Bailey, Leanne S; Friedman, Daniela B

2009-12-01

This paper describes the development, implementation, and evaluation of a pilot recycling campaign. The goal of the campaign was to increase people's awareness and knowledge about recycling and the link between a healthy environment and the public's health. A total of 258 individuals attended campaign week events and completed an initial survey. Results identified inconvenience of recycling facility locations as a key barrier to recycling. Post-campaign survey results revealed increased recycling of paper, plastic, glass, and cans (p < 0.05). The majority of participants "agreed" or "strongly agreed" that as a result of campaign messages they had greater awareness about recycling (88.4%) and their recycling efforts increased (61.6%).

Herpes Zoster Meningitis Presenting With a Cerebrospinal Fluid Leukemoid Reaction in an Adolescent With preB-ALL in Remission.

PubMed

Adachi, Kristina; Song, Sophie X; Kao, Roy L; Van Dyne, Elizabeth; Kempert, Pamela; Deville, Jaime G

2016-08-01

A 19-year-old girl with a history of precursor B acute lymphoblastic leukemia in remission presented with fever, headache, and a skin rash. Cerebrospinal fluid (CSF) examination reported pleocytosis with blast-like cells concerning for a central nervous system leukemic relapse. After the patient showed significant improvement on intravenous acyclovir, a repeat lumbar puncture revealed normalization of CSF. The abnormal CSF cells were reviewed and ultimately determined to be activated and atypical lymphocytes. The patient recovered uneventfully. Atypical lymphocytes resembling leukemic blasts are an unusual finding in viral meningitis. Varicella zoster virus reactivation should be considered during initial evaluation for central nervous system relapse of leukemia.

Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women.

PubMed

Nayak, Smita; Roberts, Mark S; Greenspan, Susan L

2011-12-06

The best strategies to screen postmenopausal women for osteoporosis are not clear. To identify the cost-effectiveness of various screening strategies. Individual-level state-transition cost-effectiveness model. Published literature. U.S. women aged 55 years or older. Lifetime. Payer. Screening strategies composed of alternative tests (central dual-energy x-ray absorptiometry [DXA], calcaneal quantitative ultrasonography [QUS], and the Simple Calculated Osteoporosis Risk Estimation [SCORE] tool) initiation ages, treatment thresholds, and rescreening intervals. Oral bisphosphonate treatment was assumed, with a base-case adherence rate of 50% and a 5-year on/off treatment pattern. Incremental cost-effectiveness ratios (2010 U.S. dollars per quality-adjusted life-year [QALY] gained). At all evaluated ages, screening was superior to not screening. In general, quality-adjusted life-days gained with screening tended to increase with age. At all initiation ages, the best strategy with an incremental cost-effectiveness ratio (ICER) of less than $50,000 per QALY was DXA screening with a T-score threshold of -2.5 or less for treatment and with follow-up screening every 5 years. Across screening initiation ages, the best strategy with an ICER less than $50,000 per QALY was initiation of screening at age 55 years by using DXA -2.5 with rescreening every 5 years. The best strategy with an ICER less than $100,000 per QALY was initiation of screening at age 55 years by using DXA with a T-score threshold of -2.0 or less for treatment and then rescreening every 10 years. No other strategy that involved treatment of women with osteopenia had an ICER less than $100,000 per QALY. Many other strategies, including strategies with SCORE or QUS prescreening, were also cost-effective, and in general the differences in effectiveness and costs between evaluated strategies was small. Probabilistic sensitivity analysis did not reveal a consistently superior strategy. Data were primarily from white women. Screening initiation at ages younger than 55 years were not examined. Only osteoporotic fractures of the hip, vertebrae, and wrist were modeled. Many strategies for postmenopausal osteoporosis screening are effective and cost-effective, including strategies involving screening initiation at age 55 years. No strategy substantially outperforms another. National Center for Research Resources.

Cystoscopic diagnosis of polypoid cystitis in two pet rabbits.

PubMed

Di Girolamo, Nicola; Bongiovanni, Laura; Ferro, Silvia; Melidone, Raffaele; Nicoletti, Annalisa; Duca, Valeria Del; Donnelly, Thomas M; Selleri, Paolo

2017-07-01

CASE DESCRIPTION AS-year-old male Dwarf rabbit and 4-year-old female Mini-Rex rabbit were evaluated because of anorexia and urine scalding of the perineum. CLINICAL FINDINGS Abdominal radiography revealed a diffuse increase in the opacity of the urinary bladder attributable to urinary sludge. In 1 rabbit, abdominal ultrasonography revealed several mass-like lesions protruding from the mucosal surface into the lumen of the urinary bladder. Rabbits were anesthetized, and cystoscopy was performed with a rigid 2.7-mm, 30° endoscope. Histologic analysis of tissue samples obtained through the cystoscope operating channel revealed findings consistent with polypoid cystitis. TREATMENT AND OUTCOME To remove the urinary sludge from each rabbit, the urinary bladder was filled with sterile saline (0.9% NaCl) solution and emptied with a gentle massage several times until the ejected fluid was transparent. Rabbits were treated with NSAIDs, antimicrobials (chosen following microbial culture of urine and antimicrobial susceptibility testing), bathing of the perineum, and a low-calcium diet. The male rabbit died of unrelated causes 18 months later; postmortem examination findings confirmed the polypoid cystitis. The female rabbit remained disease free through to last follow-up (12 months after initial evaluation). CLINICAL RELEVANCE This was the first report of polypoid cystitis in pet rabbits. Although ultrasonographic findings supported this diagnosis, a definitive diagnosis was achieved through cystoscopy and lesion biopsy. Treatments administered were intended to reduce the potential sources of irritation. Research is needed to investigate the effectiveness of the applied interventions and the association between excessive urinary calcium excretion and polyploid cystitis in rabbits.

Motor outcome differences between two groups of children with spastic diplegia who received different intensities of early onset physiotherapy followed for 5 years.

PubMed

Kanda, Toyoko; Pidcock, Frank S; Hayakawa, Katumi; Yamori, Yuriko; Shikata, Yuko

2004-03-01

The objective of this study is to determine the clinical effectiveness of early onset long-term intensive physiotherapy on motor development in children with spastic diplegic cerebral palsy (CP). The study was a non-randomized cohort study with 62 months (mean) follow-up. The participants were ten infants who were first examined before 3 months of age corrected for prematurity. All had a gestational age of less than 33 weeks and a birth weight of less than 2000 g. Brain magnetic resonance imaging revealed periventricular white matter injury in nine subjects and moderate grade bilateral porencephaly in one. Five completed a full course of training of 52 months (mean), two did not receive therapy, and three received an insufficient course of therapy. The study was conducted at the Regional Center for Children with Disabilities including outpatient clinics and a school for children with special needs. The Vojta Method was used, which is an extensive family oriented physiotherapy program which uses isometric strengthening of muscles with tactile stimulation. Subjects were evaluated for the highest motor developmental level at the outcome evaluation 59 months (mean) after initiation of therapy. Four of the five who completed training could either stand still for 5 s or walk at the time of the outcome evaluation 52 months after the beginning of the therapy program. None of the five subjects with no training or insufficient training could accomplish this task when evaluated 64 months following therapy initiation. This was a statistically significant difference (P = 0.0278). A consistently applied physiotherapy program resulted in better motor outcomes in this group of children at risk for developing spastic diplegic CP.

Utilization of cone-beam CT for offline evaluation of target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment.

PubMed

Paluska, Petr; Hanus, Josef; Sefrova, Jana; Rouskova, Lucie; Grepl, Jakub; Jansa, Jan; Kasaova, Linda; Hodek, Miroslav; Zouhar, Milan; Vosmik, Milan; Petera, Jiri

2012-01-01

To assess target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment and to assess possibility of safety margin reduction. Implementation of IGRT should influence safety margins. Utilization of cone-beam CT provides current 3D anatomic information directly in irradiation position. Such information enables reconstruction of the actual dose distribution. Seventeen prostate patients were treated with daily bony anatomy image-guidance. Cone-beam CT (CBCT) scans were acquired once a week immediately after bony anatomy alignment. After the prostate, seminal vesicles, rectum and bladder were contoured, the delivered dose distribution was reconstructed. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed a 1 cm safety margin. Alternative plans assuming a smaller 7 mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with the initial ones. Rectal and bladder volumes irradiated with doses higher than 75 Gy, 70 Gy, 60 Gy, 50 Gy and 40 Gy were analyzed. In 12% of reconstructed plans the prostate coverage was not sufficient. The prostate underdosage was observed in 5 patients. Coverage of seminal vesicles was not satisfactory in 3% of plans. Most of the target underdosage corresponded to excessive rectal or bladder filling. Evaluation of alternative plans assuming a smaller 7 mm margin revealed 22% and 11% of plans where prostate and seminal vesicles coverage, respectively, was compromised. These were distributed over 8 and 7 patients, respectively. Sufficient dose coverage of target volumes was not achieved for all patients. Reducing of safety margin is not acceptable. Initial rectal and bladder volumes cannot be considered representative for subsequent treatment.

Effect of Visual Art School-Based Stroke Intervention for Middle School Students.

PubMed

Johnson, Ashleigh B; Montgomery, Chelsea M; Dillard, Wesley A; Morrill, Kenneth; Hoesli, Coral; Gillette, Wesley M; Johnson, Brandon K; Nathaniel, Thomas I

2017-08-01

Community stroke awareness initiatives have traditionally been used to expand knowledge of stroke signs and risk factors to high-risk adult populations. Here, we use a novel unfettered, visual art-based approach for an elementary school initiative to raise stroke awareness. Seventh graders in a middle school art class received stroke awareness training during the course of the 2015 to 2016 school year through their teacher in the visual arts class. In turn, they used this training to develop their own artistic interpretations of key stroke awareness concepts via project-based learning and then present their projects to raise awareness about stroke. We evaluated our predata and postdata to determine whether the visual art school-based stroke intervention was effective in both educating students about stroke and enabling them to effectively disseminate this information to parents and other adults in their community. The pretest evaluation indicates a fair or good knowledge about stroke, and no student indicated an "outstanding" or "excellent" knowledge. The posttest evaluation indicated a higher degree of stroke awareness because students were rated as having an "outstanding," "excellent," or "very good" performance especially in the ability to translate knowledge of stroke awareness lessons learned in their art class into a well-articulated stroke-related project and presentation. Pearson χ test reveals significant difference (P < .001) between the pretest and posttest evaluations. Our results indicate that our school-based stroke intervention was effective in both educating students about stroke and enabling them to effectively disseminate this information to parents and other adults in their community. The use of a visual art teacher to lead the educational component in the intervention indicates that expertise in neurology or stroke is not necessary to facilitate understanding of stroke and highlights the importance of creativeness in stroke education for children.

CMAQ Involvement in Air Quality Model Evaluation International Initiative

EPA Pesticide Factsheets

Description of Air Quality Model Evaluation International Initiative (AQMEII). Different chemical transport models are applied by different groups over North America and Europe and evaluated against observations.

Information literacy needs in graduate-level health sciences education.

PubMed

Kleyman, Emily Z; Tabaei, Sara

2012-01-01

To determine whether incorporating information literacy education through workshops led by library faculty improves students' information literacy skills. A series of information literacy initiatives were incorporated into the curriculum of a physician assistant program. Initiatives included two library workshops, class instruction, and a research paper. Assessment included subjective and objective measures of students' information literacy skills and research competencies. Students' ratings of their skills were significantly higher on the postmeasure (t37 = 2.85, P = .007). The objective measures of these skills revealed an increase from 25% to 65% of the class scoring above 70% correct. Class assignments also revealed an improvement from 10% of the class citing and referencing material correctly at the beginning of the initiative to 80% at the end of the initiative. Engaging academic library faculty and providing students with guided instruction has a significant positive effect on objective as well as subjective measures of students' skills.

Evaluating a complex, multi-site, community-based program to improve healthcare quality: the summative research design for the Aligning Forces for Quality initiative.

PubMed

Scanlon, Dennis P; Wolf, Laura J; Alexander, Jeffrey A; Christianson, Jon B; Greene, Jessica; Jean-Jacques, Muriel; McHugh, Megan; Shi, Yunfeng; Leitzell, Brigitt; Vanderbrink, Jocelyn M

2016-08-01

The Aligning Forces for Quality (AF4Q) initiative was the Robert Wood Johnson Foundation's (RWJF's) signature effort to increase the overall quality of healthcare in targeted communities throughout the country. In addition to sponsoring this 16-site complex program, RWJF funded an independent scientific evaluation to support objective research on the initiative's effectiveness and contributions to basic knowledge in 5 core programmatic areas. The research design, data, and challenges faced during the summative evaluation phase of this near decade-long program are discussed. A descriptive overview of the summative research design and its development for a multi-site, community-based, healthcare quality improvement initiative is provided. The summative research design employed by the evaluation team is discussed. The evaluation team's summative research design involved a data-driven assessment of the effectiveness of the AF4Q program at large, assessments of the impact of AF4Q in the specific programmatic areas, and an assessment of how the AF4Q alliances were positioned for the future at the end of the program. The AF4Q initiative was the largest privately funded community-based healthcare improvement initiative in the United States to date and was implemented at a time of rapid change in national healthcare policy. The implementation of large-scale, multi-site initiatives is becoming an increasingly common approach for addressing problems in healthcare. The summative evaluation research design for the AF4Q initiative, and the lessons learned from its approach, may be valuable to others tasked with evaluating similarly complex community-based initiatives.

The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients.

PubMed

Lycke, Michelle; Lefebvre, Tessa; Pottel, Lies; Pottel, Hans; Ketelaars, Lore; Stellamans, Karin; Eygen, Koen Van; Vergauwe, Philippe; Werbrouck, Patrick; Goethals, Laurence; Schofield, Patricia; Boterberg, Tom; Debruyne, Philip R

2017-01-01

Research has indicated that cancer-related cognitive impairments (CRCI) may be influenced by psychosocial factors such as distress, worry and fatigue. Therefore, we aimed to validate the distress thermometer (DT) as a screening tool to detect CRCI six months post-treatment-initiation in a group of general cancer patients. Patients (≥18 years, n = 125) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated at baseline (T0) and six months post-treatment-initiation (T1) for CRCI by a neuropsychological assessment, including patient-reported outcome measures (PROMs). Assessed cognitive domains included premorbid intelligence, attention, processing speed, flexibility, verbal and visual episodic memory and verbal fluency. PROMs entailed distress (DT, cut-off ≥4, range 0-10), anxiety and depression, fatigue (FACIT-fatigue scale) and subjective cognitive complaints. At T0, 60.4% of patients showed a DT score of ≥4, whereas 50% met this criterion at T1. According to the definition of the International Cognition and Cancer Task Force, 25.5% and 28.3% of patients presented with a CRCI at T0 and T1, respectively. When evaluating the DT as a screening tool for CRCI at T1, data showed an inverse relationship between the DT and CRCI. ROC-curve analysis revealed an AUC <0.5. ROC-curve analyses evaluating the DT and FACIT-fatigue scale as screening tools for subjective cognitive complaints showed an AUC ± SE of, respectively, 0.642 ± 0.067 and 0.794 ± 0.057. The DT at T0 cannot be used to screen for objective CRCI at T1, but both the DT and FACIT-fatigue scale at T0 showed potential as screening tools for subjective cognitive complaints at T1.

Retrospective Evaluation of the Short-Term Sustainability of the Locally Grown Produce Initiative of the Hunger Prevention and Nutrition Assistance Program in New York State.

PubMed

Allsopp, Marie A K; Hosler, Akiko S

2018-03-27

The Hunger Prevention and Nutrition Assistance Program (HPNAP) is a New York State Department of Health program. The HPNAP improves nutritional quality of food available at food banks, food pantries, soup kitchens, and emergency shelters through contractual relationships to fund the purchase, delivery, storage, and service of nutritious food. To determine whether a one-time fiscal stimulus of the Locally Grown Produce Initiative to HPNAP contractors in 2012-2013 would result in a short-term sustainable increase in the proportion of dollars spent on New York State Grown (NYSG) produce. Quasi-experimental, nonequivalent control group design. We analyzed New York State Department of Health administrative data regarding expenditures on all produce and NYSG produce by HPNAP contractors. New York State. The proportion of dollars spent on NYSG produce during 2011-2012 (preintervention) and 2013-2014 (postintervention) was compared between HPNAP food bank contractors (recipients of stimulus money, n = 8) and non-food bank contractors (nonrecipients, n = 34) using nonparametric methods. The HPNAP Locally Grown Produce Initiative was associated with an increased proportion of NYSG produce spending by food bank contractors that received a fiscal stimulus 1 year later. Upstate food banks had the largest increase (median 31.6%) among all HPNAP contractors. The results of this study revealed that the Locally Grown Produce Initiative fiscal stimulus had a positive, year-long and statewide effect on the proportion of expenditure on NYSG produce by food banks. We hope that the initial success seen in New York State may encourage other states to adopt similar initiatives in future.

New Constraints on the Abundance of 60Fe in the Early Solar System

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

Trappitsch, Reto; Boehnke, Patrick; Stephan, Thomas

Establishing the abundance of the extinct radionuclide 60Fe (half-life 2.62 Ma) in the early solar system is important for understanding the astrophysical context of solar system formation. While bulk measurements of early solar system phases show a low abundance consistent with galactic background, some in situ measurements by secondary ion mass spectrometry (SIMS) imply a higher abundance, which would require injection from a nearby supernova (SN). In this paper, we present in situ nickel isotopic analyses by resonance ionization mass spectrometry (RIMS) in a chondrule from the primitive meteorite Semarkona (LL3.00). The same chondrule had been previously analyzed by SIMS.more » Despite improved precision compared to SIMS, the RIMS nickel isotopic data do not reveal any resolved excesses of 60Ni that could be unambiguously ascribed to in situ 60Fe decay. Linear regression of 60Ni/ 58Ni versus 56Fe/ 58Ni yields an initial 60Fe/ 56Fe ratio for this chondrule of (3.8 ± 6.9) × 10 -8, which is consistent with both the low initial value found by bulk measurements and the low end of the range of initial ratios inferred from some in situ work. The same regression also gives a solar initial 60Ni/ 58Ni ratio, which shows that this sample was not disturbed by nickel mobilization, thus agreeing with a low initial 60Fe/ 56Fe ratio. These findings agree with a re-evaluation of previous SIMS measurements of the same sample. Finally, supernova injection of 60Fe into the solar system or its parental cloud material is therefore not necessary to account for the measured solar system's initial amount of 60Fe.« less

New Constraints on the Abundance of 60Fe in the Early Solar System

NASA Astrophysics Data System (ADS)

Trappitsch, Reto; Boehnke, Patrick; Stephan, Thomas; Telus, Myriam; Savina, Michael R.; Pardo, Olivia; Davis, Andrew M.; Dauphas, Nicolas; Pellin, Michael J.; Huss, Gary R.

2018-04-01

Establishing the abundance of the extinct radionuclide 60Fe (half-life 2.62 Ma) in the early solar system is important for understanding the astrophysical context of solar system formation. While bulk measurements of early solar system phases show a low abundance consistent with galactic background, some in situ measurements by secondary ion mass spectrometry (SIMS) imply a higher abundance, which would require injection from a nearby supernova (SN). Here we present in situ nickel isotopic analyses by resonance ionization mass spectrometry (RIMS) in a chondrule from the primitive meteorite Semarkona (LL3.00). The same chondrule had been previously analyzed by SIMS. Despite improved precision compared to SIMS, the RIMS nickel isotopic data do not reveal any resolved excesses of 60Ni that could be unambiguously ascribed to in situ 60Fe decay. Linear regression of 60Ni/58Ni versus 56Fe/58Ni yields an initial 60Fe/56Fe ratio for this chondrule of (3.8 ± 6.9) × 10‑8, which is consistent with both the low initial value found by bulk measurements and the low end of the range of initial ratios inferred from some in situ work. The same regression also gives a solar initial 60Ni/58Ni ratio, which shows that this sample was not disturbed by nickel mobilization, thus agreeing with a low initial 60Fe/56Fe ratio. These findings agree with a re-evaluation of previous SIMS measurements of the same sample. Supernova injection of 60Fe into the solar system or its parental cloud material is therefore not necessary to account for the measured solar system’s initial amount of 60Fe.

