Science.gov

Sample records for long-term hospitalization experience

  1. In-hospital and long-term mortality in Takotsubo cardiomyopathy: a community hospital experience

    PubMed Central

    Vriz, Olga; Brosolo, Gabriele; Martina, Stefano; Pertoldi, Franco; Citro, Rodolfo; Mos, Lucio; Ferrara, Francesco; Bossone, Eduardo

    2016-01-01

    Background Takotsubo cardiomyopathy (TTC) is characterized by reversible left ventricular dysfunction, frequently precipitated by a stressful event. Despite the favorable course and good long-term prognosis, a variety of complications may occur in the acute phase of the disease. The aim of this study was to evaluate the in-hospital and long-term outcomes of a cohort of TTC patients. Methods Fifty-five patients (mean age 68.1±12 years) were prospectively followed for a mean of 69.6±32.2 months (64,635 days). In-hospital (death, heart failure, arrhythmias) and long-term events (death and recurrences) were recorded. Results Patients were predominantly women (87.3%) who experienced a recent stressful event (emotional or physical) and were admitted to hospital for chest pain. Eleven patients (20%) had a diagnosis of depressive disorder, and arterial hypertension was the most frequent cardiovascular risk factor. The ECG revealed ST-segment elevation in 43.6% of patients. At angiography, seven cases (12.7%) had at least one significant (≥50%) coronary artery stenosis and four patients (7.3%) had myocardial bridging of the left anterior descending artery. During hospitalization, three patients died (one from cardiac causes) and cardiovascular complications occurred in 12 patients. During follow-up, five patients died (none from cardiac causes), six patients had recurrences within the first year. Two patients had two recurrences: one after 114 days, triggered by an asthma attack as the first event, and the other after 1,850 days. Conclusions In TTC patients, in-hospital and long-term mortality is primarily due to non-cardiovascular causes. Recurrences are not infrequent and coronary artery disease is not an uncommon finding. PMID:27406446

  2. Long Term Outcome in Patients with Esophageal Stenting for Cancer Esophagus - Our Experience at a Rural Hospital of Punjab, India

    PubMed Central

    Singh, Abhitesh; Singh, Anantbir; Sharma, Ghansham; Bhatia, Parmod Kumar; Grover, Amarjeet Singh

    2016-01-01

    Introduction Cancer of the esophagus is among the leading cause of cancer deaths in Punjab, India. Patients generally present with dysphagia as their first symptom and more often they have advanced disease at the time of presentation to a tertiary care centre. Palliative procedures have important roles in this setting. Stenting is the best option to palliate the symptoms of dysphagia, from which patient is suffering the most. Aim To know the success rate, early and long term complications and mortality in esophageal stenting, when it was done in malignant esophageal stricture patients. Materials and Methods One hundred patients, who had undergone esophageal stenting from January 2012 to January 2015, were included in the study. We retrospectively analysed the data for patient characteristics, causes of non-operability, early and long term complications, re-interventions, efficacy and mortality. Results Out of 100 patients, indications for stenting were locally advanced disease not amenable to surgery (52%), metastatic disease (35%), CVA (1%), cardiac and respiratory problem (8%), un-willing for surgery in 5% of patients. Majority of patients (94%) had squamous cell carcinoma, while only 6% had adenocarcinoma. 84% of patients presented with dysphagia with or without chest pain and recurrent cough while 16% had recurrent vomiting. 58% had dysphagia to liquids and solids and 17% had complete dysphagia. After stenting 93% had significant improvement in dysphagia score from median of 3 to 1. Post procedure stay was 3.61±1.0 days. One patient had procedure related major complication in the form of post procedural bleed (after 16 days of stenting) leading to death of that patient. Minor complications were present in 52 patients treated conservatively not affecting the efficacy of procedure. These include pain after stenting (38%), stent obstruction (23%) and stent migration (6%). All the minor complications were treated conservatively except in six patients in whom re

  3. Long-Term Care Policy: Singapore's Experience.

    PubMed

    Chin, Chee Wei Winston; Phua, Kai-Hong

    2016-01-01

    Singapore, like many developed countries, is facing the challenge of a rapidly aging population and the increasing need to provide long-term care (LTC) services for elderly in the community. The Singapore government's philosophy on care for the elderly is that the family should be the first line of support, and it has relied on voluntary welfare organizations (VWOs) or charities for the bulk of LTC service provision. For LTC financing, it has emphasized the principles of co-payment and targeting of state support to the low-income population through means-tested government subsidies. It has also instituted ElderShield, a national severe disability insurance scheme. This paper discusses some of the challenges facing LTC policy in Singapore, particularly the presence of perverse financial incentives for hospitalization, the pitfalls of over-reliance on VWOs, and the challenges facing informal family caregivers. It discusses the role of private LTC insurance in LTC financing, bearing in mind demand- and supply-side failures that have plagued the private LTC insurance market. It suggests the need for more standardized needs assessment and portable LTC benefits, with reference to the Japanese Long-Term Care Insurance program, and also discusses the need to provide more support to informal family caregivers.

  4. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  5. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  6. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  7. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  8. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  9. Long-term experience with indapamide.

    PubMed

    Beling, S; Vukovich, R A; Neiss, E S; Zisblatt, M; Webb, E; Losi, M

    1983-07-01

    Indapamide, 2.5 mg administered once daily for periods up to 36 months, was found to be safe and effective for the long-term control of mild to moderate hypertension. The effects of hydrochlorothiazide, 50 mg, and indapamide, 2.5 mg, were studied in two randomized, double-blind, multicenter trials. Data from the two multicenter trials (20 study sites) were pooled for purposes of comparison. Significant reductions in systolic and diastolic blood pressure, with patients in both supine and standing positions, occurred in both groups within the first 8 weeks of treatment. This effect was maintained throughout the active treatment period. Success, as determined by the therapeutic success rate (percentage of patients with decreases of standing phase V diastolic blood pressure of at least 10 mm Hg or to below 90 mm Hg), occurred in 53% of the patients given hydrochlorothiazide and in 56% of the indapamide-treated patients. During the study period, the nature, frequency, and severity of adverse reactions were similar for both groups. There was no clinically significant difference between the treatment groups for the laboratory assessments. Patients who completed the multicenter trials were eligible for participation in an ongoing long-term extension study of the safety of indapamide. Data are available for periods up to 36 months and demonstrate neither augmentation of clinical or laboratory adverse effects nor any potentially harmful indicators that could be attributed to prolonged treatment.

  10. Catheter-related Blood Stream Infection in Patients Receiving Long-term Home Parenteral Nutrition: Tertiary Care Hospital Experience in Saudi Arabia

    PubMed Central

    Al-Tawil, Esraa S.; Almuhareb, Alanoud M.; Amin, Hamdy M.

    2016-01-01

    Background/Aim: Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN. Patients and Methods: A retrospective chart review was conducted for patients enrolled in the HPN program between 2006 and 2012. Data on the demographic characteristics, indications and duration of PN therapy, catheter type, number of admissions because of CRBSI, and blood culture results were recorded. Results: Eight pediatric patients were included (mean age of 3.5 years at the start of HPN). Microvillus inclusive disease was noted in 50% of these patients, and 75% of them received HPN under parents' care. CRBSI resulted in 60 admissions with a median of 182 days of hospital stay and 74 changes of central venous catheters. The rate of CRBSI was 2.9 per 1000 catheter days. Staphylococcus species were the most prevalent pathogens (32%), followed by Klebsiella pneumoniae (5%). Conclusion: In this small group of HPN patients, the BSI rate was 2.9 infections per 1000 catheter days, and most common causative organisms were Staphylococcus species. We believe that a well-established training program for caregivers can reduce the rate of infectious complications associated with long-term PN support. PMID:27488325

  11. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  12. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  13. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  14. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  15. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  16. Space station experiment definition: Long term cryogenic fluid storage

    NASA Technical Reports Server (NTRS)

    Riemer, David H.

    1987-01-01

    A preliminary design of an experiment to demonstrate and evaluate long-term cryogenic fluid storage and transfer technologies has been performed. This Long-Term Cryogenic Fluid Storage (LTCFS) experiment is a Technology Development Mission (TDM) experiment proposed by the NASA Lewis Research Center to be deployed on the Initial Operational Capability (IOC) space station. Technologies required by future orbital cryogenic systems such as Orbital Transfer Vehicles (OTV's) were defined, and critical technologies requiring demonstration were chosen to be included in the experiment. A three-phase test program was defined to test the following types of technologies: (1) Passive Thermal Technologies; (2) Fluid Transfer Technologies; and (3) Active Refrigeration Technologies. The development status of advanced technologies required for the LTCFS experiment is summarized, including current, past and future programs.

  17. Visualization of hospital cleanliness in three Japanese hospitals with a tendency toward long-term care

    PubMed Central

    2014-01-01

    Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface was sampled 8 times in 2 months. These areas were located in different ward units (Internal Medicine, Surgery, and Obstetrics and Gynecology). Detection limits for the ATP and stamp methods were determined by spike experiments with a diluted bacterial solution and a wipe test on student tables not in use during winter vacation, respectively. Values were expressed as the fold change over the detection limit, and a sample with a value higher than the detection limit by either method was defined as positive. Results The detection limits were determined to be 127 relative light units (RLU) per 100 cm2 for the ATP method and 5.3 colony-forming units (CFU) per 10 cm2 for the stamp method. The positive frequency of the ATP and stamp methods was 59.8% (450/752) and 47.7% (359/752), respectively, although no significant difference in the positive frequency among the hospitals was seen. Both methods revealed the presence of a wide range of organic contamination spread via hand touching, including microbial contamination, with a preponderance on the entrance floor and in patient rooms. Interestingly, the data of both methods indicated considerable variability regardless of daily visual assessment with usual wiping, and positive surfaces were irregularly seen. Nurse areas were relatively cleaner than patient areas. Finally, there was no significant correlation between the number of patients or medical personnel in the hospital and organic or microbiological contamination. Conclusions

  18. Experiences of the Long Term Stability at SLS

    SciTech Connect

    Wei, F. Q.

    2007-01-19

    The long term stability on the scale from days to a year, besides the short term stability, is one of key performance indicators of a light source. The Swiss Light Source (SLS) was installed and commissioned in 2000. It has successfully worked for more than 5 years without re-alignment of the machine. Hydrostatic Leveling System (HLS) and Horizontal Position System (HPS) have been added at supports of the storage ring (48 girders). They made evidence that the position of SLS Storage Ring (SR) is very stable on the time scale of a day, a week, a month and a year. The evidence for the long term stability is also provided by frequency of the RF cavity. The HLS is a powerful tool. The analysis of the HLS data shows that the vertical displacements, which are adjusted to correct average orbit deviations, of the SLS storage ring foundation and of the girder supports were in the range of 0.15 mm in 2003. The site, the building foundation, the mechanical supports and the temperature control are important pre-conditions to get the good long term stability. The experience gained with the long term stability at SLS is presented.

  19. Geriatrics and the triple aim: defining preventable hospitalizations in the long-term care population.

    PubMed

    Ouslander, Joseph G; Maslow, Katie

    2012-12-01

    Reducing preventable hospitalizations is fundamental to the "triple aim" of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long-term care (LTC) because they often experience negative effects of hospitalization, including hospital-acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community- and institution-based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population.

  20. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    PubMed Central

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria. PMID:24159497

  1. Music and Well-Being in Long-Term Hospitalized Children

    ERIC Educational Resources Information Center

    Longhi, Elena; Pickett, Nick

    2008-01-01

    The aim of this study was to investigate the physiological responses of long-term hospitalized children when exposed to live music. Twenty-one paediatric patients at Great Ormond Street Children's Hospital, London, between 3 months and 14 years of age, took part in the study. They were all long-term patients with cardiac and/or respiratory…

  2. Fall-Related Hospitalization and Facility Costs among Residents of Institutions Providing Long-Term Care

    ERIC Educational Resources Information Center

    Carroll, Norman V.; Delafuente, Jeffrey C.; Cox, Fred M.; Narayanan, Siva

    2008-01-01

    Purpose: The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and Methods: The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers.…

  3. Innovative use of tele-ICU in long-term acute care hospitals.

    PubMed

    Mullen-Fortino, Margaret; Sites, Frank D; Soisson, Michael; Galen, Julie

    2012-01-01

    Tele-intensive care units (ICUs) typically provide remote monitoring for ICUs of acute care, short-stay hospitals. As part of a joint venture project to establish a long-term acute level of care, Good Shepherd Penn Partners became the first facility to use tele-ICU technology in a nontraditional setting. Long-term acute care hospitals care for patients with complex medical problems. We describe describes the benefits and challenges of integrating a tele-ICU program into a long-term acute care setting and the impact this model of care has on patient care outcomes.

  4. The long-term experience of family life after stroke.

    PubMed

    Kitzmüller, Gabriele; Asplund, Kenneth; Häggström, Terttu

    2012-02-01

    Stroke is a life-threatening and disabling illness known to have a significant impact on families. The purpose of this study was to illuminate the long-term experience of family life after stroke of stroke survivors and their spouses and children, particularly regarding marital and parent-child relationships. Thirty-seven narrative interviews were conducted with stroke survivors and their spouses and adult children who were minors at onset of the illness. A qualitative approach inspired by Gadamer's hermeneutic and van Manen's phenomenological understanding of lived experience was used. The analysis revealed four themes: the family as a lifebuoy, absent presence, broken foundations, and finding a new marital path. Lack of communication and altered roles and relationships endangered marital equilibrium and parent-child relationships after stroke. This study highlighted the need for professional family support as families were unprepared for the life changes that occurred. Nurses and other healthcare workers should examine family relationships and communication patterns and view the family as a unit composed of unique persons with different needs. Further research on the experiences of stroke survivors' children seems urgent.

  5. Long-term experiences of Norwegian live kidney donors: qualitative in-depth interviews

    PubMed Central

    Bjørk, Ida Torunn; Wahl, Astrid Klopstad; Lennerling, Annette; Andersen, Marit Helen

    2017-01-01

    Objective Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. Design Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. Participants 16 donors representing all parts of Norway who donated a kidney in 2001–2004 participated in the study. The interviews were analysed using an interpretative approach. Results The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics—tension still under the surface, ambivalence—healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Conclusions Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation. PMID:28209606

  6. Long Term Stability of Coriolis Flow Meters: DESY experience

    NASA Astrophysics Data System (ADS)

    Boeckmann, T.; Bozhko, Y.; Escherich, K.; Petersen, B.; Putselyk, S.; Schnautz, T.; Sellmann, D.; Zhirnov, A.

    2017-02-01

    The measurement of coolant flow is important operational parameter for reliable operation of cryogenic system with superconducting magnets or cavities as well as for the system diagnostics in case of non-steady-state operation, e.g. during cool-down/warm-up or other transients. Proper flowmeter is chosen according to the different parameters, e.g. turn-down, operating temperature range, leak-tightness, pressure losses, long-term stability, etc. For helium cryogenics, the Venturi tube or Orifice, as well as Coriolis flow meters are often applied. For the present time, the orifices are usually used due to their simplicity and low costs, however, low turn-down range, large pressure drop, restriction of flow area, susceptibility to thermoacoustic oscillations limit their useful operation range. Operational characteristics of Venturi tubes is substantially improved in comparison to orifices, however, relative high costs and susceptibility to thermoacoustic oscillations still limit their application to special cases. The Coriolis flow meters do not have typical drawbacks of Venturi tube and orifices, however long-term stability over many years was not demonstrated yet. This paper describes the long-term behaviour of Coriolis flow meters after many years of operation at AMTF and XMTS facilities.

  7. Reduced Right Ventricular Function Predicts Long-Term Cardiac Re-Hospitalization after Cardiac Surgery

    PubMed Central

    Goldsmith, Yulia; Chan, Jacqueline; Iskandir, Marina; Gulkarov, Iosif; Tortolani, Anthony; Brener, Sorin J.; Sacchi, Terrence J.; Heitner, John F.

    2015-01-01

    Background The significance of right ventricular ejection fraction (RVEF), independent of left ventricular ejection fraction (LVEF), following isolated coronary artery bypass grafting (CABG) and valve procedures remains unknown. The aim of this study is to examine the significance of abnormal RVEF by cardiac magnetic resonance (CMR), independent of LVEF in predicting outcomes of patients undergoing isolated CABG and valve surgery. Methods From 2007 to 2009, 109 consecutive patients (mean age, 66 years; 38% female) were referred for pre-operative CMR. Abnormal RVEF and LVEF were considered <35% and <45%, respectively. Elective primary procedures include CABG (56%) and valve (44%). Thirty-day outcomes were perioperative complications, length of stay, cardiac re-hospitalizations and early mortaility; long-term (> 30 days) outcomes included, cardiac re-hospitalization, worsening congestive heart failure and mortality. Mean clinical follow up was 14 months. Findings Forty-eight patients had reduced RVEF (mean 25%) and 61 patients had normal RVEF (mean 50%) (p<0.001). Fifty-four patients had reduced LVEF (mean 30%) and 55 patients had normal LVEF (mean 59%) (p<0.001). Patients with reduced RVEF had a higher incidence of long-term cardiac re-hospitalization vs. patients with normal RVEF (31% vs.13%, p<0.05). Abnormal RVEF was a predictor for long-term cardiac re-hospitalization (HR 3.01 [CI 1.5-7.9], p<0.03). Reduced LVEF did not influence long-term cardiac re-hospitalization. Conclusion Abnormal RVEF is a stronger predictor for long-term cardiac re-hospitalization than abnormal LVEF in patients undergoing isolated CABG and valve procedures. PMID:26197273

  8. The Regulatory Environment and Rural Hospital Long-Term Care Strategies from 1997 to 2003

    ERIC Educational Resources Information Center

    Fennell, Mary L.; Campbell, Susan E.

    2007-01-01

    Context: Since the passage of the Balanced Budget Act of 1997, rural hospitals have struggled with the need to strategically adapt to an abundance of changing reimbursement and regulatory programs, as well as to respond to the needs of an increasingly frail elder population in need of postacute and long-term care (LTC). Purpose: This article has 2…

  9. CHILDHOOD RESPIRATORY SYMPTOMS, HOSPITAL ADMISSIONS, AND LONG-TERM EXPOSURE TO AIRBORNE PARTICULATE MATTER

    EPA Science Inventory

    The effects of long-term exposure to air pollution on respiratory symptoms and respiratory hospitalization (for asthma, bronchitis or pneumonia) were assessed in a cross-sectional study of children (ages 7--11 years, N=667) living in a moderately industrialized city in Central Sl...

  10. Risk factors of scabies in psychiatric and long-term care hospitals: a nationwide mail-in survey in Japan.

    PubMed

    Makigami, Kuniko; Ohtaki, Noriko; Ishii, Norihisa; Yasumura, Seiji

    2009-09-01

    Despite the commonness of scabies in Japanese institutional settings, the nationwide prevalence of scabies has not been elucidated. This study was conducted to assess the prevalence of scabies and control measures in Japanese hospitals. A questionnaire on scabies epidemiology (e.g. number of patients and onsets of outbreak) and preventive measures were sent to psychiatric hospitals and long-term care hospitals nationwide (n = 1795) in January 2005. Seven hundred and forty-one hospitals responded (41.3%). Three hundred and thirty-three (44.9%) respondent hospitals had one or more scabies cases in 2004. Among 159 hospitals that had experienced scabies outbreak, only 32 of them reported cases of crusted scabies. Multivariate regression analysis showed that hospitals had a greater number of beds, and that acute- and long-term care wards were more likely to experience scabies onsets. Hospitals that compiled their infection control manuals on scabies, treated suspicious patients with scabicides without confirmed diagnosis, and performed skin checkup of inpatients were more likely to experience scabies cases. Infection control personnel should be aware that unrecognized crusted scabies can cause outbreaks. Higher patient turnover is a risk factor for scabies introduction into a hospital. Preventive measures against scabies, such as patient screening at admission and treating all suspicious patients without confirmed diagnosis, were not effective to avoid scabies introduction.

  11. Improving patient safety in a UK dental hospital: long-term use of clinical audit.

    PubMed

    Ashley, M P; Pemberton, M N; Saksena, A; Shaw, A; Dickson, S

    2014-10-01

    The improvement of patient safety has been a long-term aim of healthcare organisations and following recent negative events within the UK, the focus on safety has rightly increased. For over twenty years, clinical audit has been the tool most frequently used to measure safety-related aspects of healthcare and when done so correctly, can lead to sustained improvements. This paper explains how clinical audit is used as a safety improvement tool in an English dental hospital and gives several examples of projects that have resulted in long-term improvements in secondary dental care.

  12. Long-Term English Language Learners' Perceptions of Their Language and Academic Learning Experiences

    ERIC Educational Resources Information Center

    Kim, Won Gyoung; García, Shernaz B.

    2014-01-01

    Long-term, adolescent English language learners (ELLs) experience persistent academic underachievement in spite of several years of schooling; yet, the research on this topic is scant. To increase our understanding of these students' educational experiences, we explored perceptions of 13 long-term ELLs about their schooling in the context of their…

  13. Long-Term Effects of Labeling a Rape Experience

    ERIC Educational Resources Information Center

    McMullin, Darcy; White, Jacquelyn W.

    2006-01-01

    Research has found that approximately half of women who report an experience that meets the legal definition of rape do not label it rape. It has been assumed that labeling the experience as rape is necessary and beneficial for recovery; however, conflicting findings have been reported. In the present study, a longitudinal design was utilized to…

  14. Long-term survival following in-hospital cardiac arrest: A matched cohort study☆

    PubMed Central

    Feingold, Paul; Mina, Michael J.; Burke, Rachel M.; Hashimoto, Barry; Gregg, Sara; Martin, Greg S.; Leeper, Kenneth; Buchman, Timothy

    2016-01-01

    Background Each year, 200,000 patients undergo an in-hospital cardiac arrest (IHCA), with approximately 15–20% surviving to discharge. Little is known, however, about the long-term prognosis of these patients after discharge. Previous efforts to describe out-of-hospital survival of IHCA patients have been limited by small sample sizes and narrow patient populations Methods A single institution matched cohort study was undertaken to describe mortality following IHCA. Patients surviving to discharge following an IHCA between 2008 and 2010 were matched on age, sex, race and hospital admission criteria with non-IHCA hospital controls and follow-up between 9 and 45 months. Kaplan–Meier curves and Cox PH models assessed differences in survival. Results Of the 1262 IHCAs, 20% survived to hospital discharge. Of those discharged, survival at 1 year post-discharge was 59% for IHCA patients and 82% for controls (p < 0.0001). Hazard ratios (IHCA vs. controls) for mortality were greatest within the 90 days following discharge (HR = 2.90, p < 0.0001) and decreased linearly thereafter, with those surviving to one year post-discharge having an HR for mortality below 1.0. Survival after discharge varied amongst IHCA survivors. When grouped by discharge destination, out of hospital survival varied; in fact, IHCA patients discharged home without services demonstrated no survival difference compared to their non-IHCA controls (HR 1.10, p = 0.72). IHCA patients discharged to long-term hospital care or hospice, however, had a significantly higher mortality compared to matched controls (HR 3.91 and 20.3, respectively; p < 0.0001). Conclusion Among IHCA patients who survive to hospital discharge, the highest risk of death is within the first 90 days after discharge. Additionally, IHCA survivors overall have increased long-term mortality vs. controls. Survival rates were varied widely with different discharge destinations, and those discharged to home, skilled nursing facilities or to

  15. Long term alternative crop rotation experiment: USDA-ARS Akron, Colorado

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 1990 a long term alternative crop rotation experiment was established at the USDA-ARS Central Great Plains Research Station at Akron Colorado. The goal of this long term effort was to ultimately identify crop rotations other than winter wheat (Triticum aestivum L.) -fallow (WF) that are viable ro...

  16. Developing pharmacy applications using a microcomputer relational database in a long-term care psychiatric hospital.

    PubMed

    Salek, W

    1989-03-01

    The database applications developed with a microcomputer for a 1000 bed long-term care forensic psychiatric care hospital are described. The implementation of a microcomputer system was instituted as an interim measure prior to the development of a hospital wide minicomputer system. Primary emphasis was placed on increasing the efficiency of professional staff while enhancing clinical therapeutic monitoring. The system operates on an IBM-AT with 30 megabyte hard disk drive and an Epson FX-100 dot matrix printer. A relational database manager, Team-Up, was utilized in the development of applications that included census maintenance, scheduled drug inventory, drug regimen review, drug utilization protocols and a skilled nursing unit dose patient profile. Other ancillary functions included generation of stock labels, a literature abstract database and an on-line policy and procedure manual. Advantages of the system include an increase in staff productivity through the use of information that is readily attainable from the patient database. Possible disadvantages are the programming and hardware limitations imposed by a microcomputer system. Long term care psychiatric facilities may be able to enhance staff efficiency by computerizing existing manual systems. Because of the diverse and specialized requirements of long term care facilities, a microcomputer used in conjunction with a programmable relational database can be easily customized to fulfill this need.

  17. Space station experiment definition: Long-term cryogenic fluid storage

    NASA Technical Reports Server (NTRS)

    Jetley, R. L.; Scarlotti, R. D.

    1987-01-01

    The conceptual design of a space station Technology Development Mission (TDM) experiment to demonstrate and evaluate cryogenic fluid storage and transfer technologies is presented. The experiment will be deployed on the initial operational capability (IOC) space station for a four-year duration. It is modular in design, consisting of three phases to test the following technologies: passive thermal technologies (phase 1), fluid transfer (phase 2), and active refrigeration (phase 3). Use of existing hardware was a primary consideration throughout the design effort. A conceptual design of the experiment was completed, including configuration sketches, system schematics, equipment specifications, and space station resources and interface requirements. These requirements were entered into the NASA Space Station Mission Data Base. A program plan was developed defining a twelve-year development and flight plan. Program cost estimates are given.

  18. Long Term Physical Health Consequences of Adverse Childhood Experiences

    PubMed Central

    Monnat, Shannon M.; Chandler, Raeven Faye

    2015-01-01

    This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 US adults aged 18–64 from the 2009–2012 Behavioral Risk Factor Surveillance System (BRFSS). We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self-rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family-based adverse childhood experiences on adult health outcomes and suggest that adult SES and stress-related coping behaviors may be crucial links between trauma in the childhood home and adult health. PMID:26500379

  19. Valve surgery in octogenarians: In-hospital and long-term outcomes

    PubMed Central

    Bossone, Eduardo; Di Benedetto, Giuseppe; Frigiola, Alessandro; Carbone, Giannignazio Luigi; Panza, Antonello; Cirri, Silvia; Ballotta, Andrea; Messina, Stefano; Rega, Saverio; Citro, Rodolfo; Trimarchi, Santi; Fang, Jianming; Righini, Paolo; Distante, Alessandro; Eagle, Kim A; Mehta, Rajendra H

    2007-01-01

    BACKGROUND: Global population aging and greater age-related incidence of ischemic, degenerative and calcific valve disease have led to an increasing number of very elderly patients being referred for valve surgery. However, their preoperative risk factors, and in-hospital and long-term outcomes have not been thoroughly investigated. METHODS: Three hundred seven consecutive patients 80 years and older (60% female; mean age 83±2.4 years) attending three major Italian cardiac centres to undergo valve surgery were evaluated. Seventy-nine patients underwent mitral valve surgery (isolated n=30, combined n=49) and 228 underwent aortic valve surgery (isolated n=134, combined n=94). RESULTS: The most frequent in-hospital complications were atrial arrhythmias, need for inotropic support for more than 48 h, renal insufficiency, congestive heart failure, respiratory failure, and stroke or transient ischemic attack. The in-hospital mortality rate was 9.7% (30 of 307). Multivariate logistic regression identified the following clinical variables as predictors of in-hospital death: New York Heart Association functional class IV, diabetes, hypertension, renal insufficiency at presentation, rheumatic etiology and left ventricular ejection fraction of less than 45%. Late mortality occurred in 45 of 277 patients (16.2%), but there was a substantial improvement in the New York Heart Association functional class of the 232 long-term survivors (from 3.0±0.7 to 1.7±0.6; P<0.0001). CONCLUSIONS: Surgery seems to be an effective therapeutic option for selected symptomatic octogenarians with valve disease, associated with good long-term survival and an improved functional class. Operative mortality is related more to patients’ preoperative clinical status and increased comorbidity than the type of surgery per se. PMID:17347695

  20. Long-term oxytocin administration enhances the experience of attachment.

    PubMed

    Bernaerts, Sylvie; Prinsen, Jellina; Berra, Emmely; Bosmans, Guy; Steyaert, Jean; Alaerts, Kaat

    2017-04-01

    The neuropeptide 'oxytocin' (OT) is known to play a pivotal role in a variety of complex social behaviors by promoting a prosocial attitude and interpersonal bonding. Previous studies showed that a single-dose of exogenously administered OT can affect trust and feelings of attachment insecurity. With the present study, we explored the effects of two weeks of daily OT administration on measures of state and trait attachment using a double-blind between-subjects randomized placebo-controlled design. In 40 healthy young adult men state and trait attachment were assessed before and after two weeks of daily intranasal OT (24 IU) or placebo using the State Adult Attachment Scale and the Inventory of Parent and Peer Attachment. Mood, social responsiveness and quality of life were additionally assessed as secondary outcome measures. Reductions in attachment avoidance and increases in reports of attachment toward peers were reported after two weeks of OT treatment. Further, treatment-induced changes were most pronounced for participants with less secure attachment towards their peers. indicating that normal variance at baseline modulated treatment response. OT treatment was additionally associated with changes in mood, indicating decreases in feelings of tension and (tentatively) anger in the OT group, not in the placebo group. Further, at the end of the two-week trial, both treatment groups (OT, placebo) reported to experience an increase in social responsiveness and quality of life, but the effects were only specific to the OT-treatment in terms of reports on 'social motivation'. In summary, the observed improvements on state and trait dimensions of attachment after a multiple-dose treatment with OT provide further evidence in support of a pivotal role of OT in promoting the experience of attachment.