New Constraints on the Abundance of 60Fe in the Early Solar System

DOE PAGES

Trappitsch, Reto; Boehnke, Patrick; Stephan, Thomas; ...

2018-04-19

Establishing the abundance of the extinct radionuclide 60Fe (half-life 2.62 Ma) in the early solar system is important for understanding the astrophysical context of solar system formation. While bulk measurements of early solar system phases show a low abundance consistent with galactic background, some in situ measurements by secondary ion mass spectrometry (SIMS) imply a higher abundance, which would require injection from a nearby supernova (SN). In this paper, we present in situ nickel isotopic analyses by resonance ionization mass spectrometry (RIMS) in a chondrule from the primitive meteorite Semarkona (LL3.00). The same chondrule had been previously analyzed by SIMS.more » Despite improved precision compared to SIMS, the RIMS nickel isotopic data do not reveal any resolved excesses of 60Ni that could be unambiguously ascribed to in situ 60Fe decay. Linear regression of 60Ni/ 58Ni versus 56Fe/ 58Ni yields an initial 60Fe/ 56Fe ratio for this chondrule of (3.8 ± 6.9) × 10 -8, which is consistent with both the low initial value found by bulk measurements and the low end of the range of initial ratios inferred from some in situ work. The same regression also gives a solar initial 60Ni/ 58Ni ratio, which shows that this sample was not disturbed by nickel mobilization, thus agreeing with a low initial 60Fe/ 56Fe ratio. These findings agree with a re-evaluation of previous SIMS measurements of the same sample. Finally, supernova injection of 60Fe into the solar system or its parental cloud material is therefore not necessary to account for the measured solar system's initial amount of 60Fe.« less

The influence of school demographic factors and perceived student discrimination on delinquency trajectory in adolescence.

PubMed

Le, Thao N; Stockdale, Gary

2011-10-01

The purpose of this study was to examine the effects of school demographic factors and youth's perception of discrimination on delinquency in adolescence and into young adulthood for African American, Asian, Hispanic, and white racial/ethnic groups. Using data from the National Longitudinal Study of Adolescent Health (Add Health), models testing the effect of school-related variables on delinquency trajectories were evaluated for the four racial/ethnic groups using Mplus 5.21 statistical software. Results revealed that greater student ethnic diversity and perceived discrimination, but not teacher ethnic diversity, resulted in higher initial delinquency estimates at 13 years of age for all groups. However, except for African Americans, having a greater proportion of female teachers in the school decreased initial delinquency estimates. For African Americans and whites, a larger school size also increased the initial estimates. Additionally, lower social-economic status increased the initial estimates for whites, and being born in the United States increased the initial estimates for Asians and Hispanics. Finally, regardless of the initial delinquency estimate at age 13 and the effect of the school variables, all groups eventually converged to extremely low delinquency in young adulthood, at the age of 21 years. Educators and public policy makers seeking to prevent and reduce delinquency can modify individual risks by modifying characteristics of the school environment. Policies that promote respect for diversity and intolerance toward discrimination, as well as training to help teachers recognize the precursors and signs of aggression and/or violence, may also facilitate a positive school environment, resulting in lower delinquency. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Sensor design for outdoor racing bicycle field testing for human vibration comfort evaluation

NASA Astrophysics Data System (ADS)

Vanwalleghem, Joachim; De Baere, Ives; Loccufier, Mia; Van Paepegem, Wim

2013-09-01

This paper is concerned with the vibrational comfort evaluation of the cyclist when cycling a rough surface. Outdoor comfort tests have so far only been done through instrumenting the bicycle with accelerometers. This work instruments a racing bicycle with custom-made contact force sensors and velocity sensors to acquire human comfort through the absorbed power method. Comfort evaluation is assessed at the hand-arm and seat interface of the cyclist with the bicycle. By means of careful finite-element analysis for designing the force gauges at the handlebar and the seat combined with precise calibration of both force and velocity sensors, all sensors have proven to work properly. Initial field tests are focused on the proper functioning of the designed sensors and their suitability for vibration comfort measurements. Tests on a cobblestone road reveal that the outcome of the absorbed power values is within the same range as those from laboratory tests found in the literature. This sensor design approach for outdoor testing with racing bicycles may give a new interpretation on evaluating the cyclist's comfort since the vibrational load is not only quantified in terms of acceleration but also in terms of force and velocity at the bicycle-cyclist contact points.

Epidemiology of ametropia of U.S. Army recruits.

PubMed

McAlister, W H; Wingert, T A

1995-02-01

All people attempting to enlist in the U.S. Army must undergo a physical examination that requires a rudimentary vision screening. Those who pass the physical, upon reporting to basic training, are again evaluated and any treatment necessary to allow the recruits to function during their initial indoctrination is provided. Those who fail to see 20/20 O.D. and O.S. with their current spectacles fail the screening and are evaluated by an optometrist. If their condition is not disqualifying, appropriate correction is prescribed. We reviewed the records of all the recruits in a 1-month period who either required spectacles to see 20/20 or failed the screening at the 43rd AG BN (reception). Epidemiological evaluation revealed most to be either simple myopes or myopic astigmats. Hyperopia and hyperopic astigmatism accounted for the next most common diagnosis. Other conditions included anisometropia, antimetropia, amblyopia, keratoconus, and nystagmus. Examinations of these recruits were very limited, with dilated fundus evaluations being performed only when there was a high probability of a disqualifying condition. Therefore, it is unknown what retinal disease or degeneration may be present other than what would be visible with direct ophthalmoscopy.

An evaluation of problem-based learning in a nursing theory and practice module.

PubMed

Barrow, Elizabeth J; Lyte, Geraldine; Butterworth, Tony

2002-03-01

Interest in Problem-Based Learning (PBL) within nurse education has increased internationally in recent years. The expectations of this teaching/learning strategy are that it will enable nurses to develop skills required for professional practice including: enquiry, reasoning, interpersonal and lifelong learning skills. However, to date, there is little empirical evidence within nursing literature to support such expectations. This study evaluated the reiterative PBL approach in an undergraduate programme within one University. The Responsive Evaluation Model (Guba & Lincoln 1989) guided the design of the study, permitting multiple methods of observation, focus group interview s and a questionnaire. Findings revealed an overall positive student experience of PBL. However, many students found PBL initially stressful due to the deliberately ambiguous nature of the scenario and the requirement upon students to direct their own le arning. The tutor role was unclear to some students, while others found the facilitative approach empowering. Recommendations are offered which may be of value to students, teachers and practitioners implementing and facilitating PBL within Making A Difference curricula (Department of Health 1999).

Cultural Adaptation and Reliability of the Compliance with Standard Precautions Scale (CSPS) for Nurses in Brazil 1

PubMed Central

Pereira, Fernanda Maria Vieira; Lam, Simon Ching; Gir, Elucir

2017-01-01

ABSTRACT Objective: this study aimed to carry of the cultural adaptation and to evaluate the reliability of the Compliance with Standard Precautions Scale (CSPS) for nurses in Brazil. Method: the adaptation process entailed translation, consensus among judges, back-translation, semantic validation and pretest. The reliability was evaluated by internal consistency (Cronbach alpha) and stability (test-retest). The instrument was administered to a sample group of 300 nurses who worked in a large hospital located in the city of São Paulo/SP, Brazil. Results: through the semantic validation, the items from the scale were considered understandable and deemed important for the nurse´s clinical practice. The CSPS Brazilian Portuguese version (CSPS-PB) revealed excellent interpretability. The Cronbach`s alpha was 0.61 and the intraclass correlation coefficient was 0.85. Conclusion: the initial study showed that CSPS-PB is appropriate to assess compliance with standard precautions among nurses in Brazil. The reliability was considered acceptable. Furhter study is necessary to evaluate its comprehensive psychometric properties. PMID:28301030

Improving agricultural knowledge management: The AgTrials experience

PubMed Central

Hyman, Glenn; Espinosa, Herlin; Camargo, Paola; Abreu, David; Devare, Medha; Arnaud, Elizabeth; Porter, Cheryl; Mwanzia, Leroy; Sonder, Kai; Traore, Sibiry

2017-01-01

Background: Opportunities to use data and information to address challenges in international agricultural research and development are expanding rapidly. The use of agricultural trial and evaluation data has enormous potential to improve crops and management practices. However, for a number of reasons, this potential has yet to be realized. This paper reports on the experience of the AgTrials initiative, an effort to build an online database of agricultural trials applying principles of interoperability and open access. Methods: Our analysis evaluates what worked and what did not work in the development of the AgTrials information resource. We analyzed data on our users and their interaction with the platform. We also surveyed our users to gauge their perceptions of the utility of the online database. Results: The study revealed barriers to participation and impediments to interaction, opportunities for improving agricultural knowledge management and a large potential for the use of trial and evaluation data.  Conclusions: Technical and logistical mechanisms for developing interoperable online databases are well advanced.  More effort will be needed to advance organizational and institutional work for these types of databases to realize their potential. PMID:28580127

Climate change initiatives of state departments of transportation : synthesis

DOT National Transportation Integrated Search

2008-01-01

The WSDOT Public Transportation Division Director requested a synthesis report on the role of state departments of transportation in climate change initiatives. A search of available information has revealed a host of measures underway to reduce gree...

Promoting pre-conceptional use of folic acid to Hispanic women: a social marketing approach.

PubMed

Quinn, Gwendolyn P; Hauser, Kimberlea; Bell-Ellison, Bethany A; Rodriguez, Nydia Y; Frías, Jaime L

2006-09-01

To develop a culturally appropriate communication initiative in an effort to promote the use of pre-conceptional folic acid among Hispanic women of childbearing age. The materials were designed to communicate information about the risks of neural tube defects and the value of folic acid supplementation before conception. The initiative was developed using a social marketing approach. A series of focus groups were conducted with Hispanic women, particularly Mexican and Mexican-American women, to gain an understanding of their knowledge, attitudes, and behaviors regarding birth defects and folic acid. Additionally focus groups assessed women's preferences for existing folic acid education materials. Qualitative analysis of coded transcripts revealed key themes which were incorporated into a multi-media initiative. Critical themes of the research highlighted the need to include the role of partners and a sense of family in the promotions aimed at these groups. Another key component was the need to dispel myths which act as barriers to pre-conceptional folic acid use. Other important elements included in the media products were the need for Spanish and English versions, an explanation of neural tube defects, and a reference to the cost of the supplements. The final products of the initiative included Spanish and English versions of a brochure, photo-novella, and radio public service announcement. Pre-testing results showed women understood the message, thought the message was for women like them, and expected to begin taking a folic acid supplement. Results of the overall evaluation of the initiative are on-going.

Use of hospital-related health care among Health Links enrollees in the Central Ontario health region: a propensity-matched difference-in-differences study

PubMed Central

Mondor, Luke; Walker, Kevin; Bai, Yu Qing; Wodchis, Walter P.

2017-01-01

Background: Health Links are a new model of providing care coordination for high-cost, high-needs patients in Ontario. We evaluated use of hospital-related health care services among Health Links patients in the Central Local Health Integration Network (LHIN) of Ontario in the year before versus after program enrolment and compared rates of use with those among similar patients with complex needs not enrolled in the program (comparator group). Methods: We identified all patients who received a Health Links coordinated care plan before Jan. 1, 2015, using linked registry and health administrative data. We used propensity scores to match (1:1) enrollees (registry) with comparator patients (administrative data). Using a difference-in-differences approach with generalized estimating equations, we evaluated 5 measures of Health Link performance: rates of hospital admission, emergency department visits, days in acute care, 30-day readmissions and 7-day postdischarge primary care follow-up. Results: Of the 344 enrollees in the registry, we matched 313 [91.0%] to comparator patients. All measured sociodemographic, comorbidity and health care use characteristics were balanced between the 2 groups (all standardized differences < 0.10). For enrollees, the rate of days in acute care per person-year increased by 35% (incidence rate ratio 1.35 [confidence interval 1.11-1.65]) after versus before the index date, but differences were nonsignificant for all other measures. Difference-in-differences analyses revealed greater reductions in hospital admissions, emergency department visits and acute care days after the index date in the comparator group than among enrollees. Interpretation: Initial implementation of the Health Link program in the Central LHIN did not reduce selected indicators of Health Link performance among enrollees. As the Health Link program evolves and standardization is implemented, future research may reveal effects from the initiative in other outcomes or with longer follow-up. PMID:29025737

Functional imaging in differentiating bronchial masses: an initial experience with a combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan.

PubMed

Kumar, Arvind; Jindal, Tarun; Dutta, Roman; Kumar, Rakesh

2009-10-01

To evaluate the role of combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest. Prospective observational study. Place of study: All India Institute of Medical Sciences, New Delhi, India. 7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent (18)F-FDG PET-CT scan, (68)Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor. Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild (18)F-FDG uptake and high (68)Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of (18)F-FDG and high (68)Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of (18)F-FDG and no uptake of (68)Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild (18)F-FDG uptake and no (68)Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate (18)F-FDG uptake and mild focal (68)Ga DOTA-TOC uptake. This initial experience with the combined use of (18)F-FDG and (68)Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.

The Use of the Data Assimilation Research Testbed for Initializing and Evaluating IPCC Decadal Forecasts

NASA Astrophysics Data System (ADS)

Raeder, K.; Anderson, J. L.; Lauritzen, P. H.; Hoar, T. J.; Collins, N.

2010-12-01

DART (www.image.ucar.edu/DAReS/DART) is a general purpose, freely available, ensemble Kalman filter, data assimilation system, which is being used to generate state-of-the-art, partially coupled, ocean-atmosphere re-analyses in support of the decadal predictions planned for the next IPCC report. The resulting gridded product is directly comparable to the state variables output by POP and CAM (oceanic and atmospheric components of NCAR's Community Earth System Model climate model) because those are the assimilating models. Other models could also benefit from comparison against these reanalyses, since the ocean analyses are at the leading edge of ocean state estimation, and the atmospheric analyses are competitive with operational centers'. Such comparisons can reveal model biases and predictability characteristics, and do so in a quantitative way, since the ensemble nature of the analyses provides an objective estimate of the analysis error. The analyses will also be used as initial conditions for the decadal forecasts because they are the most realistic available. The generation of such analyses has revealed errors in model formulation for several versions of the finite volume core CAM, which has led to model improvements in each case. New models can be incorporated into DART in a matter of weeks, allowing them to be compared directly against available observations. The observations currently used in the assimilations include, for the ocean; temperature and salinity from the World Ocean Database (floats, drifters, moorings, autonomous pinipeds, and others), and for the atmosphere; temperature and winds from radiosondes, satellite drift winds, ACARS and aircraft. Observations of ocean currents and atmospheric moisture and pressure are also available. Global Positioning System profiles of atmospheric temperature and moisture are available for recent years. All that is required to add new observations to the suite is the forward operator, which generates an estimate of the observation from the model state. In summary, DART provides a flexible, convenient, rigorous environment for evaluating models in the context of real observations.

Central diabetes insipidus in an African Grey parrot.

PubMed

Starkey, Simon R; Wood, Catherine; de Matos, Ricardo; Ledbetter, Eric C; Morrisey, James K

2010-08-15

A 5.5-year-old sexually intact female African Grey parrot (Psittacus erithacus) was evaluated for a 1-year history of pronounced polyuria and polydipsia. The bird also had a 1-month history of signs of mild depression and mydriasis. Physical examination revealed a thin body condition and incomplete bilateral mydriasis. Other examination findings as well as CBC and screening radiography results were unremarkable. Plasma biochemical analysis revealed mild hypernatremia. The bird had a 3.3% loss in body weight over 170 minutes during a water deprivation test, and urine osmolality remained low. After IM administration of 0.9 microg of desmopressin, the rate of weight loss decreased substantially and urine osmolality increased 300% over the following 200 minutes. Initial attempts to treat the bird with orally administered desmopressin failed to correct the polydipsia and polyuria. Ultimately, IM administration of 24 microg of desmopressin/kg (10.9 microg/lb) every 12 hours yielded a noticeable reduction in water consumption and urine production over a 6- to 8-hour period. Eight months later, the bird was returned for a recheck examination, at which time it was in good health and continued to respond to the medication. Despite continued response to the medication, right-sided internal ophthalmoparesis was detected 16 months after the initial diagnosis. To the authors' knowledge, central diabetes insipidus in birds has not been reported. The condition should be considered in birds with clinical signs of disease similar to those in mammals. Long-term IM administration of desmopressin may be a viable treatment option.

Initial Development and Psychometric Properties of a New Measure of Substance Use Disorder "Recovery Progression": The Recovery Progression Measure (RPM).

PubMed

Elison, Sarah; Davies, Glyn; Ward, Jonathan

2016-07-28

There is a growing literature around substance use disorder treatment outcomes measures. Various constructs have been suggested as being appropriate for measuring recovery outcomes, including "recovery capital" and "treatment progression." However, these previously proposed constructs do not measure changes in psychosocial functioning during the recovery process. Therefore, a new psychometric assessment, the "Recovery Progression Measure" (RPM), has been developed to measure this recovery oriented psychosocial change. The aims of this study were to evaluate the reliability and factor structure of the RPM via data collected from 2218 service users being treated for their substance dependence. Data were collected from service users accessing the Breaking Free Online (BFO) substance use disorder treatment and recovery program, which has within its baseline assessment a 36-item psychometric measure previously developed by the authors to assess the six areas of functioning described in the RPM. Reliability analyses and exploratory factor analyses (EFA) were conducted to examine the underlying factor structure of the RPM measure. Internal reliability of the RPM measure was found to be excellent (α > .70) with the overall assessment to have reliability α = .89, with item-total correlations revealing moderate-excellent reliability of individual items. EFA revealed the RPM to contain an underlying factor structure of eight components. This study provides initial data to support the reliability of the RPM as a recovery measure. Further work is now underway to extend these findings, including convergent and predictive validity analyses.

[Toxoplasmosis peri-myocarditis as initial manifestation of highly malignant non-Hodgkin's lymphoma].

PubMed

Zweiker, R; Eber, B; Samonigg, H; Reisinger, E C; Kasparek, A; Schumacher, M; Fruhwald, F M; Apfelbeck, U; Klein, W

1994-03-01

A case report of a 28-year-old mother of two children with FUO is presented. Physical examination revealed an anemic and febrile woman, who lost 10 kg of weight during the past 3 months. Furthermore, two lymphatic nodes with diameters below 1 cm were detected at the neck and inguinal region. A search for origin of fever including evaluation of foci, malignancies and laboratory investigations was primarily unsuccessful. At day 7 after admission a pericardial murmur could be heard. Echocardiography revealed a pericardial effusion, which increased up to 4 cm during the following days, leading to hemodynamic impairment and asystole. Immediate CR was successful, pericardial effusion was aspirated. Looking for etiology of fever the presence of IgM-antibodies against toxoplasma gondii by an ELISA test was possible. Therefore, toxoplasmosis was diagnosed and a treatment-regimen comprising pyrimethamin and sulfadiazin was initiated. Because of the threat to life and very high titers of C-reactive protein, antibiotic therapy (imipenem) was given additionally. An immunologic impairment was excluded by normal ratio of CD4:CD8 of lymphocytes, normal HIV-test and a nonsuspicious Jamshidi-biopsy of the bone marrow. However, in week 9 after admission lymphatic node-tumors suddenly appeared at the neck and pulmonary hilus. After diagnostic exstirpation a malignant non-Hodgkin-lymphoma (T-cell-type) was diagnosed. It is concluded that in obscure pericardial effusion toxoplasmosis should be considered and that this manifestation may be a precursor of malignant non-Hodgkin-lymphoma.

Periodontal therapy for severe chronic periodontitis with periodontal regeneration and different types of prosthesis.

PubMed

Kinumatsu, Takashi; Umehara, Kazuhiro; Nagano, Kyosuke; Saito, Atsushi

2014-01-01

We report a patient with severe chronic periodontitis requiring regenerative periodontal surgery and different types of prosthesis in the maxillary and mandibular regions. The patient was a 57-year-old woman who presented with the chief complaint of occlusal pain. An initial clinical examination revealed that 73% of sites had a probing depth of ≥4 mm, and 60% of sites exhibiting bleeding on probing. Radiographic examination revealed vertical bone defects in the molar region and widening of the periodontal ligament space around teeth #17 and 24. Initial periodontal therapy was implemented based on a clinical diagnosis of severe chronic periodontitis. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using enamel matrix derivative was performed on #14, 15, and 35-37. Tunnel preparation was performed on #46 as it had a 2-wall vertical bony defect and Degree 3 furcation involvement. Other sites with residual periodontal pockets were treated by modified Widman flap surgery. After a re-evaluation, functional rehabilitation was implemented with a removable maxillary partial denture and a fixed mandibular bridge. No further deterioration was observed in the periodontal condition of most of the teeth during a 2-year period of supportive periodontal therapy (SPT). The patient is currently still undergoing SPT and some minor problems remain. However, the results suggest that treatment and subsequent maintenance for severe periodontitis with traumatic occlusion can be successful as long as the appropriate periodontal and prosthodontic treatment is planned and careful SPT carried out.

The influence of the compression interface on the failure behavior and size effect of concrete

NASA Astrophysics Data System (ADS)

Kampmann, Raphael

The failure behavior of concrete materials is not completely understood because conventional test methods fail to assess the material response independent of the sample size and shape. To study the influence of strength and strain affecting test conditions, four typical concrete sample types were experimentally evaluated in uniaxial compression and analyzed for strength, deformational behavior, crack initiation/propagation, and fracture patterns under varying boundary conditions. Both low friction and conventional compression interfaces were assessed. High-speed video technology was used to monitor macrocracking. Inferential data analysis proved reliably lower strength results for reduced surface friction at the compression interfaces, regardless of sample shape. Reciprocal comparisons revealed statistically significant strength differences between most sample shapes. Crack initiation and propagation was found to differ for dissimilar compression interfaces. The principal stress and strain distributions were analyzed, and the strain domain was found to resemble the experimental results, whereas the stress analysis failed to explain failure for reduced end confinement. Neither stresses nor strains indicated strength reductions due to reduced friction, and therefore, buckling effects were considered. The high-speed video analysis revealed localize buckling phenomena, regardless of end confinement. Slender elements were the result of low friction, and stocky fragments developed under conventional confinement. The critical buckling load increased accordingly. The research showed that current test methods do not reflect the "true'' compressive strength and that concrete failure is strain driven. Ultimate collapse results from buckling preceded by unstable cracking.

Intensification of abamectin pesticide degradation using the combination of ultrasonic cavitation and visible-light driven photocatalytic process: Synergistic effect and optimization study.

PubMed

Mosleh, Soleiman; Rahimi, Mahmood Reza

2017-03-01

Degradation of abamectin pesticide was carried out using visible light driven Cu 2 (OH)PO 4 -HKUST-1 MOF photocatalyst through the sonophotocatalytic technique. Cu 2 (OH)PO 4 -HKUST-1 MOF as a visible-light driven photocatalyst, was synthesized and characterized by XRD, SEM, EDS and DRS. The direct bang gaps of HKUST-1 MOF and Cu 2 (OH)PO 4 -HKUST-1 MOF were estimated about 2.63 and 2.59eV, respectively, which reveals that these photocatalysts can be activated under blue light illumination. All sonophotodegradation experiments were performed using a continuous flow-loop reactor. The central composite design (CCD) methodology was applied for modeling, optimization and investigation of influence of operational parameters, i.e. irradiation time, pH, solution flow rate, oxygen flow rate, initial concentration and photocatalyst dosage on the sonophotocatalytic degradation of abamectin. The maximum degradation efficiency of 99.93% was found at optimal values as 20min, 4, 90mL/min, 0.2mL/min, 30mg/L and 0.4g/L, for irradiation time, pH, solution flow rate, oxygen flow rate, initial concentration and photocatalyst dosage, respectively. Evaluation of the synergism in the combination of ultrasonic and photocatalysis lead to a synergistic index of 2.19, which reveals that coupling of ultrasonic and photocatalysis has a greater efficiency than the sum of individual procedures for degradation of abamectin. Copyright © 2016 Elsevier B.V. All rights reserved.

A model to evaluate quality and effectiveness of disease management.

PubMed

Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R

2008-12-01

Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.

Management of minor head injury in patients receiving oral anticoagulant therapy: a prospective study of a 24-hour observation protocol.

PubMed

Menditto, Vincenzo G; Lucci, Moira; Polonara, Stefano; Pomponio, Giovanni; Gabrielli, Armando

2012-06-01

Patients receiving warfarin who experience minor head injury are at risk of intracranial hemorrhage, and optimal management after a single head computed tomography (CT) scan is unclear. We evaluate a protocol of 24-hour observation followed by a second head CT scan. In this prospective case series, we enrolled consecutive patients receiving warfarin and showing no intracranial lesions on a first CT scan after minor head injury treated at a Level II trauma center. We implemented a structured clinical pathway, including 24-hour observation and a CT scan performed before discharge. We then evaluated the frequency of death, admission, neurosurgery, and delayed intracranial hemorrhage. We enrolled and observed 97 consecutive patients. Ten refused the second CT scan and were well during 30-day follow-up. Repeated CT scanning in the remaining 87 patients revealed a new hemorrhage lesion in 5 (6%), with 3 subsequently hospitalized and 1 receiving craniotomy. Two patients discharged after completing the study protocol with 2 negative CT scan results were admitted 2 and 8 days later with symptomatic subdural hematomas; neither received surgery. Two of the 5 patients with delayed bleeding at 24 hours had an initial international normalized ratio greater than 3.0, as did both patients with delayed bleeding beyond 24 hours. The relative risk of delayed hemorrhage with an initial international normalized ratio greater than 3.0 was 14 (95% confidence interval 4 to 49). For patients receiving warfarin who experience minor head injury and have a negative initial head CT scan result, a protocol of 24-hour observation followed by a second CT scan will identify most occurrences of delayed bleeding. An initial international normalized ratio greater than 3 suggests higher risk. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

On the Impact of Multi-GNSS Observations on Real-Time Precise Point Positioning Zenith Total Delay Estimates

NASA Astrophysics Data System (ADS)

Ding, Wenwu; Teferle, Norman; Kaźmierski, Kamil; Laurichesse, Denis; Yuan, Yunbin

2017-04-01

Observations from multiple Global Navigation Satellite System (GNSS) can improve the performance of real-time (RT) GNSS meteorology, in particular of the Zenith Total Delay (ZTD) estimates. RT ZTD estimates in combination with derived precipitable water vapour estimates can be used for weather now-casting and the tracking of severe weather events. While a number of published literature has already highlighted this positive development, in this study we describe an operational RT system for extracting ZTD using a modified version of the PPP-wizard (with PPP denoting Precise Point Positioning). Multi-GNSS, including GPS, GLONASS and Galileo, observation streams are processed using a RT PPP strategy based on RT satellite orbit and clock products from the Centre National d'Etudes Spatiales (CNES). A continuous experiment for 30 days was conducted, in which the RT observation streams of 20 globally distributed stations were processed. The initialization time and accuracy of the RT troposphere products using single and/or multi-system observations were evaluated. The effect of RT PPP ambiguity resolution was also evaluated. The results revealed that the RT troposphere products based on single system observations can fulfill the requirements of the meteorological application in now-casting systems. We noted that the GPS-only solution is better than the GLONASS-only solution in both initialization and accuracy. While the ZTD performance can be improved by applying RT PPP ambiguity resolution, the inclusion of observations from multiple GNSS has a more profound effect. Specifically, we saw that the ambiguity resolution is more effective in improving the accuracy, whereas the initialization process can be better accelerated by multi-GNSS observations. Combining all systems, RT troposphere products with an average accuracy of about 8 mm in ZTD were achieved after an initialization process of approximately 9 minutes, which supports the application of multi-GNSS observations and ambiguity resolution for RT meteorological applications.

Pain and brachial plexus lesions: evaluation of initial outcomes after reconstructive microsurgery and validation of a new pain severity scale.

PubMed

Bonilla, Gonzalo; Di Masi, Gilda; Battaglia, Danilo; Otero, José María; Socolovsky, Mariano

2011-01-01

Peripheral nerve lesions usually are associated with neuropathic pain. In the present paper, we describe a simple scale to quantify pain after brachial plexus injuries and apply this scale to a series of patients to determine initial outcomes after reconstructive surgery. Fifty-one patients with traumatic brachial plexus avulsion injuries were treated over the period of one calendar year at one center by the same surgical team. Of these, 28 patients who were available for follow-up reported some degree of neuropathic pain radiating towards the hand or forearm and underwent reconstructive microsurgery and direct pain management, including trunk and nerve neurolysis and repair. A special pain severity rating scale was developed and used to assess patients' pain before and after surgery, over a minimum follow-up of 6 months. An independent researcher, not part of the surgical team, performed all pre- and postoperative evaluations. Of the 28 patients with brachial plexus traction injuries who met eligibility criteria, 93% were male, and most were young (mean age, 27.6 years). The mean preoperative severity of pain using our scale was 30.9 out of a maximum of 37 (± 0.76 SD), which fell to a mean of 6.9 (± 0.68 SD) 6 months post-procedure. On average, pain declined by 78% across the whole series, a decline that was statistically significant (p < .001). Subset analysis revealed similar improvements across all the different parameters of pain. We have designed and tested a simple and reliable method by which to quantify neuropathic pain after traumatic brachial plexus injuries. Initial surgical treatment of the paralysis--including nerve, trunk and root reconstruction, and neurolysis--comprises an effective means by which to initially treat neuropathic pain. Ablative or neuromodulative procedures, like dorsal root entry zone, should be reserved for refractory cases.

Sleep variability and fatigue in adolescents: Associations with school-related features.

PubMed

Matos, M G; Gaspar, T; Tomé, G; Paiva, T

2016-10-01

This study aims to evaluate the influences of sleep duration and sleep variability (SleepV), upon adolescents' school-related situations. The Health Behaviour in School-Aged Children (HBSC) survey is based on a self-completed questionnaire. The participants were 3164 pupils (53.7% girls), attending the 8th and 10th grades, 14.9 years old, and were inquired about subjective sleep duration during the week and weekends, SleepV, fatigue, difficulties in sleep initiation, school achievement, feelings towards schools, pressure with school work and skipping classes. Multiple regression models used, as dependent variables: (a) school achievement, (b) disliking school, (c) pressure with school work and (d) skipping classes, using as independent variables, each of the remaining school-related variables, fatigue, total sleep duration and difficulties in sleep initiation. The average sleep duration in the week and during weekdays was lower than recommended for these age groups, and almost half of students had high SleepV between weekdays and weekends. A logistic model revealed that the absence of SleepV was associated with lower perception of school work pressure, less frequent skipping classes, more infrequent fatigue and more infrequent difficulties in sleep initiation. Poor sleep quality, SleepV and insufficient sleep duration affected negatively school-related variables. © 2015 International Union of Psychological Science.

Longitudinal patterns of semantic and episodic memory in frontotemporal lobar degeneration and Alzheimer's disease.

PubMed

Xie, Sharon X; Libon, David J; Wang, Xingmei; Massimo, Lauren; Moore, Peachie; Vesely, Luisa; Khan, Alea; Chatterjee, Anjan; Coslett, H Branch; Hurtig, Howard I; Liang, Tsao-Wei; Grossman, Murray

2010-03-01

The longitudinal assessment of episodic and semantic memory was obtained from 236 patients diagnosed with Alzheimer's disease (AD, n = 128) and with frontotemporal lobar degeneration (FTLD, n = 108), including patients with a social comportment/dysexecutive (SOC/EXEC) disorder, progressive nonfluent aphasia (PNFA), semantic dementia (SemD), and corticobasal syndrome (CBS). At the initial assessment, AD patients obtained a lower score on the delayed free recall test than other patients. Longitudinal analyses for delayed free recall found converging performance, with all patients reaching the same level of impairment as AD patients. On the initial evaluation for delayed recognition, AD patients also obtained lower scores than other groups. Longitudinal analyses for delayed recognition test performance found that AD patients consistently produced lower scores than other groups and no convergence between AD and other dementia groups was seen. For semantic memory, there were no initial between-group differences. However, longitudinal analyses for semantic memory revealed group differences over illness duration, with worse performance for SemD versus AD, PNFA, SOC/EXEC, and CBS patients. These data suggest the presence of specific longitudinal patterns of impairment for episodic and semantic memory in AD and FTLD patients suggesting that all forms of dementia do not necessarily converge into a single phenotype.

Matrix-type transdermal films to enhance simvastatin ex vivo skin permeability.

PubMed

El-Say, Khalid M; Ahmed, Osama A A; Aljaeid, Bader M; Zidan, Ahmed S

2017-06-01

This study aimed at employing Plackett-Burman design in screening formulation variables that affect quality of matrix-type simvastatin (SMV) transdermal film. To achieve this goal, 12 formulations were prepared by casting method. The investigated variables were Eudragit RL percentage, polymer mixture percentage, plasticizer type, plasticizer percentage, enhancer type, enhancer percentage and dichloromethane fraction in organic phase. The films were evaluated for physicochemical properties and ex vivo SMV permeation. SMV initial, delayed flux, diffusivity and permeability coefficient were calculated on the delayed flux phase with constraint to minimize the initial flux and approaching steady-state flux. The obtained results revealed flat films with homogeneous distribution of SMV within the films. Thickness values changed from 65 to 180 μm by changing the factors' combinations. Most of the permeation profiles showed sustained release feature with fast permeation phase followed by slow phase. Analysis of variance (ANOVA) showed significant effects (p < 0.05) of the investigated variables on the responses with Prob > F values of 0.0147, 0.0814, 0.0063 and 0.0142 for the initial and delayed fluxes, permeability coefficients and diffusivities, respectively. The findings of screening study showed the importance of the significant variables to be scaled up for full optimization study as a promising alternative drug delivery system.

Provision of pandemic disease information by health sciences librarians: a multisite comparative case series*†‡§

PubMed Central

Featherstone, Robin M; Boldt, R. Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

2012-01-01

Objective: The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Methods: Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Results: Comparison of the four cases revealed a distinct difference between “client-initiated” and “librarian-initiated” provision of pandemic information. Librarian-initiated projects utilized social software to “push” information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Conclusions: Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease. PMID:22514506

Dynamic patient counseling: a novel concept in idiopathic pulmonary fibrosis.

PubMed

Brown, A Whitney; Shlobin, Oksana A; Weir, Nargues; Albano, Maria C; Ahmad, Shahzad; Smith, Mary; Leslie, Kevin; Nathan, Steven D

2012-10-01

The characteristics of long-term survivors with idiopathic pulmonary fibrosis (IPF) have never been fully elucidated. We sought to illustrate the attenuated mortality and describe the characteristics of patients with IPF who survived at least 5 years beyond their initial presentation. Patients with IPF evaluated between 1997 and 2006 were identified through the clinic database. Patients who survived beyond 5 years from the time of their evaluation were compared with those who died or underwent lung transplantation within 5 years. Survival analyses were performed from the time of initial evaluation and contingent on annualized survival thereafter. Eighty-seven patients who survived at least 5 years formed the comparator group to whom other patients were contrasted. These patients had a higher BMI, FVC % predicted, FEV1 % predicted, total lung capacity % predicted, and diffusing capacity of lung for carbon monoxide % predicted, but a lower FEV1/FVC ratio and lower mean pulmonary artery pressures. More than one-half of these patients had moderate or severe disease at the time of presentation. Our annualized contingent survival analyses revealed a progressively increasing median survival dependent on the duration of the disease. Although we were able to demonstrate differences in our 5-year survivors, rather than being a distinct group, these patients appear to exist within a continuum of improving survival dependent on prior disease duration. This progressively improving time-dependent prognosis mandates the serial reevaluation of an individual patient’s projected outcomes. The implementation of dynamic counseling is an important concept in more accurately predicting life expectancy for patients with IPF who are frequently haunted by the prospects of a dismal survival.

Artifacts Introduced in the Point Evaluation of Functions Expanded into a Degree 360 Spherical Harmonic Series

NASA Technical Reports Server (NTRS)

Rapp, R.

1999-01-01

An expansion of a function initially given in 1deg cells was carried out to degree 360 by using 30'cells whose value was initially assigned to be the value of the 1deg cell in which it fell. The evaluation of point values of the function from the degree 360 expansion revealed spurious patterns attributed to the coefficients from degree 181 to 360. Expansion of the original function in 1deg cells to degree 180 showed no problems in the point evaluation. Mean 1deg values computed from both degree 180 to 360 expansions showed close agreement with the original function. The artifacts could be removed if the 30' values were interpolated by spline procedures from adjacent I' cells. These results led to an examination of the gravity anomalies and geoid undulations from EGM96 in areas where I' values were "split up" to form 30'cells. The area considered was 75degS to 85degS, 100degE to 120degE where the split up cells were basically south of 81 degS. A small, latitude related, and possibly spurious effect might be detectable in anomaly variations in the region. These results suggest that point values of a function computed from a high degree expansion may have spurious signals unless the cell size is compatible with the maximum degree of expansion. The spurious signals could be eliminated by using a spline interpolation procedure to obtain the 30'values from the 1deg values.

ARMY GAS-COOLED REACTOR SYSTEMS PROGRAM. Quarterly Progress Report, October 1-December 31, 1963

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

None

1964-02-15

The ML-1 power plant did not operate during the report period; low power reactor physics and shielding experiments were conducted with the ML-1 reactor. Evaluation of moderate corrosion observed on aluminum parts exposed to the ML-1 shield solution indicated no loss of performance capability. Preliminary tests showed that the corrosion probably was caused by heavy metal ions or chlorides in the solution, Massive corrosion observed on the ML-1 fuel element lower spiders was attributed to sub-standard material; failure of some spiders was attributed to a combination of corrosion and sub-standard fabrication. Evaluation indicated that the upper spiders will perform satisfactorilymore » for the design lifetime. Modification, repair, and reassembly of the CSN-1A t-c set was completed. Operation demonstrated bearing stability, but showed that the turbine effective flow area was too large. A bypass flow path in the turbine was being corrected. The TCS-670 t-c set will be stored indefinitely. Since a commercial alternator will be used for the ML-1A, further development of the brushless alternator was postponed indefinitely. Evaluation revealed that the ML-1 improved precooler design was not compatible with ML-1A requirements. Operntion of the IB-17R-2 and -3 test elements in the GETR continued without incident. Preliminary design of the ML-1A power plant was initiated. Design of modifications to the GCRE facility to adapt it to testing the ML-1 reactor skid was initiated. (auth)« less

An evaluation of deficits in semantic cueing and proactive and retroactive interference as early features of Alzheimer's disease.