  1. Long term experience and performance of COMPASS RICH-1

    NASA Astrophysics Data System (ADS)

    Tessarotto, F.; Abbon, P.; Alexeev, M.; Birsa, R.; Bordalo, P.; Bradamante, F.; Bressan, A.; Büchele, M.; Chiosso, M.; Ciliberti, P.; Dafni, T.; Dalla Torre, S.; Dasgupta, S.; Delagnes, E.; Denisov, O.; Duic, V.; Ferrero, A.; Finger, M.; Finger, M., Jr.; Fischer, H.; Franco, C.; Gerassimov, S.; Gobbo, B.; Gregori, M.; Herrmann, F.; Ketzer, B.; Königsmann, K.; Konorov, I.; Kunne, F.; Levorato, S.; Maggiora, A.; Makke, N.; Martin, A.; Menon, G.; Neyret, D.; Novakova, K.; Panzieri, D.; Paul, S.; Pereira, F. A.; Polak, J.; Rocco, E.; Santos, C. A.; Sbrizzai, G.; Schiavon, P.; Schopferer, S.; Slunecka, M.; Sozzi, F.; Steiger, L.; Sulc, M.; Takekawa, S.

    2014-09-01

    COMPASS RICH-1 is a large size gaseous Imaging Cherenkov Detector providing hadron identification in the range from 3 to 55 GeV/c, in the wide acceptance spectrometer of the COMPASS Experiment at CERN SPS. It uses a 3 m long C4F10 radiator, a 21 m2 large VUV mirror surface and two kinds of photon detectors: MAPMTs and MWPCs with CsI photocathodes, covering a total of 5.5 m2. It is in operation since 2002 and its performance increased thanks to progressive optimization and to a major upgrade of its photon detection system, implemented in 2006; a new upgrade is foreseen for 2016, with the use of MPGD-based photon detectors. The main characteristics of COMPASS RICH-1 components are described and the most critical aspects related to the C4F10 radiator gas system, to the mirrors and their alignment, as well as the performance of the photon detectors are presented and discussed. The response of the MWPCs and the observed evolution of the effective quantum efficiency of the CsI photocathodes is analyzed. The properties and performance of the MAPMTs with individual fused lens telescopes are presented together with the readout characteristics. The PID performance of COMPASS RICH-1 is discussed and the future upgrade program is mentioned.

  2. Initial and long-term costs of patients hospitalized with West Nile virus disease.

    PubMed

    Staples, J Erin; Shankar, Manjunath B; Sejvar, James J; Meltzer, Martin I; Fischer, Marc

    2014-03-01

    There are no published data on the economic burden for specific West Nile virus (WNV) clinical syndromes (i.e., fever, meningitis, encephalitis, and acute flaccid paralysis [AFP]). We estimated initial hospital and lost-productivity costs from 80 patients hospitalized with WNV disease in Colorado during 2003; 38 of these patients were followed for 5 years to determine long-term medical and lost-productivity costs. Initial costs were highest for patients with AFP (median $25,117; range $5,385-$283,381) and encephalitis (median $20,105; range $3,965-$324,167). Long-term costs were highest for patients with AFP (median $22,628; range $624-$439,945) and meningitis (median $10,556; range $0-$260,748). Extrapolating from this small cohort to national surveillance data, we estimated the total cumulative costs of reported WNV hospitalized cases from 1999 through 2012 to be $778 million (95% confidence interval $673 million-$1.01 billion). These estimates can be used in assessing the cost-effectiveness of interventions to prevent WNV disease.

  3. Long Term Psychological and Physical Effects of the POW Experience: A Review of the Literature

    DTIC Science & Technology

    1974-01-01

    are seen along ,i single dimension in which somatic and psychodynamic factors are intertwined. The Isolation of Cause and Effect ...AD-A014 080 LONG TERM PSYCHOLOGICAL AND PHYSICAL EFFECTS OF THE POW EXPERIENCE: A REVIEW OF THE LITERATURE Julius Segal Naval Health Research...DEPARTMENT OF COMMERCE 248072 LONG-TERM PSVCHOLOSiCAL AND PHYSICAL EFFECTS OF THE POW EXPERIENCE: A REVIEW OF THE LITERATURE 0 0 **! H D ,=35 J

  4. Long-term effect of home telehealth services on preventable hospitalization use.

    PubMed

    Jia, Huanguang; Chuang, Ho-Chih; Wu, Samuel S; Wang, Xinping; Chumbler, Neale R

    2009-01-01

    In this study, we assessed the longitudinal effect of a Department of Veterans Affairs (VA) patient-centered Care Coordination Home Telehealth (CCHT) program on preventable hospitalization use by veterans with diabetes mellitus (DM) at four VA medical centers. We used a matched treatment-control design (n = 387 for both groups). All patients were followed for 4 years. We operationalized ambulatory care-sensitive conditions (ACSCs) by applying Agency for Healthcare Research and Quality criteria to VA inpatient databases to determine preventable hospitalization use. We used a generalized linear mixed model to estimate the adjusted effect of the CCHT program on preventable hospitalization use over time. During the initial 18 months of follow-up, CCHT enrollees were less likely to be admitted for a preventable hospitalization than their nonenrollee counterparts, and this difference diminished during the rest of the 4-year follow-up period. The VA CCHT program for DM patients reduced preventable hospitalizations. These findings are some of the first that have systematically examined the extent to which home telehealth programs have a long-term effect on preventable hospitalization use.

  5. Long-term exposure to traffic pollution and hospital admissions in London.

    PubMed

    Halonen, Jaana I; Blangiardo, Marta; Toledano, Mireille B; Fecht, Daniela; Gulliver, John; Anderson, H Ross; Beevers, Sean D; Dajnak, David; Kelly, Frank J; Tonne, Cathryn

    2016-01-01

    Evidence on the effects of long-term exposure to traffic pollution on health is inconsistent. In Greater London we examined associations between traffic pollution and emergency hospital admissions for cardio-respiratory diseases by applying linear and piecewise linear Poisson regression models in a small-area analysis. For both models the results for children and adults were close to unity. In the elderly, linear models found negative associations whereas piecewise models found non-linear associations characterized by positive risks in the lowest and negative risks in the highest exposure category. An increased risk was observed among those living in areas with the highest socioeconomic deprivation. Estimates were not affected by adjustment for traffic noise. The lack of convincing positive linear associations between primary traffic pollution and hospital admissions agrees with a number of other reports, but may reflect residual confounding. The relatively greater vulnerability of the most deprived populations has important implications for public health.

  6. Long-term effects of earthquake experience of young persons on cardiovascular disease risk factors

    PubMed Central

    Li, Na; Wang, Yumei; Yu, Lulu; Song, Mei; Wang, Lan; Ji, Chunpeng

    2016-01-01

    Introduction The aim of the study was to study the long-term effect on cardiovascular disease risk factors of stress from direct experience of an earthquake as a young person. Material and methods We selected workers born between July 1, 1958 and July 1, 1976 who were examined at Kailuan General Hospital between May and October of 2013. Data on cardiovascular events were taken during the workers’ annual health examination conducted between 2006 and 2007. All subjects were divided into three groups according to their experience of the Tangshan earthquake of July 28, 1976, as follows: control group; exposed group 1 and exposed group 2. We compared cardiovascular disease risk factors between the three groups as well as by gender and age. Results One thousand one hundred and ninety-six workers were included in the final statistical analysis. Among all subjects, resting heart rate (p = 0.003), total cholesterol (p < 0.001), and fasting blood glucose (p < 0.001) were significantly higher among those who experienced the earthquake compared with unexposed controls, but were unrelated to loss of relatives. No significant difference in triglyceride levels was observed between the three groups (p = 0.900). Further refinement showed that the effects were restricted to males 40 years of age or older at the time of analysis, but were due primarily to age at the time of earthquake exposure (p = 0.002, p < 0.001 and p = 0.002). Conclusions Earthquake experience in the early years of life has long-term effects on adult resting heart rate, total cholesterol, and fasting plasma glucose, especially among men. PMID:28144258

  7. A long-term frequency stabilized deep ultraviolet laser for Mg+ ions trapping experiments

    NASA Astrophysics Data System (ADS)

    Zhang, J.; Yuan, W. H.; Deng, K.; Deng, A.; Xu, Z. T.; Qin, C. B.; Lu, Z. H.; Luo, J.

    2013-12-01

    As many precision laser spectroscopy experiments require frequency stabilized lasers, development of long-term stabilized lasers is of great interest. In this work, we report long-term frequency stabilization of a 280 nm deep ultraviolet laser to a high precision wavemeter with digital servo control such that the long-term drift of the laser frequency was greatly reduced. Long-term laser frequency drift was measured with a fiber frequency comb system over 8 h. After locking, the maximum drift rate of the 280 nm laser was lowered from 576 MHz/h to 6.4 MHz/h. With proper environment control of the wavemeter, the maximum drift rate of the 280 nm laser was further lowered to less than 480 kHz/h. The locked laser system was successfully used in a Mg+ ions trapping experiment, which was also discussed in this work.

  8. Is Long-Term Structural Priming Affected by Patterns of Experience with Individual Verbs?

    ERIC Educational Resources Information Center

    Kaschak, Michael P.; Borreggine, Kristin L.

    2008-01-01

    Several recent papers have reported long-term structural priming effects in experiments where previous patterns of experience with the double object and prepositional object constructions are shown to affect later patterns of language production for those constructions. The experiments reported in this paper address the extent to which these…

  9. Long-Term Survival of Patients Receiving Artificial Nutrition in Japanese Psychiatric Hospitals

    PubMed Central

    Abe, Keiichi; Yamashita, Ryuko; Kondo, Keiko; Takayama, Keiko; Yokota, Osamu; Sato, Yoshiki; Kawai, Mitsumasa; Ishizu, Hideki; Nakashima, Tadao; Hayashi, Hideki; Nakata, Kenji; Asaba, Hiroyuki; Kadota, Koichi; Tanaka, Kazuyoshi; Morisada, Yumi; Oshima, Etsuko; Terada, Seishi

    2016-01-01

    Background/Aims Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG) tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival. PMID:27843445

  10. Long term experience with the “industrial” 3He vapour-pressure thermometer

    NASA Astrophysics Data System (ADS)

    Benda, V.; Vafeiadis, T.

    2017-02-01

    On the basis of very good experience with a prototype of a 3He vapour-pressure thermometer installed in the magnet feed box (MFB – prototype of LHC magnet test bench), an upgraded version of this thermometer was developed with emphasis on the improvement of its long term stability, reliability and “series” production. The thermometer is working typically around 1.9 K. This article summarises the key points of the prototype design, its upgrade leading to the “industrial/series” realization, the long term experience and the calibration crosscheck of these thermometers after 15 years of operation.

  11. Optimizing laboratory test utilization in long-term acute care hospitals

    PubMed Central

    Krug, Brian S.; Grigonis, Antony M.; Dawson, Amanda; Jing, Yuqing; Hammerman, Samuel I.

    2017-01-01

    Laboratory tests can be considered inappropriate if overused or when repeated, unnecessary “routine” testing occurs. For chronically critically ill patients treated in long-term acute care hospitals (LTACHs), inappropriate testing may result in unnecessary blood draws that could potentially harm patients or increase infections. A quality improvement initiative was designed to increase physician awareness of their patterns of lab utilization in the LTACH environment. Within a large network of LTACHs, 9 hospitals were identified as having higher patterns of lab utilization than other LTACHs. Meetings were held with administrative staff and physicians, who designed and implemented hospital-specific strategies to address lab utilization. Lab utilization was measured in units of lab tests ordered per inpatient day (lab UPPD) for 8 months prior to the initial meeting and 7 months after the meeting. A repeated measures mixed model determined that postintervention lab utilization improved, on average and adjusted by case mix index, by 0.37 lab UPPD (t = −3.61, 95% CI 0.17 to 0.58) compared to the preintervention period. Overall, the case mix index 8 months prior to the intervention was no different than it was 7 months after the initial meeting (t[8] = −0.96, P = 0.37). Patient safety and outcome measures, including percentage of patients weaned from a ventilator, readmission rates, central catheter utilization rates, and the incidence of methicillin-resistant Staphylococcus aureus and other multidrug resistant organisms, showed no significant change. Hospital staff meetings focused on lab utilization and the development and deployment of tailored lab utilization strategies were associated with LTACHs achieving significantly lower lab utilization without negatively impacting quality outcomes. PMID:28127124

  12. Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort.

    PubMed

    Myint, P K; Hawkins, K R; Clark, A B; Luben, R N; Wareham, N J; Khaw, K-T; Wilson, A M

    2016-03-01

    Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-years, mean 6·1 years, range 0·08-15·2 years). Cox regression models were constructed to examine the all-cause, respiratory and cardiovascular mortality using date of pneumonia onset as baseline with binary pneumonia status as exposure. A total of 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4-9·9] and 5·9 (95% CI 3·5-9·7), respectively (with very few respiratory deaths within the same period) in cases compared to controls after adjusting for age, sex, asthma, smoking status, pack years, systolic and diastolic blood pressure, diabetes, physical activity, waist-to-hip ratio, prevalent cardiovascular and respiratory diseases. All outcomes assessed also showed increased risk of death in cases compared to controls after 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9-30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.

  13. Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients.

    PubMed

    Gaughan, James; Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

    2017-02-28

    We examine the relationship between long-term care supply (care home beds and prices) and (i) the probability of being discharged to a care home and (ii) length of stay in hospital for patients admitted to hospital for hip fracture or stroke. Using patient level data from all English hospitals and allowing for a rich set of demographic and clinical factors, we find no association between discharge destination and long-term care beds supply or prices. We do, however, find evidence of bed blocking: hospital length of stay for hip fracture patients discharged to a care home is shorter in areas with more long-term care beds and lower prices. Length of stay is over 30% shorter in areas in the highest quintile of care home beds supply compared to those in the lowest quintile.

  14. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... beds in intensive care type inpatient units (for eligibility of hospitals with distinct parts electing...-term care services (âswing-bedsâ). 482.66 Section 482.66 Public Health CENTERS FOR MEDICARE & MEDICAID... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement...

  15. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... beds in intensive care type inpatient units (for eligibility of hospitals with distinct parts electing...-term care services (âswing-bedsâ). 482.66 Section 482.66 Public Health CENTERS FOR MEDICARE & MEDICAID... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement...

  16. Long-term Ecosystem Experiments, Data Assimilation, and Meta-Analysis

    NASA Astrophysics Data System (ADS)

    Hungate, B. A.; Van Groenigen, K. J.; Osenberg, C. W.; van Gestel, N.

    2015-12-01

    Land ecosystems affect climate and the atmosphere, and climate and atmospheric change affects ecosystems. Syntheses of ecosystem experiments investigating their responses to environmental change holds promise for understanding how to model these interactions, and thereby gain insight into Earth's future biosphere, atmosphere, and climate. Long-term experiments examining ecosystem responses are thought to be especially important in this effort, for their potential to reveal cumulative and progressive effects, subtle effects initially undetectable experimentally, but manifest more clearly over time, often with stronger implications for modeled responses than the more dramatic, short-term experimental responses. Here, we present new analyses of long-term experiments manipulating temperature, CO2 concentration, and precipitation, testing the general hypothesis that there are common temporal patterns of responses that reveal general biogeochemical characterizing ecosystem responses to these environmental changes. For example, we show that increased carbon input with elevated CO2 stimulates emissions of nitrous oxide and methane, important greenhouse gases, and that effects show no signs of diminishing over the duration of experiments that have documented responses. At the same time, we show that the temporal resolution for this response is limited, pointing to a potential limitation in the ability of experiments to address clearly long-term hypotheses. We also show that warming tends to have limited cumulative effects on total soil carbon stocks in long-term experiments, and explore the mechanisms underlying this response. Finally, we discuss the implications of these findings for models used to simulate long-term ecosystem responses to these environmental forcings, as well as the implications of these findings for the next generation of terrestrial ecosystem experiments.

  17. Space Life Sciences Research: The Importance of Long-Term Space Experiments

    NASA Technical Reports Server (NTRS)

    1993-01-01

    This report focuses on the scientific importance of long-term space experiments for the advancement of biological science and the benefit of humankind. It includes a collection of papers that explore the scientific potential provided by the capability to manipulate organisms by removing a force that has been instrumental in the evolution and development of all organisms. Further, it provides the scientific justification for why the long-term space exposure that can be provided by a space station is essential to conduct significant research.

  18. Antimicrobial Stewardship in a Long-Term Acute Care Hospital Using Offsite Electronic Medical Record Audit.

    PubMed

    Beaulac, Kirthana; Corcione, Silvia; Epstein, Lauren; Davidson, Lisa E; Doron, Shira

    2016-04-01

    OBJECTIVE To offer antimicrobial stewardship to a long-term acute care hospital using telemedicine. METHODS We conducted an uninterrupted time-series analysis to measure the impact of antimicrobial stewardship on hospital-acquired Clostridium difficile infection (CDI) rates and antimicrobial use. Simple linear regression was used to analyze changes in antimicrobial use; Poisson regression was used to estimate the incidence rate ratio in CDI rates. The preimplementation period was April 1, 2010-March 31, 2011; the postimplementation period was April 1, 2011-March 31, 2014. RESULTS During the preimplementation period, total antimicrobial usage was 266 defined daily doses (DDD)/1,000 patient-days (PD); it rose 4.54 (95% CI, -0.19 to 9.28) per month then significantly decreased from preimplementation to postimplementation (-6.58 DDD/1,000 PD [95% CI, -11.48 to -1.67]; P=.01). The same trend was observed for antibiotics against methicillin-resistant Staphylococcus aureus (-2.97 DDD/1,000 PD per month [95% CI, -5.65 to -0.30]; P=.03). There was a decrease in usage of anti-CDI antibiotics by 50.4 DDD/1,000 PD per month (95% CI, -71.4 to -29.2; P<.001) at program implementation that was maintained afterwards. Anti-Pseudomonas antibiotics increased after implementation (30.6 DDD/1,000 PD per month [95% CI, 4.9-56.3]; P=.02) but with ongoing education this trend reversed. Intervention was associated with a decrease in hospital-acquired CDI (incidence rate ratio, 0.57 [95% CI, 0.35-0.92]; P=.02). CONCLUSION Antimicrobial stewardship using an electronic medical record via remote access led to a significant decrease in antibacterial usage and a decrease in CDI rates.

  19. Engineering and agronomy aspects of a long-term precision agriculture field experiment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Much research has been conducted on specific precision agriculture tools and implementation strategies, but little has been reported on long-term evaluation of integrated precision agriculture field experiments. In 2004 our research team developed and initiated a multi-faceted “precision agriculture...

  20. A Mathematician Learns the Basics of Writing Instruction: An Immersion Experience with Long-Term Benefits

    ERIC Educational Resources Information Center

    Doty, Lynne L.

    2012-01-01

    Initially designed to be an interdisciplinary experiment that would change attitudes about mathematics, the semester-long collaboration between a writing instructor and a mathematics instructor yielded unexpected long-term results. The collaboration served as an immersion in methods and techniques used by writing instructors. Description of…

  1. Trajectories, Long-Term Outcomes and Family Experiences of 76 Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Chamak, Brigitte; Bonniau, Béatrice

    2016-01-01

    The aim of this retrospective study was to retrace the trajectories and long-term outcomes of individuals with autism in France, and to explore the family experiences. Data obtained from parents enables us to follow the trajectories of 76 adults. Two-thirds of adults with severe autism had a very poor outcome. Those with moderate autism had a…

  2. Long-Term Career Impact and Professional Applicability of the Study Abroad Experience

    ERIC Educational Resources Information Center

    Franklin, Kimberly

    2010-01-01

    Research shows that study abroad experience affects professional qualifications. It is evident that employers value the skills and knowledge potentially gained from study abroad and that these competencies are transferable on the job. Nearly all known research lacks a longitudinal component. Of the few studies that focus on long-term outcomes,…

  3. Experiences of participation in occupations of women on long-term sick leave.

    PubMed

    Johansson, Christina; Isaksson, Gunilla

    2011-12-01

    The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the women's long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment.

  4. INTERCAL: long-term inter-comparison experiment for dose rate and spectrometric probes.

    PubMed

    Bleher, M; Doll, H; Harms, W; Stöhlker, U

    2014-08-01

    The Schauinsland inter-calibration facility (INTERCAL) has been designed to enable long-term comparison experiments for 20 different dose rate probes from different networks. Two reference probes characterised by the European Radiation Dosimetry WG3 inter-calibration experiments in 2008 and 2009 have been installed at the INTERCAL facility. Additional instrumentation provides measured data of activity in air and nuclide-specific dose rate as well as environmental parameters such as air pressure, temperature, precipitation and soil moisture. Complementary to WG3 experiments, the INTERCAL platform is an ideal framework to investigate the long-term behaviour of dose rate probes and different spectrometry systems under environmental conditions. Two additional exposure experiments were performed in April 2009 and in May 2012.

  5. Long-Term Outcomes of Group B Eyes in Patients with Retinoblastoma Treated with Short-Course Chemoreduction: Experience from Children's Hospital Los Angeles/University of Southern California

    PubMed Central

    Zhu, Dagny; Berry, Jesse L.; Ediriwickrema, Lilangi; Wong, Kenneth; Lee, Thomas C.; Murphree, A. Linn; Kim, Jonathan W.; Jubran, Rima

    2015-01-01

    Background/Aims Chemoreduction protocols for retinoblastoma vary widely across institutions. Herein, we compare a 3- versus 6-cycle chemotherapy approach for group B retinoblastoma. Methods A nonrandomized, retrospective review of patients diagnosed with group B retinoblastoma from 1991-2011 at Children's Hospital Los Angeles was performed. A total of 72 eyes of 63 patients were analyzed. Mean follow-up time was 82 months (range 6-272 months). Main outcome measures were globe salvage and need for external beam radiation. Results Forty-six patients (55 eyes) were treated upfront with 3 cycles of carboplatin, etoposide, and vincristine; 17 patients (17 eyes) received 6 cycles. Thirty-seven eyes (67%) in the 3-cycle group were cured with initial chemoreduction alone. An additional 10 eyes with persistent or recurrent tumors were rescued with 3 more cycles for a total salvage rate of 85% (47/55 eyes). In the 6-cycle group, 16 of 17 eyes (94%) avoided radiation and enucleation. Conclusion The initial recurrence rate was higher for the 3-cycle group (p = 0.03). However, eyes failing short-course chemoreduction were rescued with 3 additional cycles and achieved a similar overall event-free survival rate (p = 0.16). In our cohort, this short-course approach spared 63% (29/46) of patients with group B retinoblastoma the extra 3 cycles of systemic chemotherapy. PMID:27172535

  6. Estimating hydroxyl radical photochemical formation rates in natural waters during long-term laboratory irradiation experiments.

    PubMed

    Sun, Luni; Chen, Hongmei; Abdulla, Hussain A; Mopper, Kenneth

    2014-04-01

    In this study it was observed that, during long-term irradiations (>1 day) of natural waters, the methods for measuring hydroxyl radical (˙OH) formation rates based upon sequentially determined cumulative concentrations of photoproducts from probes significantly underestimate actual ˙OH formation rates. Performing a correction using the photodegradation rates of the probe products improves the ˙OH estimation for short term irradiations (<1 day), but not long term irradiations. Only the 'instantaneous' formation rates, which were obtained by adding probes to aliquots at each time point and irradiating these sub-samples for a short time (≤2 h), were found appropriate for accurately estimating ˙OH photochemical formation rates during long-term laboratory irradiation experiments. Our results also showed that in iron- and dissolved organic matter (DOM)-rich water samples, ˙OH appears to be mainly produced from the Fenton reaction initially, but subsequently from other sources possibly from DOM photoreactions. Pathways of ˙OH formation in long-term irradiations in relation to H2O2 and iron concentrations are discussed.

  7. Australian men's long term experiences following prostatectomy: a qualitative descriptive study.

    PubMed

    O'Shaughnessy, Peter 'kevin'; Laws, Tom A

    The experiences of men in the immediate postoperative period following surgery for primary prostate cancer are well reported in the literature. Recognition of the unresolved morbidity encountered by men in the medium term suggests that a more complete understanding of how men cope in the long term is needed. Health professionals are deserving of a more complete literature for the purpose of providing holistic care for this group of men, providing informed advocacy and better support for men living with the diagnosis of prostate cancer. Emerging literature reveals that men's knowledge of the long term problems associated with prostatectomy was inadequate at the time they consented to treatment; the likely outcomes at all phases of recovery should be taken into account when deciding on choice of treatment or no treatment. This qualitative study aims to describe men's long term recovery following prostatectomy for the purpose identifying the effects of unresolved post surgical morbidity. The content analysis of focus group interviews revealed that incontinence and impotence were a major source of emotional tension affecting the men's social interactions and sense of self-worth. The men expressed great regret over the lack of information accessible to them for evaluating the risk and nature of long term problems. The thick description provided in this study identifies the need for empathetic assessment of men with ongoing post surgical issues and alerts the reader to the inadequacies of information provided prior to consent to prostatectomy.

  8. Soil Organic Matter Dynamics in the Rothamsted Long-term Experiments

    NASA Astrophysics Data System (ADS)

    MacDonald, A.; Poulton, P.

    2009-04-01

    Soil science research at Rothamsted dates from 1843 when John Bennet Lawes and Joseph Henry Gilbert started the first of a series of what became long-term field experiments. The main object of these experiments was to examine the effect of inorganic and organic fertilisers and manures on crop yield and soil fertility. These "Classical Field Experiments" included studies on winter wheat (Broadbalk 1843), spring barley (Hoos Barley 1852) and permanent grassland (Park Grass 1856). Additional experiments were established in the 20th century to examine the value of ley-arable cropping, including the Highfield and Fosters Ley-arable experiments (1948) and the Woburn Ley-arable experiment (1938). More recently, the effects of incorporating organic manures and cereal straw have been examined. Early results quickly showed the benefits of inorganic N and P fertilisers on crop production, but the effects of contrasting land uses and management practices on soil properties emerged more slowly. Measurements of soil organic carbon (C) and nitrogen (N) in soils taken at intervals from the long-term experiments indicate that the rate of soil organic matter (SOM) accumulation is controlled largely by the balance between the rate of organic matter inputs and its oxidation rate, and that these are strongly influenced by land use and management, soil texture (especially clay content) and climate. A recent examination of soil organic C data from two long-term grassland experiments in the UK (including Park Grass) indicates that any changes observed in soil organic C under long-term grasslands over the past 40 years are more likely to be due to changes in land use and management rather than climate change. Data from the Rothamsted Long-term experiments have been used to develop and test biogeochemical models of C and N dynamics. In particular, the Roth-C model has successfully simulated soil C dynamics in the long-term experiments at Rothamsted and elsewhere. This model uses several

  9. Geological Disposal of Radioactive Waste: A Long-Term Socio-Technical Experiment.

    PubMed

    Schröder, Jantine

    2016-06-01

    In this article we investigate whether long-term radioactive waste management by means of geological disposal can be understood as a social experiment. Geological disposal is a rather particular technology in the way it deals with the analytical and ethical complexities implied by the idea of technological innovation as social experimentation, because it is presented as a technology that ultimately functions without human involvement. We argue that, even when the long term function of the 'social' is foreseen to be restricted to safeguarding the functioning of the 'technical', geological disposal is still a social experiment. In order to better understand this argument and explore how it could be addressed, we elaborate the idea of social experimentation with the notion of co-production and the analytical tools of delegation, prescription and network as developed by actor-network theory. In doing so we emphasize that geological disposal inherently involves relations between surface and subsurface, between humans and nonhumans, between the social, material and natural realm, and that these relations require recognition and further elaboration. In other words, we argue that geological disposal concurrently is a social and a technical experiment, or better, a long-term socio-technical experiment. We end with proposing the idea of 'actor-networking' as a sensitizing concept for future research into what geological disposal as a socio-technical experiment could look like.

  10. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Method of payment for preadmission services under the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  11. Effectiveness of a Psychosocial Intervention Model for Persons with Chronic Psychiatric Disorders in Long-Term Hospitalization

    ERIC Educational Resources Information Center

    Elbaz-Haddad, Merav; Savaya, Riki

    2011-01-01

    The article describes a psychosocial model of intervention with psychiatric patients in long-term hospitalization in a psychiatric ward in Israel and reports the findings of the evaluation conducted of its effectiveness. The model was aimed at maintaining or improving the patients' functioning in four main areas: personal hygiene, environmental…

  12. Long-Term Network Experiments and Interdisciplinary Campaigns Conducted by the USDA-Agricultural Research Service

    NASA Astrophysics Data System (ADS)

    Goodrich, D. C.; Kustas, W. P.; Cosh, M. H.; Moran, S. M.; Marks, D. G.; Jackson, T. J.; Bosch, D. D.; Rango, A.; Seyfried, M. S.; Scott, R. L.; Prueger, J. H.; Starks, P. J.; Walbridge, M. R.

    2014-12-01

    The USDA-Agricultural Research Service has led, or been integrally involved in, a myriad of interdisciplinary field campaigns in a wide range of locations both nationally and internationally. Many of the shorter campaigns were anchored over the existing national network of ARS Experimental Watersheds and Rangelands. These long-term outdoor laboratories provided a critical knowledge base for designing the campaigns as well as historical data, hydrologic and meteorological infrastructure coupled with shop, laboratory, and visiting scientist facilities. This strong outdoor laboratory base enabled cost-efficient campaigns informed by historical context, local knowledge, and detailed existing watershed characterization. These long-term experimental facilities have also enabled much longer term lower intensity experiments, observing and building an understanding of both seasonal and inter-annual biosphere-hydrosphere-atmosphere interactions across a wide range of conditions. A sampling of these experiments include MONSOON'90, SGP97, SGP99, Washita'92, Washita'94, SMEX02-05 and JORNEX series of experiments, SALSA, CLASIC and longer-term efforts over the ARS Little Washita, Walnut Gulch, Little River, Reynolds Creek, and OPE3 Experimental Watersheds. This presentation will review some of the highlights and key findings of these campaigns and long-term efforts including the inclusion of many of the experimental watersheds and ranges in the Long-Term Agro-ecosystems Research (LTAR) network. The LTAR network also contains several locations that are also part of other observational networks including the CZO, LTER, and NEON networks. Lessons learned will also be provided for scientists initiating their participation in large-scale, multi-site interdisciplinary science.

  13. Global change and soil functions - long-term experiments and alternative approaches

    NASA Astrophysics Data System (ADS)

    Gerzabek, M. H.

    2009-04-01

    Soils are practically a non-renewable resource and provide numerous functions for humans and the environment. Both managed and natural soils are under constant development. Soil use changes, however, have the most considerable impact on soil properties. Changes of the nutrient status and productivity were already in the focus of long-term experiments since the middle of the 19th century. From them we learned that equilibrium conditions after management changes in many cases need more than 150 years to be reached. Today, humus dynamics and the impact of soil management on greenhouse gas emission and trapping have gained considerable importance. Investigations in Austria have shown that carbon stocks on average differ by a factor of two between arable land and extensive pasture. Soil tillage regimes and mineral and organic fertilization have additional impacts on humus stocks and dynamics. The long-term changes in humus contents influence different soil functions. Enzyme activities e.g. increase with increasing soil organic matter contents, as does the aggregate stability, just as an example for several physical soil functions. The retention of heavy metals and organic pollutants is heavily influenced by long-term changes of soil organic matter. A variability of a factor of 3 to 5 was observed in long-term experiments in Sweden and Austria. Another aspect is the long-term development of soils and their properties and especially their impact on ecological soil functions. Soil development leads to significant alterations of soil properties, especially accumulation of soil organic matter (SOM), weathering and secondary soil minerals and influence nutrient dynamics and contaminant retention. Soil development itself is distinctly altered by soil use and management resulting e.g. in different SOM accumulation patterns. Such investigations call for additional methodological approaches as e.g. chronosequence and climosequence approaches, which will be exemplified by studies

  14. Long-term effects of traumatic experience: Comparison study in the adolescent IDPs in Serbia.

    PubMed

    Matsunaga, Chieko; Ristic, Dragana; Niregi, Mitsuki

    2006-12-01

    The purpose of this study is to examine the long term psychological effects of war stress regarded as traumatic experience. The subjects are Serbian internally displaced people (IDP) of adolescent population from Kosovo. It is a very big concern whether the adolescents would overcome the social and psychological difficulties caused by the war stress in order to reconstruct the better society. The result came out that the long-term effects still exist in PTSD, depression and hopelessness, which affects self-esteem and the attitude in purpose in life that are important factors for personality development. This paper also examines the difference between IDPs with war stress and the adolescent sufferers of the big earthquake in Japan.

  15. Long-Term Experience with Chinese Language Shapes the Fusiform Asymmetry of English Reading

    PubMed Central

    Mei, Leilei; Xue, Gui; Lu, Zhong-Lin; Chen, Chuansheng; Wei, Miao; He, Qinghua; Dong, Qi

    2015-01-01

    Previous studies have suggested differential engagement of the bilateral fusiform gyrus in the processing of Chinese and English. The present study tested the possibility that long-term experience with Chinese language affects the fusiform laterality of English reading by comparing three samples: Chinese speakers, English speakers with Chinese experience, and English speakers without Chinese experience. We found that, when reading words in their respective native language, Chinese and English speakers without Chinese experience differed in functional laterality of the posterior fusiform region (right laterality for Chinese speakers, but left laterality for English speakers). More importantly, compared with English speakers without Chinese experience, English speakers with Chinese experience showed more recruitment of the right posterior fusiform cortex for English words and pseudowords, which is similar to how Chinese speakers processed Chinese. These results suggest that long-term experience with Chinese shapes the fusiform laterality of English reading and have important implications for our understanding of the cross-language influences in terms of neural organization and of the functions of different fusiform subregions in reading. PMID:25598049

  16. Long-term experience with Chinese language shapes the fusiform asymmetry of English reading.

    PubMed

    Mei, Leilei; Xue, Gui; Lu, Zhong-Lin; Chen, Chuansheng; Wei, Miao; He, Qinghua; Dong, Qi

    2015-04-15

    Previous studies have suggested differential engagement of the bilateral fusiform gyrus in the processing of Chinese and English. The present study tested the possibility that long-term experience with Chinese language affects the fusiform laterality of English reading by comparing three samples: Chinese speakers, English speakers with Chinese experience, and English speakers without Chinese experience. We found that, when reading words in their respective native language, Chinese and English speakers without Chinese experience differed in functional laterality of the posterior fusiform region (right laterality for Chinese speakers, but left laterality for English speakers). More importantly, compared with English speakers without Chinese experience, English speakers with Chinese experience showed more recruitment of the right posterior fusiform cortex for English words and pseudowords, which is similar to how Chinese speakers processed Chinese. These results suggest that long-term experience with Chinese shapes the fusiform laterality of English reading and have important implications for our understanding of the cross-language influences in terms of neural organization and of the functions of different fusiform subregions in reading.

  17. A vision of long-term care. To care for tomorrow's elderly, hospitals must plan now, not react later.

    PubMed

    Kodner, D L

    1989-12-01

    In the next two decades, rapid, fundamental changes will take place in the way we finance, organize, and provide long-term care services. Because the elderly make up such a large portion of the patient population, America's hospitals should be concerned--and involved. There are six keys to the future of long-term care: a sharp increase in elderly population, a new generation of elderly, restrained government role, intergenerational strains, growing corporate concern, and the rise of "gerotechnology." These trends and countertrends will result in a new look in the long-term care landscape. By the year 2010, changes will include a true public-private financing system, provider reimbursement on the basis of capitation and prospective payment, coordinated access to services, dominant alternative delivery systems, a different breed of nursing homes, fewer staffing problems, patient-centered care, a new importance in housing, and an emphasis on prevention. For hospitals, this future vision of long-term care means that significant opportunities will open up to meet the needs of the elderly-at-risk and to achieve a competitive position in the burgeoning elderly care industry.

  18. Antifouling properties of tough gels against barnacles in a long-term marine environment experiment.

    PubMed

    Murosaki, T; Noguchi, T; Hashimoto, K; Kakugo, A; Kurokawa, T; Saito, J; Chen, Y M; Furukawa, H; Gong, J P

    2009-10-01

    In the marine environment, the antifouling (AF) properties of various kinds of hydrogels against sessile marine organisms (algae, sea squirts, barnacles) were tested in a long-term experiment. The results demonstrate that most hydrogels can endure at least 2 months in the marine environment. In particular, mechanically tough PAMPS/PAAm DN and PVA gels exhibited AF activity against marine sessile organisms, especially barnacles, for as long as 330 days. The AF ability of hydrogels toward barnacles is explained in terms of an 'easy-release' mechanism in which the high water content and the elastic modulus of the gel are two important parameters.

  19. Latest development and status of long term experience in CFB-technology

    SciTech Connect

    Cleve, K.

    1999-07-01

    CFB-fired steam generators have successfully been in operation for over 15 years. After this period of time enough practical knowledge is available to report on the Long Term Experience of selected plants. The success of CFB-fired steam generators--because of their outstanding environmental performance as well as their fuel flexibility--has led world-wide to more and larger units. In addition to well-proven components, the CFB-process is continuously being improved and New Developments are incorporated.

  20. Long-term patterns of dental attendance and caries experience among British adults: a retrospective analysis.

    PubMed

    Aldossary, Arwa; Harrison, Victoria E; Bernabé, Eduardo

    2015-02-01

    There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long-term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥ 16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular-attenders) based on their responses to three questions on lifetime dental-attendance patterns. The association between dental-attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio-economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long-term dental attendance and caries experience was found in adjusted models. Former and never regular-attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular-attenders. No differences in DMFT or its components were found between current and always regular-attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses.

  1. Molecular Correlates of Cortical Network Modulation by Long-Term Sensory Experience in the Adult Rat Barrel Cortex

    ERIC Educational Resources Information Center

    Vallès, Astrid; Granic, Ivica; De Weerd, Peter; Martens, Gerard J. M.

    2014-01-01

    Modulation of cortical network connectivity is crucial for an adaptive response to experience. In the rat barrel cortex, long-term sensory stimulation induces cortical network modifications and neuronal response changes of which the molecular basis is unknown. Here, we show that long-term somatosensory stimulation by enriched environment…

  2. Long-term and trans-generational effects of neonatal experience on sheep behaviour.

    PubMed

    Clark, Corinna; Murrell, Joanna; Fernyhough, Mia; O'Rourke, Treasa; Mendl, Michael

    2014-07-01

    Early life experiences can have profound long-term, and sometimes transgenerational, effects on individual phenotypes. However, there is a relative paucity of knowledge about effects on pain sensitivity, even though these may impact on an individual's health and welfare, particularly in farm animals exposed to painful husbandry procedures. Here, we tested in sheep whether neonatal painful and non-painful challenges can alter pain sensitivity in adult life, and also in the next generation. Ewes exposed to tail-docking or a simulated mild infection (lipopolysaccharide (LPS)) on days 3–4 of life showed higher levels of pain-related behaviour when giving birth as adults compared with control animals. LPS-treated ewes also gave birth to lambs who showed decreased pain sensitivity in standardized tests during days 2–3 of life. Our results demonstrate long-term and trans-generational effects of neonatal experience on pain responses in a commercially important species and suggest that variations in early life management can have important implications for animal health and welfare.

  3. Supporting a relative's move into long-term care: starting point shapes family members' experiences.

    PubMed

    Sussman, Tamara; Dupuis, Sherry

    2012-12-01

    This grounded-theory study explored family members' experiences supporting a relative's move into a long-term care (LTC) home. Each stage in the transition process, and the role of starting point in shaping the experience, were examined. Twenty family members who moved a relative into an LTC home were interviewed within six weeks of the move. The findings revealed that the starting point had a profound effect on family members' experiences accepting the need for, and timing of, their relative's move into LTC (pre-move), and on believing that the selected LTC home was a positive environment for their relative (post-move). LTC home policies and processes were also important. However, when pre-move acceptance was compromised by circumstances attributed to the starting point, these policies and processes were not as effective in fostering post-move acceptance. Conditions that support positive transitions before, during, and after the move from each starting point are discussed.

  4. Appraisal of the cancer experience by family members and survivors in long-term survivorship.

    PubMed

    Bowman, Karen F; Rose, Julia H; Deimling, Gary T

    2006-09-01

    This study assessed the appraisal of the stressfulness of the cancer experience and its correlates for family members and older survivors living in the long-term survivorship phase of the disease. On average, family members appraised the cancer experience as more stressful than their surviving relatives. Beliefs about the effect of the diagnosis and treatment on family members were important correlates for both family members and survivors in the appraisal process. Cancer characteristics were not related to appraisal for survivors, but stage at diagnosis was associated with a more stressful appraisal for family members. Demographic characteristics were unrelated to appraisal for family members, but being African-American was linked to a less stressful appraisal for survivors. These findings highlight the stressful impact of the cancer experience on family members and can help guide health care interventions which include family members from African-American and White ethnicities.

  5. Long-Term Soil Experiments: A Key to Managing Earth's Rapidly Changing Critical Zones

    NASA Astrophysics Data System (ADS)

    Richter, D., Jr.

    2014-12-01

    In a few decades, managers of Earth's Critical Zones (biota, humans, land, and water) will be challenged to double food and fiber production and diminish adverse effects of management on the wider environment. To meet these challenges, an array of scientific approaches is being used to increase understanding of Critical Zone functioning and evolution, and one amongst these approaches needs to be long-term soil field studies to move us beyond black boxing the belowground Critical Zone, i.e., to further understanding of processes driving changes in the soil environment. Long-term soil experiments (LTSEs) provide direct observations of soil change and functioning across time scales of decades, data critical for biological, biogeochemical, and environmental assessments of sustainability; for predictions of soil fertility, productivity, and soil-environment interactions; and for developing models at a wide range of temporal and spatial scales. Unfortunately, LTSEs globally are not in a good state, and they take years to mature, are vulnerable to loss, and even today remain to be fully inventoried. Of the 250 LTSEs in a web-based network, results demonstrate that soils and belowground Critical Zones are highly dynamic and responsive to human management. The objective of this study is to review the contemporary state of LTSEs and consider how they contribute to three open questions: (1) can soils sustain a doubling of food production in the coming decades without further impinging on the wider environment, (2) how do soils interact with the global C cycle, and (3) how can soil management establish greater control over nutrient cycling. While LTSEs produce significant data and perspectives for all three questions, there is on-going need and opportunity for reviews of the long-term soil-research base, for establishment of an efficiently run network of LTSEs aimed at sustainability and improving management control over C and nutrient cycling, and for research teams that

  6. Tuberculosis among long term hospital residents: report of a recent outbreak.

    PubMed

    Taylor, D R; Allison, G; Phillips, D E

    1991-10-09

    Following the diagnosis of a case of miliary tuberculosis in a ward of 30 psychogeriatric patients, a further seven patients required treatment for active tuberculosis, and an additional four received prophylactic therapy. Tuberculosis contributed significantly to the deaths of three patients during the outbreak. This report highlights the particular risks of both reactivation and primary tuberculosis among geriatric patients receiving long term residential care. Late diagnosis contributed to the extent of the outbreak. Previous studies indicate that occult transmission of tuberculosis is relatively common in this group. An active policy of screening and prophylactic treatment is advised.

  7. Long-term Disability Associated With War-related Experience Among Vietnam Veterans

    PubMed Central

    Gregory, Robert; Salomon, Joshua A.

    2015-01-01

    Background: Recent combat operations have involved large numbers of personnel. Long-term health effects of military deployment remain largely unknown. Objectives: To examine patterns and trends in long-term disability among combat veterans and to relate disability to aspects of wartime experience. Participants: A total of 60,228 Australian military personnel deployed between 1962 and 1975 during the Vietnam War, and 82,877 military personnel who were not deployed overseas. Outcome Measures: Accepted physician-assessed disability claims were evaluated over follow-up periods up to 50 years after deployment, and compared with age-matched controls. Multivariable analysis was used to examine differences by service branch, rank, age, and deployment duration. Results: The steepest rise in disability incidence was observed among Vietnam veterans starting in the 1990s, around 20–30 years after deployment for most veterans. After 1994, when Statements of Principles were introduced to guide evaluation of disability claims, the hazard ratio for disability incidence was 1.53 (95% confidence interval, 1.32–1.77) compared with the prior period. By January 2011, after an average follow-up of 42.5 years, 69.7% (95% confidence interval, 69.4%–70.1%) of veterans had at least 1 war-related disability. Many veterans had multiple disabilities, with leading causes being eye and ear disorders (48.0%), mental health conditions (47.9%), and musculoskeletal disorders (18.4%). For specific categories of disability, relative risks for accepted claims among veterans compared with controls were highest for mental health disorders, at 22.9 (21.9–24.0) and lowest for injuries, at 1.5 (1.4–1.6) with a relative risk for any disability of 3.7 (3.7–3.8). Veterans with service of >1 year were 2.5 (2.2–2.7) times more likely to have a mental health disability than those who served <100 days, and 2.3 (2.1–2.5) times more likely to have other disabilities. Conclusions: Long-term effects of

  8. Long-term reactive transport modelling of Berea and chalk core flood experiment

    NASA Astrophysics Data System (ADS)

    Souza, A. V.; Godoy, J.; Tonietto, G.

    2013-12-01

    Carbon sequestration in geological structures establishes a long-term chemical system between the dissolved gas, fluids and rocks from the injection site. Thus, the time scale used to assess the progress of chemical reactions is normally between tens and hundreds of years. Geochemical modeling is used in a variety of fields, including environmental protection and remediation, the petroleum industry, and economic geology and it is one of the best alternatives to evaluate the reactions with geochemical data possible injection sites. In this work we used data presented in a recent article (SPE165500) in different scenarios injection with three scales 50, 100, 250 and 1000 years. The experimental data used were from core flood experiment Berea and chalk in a condition similar to those found in the reservoirs of the North Sea. (340 bar and 130 C). The approach used to the lack of appropriate kinetic parameter in reservoir conditions, was the use of experimental data collected in two different conditions (340 bar and 130 C) and (2 Bar at room temperature) after the rocky core. The numerical simulations carried out using the same conditions with two different geochemical softwares PHREEQC and TOUGHREACTS. The results provide a detailed understanding of the system resulting rock-fluid-CO2 in the medium and long term. However, the accuracy of the models is strongly dependent on the mineral primary and secondary cores found in rocks.

  9. Long-term experiments on man's stay in biological life-support system

    NASA Astrophysics Data System (ADS)

    Gitelson, I. I.; Terskov, I. A.; Kovrov, B. G.; Lisovskii, G. M.; Okladnikov, Yu. N.; Sid'Ko, F. Ya.; Trubachev, I. N.; Shilenko, M. P.; Alekseev, S. S.; Pan'kova, I. M.; Tirranen, L. S.

    We describe the experimental system having maximal possible closure of material recycling in an ecosystem, including people and plants, which was carried out in a hermetically sealed experimental complex ``BIOS-3'', 315 m2 in volume. The system included 2 experimentators and 3 phytotrons with plants (total sowing area of 63 m2). Plants were grown with round-the-clock lamp irradiation with 130 Wm-2 PAR intensity. The plants production was food for people. Water exchange of ecosystem, as well as gas exchange, was fully closed excluding liquids and gas samples taken for chemical analysis outside the system. The total closure of material turnover constituted 91%. Health state of the crew was estimated before, during and after the experiment. A 5-months period did not affect their health. The experiments carried out prove that the closed ecosystem of ``man-plants'' is a prototype of a life-support system for long-term space expeditions.

  10. The effect of hospital mergers on long-term sickness absence among hospital employees: a fixed effects multivariate regression analysis using panel data

    PubMed Central

    2014-01-01

    Background Hospitals are merging to become more cost-effective. Mergers are often complex and difficult processes with variable outcomes. The aim of this study was to analyze the effect of mergers on long-term sickness absence among hospital employees. Methods Long-term sickness absence was analyzed among hospital employees (N = 107 209) in 57 hospitals involved in 23 mergers in Norway between 2000 and 2009. Variation in long-term sickness absence was explained through a fixed effects multivariate regression analysis using panel data with years-since-merger as the independent variable. Results We found a significant but modest effect of mergers on long-term sickness absence in the year of the merger, and in years 2, 3 and 4; analyzed by gender there was a significant effect for women, also for these years, but only in year 4 for men. However, men are less represented among the hospital workforce; this could explain the lack of significance. Conclusions Mergers has a significant effect on employee health that should be taken into consideration when deciding to merge hospitals. This study illustrates the importance of analyzing the effects of mergers over several years and the need for more detailed analyses of merger processes and of the changes that may occur as a result of such mergers. PMID:24490750

  11. Association of hospitalization with long-term cognitive and brain MRI changes in the ARIC cohort

    PubMed Central

    Sharrett, A. Richey; Coresh, Josef; Schneider, Andrea L.C.; Alonso, Alvaro; Knopman, David S.; Mosley, Thomas H.; Gottesman, Rebecca F.

    2015-01-01

    Objective: To determine whether hospitalization is associated with subsequent cognitive decline or changes on brain MRI in a community-based cohort. Methods: Baseline and follow-up cognitive testing (n = 2,386) and MRI scans with standardized assessments (n = 885) were available from a subset of white and black participants in the Atherosclerosis Risk in Communities study. Cognitive tests included the Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT). Hospitalization characteristics were determined using ICD-9 codes. Regression models adjusted for demographics, education, comorbidities, and APOE ε4 were used to estimate the independent association of hospitalization with changes in cognition or neuroimaging. Results: Over a mean 14.1 years between visits, 1,266 participants (53.1%) were hospitalized. Hospitalization compared with no hospitalization was associated with greater decline in DSST scores (1.25 points greater decline, p < 0.001) but no difference in DWRT or WFT score change. Each additional hospitalization, as well as a critical illness vs noncritical illness hospitalization, was associated with greater decline in DSST scores. A subset of participants (n = 885) underwent MRI scans separated by 10.5 years. Hospitalization (n = 392) compared with no hospitalization was associated with a 57% higher odds of increasing ventricular size at follow-up. Each additional hospitalization, as well as having a critical illness vs noncritical illness hospitalization, and having a hospitalization with major surgery vs no surgery was associated with greater odds of increased ventricular size. Conclusions: Cognitive decline and neuroimaging changes may occur after hospitalization, independent of baseline demographics and comorbidities. PMID:25762715

  12. Survey of weed composition befor maize sowing in long-term fertilization experiment.

    PubMed

    Kismányoky, A; Lehoczky, E

    2007-01-01

    The study was carried out in a long-term fertilization field experiment of the Experimental Station of University of Pannonia, Department of Crop Science and Soil Science in 2006. The Long-term fertilization experiment was set up in 1983. In the experiment, the success of the weeds ability to grow under the influence of NPK, NPK + FYM* and NPK + straw treatments was compared, and the effect of increasing Nitrogen dosing on weediness was studied. The bifactorial test was arranged in split plot design with three replications. Treatment A: nutrient: NPK, NPK + 35 t/ha FYM* and NPK + straw manure. Treatment B: N kg/ha(-1) N0-N4 (0, 70, 140, 210, 280), and 100 kg P2O5 ha(-1) & 100 kg K20. The weed survey was made on 2nd of May 2006. There were spraying no herbicide until the survey. For the weed survey the Balázs-Ujvárosi coenological method was applied. Altogether, we have found 23 weed species in the trial. In the NPK treatment there were 20 species, in the treatment NPK+organic manure there were 17 species and in the NPK+ stalk rest treatment there were 16 weed species. The most dominant of the weeds on the NPK and NPK+straw manure treatments was Veronica hederifolia while on the fertilizer + FYM, the A. theophrasti was most dominant. The average weed covering value of the treatment NPK + FYM was 1.36 times higher (10.87%) than that of treatment NPK only (7.97%) and 3.65 times higher than on the NPK + straw manure treatment.

  13. Molecular correlates of cortical network modulation by long-term sensory experience in the adult rat barrel cortex

    PubMed Central

    Vallès, Astrid; Granic, Ivica; De Weerd, Peter; Martens, Gerard J.M.

    2014-01-01

    Modulation of cortical network connectivity is crucial for an adaptive response to experience. In the rat barrel cortex, long-term sensory stimulation induces cortical network modifications and neuronal response changes of which the molecular basis is unknown. Here, we show that long-term somatosensory stimulation by enriched environment up-regulates cortical expression of neuropeptide mRNAs and down-regulates immediate-early gene (IEG) mRNAs specifically in the barrel cortex, and not in other brain regions. The present data suggest a central role of neuropeptides in the fine-tuning of sensory cortical circuits by long-term experience. PMID:25171421

  14. Long-term experience with (laterally) extended endopelvic resection (LEER) in relapsed pelvic malignancies.

    PubMed

    Höckel, Michael

    2015-03-01

    Gynecologic cancers recurring in the pelvis are generally advanced in malignant progression limiting curative treatment approaches. The cancer field theory links cancer progression to reversed morphogenesis and allows the exact anatomical delineation of the cancer field, i.e., the tissue compartment of potential tumor infiltration related to the tumor's ontogenetic stage. Cancer surgery is redefined with the resection of ontogenetic stage-related cancer fields instead of the mere removal of the malignant tumor with an uninvolved tissue margin. Most gynecologic pelvic malignancies recurring in the pelvis represent ontogenetic stages 3 and 4. (Laterally) extended endopelvic resection ((L)EER) has been designed to resect the cancer fields of gynecologic tumors in these advanced ontogenetic stages. This paper reports long-term experience with (L)EER for relapsed pelvic malignancies strongly supporting the cancer field theory and the principle and practice of cancer field resection.

  15. Care assistant experiences of dementia care in long-term nursing and residential care environments.

    PubMed

    Talbot, Rebecca; Brewer, Gayle

    2016-11-01

    Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.

  16. Long- term effects of previous experience determine nutrient discrimination abilities in birds

    PubMed Central

    Schaefer, H Martin; Spitzer, Kathrin; Bairlein, Franz

    2008-01-01

    Background Foraging behaviour is an essential ecological process linking different trophic levels. A central assumption of foraging theory is that food selection maximises the fitness of the consumer. It remains unknown, however, whether animals use innate or learned behaviour to discriminate food rewards. While many studies demonstrated that previous experience is a strong determinant of complex food choices such as diet mixing, the response to simple nutritional stimuli, such as sugar concentrations, is often believed to be innate. Results Here we show that previous experience determines the ability to track changes in sugar composition in same-aged individuals of a short-lived migratory songbird, the garden warbler (Sylvia borin). Although birds received identical foods for seven months prior to the experiment, wild-caught birds achieved higher sugar intake rates than hand-raised birds when confronted with alternative, differently coloured, novel food types. Hand-raised and wild birds did not differ in their initial colour selection or overall food intake, but wild birds were quicker to adjust food choice to varying sugar intake. Conclusion Over a period of at least seven months, broader previous experience translates into a higher plasticity of food choice leading to higher nutrient intake. Our results thus highlight the need to address previous long-term experience in foraging experiments. Furthermore, they show that hand-raised animals are often poor surrogates for testing the foraging behaviour of wild animals. PMID:18291043

  17. STROBE-Long-Term Exposure to Ambient Fine Particulate Air Pollution and Hospitalization Due to Peptic Ulcers

    PubMed Central

    Wong, Chit-Ming; Tsang, Hilda; Lai, Hak-Kan; Thach, Thuan-Quoc; Thomas, G. Neil; Chan, King-Pan; Lee, Siu-Yin; Ayres, Jon G.; Lam, Tai-Hing; Leung, Wai K.