PubMed

Crocco, Elizabeth; Curiel, Rosie E; Acevedo, Amarilis; Czaja, Sara J; Loewenstein, David A

2014-09-01

To determine the degree to which susceptibility to different types of semantic interference may reflect the initial manifestations of early Alzheimer's disease (AD) beyond the effects of global memory impairment. Normal elderly (NE) subjects (n = 47), subjects with amnestic mild cognitive impairment (aMCI; n = 34), and subjects with probable AD (n = 40) were evaluated by using a unique cued recall paradigm that allowed for evaluation of both proactive and retroactive interference effects while controlling for global memory impairment (i.e., Loewenstein-Acevedo Scales of Semantic Interference and Learning [LASSI-L] procedure). Controlling for overall memory impairment, aMCI subjects had much greater proactive and retroactive interference effects than NE subjects. LASSI-L indices of learning by using cued recall revealed high levels of sensitivity and specificity, with an overall correct classification rate of 90%. These measures provided better discrimination than traditional neuropsychological measures of memory function. The LASSI-L paradigm is unique and unlike other assessments of memory in that items posed for cued recall are explicitly presented, and semantic interference and cueing effects can be assessed while controlling for initial level of memory impairment. This is a powerful procedure that allows the participant to serve as his or her own control. The high levels of discrimination between subjects with aMCI and normal cognition that exceeded traditional neuropsychological measures makes the LASSI-L worthy of further research in the detection of early AD. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS).

PubMed

Newman-Beinart, Naomi A; Norton, Sam; Dowling, Dominic; Gavriloff, Dimitri; Vari, Chiara; Weinman, John A; Godfrey, Emma L

2017-06-01

There is no gold standard for measuring adherence to prescribed home exercise. Self-report diaries are commonly used however lack of standardisation, inaccurate recall and self-presentation bias limit their validity. A valid and reliable tool to assess exercise adherence behaviour is required. Consequently, this article reports the development and psychometric evaluation of the Exercise Adherence Rating Scale (EARS). Development of a questionnaire. Secondary care in physiotherapy departments of three hospitals. A focus group consisting of 8 patients with chronic low back pain (CLBP) and 2 physiotherapists was conducted to generate qualitative data. Following on from this, a convenience sample of 224 people with CLBP completed the initial 16-item EARS for purposes of subsequent validity and reliability analyses. Construct validity was explored using exploratory factor analysis and item response theory. Test-retest reliability was assessed 3 weeks later in a sub-sample of patients. An item pool consisting of 6 items was found suitable for factor analysis. Examination of the scale structure of these 6 items revealed a one factor solution explaining a total of 71% of the variance in adherence to exercise. The six items formed a unidimensional scale that showed good measurement properties, including acceptable internal consistency and high test-retest reliability. The EARS enables the measurement of adherence to prescribed home exercise. This may facilitate the evaluation of interventions promoting self-management for both the prevention and treatment of chronic conditions. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Hospital Disaster Preparedness in Italy: a preliminary study utilizing the World Health Organization Hospital Emergency Response Evaluation Toolkit.

PubMed

Ingrassia, Pier L; Mangini, Marco; Azzaretto, Massimo; Ciaramitaro, Ilenia; Costa, Laura; Burkle, Frederick M; Della Corte, Francesco; Djalali, Ahmadreza

2016-12-01

Natural and human-initiated disasters are occurring with greater devastating consequences and increased frequency. During these events, hospitals have the burden to care for acutely ill and injured patients. The aim of this study was to evaluate the level of disaster preparedness of Italian hospitals. Site visits were conducted from January, 2014 to December, 2014. The hospital emergency response checklist, developed by the WHO, was used as an evaluation toolkit. It consists of 92 items classified as 9 key components, such as command and control, triage, and critical services. The status of each component was determined by consensus of 3 independent evaluators. The study selected 15 hospitals from different areas in Italy. Out of the 15 hospitals, 12 were considered to be at insufficients level of preparedness, only 3 were considered to have an effective level of preparedness. The average preparedness of all components were lower than the optimal level suggested by the WHO checklist. The study revealed that a large majority of Italian hospitals evaluated are not well prepared to manage potential disasters. Also, all important elements of hospital preparedness, such as the command system, surge capacity, and safety, were insufficiently implemented. Nationwide standards, guidelines and procedures are required to improve hospital disaster preparedness in Italy.

An Empirical Study on Low-Carbon: Human Resources Performance Evaluation

PubMed Central

Chen, Quan; Tsai, Sang-Bing; Zhou, Jie; Yu, Jian; Chang, Li-Chung; Li, Guodong; Zheng, Yuxiang; Wang, Jiangtao

2018-01-01

Low-carbon logistics meets the requirements of a low-carbon economy and is the most effective operating model for logistic development to achieve sustainability by coping with severe energy consumption and global warming. Low-carbon logistics aims to reduce carbon intensity rather than simply reduce energy consumption and carbon emissions. Human resources are an important part of the great competition in the logistics market and significantly affect the operations of enterprises. Performance evaluations of human resources are particularly important for low-carbon logistics enterprises with scarce talents. Such evaluations in these enterprises are of great significance for their strategic development. This study constructed a human resource performance evaluation system to assess non-managerial employees’ low-carbon job capacity, job performance, and job attitude in the low-carbon logistics sector. The case study results revealed that the investigated company enjoyed initial success after having promoted low-carbon concepts and values to its non-managerial employees, and the success was demonstrated by excellent performance in its employees’ job attitude and knowledge. This study adopts the AHP method to reasonably determine an indicator system of performance evaluation and its weight to avoid certain human-caused bias. This study not only fills the gap in the related literature, but can also be applied to industrial practice. PMID:29301375

Recycling of end-of-life reverse osmosis membranes by oxidative treatment: a technical evaluation.

PubMed

Coutinho de Paula, Eduardo; Gomes, Júlia Célia Lima; Amaral, Míriam Cristina Santos

2017-07-01

The adverse impacts caused by the disposal of thousands of tonnes per annum of reverse osmosis (RO) membranes modules have grown dramatically around the world. The objective of this study was to evaluate the technical feasibility of recycling by chemical oxidation of end-of-life RO membranes for applications in other separation processes with specifications less rigorous. The recycling technique consisted in to cause a membrane exposition with oxidant solutions in order to remove its aromatic polyamide layer and subsequent conversion to a porous membrane. The recycling technique was evaluated by water permeability and salt rejection tests before and after the oxidative treatments. Initially, membranes' chemical cleaning and pretreatment procedures were assessed. Among factors evaluated, the oxidizing agent, its concentration and pH, associated with the oxidative treatment time, showed important influence on the oxidation of the membranes. Results showed that sodium hypochlorite and potassium permanganate are efficient agents for the membrane recycling. The great increased permeability and decreased salt rejection indicated changes on membranes' selective properties. Scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), atomic force microscopy (AFM), and contact angle characterization techniques revealed marked changes on the main membranes' physical-chemical properties, such as morphology, roughness and hydrophobicity. Reuse of produced effluents and fouling tendency of recycled membranes were also evaluated.

Evaluation of food-relevant chemicals in the ToxCast high ...

EPA Pesticide Factsheets

There are thousands of chemicals that are directly added to or come in contact with food, many of which have undergone little to no toxicological evaluation. The ToxCast high-throughput screening (HTS) program has evaluated over 1,800 chemicals in concentration-response across ~820 assay endpoints and continues to grow; with all data completely available to the public, this resource serves as a unique opportunity to evaluate the bioactivity of chemicals in vitro. This study investigated the chemical landscape of the food-relevant chemical universe using cheminformatics analyses, and subsequently evaluated the bioactivity of food-relevant chemicals included in the ToxCast HTS program. Initially, a list of 9,437 food-relevant chemicals was compiled by comprehensively mining publicly available sources for direct food additives, food contact substances, indirect food additives, and pesticides. Of these food-relevant chemicals, 4,638 were associated with curated structure definition files amenable to defining physical/chemical features used to generate chemical fingerprints. Clustering was conducted based on the chemical fingerprints using a self-organizing map approach. This revealed that pesticides, food contact substances, and direct food additives generally clustered apart from one another, supporting that these categories reflect not only different uses but also distinct chemistries. Subsequently, 967 of the 9,437 food-relevant chemicals were identified in the T

An Empirical Study on Low-Carbon: Human Resources Performance Evaluation.

PubMed

Chen, Quan; Tsai, Sang-Bing; Zhai, Yuming; Zhou, Jie; Yu, Jian; Chang, Li-Chung; Li, Guodong; Zheng, Yuxiang; Wang, Jiangtao

2018-01-03

Low-carbon logistics meets the requirements of a low-carbon economy and is the most effective operating model for logistic development to achieve sustainability by coping with severe energy consumption and global warming. Low-carbon logistics aims to reduce carbon intensity rather than simply reduce energy consumption and carbon emissions. Human resources are an important part of the great competition in the logistics market and significantly affect the operations of enterprises. Performance evaluations of human resources are particularly important for low-carbon logistics enterprises with scarce talents. Such evaluations in these enterprises are of great significance for their strategic development. This study constructed a human resource performance evaluation system to assess non-managerial employees' low-carbon job capacity, job performance, and job attitude in the low-carbon logistics sector. The case study results revealed that the investigated company enjoyed initial success after having promoted low-carbon concepts and values to its non-managerial employees, and the success was demonstrated by excellent performance in its employees' job attitude and knowledge. This study adopts the AHP method to reasonably determine an indicator system of performance evaluation and its weight to avoid certain human-caused bias. This study not only fills the gap in the related literature, but can also be applied to industrial practice.

Insights from an Evaluability Assessment of the U.S. Forest Service "More Kids in the Woods" Initiative

ERIC Educational Resources Information Center

Zint, Michaela T.; Covitt, Beth A.; Dowd, Patrick F.

2011-01-01

We conducted an evaluability assessment of the U.S. Forest Service's "More Kids in the Woods" internal grant initiative based on a review of 26 funded proposals, the creation of logic models, and a survey of project leaders. Evaluations of the initiative are warranted because it has clear outcome objectives, is implemented as intended, and results…

Department of Defense (DOD) Automated Biometric Identification System (ABIS) Version 1.2: Initial Operational Test and Evaluation Report

DTIC Science & Technology

2015-05-01

Director, Operational Test and Evaluation Department of Defense (DOD) Automated Biometric Identification System (ABIS) Version 1.2 Initial...Operational Test and Evaluation Report May 2015 This report on the Department of Defense (DOD) Automated Biometric Identification System...COVERED - 4. TITLE AND SUBTITLE Department of Defense (DOD) Automated Biometric Identification System (ABIS) Version 1.2 Initial Operational Test

Preparing for Evaluation: Lessons from the Evaluability Assessment of the Teagle Foundation's College-Community Connections Initiative. Report

ERIC Educational Resources Information Center

Black, Kristin

2016-01-01

Funders, policymakers, and program leaders recognize the value of high-quality evidence. To make good use of a program evaluation, initiatives must contend with a set of fundamental questions first. Some of these are about the initiative itself: What outcomes does it seek to affect? Are daily activities in line with long-term goals? Others are…

The impact of persistent visually disabling vitreous floaters on health status utility values.

PubMed

Zou, Haidong; Liu, Haiyun; Xu, Xun; Zhang, Xi

2013-08-01

To assess the time trade-off (TTO) utility values in patients with persistent visually disabling vitreous floaters (DVF) and to determine the reliability and validity of TTO methods in DVF patients. Prospective cross-sectional questionnaire survey: Eligible patients with persistent DVF referred to the Shanghai First People's Hospital outpatient service between January 2006 and February 2010, and randomly selected normal vision general population residents, were enrolled. All participants underwent TTO utility value evaluation. After 4-5 weeks, the patients were asked to undergo second TTO utility value evaluation during the follow-up interview. The mean initial utility values of the 107 persistent DVF patients were 0.904 ± 0.054. Regression analyses revealed that length of education, visual acuity in the poorer-vision eye and employment status were associated with utility values (all P < 0.01). All patients took part in the follow-up interview; the intra-class correlation coefficient for TTO utility values at the initial and follow-up interviews was 0.855. In the 91 general population residents, the mean utility value was 0.923 ± 0.032, which was statistically higher than that of active study patients (t = 3.01, P < 0.01). Persistent DVF can substantially diminish the patients' perception of their life, and can be measured by TTO utility values with high reliability and construct validity.

Re-evaluation of bone pain in patients with type 1 Gaucher disease suggests that bone crises occur in small bones as well as long bones.

PubMed

Baris, Hagit N; Weisz Hubshman, Monika; Bar-Sever, Zvi; Kornreich, Liora; Shkalim Zemer, Vered; Cohen, Ian J

2016-09-01

Bone crises in type 1 Gaucher disease are reported in long bones and occasionally in weight bearing bones and other bones, but rarely in small bones of the hands and feet. We retrospectively examined the incidence of bone pain in patients followed at the Rabin Medical Center, Israel, before and following the initiation of enzyme replacement therapy (ERT) and evaluated them for bone crises. Of 100 type I Gaucher disease patients, 30 (30%) experienced one or more bone crises. Small bone crises represented 31.5% of all bone crises and were always preceded by crises in other bones. While the incidence of long bone crises reduced after the initiation of ERT, small bone crises increased. Almost 60% of patients with bone crises were of the N370S/84GG genotype suggesting a greater susceptibility of N370S/84GG patients to severe bone complications. These patients also underwent the greatest number of splenectomies (70.6% of splenectomised patients). Splenectomised patients showed a trend towards increased long and small bone crises after surgery. Active investigation of acute pain in the hands and feet in patients in our cohort has revealed a high incidence of small bone crises. Physicians should consider imaging studies to investigate unexplained pain in these areas. Copyright © 2015 Elsevier Inc. All rights reserved.

Organic acids from root exudates of banana help root colonization of PGPR strain Bacillus amyloliquefaciens NJN-6

PubMed Central

Yuan, Jun; Zhang, Nan; Huang, Qiwei; Raza, Waseem; Li, Rong; Vivanco, Jorge M.; Shen, Qirong

2015-01-01

The successful colonization of plant growth promoting rhizobacteria (PGPR) in the rhizosphere is an initial and compulsory step in the protection of plants from soil-borne pathogens. Therefore, it is necessary to evaluate the role of root exudates in the colonization of PGPR. Banana root exudates were analyzed by high pressure liquid chromatography (HPLC) which revealed exudates contained several organic acids (OAs) including oxalic, malic and fumaric acid. The chemotactic response and biofilm formation of Bacillus amyloliquefaciens NJN-6 were investigated in response to OA’s found in banana root exudates. Furthermore, the transcriptional levels of genes involved in biofilm formation, yqxM and epsD, were evaluated in response to OAs via quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Results suggested that root exudates containing the OAs both induced the chemotaxis and biofilm formation in NJN-6. In fact, the strongest chemotactic and biofilm response was found when 50 μM of OAs were applied. More specifically, malic acid showed the greatest chemotactic response whereas fumaric acid significantly induced biofilm formation by a 20.7–27.3% increase and therefore biofilm formation genes expression. The results showed banana root exudates, in particular the OAs released, play a crucial role in attracting and initiating PGPR colonization on the host roots. PMID:26299781

Incentivising effort in governance of public hospitals: Development of a delegation-based alternative to activity-based remuneration.

PubMed

Søgaard, Rikke; Kristensen, Søren Rud; Bech, Mickael

2015-08-01

This paper is a first examination of the development of an alternative to activity-based remuneration in public hospitals, which is currently being tested at nine hospital departments in a Danish region. The objective is to examine the process of delegating the authority of designing new incentive schemes from the principal (the regional government) to the agents (the hospital departments). We adopt a theoretical framework where, when deciding about delegation, the principal should trade off an initiative effect against the potential cost of loss of control. The initiative effect is evaluated by studying the development process and the resulting incentive schemes for each of the departments. Similarly, the potential cost of loss of control is evaluated by assessing the congruence between focus of the new incentive schemes and the principal's objectives. We observe a high impact of the effort incentive in the form of innovative and ambitious selection of projects by the agents, leading to nine very different solutions across departments. However, we also observe some incongruence between the principal's stated objectives and the revealed private interests of the agents. Although this is a baseline study involving high uncertainty about the future, the findings point at some issues with the delegation approach that could lead to inefficient outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Improving the peer review skills of young rheumatologists and researchers in rheumatology: the EMEUNET Peer Review Mentoring Program.

PubMed

Rodríguez-Carrio, Javier; Putrik, Polina; Sepriano, Alexandre; Moltó, Anna; Nikiphorou, Elena; Gossec, Laure; Kvien, Tore K; Ramiro, Sofia

2018-01-01

Although peer review plays a central role in the maintenance of high standards in scientific research, training of reviewing skills is not included in the common education programmes. The Emerging EULAR (European League Against Rheumatism) Network (EMEUNET) developed a programme to address this unmet need. The EMEUNET Peer Review Mentoring Program for Rheumatology Journals promotes a systematic training of reviewing skills by engaging mentees in a 'real world' peer review experience supervised by experienced mentors with support from rheumatology journals. This viewpoint provides an overview of this initiative and its outcomes, and discusses its potential limitations. Over 4 years, 18 mentors and 86 mentees have participated. Among the 33 participants who have completed the programme, 13 (39.3%) have become independent reviewers for Annals of the Rheumatic Diseases after the training. This programme has been recently evaluated by a survey and qualitative interviews, revealing a high interest in this initiative. The main strengths (involvement of a top journal and learning opportunities) and weaknesses of the programme (limited number of places and insufficient dissemination) were identified. Overall, this programme represents an innovative and successful approach to peer review training. Continuous evaluation and improvement are key to its functioning. The EMEUNET Peer Review Mentoring Program may be used as a reference for peer review training in areas outside rheumatology.

Force decay and deformation of orthodontic elastomeric ligatures.

PubMed

Taloumis, L J; Smith, T M; Hondrum, S O; Lorton, L

1997-01-01

This study evaluated commercially available molded gray elastomeric ligatures from seven companies for force decay, dimensional change, and the relationship between ligature dimension and force. The initial wall thickness, inside diameter, outside diameter, and force levels of each ligature were measured. Three of four test groups of ligatures were stretched over stainless steel dowels with a circumference approximating that of a large orthodontic twin bracket. Test group 1 was kept at room temperature and humidity for 28 days and test group 2 in a synthetic saliva bath at 37 degrees C, pH 6.84 for 28 days. The residual forces and dimensional changes were measured. The third test group was placed in a synthetic saliva bath at 37 degrees C, pH 6.84, and force levels recorded at initial, 24 hours, 7 days, 14 days, and 28 days. The fourth test group of unstretched samples was placed in a synthetic saliva bath at 37 degrees C, pH 6.84 for 28 days to evaluate dimensional changes due solely to moisture sorption. The results for stretched samples in a simulated oral environment revealed the following: (1) Moisture and heat had a pronounced effect on force decay and permanent deformation, (2) a positive correlation existed between the wall thickness and force, (3) a negative correlation existed between the inside diameter and force, (4) a weak correlation existed between outside diameter and force, (5) the greatest force loss occurred in the first 24 hours and the decay pattern was similar for all ligatures tested, and (6) unstretched ligatures absorbed moisture in the range of 0.060% to 3.15%. The ligatures tested appear to be suitable for use during initial aligning and leveling. However, the rapid force loss and permanent deformation of these products may preclude their use for rotational and torque corrections.

Experimental residual stress evaluation of hydraulic expansion transitions in Alloy 690 steam generator tubing

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

McGregor, R.; Doherty, P.; Hornbach, D.