    2016-01-01

    Abstract Little is known about the effect of air pollution on the gastrointestinal (GI) system. We investigated the association between long-term exposures to outdoor fine particles (PM2.5) and hospitalization for peptic ulcer diseases (PUDs) in a large cohort of Hong Kong Chinese elderly. A total of 66,820 subjects aged ≥65 years who were enrolled in all 18 Government Elderly Health Service centers of Hong Kong participated in the study voluntarily between 1998 and 2001. They were prospectively followed up for more than 10 years. Annual mean exposures to PM2.5 at residence of individuals were estimated by satellite data through linkage with address details including floor level. All hospital admission records of the subjects up to December 31, 2010 were retrieved from the central database of Hospital Authority. We used Cox regression to estimate the hazard ratio (HR) for PUD hospitalization associated with PM2.5 exposure after adjustment for individual and ecological covariates. A total of 60,273 subjects had completed baseline information including medical, socio-demographic, lifestyle, and anthropometric data at recruitment. During the follow-up period, 1991 (3.3%) subjects had been hospitalized for PUD. The adjusted HR for PUD hospitalization per 10 μg/m3 of PM2.5 was 1.18 (95% confidence interval: 1.02–1.36, P = 0.02). Further analysis showed that the associations with PM2.5 were significant for gastric ulcers (HR 1.29; 1.09–1.53, P = 0.003) but not for duodenal ulcers (HR 0.98; 0.78 to 1.22, P = 0.81). Long-term exposures to PM2.5 were associated with PUD hospitalization in elder population. The mechanism underlying the PM2.5 in the development of gastric ulcers warrants further research. PMID:27149464

  18. Diversity-function relationships changed in a long-term restoration experiment.

    PubMed

    Doherty, James M; Callaway, John C; Zedler, Joy B

    2011-09-01

    The central tenet of biodiversity-ecosystem function (BEF) theory, that species richness increases function, could motivate restoration practitioners to incorporate a greater number of species into their projects. But it is not yet clear how well BEF theory predicts outcomes of restoration, because it has been developed through tests involving short-run and tightly controlled (e.g., weeded) experiments. Thus, we resampled our 1997 BEF experiment in a restored salt marsh to test for long-term effects of species richness (plantings with 1, 3, and 6 species per 2 x 2 m plot), with multiple ecosystem functions as response variables. Over 11 years, 1- and 6-species assemblages converged on intermediate richness (mean = 3.9 species/ 0.25-m2 plot), and composition changed nonrandomly throughout the site. While three species became rare, the two most productive species became co-dominant. The two dominants controlled and increased shoot biomass, which appeared to decrease species richness. Diversity-function relationships became less positive over 11 years and differed significantly with (a) the species-richness metric (planted vs. measured), and (b) the indicator of function (shoot biomass, height, and canopy layering). The loss of positive relationships between species richness and function in our restored site began soon after we stopped weeding and continued with increasing dominance by productive species. Where species-rich plantings are unlikely to ensure long-term restoration of functions, as in our salt marsh, we recommend dual efforts to establish (1) dominant species that provide high levels of target functions, and (2) subordinate species, which might provide additional functions under current or future conditions.

  19. Does long-term experience of nonstandard employment increase the incidence of depression in the elderly?

    PubMed Central

    Kang, Mo-Yeol; Kang, Young-Joong; Lee, Woncheol; Yoon, Jin-Ha

    2016-01-01

    Objectives: Our prospective study aimed to elucidate the effect of long-term experience of nonstandard employment status on the incidence of depression in elderly population using the Korean Longitudinal Study of Ageing (KLoSA) study. Methods: This study used the first- to fourth-wave cohorts of KLoSA. After the exclusion of the unemployed and participants who experienced a change in employment status during the follow-up periods, we analyzed a total of 1,817 participants. Employment contracts were assessed by self-reported questions:standard or nonstandard employment. The short form of the Center for Epidemiologic Studies Depression Scale (CES-D) served as the outcome measure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards models to evaluate the association between standard/nonstandard employees and development of depression. Results: The mean age of the participants was 53.90 (±7.21) years. We observed that nonstandard employment significantly increased the risk of depression. Compared with standard employees, nonstandard employees had a 1.5-fold elevated risk for depression after adjusting for age, gender, CES-D score at baseline, household income, occupation category, current marital status, number of living siblings, perceived health status, and chronic diseases [HR=1.461, 95% CI= (1.184, 1.805) ]. Moreover, regardless of other individual characteristics, the elevated risk of depression was observed among all kinds of nonstandard workers, such as temporary and day workers, full-time and part-time workers, and directly employed and dispatched labor. Conclusions: The 6-year follow-up study revealed that long-term experience of nonstandard employment status increased the risk of depression in elderly population in Korea. PMID:27108642

  20. Long-term experiments to better understand soil-human interactions

    NASA Astrophysics Data System (ADS)

    Bormann, B. T.; Homann, P. S.

    2011-12-01

    Interactions between soils and people may be transforming global conditions, but the interactions are poorly understood. Changes in soils have proven difficult to quantify, especially in complex ecosystems manifesting large spatiotemporal variability. Long-term ecosystem experiments that evaluate soil change and demonstrate alternative choices are important to understanding changes, discovering new controls and drivers, and influencing decisions. Inspired by agriculture studies, like Rothamsted, the US Forest Service established in 1990 a network of operational-scale experiments across the Pacific Northwest to evaluate long-term effects of different forest management and disturbance regimes. With a strong experimental design, these experiments are now helping to better understand the long-term effects of managing tree harvesting (clearcutting and thinning), woody debris, and tree and understory species composition, and-serendipitously-the effects of fire. Initial results from the Southern Oregon experimental site indicate surprisingly rapid soil changes in some regimes but not others. We've also learned that rapid change presents challenges to repeat sampling. We present our sample-archive and comparable-layer approaches that seek to accommodate changes in surface elevation, aggregation and disaggregation, and mineral-soil exports. Thinning mature forest stands (80-100 yrs old) did not significantly change soil C in 11-yrs. A small upper-layer C increase was observed after thinning, but it was similar to the control. Significant increases in upper-layer soil N were observed with most treatments, but all increases were similar to the control. Leaving woody debris had little effect. The most remarkable change occurred when mature stands were clearcut and Douglas-firs were planted and tended. Associated with rapid growth of Douglas-fir, an average of 8 Mg C ha-1 was lost from weathered soil 4-18 cm deep. This contrasts with clearcuts where early-seral hardwoods and

  1. 241Am migration in a sandy aquifer studied by long-term column experiments.

    PubMed

    Artinger, Robert; Schuessler, Wolfram; Scherbaum, Franz; Schild, Dieter; Kim, Jae-Il

    2002-11-15

    The migration behavior of 241Am(III) in a sandy aquifer was studied under near-natural conditions by long-term column experiments of more than 1 year duration. Columns with 50 cm length and 5 cm in diameter were packed with aeolian quartz sand and equilibrated with two different groundwaters having an original dissolved organic carbon concentration (DOC) of 1.1 and 7.2 mg x dm(-3), respectively,from the Gorleben site (Lower Saxony, Germany). In each experiment, 1 cm3 of Am-spiked groundwater ([Am] = 0.2 to 2 micromol x dm(-3)) was injected into the column. The flow rate of the groundwater was adjusted to 0.28 m x d(-1). A small colloid-borne Am fraction was found to elute together with tritiated water. After 414 and 559 days, respectively, the experiments were terminated. Whereas the nonsorbing tracer of tritiated water would have covered a distance of about 350 m in that time period, the maximum of the Am activity was detected between 32 and 40 mm column length. Applying selective dissolution analysis to the sand surface, Am was found to be preferentially bound to iron hydroxide/oxide sites. From this Am distribution, a retardation factor R of about 10(4) was determined and compared to static batch experiments. The Am breakthrough was calculated forthe conditions of the column experiment

  2. An off year for consolidation. 1997 hospital mergers, acquisitions, joint ventures and long-term leases.

    PubMed

    Japsen, B

    1998-01-12

    Because of a significant drop in the number of major corporate mergers and acquisitions, total hospital consolidation in 1997 was well off the record-setting pace of previous years. The number of hospitals involved in dealmaking dropped 18% to 627 compared with the previous year, according to Modern Healthcare's fourth annual roundup of consolidation activity. And there were only four corporate deals, compared with 11 in 1996.

  3. Decreasing trend of Legionella isolation in a long-term microbial monitoring program in Greek hospitals.

    PubMed

    Velonakis, Emanouil; Karanika, Maria; Mouchtouri, Varavara; Thanasias, Efthimios; Katsiaflaka, Anna; Vatopoulos, Alkis; Hadjichristodoulou, Christos

    2012-01-01

    Legionnaires' disease is a known cause of severe pneumonia in a nosocomial setting. This study examined Legionella isolation in Greek hospitals. Water samples and swabs of showerheads from 41 hospitals were collected over a four-year period (2004-2007) from hot and cold water systems and cooling towers in Greece. In total, 1058 samples were examined for the presence of Legionella. From the hot water samples examined, 166 out of 607 (27.3%) were positive for Legionella, including 111 (18.3%) positive for Legionella pneumophila sg1 samples. The temperature of hot water samples less than 55°C was statistically significant, associated with Legionella spp. isolation (RR 4.01, 95%CI 2.33-6.92). Ten out of 17 (58.8%) hospital cooling towers required remedial actions due to Legionella colonization. Reemergence of Legionella spp. colonization was evident in more than half of the hospitals where frequent monitoring and appropriate risk assessment plans were absent or lacking. Hospitals that were monitored continuously over the study period presented a decreasing trend of Legionella colonization. Environmental risk assessment together with Legionella isolation should be enforced systematically in hospitals.

  4. Weed Diversity Affects Soybean and Maize Yield in a Long Term Experiment in Michigan, USA.

    PubMed

    Ferrero, Rosana; Lima, Mauricio; Davis, Adam S; Gonzalez-Andujar, Jose L

    2017-01-01

    Managing production environments in ways that promote weed community diversity may enhance both crop production and the development of a more sustainable agriculture. This study analyzed data of productivity of maize (corn) and soybean in plots in the Main Cropping System Experiment (MCSE) at the W. K. Kellogg Biological Station Long-Term Ecological Research (KBS-LTER) in Michigan, USA, from 1996 to 2011. We used models derived from population ecology to explore how weed diversity, temperature, and precipitation interact with crop yields. Using three types of models that considered internal and external (climate and weeds) factors, with additive or non-linear variants, we found that changes in weed diversity were associated with changes in rates of crop yield increase over time for both maize and soybeans. The intrinsic capacity for soybean yield increase in response to the environment was greater under more diverse weed communities. Soybean production risks were greatest in the least weed diverse systems, in which each weed species lost was associated with progressively greater crop yield losses. Managing for weed community diversity, while suppressing dominant, highly competitive weeds, may be a helpful strategy for supporting long term increases in soybean productivity. In maize, there was a negative and non-additive response of yields to the interaction between weed diversity and minimum air temperatures. When cold temperatures constrained potential maize productivity through limited resources, negative interactions with weed diversity became more pronounced. We suggest that: (1) maize was less competitive in cold years allowing higher weed diversity and the dominance of some weed species; or (2) that cold years resulted in increased weed richness and prevalence of competitive weeds, thus reducing crop yields. Therefore, we propose to control dominant weed species especially in the years of low yield and extreme minimum temperatures to improve maize yields

  5. Weed Diversity Affects Soybean and Maize Yield in a Long Term Experiment in Michigan, USA

    PubMed Central

    Ferrero, Rosana; Lima, Mauricio; Davis, Adam S.; Gonzalez-Andujar, Jose L.

    2017-01-01

    Managing production environments in ways that promote weed community diversity may enhance both crop production and the development of a more sustainable agriculture. This study analyzed data of productivity of maize (corn) and soybean in plots in the Main Cropping System Experiment (MCSE) at the W. K. Kellogg Biological Station Long-Term Ecological Research (KBS-LTER) in Michigan, USA, from 1996 to 2011. We used models derived from population ecology to explore how weed diversity, temperature, and precipitation interact with crop yields. Using three types of models that considered internal and external (climate and weeds) factors, with additive or non-linear variants, we found that changes in weed diversity were associated with changes in rates of crop yield increase over time for both maize and soybeans. The intrinsic capacity for soybean yield increase in response to the environment was greater under more diverse weed communities. Soybean production risks were greatest in the least weed diverse systems, in which each weed species lost was associated with progressively greater crop yield losses. Managing for weed community diversity, while suppressing dominant, highly competitive weeds, may be a helpful strategy for supporting long term increases in soybean productivity. In maize, there was a negative and non-additive response of yields to the interaction between weed diversity and minimum air temperatures. When cold temperatures constrained potential maize productivity through limited resources, negative interactions with weed diversity became more pronounced. We suggest that: (1) maize was less competitive in cold years allowing higher weed diversity and the dominance of some weed species; or (2) that cold years resulted in increased weed richness and prevalence of competitive weeds, thus reducing crop yields. Therefore, we propose to control dominant weed species especially in the years of low yield and extreme minimum temperatures to improve maize yields

  6. Detailed description of a long-term low-level waste degradation experiment

    SciTech Connect

    Caron, F.; Torok, J.; Haas, M.K.; Manni, G.

    1997-12-31

    This work gives a detailed description of the important aspects of a long-term Low-Level Radioactive Waste (LLRW) degradation experiment, performed at Chalk River Laboratories (CRL). This experiment utilized actual LLRW. The wastes consist of unconditioned compacted refuse (paper, mop heads, paper towels, used clothing, etc.), which represents the bulk of the waste volume intended for near-surface disposal at CRL. Waste material was collected and compacted to make a total of 11 bales for this experiment. Each bale was then placed and sealed in separate steel containers which were connected to sampling lines. After a dry monitoring period, water was added to promote leaching and decomposition of the wastes. The leachate sampled had a composition similar to landfill leachates. Some applications of this experiment, used to support the safety case of near-surface disposal, are briefly discussed in this paper, e.g., the production of colloidal material, the nature and role of dissolved organics of microbial origin, etc.

  7. Study on the weediness of winter wheat in a long-term fertilization field experiment.

    PubMed

    Lehoczky, E; Kismányoky, A; Kismányoky, T

    2006-01-01

    The study was carried out in Keszthely, in the long-term fertilization field experiment in April of 2005. In the experiment we had opportunity to compare the weediness in NPK and NPK + FYM* treatments, and we could study the effect of increasing N dosis on the weeds and winter wheat. The weed survey was made on the 20th of April at the end of tillering. For the weed survey used the Balázs-Ujvárosi method. After that we collected all the weeds from the plots per 1 m2. We counted, measured the fresh and dry matter weight of aerial parts. Winter wheat sampels were taken also from all plots (1 running meter per plot). In the experiment 10 weed species were found, 9 annual: Ambrosia artemisiifolia, Consolida regalis, Galium aparine, Lamiunt amplexicaule, Matricaria inodora, Papaver rhoeas, Stellaria media, Veronica hederifolia, Veronica triphyllos, and 1 perennial: Cirsium arvense. Veronica hederifolia was the dominant species in both fertilized plots, Stellaria media has the second highest weed coverage. The manuring treatments, and the N-dosis has important and significantly effect to the weedeness and the biomass production of winter wheat. On the control plots was the relation of biomass weight of weeds the highest. This relation reduced to the effect of N treatments, wich had an favorable effect on the winter wheat.

  8. Neuroplasticity beyond Sounds: Neural Adaptations Following Long-Term Musical Aesthetic Experiences

    PubMed Central

    Reybrouck, Mark; Brattico, Elvira

    2015-01-01

    Capitalizing from neuroscience knowledge on how individuals are affected by the sound environment, we propose to adopt a cybernetic and ecological point of view on the musical aesthetic experience, which includes subprocesses, such as feature extraction and integration, early affective reactions and motor actions, style mastering and conceptualization, emotion and proprioception, evaluation and preference. In this perspective, the role of the listener/composer/performer is seen as that of an active “agent” coping in highly individual ways with the sounds. The findings concerning the neural adaptations in musicians, following long-term exposure to music, are then reviewed by keeping in mind the distinct subprocesses of a musical aesthetic experience. We conclude that these neural adaptations can be conceived of as the immediate and lifelong interactions with multisensorial stimuli (having a predominant auditory component), which result in lasting changes of the internal state of the “agent”. In a continuous loop, these changes affect, in turn, the subprocesses involved in a musical aesthetic experience, towards the final goal of achieving better perceptual, motor and proprioceptive responses to the immediate demands of the sounding environment. The resulting neural adaptations in musicians closely depend on the duration of the interactions, the starting age, the involvement of attention, the amount of motor practice and the musical genre played. PMID:25807006

  9. Factors Differentiating Hospital Transfers from Long-term Care Facilities with High and Low Transfer Rates.

    ERIC Educational Resources Information Center

    Teresi, Jeanne A.; And Others

    1991-01-01

    Examined differences among nursing homes in rates at which they transfer patients to hospitals. Data from nursing staff and charts on 286 most recent transfers from 10 nursing homes revealed that, from relatively equivalent patient populations, high-rate facilities transferred more chronically ill, physically frail patients and patients with…

  10. Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up.

    PubMed

    Kammer, Jessica; Ziesing, Stefan; Davila, Lukas Aguirre; Bültmann, Eva; Illsinger, Sabine; Das, Anibh M; Haffner, Dieter; Hartmann, Hans

    2016-10-01

    Objective In this retrospective study, we aimed to assess frequency, types, and long-term outcome of neurological disease during acute Mycoplasma pneumoniae (M. pneumoniae) infection in pediatric patients. Materials and Methods Medical records of patients hospitalized with acute M. pneumoniae infection were reviewed. Possible risk factors were analyzed by uni- and multivariate regression. Patients with neurological symptoms were followed up by expanded disability status score (EDSS) and the cognitive problems in children and adolescents (KOPKJ) scale. Results Out of 89 patients, 22 suffered from neurological symptoms and signs. Neurological disorders were diagnosed in 11 patients: (meningo-) encephalitis (n = 6), aseptic meningitis (n = 3), transverse myelitis (n = 1), and vestibular neuritis (n = 1), 11 patients had nonspecific neurological symptoms and signs. Multivariate logistic regression identified lower respiratory tract symptoms as a negative predictor (odds ratio [OR] = 0.1, p < 0.001), a preexisting immune deficit was associated with a trend for a decreased risk (OR = 0.12, p = 0.058). Long-term follow-up after a median of 5.1 years (range, 0.6-13 years) showed ongoing neurological deficits in the EDSS in 8/18, and in the KOPKJ in 7/17. Conclusion Neurological symptoms occurred in 25% of hospitalized pediatric patients with M. pneumoniae infection. Outcome was often favorable, but significant sequels were reported by 45%.

  11. A smart homecage system with 3D tracking for long-term behavioral experiments.

    PubMed

    Byunghun Lee; Kiani, Mehdi; Ghovanloo, Maysam

    2014-01-01

    A wirelessly-powered homecage system, called the EnerCage-HC, that is equipped with multi-coil wireless power transfer, closed-loop power control, optical behavioral tracking, and a graphic user interface (GUI) is presented for long-term electrophysiology experiments. The EnerCage-HC system can wirelessly power a mobile unit attached to a small animal subject and also track its behavior in real-time as it is housed inside a standard homecage. The EnerCage-HC system is equipped with one central and four overlapping slanted wire-wound coils (WWCs) with optimal geometries to form 3-and 4-coil power transmission links while operating at 13.56 MHz. Utilizing multi-coil links increases the power transfer efficiency (PTE) compared to conventional 2-coil links and also reduces the number of power amplifiers (PAs) to only one, which significantly reduces the system complexity, cost, and dissipated heat. A Microsoft Kinect installed 90 cm above the homecage localizes the animal position and orientation with 1.6 cm accuracy. An in vivo experiment was conducted on a freely behaving rat by continuously delivering 24 mW to the mobile unit for > 7 hours inside a standard homecage.

  12. A facility for long-term Mars simulation experiments: the Mars Environmental Simulation Chamber (MESCH).

    PubMed

    Jensen, Lars Liengaard; Merrison, Jonathan; Hansen, Aviaja Anna; Mikkelsen, Karina Aarup; Kristoffersen, Tommy; Nørnberg, Per; Lomstein, Bente Aagaard; Finster, Kai

    2008-06-01

    We describe the design, construction, and pilot operation of a Mars simulation facility comprised of a cryogenic environmental chamber, an atmospheric gas analyzer, and a xenon/mercury discharge source for UV generation. The Mars Environmental Simulation Chamber (MESCH) consists of a double-walled cylindrical chamber. The double wall provides a cooling mantle through which liquid N(2) can be circulated. A load-lock system that consists of a small pressure-exchange chamber, which can be evacuated, allows for the exchange of samples without changing the chamber environment. Fitted within the MESCH is a carousel, which holds up to 10 steel sample tubes. Rotation of the carousel is controlled by an external motor. Each sample in the carousel can be placed at any desired position. Environmental data, such as temperature, pressure, and UV exposure time, are computer logged and used in automated feedback mechanisms, enabling a wide variety of experiments that include time series. Tests of the simulation facility have successfully demonstrated its ability to produce temperature cycles and maintain low temperature (down to -140 degrees C), low atmospheric pressure (5-10 mbar), and a gas composition like that of Mars during long-term experiments.

  13. Histopathology Image Analysis in Two Long-Term Animal Experiments with Helical Flow Total Artificial Heart.

    PubMed

    Wotke, Jiri; Homolka, Pavel; Vasku, Jaromír; Dobsak, Petr; Palanova, Petra; Mrkvicova, Veronika; Konecny, Petr; Soska, Vladimir; Pohanka, Michal; Novakova, Marie; Yurimoto, Terumi; Saito, Itsuro; Inoue, Yusuke; Isoyama, Takashi; Abe, Yusuke

    2016-12-01

    Histopathological analysis can provide important information in long-term experiments with total artificial heart (TAH). Recently, a new type of blood pump, the helical flow total artificial heart (HF-TAH) was developed. This study aimed to investigate the changes in selected vital organs in animal experiments with implanted HF-TAH. Samples from lung, liver, and kidneys from two female goats (No. 1301 and No. 1304) with implanted HF-TAH were analyzed. Tissue samples were fixed in 10% formaldehyde and 4 µm thick transverse sections were stained with hematoxylin-eosin (HE). Additional staining was done for detection of connective tissue (Masson-Goldner stain) and for detection of iron (hemosiderin) deposits (Perls stain). Sections were scanned at 100× and 500× magnification with a light microscope. Experiment no. 1301 survived 100 days (cause of termination was heavy damage of the right pump); experimental goat no.1304 survived 68 days and was sacrificed due to severe right hydrodynamic bearing malfunction. Histopathological analysis of liver samples proved signs of chronic venostasis with limited focal necrotic zones. Dilated tubules, proteinaceous material in tubular lumen, and hemosiderin deposits were detected in kidney samples. Contamination of the organs by embolized micro-particles was suspected at the autopsy after discovery of visible damage (scratches) of the pump impeller surface (made from titanium alloy) in both experiments. Sporadic deposits of foreign micro-particles (presumably titanium) were observed in most of the analyzed parenchymal organs. However, the described deposits were not in direct connection with inflammatory reactions in the analyzed tissues. Histopathological analysis showed the presence of minimal contamination of the lung, kidney, and liver tissue samples by foreign material (titanium very likely). The analysis showed only limited pathological changes, especially in liver and kidneys, which might be attributed to the influence of

  14. Sarin experiences in Japan: acute toxicity and long-term effects.

    PubMed

    Yanagisawa, N; Morita, H; Nakajima, T

    2006-11-01

    Two terrorist attacks with the nerve agent Sarin affected citizens in Matsumoto and Tokyo, Japan in 1994 and 1995, killing 19 and injuring more the 6000. Sarin, a very potent organophosphate nerve agent, inhibits acetylcholinesterase (AchE) activity within the central, peripheral, and autonomic nervous systems. Acute and long-term Sarin effects upon humans were well documented in these two events. Sarin gas inhalation caused instantaneous death by respiratory arrest in 4 victims in Matsumoto. In Tokyo, two died in station yards and another ten victims died in hospitals within a few hours to 3 months after poisoning. Six victims with serum ChE below 20% of the lowest normal were resuscitated from cardiopulmonary arrest (CPA) or coma with generalized convulsion. Five recovered completely and one remained in vegetative state due to anoxic brain damage. EEG abnormalities persisted for up to 5 years. Miosis and copious secretions from the respiratory and GI tracts (muscarinic effects) were common in severely to slightly affected victims. Weakness and twitches of muscles (nicotinic effects) appeared in severely affected victims. Neuropathy and ataxia were observed in small number (less than 10%) of victims, which findings disappeared between 3 days and 3 months. Leukocytosis and high serum CK levels were common. Hyperglycemia, ketonuria, low serum triglyceride, hypopotassemia were observed in severely affected victims, which abnormalities were attributed to damage of the adrenal medulla. Oximes, atropine sulphate, diazepam and ample intravenous infusion were effective treatments. Pralidoxime iodide IV reversed cholinesterase and symptoms quickly even if administered 6 h after exposure. Post Traumatic Stress Disorder (PTSD) was less than 8% after 5 years. However, psychological symptoms continue in victims of both incidents. In summary, both potent toxicity and quick recovery from critical ill conditions were prominent features. Conventional therapies proved effective in

  15. Long-Term Outcomes of Vestibular Schwannomas Treated With Fractionated Stereotactic Radiotherapy: An Institutional Experience

    SciTech Connect

    Kapoor, Sumit; Batra, Sachin; Carson, Kathryn; Shuck, John; Kharkar, Siddharth; Gandhi, Rahul; Jackson, Juan; Wemmer, Jan; Terezakis, Stephanie; Shokek, Ori; Kleinberg, Lawrence; Rigamonti, Daniele

    2011-11-01

    Purpose: We assessed clinical outcome and long-term tumor control after fractionated stereotactic radiotherapy (FSRT) for unilateral schwannoma. Methods and Materials: Between 1995 and 2007, 496 patients were treated with fractionated stereotactic radiotherapy at Johns Hopkins Hospital (Baltimore, MD); 385 patients had radiologic follow-up that met the inclusion criteria. The primary endpoint was treatment failure. Secondary endpoints were radiologic progression and clinical outcome. Logistic regression analysis assessed the association of age, race, tumor side, sex, and pretreatment symptoms. Results: In 11 patients (3%) treatment failed, and they required salvage (microsurgical) treatment. Radiologic progression was observed in 116 patients (30.0%), including 35 patients (9%) in whom the treatment volume more than doubled during the follow-up period, although none required surgical resection. Tumors with baseline volumes of less than 1 cm{sup 3} were 18.02 times more likely to progress than those with tumor volumes of 1 cm{sup 3} or greater (odds ratio, 18.02; 95% confidence interval, 4.25-76.32). Treatment-induced neurologic morbidity included 8 patients (1.6%) with new facial weakness, 12 patients (2.8%) with new trigeminal paresthesias, 4 patients (0.9%) with hydrocephalus (1 communicating and 3 obstructive), and 2 patients (0.5%) with possibly radiation-induced neoplasia. Conclusions: Although the rate of treatment failure is low (3%), careful follow-up shows that radiologic progression occurs frequently. When reporting outcome, the 'no salvage surgery needed' and 'no additional treatment needed' criteria for treatment success need to be complemented by the radiologic data.

  16. Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

    PubMed Central

    Engsig, Magaly; Søholm, Helle; Folke, Fredrik; Gadegaard, Peter J; Wiis, Julie Therese; Molin, Rune; Mohr, Thomas; Engsig, Frederik N

    2016-01-01

    Objective The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. Design, setting, and patients Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed. Measurements Primary endpoints were survival to hospital discharge and long-term survival. Secondary endpoint was neurological outcome assessed using the Pittsburgh cerebral performance category (CPC). Results A total of 282 patients were included in this study; 233 (83%) OHCA and 49 (17%) IHCA. The IHCA group presented more often with asystole, received bystander cardiopulmonary resuscitation (CPR) in all cases, and had shorter time to return of spontaneous circulation (ROSC). Survival to hospital discharge was 54% for OHCA and 53% for IHCA (adjusted odds ratio 0.98 [95% confidence interval {CI}; 0.43–2.24]). Age ≤60 years, bystander CPR, time to ROSC ≤10 min, and shockable rhythm at presentation were associated with survival to hospital discharge. Good neurologic outcome among survivors was achieved by 86% of OHCA and 92% of IHCA (P=0.83). After a median follow-up time of >5 years, 83% of OHCA and 77% of IHCA were alive (adjusted hazard ratio [HR] 1.51 [95% CI; 0.59–3.91]). Age ≤60 years was the only factor associated with long-term survival (adjusted HR 2.73 [95% CI; 1.36–5.52]). Conclusion There was no difference in short- and long-term survival and no difference in neurologic outcome to hospital discharge between IHCA and OHCA patients treated with TTM despite higher frequency of asystole in IHCA. PMID:27877067

  17. CQESTR Simulation of Soil Organic Matter Dynamics in Long-term Agricultural Experiments across USA

    NASA Astrophysics Data System (ADS)

    Gollany, H.; Liang, Y.; Albrecht, S.; Rickman, R.; Follett, R.; Wilhelm, W.; Novak, J.

    2009-04-01

    Soil organic matter (SOM) has important chemical (supplies nutrients, buffers and adsorbs harmful chemical compounds), biological (supports the growth of microorganisms and micro fauna), and physical (improves soil structure and soil tilth, stores water, and reduces surface crusting, water runoff) functions. The loss of 20 to 50% of soil organic carbon (SOC) from USA soils after converting native prairie or forest to production agriculture is well documented. Sustainable management practices for SOC is critical for maintaining soil productivity and responsible utilization of crop residues. As crop residues are targeted for additional uses (e.g., cellulosic ethanol feedstock) developing C models that predict change in SOM over time with change in management becomes increasingly important. CQESTR, pronounced "sequester," is a process-based C balance model that relates organic residue additions, crop management and soil tillage to SOM accretion or loss. The model works on daily time-steps and can perform long-term (100-year) simulations. Soil organic matter change is computed by maintaining a soil C budget for additions, such as crop residue or added amendments like manure, and organic C losses through microbial decomposition. Our objective was to simulate SOM changes in agricultural soils under a range of soil parent materials, climate and management systems using the CQESTR model. Long-term experiments (e.g. Champaign, IL, >100 yrs; Columbia, MO, >100 yrs; Lincoln, NE, 20 yrs) under various tillage practices, organic amendments, crop rotations, and crop residue removal treatments were selected for their documented history of the long-term effects of management practice on SOM dynamics. Simulated and observed values from the sites were significantly related (r2 = 94%, P < 0.001) with slope not significantly different from 1. Recent interest in crop residue removal for biofuel feedstock prompted us to address that as a management issue. CQESTR successfully simulated a

  18. Tracer experiment results during the Long-Term Flow Test of the Fenton Hill reservoir

    SciTech Connect

    Rodrigues, N.E.V.; Robinson, B.A.; Counce, D.A.

    1993-02-01

    Three chemical tracer experiments and one extended injection of fluid low in concentration of dissolved species have been carried out during the Long Term Flow Test (LTFT) of the Fenton Hill Hot Dry Rock (HDR) reservoir. The tracer tests,results illustrate the dynamic nature of the flow system, with more fluid traveling through longer residence time paths as heat is extracted. The total fracture volumes calculated from these tests allow us to determine the fate of unrecovered injection fluid, examine the pressure-dependence of fracture volume, and, through a comparison to the hydraulic performance, postulate a model for the nature of the pressure drops through the system. The Fresh Water Flush (FWF) test showed that while no dissolved specie behavior is truly conservative (no sources or sinks), several breakthrough curves are well explained with a pore fluid displacement model. Other dissolved components are clearly influenced by dissolution or precipitation reactions. Finally, the transient response of the chemistry during the FWF to an increase in production well pressure showed that some fractures connected to the production well preferentially open when pressure is raised.

  19. Video tracking algorithm of long-term experiment using stand-alone recording system

    NASA Astrophysics Data System (ADS)

    Chen, Yu-Jen; Li, Yan-Chay; Huang, Ke-Nung; Jen, Sun-Lon; Young, Ming-Shing

    2008-08-01

    Many medical and behavioral applications require the ability to monitor and quantify the behavior of small animals. In general these animals are confined in small cages. Often these situations involve very large numbers of cages. Modern research facilities commonly monitor simultaneously thousands of animals over long periods of time. However, conventional systems require one personal computer per monitoring platform, which is too complex, expensive, and increases power consumption for large laboratory applications. This paper presents a simplified video tracking algorithm for long-term recording using a stand-alone system. The feature of the presented tracking algorithm revealed that computation speed is very fast data storage requirements are small, and hardware requirements are minimal. The stand-alone system automatically performs tracking and saving acquired data to a secure digital card. The proposed system is designed for video collected at a 640×480 pixel with 16 bit color resolution. The tracking result is updated every 30 frames/s. Only the locomotive data are stored. Therefore, the data storage requirements could be minimized. In addition, detection via the designed algorithm uses the Cb and Cr values of a colored marker affixed to the target to define the tracked position and allows multiobject tracking against complex backgrounds. Preliminary experiment showed that such tracking information stored by the portable and stand-alone system could provide comprehensive information on the animal's activity.

  20. Recent results of comparative radiobiological experiments with short and long term expositions of Arabidopsis seed embryos

    NASA Astrophysics Data System (ADS)

    Zimmermann, M. W.; Gartenbach, K. E.; Kranz, A. R.; Baican, B.; Schopper, E.; Heilmann, C.; Reitz, G.

    1996-01-01

    Comparison of experimental data obtained from short (SDEF) and long duration exposure flights (LDEF) recently led to results, which will contribute for the estimation of genetic risk for long and/or repeated stay of man in space. Under orbital conditions biological stress and damage are induced in test subjects by cosmic radiation, especially the high energetic, densely ionizing component of heavy ions. Plant seeds were successful model systems for a biotest in studying the physiological damages and mutagenic effects caused by ionizing radiation in particular stem cells. In this article we present an overview of our space experiments with Arabidopis thaliana seeds. We present first results of investigations on certain damage endpoints (seed germination, plant survival, mutation frequencies), caused by cosmic ionizing radiation in dry dormant plant seeds ofArabidopsis thaliana after different short term (e.g. IML-1 and D-2) and long term (e.g. EURECA and LDEF-1) space exposures. Total dose effects of heavy ions and the other components of the mixed radiation field on damage endpoints and survival after space exposure and gamma-ray pre-irradiation were obtained. A new method of total dose spectrometry by neutron activation has been applied.

  1. Experience using central venous access for long-term hemodialysis. A new concept.

    PubMed

    McGonigle, D J; Schrock, L G; Hickman, R O

    1983-05-01

    Central venous access for acute renal failure has been used for a number of years. The femoral vein and, more recently, the subclavian vein have been the routes of access. This technique has many advantages, however, it also has some significant limitations. We have recently been using a catheter for long- as well as short-term hemodialysis. The catheter is placed by means of a short incision through an opening in the internal jugular vein, and maneuvered so that the tip lies in the superior portion of the right atrium. After dialysis, the catheter is filled with heparin. The catheter then requires no additional care between between hemodialysis sessions. We have reported an experience of 50 patients in whom this catheter has been used. The complications have been remarkably few, and none were serious or fatal. At present, the patient using the catheter for the longest period of time has had it in position for approximately 19 months. We believe this technique provides a significant new choice among the ways in which hemodialysis can be achieved for short- or long-term needs.

  2. The personal significance of home: habitus and the experience of receiving long-term home care.

    PubMed

    Angus, Jan; Kontos, Pia; Dyck, Isabel; McKeever, Patricia; Poland, Blake

    2005-03-01

    The physical, symbolic and experiential aspects of receiving long-term care are examined in this paper using Bourdieu's concepts of habitus and field. We draw on data from an ethnographic study of home care in 16 homes in urban, rural and remote locations in Ontario, Canada. Across all cases, data about domestic and caregiving routines were gathered through observation, interviews with clients and/or the primary family caregiver, interviews with service providers and videotaped tours of the home. Based on the analysis of these data, we argue that a transposition of logics and practices occurred when the domestic and health care fields were superimposed within the spaces of the home. Although all of the care recipients and their family caregivers indicated a strong preference for home care over institutional care, their experiences and practices within their homes were disrupted and reconfigured by the insertion of logics emanating from the healthcare field. These changes were manifested in three main themes: the politics of aesthetics; the maintenance of order and cleanliness; and transcending the limitations of the home. In each of these dimensions, it became apparent that care recipients engaged in improvisatory social practices that reflected their ambiguous and changing habitus or social location. The material spaces of their homes signified, or prompted, altered or changing social placement.

  3. A Natural Electromagnetic Fields Effect on Healthy Volunteers During Long-Term Experiment with Isolation

    NASA Astrophysics Data System (ADS)

    Gurfinkel, Yury I.; Mikhailov, Valery M.; Ushakov, Boris B.

    2008-06-01

    There were investigated four healthy volunteers at the age of 37, 40, 41 and 48 during the baseline 240-d isolation period starting from July 3, 1999 in the frame of SFINCSS-99 - "SIMULATION OF FLIGHT OF INTERNATIONAL CREW ON SPACE STATION". Before a starting of experiment with long-term isolation were carried out measurements of magnetic properties of module and sleeping places. With the regularity of 3 times a week each subject made records of no less then 3 video episodes with the total length of one minute minimum at the same time between 1 and 2 p.m. Applying vital non-invasive computer capillaroscopy of nailbed has allowed quantitatively estimating a capillary blood velocity (CBV). The microcirculation parameters obtained during experiment were compared to local indexes of geomagnetic activity. About 1500 episodes were recorded on laser disks and analyzed. Parameters of microcirculation were compared with other physiological parameters monitored in the experiment. CBV investigation during the most intensive magnetic storm for the period of isolation (A-index- 44) show, that CBV at all volunteers was considerably slowed down. The greatest delay of blood flow velocity revealed at the subject which the factor of shielding of a constant magnetic field at the level of the sleeping berth has made 2,0. CBV at the subject has made 498 ± 46 μm/s with (- 65,8 % from base line). Least delay of a CBV is revealed at the subject which the factor of shielding of a constant magnetic field at the level of the sleeping berth has made 3, 15 (-12 % from base line).

  4. [Oxidation Stress Markers Dynamics in the Experiment of Long-Term Antiorthostatic Hypokinesia (Retrospective Study)].

    PubMed

    Zhuravlyova, O A; Markin, A A; Kuzichkin, D S; Loginov, V I; Zabolotskaya, I V; Vostrikova, L V

    2016-01-01

    In blood serum of 9 volunteers aged 27 to 42, participated in the experiment with 370-day antiorthostatic hypokinesia (-5 degrees), the lipid peroxidation derivates concentration--diene conjugates (DC), malonic dialdehyde (MDA), Schiff bases (SB) as well as antioxidant defense system indices--tocopherol (TP) concentration and total antioxidative activity level (AOA) were measured. The volunteers were divided into two groups subjected to physical training regimes and used prophylactic measures. In both groups the lipoperoxidation processes initial stages depression (by 54-73%) was observed starting from 50th day, thus the lipid peroxidation final product--SB level was decreased (by 50-61%) only to the 230 day and remains approximately at the same level till the end of the experiment. The restorative period was characterized by decreasing (in 1.6-2.3 times) of MDA and SB concentrations. The decrease in lotal AOA during the aftereffect period was detected in all volunteers, and its level was significantly lower physiological norm range. Probably, long-term adaptation to the simulated weightlessness conditions is accompanied by expressed decrease in biological oxidation processes intensity and significant stress effect, as indicates by essential depression of lipid free radical oxidation in the course of the experiment. At the same time the restorative period after 370-day antiorthostatic hypokinesia was characterized by significantly expressed and prolonged readaptation stress progress. It is evidenced by practically twofold decrease in lipoperoxidation processes intensity against significant increase in TP concentration and water-soluble antioxidants functional reserves exhaustion. Lipid peroxidation activation absence in all terms of examination reflects appropriate compensation of studying impact by volunteers.

  5. Migrant care workers or migrants working in long-term care? A review of Australian experience.

    PubMed

    Howe, Anna L

    2009-01-01

    Discussion of the role of migrant care workers in long-term care (LTC) that has gained increasing attention in the United States and other developed countries in recent years is of particular relevance to Australia, where 24% of the total population is overseas-born, two-thirds of them coming from countries where English is not the primary language. Issues of interest arise regarding meeting LTC workforce demands in general and responding to the particular cultural and linguistic needs of postwar immigrants who are now reaching old age in increasing numbers. This review begins with an account of the overseas-born components of the aged care workforce and then examines this representation with reference to the four factors identified as shaping international flows of care workers in the comparative study carried out for the AARP Public Policy Institute in 2005: migration policies, LTC financing arrangements, worker recruitment and training, and credentialing. The ways in which these factors play out in Australia mean that while overseas-born workers are overrepresented in the LTC workforce, migrant care workers are not identifiable as a marginalized group experiencing disadvantage in employment conditions, nor do they offer a solution to workforce shortages. The Australian experience is different from those of other countries in many respects, but it does show that the experience of migrant care workers is not unique to LTC and points to the need to extend the search for solutions to workforce shortages and improving conditions of all care workers well beyond LTC systems to wider policy settings.

  6. Long-term lysimeter experiment to analyze the influence of the climate change on matter fluxes

    NASA Astrophysics Data System (ADS)

    Pütz, Thomas; Groh, Jannis; Wollschläger, Ute; Gerke, Horst; Priesack, Eckart; Kiese, Ralf; Borg, Erik; Vereecken, Harry

    2015-04-01

    Based on the TERENO SoilCan infrastructure, a long-term large-scale experiment was designed to study the effects of climate change on terrestrial systems. The water and matter fluxes in soil are the main focuses of SoilCan. In the frame of SoilCan, fully automated lysimeter systems were installed on several highly equipped experimental field sites of the TERENO-observatories and the relevant status variables of each ecosystem were monitored (e.g. climate, hydrology, biosphere-atmosphere exchange, biodiversity, etc.). In total, 90 lysimeters (1.5 m depth, 1m2 surface) were filled with soil monoliths at the four TERENO-observatories and were instrumented with TDRs, tensiometers, temperature sensors, soil heat flux plates, and CO2 sensors. For the controlling of the lower boundary condition, suction candle rakes were installed into the lysimeter bottoms. In combination with bi-directional pumps and tanks, the water content of the lysimeters was adjusted to the surrounded original field sites. To simulate the expected climate change, 48 lysimeters were transferred along temperature and rainfall gradients within the respective observatories and between the observatories, based on the principle 'Space for Time'. In case of the "Rur" observatory, three intensively instrumented field sites ("Wüstebach", "Rollesbroich" und "Selhausen") were equipped with lysimeter stations. These three field sites include different land uses, "Wüstebach" as a forest site, "Rollesbroich" as a grassland and "Selhausen" as an arable site. In order to standardize the agronomic management, the crop rotation at the arable lysimeters comprised winter wheat - winter rye - winter barley - oats. For investigation of the matter flux, soil solutions and leachates were regularly sampled. The water balances and the dynamics of the carbon and nitrogen fluxes in the first two years of the experiment will be presented.

  7. How Schools Can Help Students Recover from Traumatic Experiences: A Tool Kit for Supporting Long-Term Recovery. Technical Report

    ERIC Educational Resources Information Center

    Jaycox, Lisa H.; Morse, Lindsey K.; Tanielian, Terri; Stein, Bradley D.

    2006-01-01

    This tool kit is designed for schools that want to help students recover from traumatic experiences such as natural disasters, exposure to violence, abuse or assault, terrorist incidents, and war and refugee experiences. It focuses on long-term recovery, as opposed to immediate disaster response. To help schools choose an approach that suits their…

  8. Long-Term CO2 Exposure Experiments - Geochemical Effects on Brine-Saturated Reservoir Sandstone

    NASA Astrophysics Data System (ADS)

    Fischer, Sebastian; Zemke, Kornelia; Liebscher, Axel; Wandrey, Maren

    2010-05-01

    The injection of CO2 into deep saline aquifers is the most promising strategy for the reduction of CO2 emissions to the atmosphere via long-term geological storage. The study is part of the CO2SINK project conducted at Ketzin, situated 40 km west of Berlin. There, food grade CO2 has been pumped into the Upper Triassic Stuttgart Formation since June 2008. The main objective of the experimental program is to investigate the effects of long-term CO2 exposure on the physico-chemical properties of the reservoir rock. To achieve this goal, core samples from observation well Ktzi 202 have been saturated with synthetic brine and exposed to CO2 in high quality steel autoclaves at simulated reservoir P-T-conditions of 5.5 MPa and 40 ° C. The synthetic brine had a composition representative of the formation fluid (Förster et al., 2006) of 172.8 g/l NaCl, 8.0 g/l MgCl2×2H2O, 4.8 g/l CaCl2×2H2O and 0.6 g/l KCl. After 15 months, the first set of CO2-exposed samples was removed from the pressure vessels. Thin sections, XRD, SEM as well as EMP data were used to determine the mineralogical features of the reservoir rocks before and after the experiments. Additionally, NMR relaxation and MP was performed to measure poroperm and pore size distribution values of the twin samples. The analyzed samples are fine- to medium grained, moderately well- to well sorted and weakly consolidated sandstones. Quartz and plagioclase are the major components, while K-feldspar, hematite, white & dark mica, chlorite and illite are present in minor and varying amounts. Cements are composed of analcime, dolomite and anhydrite. Some samples show mm- to cm-scale cross-beddings. The laminae comprise lighter, quartz- and feldspar-dominated layers and dark-brownish layers with notably less quartz and feldspars. The results are consistent with those of Blaschke et al. (2008). The plagioclase composition indicates preferred dissolution of the Ca-component and a trend toward albite-rich phases or even pure

  9. A Performance Analysis of Long-term Acute-Care Hospitals Owned by Large, Multistate Investor-Owned Companies.

    PubMed

    Nayar, Preethy; Liu, Xinliang; McCue, Michael J

    2016-01-01

    This study provides a descriptive assessment of the operating performance of for-profit long-term acute-care hospitals owned by multistate, investor-owned companies (large FP LTCHs) compared with FP LTCHs owned by smaller FP companies (small FP LTCHs) and nonprofit LTCHs (NP LTCHs). The study used the Centers for Medicare & Medicaid Services cost report data for 290 LTCHs from 2010 through 2012 to compare the financial performance of large and small FP LTCHs and NP LTCHs. The study found that the median operating profit margin for large FP LTCHs was 8.06%, which was twice as high as that of the small FP LTCHs and NP LTCHs (4.78% and 2.80%, respectively). Larger size, serving a greater proportion of private pay and more complex patients and incurring lower operating expenses, including salary expenses, may account for the higher operating margin of the large FP LTCHs.

  10. Fertilization effects on soil organic matter turnover in a long term experiment

    NASA Astrophysics Data System (ADS)

    Gioacchini, Paola; Giordani, Gianni; Montecchio, Daniela; Nastri, Anna; Triberti, Loretta; Baldoni, Guido; Ciavatta, Claudio

    2010-05-01

    Agricultural management practices such as residues application, level and kind of fertilization and amendment, tillage intensity can affect the capacity of soil to sequester and incorporate carbon (C). These practices also influence both above-ground and below-ground plant production and, as a consequence, the amount of C that enters the soil. However, studing the dyamics of C inputs in soils and the effects of the agricultural management practices on C incorporation in soil organic matter (SOM) requires long-term field experiments. The long-term field experiment in Cadriano, at the University of Bologna, Italy, started in 1966 and still in progress, compares two continuous rotations of corn and wheat, interacting with two cattle manure supplies (M0: no manure - M1: 20 t ha-1 year-1 of fresh material) and two mineral NP rates (N0P0: no NP fertilizers - N1P1: 100 kg P2O5 ha-1 plus 200 and 300 kg N ha-1 for wheat and maize, respectively). The experimental design is a split-plot replicated twice, with fertilizer sub-plots of 56 m2 of area each. The field is annually ploughed to 40 cm depth. Crop residues are always removed, with the exception of roots and stubbles. By using the delta 13C technique we measured the amount of corn-derived C retained over a 36-years period in total soil organic C (SOC) and in the humic fraction that is referred as the most stable pool of SOC. These amounts were compared with the total inputs of belowground C (roots and rhizodepositions) in order to highlight if the capacity of soil to stabilize the new C inputs can be affected by the different fertilization practices. The results showed that the amount of corn-derived C in SOC increased in the following order: control (20.5%), Mineral (25%) Manure (29.4%), the same trend was observed for the humic fraction. On the contrary the cumulative C input over the same period followed a different order, the highest was obtained for the mineral treatment, than for the manure and the control

  11. Long-Term Results after Surgical Treatment of Ebstein's Anomaly: a 30-year Experience

    PubMed Central

    Kim, Min-Seok; Lim, Hong-Gook; Kim, Woong Han; Lee, Jeong Ryul

    2016-01-01

    Background and Objectives The aim of the study is to evaluate the long-term results after a surgical repair of Ebstein's anomaly. Subjects and Methods Forty-eight patients with Ebstein's anomaly who underwent open heart surgery between 1982 and 2013 were included. Median age at operation was 5.6 years (1 day-42.1 years). Forty-five patients (93.7%) demonstrated tricuspid valve (TV) regurgitation of less than moderate degree. When the patients were divided according to Carpentier's classification, types A, B, C, and D were 11, 21, 12, and 4 patients, respectively. Regarding the type of surgical treatment, bi-ventricular repair (n=38), one-and-a half ventricular repair (n=5), and single ventricle palliation (n=5) were performed. Of 38 patients who underwent a bi-ventricular repair, TV repairs were performed by Danielson's technique (n=20), Carpentier's technique (n=11), Cone repair (n=4), and TV annuloplasty (n=1). Two patients underwent TV replacement. Surgical treatment strategies were different according to Carpentier's types (p<0.001) and patient's age (p=0.022). Results There were 2 in-hospital mortalities (4.2%; 1 neonate and 1 infant) and 2 late mortalities during follow-up. Freedom from recurrent TV regurgitation rates at 5, 10, and 15 years were 88.6%, 66.3%, 52.7%, respectively. TV regurgitation recurrence did not differ according to surgical method (p=0.800). Survival rates at 5, 10, and 20 years were 95.8%, 95.8%, and 85.6%, respectively, and freedom from reoperation rates at 5, 10, and 15 years were 85.9%, 68.0%, and 55.8%, respectively. Conclusion Surgical treatment strategies were decided according to Carpentier's type and patient's age. Overall survival and freedom from reoperation rates at 10 years were 95.8% and 68.0%, respectively. Approximately 25% of patients required a second operation for TV during the follow-up. PMID:27721863

  12. Towards a smart experimental arena for long-term electrophysiology experiments.

    PubMed

    Jow, Uei-Ming; Kiani, Mehdi; Huo, Xueliang; Ghovanloo, Maysam

    2012-10-01

    Wireless power and data transmission have created promising prospects in biomedical research by enabling perpetual data acquisition and stimulation systems. We present a work in progress towards such a system, called the EnerCage, equipped with scalable arrays of overlapping planar spiral coils (PSC) and 3-axis magnetic sensors for focused wireless power transmission to randomly moving targets, such as small freely behaving animal subjects. The EnerCage system includes a stationary unit for 3D non-line-of-sight localization and inductive power transmission through a geometrically optimized PSC array. The localization algorithm compares the magnetic sensor outputs with a threshold to activate a PSC. All PSCs are optimized based on the worst-case misalignment, considering parasitics from the overlapping and adjacent PSCs. EnerCage also has a mobile unit attached to or implanted in the subject's body, which includes a permanent magnetic tracer for localization and back telemetry circuit for efficient closed-loop inductive power regulation. The EnerCage system is designed to enable long-term electrophysiology experiments on freely behaving small animal subjects in large experimental arenas without requiring them to carry bulky batteries. A prototype of the EnerCage system with five PSCs and five magnetic sensors achieved power transfer efficiency (PTE) of 19.6% at the worst-case horizontal misalignment of 49.1 mm (√1/3 of the PSC radius) and coupling distance of 78 mm with a mobile unit coil, 20 mm in radius. The closed-loop power management mechanism maintains the mobile unit received power at 20 mW despite misalignments, tilting, and distance variations up to a maximum operating height of 120 mm (PTE = 5%).

  13. An investigation of ESSA 7 radiation data for use in long-term earth energy experiments, phases 1 and 2

    NASA Technical Reports Server (NTRS)

    House, F. B.

    1974-01-01

    The results are presented of an investigation of ESSA 7 satellite radiation data for use in long-term earth energy experiments. Satellite systems for performing long-term earth radiation balance measurements over geographical areas, hemispheres, and the entire earth for periods of 10 to 30 years are examined. The ESSA 7 satellite employed plate and cone radiometers to measure earth albedo and emitted radiation. Each instrument had a black and white radiometer which discriminated the components of albedo and emitted radiation. Earth measurements were made continuously from ESSA 7 for ten months. The ESSA 7 raw data is processed to a point where it can be further analyzed for: (1) development of long-term earth energy experiments; and (2) document climate trends.

  14. Japanese Experience with Long-term Recovery from the 2011 Tohoku Earthquake and Tsunami Disaster

    NASA Astrophysics Data System (ADS)

    Hayashi, H.

    2015-12-01

    On March 11, 2011, a huge tsunami disaster hit Pacific coast of Tohoku region due to a magnitude of 9.0 earthquake, and killed almost 20,000 people. It was also the beginning of long-term recovery to prepare for next tsunami attack in the future. In this presentation, I would like to review the recovery process from the following five elements: quantification of tsunami hazards, public education, evacuation model, land-use planning, and real-time tsunami warning. It should be noted that there are lessons from the 2011 event at two different levels: national level and prefecture levels. In relation to the quantification of tsunami hazard and real-time tsunami warning, it followed a big change in tsunami policy at national level such as setting up two levels of tsunami scenarios for tsunami preparedness and mitigation: Level 1 tsunami (L1) and Level 2 tsunami (L2). L1 is the tsunami risk with 50 year return period, and L2 is the one with 1,000 year return period. As for public education, evacuation model, and land-use planning, There existed a big difference for what happened in the northern half of the coast and the southern half. Northern half of the coast belongs to Iwate Prefecture whose geography is rias coast. People in the Rias coast of Iwate Prefecture has been hit many times by tsunami on the average of about 50 years. With these many experiences, they succeeded in reducing the number of mortality down to 4,000 in comparison with 20,000 at the 1886 tsunami disaster. Most of the Southern half belongs to Miyagi Prefecture whose geography is coastal plain. People in the coastal plain in Miyagi Prefecture has little experience with tsunami disaster and end up with 14,000 deaths due to tsunami attack. The differences in the past tsunami experiences in these two prefectures resulted in big differences in public education, evacuation model, and land-use planning.

  15. Study Abroad for Global Engagement: The Long-Term Impact of Mobility Experiences

    ERIC Educational Resources Information Center

    Paige, R. Michael; Fry, Gerald W.; Stallman, Elizabeth M.; Josic, Jasmina; Jon, Jae-Eun

    2009-01-01

    This paper reports on the preliminary results of a research project "'Beyond immediate impact: Study abroad for global engagement' (SAGE)" which examines the long-term impact of study abroad on various forms of global engagement. The study employs a retrospective tracer study and mixed methods research design. Survey results from 6391 study-abroad…

  16. The Long Term Implication of RTLB Support: Listening to the Voices of Student Experiences

    ERIC Educational Resources Information Center

    Pillay, Poobie; Flanagan, Paul

    2011-01-01

    Resource Teachers: Learning and Behaviour (RTLB) have supported more than 15,000 students since RTLB 1999 by assisting teachers to manage and support students with learning or behaviour difficulties within inclusive classroom environments. Research indicates that there are long term positive educational effects for students receiving short-term…

  17. Long-Term Impacts of Faculty Development Programs: The Experience of Teli and Piedmont

    ERIC Educational Resources Information Center

    Barlett, Peggy F.; Rappaport, Ann

    2009-01-01

    A long-term study of two faculty development programs on sustainability and the environment reveals enduring changes in teaching, research, interdisciplinary collaboration, and engaged action. Participants in cohorts of Tufts University's Environmental Literacy Institute (12-16 years ago) and Emory University's Piedmont Project (1-5 years ago)…

  18. Simulating Soil Organic Carbon Dynamics in Long-term Agricultural Experiments Using CQESTR

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil carbon (C) models are useful for examining the complex interactions between climate, crop, and soil management practices and their influences on long-term changes in soil organic carbon (SOC). The CQESTR model was developed to evaluate the effect of agricultural management practices on short- a...

  19. Rett syndrome: long-term clinical follow-up experiences over four decades.

    PubMed

    Hagberg, Bengt

    2005-09-01

    Long-term clinical profiles of female patients with classic Rett syndrome are presented and exemplified by three cases, as experienced over four decades. Emphasized is the frequently surprisingly well-preserved eye contact and primitive memory, in contrast to a premature neuromuscular aging and often advanced peripheral atrophy, usually combined with dystonic-rigid signs that are predominantly right sided.

  20. Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.

    PubMed

    Johnston, David W; Shields, Michael A; Siminski, Peter

    2016-01-01

    This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected.

  1. Analysis of in hospital mortality and long-term survival excluding in hospital mortality after open surgical repair of ruptured abdominal aortic aneurysm

    PubMed Central

    Gwon, Jun Gyo; Cho, Yong-Pil; Han, Young Jin; Noh, Min Su

    2016-01-01

    Purpose The aim of this study was to confirm the factors that affect the mortality associated with the open surgical repair of ruptured abdominal aortic aneurysm (rAAA) and to analyze the long-term survival rates. Methods A retrospective review was performed on a prospectively collected database that included 455 consecutive patients who underwent open surgical repair for AAA between January 2001 and December 2012. We divided our analysis into in-hospital and postdischarge periods and analyzed the risk factors that affected the long-term survival of rAAA patients. Results Of the 455 patients who were initially screened, 103 were rAAA patients, and 352 were non-rAAA (nAAA) patients. In the rAAA group, 25 patients (24.2%) died in the hospital and 78 were discharged. Long-term survival was significantly better in the nAAA group (P = 0.001). The 2-, 5-, and 10-year survival rates of the rAAA patients were 87%, 73.4%, and 54.1%, respectively. Age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02–.08; P < 0.001) and aneurysm rupture (HR, 1.96; 95% CI, 1.12–.44; P = 0.01) significantly affected long-term survival. Conclusion Preoperative circulatory failure is the most common cause of death for in-hospital mortality of rAAA patients. After excluding patients who have died during the perioperative period, age is the only factor that affects the survival of rAAA patients. PMID:27904852

  2. Long-term geoelectrical monitoring of laboratory freeze-thaw experiments on bedrock samples

    NASA Astrophysics Data System (ADS)

    Kuras, Oliver; Uhlemann, Sebastian; Murton, Julian; Krautblatter, Michael

    2014-05-01

    Much attention has recently focussed on the continuous and near-real-time geophysical monitoring of permafrost-affected bedrock with permanently installed sensor arrays. It is hoped that such efforts will enhance process understanding in such environments (permafrost degradation, weathering mechanisms) and augment our capability to predict future instabilities of rock walls and slopes. With regard to electrical methods for example, recent work has demonstrated that temperature-calibrated electrical resistivity tomography (ERT) is capable of imaging recession and re-advance of rock permafrost in response to the ambient temperature regime. However, field experience also shows that several fundamental improvements to ERT methodology are still required to achieve the desired sensitivity, spatial-temporal resolution and long-term robustness that must underpin continuous geophysical measurements. We have applied 4D geoelectrical tomography to monitoring laboratory experiments simulating permafrost growth, persistence and thaw in bedrock over a period of 26 months. Six water-saturated samples of limestone and chalk of varying porosity represented lithologies commonly affected by permafrost-related instability. Time-lapse imaging of the samples was undertaken during multiple successive freeze-thaw cycles, emulating annual seasonal change over several decades. Further experimental control was provided by simultaneous measurements of vertical profiles of temperature and moisture content within the bedrock samples. These experiments have helped develop an alternative methodology for the volumetric imaging of permafrost bedrock and tracking active layer dynamics. Capacitive resistivity imaging (CRI), a technique based upon low-frequency, capacitively-coupled measurements emulates ERT methodology, but without the need for galvanic contact on frozen rock. The latter is perceived as a key potential weakness, which could lead to significant limitations as a result of the variable

  3. Spotlight on "Long-Term English Language Learners": Characteristics and Prior Schooling Experiences of an Invisible Population

    ERIC Educational Resources Information Center

    Menken, Kate; Kleyn, Tatyana; Chae, Nabin

    2012-01-01

    This article presents qualitative research findings about the characteristics and prior schooling experiences of "long-term English language learners" (LTELLs), who have attended U.S. schools for 7 years or more, and about whom there is little empirical research, despite their significant numbers. Findings indicate that these students are orally…

  4. "It Is Just Habitual": An Interpretative Phenomenological Analysis of the Experience of Long-Term Recovery from Addiction

    ERIC Educational Resources Information Center

    Shinebourne, Pnina; Smith, Jonathan A.