1995-12-31

Nuclear Steam Generator (SG) service reliability and longevity have been seriously affected worldwide by corrosion at the tube-to-tubesheet joint expansion. Current SG designs for new facilities and replacement projects enhance corrosion resistance through the use of advanced tubing materials and improved joint design and fabrication techniques. Here, transition zones of hydraulic expansions have undergone detailed experimental evaluation to define residual stress and cold-work distribution on and below the secondary-side surface. Using X-ray diffraction techniques, with supporting finite element analysis, variations are compared in tubing metallurgical condition, tube/pitch geometry, expansion pressure, and tube-to-hole clearance. Initial measurements to characterize the unexpanded tubemore » reveal compressive stresses associated with a thin work-hardened layer on the outer surface of the tube. The gradient of cold-work was measured as 3% to 0% within .001 inch of the surface. The levels and character of residual stresses following hydraulic expansion are primarily dependent on this work-hardened surface layer and initial stress state that is unique to each tube fabrication process. Tensile stresses following expansion are less than 25% of the local yield stress and are found on the transition in a narrow circumferential band at the immediate tube surface (< .0002 inch/0.005 mm depth). The measurements otherwise indicate a predominance of compressive stresses on and below the secondary-side surface of the transition zone. Excellent resistance to SWSCC initiation is offered by the low levels of tensile stress and cold-work. Propagation of any possible cracking would be deterred by the compressive stress field that surrounds this small volume of tensile material.« less

Analysis of semen parameters in male referrals: impact of reference limits, stratification by fertility categories, predictors of change, and comparison of normal semen parameters in subfertile couples.

PubMed

Baker, Karen; Li, Jianbo; Sabanegh, Edmund

2015-01-01

To [1] determine the impact of semen reference limits on referrals for male fertility evaluations, [2] analyze the stratification of subjects based on published "normal" thresholds, [3] analyze the odds of changing fertility categories during serial tests and thereby the potential impact of inherent variability of semen parameters on referrals, and [4] determine variable(s) predictive of change. Retrospective chart review. Academic referral center for male fertility. New encounters in a male fertility clinic over a 5-year period that straddles the publication of World Health Organization (WHO) 2010 reference values. None. Demographic and clinical variables, semen values, and fertility categories as follows: BE (below WHO 2010 criteria), BTWN (above WHO 2010 but below WHO 1999 criteria), and N (above WHO 1999 criteria). A total of 82.3% of initial semen tests were categorized as BE, and the predominance of this category was unchanged by publication of the WHO 2010 criteria. Men with initial semen analysis categorized as BTWN or N represented 16.2% and 1.5% of the referral population, respectively. Subjects initially categorized as BTWN were more likely to change fertility categories, and overwhelmingly this migration was downward. Analysis of normal individual semen parameters revealed statistically worse mean concentration and motility when at least one other parameter fell below the WHO 2010 criteria. Men with semen results above reference criteria are underrepresented, indicating that reference limits influence referral patterns for male fertility evaluations. Normal mean concentration and motility were lower in men with at least one other individual semen parameter below the 2010 criteria, suggesting global dysfunction in spermatogenesis. Published by Elsevier Inc.

Efficacy of It's Your Game-Tech: A Computer-Based Sexual Health Education Program for Middle School Youth.

PubMed

Peskin, Melissa F; Shegog, Ross; Markham, Christine M; Thiel, Melanie; Baumler, Elizabeth R; Addy, Robert C; Gabay, Efrat K; Emery, Susan Tortolero

2015-05-01

Few computer-based HIV, sexually transmitted infection (STI), and pregnancy prevention programs are available, and even fewer target early adolescents. In this study, we tested the efficacy of It's Your Game (IYG)-Tech, a completely computer-based, middle school sexual health education program. The primary hypothesis was that students who received IYG-Tech would significantly delay sexual initiation by ninth grade. We evaluated IYG-Tech using a randomized, two-arm nested design among 19 schools in a large, urban school district in southeast Texas (20 schools were originally randomized). The target population was English-speaking eighth-grade students who were followed into the ninth grade. The final analytic sample included 1,374 students. Multilevel logistic regression models were used to test for differences in sexual initiation between intervention and control students, while adjusting for age, gender, ethnicity, time between measures, and family structure. There was no significant difference in the delay of sexual activity or in any other sexual behavior between intervention and control students. However, there were significant positive between-group differences for psychosocial variables related to STI and condom knowledge, attitudes about abstinence, condom use self-efficacy, and perceived norms about sex. Post hoc analyses conducted among intervention students revealed some significant associations: "full exposure" (completion of all 13 lessons) and "mid-exposure" (5-8 lessons) students were less likely than "low exposure" (1-4 lessons) students to initiate sex. Collectively, our findings indicate that IYG-Tech impacts some determinants of sexual behavior, and that additional efficacy evaluation with full intervention exposure may be warranted. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Increased suicide risk and clinical correlates of suicide among patients with Parkinson's disease.

PubMed

Lee, Taeyeop; Lee, Hochang Benjamin; Ahn, Myung Hee; Kim, Juyeon; Kim, Mi Sun; Chung, Sun Ju; Hong, Jin Pyo

2016-11-01

Parkinson's disease (PD) is a debilitating, neurodegenerative condition frequently complicated by psychiatric symptoms. Patients with PD may be at higher risk for suicide than the general population, but previous estimates are limited and conflicting. The aim of this study is to estimate the suicide rate based on the clinical case registry and to identify risk factors for suicide among patients diagnosed with PD. The target sample consisted of 4362 patients diagnosed with PD who were evaluated at a general hospital in Seoul, South Korea, from 1996 to 2012. The standardized mortality ratio for suicide among PD patients was estimated. In order to identify the clinical correlates of suicide, case-control study was conducted based on retrospective chart review. The 29 suicide cases (age: 62.3 ± 13.7 years; females: 34.5%) were matched with 116 non-suicide controls (age: 63.5 ± 9.2 years; females 56.9%) by the year of initial PD evaluation. The SMR for suicide in PD patients was 1.99 (95% CI 1.33-2.85). Mean duration from time of initial diagnosis to suicide among cases was 6.1 ± 3.5 years. Case-control analysis revealed that male, initial extremity of motor symptom onset, history of depressive disorder, delusion, any psychiatric disorder, and higher L-dopa dosage were significantly associated with suicide among PD patients. Other PD-related variables such as UPDRS motor score were not significantly associated with death by suicide. Suicide risk in PD patients is approximately 2 times higher than that in the general population. Psychiatric disorders, and also L-dopa medication need further attention with respect to suicide. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of Fenton and ozone-based advanced oxidation processes as mature landfill leachate pre-treatments.

PubMed

Cortez, Susana; Teixeira, Pilar; Oliveira, Rosário; Mota, Manuel

2011-03-01

Fenton treatment (Fe(2+)/H(2)O(2)) and different ozone-based Advanced Oxidation Processes (AOPs) (O(3), O(3)/OH(-) and O(3)/H(2)O(2)) were evaluated as pre-treatment of a mature landfill leachate, in order to improve the biodegradability of its recalcitrant organic matter for subsequent biological treatment. With a two-fold diluted leachate, at optimised experimental conditions (initial pH 3, H(2)O(2) to Fe(2+) molar ratio of 3, Fe(2+) dosage of 4 mmol L(-1), and reaction time of 40 min) Fenton treatment removed about 46% of chemical oxygen demand (COD) and increased the five-day biochemical oxygen demand (BOD(5)) to COD ratio (BOD(5)/COD) from 0.01 to 0.15. The highest removal efficiency and biodegradability was achieved by ozone at higher pH values, solely or combined with H(2)O(2). These results confirm the enhanced production of hydroxyl radical under such conditions. After the application for 60 min of ozone at 5.6 g O(3)h(-1), initial pH 7, and 400 mg L(-1) of hydrogen peroxide, COD removal efficiency was 72% and BOD(5)/COD increased from 0.01 to 0.24. An estimation of the operating costs of the AOPs processes investigated revealed that Fe(2+)/H(2)O(2) was the most economical system (8.2 € m(-3)g(-1) of COD removed) to treat the landfill leachate. This economic study, however, should be treated with caution since it does not consider the initial investment, prices at plant scale, maintenance and labour costs. Copyright © 2010 Elsevier Ltd. All rights reserved.

Functional and phenotypic evaluation of eosinophils from patients with the acute form of paracoccidioidomycosis

PubMed Central

Braga, Fernanda Gambogi; Ruas, Luciana Pereira; Pereira, Ricardo Mendes; Lima, Xinaida Taligare; Antunes, Edson; Mamoni, Ronei Luciano

2017-01-01

Background Eosinophilia is a typical finding of the acute/juvenile form of paracoccidioidomycosis (PCM), a systemic mycosis endemic in Latin America. This clinical form is characterized by depressed cellular immune response and production of Th2 cytokines. Moreover, it has been shown that the increased number of eosinophils in peripheral blood of patients returns to normal values after antifungal treatment. However, the role of eosinophils in PCM has never been evaluated. This study aimed to assess the phenotypic and functional characteristics of eosinophils in PCM. Methods/Principal findings In 15 patients with the acute form of the disease, we detected expression of MBP, CCL5 (RANTES) and CCL11 (eotaxin) in biopsies of lymph nodes and liver. In addition, there were higher levels of chemokines and granule proteins in the peripheral blood of patients compared to controls. Isolation of eosinophils from blood revealed a higher frequency of CD69+ and TLR2+ eosinophils in patients compared to controls, and a lower population of CD80+ cells. We also evaluated the fungicidal capacity of eosinophils in vitro. Our results revealed that eosinophils from PCM patients and controls exhibit similar ability to kill P. brasiliensis yeast cells, although eosinophils of patients were less responsive to IL-5 stimulation than controls. Conclusion/Principal findings In conclusion, we suggest that eosinophils might play a role in the host response to fungi and in the pathophysiology of PCM by inducing an intense and systemic inflammatory response in the initial phase of the infection. PMID:28489854

School Choice in Milwaukee.

ERIC Educational Resources Information Center

Peterson, Paul E.; And Others

1996-01-01

Uses Milwaukee's school choice/voucher initiative to illustrate how politically motivated evaluation and compromise legislation can dilute potentially beneficial educational innovations. The initiative's success despite counterproductive legislative tampering and biased evaluation is addressed, along with a discussion of the evaluation's…

Characteristics of initial fearful spells and their associations with DSM-IV panic attacks and panic disorder in adolescents and young adults from the community.

PubMed

Asselmann, Eva; Pané-Farré, Christiane; Isensee, Barbara; Wittchen, Hans-Ulrich; Lieb, Roselind; Höfler, Michael; Beesdo-Baum, Katja

2014-08-01

Few studies examined characteristics of initial fearful spells (FS) or panic attacks (PA) and their relation to DSM-IV PA and panic disorder (PD). A community sample of adolescents and young adults (N=3021) was followed up in 4 waves (T0-T3) over up to 10 years. FS, PA, and PD were assessed at each wave using the DSM-IV/M-CIDI. Characteristics of the initial FS/PA including perceived reasons/triggers, appraisal, duration, and behavioral/emotional consequences of the initial FS/PA were retrospectively assessed at T1 and T2 in those reporting the experience of lifetime FS or PA at these waves (N=363). Multinomial logistic regressions adjusted for sex and age were used to reveal associations of initial FS/PA characteristics (aggregated data from T1 and T2) with PA only (N=88) and PD (N=62; lifetime incidences cumulated across assessment waves) (reference group: No PA/PD). Alcohol consumption, drugs/medication, and physical illness as perceived reasons for the initial FS/PA were associated with PA-only (OR 2.46-5.44), while feelings of depression, feelings of anxiety, and having always been anxious/nervous as perceived reasons for the initial FS/PA, appraising the initial FS/PA as terrible and long-term irritating/burdensome, subsequent feelings of depression, subsequent avoidance, and subsequent consumption of medication, alcohol, or drugs were associated with PD (OR 2.64-4.15). A longer duration until "feeling okay again" was associated with both PA-only (OR=1.29 per category) and PD (OR=1.63). Initial FS/PA characteristics were necessarily assessed retrospectively by self-report only. Thus, our data might be subject to recall/evaluation biases. Aggregated data were used and strictly prospective-longitudinal studies are necessary that replicate our findings. Assessing initial FS/PA characteristics might be useful to identify individuals at increased risk for more severe panic pathology. Copyright © 2014 Elsevier B.V. All rights reserved.

[Usefulness of stratigraphy and computerized tomography in the initial staging of osteosarcoma of the extremities. Retrospective study of 217 cases].

PubMed

Pelotti, P; Ciminari, R; Bacci, G; Avella, M; Briccoli, A

1988-01-01

The value of stratigraphy and pulmonary CT in the initial work-up of osteosarcoma of the extremities is assessed with reference to 217 patients encountered in the Bone Tumour Centre of Rizzoli Orthopaedic Institute in May 1983-May 1986. Stratigraphy revealed lung metastases not identified by standard radiography in 4 patients (1.8%), while CT revealed metastases not identified by either standard X-rays or stratigraphy in a further 6 cases (2.7%). It is concluded that the increase in the percentage of cures (about 30%) reported in the last 10 years in osteosarcoma cases given adjuvant chemotherapy cannot be explained by any difference in initial selection due to the use of these techniques that were not adopted in the historical series.

Parental encouragement of initiative-taking and adjustment in Chinese children from rural, urban, and urbanized families.

PubMed

Chen, Xinyin; Li, Dan

2012-12-01

Due to the requirements of the competitive, market-oriented urban society, parents in urban and urbanized families are more likely than parents in rural families to encourage initiative-taking in child rearing in China. The socialization experiences of children from different types of families may be related to their adjustment. This study examined parental socialization attitudes, social and school adjustment, and their relations in Chinese children from rural, urban, and urbanized families. Participants were elementary school students (N = 1,033; M age = 11 years) and their parents in China. Data were obtained from parental reports, peer evaluations, teacher ratings, and school records. A multivariate analysis of variance revealed that parents in urban and urbanized families had higher scores than parents in rural families on encouragement of initiative-taking. Urban children, particularly girls, were more sociable, obtained higher social status, and had fewer school problems than their rural counterparts. Children from urbanized families were different from rural children and similar to urban children in social and school adjustment. Moreover, multigroup invariance tests showed that parental encouragement of initiative-taking was associated more strongly with children's sociable-assertive behavior and social standing in the urban and urbanized groups than in the rural group. The results indicate that particular socialization attitudes may vary in their adaptive value in child development as a function of specific social and cultural requirements in changing societies. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Preoperative magnetic resonance imaging characteristics of oval circumscribed fast enhancing lesions in patients with newly diagnosed breast cancer.

PubMed

Lee, Jong Yoon; Jang, Mijung; Kim, Sun Mi; Yun, Bo La; Jang, Ja Yoon; Ahn, Hye Shin

2018-05-01

The aim of this study was to investigate the follow-up results and characteristics of oval circumscribed lesions with fast initial enhancement on preoperative magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer.Preoperative data from consecutive patients newly diagnosed with breast cancer between 2010 and 2013 were retrospectively reviewed. Only MRI reports containing, "oval shape, circumscribed margin, and fast initial enhancement," were extracted and analyzed. Follow-up results and clinical and pathological findings were evaluated.A total of 430 oval circumscribed lesions with fast initial enhancement were included. Forty-eight lesions were pathologically confirmed at initial workup and 382 were followed up. Among the 48 lesions, 14 were found to have additional malignancy and 34 were benign. Among the 382 followed-up lesions, only 1 was subsequently confirmed to be malignant. There were no evident changes in any of the remaining lesions during follow-up. The overall rate of malignancy was 3.5% (15/430). When lesions exhibited delayed washout enhancing kinetics (P < .001), were located ipsilaterally (P = .007), and closer to the primary tumor (P = .012), the possibility of malignancy was high. High T2-weighted imaging signal intensity suggested benignity (P = .043).Although the probability of being diagnosed with malignancy during follow-up in this study was low (0.3%), this investigation revealed several preoperative MRI characteristics that should alert clinicians to the possibility of malignancy.

Pitfalls in diagnosing limbic encephalitis - a case report.

PubMed

Kerling, F; Blümcke, I; Stefan, H

2008-11-01

The syndrome of limbic encephalitis (LE) is characterized by subacute onset of temporal lobe epilepsy, loss of short-term memory, cognitive confusion and psychiatric symptoms. We report a patient with pharmacoresistant epilepsy who underwent presurgical video-electroencephalogram (EEG)-monitoring with normal psychiatric and neuropsychological findings. Magnetic resonance imaging (MRI) revealed a hyperintense lesion within the right amygdala but no contrast enhancement. Analysis of cerebrospinal fluid (CSF) showed pleocytosis and positive oligoclonal bands, but all tests for neurotropic viruses or borrelia antibodies were negative. Presurgical evaluation identified a right mesiotemporal focus. As a tumour was the most likely differential diagnosis, we performed selective amygdalohippocampectomy of the right hemisphere. Subsequent histopathological examination revealed the surprising diagnosis of LE. As a consequence, tumour screening was initiated and a testicular carcinoma with high anti-Ma2-antibody titres was detected. Following surgical and chemotherapeutical treatment, the patient was seizure-free and Ma2-antibodies decreased below detection limits. Conclusion - This case report highlights that LE has to be considered even in patients with atypical clinical presentation, i.e. without neuropsychological deficits, if CSF analysis reveals an inflammatory response. When LE is diagnosed, extensive tumour search is mandatory to detect and treat the paraneoplastic origin of LE. Therapeutic strategies of LE include surgical treatment as well as early immunosuppression.

Long-Term Data Reveal Rate and Risk Factors for Subsequent Surgeries Following Initial ACL Reconstruction

MedlinePlus

... and Risk Factors for Subsequent Surgeries Following Initial ACL Reconstruction By Colleen Labbe, M.S. | December 1, 2013 ... surgery to reconstruct a torn anterior cruciate ligament (ACL) eventually need to have additional surgery on the ...

Invitro Evaluation of Fluoride Release from Hydroxyapatite Reinforced Glass Ionomer with or without Protective Coating

PubMed Central

Nandlal, Bhojraj

2016-01-01

Introduction Glass Ionomer Cement (GIC) is well known for its fluoride releasing property but has its own drawbacks of poor mechanical properties, sensitivity to initial desiccation and moisture contamination. To overcome these, search led to the reinforcement of hydroxyapatite and application of surface coating agent but their effect on fluoride release is still not clear. Aim To evaluate and compare the release of fluoride from Hydroxyapatite Reinforced Glass Ionomer (HA-GIC) with and without protective coating. Materials and Methods Specimens were prepared as follows- Eight percent by weight conventional glass ionomer was replaced by hydroxyapatite powder (HA) and an indigenous product was prepared (HA-GIC). This powder was mixed with liquid of conventional GIC and allowed to set, then G coat plus coating agent was applied in surface coated group and light cured. Fluoride release of the sample was measured every 24 hrs for seven days and weekly from 7th to 21st day using combination ion selective electrode. Results Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both the groups. Results of repeated measure ANOVA revealed statistically significant difference between two groups (p <0.001). Conclusion Coating the hydroxyapatite reinforced glass ionomer will allow for slow and steady release of fluoride for a long period of time into oral environment. PMID:27190957

Structural characterization and evaluation of antioxidant, anticancer and hypoglycemic activity of radiation degraded oat (Avena sativa) β- glucan

NASA Astrophysics Data System (ADS)

Hussain, Peerzada R.; Rather, Sarver A.; Suradkar, Prashant P.