    2011-01-01

    This study explores experiences and understandings of people who have engaged with the process of recovery from alcohol or drug problems over a long period of time. Although there is a large body of research studies on recovery, few have examined long-term recovery from a qualitative perspective. The participants in this study were women who have…

  5. The long-term agroecological research (LTAR) experiment in Iowa: Organic resilience in soil quality and profitability

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Long-Term Agroecological Research (LTAR) experiment, at the Iowa State University Neely-Kinyon Farm in Greenfield, Iowa, was established in 1998 to compare the agronomic, ecological, and economic performance of conventional and organic cropping systems. The certified organic systems are designed...

  6. Subplots facilitate assessment of corn yield losses from weed competition in a long-term systems experiment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Weeds can potentially limit crop yield, particularly in organic systems where herbicide technologies are unavailable. Weedy and weed-free subplots were established within full plots of a long-term cropping systems experiment, the Farming Systems Project, at Beltsville, Maryland, USA, to determine t...

  7. The Experiences of Long-Term Unemployed Young Adults in the South West of England: Some New Insights

    ERIC Educational Resources Information Center

    Lawy, Robert; Wheeler, Rachel

    2013-01-01

    In this paper we explore the experiences of three long-term unemployed young adults from different backgrounds in the 18-24 age range. The data comprise three interviews conducted over an 18-month period with seven of the original 19 participants in the research. At the time of first interview none of the young adults had been in education,…

  8. Long-Term Outcomes of an Antimicrobial Stewardship Program Implemented in a Hospital with Low Baseline Antibiotic Use

    PubMed Central

    Jenkins, Timothy C.; Knepper, Bryan C.; Shihadeh, Katherine; Haas, Michelle K.; Sabel, Allison L.; Steele, Andrew W.; Wilson, Michael L.; Price, Connie S.; Burman, William J.; Mehler, Philip S.

    2016-01-01

    Objective To evaluate the long-term outcomes of an antimicrobial stewardship program (ASP) implemented in a hospital with low baseline antibiotic use Design Quasi-experimental, interrupted-time series study Setting 525-bed public safety-net hospital Intervention Implementation of a formal ASP in July 2008 Methods We conducted a time-series analysis to evaluate the impact of the ASP over a 6.25-year period (July 1, 2008 – September 30, 2014) while controlling for trends during a 3-year preintervention period (July 1, 2005 – June 30, 2008). The primary outcome measures were total antibacterial and antipseudomonal use in days of therapy (DOT) per 1000 patient-days (PD). Secondary outcomes included antimicrobial costs and resistance, hospital-onset C. difficile infection, and other patient-centered measures. Results During the preintervention period, total antibacterial and antipseudomonal use were declining (−9.2 and −5.5 DOT/1000 PD per quarter, respectively). During the stewardship period, both continued to decline, although at lower rates (−3.7 and −2.2 DOT/1000 PD, respectively), resulting in a slope change of 5.5 DOT/1000 PD per quarter for total antibacterial use (P = .10) and 3.3 DOT/100 PD per quarter for antipseudomonal use (P = .01). Antibiotic expenditures declined markedly during the stewardship period (−$295.42/1000PD per quarter, p=.002). There were variable changes in antimicrobial resistance and few apparent changes in C. difficile infection and other patient-centered outcomes. Conclusion In a hospital with low baseline antibiotic use, implementation of an ASP was associated with sustained reductions in total antibacterial and antipseudomonal use and declining antibiotic expenditures; however, this study highlights limitations of commonly used stewardship outcome measures. PMID:25740560

  9. Risk factors for recurrence of scabies: a retrospective study of scabies patients in a long-term care hospital.

    PubMed

    Makigami, Kuniko; Ohtaki, Noriko; Ishii, Norihisa; Tamashiro, Tetsuko; Yoshida, Sadao; Yasumura, Seiji

    2011-09-01

    A considerable number of patients suffer recurrence of scabies. To elucidate risk factors for recurrence of scabies, we compared patients who experienced scabies recurrence and those who suffered scabies only once. We conducted a retrospective review of medical records of all scabies patients in a long-term care hospital for the elderly (300 beds; six wards) for a period of 42 months to determine frequency of scabies onsets, underlying diseases, history of treatment, and demographic data such as age and sex. One hundred and forty-eight patients and five hospital staff members suffered scabies during the 42-month study period. All staff members and 98 patients had no recurrence, while 50 patients experienced at least one recurrence of scabies. The cumulative number of scabies diagnoses was 228. The rates of scabies onset and recurrence were considerably different among wards. The dementia unit showed the highest rate of onset and recurrence. In addition to frequent exposure to infectious sources, problematic behavior, such as lying in other patients beds, might cause the high recurrence rate in dementia units. Higher serum total lymphocyte count and topical use of γ-benzene hexachloride were associated with lower risk of scabies recurrence. Recurrence of scabies is not uncommon among elderly patients in institutional settings. Impaired immunity may be a risk factor for recurrence of scabies. Groups with a high onset rate of scabies pose a high likelihood of recurrence. Problematic behavior of demented patients may increase the risk of recurrence. Use of effective topical treatment may effectively prevent recurrence.

  10. Long-term flow-through column experiments and their relevance to natural granitoid weathering rates

    NASA Astrophysics Data System (ADS)

    White, Art F.; Schulz, Marjorie S.; Lawrence, Corey R.; Vivit, Davison V.; Stonestrom, David A.

    2017-04-01

    (fresh granitoids) or increased slowly with time (weathered granitoids). Analysis of cumulative Na release indicated that plagioclase dissolution achieved steady state in 3 of the 4 fresh granitoids during the last decade of reaction. Surface-area normalized plagioclase dissolution rates exhibited a narrow range (0.95-1.26 10-13 moles m-2 s-1), in spite of significant stoichiometric differences (An0.21 to An0.50). Rates were an order of magnitude slower than previously reported in shorter duration experiments but generally 2-3 orders of magnitude faster than corresponding natural analogs. CrunchFlow simulations indicated that more than a hundredfold decrease in column flow rates would be required to produce near-saturation reaction affinities that would start to slow plagioclase weathering to real-world levels. Extending simulations to approximate long term weathering in naturally weathered profiles required additional decreases in the intrinsic plagioclase dissolution and kaolinite precipitation rates and relatively large decreases in the fluid flow rate, implying that exposure to reactive mineral surfaces is significantly limited in the natural environment compared to column experiments.

  11. Long-term flow-through column experiments and their relevance to natural granitoid weathering rates

    USGS Publications Warehouse

    White, Arthur F.; Schulz, Marjorie S.; Lawrence, Corey R.; Vivit, Davison V.; Stonestrom, David A.

    2017-01-01

    reaction (fresh granitoids) or increased slowly with time (weathered granitoids). Analysis of cumulative Na release indicated that plagioclase dissolution achieved steady state in 3 of the 4 fresh granitoids during the last decade of reaction. Surface-area normalized plagioclase dissolution rates exhibited a narrow range (0.95 to 1.26 10-13 moles m-2 s-1), in spite of significant stoichiometric differences (An0.21 to An0.50). Rates were an order of magnitude slower than previously reported in shorter duration experiments but generally 2 to 3 orders of magnitude faster than corresponding natural analogs. CrunchFlow simulations indicated that more than a hundredfold decrease in column flow rates would be required to produce near-saturation reaction affinities that would start to slow plagioclase weathering to real-world levels. Extending simulations to approximate long term weathering in naturally weathered profiles required additional decreases in the intrinsic plagioclase dissolution and kaolinite precipitation rates and relatively large decreases in the fluid flow rate, implying that exposure to reactive mineral surfaces is significantly limited in the natural environment compared to column experiments.

  12. Progress in the treatment of chronic hepatitis B: long-term experience with adefovir dipivoxil.

    PubMed

    Delaney, William E

    2007-05-01

    Most chronic hepatitis B patients do not undergo a curative response to interferon-alpha or nucleoside/nucleotide-based regimens and require long-term therapy. Long-term safety, efficacy and resistance profiles of hepatitis B virus (HBV) drugs are therefore crucial issues for patient management. Adefovir dipivoxil is a nucleotide prodrug indicated for the treatment of patients with hepatitis B e antigen positive or hepatitis B e antigen negative chronic hepatitis B, lamivudine-resistant HBV infection, HBV infection pre- or post-liver transplantation, or HlV co-infection. Long-term data from clinical trials of up to 5 years duration of adefovir dipivoxil have recently become available and are reviewed here. These data demonstrate that adefovir dipivoxil therapy results in sustained efficacy and safety in the majority of patients after multiple years of treatment. The efficacy of adefovir dipivoxil in treating lamivudine-resistant HBV and the delayed emergence of adefovir resistance are key factors contributing to the durable response achieved in broad groups of chronic hepatitis B patients.

  13. Long-term consequences of traumatic experiences: an assessment of former political detainees in romania

    PubMed Central

    2005-01-01

    Background Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design. Methods A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms. Results Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD. Conclusion Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system. PMID:16185364

  14. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special payment provisions when an interruption of a stay occurs in a long-term care hospital. 412.531 Section 412.531 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...

  15. Preferences for long-term care services: willingness to pay estimates derived from a discrete choice experiment.

    PubMed

    Nieboer, Anna P; Koolman, Xander; Stolk, Elly A

    2010-05-01

    Ageing populations increase pressure on long-term care. Optimal resource allocation requires an optimal mix of care services based on costs and benefits. Contrary to costs, benefits remain largely unknown. This study elicits preferences in the general elderly population for long-term care services for varying types of patients. A discrete choice experiment was conducted in a general population subsample aged 50-65 years (N = 1082) drawn from the Dutch Survey Sampling International panel. To ascertain relative preferences for long-term care and willingness to pay for these, participants were asked to choose the best of two care scenarios for four groups of hypothetical patients: frail and demented elderly, with and without partner. The scenarios described long-term care using ten attributes based on Social Production Function theory: hours of care, organized social activities, transportation, living situation, same person delivering care, room for individual preferences, coordination of services, punctuality, time on waiting list, and co-payments. We found the greatest value was attached to same person delivering care and transportation services. Low value was attached to punctuality and room for individual preferences. Nursing homes were generally considered to be detrimental for well-being except for dementia patients without a partner. Overall, long-term care services were thought to produce greatest well-being for the patients 'without a partner' and those 'with dementia'. Individuals combining these two risk factors would benefit the most from all services except transportation which was considered more important for the frail elderly. The results support the notion that long-term care services represent different value for different types of patients and that the value of a service depends upon the social context. Examination of patient profiles confirmed the notion that physical, mental and social vulnerability affect valuation of the services. Policy

  16. Impact of long-term stress in Takotsubo syndrome: Experience of patients

    PubMed Central

    Wallström, Sara; Ulin, Kerstin; Määttä, Sylvia; Omerovic, Elmir; Ekman, Inger

    2015-01-01

    Background: The connection between stress and disease has been part of folk wisdom for a long time and has even made its way into our language with phrases such as ‘scared to death’ and ‘a broken heart’. Takotsubo syndrome is a form of acute, reversible heart failure characterized by ballooning of the left ventricle. Post-menopausal women are primarily affected, but cases have been described in both sexes and at all ages. The complete pathophysiology is unknown, but the disease has been connected to psychological or physical stress and a surge in catecholamines. Despite the strong connection with stress, knowledge about the life of patients before the onset of Takotsubo syndrome is lacking. Aim: The aim of this study was to describe and interpret patients’ narratives about long-term stress experienced before the onset of Takotsubo syndrome. Method: Nineteen people diagnosed with Takotsubo syndrome were interviewed. The narrative interviews were recorded and transcribed verbatim. The resulting texts were analysed using phenomenological hermeneutics. Results: The analysis revealed that the interviewees lived under stressful circumstances, characterized by feeling burdened by responsibilities, injustice and uncertainty, long before the onset of Takotsubo syndrome. This long-term stress wore down the defences of the interviewees to the degree that their capacity was exhausted and the smallest stressor could ‘tip them over the edge’. The findings indicated that the social structure of gender possibly contributed to the interviewees’ condition. Conclusions: These findings indicated that long-term stressful circumstances may cause vulnerability to acute psychological or physical stressors and, subsequently, to the onset of Takotsubo syndrome. PMID:26572162

  17. Duration of Colonization With Klebsiella pneumoniae Carbapenemase-Producing Bacteria at Long-Term Acute Care Hospitals in Chicago, Illinois

    PubMed Central

    Haverkate, Manon R.; Weiner, Shayna; Lolans, Karen; Moore, Nicholas M.; Weinstein, Robert A.; Bonten, Marc J. M.; Hayden, Mary K.; Bootsma, Martin C. J.

    2016-01-01

    Background. High prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae has been reported in long-term acute care hospitals (LTACHs), in part because of frequent readmissions of colonized patients. Knowledge of the duration of colonization with KPC is essential to identify patients at risk of KPC colonization upon readmission and to make predictions on the effects of transmission control measures. Methods. We analyzed data on surveillance isolates that were collected at 4 LTACHs in the Chicago region during a period of bundled interventions, to simultaneously estimate the duration of colonization during an LTACH admission and between LTACH (re)admissions. A maximum-likelihood method was used, taking interval-censoring into account. Results. Eighty-three percent of patients remained colonized for at least 4 weeks, which was the median duration of LTACH stay. Between LTACH admissions, the median duration of colonization was 270 days (95% confidence interval, 91–∞). Conclusions. Only 17% of LTACH patients lost colonization with KPC within 4 weeks. Approximately half of the KPC-positive patients were still carriers when readmitted after 9 months. Infection control practices should take prolonged carriage into account to limit transmission of KPCs in LTACHs. PMID:27747253

  18. Long-term effects of prenatal x-ray of human females: reproductive experience

    SciTech Connect

    Meyer, M.B.; Tonascia, J.

    1981-09-01

    A cohort of singleton black human females exposed to diagnostic x-ray in utero and controls matched by parity, hospital of birth and birthdate have been followed to ages 25 to 30 years in Baltimore, Maryland. The search for possible effects of prenatal irradiation has focused on health, growth, development, and reproductive experience of exposed and control women. This paper reports findings related to reproductive experience. From an original data set of 1458 matched exposed-control pairs of women, questionnaire responses were received from 1109 exposed and 1124 control women including 852 each from pairs in which both the exposed and control woman responded. After careful search for alternative explanations of the findings, the authors concluded that females exposed in utero to low doses of x-ray (probably 1 to 5 rads) had significant increases in their rates of early onset of menses, births at age 15 years or less, numbers of living children, stillbirths, and sterilizing operations by their mid-twenties. These findings are compatible with animal studies in which prenatal irradiation kills many oocytes, but accelerates the development of remaining cells to stages more closely correlated with fertility. Although these animals subsequently became sterile, this cannot be tested in the current study because significantly more of the irradiated women have had surgical sterilizations.

  19. Developing biographies: the experiences of children, young people and their parents of living with a long-term condition.

    PubMed

    Bray, Lucy; Kirk, Sue; Callery, Peter

    2014-07-01

    This article reports on data from a qualitative interview study that sought to understand the experiences, choices and actions of children and young people undergoing surgery for a long-term condition and that of their parents. Using the concept of biography the article examines how the biographies of children, young people and their parents can be influenced by surgery and the ongoing management of a long-term continence condition. This article challenges previous work that characterises the presence of a condition from birth as a continuous and normal part of the illness experiences of these patients. Although this may be the case in some instances, children, young people and their parents can experience diverse and changing experiences associated with ongoing condition management as well as surgery. Biographical continuity, enrichment and disruption are all relevant concepts for such patients living with a long-term continence condition. These can be influenced by their previous experiences of their condition, their expectations, and dynamics with parents, including changes associated with development and the increasing independence of young people.

  20. Long-term results of children diagnosed with idiopathic nephrotic syndrome; single center experience

    PubMed Central

    Hacıhamdioğlu, Duygu Övünç; Kalman, Süleyman; Gök, Faysal

    2015-01-01

    Aim: The aim of this study was to determine the long-term results of children followed up with a diagnosis of nephrotic syndrome in a single center. Materials and Method: The medical data of 33 patients aged between 6 months and 10 years who were diagnosed with idiopathic nephrotic syndrome in our center between January 2000 and December 2012 and followed up for a period of 2–12 years were reviewed (Gulhane Military Medical Academy Ethics committee, 07.11.2012/10). Results: The mean age of disease onset was 3.2±2.04 years (range: 0.5–10 years) and the mean follow-up period was 6±3.4 years (range: 2–12 years). Thirteen (39.4%) of the study group (or the patients) were female and 20 (60.6%) were male. Twenty seven (1.8%) of the patients were sensitive to steroid and 6 (18.1%) were resistant to steroid. Four (12.1%) of the steroid-resistant patients had steroid-dependent nephrotic syndrome, 5 (15.2%) had frequently relapsing nephrotic syndrome and 18 (54.5%) had rarely relapsing nephrotic syndrome. Histopathological diagnoses of six patients who underwent biopsy because of resistance to steroid were as follows: focal segmental glomerulosclerosis (n=3), C1q nephropathy (n=1), diffuse mesangial proliferation (n=1) and membraneous nephropathy (n=1). Fifteen (45.5%) patients entered into full remission and 2 (6%) patients developed chronic renal failure. Treatment complications including decreased bone mineral density in three patients (9%), short stature in 2 patients (6%) and cataract in 2 patients (6%) developed. Conclusions: Children with nephrotic syndrome carry a risk in terms of short stature, osteoporosis, cataract and renal failure in the long-term follow-up. It was observed that our rates of response to steroid were similar to the literature and the most common histopathological diagnosis was focal segmental glomerulosclerosis in our patients who underwent biopsy because of resistance to steroid. It was thought that multi-center studies should be

  1. Long-term experiment to study the development, interaction, and influencing factors of DEXA parameters.

    PubMed

    Fuchs, Helmut; Gau, Christine; Hans, Wolfgang; Gailus-Durner, Valerie; Hrabě de Angelis, Martin

    2013-10-01

    Dual-energy X-ray absorption (DEXA) is commonly used to measure bone mineral density (BMD), bone mineral content (BMC), and body composition data (fat mass and lean mass) for phenotype assessment in mice. We were interested in the long-term development of BMD, BMC, lean mass, and fat mass of mice, also taking into account sex and genetic background. The dataset was used to analyze correlations among the different parameters. We analyzed males and females from inbred strains C3HeB/FeJ and C57BL/6J, starting from 42 until 528 days of age. To evaluate the effect of husbandry systems, we repeated a part of the study in a second facility with a different caging system. We also assessed different DEXA settings and repeatability of the scans. The results of this study were used to draw conclusions for the use of DEXA analysis in mouse phenotyping approaches.

  2. Bariatric surgery in type 1 diabetes mellitus; long-term experience in two cases.

    PubMed

    Fuertes-Zamorano, Nuria; Sánchez-Pernaute, Andrés; Torres García, Antonio J; Rubio Herrera, Miguel A

    2013-01-01

    In patients with obesity and type 2 diabetes, recommendations for bariatric surgery are well established. However, no consensus exists regarding its role for the management of patients with type 1 diabetes and morbid obesity. We present the long-term follow-up of two women with type 1 diabetes, morbid obesity and associated comorbidities, who underwent malabsorptive bariatric surgery. More than four years after the procedure, both have a body mass index (BMI) within the normal range and HbA1c levels below 7%. Also, they have been able to reduce their insulin requirements in more than 50%, their associated comorbidities have disappeared, and their overall quality of life has significantly improved. We compare our results with other recently published ones, emphasizing potential indications of bariatric surgery for patients with type 1 diabetes.

  3. Long-term clinical practice experience with cinacalcet for treatment of hypercalcemic hyperparathyroidism after kidney transplantation.

    PubMed

    Thiem, Ursula; Gessl, Alois; Borchhardt, Kyra

    2015-01-01

    Within this prospective, open-label, self-controlled study, we evaluated the long-term effects of the calcimimetic cinacalcet on calcium and phosphate homeostasis in 44 kidney transplant recipients (KTRs) with hypercalcemic hyperparathyroidism by comparing biochemical parameters of mineral metabolism between pre- and posttreatment periods. Results are described as mean differences (95% CIs) between pre- and posttreatment medians that summarize all repeated measurements of a parameter of interest between the date of initial hypercalcemia and cinacalcet initiation (median of 1.6 (IQR: 0.6-3.8) years) and up to four years after treatment start, respectively. Cinacalcet was initiated after 1.8 (0.8-4.7) years posttransplant and maintained for 6.2 (3.9-7.6) years. It significantly decreased total serum calcium (-0.30 (-0.34 to -0.26) mmol/L, P < 0.001) and parathyroid hormone levels (-79 (-103 to -55) pg/mL, P < 0.001). Serum levels of inorganic phosphate (Pi) and renal tubular reabsorption of phosphate to glomerular filtration rate (TmP/GFR) increased simultaneously (Pi: 0.19 (0.15-0.23) mmol/L, P < 0.001, TmP/GFR: 0.20 (0.16-0.23) mmol/L, P < 0.001). In summary, cinacalcet effectively controlled hypercalcemic hyperparathyroidism in KTRs in the long-term and increased low Pi levels without causing hyperphosphatemia, pointing towards a novel indication for the use of cinacalcet in KTRs.

  4. Long-Term Clinical Practice Experience with Cinacalcet for Treatment of Hypercalcemic Hyperparathyroidism after Kidney Transplantation

    PubMed Central

    Gessl, Alois; Borchhardt, Kyra

    2015-01-01

    Within this prospective, open-label, self-controlled study, we evaluated the long-term effects of the calcimimetic cinacalcet on calcium and phosphate homeostasis in 44 kidney transplant recipients (KTRs) with hypercalcemic hyperparathyroidism by comparing biochemical parameters of mineral metabolism between pre- and posttreatment periods. Results are described as mean differences (95% CIs) between pre- and posttreatment medians that summarize all repeated measurements of a parameter of interest between the date of initial hypercalcemia and cinacalcet initiation (median of 1.6 (IQR: 0.6–3.8) years) and up to four years after treatment start, respectively. Cinacalcet was initiated after 1.8 (0.8–4.7) years posttransplant and maintained for 6.2 (3.9–7.6) years. It significantly decreased total serum calcium (−0.30 (−0.34 to −0.26) mmol/L, P < 0.001) and parathyroid hormone levels (−79 (−103 to −55) pg/mL, P < 0.001). Serum levels of inorganic phosphate (Pi) and renal tubular reabsorption of phosphate to glomerular filtration rate (TmP/GFR) increased simultaneously (Pi: 0.19 (0.15–0.23) mmol/L, P < 0.001, TmP/GFR: 0.20 (0.16–0.23) mmol/L, P < 0.001). In summary, cinacalcet effectively controlled hypercalcemic hyperparathyroidism in KTRs in the long-term and increased low Pi levels without causing hyperphosphatemia, pointing towards a novel indication for the use of cinacalcet in KTRs. PMID:25861621

  5. [An interprofessional or an interdisciplinary problem? Distinctions to develop an analytical scheme of interdisciplinarity based on the case of a long-term care hospital].

    PubMed

    Couturier, Yves

    2009-06-01

    This communication distinguishes interdisciplinary problems from other neighbouring difficulties, such as difficulties related to work organization. The conceptual proximity between discipline and profession can in fact cause difficulties experienced in the interprofessionnal space to mistakenly incriminate interdisciplinarity. For the analyst, this proximity blurs his insight and, in effect, inhibits the development of adequate solutions to the encountered problem. Hence, this article, based on an ethnographic study of interdisciplinary relations in a small long-term care hospital, aims to alleviate the ambiguity surrounding this issue. In order to do so, this article will begin by recalling the parameters of the theoretical field of interdisciplinarity. Subsequently, the difficulties observed in the long-term care hospital's setting, as they were conceived in the light of interdisciplinarity theory, will be exposed. This article will notably highlight how the nursing staffs contribute to the maintenance of a philosophy of care favourable to the long term deployment of interdisciplinarity.

  6. Construction and performance of a long-term earthen liner experiment

    USGS Publications Warehouse

    Cartwright, Keros; Krapac, Ivan G.; Bonaparte, Rudolph

    1990-01-01

    In land burial schemes, compacted soil barriers with low hydraulic conductivity are commonly used in cover and liner systems to control the movement of liquids and prevent groundwater contamination. An experimental liner measuring 8 x 15 x 0.9 m was constructed with design criteria and equipment to simulate construction of soil liners built at waste disposal facilities. The surface of the liner was flooded with a 29.5 cm deep pond on April 12, 1988. Infiltration of water into the liner has been monitored for two years using 4 large-ring (1.5 m OD) and 32 small-ring (0.28 m OD) infiltrometers, and a water-balance that accounts for total infiltration and evaporation. Average long-term infiltration fluxes based on two years of monitoring are 5.8 x 10-9 cm/s, 6.0 x 10-8 cm/s and 5.6 x 10-8 for the large-ring, small-ring, and water-balance data, respectively. The saturated hydraulic conductivity of the liner based on small-ring data, estimated using Darcy's Law and the Green-Ampt Approximation, is 3 x 10-8 and 4 x 10-8 cm/s, respectively. All sets of data indicate that the liner's performance exceed that which is required by the U.S. EPA.

  7. Dual institution experience of extranodal marginal zone lymphoma reveals excellent long-term outcomes.

    PubMed

    Starr, Adam G; Caimi, Paolo F; Fu, PingFu; Massoud, Mira R; Meyerson, Howard; Hsi, Eric D; Mansur, David B; Cherian, Sheen; Singh, Arun D; Cooper, Brenda W; De Lima, Marcos J G; Lazarus, Hillard M; Gerson, Stanton L; Jagadeesh, Deepa; Smith, Mitchell R; Dean, Robert M; Pohlman, Brad L; Hill, Brian T; William, Basem M

    2016-05-01

    Extranodal marginal zone lymphoma (EMZL) is a B-cell lymphoma arising from mucosa-associated lymphoid tissue (MALT). The disease characteristics, clinical course and treatment vary considerably based on site of involvement. Because long-term outcome data for EMZL are limited, we sought to describe the clinical details of a large number of patients with EMZL evaluated at the Case Comprehensive Cancer Center over a 12-year period to identify prognostic markers including the impact of site of involvement. We identified 211 cases of EMZL involving the stomach (30%), ocular adnexa (19%), lungs (16%) and intestines (9%). Initial treatment included antibiotics (18%), radiation (21%), rituximab (20%), chemotherapy (3%), rituximab + chemotherapy (7%), surgery (17%) or observation (8%). After a median follow-up of 44·3 months (range 2·2-214·9), median progression-free survival (PFS) was 68·2 months (95% confidence interval [CI] 54·5-111·3) and median overall survival (OS) has not been reached. Age >60 years, elevated lactate dehydrogenase level (LDH), ≥4 lymph node groups involvement, and high follicular lymphoma international prognostic index (FLIPI) were associated with inferior PFS/OS. In summary, patients with EMZL have excellent prognosis with median OS in excess of 10 years. Age, elevated LDH, advanced disease, and high FLIPI score are associated with worse outcomes.

  8. Climate effects and feedback structure determining weed population dynamics in a long-term experiment.

    PubMed

    Lima, Mauricio; Navarrete, Luis; González-Andujar, José Luis

    2012-01-01

    Pest control is one of the areas in which population dynamic theory has been successfully applied to solve practical problems. However, the links between population dynamic theory and model construction have been less emphasized in the management and control of weed populations. Most management models of weed population dynamics have emphasized the role of the endogenous process, but the role of exogenous variables such as climate have been ignored in the study of weed populations and their management. Here, we use long-term data (22 years) on two annual weed species from a locality in Central Spain to determine the importance of endogenous and exogenous processes (local and large-scale climate factors). Our modeling study determined two different feedback structures and climate effects in the two weed species analyzed. While Descurainia sophia exhibited a second-order feedback and low climate influence, Veronica hederifolia was characterized by a first-order feedback structure and important effects from temperature and rainfall. Our results strongly suggest the importance of theoretical population dynamics in understanding plant population systems. Moreover, the use of this approach, discerning between the effect of exogenous and endogenous factors, can be fundamental to applying weed management practices in agricultural systems and to controlling invasive weedy species. This is a radical change from most approaches currently used to guide weed and invasive weedy species managements.

  9. Long-term outcomes of the shaken baby syndrome prevention program: Turkey’s experience

    PubMed Central

    Taşar, Medine Ayşin; Şahin, Figen; Polat, Selda; İlhan, Mustafa; Çamurdan, Aysu; Dallar, Yıldız; Beyazova, Ufuk

    2014-01-01

    Aim: Shaken baby syndrome (SBS) is a condition which may cause to serious health problems in the baby. SBS may be prevented by increasing awareness with giving education to parents especially in the early postnatal period. In shaken baby prevention programs, education is recommended to be given before the 2–4th month during which the frequency of crying is increased. It is important that education given in the early period is permanent until the period during which the frequency of crying is increased. The aim of this study was to evaluate the persistency of the benefit of the SBS prevention program until the 2–4th month during which crying is intensified. Material and Methods: This study is an interventional study. When the babies became 2–4 months old, a questionnaire which questioned the usefulness of education and the experiences with babies was applied to a group selected randomly among the mothers who received SBS prevention education during pregnancy or in the first 7 postnatal days (group A). The same questionnaire was applied to 143 mothers whose babies completed their first 2 months, who presented to the hospital for vaccination and who did not receive education about SBS as the control group (group B). The data were evaluated using the Statistical Program for Social Sciences (SPSS) 15.0 statistical analysis package program. Ethical approval was obtained from the local ethics committee (30.12.2009, 2785). Results: The rate of the mothers who stated “yes” to the sentence “babies occasionally cry” which was one of the main messages of the education was statistically significantly higher in group A compared to group B (p=0.001). The rate of the mothers who stated “I agree” to the sentence “battering is harmful for babies” was statistically significantly higher in group A compared to group B (p=0.001). Conclusions: Conclusively, it was found that SBS prevention program education was permanent until the 2–4th month. PMID:26078664

  10. Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication

    PubMed Central

    Bhadravathi, Manjunath Chaluvaiah; Kumar, Adarsh; Narang, Ridhi; Gupta, Ambika; Singh, Harneet

    2016-01-01

    Introduction Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. Aim To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. Materials and Methods A cross-sectional study was undertaken on a total of 84 children aged 2–12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. Results Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). Conclusion Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy. PMID:27504416

  11. Uptake of ferrocyanide in willow and poplar trees in a long term greenhouse experiment.

    PubMed

    Dimitrova, Tsvetelina; Repmann, Frank; Raab, Thomas; Freese, Dirk

    2015-04-01

    Phytoremediation of sites contaminated with iron cyanides can be performed using poplar and willow trees. Poplar and willow trees were grown in potting substrate spiked with ferrocyanide concentrations of up to 2,000 mg kg(-1) for 4 and 8 weeks respectively. Soil solution and leaf tissue of different age were sampled for total cyanide analysis every week. Chlorophyll content in the leaves was determined to quantify cyanide toxicity. Results showed that cyanide in the soil solution of spiked soils differed between treatments and on weekly basis and ranged from 0.5 to 1,200 mg l(-1). The maximum cyanide content in willow and poplar leaves was 518 mg kg(-1) fresh weight (FW) and 148 mg kg(-1) FW respectively. Cyanide accumulated in the leaves increased linearly with increasing cyanide concentration in the soil solution. On the long term, significantly more cyanide was accumulated in old leaf tissue than in young tissue. Chlorophyll content in poplar decreased linearly with increasing cyanide in the soil solution and in leaf tissue, and over time. The inhibitory concentration (IC50) value for poplars after 4 weeks of exposure was 173 mg l(-1) and for willow after 8 weeks of exposure-768 mg l(-1). Results show that willows tolerate much more cyanide and over a longer period than poplars, making them very appropriate for remediating sites highly contaminated with iron cyanides.

  12. Long-Term Outcomes and Complications in Patients With Craniopharyngioma: The British Columbia Cancer Agency Experience

    SciTech Connect

    Lo, Andrea C.; Howard, A. Fuchsia; Nichol, Alan; Sidhu, Keerat; Abdulsatar, Farah; Hasan, Haroon; Goddard, Karen

    2014-04-01

    Purpose: We report long-term outcomes and complications of craniopharyngioma patients referred to our institution. Methods and Materials: Between 1971 and 2010, 123 consecutive patients received primary treatment for craniopharyngioma in British Columbia and were referred to our institution. The median age was 30 years (range, 2-80 years). Thirty-nine percent of patients were treated primarily with subtotal resection (STR) and radiation therapy (RT), 28% with STR alone, 15% with gross total resection, 11% with cyst drainage (CD) alone, 5% with CD+RT, and 2% with RT alone. Eight percent of patients received intracystic bleomycin (ICB) therapy. Results: Median follow-up was 8.9 years, and study endpoints were reported at 10 years. Ten-year Kaplan-Meier progression-free survival (PFS) was 46%. Patients treated with STR+RT or CD+RT had the highest PFS (82% and 83%, respectively). There were no significant differences between PFS after adjuvant versus salvage RT (84% vs 74%, respectively; P=.6). Disease-specific survival (DSS) was 88%, and overall survival (OS) was 80%. Primary treatment modality did not affect DSS or OS, while older age was a negative prognostic factor for OS but not DSS. Kaplan-Meier rates for visual deterioration, anterior pituitary hormone deficiency, diabetes insipidus, seizure disorder, and cerebrovascular events (CVE) due to treatment, not tumor progression, were 27%, 76%, 45%, 16%, and 11%, respectively. The CVE rate was 29% in patients who received ICB compared to 10% in those who did not (P=.07). Conclusions: We report favorable PFS in patients with craniopharyngioma, especially in those who received RT after surgery. DSS and OS rates were excellent regardless of primary treatment modality. We observed a high incidence of hypopituitarism, visual deterioration, and seizure disorder. Eleven percent of patients experienced CVEs after treatment. There was a suggestion of increased CVE risk in patients treated with ICB.

  13. Long Term Incidence of Secondary Malignancies Following Allogeneic Hematopoietic Cell Transplantation: a Single Center Experience.

    PubMed

    Michelis, Fotios V; Kotchetkov, Rouslan; Grunwald, Rebecca M; Azeem, Aamir; Atenafu, Eshetu G; Lipton, Jeffrey H; Loach, David; Gupta, Vikas; Kuruvilla, John; Kim, Dennis D; Viswabandya, Auro; Deotare, Uday; Messner, Hans A

    2017-02-27

    To review the emergence of secondary malignancies (SM) in recipients of allogeneic hematopoietic cell transplantation (HCT). We documented the occurrence of SM in 2415 allogeneic HCT recipients, ages 18-71, in a single center over four decades. SM was seen in 209 patients, including 58 with non-metastatic squamous cell (SCC) and basal cell carcinoma (BCC) of the skin. Cumulative incidence of SM was 6.3% at 10 years, 13.5% at 20 years and 17.6% at 30 years post-HCT. Median age at diagnosis of SM was 61 years (range 21-85). By multivariable analysis, older age at HCT was the only independent prognostic factor for SM (HR=1.39 for age 41-55 and HR=1.92 for age >55 compared to age ≤40, p=0.001). The rate of SM (excluding non-metastatic SCC/BCC of skin) after HCT was 2.07 times higher (p=0.01) compared to the general population. Overall survival (OS) following diagnosis of SM (excluding non-metastatic SCC/BCC of skin) was 58% at 5 years and 50% at 10 years post-diagnosis. ECOG score was the only independent predictor of OS on multivariable analysis, with over 2 fold increased risk of death for patients with an ECOG score of 1 and over 6 fold for ECOG 2-4, compared to ECOG score 0 (p<0.0001). Forty (19%) of the 209 patients diagnosed with SM subsequently developed another new malignancy. OS was 68% and 51% at 5 and 10 years, respectively. The survival of SM patients post-HCT is favorable, thus warranting diligent long-term cancer screening and standard of care treatment. ECOG status of these patients is a predominant prognostic factor.

  14. Environmental response to sewage treatment strategies: Hong Kong's experience in long term water quality monitoring.

    PubMed

    Xu, Jie; Lee, Joseph H W; Yin, Kedong; Liu, Hongbin; Harrison, Paul J

    2011-11-01

    In many coastal cities around the world, marine outfalls are used for disposal of partially treated wastewater effluent. The combined use of land-based treatment and marine discharge can be a cost-effective and environmentally acceptable sewage strategy. Before 2001, screened sewage was discharged into Victoria Harbour through many small outfalls. After 2001, the Hong Kong Harbour Area Treatment Scheme (HATS) was implemented to improve the water quality in Victoria Harbour and surrounding waters. Stage I of HATS involved the construction of a 24 km long deep tunnel sewerage system to collect sewage from the densely populated urban areas of Hong Kong to a centralized sewage treatment plant at Stonecutters Island. A sewage flow of 1.4 million m3 d(-1) receives Chemically Enhanced Primary Treatment (CEPT) followed by discharge via a 1.2 km long outfall 2 km west of the harbor. The ecosystem recovery in Victoria Harbour and the environmental response to sewage abatement after the implementation of HATS was studied using a 21-year data set from long term monthly water quality monitoring. Overall, the pollution control scheme has achieved the intended objectives. The sewage abatement has resulted in improved water quality in terms of a significant reduction in nutrients and an increase in bottom DO levels. Furthermore, due to the efficient tidal mixing and flushing, the impact of the HATS discharge on water quality in the vicinity of the outfall location is relatively limited. However, Chl a concentrations have not been reduced in Victoria Harbour where algal growth is limited by hydrodynamic mixing and water clarity rather than nutrient concentrations. Phosphorus removal in the summer is suggested to reduce the risk of algal blooms in the more weakly-flushed and stratified southern waters, while nutrient removal is less important in other seasons due to the pronounced role played by hydrodynamic mixing. The need for disinfection of the effluent to reduce bacterial (E

  15. Long-term ex vivo bovine experiments with the Gyro C1E3 centrifugal blood pump.

    PubMed

    Kawahito, Shinji; Maeda, Tomohiro; Motomura, Tadashi; Takano, Tamaki; Nonaka, Kenji; Linneweber, Joerg; Ichikawa, Seiji; Kawamura, Masaki; Glueck, Julie; Fujisawa, Akira; Makinouchi, Kenzo; Nosé, Yukihiko

    2003-01-01

    Centrifugal blood pumps are used widely for cardiopulmonary bypass, as ventricular assist devices, and for extracorporeal membrane oxygenation (ECMO). However, there is no centrifugal blood pump that is suitable for long-term ECMO. The authors developed the Gyro C1E3 centrifugal blood pump (Kyocera Corporation, Kyoto, Japan), which has superior antithrombogenic, antitraumatic, and hydraulic features in comparison with the conventional centrifugal blood pumps. Five ex vivo long-term durability tests of the Gyro C1E3 were performed using healthy miniature calves. The ECMO circuit was composed of a prototype hollow fiber silicone membrane oxygenator and a Gyro C1E3 pump. Venous blood was drained from the left jugular vein of a calf, passed through the oxygenator and infused into the left carotid artery using a Gyro C1E3. Ex vivo studies were performed from 7 to 15 days at a blood flow rate of 1 L/min. During this period, the Gyro C1E3 demonstrated a stable performance without exchanging the pump. Bleeding complications were the major reason for termination of each experiment. Rotational speed was maintained around 2,000 rpm. All five calves demonstrated neither abnormal signs nor abnormal blood examination data throughout the experiment. Neither clot nor thrombus formations were found during the necropsy in the cannula or pump nor were infarctions observed in any of the major organs. In conclusion, the Gyro C1E3 showed a stable and reliable performance during long-term ex vivo bovine experiments under the conditions tested.

  16. Using 31P-NMR to investigate dynamics of soil phosphorus compounds in the Rothamsted Long Term Experiments

    NASA Astrophysics Data System (ADS)

    Blackwell, Martin; Turner, Ben; Granger, Steve; Hooper, Tony; Darch, Tegan; Hawkins, Jane; Yuan, Huimin; McGrath, Steve

    2015-04-01

    The technique of 31P-NMR spectroscopy has done more to advance the knowledge of phosphorus forms (especially organic phosphorus) in environmental samples than any other method. The technique has advanced such that specific compounds can be identified where previously only broad categories such as orthophosphate monoesters and diesters were distinguishable. The Soil Archive and Long Term Experiments at Rothamsted Research, UK, potentially provides an unequalled opportunity to use this technique to observe changes in soil phosphorus compounds with time and under different treatments, thereby enhancing our understanding of phosphorus cycling and use by plants. Some of the earliest work using this technique on soils was carried out by Hawkes et al. in 1984 and this used soils from two of the oldest Rothamsted Long Term Experiments, namely Highfield and Park Grass. Here we revisit the samples studied in this early work and reanalyse them using current methodology to demonstrate how the 31P-NMR technique has advanced. We also present results from a study on the phosphorus chemistry in soils along the Hoosfield acid strip (Rothamsted, UK), where a pH gradient from 3.7 to 7.8 occurs in a single soil with little variation in total phosphorus (mean ± standard deviation 399 ± 27 mg P kg-1). Soil pH was found to be an important factor in determining the proportion of phosphomonoesters and phosphodiesters in the soil organic phosphorus, although total organic phosphorus concentrations were a relatively consistent proportion of the total soil phosphorus (36 ± 2%) irrespective of soil pH. Key words. 31P-NMR, soil organic phosphorus, long term experiments, Hoosfield acid strip

  17. Reinterpreting Long-Term Evolution Experiments: Is Delayed Adaptation an Example of Historical Contingency or a Consequence of Intermittent Selection?

    PubMed Central

    Maisnier-Patin, Sophie

    2016-01-01

    Van Hofwegen et al. demonstrated that Escherichia coli rapidly evolves the ability to use citrate when long selective periods are provided (D. J. Van Hofwegen, C. J. Hovde, and S. A. Minnich, J Bacteriol 198:1022–1034, 2016, http://dx.doi.org/10.1128/JB.00831-15). This contrasts with the extreme delay (15 years of daily transfers) seen in the long-term evolution experiments of Lenski and coworkers. Their idea of “historical contingency” may require reinterpretation. Rapid evolution seems to involve selection for duplications of the whole cit locus that are too unstable to contribute when selection is provided in short pulses. PMID:26883821

  18. Ethics consultation in pediatrics: long-term experience from a pediatric oncology center.

    PubMed

    Johnson, Liza-Marie; Church, Christopher L; Metzger, Monika; Baker, Justin N

    2015-01-01

    There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000-2011) at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is needed on the role of ethics consultation in pediatrics.

  19. Atmospheric Chemistry Experiment (ACE) Measurements of Tropospheric and Stratospheric Chemistry and Long-Term Trends

    NASA Technical Reports Server (NTRS)

    Rinsland, Curtis P.; Bernath, Peter; Boone, Chris; Nassar, Ray

    2007-01-01

    We highlight chemistry and trend measurement results from the Atmospheric Chemistry Experiment (ACE) which is providing precise middle troposphere to the lower thermosphere measurements with a 0.02/cm resolution Fourier transform spectrometer covering 750-4400/cm

  20. Chernozem aggregate waterstability loss investigation in a long-term bare fallow experiment

    NASA Astrophysics Data System (ADS)

    Vasilyeva, N. A.; Milanovskiy, E. Y.

    2009-04-01

    POM (0.5%). In analytical aspect of the research possibility to describe soil components as a whole through parameters of soil particles and SOM characteristics can be realized: a) profile distribution of the average Corg content over soil layer mass is closely fitted by the sum (exp1+exp2+C), indicating particular OM pools; b) Corg content (~2%) of stable to long-term degradation sorbed SOM is set in the power parameter of experimental curve SSA (Corg) for chernozem under grassland. c) fractal dimension discontinuities correspond to classification boundaries of colloidal, clay, silt and sand particles (0.5; 2; 20 mkm); d) qualitative change of hydrophobic properties is described by one parameter presumably related to structure of high molecular HS.

  1. Long term experience with semi-conductive glaze high voltage post insulators

    SciTech Connect

    Baker, A.C.; Maney, J.W.; Szilagyi, Z. )

    1990-01-01

    Insulators using semi-conductive glaze have long been known for their superior contamination performance. Early glazes for this type however were not stable and successful use of semi-conductive glazed porcelain insulators was delayed many years until tin-antimony oxide glazes were developed. Service experience of eighteen years is now available for line and station post insulators with this type of glaze. Based on this experience, the aging characteristics of tin-antimony oxide semi-conductive glazes are described and quantified. Several different applications of these insulators are also described.

  2. Ethics Consultation in Pediatrics: Long-Term Experience from a Pediatric Oncology Center

    PubMed Central

    Johnson, Liza-Marie; Church, Christopher L.; Metzger, Monika; Baker, Justin N.

    2015-01-01

    There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000–2011) at St. Jude Children’s Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician’s fiduciary responsibility to the patient. Non-patient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision-making among multiple stakeholders and further prospective research is needed on the role of ethics consultation in pediatrics. PMID:25970382

  3. Interaction between mode of learning and subjective experience: translation effects in long-term memory.

    PubMed

    Rackie, James M; Brandt, Karen R; Eysenck, Michael W

    2015-01-01

    It has been suggested that writing auditorily presented words at encoding involves distinctive translation processes between visual and auditory domains, leading to the formation of distinctive memory traces at retrieval. This translation effect leads to higher levels of recognition than the writing of visually presented words, a non-translation effect. The present research investigated whether writing and the other translation effect of vocalisation (vocalising visually presented words) would be present in tests of recall, recognition memory and whether these effects are based on the subjective experience of remembering or knowing. Experiment 1 found a translation effect in the auditory domain in recall, as the translation effect of writing yielded higher recall than both non-translation effects of vocalisation and silently hearing. Experiment 2 found a translation effect in the visual domain in recognition, as the translation effect of vocalisation yielded higher recognition than both non-translation effects of writing and silently reading. This translation effect was attributable to the subjective experience of remembering rather than knowing. The present research therefore demonstrates the beneficial effect of translation in both recall and recognition, with the effect of vocalisation in recognition being based on rich episodic remembering.

  4. The Long-Term Effects of War Experiences on Children's Depression in the Republic of Croatia

    ERIC Educational Resources Information Center

    Brajsa-Zganec, A.

    2005-01-01

    Objective:: The aim of the study was to investigate whether different levels of depressive symptoms in early adolescent boys and girls could be predicted on the basis of war experiences, perceived available social support (instrumental support, support to self-esteem, belonging and acceptance) and extraversion. Methods:: The sample consisted of…

  5. Early Experiences Can Alter Gene Expression and Affect Long-Term Development. Working Paper #10

    ERIC Educational Resources Information Center

    National Scientific Council on the Developing Child, 2010

    2010-01-01

    New scientific research shows that environmental influences can actually affect whether and how genes are expressed. Thus, the old ideas that genes are "set in stone" or that they alone determine development have been disproven. In fact, scientists have discovered that early experiences can determine how genes are turned on and off and even…

  6. The Black Professor Abroad: Long-Term Teaching Experiences in Foreign Lands

    ERIC Educational Resources Information Center

    Fikes, Robert, Jr.

    2006-01-01

    The experiences of African American professors reach back nearly 150 years beginning with their pioneering efforts to educate Africans in Liberia. With the gradual racial integration of the American professoriate in the post-World War II era and the redoubled effort of the federal government and private agencies, along with the support of colleges…

  7. Analyzing fertilizer-induced dynamics of soluble organic matter composition in soils from long-term field experiments

    NASA Astrophysics Data System (ADS)

    Ellerbrock, Ruth; Gerke, Horst, H.

    2016-04-01

    Fertilization and soil management can affect soil organic matter. However, it is unclear how amount and composition of SOM will be changed by mineral and organic fertilization. The objective of this study was to test the applicability of infrared spectroscopy for analyzing management-induced impacts on OM composition. Ap horizon samples were collected from the long term-field experiments at Bad Lauchstädt (loam), Groß Kreutz and Müncheberg (loamy sand) of plots fertilized with farmyard manure (FYM), farmyard manure plus mineral nitrogen (FYM+N), and mineral nitrogen only (N), and an unfertilized Control plot. Fourier-transform infrared (FTIR) spectroscopy was used to analyze SOM, hot water soluble (OM-HW) and sodium pyrophosphate soluble (OM-PY) organic matter fractions. The OM composition was evaluated in terms of the ratio between absorption band intensities in FTIR. The soluble OM fractions of FYM had larger C=O/C-O-C ratios as compared to N and Control. While the cation exchange capacity (CEC) of OM-PY from FYM plots was larger, it was smaller for the N plots as compared to that of the Control at all sites. The results allowed identifying fertilization-induced long-term dynamics in (i) the OM composition and (ii) the CEC and the potential wettability of SOM and OM fractions. The OM-PY fraction could be used to identify and characterize the long-term changes in organic matter composition. For a more quantitative analysis, however, more replicate samples and a seasonal differentiation would be required to separate between shorter- and longer-term changes.

  8. Long-Term Operating Experience with High-Power Gyrotron Oscillators

    NASA Astrophysics Data System (ADS)

    Felch, Kevin

    2005-10-01

    High-power, megawatt-class gyrotron oscillators have now been used in electron cyclotron heating (ECH) experiments for several years. The long periods of sustained operation have provided important information about the design limits that had initially been placed on the key elements of the gyrotron. In particular, observations made on recent 110 GHz, 1 MW gyrotrons used in ECH experiments on DIII-D at General Atomics indicate that several of the important components of the device, including the electron guns, interaction cavities and diamond output windows, have performed quite well, while analyses of the electron beam collectors on some of the devices indicate that design limits have often been exceeded. Observations made on these gyrotrons will be summarized and plans to address problem areas will be discussed.

  9. Growth properties of protoplanetary dust in a long-term microgravity experiment

    NASA Astrophysics Data System (ADS)

    Brisset, Julie; Kothe, Stefan; Weidling, Rene; Heisselmann, Daniel; Blum, Juergen

    2014-11-01

    In the very first steps of the formation of a new planetary system, dust agglomerates and grows inside the protoplanetary disk that rotates around the newly formed star. In this disk, collisions between the dust particles, induced by interactions with the surrounding gas, lead to sticking. Aggregates start growing until their sizes and relative velocities are high enough for collisions to result in bouncing or fragmentation. As part of a series of microgravity experiments aiming at the investigation of the transitions between sticking, bouncing and fragmentation of colliding dust aggregates, the Suborbital Particle and Aggregation Experiment (SPACE) was designed, built and operated both at the drop tower in Bremen (August 2011) and on the REXUS 12 suborbital rocket (March 2012). The SPACE experiment allowed for the observation of collisions between aggregates of sizes of a few 100 µm that were composed of SiO2, a commonly used protoplanetary dust analog material. At velocities below 10 cm/s, clusters composed of a high number of aggregates (more than 10^4) formed and grew to sizes of up to 5 mm. The analysis of these collisions delivered valuable input to a current dust collision model, which maps the outcome of collisions depending on the aggregate sizes and their relative velocities. The sticking probability of sub-mm-sized dust aggregates could directly be measured during the suborbital rocket flight, over a velocity range covering the transition between the sticking and bouncing regimes. In addition, the evolution of clusters formed from sub-mm-sized aggregates during the different experiments could be observed and some of their intrinsic properties derived. The measured characteristics were the cluster fractal dimensions, the tensile strength of their outer aggregate layer and the effective surface energy of their constituents. Threshold energies for cluster restructuring and fragmentation could also be determined. All these cluster properties are important

  10. Long-term effects of the Moving to Opportunity residential mobility experiment on crime and delinquency

    PubMed Central

    Sciandra, Matthew; Sanbonmatsu, Lisa; Duncan, Greg J.; Gennetian, Lisa A.; Katz, Lawrence F.; Kessler, Ronald C.; Kling, Jeffrey R.; Ludwig, Jens

    2013-01-01

    Objectives Using data from a randomized experiment, to examine whether moving youth out of areas of concentrated poverty, where a disproportionate amount of crime occurs, prevents involvement in crime. Methods We draw on new administrative data from the U.S. Department of Housing and Urban Development’s Moving to Opportunity (MTO) experiment. MTO families were randomized into an experimental group offered a housing voucher that could only be used to move to a low-poverty neighborhood, a Section 8 housing group offered a standard housing voucher, and a control group. This paper focuses on MTO youth ages 15–25 in 2001 (n = 4,643) and analyzes intention to treat effects on neighborhood characteristics and criminal behavior (number of violent- and property-crime arrests) through 10 years after randomization. Results We find the offer of a housing voucher generates large improvements in neighborhood conditions that attenuate over time and initially generates substantial reductions in violent-crime arrests and sizable increases in property-crime arrests for experimental group males. The crime effects attenuate over time along with differences in neighborhood conditions. Conclusions Our findings suggest that criminal behavior is more strongly related to current neighborhood conditions (situational neighborhood effects) than to past neighborhood conditions (developmental neighborhood effects). The MTO design makes it difficult to determine which specific neighborhood characteristics are most important for criminal behavior. Our administrative data analyses could be affected by differences across areas in the likelihood that a crime results in an arrest. PMID:24348277

  11. Different early rearing experiences have long term effects on cortical organization in captive chimpanzees (Pan troglodytes)

    PubMed Central

    Bogart, Stephanie L.; Bennett, Allyson J.; Schapiro, Steven J.; Reamer, Lisa A.; Hopkins, William D.

    2014-01-01

    Consequences of rearing history in chimpanzees (Pan troglodytes) have been explored in relation to behavioral abnormalities and cognition, however, little is known about the effects of rearing conditions on anatomical brain development. Human studies have revealed that experiences of maltreatment and neglect during infancy and childhood can have detrimental effects on brain development and cognition. In this study, we evaluated the effects of early rearing experience on brain morphology in 92 captive chimpanzees (ages 11-43) who were either reared by their mothers (n = 46) or in a nursery (n = 46) with age-group peers. Magnetic resonance brain images were analyzed with a processing program (BrainVISA) that extracts cortical sulci. We obtained various measurements from 11 sulci located throughout the brain, as well as whole brain gyrification and white and grey matter volumes. We found that mother-reared chimpanzees have greater global white-to-grey matter volume, more cortical folding and thinner grey matter within the cortical folds than nursery-reared animals. The findings reported here are the first to demonstrate that differences in early rearing conditions have significant consequences on brain morphology in chimpanzees and suggests potential differences in the development of white matter expansion and myelination. PMID:24206013

  12. The Messenger Matters: Teacher Research Experiences and Effective, Long-term Science Communication

    NASA Astrophysics Data System (ADS)

    Timm, K.; Warburton, J.; Larson, A. M.

    2010-12-01

    PolarTREC - Teachers and Researchers Exploring and Collaborating, an NSF-Funded program of the Arctic Research Consortium of the US, matches K-12 teachers with researchers for 2-6 week hands on research experiences in the polar regions. During their teacher research experience, teachers and researchers in the field communicate widely with students and members of the public online through teacher journals, photo galleries, interactive discussion forums, multimedia resources, and real-time live events that connect the science of the Arctic or Antarctic to students and the public around the world. Due to the exciting nature of field-based polar science and the novelty of teacher participation, PolarTREC creates a natural pathway for information—from scientists to students and the general public. Initial data from the PolarTREC evaluation indicates that researchers viewed the dissemination activities of PolarTREC as an essential outreach activity allowing them to meet broader impact objectives of their project. Many researchers noted that conducting outreach through PolarTREC was “easy,” and that it “really increased our public image and bridged the separation between science and the public at large.” Although the immediate outreach activities related to the field experience are valuable, the lasting impacts of PolarTREC are related to the professional development received by the teachers through their participation. Many K-12 teachers, in both undergraduate and graduate education, have little opportunity to actually conduct inquiry-based science. The curriculum at this level consists of primarily memorizing facts and conducting contrived experiments (Michaels et al, 2008). After being embedded in an actual research project with professional scientists, participating teachers reported significant increases in their knowledge of the polar regions and improvements in their ability to teach pertinent science concepts. In particular, teachers had a better

  13. A Smart Wirelessly Powered Homecage for Long-Term High-Throughput Behavioral Experiments.

    PubMed

    Lee, Byunghun; Kiani, Mehdi; Ghovanloo, Maysam

    2015-09-01

    A wirelessly powered homecage system, called the EnerCage-HC, that is equipped with multicoil wireless power transfer, closed-loop power control, optical behavioral tracking, and a graphic user interface is presented for longitudinal electrophysiology and behavioral neuroscience experiments. The EnerCage-HC system can wirelessly power a mobile unit attached to a small animal subject and also track its behavior in real-time as it is housed inside a standard homecage. The EnerCage-HC system is equipped with one central and four overlapping slanted wire-wound coils with optimal geometries to form three- and four-coil power transmission links while operating at 13.56 MHz. Utilizing multicoil links increases the power transfer efficiency (PTE) compared with conventional two-coil links and also reduces the number of power amplifiers to only one, which significantly reduces the system complexity, cost, and heat dissipation. A Microsoft Kinect installed 90 cm above the homecage localizes the animal position and orientation with 1.6-cm accuracy. Moreover, a power management ASIC, including a high efficiency active rectifier and automatic coil resonance tuning, was fabricated in a 0.35-μm 4M2P standard CMOS process for the mobile unit. The EnerCage-HC achieves a max/min PTE of 36.3%/16.1% at the nominal height of 7 cm. In vivo experiments were conducted on freely behaving rats by continuously delivering 24 mW to the mobile unit for >7 h inside a standard homecage.