2018-03-01

Oat β-D-glucan after extraction was degraded at doses of 3, 6, 9, 12 and 15 kGy. The average molecular weight decreased to 45 kDa at dose of 15 kGy from an initial value of 200 kDa in native sample. XRD analysis revealed no significant change in diffraction pattern of irradiated samples when compared with control, except a decrease in intensity of x-ray diffraction. The results of the antioxidant activity revealed decrease in EC50 values and corresponding increase in antioxidant activity of radiation degraded oat β-D-glucan. Results of the anticancer studies indicated that cytotoxicity of gamma irradiated oat β-D-glucan in cancer cell lines was highest against colo-205 and MCF7 cancer cells compared to T47D cell and no cytotoxicity was observed in normal cell lines at all concentrations used. Evaluation of hypoglycemic activity showed highest inhibition in α-glucosidase activity compared to α-amylase activity due to gamma irradiation of oat β-D-glucan. Comparison of the EC50 values of known standards and gamma irradiated oat beta-glucan samples indicates that radiation treatment significantly modified the biological activity of the beta-glucan samples. Therefore, it is suggested that gamma irradiation can be used for producing low molecular weight oat β-D-glucan; which can help in modifying the biological activities.

A formative evaluation of the collegiate training initiative--air traffic control specialist (CTI-ATCS) program.

DOT National Transportation Integrated Search

1996-02-01

This report describes the initial formative evaluation of the Federal Aviation Administration (FAA) College Training Initiative - Air Traffic Control Specialist (CTI-ATCS) Program. The purpose of the CTI-ATCS program is to test "the concept that non-...

Hardware Testing for the Optical PAyload for Lasercomm Science (OPALS)

NASA Technical Reports Server (NTRS)

Slagle, Amanda

2011-01-01

Hardware for several subsystems of the proposed Optical PAyload for Lasercomm Science (OPALS), including the gimbal and avionics, was tested. Microswitches installed on the gimbal were evaluated to verify that their point of actuation would remain within the acceptable range even if the switches themselves move slightly during launch. An inspection of the power board was conducted to ensure that all power and ground signals were isolated, that polarized components were correctly oriented, and that all components were intact and securely soldered. Initial testing on the power board revealed several minor problems, but once they were fixed the power board was shown to function correctly. All tests and inspections were documented for future use in verifying launch requirements.

Psychophysical evaluation of three-dimensional auditory displays

NASA Technical Reports Server (NTRS)

Wightman, Frederic L.

1991-01-01

Work during this reporting period included the completion of our research on the use of principal components analysis (PCA) to model the acoustical head related transfer functions (HRTFs) that are used to synthesize virtual sources for three dimensional auditory displays. In addition, a series of studies was initiated on the perceptual errors made by listeners when localizing free-field and virtual sources. Previous research has revealed that under certain conditions these perceptual errors, often called 'confusions' or 'reversals', are both large and frequent, thus seriously comprising the utility of a 3-D virtual auditory display. The long-range goal of our work in this area is to elucidate the sources of the confusions and to develop signal-processing strategies to reduce or eliminate them.

Acute B cell lymphoblastic leukaemia in a 12-week-old greyhound.

PubMed

Adams, J; Mellanby, R J; Villiers, E; Baines, S; Woodger, N

2004-11-01

A 12-week-old greyhound had a two-day history of lethargy, inappetence and shifting lameness. Clinical examination revealed pyrexia and hepatosplenomegaly. Haematological examination showed anaemia, thrombocytopenla, neutropenla and large numbers of atypical mononuclear leucocytes. A diagnosis of acute B cell lymphoblastic leukaemia was made following flow cytometric immunophenotyping of the leucocytes. The owner declined further evaluation and the dog was treated symptomatically with antibiotics. After a brief improvement, the dog's condition deteriorated and it was euthanased four days after initial presentation. The case was unusual because acute lymphoid leukaemia in the dog is most frequently reported in mature animals. This is in contrast to humans, where acute leukaemia is one of the most common childhood cancers.

Induction hardening treatment and simulation for a grey cast iron used in engine cylinder liners

NASA Astrophysics Data System (ADS)

Castellanos-Leal, E. L.; Miranda, D. A.; Coy, A. E.; Barrero, J. G.; González, J. A.; Vesga Rueda, O. P.

2017-01-01

In this research, a technical study of induction hardening in a grey cast iron used in engine cylinder liners manufactured by LAVCO Ltda., a Colombian foundry company, was carried out. Metallurgical parameters such as austenitization temperature, cooling rate, and quenching severity were determined. These factors are exclusively dependent on chemical composition and initial microstructure of grey cast iron. Simulations of induction heating through finite elements method were performed and, the most appropriate experimental conditions to achieve the critical transformation temperature was evaluated to reach a proper surface hardening on the piece. Preliminary results revealed an excellent approximation between simulation and heating test performed with a full bridge inverter voltage adapted with local technology.

Experimental Study on Fatigue Behaviour of Shot-Peened Open-Hole Steel Plates

PubMed Central

Wang, Zhi-Yu; Wang, Qing-Yuan; Cao, Mengqin

2017-01-01

This paper presents an experimental study on the fatigue behaviour of shot-peened open-hole plates with Q345 steel. The beneficial effects induced by shot peening on the fatigue life improvement are highlighted. The characteristic fatigue crack initiation and propagation modes of open-hole details under fatigue loading are revealed. The surface hardening effect brought by the shot peening is analyzed from the aspects of in-depth micro-hardness and compressive residual stress. The fatigue life results are evaluated and related design suggestions are made as a comparison with codified detail categories. In particular, a fracture mechanics theory-based method is proposed and demonstrated its validity in predicting the fatigue life of studied shot-peened open-hole details. PMID:28841160

Gastric marginal zone lymphoma of mucosa-associated lymphoid tissue and signet ring cell carcinoma, synchronous collision tumour of the stomach: a case report.

PubMed

George, Smiley Annie; Junaid, T A

2014-01-01

To report a rare case of synchronous marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) signet ring cell carcinoma occurring as a collision tumour in the stomach. A 53-year-old man was diagnosed initially with signet ring cell carcinoma of the stomach. The microscopy of the subsequent total gastrectomy revealed a collision tumour of MALT lymphoma and signet ring cell carcinoma associated with Helicobacter pylori gastritis. This case highlighted the importance of a careful evaluation of the accompanying lymphoid population in the biopsy samples of gastric adenocarcinoma and underlined the need for multiple endoscopic biopsies to detect these rare synchronous tumours. © 2013 S. Karger AG, Basel.

Gastric Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue and Signet Ring Cell Carcinoma, Synchronous Collision Tumour of the Stomach: A Case Report

PubMed Central

George, Smiley Annie; Junaid, T.A.

2014-01-01

Objective To report a rare case of synchronous marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) signet ring cell carcinoma occurring as a collision tumour in the stomach. Clinical Presentation and Intervention A 53-year-old man was diagnosed initially with signet ring cell carcinoma of the stomach. The microscopy of the subsequent total gastrectomy revealed a collision tumour of MALT lymphoma and signet ring cell carcinoma associated with Helicobacter pylori gastritis. Conclusion This case highlighted the importance of a careful evaluation of the accompanying lymphoid population in the biopsy samples of gastric adenocarcinoma and underlined the need for multiple endoscopic biopsies to detect these rare synchronous tumours. PMID:24247357

Surgical stabilization of shoulder luxation in a pot-bellied pig.

PubMed

Rubio-Martínez, Luis M; Rioja, Eva; Shakespeare, A S

2013-03-15

Case Description-A 4.6-month-old pot-bellied pig was evaluated because of non-weight-bearing lameness (grade 5/5) in the right forelimb of 4 days' duration. Clinical Findings-Clinical and radiographic examination revealed a closed, lateral luxation of the right shoulder joint. Treatment and Outcome-Initial attempts at closed reduction failed to provide adequate stability of the shoulder joint. Open reduction and internal fixation by placement of 2 lateral tension sutures with a system designed for canine cranial cruciate ligament repair provided adequate joint stability and a successful outcome. Conclusions and Clinical Relevance-Stabilization of the shoulder joint with lateral tension sutures after open reduction should be considered for management of lateral shoulder luxation in pot-bellied pigs.

Improving transition of care for veterans after total joint replacement.

PubMed

Green, Uthona R; Dearmon, Valorie; Taggart, Helen

2015-01-01

Patients transitioning from hospital to home are at risk for readmission to the hospital. Readmissions are costly and occur too often. Standardized discharge education processes have shown to decrease readmissions. The purpose of this quality improvement project was to utilize evidence-based practice changes to decrease 30-day all-cause readmissions after total joint replacement. Review of literature revealed that improved discharge education can decrease unnecessary readmissions after discharge. A quality improvement project was developed including standardized total joint replacement discharge education, teach-back education methodology, and improved postdischarge telephone follow-up. The quality improvement project was initiated and outcomes were evaluated. Improving coordination of the discharge process, enhanced education for patients/caregivers, and postdischarge follow-up decreased total joint replacement readmissions.

“This Is Public Health: Recycling Counts!” Description of a Pilot Health Communications Campaign

PubMed Central

L.Chase, Nancy; Dominick, Gregory M.; Trepal, Amy; Bailey, Leanne S.; Friedman, Daniela B.

2009-01-01

This paper describes the development, implementation, and evaluation of a pilot recycling campaign. The goal of the campaign was to increase people’s awareness and knowledge about recycling and the link between a healthy environment and the public’s health. A total of 258 individuals attended campaign week events and completed an initial survey. Results identified inconvenience of recycling facility locations as a key barrier to recycling. Post-campaign survey results revealed increased recycling of paper, plastic, glass, and cans (p < 0.05). The majority of participants “agreed” or “strongly agreed” that as a result of campaign messages they had greater awareness about recycling (88.4%) and their recycling efforts increased (61.6%). PMID:20049239

Experience with management of posterior urethral injury associated with pelvic fracture.

PubMed

Coffield, K S; Weems, W L

1977-06-01

Review of records from 205 patients with pelvic fracture and hematuria revealed that 121 underwent urologic and radiographic evaluation. Of these patients 20 had severe posterior urethral injuries documented by urethrography of voiding cystourethrography: 9 underwent primary repair and 11 had delayed scrotal-inlay urethroplasty after initial cystostomy alone. Patients who underwent primary repair had a 77 per cent incidence of stricture, a 22 per cent incidence of incontinence and a 33 per cent incidence of impotency. Patients who underwent delayed closure had no incidence of stricture, incontinence or impotence. Patients in both groups had urinary tract infections. Simple cystostomy followed by delayed scrotal-inlay urethroplasty appears superior to primary realignment in the management of patients with posterior urethral injuries.

Left atrial appendage myxofibrosarcoma: A rare masquerader of myxoma and thrombus-"all that glitters is not gold".

PubMed

Khan, Muhammad Shoaib; Reddy, Sahadev; Lombardi, Richard; Isabel, Pitti; Mcgregor, Walter E; Tang, Bang; Gabriel, George; Biederman, Robert W

2018-02-01

Left atrial appendage mass can occasionally pose a serious challenge to physicians to identify the nature of the mass with the aid of imaging techniques. We present a case of 67-year-old man, who was evaluated for suspected left atria myxoma. Transesophageal echocardiography revealed a heterogeneous density originating from left atrial appendage, thought to be most consistent with a myxoma. Cardiac magnetic resonance imaging, uncharacteristically, gave an equivocal picture, suggesting the mass to be a myxoma on initial imaging and a thrombus with evidence of liquefaction necrosis following postcontrast enhancement. Surprisingly, histopathology of the mass following its surgical excision yielded a rare diagnosis of myxofibrosarcoma. © 2017, Wiley Periodicals, Inc.

Evaluation of New Century High Schools: Profile of an Initiative to Create and Sustain Small, Successful High Schools. Final Report

ERIC Educational Resources Information Center

Foley, Eileen M.; Klinge, Allan; Reisner, Elizabeth R.

2007-01-01

The evaluation of the New Century High Schools (NCHS) initiative examined operations and student outcomes in 75 schools from 2002-2003 through 2005-2006. This report, the final in a series of annual evaluation reports, presents data collected over those years, with a focus on school year 2005-2006. The NCHS initiative grew out of a program theory…

Integrated corridor management initiative : demonstration phase evaluation - final national evaluation framework.

DOT National Transportation Integrated Search

2012-05-01

This report provides an analytical framework for evaluating the two field deployments under the United States Department of Transportation (U.S. DOT) Integrated Corridor Management (ICM) Initiative Demonstration Phase. The San Diego Interstate 15 cor...

Optimization of High-Dimensional Functions through Hypercube Evaluation

PubMed Central

Abiyev, Rahib H.; Tunay, Mustafa

2015-01-01

A novel learning algorithm for solving global numerical optimization problems is proposed. The proposed learning algorithm is intense stochastic search method which is based on evaluation and optimization of a hypercube and is called the hypercube optimization (HO) algorithm. The HO algorithm comprises the initialization and evaluation process, displacement-shrink process, and searching space process. The initialization and evaluation process initializes initial solution and evaluates the solutions in given hypercube. The displacement-shrink process determines displacement and evaluates objective functions using new points, and the search area process determines next hypercube using certain rules and evaluates the new solutions. The algorithms for these processes have been designed and presented in the paper. The designed HO algorithm is tested on specific benchmark functions. The simulations of HO algorithm have been performed for optimization of functions of 1000-, 5000-, or even 10000 dimensions. The comparative simulation results with other approaches demonstrate that the proposed algorithm is a potential candidate for optimization of both low and high dimensional functions. PMID:26339237

Novel biosynthesized silver nanoparticles from cobweb as adsorbent for Rhodamine B: equilibrium isotherm, kinetic and thermodynamic studies

NASA Astrophysics Data System (ADS)

Azeez, Luqmon; Lateef, Agbaje; Adebisi, Segun A.; Oyedeji, Abdulrasaq O.

2018-03-01

This study has investigated the adsorption of Rhodamine B (Rh-B) dye on novel biosynthesized silver nanoparticles (AgNPs) from cobweb. The effects of contact time, initial pH, initial dye concentration, adsorbent dosage and temperature were studied on the removal of Rh-B and they significantly affected its uptake. Adsorption isotherms were evaluated using Langmuir, Freundlich, Temkin and Dubinin-Radushkevich isotherm models. The adsorption process was best described by Langmuir isotherm with R 2 of 0.9901, indicating monolayer adsorption. The maximum adsorption capacity ( q max) of 59.85 mg/g showed that it has relatively high performance, while adsorption intensity showed a favourable adsorption process. Pseudo-second-order kinetics fitted best the rate of adsorption and intra-particle diffusion revealed both surface adsorption and intra-particle diffusion-controlled adsorption process. Negative values of thermodynamic parameters (Δ H°, Δ S° and Δ G°) indicated an exothermic and spontaneous adsorption process. The mean sorption energy ( E) and activation energy ( E a) suggested the uptake of Rh-B onto AgNPs was chemical in nature (chemosorption).

Application of response surface methodology (RSM) for the removal of methylene blue dye from water by nano zero-valent iron (NZVI).

PubMed

Khosravi, Morteza; Arabi, Simin

In this study, iron zero-valent nanoparticles were synthesized, characterized and studied for removal of methylene blue dye in water solution. The reactions were mathematically described as the function of parameters such as nano zero-valent iron (NZVI) dose, pH, contact time and initial dye concentration, and were modeled by the use of response surface methodology. These experiments were carried out as a central composite design consisting of 30 experiments determined by the 2(4) full factorial designs with eight axial points and six center points. The results revealed that the optimal conditions for dye removal were NZVI dose 0.1-0.9 g/L, pH 3-11, contact time 20-100 s, and initial dye concentration 10-50 mg/L, respectively. Under these optimal values of process parameters, the dye removal efficiency of 92.87% was observed, which very close to the experimental value (92.21%) in batch experiment. In the optimization, R(2) and R(2)adj correlation coefficients for the model were evaluated as 0.96 and 0.93, respectively.

Immune-mediated pure red cell aplasia in a domestic ferret.

PubMed

Malka, Shachar; Hawkins, Michelle G; Zabolotzky, Shanon M; Mitchell, Elizabeth B; Owens, Sean D

2010-09-15

An 8-month-old spayed female domestic ferret (Mustela putorius furo) was referred for examination to determine the cause of lethargy and severe anemia. Initial examination revealed that the ferret was lethargic but with appropriate mentation. The only other abnormal findings were severe pallor of the mucous membranes, nasal planum, and skin and a PCV of 8%. Pure red cell aplasia (PRCA) was diagnosed on the basis of cytologic evaluation of a bone marrow biopsy specimen. Medical treatment included blood transfusions, IM administration of iron dextran, oral administration of antimicrobials and gastrointestinal tract protectants, and SC administration of erythropoietin. Once PRCA was diagnosed, the ferret was orally administered prednisone, cyclosporine, and azathioprine. Nine months after onset of treatment, the PRCA was in remission and the ferret was doing well. Immunosuppressive treatment was discontinued at 14 months after onset of treatment, and 36 months after initial examination, the ferret appeared to be healthy. It is important that PRCA be considered as a differential diagnosis for a ferret with severe anemia. Prolonged immunosuppressive treatment was successful in the ferret described here.

Evaluation of selected chemical processes for production of low-cost silicon, phase 2

NASA Technical Reports Server (NTRS)

Blocher, J. M., Jr.; Browning, M. F.; Wilson, W. J.; Carmichael, D. C.

1977-01-01

Potential designs for an integrated fluidized-bed reactor/zinc vaporizer/SiCl4 preheater unit are being considered and heat-transfer calculations have been initiated on versions of the zinc vaporizer section. Estimates of the cost of the silicon prepared in the experimental facility have been made for projected capacities of 25, 50, 75, and 100 metric ton of silicon. A 35 percent saving is obtained in going from 25 metric ton/year to the 50 metric ton/year level. This analysis, coupled with the recognition that use of two reactors in the 50 metric ton/year version allows for continued operation (at reduced capacity) with one reactor shut down, has resulted in a recommendation for adoption of an experimental facility capacity of 50 metric ton/year or greater. At this stage, the change to a larger size facility would not increase the design costs appreciably. In the experimental support program, the effects of seed bed particle size and depth were studied, and operation of the miniplant with a new zinc vaporizer was initiated, revealing the need for modification of the latter.

Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women

PubMed Central

2014-01-01

Background Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings. Methods A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session. Results Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 – 0.95, p = 0.016). Conclusion The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. PMID:24884597

Alginate-immobilized bentonite clay: adsorption efficacy and reusability for Cu(II) removal from aqueous solution.

PubMed

Tan, Wei Shang; Ting, Adeline Su Yien

2014-05-01

This study evaluated the use of alginate-immobilized bentonite to remove Cu(II) as an alternative to mitigate clogging problems. The adsorption efficacy (under the influence of time, pH and initial Cu(II) concentration) and reusability of immobilized-bentonite (1% w/v bentonite) was tested against plain alginate beads. Results revealed that immobilized bentonite demonstrated significantly higher sorption efficacy compared to plain alginate beads with 114.70 and 94.04 mg Cu(II) adsorbed g(-1) adsorbent, respectively. Both sorbents were comparable in other aspects where sorption equilibrium was achieved within 6 h, with optimum pH between pH 4 and 5 for adsorption, displayed maximum adsorption capacity at initial Cu(II) concentrations of 400 mg l(-1), and demonstrated excellent reusability potential with desorption greater than 90% throughout three consecutive adsorption-desorption cycles. Both sorbents also conformed to Langmuir isotherm and pseudo-second order kinetic model. Immobilized bentonite is therefore recommended for use in water treatments to remove Cu(II) without clogging the system. Copyright © 2013 Elsevier Ltd. All rights reserved.

Procedure for calculating estimated ultimate recoveries of Bakken and Three Forks Formations horizontal wells in the Williston Basin

USGS Publications Warehouse

Cook, Troy A.

2013-01-01

Estimated ultimate recoveries (EURs) are a key component in determining productivity of wells in continuous-type oil and gas reservoirs. EURs form the foundation of a well-performance-based assessment methodology initially developed by the U.S. Geological Survey (USGS; Schmoker, 1999). This methodology was formally reviewed by the American Association of Petroleum Geologists Committee on Resource Evaluation (Curtis and others, 2001). The EUR estimation methodology described in this paper was used in the 2013 USGS assessment of continuous oil resources in the Bakken and Three Forks Formations and incorporates uncertainties that would not normally be included in a basic decline-curve calculation. These uncertainties relate to (1) the mean time before failure of the entire well-production system (excluding economics), (2) the uncertainty of when (and if) a stable hyperbolic-decline profile is revealed in the production data, (3) the particular formation involved, (4) relations between initial production rates and a stable hyperbolic-decline profile, and (5) the final behavior of the decline extrapolation as production becomes more dependent on matrix storage.

Clinical Application of Liquid Biopsy in Targeted Therapy of Metastatic Colorectal Cancer

PubMed Central

Trojan, Jörg; Klein-Scory, Susanne; Koch, Christine; Schmiegel, Wolff

2017-01-01

Background. Colorectal cancers (CRC) shed DNA into blood circulation. There is growing evidence that the analysis of circulating tumor DNA can be effectively used for monitoring of disease, to track tumor heterogeneity and to evaluate response to treatment. Case Presentation. Here, we describe two cases of patients with advanced CRC. The first case is about a patient with no available tissue for analysis of RAS mutation status. Liquid biopsy revealed RAS-wild-type and the therapy with anti-EGFR (epidermal growth factor receptor) monoclonal antibody cetuximab could be initiated. In the second case, the mutational profile of a patient with initial wild-type RAS-status was continually tracked during the course of treatment. An acquired KRAS exon 3 mutation was detected. The number of KRAS mutated fragments decreased continuously after the discontinuation of the therapy with EGFR-specific antibodies. Conclusion. Liquid biopsy provides a rapid genotype result, which accurately reproduces the current mutation status of tumor tissue. Furthermore, liquid biopsy enables close monitoring of the onset of secondary resistance to anti-EGFR therapy. PMID:28232873

Clinical Application of Liquid Biopsy in Targeted Therapy of Metastatic Colorectal Cancer.

PubMed

Trojan, Jörg; Klein-Scory, Susanne; Koch, Christine; Schmiegel, Wolff; Baraniskin, Alexander

2017-01-01

Background. Colorectal cancers (CRC) shed DNA into blood circulation. There is growing evidence that the analysis of circulating tumor DNA can be effectively used for monitoring of disease, to track tumor heterogeneity and to evaluate response to treatment. Case Presentation. Here, we describe two cases of patients with advanced CRC. The first case is about a patient with no available tissue for analysis of RAS mutation status. Liquid biopsy revealed RAS-wild-type and the therapy with anti-EGFR (epidermal growth factor receptor) monoclonal antibody cetuximab could be initiated. In the second case, the mutational profile of a patient with initial wild-type RAS-status was continually tracked during the course of treatment. An acquired KRAS exon 3 mutation was detected. The number of KRAS mutated fragments decreased continuously after the discontinuation of the therapy with EGFR-specific antibodies. Conclusion . Liquid biopsy provides a rapid genotype result, which accurately reproduces the current mutation status of tumor tissue. Furthermore, liquid biopsy enables close monitoring of the onset of secondary resistance to anti-EGFR therapy.

Controlled initiation of chromosomal replication in Escherichia coli requires functional Hda protein.

PubMed

Camara, Johanna Eltz; Skarstad, Kirsten; Crooke, Elliott

2003-05-01

Regulatory inactivation of DnaA helps ensure that the Escherichia coli chromosome is replicated only once per cell cycle, through accelerated hydrolysis of active replication initiator ATP-DnaA to inactive ADP-DnaA. Analysis of deltahda strains revealed that the regulatory inactivation of DnaA component Hda is necessary for maintaining controlled initiation but not for cell growth or viability.

Cerebellar contribution to the prediction of self-initiated sounds.

PubMed

Knolle, Franziska; Schröger, Erich; Kotz, Sonja A

2013-10-01

In everyday life we frequently make the fundamental distinction between sensory input resulting from our own actions and sensory input that is externally-produced. It has been speculated that making this distinction involves the use of an internal forward-model, which enables the brain to adjust its response to self-produced sensory input. In the auditory domain, this idea has been supported by event-related potential and evoked-magnetic field studies revealing that self-initiated sounds elicit a suppressed N100/M100 brain response compared to externally-produced sounds. Moreover, a recent study reveals that patients with cerebellar lesions do not show a significant N100-suppression effect. This result supports the theory that the cerebellum is essential for generating internal forward predictions. However, all except one study compared self-initiated and externally-produced auditory stimuli in separate conditions. Such a setup prevents an unambiguous interpretation of the N100-suppression effect when distinguishing self- and externally-produced sensory stimuli: the N100-suppression can also be explained by differences in the allocation of attention in different conditions. In the current electroencephalography (EEG)-study we investigated the N100-suppression effect in an altered design comparing (i) self-initiated sounds to externally-produced sounds that occurred intermixed with these self-initiated sounds (i.e., both sound types occurred in the same condition) or (ii) self-initiated sounds to externally-produced sounds that occurred in separate conditions. Results reveal that the cerebellum generates selective predictions in response to self-initiated sounds independent of condition type: cerebellar patients, in contrast to healthy controls, do not display an N100-suppression effect in response to self-initiated sounds when intermixed with externally-produced sounds. Furthermore, the effect is not influenced by the temporal proximity of externally-produced sounds to self-produced sounds. Controls and patients showed a P200-reduction in response to self-initiated sounds. This suggests the existence of an additional and probably more conscious mechanism for identifying self-generated sounds that does not functionally depend on the cerebellum. Copyright © 2012 Elsevier Srl. All rights reserved.

Esophageal leiomyoma in a dog causing esophageal distension and treated by transcardial placement of a self-expanding, covered, nitinol esophageal stent.

PubMed

Robin, Elisabeth M; Pey, Pascaline B; de Fornel-Thibaud, Pauline; Moissonnier, Pierre H M; Freiche, Valérie

2018-02-01

CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement. CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma. TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs. CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.

Comparative evaluation of Bis(thiosemicarbazone)- Biotin and Met-ac-TE3A for tumor imaging

NASA Astrophysics Data System (ADS)

Singh, Sweta; Tiwari, Anjani K.; Varshney, Raunak; Mathur, R.; Shukla, Gauri; Bag, N.; Singh, B.; Mishra, Anil K.

2016-01-01

2,2‧,2″-(11-(2-((4-mercapto-1-methoxy-1-oxobutan-2-yl)amino)-2-oxoethyl)-1,4,8,11-tetraaza cyclotetradecane-1,4,8-triyl)triacetic acid, Met-ac-TE3A and (E)-N-methyl-2-((E)-3-(2-(2-(5-((3aS,4S,6aR)-2-oxohexahydro-1H-thieno[3,4-d]imidazol-4-yl)pentanoyl)hydrazinecarbono-thioyl)hydrazonobutan-2-ylidene)hydrazinecarbothioamide, Bis(thiosemicarbazone)- Biotin were synthesized and evaluated for imaging application. The pharmacokinetics of these ligands were determined by tracer methods. In vitro human serum stability of 99mTc Met-ac-TE3A/99mTc Bis(thiosemicarbazone)-Biotin after 24 h was found to be 96.5% and 97.0% respectively. Blood kinetics of both ligands in normal rabbits showed biphasic clearance pattern. Ex vivo biodistribution study revealed significant initial tumor uptake and high tumor/muscles ratio which is a pre-requisite condition for a ligand to work as SPECT-radiopharmaceutical for tumor imaging.

Novel Metal Ion Based Estrogen Mimics for Molecular Imaging

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

Rajagopalan, Raghavan

The overall objective of the SBIR Phase I proposal is to prepare and evaluate a new class of {sup 99m}Tc or {sup 94m}Tc containing estrogen-like small molecules ('estrogen mimics') for SPECT or PET molecular imaging of estrogen receptor positive (ER+) tumors. In this approach, the metal ion is integrated into the estrone skeleton by isosteric substitution of a carbon atom in the steroidal structure to give new class of mimics that are topologically similar to the native estrogen (Fig. 1). Although both N{sub 2}S{sub 2} and N{sub 3}S mimics 1 and 2 were considered as target structures, molecular modeling studymore » revealed that the presence of the acetyl group at position-15 in the N{sub 3}S mimic 2 causes steric hinderance toward binding of 2 to SHBG. Therefore, initial efforts were directed at the synthesis and evaluation of the N{sub 2}S{sub 2} mimic 1.« less

Design, Development, and Initial Evaluation of a Terminology for Clinical Decision Support and Electronic Clinical Quality Measurement.

PubMed

Lin, Yanhua; Staes, Catherine J; Shields, David E; Kandula, Vijay; Welch, Brandon M; Kawamoto, Kensaku

2015-01-01

When coupled with a common information model, a common terminology for clinical decision support (CDS) and electronic clinical quality measurement (eCQM) could greatly facilitate the distributed development and sharing of CDS and eCQM knowledge resources. To enable such scalable knowledge authoring and sharing, we systematically developed an extensible and standards-based terminology for CDS and eCQM in the context of the HL7 Virtual Medical Record (vMR) information model. The development of this terminology entailed three steps: (1) systematic, physician-curated concept identification from sources such as the Health Information Technology Standards Panel (HITSP) and the SNOMED-CT CORE problem list; (2) concept de-duplication leveraging the Unified Medical Language System (UMLS) MetaMap and Metathesaurus; and (3) systematic concept naming using standard terminologies and heuristic algorithms. This process generated 3,046 concepts spanning 68 domains. Evaluation against representative CDS and eCQM resources revealed approximately 50-70% concept coverage, indicating the need for continued expansion of the terminology.

Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

PubMed

Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

2015-07-01

The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury.

Data-mining for sulfur and fluorine: an evaluation of pharmaceuticals to reveal opportunities for drug design and discovery.

PubMed

Ilardi, Elizabeth A; Vitaku, Edon; Njardarson, Jon T

2014-04-10

Among carbon, hydrogen, oxygen, and nitrogen, sulfur and fluorine are both leading constituents of the pharmaceuticals that comprise our medicinal history. In efforts to stimulate the minds of both the general public and expert scientist, statistics were collected from the trends associated with therapeutics spanning 12 disease categories (a total of 1969 drugs) from our new graphical montage compilation: disease focused pharmaceuticals posters. Each poster is a vibrant display of a collection of pharmaceuticals (including structural image, Food and Drug Administration (FDA) approval date, international nonproprietary name (INN), initial market name, and a color-coded subclass of function) organized chronologically and classified according to an association with a particular clinical indication. Specifically, the evolution and structural diversity of sulfur and the popular integration of fluorine into drugs introduced over the past 50 years are evaluated. The presented qualitative conclusions in this article aim to promote innovative insights into drug development.

[Establishment and evaluation of an in vitro method for neutrophil extracellular trap generation and degradation].

PubMed

Li, Jinlong; Zhang, Yidan; Zhou, Xin; Ji, Wenjie; Zhao, Jihong; Wei, Luqing; Li, Yuming

2014-09-01

To evaluate a novel method for in vitro generation and degradation of neutrophil extracellular traps (NETs), which are a newly recognized structure that is involved in the pathogenesis of autoimmune diseases and thrombosis. Neutrophils from peripheral blood of healthy donors were obtained by Ficoll-Histopaque gradient separation. NET release was initiated by phorbol myristate acetate (PMA) and validated by immunofluorescence staining and agarose gel electrophoresis. NETs degraded by DNase I and healthy human plasma were quantified by fluorescence spectrometry after staining with PicoGreen. HE staining showed that the purity of neutrophils was up to 95% after Ficoll-Histopaque gradient separation. NET immunofluorescent staining revealed that the network structure was mainly composed of DNA and histones, with molecular length more than 10 kb as demonstrated by agarose gel electrophoresis. Moreover, both DNase and healthy human plasma could induce the degradation of NETs, in varying degrees. This work established an efficient method for in vitro generation and degradation of human NETs.

Evaluation of an Interdisciplinary Curriculum Teaching Team-based Palliative Care Integration in Oncology

PubMed Central

Head, Barbara A.; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeifer, Mark

2015-01-01

For students of the health care professions to succeed in today's healthcare environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences. PMID:25708910

Flow cytometry, morphometry and histopathology as biomarkers of benzo[a]pyrene exposure in brown bullheads (ameiurus nebulosus)

USGS Publications Warehouse

Grady, Andrew W.; McLaughlin, Ronald M.; Caldwell, Charles W.; Schmitt, Christopher J.; Stalling, David L.

1992-01-01

Brown bullheads were given a single intraperitoneal dose of 0, 5, 25 or 125 mg kg−1 benzo[a]pyrene (BaP), a carcinogenic polycyclic aromatic hydrocarbon, and evaluated over 18 months. Flow cytometric analyses of hepatocyte DNA content indicated an increase in DNA synthesis in BaP-exposed fish prior to day 14 post-exposure. Thereafter, all flow cytometric variables returned to initial levels. Histopathological evaluation of livers from fish sampled at 18 months revealed significant differences among treatments in the amount of hepatic macrophage ceroid pigmentation and basophilic staining intensity. No neoplasms or changes in blood cell DNA content were detected. Significant morphometric variations existed among fish, but differences between sexes overshadowed differences attributable to dose. Flow cytometry yielded no evidence of long-term DNA alterations from a single exposure to BaP; however, the differences detected by DNA analysis shortly after the toxic event suggest that flow cytometric cell cycle analysis may be useful for documenting continuing exposures.

How shared reality is created in interpersonal communication.

PubMed

Echterhoff, Gerald; Schmalbach, Bjarne

2017-12-29

Communication is a key arena and means for shared-reality creation. Most studies explicitly devoted to shared reality have focused on the opening part of a conversation, that is, a speaker's initial message to an audience. The aspect of communication examined by this research is the evaluative adaptation (tuning) of the messages to the audience's attitude or judgment. The speaker's shared-reality creation is typically assessed by the extent to which the speaker's evaluative representation of the topic matches the audience-tuned view expressed in the message. We first review research on such audience-tuning effects, with a focus on shared-reality goals and conditions facilitating the generalization of shared reality. We then review studies using other paradigms that illustrate factors of shared-reality creation in communication, including mere message production, grounding, validation responses, and communication about commonly known information (including stereotypes) in intragroup communication. The different lines of research reveal the potency, but also boundary conditions, of communication effects on shared reality. Copyright © 2017. Published by Elsevier Ltd.

Paradoxical Seizure Response to Phenytoin in an Epileptic Heroin Addict.

PubMed

Vasagar, Brintha; Verma, Beni R; Dewberry, Robert G; Pula, Thaddeus

2015-06-01

Phenytoin has a narrow therapeutic window and seizures can occur at both ends of the spectrum. A 41-year-old man with a history of a seizure disorder and heroin addiction presented with dizziness following 2 generalized tonic-clonic seizures that occurred earlier that day. The patient had received a loading dose of phenytoin for seizures associated with a subtherapeutic level 5 days previously. Initial evaluation revealed an elevated phenytoin level of 32.6 mcg/mL and an opiate-positive toxicology screen. Levetiracetam was started on the day of presentation and phenytoin was held until the level returned to the therapeutic range. The patient's dizziness resolved and he had no additional seizures. Evaluation for reversible causes of seizure activity along with anticonvulsant administration is generally the standard of care for breakthrough seizures. Phenytoin blood levels, if supratherapeutic, may be at least partially responsible for breakthrough seizure activity; in this circumstance, holding phenytoin and temporarily adding another anticonvulsant may be indicated.

Correlation of pelvic organ prolapse quantification system scores with obstetric parameters and lower urinary tract symptoms in primiparae postpartum.

PubMed

Liang, Ching-Chung; Tseng, Ling-Hong; Horng, Shang-Gwo; Lin, I-wen; Chang, Shuenn-Dhy

2007-05-01

This study investigated the correlation between results of the pelvic organ prolapse quantification (POPQ) system at 3 days and at 2 months postpartum with obstetric parameters and lower urinary tract symptoms (LUTS) in 125 primiparae with vaginal delivery. The clinical characteristics, prevalence of pregnancy-related LUTS, and POPQ scores were evaluated. Regarding the relationship of obstetric parameters with POPQ scoring, the gh was found positively correlated with the body mass index and vaginal laceration at 2 months postpartum. The POPQ evaluation did not find the LUTS to be significantly related to the prolapse score. The mean scores of points C and D were significantly increased, and gh, pb, and tvl were significantly decreased between the initial and 2-month follow-up scores. Our results revealed that a decrease in vaginal size is the principal change during the first 2 months postpartum and that with the exception of gh, neither the obstetric parameters nor the LUTS were associated with the POPQ scoring system.

Evaluation of a "loss-framed" minimal intervention to increase mammography utilization among medically un- and under-insured women.

PubMed

Abood, Doris A; Coster, Daniel C; Mullis, Ann K; Black, David R

2002-01-01

This study was conducted because mammography is under-utilized, even though it is the most effective early detection screening device for breast cancer. A loss-framed telephonic message based on prospect theory was evaluated for the effects on mammography utilization among medically un- and under-insured women living in demographically similar rural counties in Florida. The sample consisted mostly of White women (approximately 89%) 50-64 years old. Experimental group participants received the loss-framed message telephonically and those in the comparison group received the "usual telephone procedure." Logistic regression analyses revealed that women who received the loss-framed message were six times more likely to obtain a mammogram (OR = 6.6, P < 0.0001). The impact of the loss-framed message persisted even after adjustment for initial versus re-screen mammogram effects. This in-reach, loss-framed, minimal intervention seems to have viability and may serve as an alternative or adjunct program for encouraging women to receive mammograms.

Evaluation of an Interdisciplinary Curriculum Teaching Team-Based Palliative Care Integration in Oncology.

PubMed

Head, Barbara A; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeiffer, Mark

2016-06-01

For students of the health care professions to succeed in today's health care environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work, and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences.

Characterization of primary pulmonary adenosquamous carcinoma-associated pleural effusion.

PubMed

Stewart, Jennifer; Holloway, Andrew; Rasotto, Roberta; Bowlt, Kelly

2016-03-01

A 10-year-old, female spayed Shih Tzu was presented due to weight loss, increased respiratory effort and lethargy, determined to be secondary to a congenital para-esophageal diaphragmatic defect with partial herniation of the stomach and spleen. Four days following reduction surgery of the displaced abdominal organs thoracic effusion developed. Thoracic fluid evaluation revealed a cell-rich, protein-poor modified transudate with neutrophils, reactive mesothelial cells, and atypical epitheloid cells which occasionally appeared to be keratinizing, consistent with neoplastic exfoliation. Thoracic effusion recurred 2 days later, with similar characteristics as the initial sample. Computed tomography (CT) indicated consolidation and displacement of the right middle and accessory lung lobes. Exploratory thoracic surgery demonstrated a thickened, hyperemic right middle lung lobe, and thickened pericardial diaphragmatic ligament. Histologic evaluation of these tissues identified a primary pulmonary adenosquamous carcinoma with intravascular and pleural invasion. Based on these cytologic, histologic, and clinical findings, we conclude that primary pulmonary carcinomas may involve superficial thoracic structures and exfoliate into a thoracic effusion. © 2016 American Society for Veterinary Clinical Pathology.

The Effect of Remelting on the Physical Properties of Borotellurite Glass Doped with Manganese

PubMed Central

Hashim, Syed Putra Hashim Syed; Sidek, Haji Abdul Aziz; Halimah, Mohamed Kamari; Matori, Khamirul Amin; Yusof, Wan Mohamad Daud Wan; Zaid, Mohd Hafiz Mohd

2013-01-01

A systematic set of borotellurite glasses doped with manganese (1–x) [(B2O3)0.3(TeO2)0.7]-xMnO, with x = 0.1, 0.2, 0.3 and 0.4 mol%, were successfully synthesized by using a conventional melt and quench-casting technique. In this study, the remelting effect of the glass samples on their microstructure was investigated through density measurement and FT-IR spectra and evaluated by XRD techniques. Initial experimental results from XRD evaluation show that there are two distinct phases of glassy and crystallite microstructure due to the existence of peaks in the sample. The different physical behaviors of the studied glasses were closely related to the concentration of manganese in each phase. FTIR spectra revealed that the addition of manganese oxide contributes the transformation of TeO4 trigonal bipyramids with bridging oxygen (BO) to TeO3 trigonal pyramids with non-bridging oxygen (NBO). PMID:23296276

Numerical simulation of vortex pyrolysis reactors for condensable tar production from biomass

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

Miller, R.S.; Bellan, J.

1998-08-01

A numerical study is performed in order to evaluate the performance and optimal operating conditions of vortex pyrolysis reactors used for condensable tar production from biomass. A detailed mathematical model of porous biomass particle pyrolysis is coupled with a compressible Reynolds stress transport model for the turbulent reactor swirling flow. An initial evaluation of particle dimensionality effects is made through comparisons of single- (1D) and multi-dimensional particle simulations and reveals that the 1D particle model results in conservative estimates for total pyrolysis conversion times and tar collection. The observed deviations are due predominantly to geometry effects while directional effects frommore » thermal conductivity and permeability variations are relatively small. Rapid ablative particle heating rates are attributed to a mechanical fragmentation of the biomass particles that is modeled using a critical porosity for matrix breakup. Optimal thermal conditions for tar production are observed for 900 K. Effects of biomass identity, particle size distribution, and reactor geometry and scale are discussed.« less

Explore the reaction mechanism of the Maillard reaction: a density functional theory study.

PubMed

Ren, Ge-Rui; Zhao, Li-Jiang; Sun, Qiang; Xie, Hu-Jun; Lei, Qun-Fang; Fang, Wen-Jun

2015-05-01

The mechanism of Maillard reaction has been investigated by means of density functional theory calculations in the gaseous phase and aqueous solution. The Maillard reaction is a cascade of consecutive and parallel reaction. In the present model system study, glucose and glycine were taken as the initial reactants. On the basis of previous experimental results, the mechanisms of Maillard reaction have been proposed, and the possibility for the formation of different compounds have been evaluated through calculating the relative energy changes for different steps of reaction under different pH conditions. Our calculations reveal that the TS3 in Amadori rearrangement reaction is the rate-determining step of Maillard reaction with the activation barriers of about 66.7 and 68.8 kcal mol(-1) in the gaseous phase and aqueous solution, respectively. The calculation results are in good agreement with previous studies and could provide insights into the reaction mechanism of Maillard reaction, since experimental evaluation of the role of intermediates in the Maillard reaction is quite complicated.

Design, Development, and Initial Evaluation of a Terminology for Clinical Decision Support and Electronic Clinical Quality Measurement

PubMed Central

Lin, Yanhua; Staes, Catherine J; Shields, David E; Kandula, Vijay; Welch, Brandon M; Kawamoto, Kensaku

2015-01-01

When coupled with a common information model, a common terminology for clinical decision support (CDS) and electronic clinical quality measurement (eCQM) could greatly facilitate the distributed development and sharing of CDS and eCQM knowledge resources. To enable such scalable knowledge authoring and sharing, we systematically developed an extensible and standards-based terminology for CDS and eCQM in the context of the HL7 Virtual Medical Record (vMR) information model. The development of this terminology entailed three steps: (1) systematic, physician-curated concept identification from sources such as the Health Information Technology Standards Panel (HITSP) and the SNOMED-CT CORE problem list; (2) concept de-duplication leveraging the Unified Medical Language System (UMLS) MetaMap and Metathesaurus; and (3) systematic concept naming using standard terminologies and heuristic algorithms. This process generated 3,046 concepts spanning 68 domains. Evaluation against representative CDS and eCQM resources revealed approximately 50–70% concept coverage, indicating the need for continued expansion of the terminology. PMID:26958220

Model study of St. Stephen powerhouse fish passage facilities, Cooper River rediversion project, South Carolina. Final report

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

Hite, J.E.; Murphy, T.E.

1998-09-01

This report documents a model study of the St. Stephen Power Plant, located in Berkely County, South Carolina. A previous model study revealed that the fish lift at the powerhouse could be improved by providing auxiliary attraction flows to the fish entrances. An auxiliary attraction flow (AAF) system was proposed that uses a siphon to obtain the auxiliary attraction water from the reservoir. The model investigations reported herein address the flow conditions at the discharge end of the siphon; the hydraulic aspects of the siphon are not addressed. Three different models were used to evaluate flow conditions at the dischargemore » end of the AAF system. A 1:25-scale model of the St. Stephen powerhouse was used to improve the fish entrance conditions and to evaluate the outlet conditions for the initial AAF system. As the investigations progressed, the design of the siphon discharge system was modified to include downstream fish migration and debris passage.« less

Evaluation of a Socio-Cultural Intervention to Reduce Unprotected Sex for HIV Among African American/Black Women

PubMed Central

Boekeloo, B; Geiger, T; Wang, M; Ishman, N; Quinton, S; Allen, G; Ali, B; Snow, D

2015-01-01

African American/Black (Black) women suffer disproportionately to other women from HIV. An HIV prevention intervention combining two previous evidenced-based HIV intervention programs; “Coping with Work and Family Stress” and “Hip Hop 2 Prevent Substance Abuse and HIV”, was evaluated in a diverse sample of Black women (n=205). Study participants at 10 recruitment sites were assigned non-randomly to either the intervention or comparison group and then surveyed at baseline, immediate posttest, and 6-month follow-up. General Estimating Equation modeling revealed that participants in the comparison group reported less unprotected sex at immediate post-test and the intervention group less unprotected sex at 6-month follow-up. Despite the initial drop in reported unprotected sex in the comparison group, this study suggests that an HIV risk reduction intervention tailored to address Black women’s socio-cultural stress and enhance their coping may reduce their unprotected sex at 6-months. PMID:25645327

Pseudo Gitelman Syndrome Associated With Pregnancy.

PubMed

Yoshihara, Masato; Sayo, Akira; Mayama, Michinori; Oguchi, Hidenori

2015-10-01

Gitelman syndrome is a rare inherited renal tubulopathy associated with metabolic alkalosis and electrolyte disorders. Pseudo Gitelman syndrome presents with the same clinical characteristics as Gitelman syndrome, yet without genetic mutations in SLC12A3. A 32-year-old woman with no remarkable medical and family history developed hypokalemia at 32 weeks of gestation. Laboratory findings were consistent with Gitelman syndrome and potassium supplementation was initiated. The patient delivered a healthy neonate at 40 weeks of gestation and the electrolyte disorders drastically improved. After delivery, genomic analysis revealed no evidence of mutations in SLC12A3, and pseudo Gitelman syndrome was finally diagnosed. Pseudo Gitelman syndrome, presenting with Gitelman syndrome-like renal tubulopathy without mutations in SLC12A3, can cause a temporary electrolyte imbalance based on the physiologic changes of pregnancy. Although pregnant women with isolated hypokalemia need not be evaluated for Gitelman or pseudo Gitelman syndrome, if it is accompanied by metabolic alkalosis, hypocalciuria, hypomagnesia, and activation of the renin-angiotensin-aldosterone system without hypertension, this evaluation should be considered.

Strand invasion structures in the inverted repeat of Candida albicans mitochondrial DNA reveal a role for homologous recombination in replication.

PubMed

Gerhold, Joachim M; Aun, Anu; Sedman, Tiina; Jõers, Priit; Sedman, Juhan

2010-09-24

Molecular recombination and transcription are proposed mechanisms to initiate mitochondrial DNA (mtDNA) replication in yeast. We conducted a comprehensive analysis of mtDNA from the yeast Candida albicans. Two-dimensional agarose gel electrophoresis of mtDNA intermediates reveals no bubble structures diagnostic of specific replication origins, but rather supports recombination-driven replication initiation of mtDNA in yeast. Specific species of Y structures together with DNA copy number analyses of a C. albicans mutant strain provide evidence that a region in a mainly noncoding inverted repeat is predominantly involved in replication initiation via homologous recombination. Our further findings show that the C. albicans mtDNA forms a complex branched network that does not contain detectable amounts of circular molecules. We provide topological evidence for recombination-driven mtDNA replication initiation and introduce C. albicans as a suitable model organism to study wild-type mtDNA maintenance in yeast. Copyright © 2010 Elsevier Inc. All rights reserved.

Operational evaluation of initial data link air traffic control services, Vol. 1

DOT National Transportation Integrated Search

1990-02-01

This report details the results of an operational evaluation of Initial Data Link Air Traffic Control (ATC) Services. The Operational Evaluation was conducted at the Federal Aviation Administration (FAA) Technical Center utilizing the Data Link test ...

Operational evaluation of initial data link air traffic control services, Vol. 2 - Appendixes

DOT National Transportation Integrated Search

1990-02-01

This report details the results of an operational evaluation of Initial Data : LInk Air Traffic Control (ATC) Services. The Operational Evaluation was : conducted at the Federal Aviation Administration (FAA)Technical Center utilizing : the Data Link ...

34 CFR 300.301 - Initial evaluations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Initial evaluations. 300.301 Section 300.301 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND... DISABILITIES Evaluations, Eligibility Determinations, Individualized Education Programs, and Educational...

EVALUATION OF CHLORPYRIFOS UPTAKE IN STERILIZED AND NON-STERILIZED SEDIMENT

EPA Science Inventory

In order to evaluate chemical interactions in sediment, initial experiments were designed to assess the role of microbial activitiy on chemical fate of chlorpyrifos. In these initial experiments, sediment uptake of chlorpyrifos was evaluated using Enzyme Linked Immunosorbent Assa...

Lessons from Library Power: Enriching Teaching and Learning. Final Report of the Evaluation of the National Library Power Initiative, an Initiative of the DeWitt Wallace-Reader's Digest Fund.

ERIC Educational Resources Information Center

Zweizig, Douglas L.; Hopkins, Dianne McAfee

This book presents the results of an evaluation of Library Power, an initiative of the DeWitt Wallace-Reader's Digest Fund that provided support for school library development in 19 communities. Following an introductory chapter, the chapters are organized around key questions of the evaluation. Chapters 2 through 4 address the implementation of…

From Schools to Community Learning Centers: A Program Evaluation of a School Reform Process

ERIC Educational Resources Information Center

Magolda, Peter; Ebben, Kelsey

2007-01-01

This manuscript reports on a program evaluation of a school reform initiative conducted in an Ohio city. The paper describes, interprets, and evaluates this reform process aimed at transforming schools into community learning centers. The manuscript also describes and analyzes the initiative's program evaluation process. Elliot Eisner's [(1998).…

Evaluating Teachers' Professional Development Initiatives: Towards an Extended Evaluative Framework

ERIC Educational Resources Information Center

Merchie, Emmelien; Tuytens, Melissa; Devos, Geert; Vanderlinde, Ruben

2018-01-01

Evaluating teachers' professional development initiatives (PDI) is one of the main challenges for the teacher professionalisation field. Although different studies have focused on the effectiveness of PDI, the obtained effects and evaluative methods have been found to be widely divergent. By means of a narrative review, this study provides an…

Formative Evaluation of the Understanding the Early Years Initiative. Final Report

ERIC Educational Resources Information Center

Human Resources and Skills Development Canada, 2009

2009-01-01

This report presents the findings of the formative evaluation of the Understanding the Early Years (UEY) Initiative. The evaluation was conducted to examine issues of implementation and design, early progress in achieving immediate objectives, and issues related to accountability. The evaluation team was also asked to provide preliminary guidance…

Creating a Space for Student Voice in an Educational Evaluation

ERIC Educational Resources Information Center

Bourke, Roseanna; MacDonald, Jo

2018-01-01

Evaluation research focusing on educational initiatives that impact on the learning and lives of young people must be challenged to incorporate 'student voice'. In a context of conventional evaluation models of government-led initiatives, student voice is a compelling addition, and challenges the nature of traditional forms of evaluation. It…

Thoracic osteomyelitis and epidural abscess formation due to cat scratch disease: case report.

PubMed

Dornbos, David; Morin, Jocelyn; Watson, Joshua R; Pindrik, Jonathan

2016-12-01

Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease. A 5-year-old girl, who initially presented with vague constitutional symptoms, was diagnosed with cat scratch disease following biopsy of an inguinal lymph node. Despite appropriate antibiotics, she presented several weeks later with recurrent symptoms and back pain. Magnetic resonance imaging revealed 2 foci of osteomyelitis at T-8 and T-11 with an associated anterior epidural abscess from T-9 to T-12. Percutaneous image-guided vertebral biopsy revealed B. henselae by polymerase chain reaction analysis, and she was treated conservatively with doxycycline and rifampin with favorable clinical outcome.

Influence of p53 status on the effects of boron neutron capture therapy in glioblastoma.

PubMed

Seki, Keiko; Kinashi, Yuko; Takahashi, Sentaro

2015-01-01

The tumor suppressor gene p53 is mutated in glioblastoma. We studied the relationship between the p53 gene and the biological effects of boron neutron capture therapy (BNCT). The human glioblastoma cells; A172, expressing wild-type p53, and T98G, with mutant p53, were irradiated by the Kyoto University Research Reactor (KUR). The biological effects after neutron irradiation were evaluated by the cell killing effect, 53BP1 foci assay and apoptosis induction. The survival-fraction data revealed that A172 was more radiosensitive than T98G, but the difference was reduced when boronophenylalanine (BPA) was present. Both cell lines exhibited similar numbers of foci, suggesting that the initial levels of DNA damage did not depend on p53 function. Detection of apoptosis revealed a lower rate of apoptosis in the T98G. BNCT causes cell death in glioblastoma cells, regardless of p53 mutation status. In T98G cells, cell killing and apoptosis occurred effectively following BNCT. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Diffuse myelitis after treatment of cerebral aspergillosis in an immune competent patient.

PubMed

Mollahoseini, Reza; Nikoobakht, Mahdi

2011-01-01

Presentation of an unusual case of cerebral aspergillosis in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric and dural lesions. An open biopsy was conducted. Histological evaluation revealed hyphe-like structure in the necrotic area, within vessel walls, and lumina, suggestive aspergillus fumigatus . Furthermore, brancheal hyphae in potassium hydrxide 15% and colonies on sabourud dextrose agar were observed. Based of the above findings the patient underwent anti fungal therapy. The patient recovered and continued a normal life however a follow up MRI was performed after 3 months from recovery. No significant abnormality was observed from the MRI procedure. One month later the patient developed signs and symptoms of spinal cord involvement which seemed to be the result of myelitis. A brain MR showed no abnormalities .Therefore it seemed reasonable to administer corticosteroid as a treatment for suspected active demyelinating process. During the above treatment, signs and symptoms of myelopathy disappeared and a whole spine MRI showed remarkable improvement.

Primary Progressive Speech Abulia.

PubMed

Milano, Nicholas J; Heilman, Kenneth M

2015-01-01

Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment. The three variants of PPA include the nonfluent/agrammatic, semantic, and logopenic types. The goal of this report is to describe two patients with a loss of speech initiation that was associated with bilateral medial frontal atrophy. Two patients with progressive speech deficits were evaluated and their examinations revealed a paucity of spontaneous speech; however their naming, repetition, reading, and writing were all normal. The patients had no evidence of agrammatism or apraxia of speech but did have impaired speech fluency. In addition to impaired production of propositional spontaneous speech, these patients had impaired production of automatic speech (e.g., reciting the Lord's Prayer) and singing. Structural brain imaging revealed bilateral medial frontal atrophy in both patients. These patients' language deficits are consistent with a PPA, but they are in the pattern of a dynamic aphasia. Whereas the signs-symptoms of dynamic aphasia have been previously described, to our knowledge these are the first cases associated with predominantly bilateral medial frontal atrophy that impaired both propositional and automatic speech. Thus, this profile may represent a new variant of PPA.

Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass.

PubMed

Ayaz, Sevin; Ayaz, Ümit Yaşar

2016-01-01

We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUV max ) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy.

An initial evaluation of a mindful parenting program.

PubMed

Maloney, Raelynn; Altmaier, Elizabeth

2007-12-01

A growing number of children are experiencing marital transition. The effects of divorce on children have typically been considered deleterious, although factors can buffer the difficulty of postdivorce adjustment. One of these factors is a positive relationship with a parental figure. Unfortunately, divorce often overwhelms parents with a series of changes that compromise their parenting skills. One new approach to improving parenting after divorce is mindful parenting, which aims to enhance interpersonal and emotional connection in the parent-child relationship. This program is intended to facilitate parents' self-awareness, their mindfulness, and their intentionality in responding to their child's needs. The present study reports on the implementation of the Mindful Parenting Program, delivered in two groups to 12 recently divorced parents with preschool-aged children. Program effectiveness was conducted on two levels. First, mindfulness measured by the Toronto Mindfulness Scale revealed significant increases over the intervention and posttest period. Second, in-home behavioral observations conducted pre- and postintervention revealed no changes in parent-child relationships. These findings are discussed within the larger context of facilitating effective parenting postdivorce.

Transient neonatal renal failure and massive polyuria in MEGDEL syndrome.

PubMed

Harbulot, Carole; Paquay, Stéphanie; Dorboz, Imen; Pichard, Samia; Bourillon, Agnès; Benoist, Jean-François; Jardel, Claude; Ogier de Baulny, Hélène; Boespflug-Tanguy, Odile; Schiff, Manuel

2016-06-01

MEGDEL (3-methylglutaconic aciduria with deafness, encephalopathy, and Leigh-like syndrome) syndrome is a mitochondrial disorder associated with recessive mutations in SERAC1. To report transient neonatal renal findings in MEGDEL syndrome. This 7 year-old girl was the first child of consanguineous Turkish parents. She exhibited an acute neonatal deterioration with severe lactic acidosis and liver failure. Initial evaluation revealed massive polyuria and renal failure with 3-methylglutaconic aciduria. Symptoms and biological findings progressively improved with symptomatic treatment but lactic acidosis and high lactate to pyruvate ratio along with 3-methylglutaconic aciduria persisted. At 8 months of age, a subacute neurological degradation occurred with severe hypotonia, dystonia with extrapyramidal movements and failure to thrive. Brain MRI revealed basal ganglia lesions suggestive of Leigh syndrome. At 3 years of age, sensorineural deafness was documented. MEGDEL syndrome was further confirmed by the identification of an already reported homozygous mutation in SERAC1. Transient neonatal polyuria and renal failure have not been reported to date in SERAC1 defective patients. Such neonatal kidney findings expand the clinical spectrum of MEGDEL syndrome.

The Springfield Weed and Seed Initiative: A Process Description and Evaluation.

ERIC Educational Resources Information Center

Hanna, Donald G.

A process description and preliminary evaluation are provided for the Weed and Seed initiative in Springfield (Illinois). This initiative involved local, state, and federal resources in projects that included (1) facility improvement, (2) drug prevention, (3) youth education and child care, (4) jobs and vocational training, (5) resident…

National Evaluation of the Youth Firearms Violence Initiative.

ERIC Educational Resources Information Center

Dunworth, Terence

Between 1985 and 1994 the rate of violent criminal acts committed by juveniles rose sharply. Juvenile homicides committed with a handgun more than doubled. This bulletin discusses the national evaluation of the Youth Firearms Violence Initiative (YFVI), a program initiated by the Office of Community Oriented Policing Services (COPS) to fund…