  14. How does adaptation sweep through the genome? Insights from long-term selection experiments.

    PubMed

    Burke, Molly K

    2012-12-22

    A major goal in evolutionary biology is to understand the origins and fates of adaptive mutations. Natural selection may act to increase the frequency of de novo beneficial mutations, or those already present in the population as standing genetic variation. These beneficial mutations may ultimately reach fixation in a population, or they may stop increasing in frequency once a particular phenotypic state has been achieved. It is not yet well understood how different features of population biology, and/or different environmental circumstances affect these adaptive processes. Experimental evolution is a promising technique for studying the dynamics of beneficial alleles, as populations evolving in the laboratory experience natural selection in a replicated, controlled manner. Whole-genome sequencing, regularly obtained over the course of sustained laboratory selection, could potentially reveal insights into the mutational dynamics that most likely occur in natural populations under similar circumstances. To date, only a few evolution experiments for which whole-genome data are available exist. This review describes results from these resequenced laboratory-selected populations, in systems with and without sexual recombination. In asexual systems, adaptation from new mutations can be studied, and results to date suggest that the complete, unimpeded fixation of these mutations is not always observed. In sexual systems, adaptation from standing genetic variation can be studied, and in the admittedly few examples we have, the complete fixation of standing variants is not always observed. To date, the relative frequency of adaptation from new mutations versus standing variation has not been tested using a single experimental system, but recent studies using Caenorhabditis elegans and Saccharomyces cerevisiae suggest that this a realistic future goal.

  15. A Smart Wirelessly Powered Homecage for Long-Term High-Throughput Behavioral Experiments

    PubMed Central

    Lee, Byunghun; Kiani, Mehdi

    2015-01-01

    A wirelessly powered homecage system, called the EnerCage-HC, that is equipped with multicoil wireless power transfer, closed-loop power control, optical behavioral tracking, and a graphic user interface is presented for longitudinal electrophysiology and behavioral neuroscience experiments. The EnerCage-HC system can wirelessly power a mobile unit attached to a small animal subject and also track its behavior in real-time as it is housed inside a standard homecage. The EnerCage-HC system is equipped with one central and four overlapping slanted wire-wound coils with optimal geometries to form three- and four-coil power transmission links while operating at 13.56 MHz. Utilizing multicoil links increases the power transfer efficiency (PTE) compared with conventional two-coil links and also reduces the number of power amplifiers to only one, which significantly reduces the system complexity, cost, and heat dissipation. A Microsoft Kinect installed 90 cm above the homecage localizes the animal position and orientation with 1.6-cm accuracy. Moreover, a power management ASIC, including a high efficiency active rectifier and automatic coil resonance tuning, was fabricated in a 0.35-μm 4M2P standard CMOS process for the mobile unit. The EnerCage-HC achieves a max/min PTE of 36.3%/16.1% at the nominal height of 7 cm. In vivo experiments were conducted on freely behaving rats by continuously delivering 24 mW to the mobile unit for >7 h inside a standard homecage. PMID:26257586

  16. Real-world clinical experience with long-term miglustat maintenance therapy in type 1 Gaucher disease: the ZAGAL project

    PubMed Central

    Giraldo, Pilar; Alfonso, Pilar; Atutxa, Koldo; Fernández-Galán, María A.; Barez, Abelardo; Franco, Rafael; Alonso, Dora; Martin, Alejandro; Latre, Paz; Pocovi, Miguel

    2009-01-01

    There are few published data from real-world clinical experience with miglustat (Zavesca®), an oral inhibitor of glucosylceramide synthase, in type 1 Gaucher disease. We report data from a prospective, open-label investigational study that evaluated substrate reduction therapy with miglustat 100 mg t.i.d. as a maintenance therapy in patients with Type 1 Gaucher disease who had been switched from previous enzyme replacement therapy. Long-term data on changes in organ size, blood counts, disease severity bio-markers, bone marrow infiltration, overall clinical status and safety/tolerability were analyzed from 28 patients with Type 1 Gaucher disease who were attending routine clinic visits. Assessments were performed at six, 12, 24, 36 and 48 months of therapy. Disease severity biomarkers improved up to 48 months after initiation of miglustat, while other disease parameters remained stable. Miglustat showed an acceptable profile of safety and tolerability throughout treatment. In conclusion, miglustat is an effective therapy for the long-term maintenance of patients with Type 1 Gaucher disease previously stabilized with enzyme replacement therapy. PMID:19608672

  17. Young and midlife stroke survivors' experiences with the health services and long-term follow-up needs.

    PubMed

    Martinsen, Randi; Kirkevold, Marit; Sveen, Unni

    2015-02-01

    The aim of this qualitative study was to explore young and midlife stroke survivors' experiences with the health services and to identify long-term follow-up needs. Sixteen participants from two cohorts were interviewed in-depth. The interviews were analyzed applying a hermeneutic-phenomenological analysis. The participants struggled to gain access to follow-up health services. They felt that whether they were systematically followed up was more coincidental than planned. Young and midlife stroke survivors thus appear vulnerable to falling outside the follow-up system. Those participants who received some follow-up care perceived it as untailored to their specific needs. To be considered supportive, the follow-up programs must be in line with their long-term needs, take into account their particular challenges as young and midlife stroke survivors, and be planned in close collaboration with the individual patient. To secure systematic and follow-up health services tailored to the individual, knowledgeable and committed healthcare professionals should play a prominent role within the community health services.

  18. Long-Term (4 mo) Oxygen Isotope Exchange Experiment between Zircon and Hydrothermal Fluid

    NASA Astrophysics Data System (ADS)

    Bindeman, I. N.; Schmitt, A. K.; Lundstrom, C.; Golledge, S.

    2013-12-01

    Knowing oxygen diffusivity in zircon has several critical applications: 1) establishing zircon stability and solubility in hot silica-saturated hydrothermal solutions; 2) deriving metamorphic and magmatic heating timescales from intra-crystal oxygen isotopic gradients; 3) assessing the survivability of oxygen isotopic signatures in Hadean zircons. We report results of a microanalytical investigation of an isotope exchange experiment using a cold-seal pressure apparatus at 850°C and 500 MPa over 4 months duration. Natural zircon, quartz and rutile were sealed with a silica-rich solution doped with 18-O, D, 7-Li and 10-B in a gold capsule. The diffusion length-scales were examined by depth profiling using time-of-flight (TOF) and high-sensitivity dynamic secondary ionization mass spectrometry (SIMS). Starting materials had distinct and homogeneous δ18O: zircon from Mesa Falls tuff of Yellowstone (+3.6‰), rutile from Karelia (-29‰), Bishop Tuff Quartz (+8.4‰), and δ18O doped water (+400‰). Starting material zircon showed invariant 18O/16O during depth profiling. After the 4 month experiment, rutile crystal surfaces displayed etching (100's of nm), while zircon exteriors lacked visible change. Quartz was completely dissolved and reprecipitated in a minor residue. Rutile developed ~2 μm long Fickian diffusion profiles largely consistent with the wet diffusion coefficients for rutile previously reported [1]. Surface U-Pb dating of zircon detected no significant Pb loss from the outermost ~300 nm of the crystal face and returned identical core-face ages. We performed δ18O depth profiling of zircon in two directions. First, forward profiles (crystal rim inwards) by dynamic SIMS (no surface treatment besides Au-coating; Cs+ beam of 20 kV impact energy) showed initially high and decreasing 18O/16O over ~130 nm; TOF-SIMS forward profiles using a 2 kV Cs+ sputter beam and 25 kV Bi3+ primary ions on uncoated zircon surfaces (cleaned for 2 min with HF) yielded

  19. Short-term versus long-term responses to drought stress: coupling manipulation experiments with gradient studies

    NASA Astrophysics Data System (ADS)

    Martin, Nicolas; Misson, Laurent

    2010-05-01

    Water availability is the main factor shaping plants form and function in Mediterranean ecosystems. Understanding the mechanisms that drive plants productivity in drought conditions is crucial in a climate change context. So far, functional relationships between drought stress and leaf physiology has mostly been studied in short term experiments unable to address the potential acclimation in leaf function and the link between short term responses and long term acclimation. Here we hypothesize that the functional relationships between drought and leaf physiology can change under the temporal scale at witch drought is applied. Hence, we measured leaf physiological parameters (gs, gm, Amax, Vcmax Jmax) implicated in the limitation of carbon assimilation on Holm Oak leaves using a design combining 2 contrasting field experiments: (1) a rainfall exclusion experiment simulating a spring extreme drought in order to study short term processes, (2) a natural rainfall gradient (650 mm to 1150 mm) made of 3 plots in order to study long term acclimation. For each experiment we related leaf physiological parameters and their respective limitation to carbon assimilation with predawn leaf water potential as a surrogate of drought stress. Results showed that functional relationships relating gs, Vcmax and Jmax to leaf water potential changed in the total rainfall exclusion, probably because of a strong effect of spring drought on phenology. In addition, trees in the wet plot of the rainfall gradient showed a stronger stomatal conductance decline relative to leaf water potential than trees in the dry plot. We interpret these changes as a result of structural modification at canopy level in the rainfall gradient related to changes in leaf area index (LAI), hydraulic adjustment or fine root/LAI ratio. As a consequence, stomatal limitation of carbon assimilation was stronger in the wet plot than in the dry plot, while total limitation was lower in the dry plot. Water conservation in

  20. Experiences in long-term evaluation of mercury emission monitoring systems

    SciTech Connect

    Chin-Min Cheng; Hung-Ta Lin; Qiang Wang; Chien-Wei Chen; Chia-Wei Wang; Ming-Chung Liu; Chi-Kuan Chen; Wei-Ping Pan

    2008-09-15

    Six mercury continuous emission monitoring (CEM) systems provided by two leading mercury (Hg) CEM system manufacturers were tested at five coal combustion utilities. The linearity, response time, day-to-day stability, efficiency of the Hg speciation modules, and ease of use were evaluated by following procedures specified in the Code of Federal Regulation Title 40 Part 75 (40 CFR Part 75). Mercury monitoring results from Hg CEM systems were compared to an EPA-recognized reference method. A sorbent trap sampling system was also evaluated in this study to compare the relative accuracy to the reference method as well as to Hg CEM systems. A conceptual protocol proposed by U.S. EPA (Method 30A) for using an Hg CEM system as the reference method for the Hg relative accuracy (RA) test was also followed to evaluate the workability of the protocol. This paper discusses the operational experience obtained from these field studies and the remaining challenges to overcome while using Hg CEM systems and the sorbent trap method for continuous Hg emission monitoring. 3 refs., 5 figs., 11 tabs.

  1. Long-term experience with a low-dose oral contraceptive.

    PubMed

    Brill, K; Schnitker, J; Albring, M

    1990-12-01

    Oral contraception has proved to be the most efficient reversible method of fertility control for over 25 years. During this period, various investigations and epidemiological studies have suggested that some risks may be involved, but, on the other hand, a number of non-contraceptive benefits have become obvious. The results of these investigations were taken into account when new formulations had to be developed, with an aim to improving hormonal fertility control with regard to its tolerance, cycle control, and impact on metabolism. Since then, the objective of research has been to contrive new hormonal contraceptives which ensure safety to the largest possible extent, from a medical point of view, for the sake of the patient, without affecting contraceptive effectiveness. The aim to reduce side-effects connected with the use of oral contraception, as well as to lower the risks possibly involved, has obviously been achieved by extensive research. Both by devising a new substance and reducing doses, the criteria of modern low-dose oral contraception have been met, as has become evident in the course of the clinical experience gathered with Femovan.

  2. Integration of Long term experiments on terrestrial ecosystem in AnaEE-France Research Infrastructure : concept and adding value

    NASA Astrophysics Data System (ADS)

    Chanzy, André; Chabbi, Abad; Houot, Sabine; Lafolie, François; Pichot, Christian; Raynal, Hélène; Saint-André, Laurent; Clobert, Jean; Greiveldinger, Lucile

    2015-04-01

    Continental ecosystems represent a critical zone that provide key ecological services to human populations like biomass production, that participate to the regulation of the global biogeochemical cycles and contribute and contribute to the maintenance of air and water quality. Global changes effects on continental ecosystems are likely to impact the fate of humanity, which is thus facing numerous challenges, such as an increasing demand for food and energy, competition for land and water use, or rapid climate warming. Hence, scientific progress in our understanding of the continental critical zone will come from studies that address how biotic and abiotic processes react to global changes. Long term experiments are required to take into account ecosystem inertia and feedback loops and to characterize trends and threshold in ecosystem dynamics. In France, 20 long-term experiments on terrestrial ecosystems are gathered within a single Research Infrastructure: ANAEE-France (http://www.anaee-s.fr), which is a part of AnaEE-Europe (http://www.anaee.com/). Each experiment consist in applying differentiated pressures on different plot over a long period (>20 years) representative of a range of management options. The originality of such infrastructure is a combination of experimental set up and long-term monitoring of simultaneous measurements of key ecosystem variables and parameters through a multi-disciplinary approach and replications of each treatment that improve the statistical strength of the results. The sites encompass gradients of climate conditions, ecosystem complexity and/or management, and can be used for calibration/validation of ecosystem functioning models as well as for the design of ecosystem management strategies. Gathering those experiments in a single research infrastructure is an important issue to enhance their visibility and increase the number of hosting scientific team by offering a range of services. These are: • Access to the ongoing long

  3. Soil fertility increases with plant species diversity in a long-term biodiversity experiment.

    PubMed

    Dybzinski, Ray; Fargione, Joseph E; Zak, Donald R; Fornara, Dario; Tilman, David

    2008-11-01

    Most explanations for the positive effect of plant species diversity on productivity have focused on the efficiency of resource use, implicitly assuming that resource supply is constant. To test this assumption, we grew seedlings of Echinacea purpurea in soil collected beneath 10-year-old, experimental plant communities containing one, two, four, eight, or 16 native grassland species. The results of this greenhouse bioassay challenge the assumption of constant resource supply; we found that bioassay seedlings grown in soil collected from experimental communities containing 16 plant species produced 70% more biomass than seedlings grown in soil collected beneath monocultures. This increase was likely attributable to greater soil N availability, which had increased in higher diversity communities over the 10-year-duration of the experiment. In a distinction akin to the selection/complementarity partition commonly made in studies of diversity and productivity, we further determined whether the additive effects of functional groups or the interactive effects of functional groups explained the increase in fertility with diversity. The increase in bioassay seedling biomass with diversity was largely explained by a concomitant increase in N-fixer, C4 grass, forb, and C3 grass biomass with diversity, suggesting that the additive effects of these four functional groups at higher diversity contributed to enhance N availability and retention. Nevertheless, diversity still explained a significant amount of the residual variation in bioassay seedling biomass after functional group biomass was included in a multiple regression, suggesting that interactions also increased fertility in diverse communities. Our results suggest a mechanism, the fertility effect, by which increased plant species diversity may increase community productivity over time by increasing the supply of nutrients via both greater inputs and greater retention.

  4. Long-term experience of mycophenolate mofetil for treatment of diffuse cutaneous systemic sclerosis

    PubMed Central

    Le, Elizabeth N; Wigley, Fredrick M; Shah, Ami A; Boin, Francesco; Hummers, Laura K

    2013-01-01

    Background Immunosuppressive therapy may potentially alter the natural disease course of scleroderma. There have been reports of using mycophenolate mofetil (MMF) for the treatment of scleroderma skin disease. Objective To analyse the experience of using MMF for the treatment of active diffuse cutaneous scleroderma. Methods The authors compared the change in mean modified Rodnan skin scores (mRSS) in an MMF cohort at baseline with scores at 3, 6, 9 and 12 months and with those of historical controls from a pooled analysis of three multicentre randomised clinical trials of recombinant human relaxin, d-penicillamine and oral bovine type I collagen. Results Improvement in mRSS after treatment with MMF compared with baseline was seen as early as 3 months and continued through the 12-month follow-up. The mRSS of the MMF cohort was not different from that of the historical controls at 6 months (MMF −3.05±7.4 vs relaxin −4.83±6.99, p=0.059), but was significantly lower at 12 months (MMF −7.59±10.1 vs d-penicillamine −2.47±8.6, p<0.001; collagen −3.4±7.12, p=0.002). General and muscle severity scores and quality of life measures also improved compared with baseline. Pulmonary function remained stable. Conclusions MMF may benefit skin disease in patients with diffuse scleroderma, but prospective studies are required to determine its role. PMID:21378404

  5. Long-term animal experiments with an intraventricular axial flow blood pump.

    PubMed

    Yamazaki, K; Kormos, R L; Litwak, P; Tagusari, O; Mori, T; Antaki, J F; Kameneva, M; Watach, M; Gordon, L; Mukuo, H; Umezu, M; Tomioka, J; Outa, E; Griffith, B P; Koyanagai, H

    1997-01-01

    A miniature intraventricular axial flow blood pump (IVAP) is undergoing in vivo evaluation in calves. The IVAP system consists of a miniature (phi 13.9 mm) axial flow pump that resides within the left ventricular (LV) chamber and a brushless DC motor. The pump is fabricated from titanium alloy, and the pump weight is 170 g. It produces a flow rate of over 5 L/min against 100 mmHg pressure at 9,000 rpm with an 8 W total power consumption. The maximum total efficiency exceeds 17%. A purged lip seal system is used in prototype no. 8, and a newly developed "Cool-Seal" (a low temperature mechanical seal) is used in prototype no. 9. In the Cool-Seal system, a large amount of purge flow is introduced behind the seal faces to augment convective heat transfer, keeping the seal face temperature at a low level for prevention of heat denaturation of blood proteins. The Cool-Seal system consumes < 10 cc purge fluid per day and has greatly extended seal life. The pumps were implanted in three calves (26, 30, and 168 days of support). The pump was inserted through a left thoracotomy at the fifth intercostal space. Two pursestring sutures were placed on the LV apex, and the apex was cored with a myocardial punch. The pump was inserted into the LV with the outlet cannula smoothly passing through the aortic valve without any difficulty. Only 5 min elapsed between the time of chest opening and initiation of pumping. Pump function remained stable throughout in all experiments. No cardiac arrhythmias were detected, even at treadmill exercise tests. The plasma free hemoglobin level remained in the acceptable range. Post mortem examination did not reveal any interference between the pump and the mitral apparatus. No major thromboembolism was detected in the vital organs in Cases 1 or 2, but a few small renal infarcts were detected in Case 3.

  6. Recycling vs. stabilisation of soil sugars - a long-term laboratory incubation experiment

    NASA Astrophysics Data System (ADS)

    Basler, A.; Dippold, M.; Helfrich, M.; Dyckmans, J.

    2015-06-01

    Independent of its chemical structure carbon (C) persists in soil for several decades, controlled by stabilisation and recycling. To disentangle the importance of the two factors on the turnover dynamics of soil sugars, an important compound of soil organic matter (SOM), a three year incubation experiment was conducted on a silty loam soil under different types of land use (arable land, grassland and forest) by adding 13C-labeled glucose. The compound specific isotope analysis of soil sugars was used to examine the dynamics of different sugars during incubation. Sugar dynamics were dominated by a pool of high mean residence times (MRT) indicating that recycling plays an important role for sugars. However, this was not substantially affected by soil C content. Six months after label addition the contribution of the label was much higher for microbial biomass than for CO2 production for all examined soils, corroborating that substrate recycling was very effective within the microbial biomass. Two different patterns of tracer dynamics could be identified for different sugars: while fucose (fuc) and mannose (man) showed highest label contribution at the beginning of the incubation with a subsequent slow decline, galactose (gal) and rhamnose (rha) were characterised by slow label incorporation with subsequently constant levels, which indicates that recycling is dominating the dynamics of these sugars. This may correspond to (a) different microbial growing strategies (r and K-strategist) or (b) location within or outside the cell membrane (lipopolysaccharides vs. exopolysaccharides) and thus be subject of different re-use within the microbial food web. Our results show how the microbial community recycles substrate very effectively and that high losses of substrate only occur during initial stages after substrate addition.

  7. Long-term monitoring experiences at the HADES underground lab and its relevance for radwaste repository monitoring

    SciTech Connect

    Verstricht, Jan

    2013-07-01

    In the frame of its radwaste disposal research programme, SCK-CEN started the construction of the HADES underground research facility in 1980. Including several extensions and a comprehensive experimental programme, it has provided a lot of experience on monitoring. Monitoring is performed for many reasons: construction follow-up, field characterisation, investigation of phenomena, and model validations - in which the underground lab offers the opportunity for up-scaling conventional laboratory set-ups. Construction monitoring has allowed to develop and optimise the underground construction techniques in a previously poorly known environment, resulting in a well-mastered application of mechanised methods for gallery construction with minimal damage to the host formation. Access to this formation also allows its characterisation, both geotechnical, geological and geochemical, and the detailed investigation of phenomena such as fracturing and oxidation. Finally, instrumented set-ups allow to test various numerical models by comparing the observations with the predicted behaviour. The specific conditions of the underground laboratory put particular requirements to the sensors. These conditions include the long-term nature of many set-ups - typically several years to decades, the inaccessibility of many sensors after installation, high mechanical and water pressures, and corrosion. Combined with the fact that many sensors are custom made, obtaining and maintaining a fully functional instrumented set-up can be challenging. A lot of experience has therefore been gained which is very valuable when designing the monitoring of radwaste repositories - and it has allowed us to determine the critical success factors for monitoring. Engineers tend to look at this first from a technical viewpoint - and there are many technical aspects indeed that determine the reliability of monitoring. A first one is the combination of different observations ('redundancy') which can be

  8. Incidence and influence of hospitalization for recurrent syncope and its effect on short- and long-term all-cause and cardiovascular mortality.

    PubMed

    Ruwald, Martin H; Numé, Anna-Karin; Lamberts, Morten; Hansen, Carolina M; Hansen, Morten L; Vinther, Michael; Kober, Lars; Torp-Pedersen, Christian; Hansen, Jim; Gislason, Gunnar H

    2014-05-15

    Recurrence of syncope is a common event, but the influence of recurrent syncope on the risk of death has not previously been investigated on a large scale. We examined the prognostic impact of recurrent syncope in a nationwide cohort of patients with syncope. All patients (n = 70,819) hospitalized from 2001 to 2009 in Denmark with a first-time diagnosis of syncope aged from 15 to 90 years were identified from national registries. Recurrence of syncope was incorporated as a time-dependent variable in multivariable-adjusted Cox models on the outcomes of 30-day, 1-year, and long-term all-cause mortality and cardiovascular death. During a mean follow-up of 3.9 ± 2.6 years, a total of 11,621 patients (16.4%) had at least 1 hospitalization for recurrent syncope, with a median time to recurrence of 251 days (33 to 364). A total of 14,270 patients died, and 3,204 deaths were preceded by a hospitalization for recurrent syncope. The long-term risk of all-cause death was significantly associated with recurrent syncope (hazard ratio 2.64, 95% confidence interval 2.54 to 2.75) compared with those with no recurrence. On 1-year mortality, recurrent syncope was associated with a 3.2-fold increase in risk and on 30-day mortality associated with a threefold increase. The increased mortality risk was consistent over age groups 15 to 39, 40 to 59, and 60 to 89 years, and a similar pattern of increase in both long-term and short-term risk of cardiovascular death was evident. In conclusion, recurrent syncope is independently associated with all-cause and cardiovascular mortality across all age groups exhibiting a high prognostic influence. Increased awareness on high short- and long-term risk of adverse events in subjects with recurrent syncope is warranted for future risk stratification.

  9. Effects of crop rotation and reduced nitrogen fertilisation on Apera spica-venti populations in a long-term experiment.

    PubMed

    Schulz, A; Pallurt, B; Gerowitt, B

    2011-01-01

    Apera spica-venti is one of the most serious annual grass weeds in Germany and may cause considerably yield losses in untreated fields. A long-term field experiment was conducted investigating the effects of crop rotation and nitrogen fertiliser use on A. spica-venti populations. A six-field cash-crop rotation with 67% winter cereals and a six-field fodder crop rotation with 50% winter cereals were studied. The rate of tillering was in the fodder crop rotation significantly higher than in the cash crop rotation. The halving of nitrogen fertilizer dose caused a significant increase in the tillering rate. Most plants of A. spica-venti emerged in winter wheat. There was an increase of emerged A. spica-venti in winter wheat from year to year.

  10. Long-term operation of ''Orlan'' space suits in the ''Mir'' orbiting station: Experience obtained and its application

    NASA Astrophysics Data System (ADS)

    Abramov, I. P.; Glazov, G. M.; Svertshek, V. I.

    2002-07-01

    The started assembly of the International Space Station (ISS) and its further operation will call for a great number of extravehicular activity sorties (EVA) to be performed by ISS crews. Therefore, of great importance is to make use of the EVA experience gained by cosmonauts in the process of 15-year operation of the Mir orbiting station (OS). Over the 15-year period, Mir crewmembers wearing Orlan type semi-rigid space suits have accumulated 158 man/sorties from the orbiting station. Crewmembers used 15 suits in orbit and some of the suits were in operation for more than 3 years. The paper presents principal design features, which provide effective and safe operation of orbit-based suits, and briefly describes procedures for preparation and maintenance of suit systems, which ensure long-term operation of space suit in orbit. The paper gives results of the space suit modifications, presents suit performance characteristics and lists novel or upgraded components of the space suit and its systems. The paper also summarizes improvements in the Orlan type suits described in some earlier publications. They refer, in the first run, to the improvement of space suit operations characteristics and reliability, and the utilization of the Orlan type space suit in the ISS program. The paper analyses the experience gained and drawbacks detected and observations made, and gives statistical data on long-term space suit operations aboard the Mir station. The paper reviews certain problems in the process of EVAs performed from the station, and describes the ways of their solution as applied to the further utilization of the suit within the ISS program.

  11. Long-term regional shifts in plant community composition are largely explained by local deer impact experiments.

    PubMed

    Frerker, Katie; Sabo, Autumn; Waller, Donald

    2014-01-01

    The fact that herbivores and predators exert top-down effects to alter community composition and dynamics at lower trophic levels is no longer controversial, yet we still lack evidence of the full nature, extent, and longer-term effects of these impacts. Here, we use results from a set of replicated experiments on the local impacts of white-tailed deer to evaluate the extent to which such impacts could account for half-century shifts in forest plant communities across the upper Midwest, USA. We measured species' responses to deer at four sites using 10-20 year-old deer exclosures. Among common species, eight were more abundant outside the exclosures, seven were commoner inside, and 16 had similar abundances in- and outside. Deer herbivory greatly increased the abundance of ferns and graminoids and doubled the abundance of exotic plants. In contrast, deer greatly reduced tree regeneration, shrub cover (100-200 fold in two species), plant height, plant reproduction, and the abundance of forbs. None of 36 focal species increased in reproduction or grew taller in the presence of deer, contrary to expectations. We compared these results to data on 50-year regional shifts in species abundances across 62 sites. The effects of herbivory by white-tailed deer accurately account for many of the long-term regional shifts observed in species' abundances (R2 = 0.41). These results support the conjecture that deer impacts have driven many of the regional shifts in forest understory cover and composition observed in recent decades. Our ability to link results from shorter-term, local experiments to regional long-term studies of ecological change strengthens the inferences we can draw from both approaches.

  12. Long-Term Care

    MedlinePlus

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... the Escape (Esc) button on your keyboard.) Most Care Provided at Home Long-term care is provided ...

  13. Carbon sequestration strategies for crop- and grasslands evaluated in long-term field experiments in Northern Europe

    NASA Astrophysics Data System (ADS)

    Kätterer, Thomas; Bolinder, Martin; Börjesson, Gunnar; Kirchmann, Holger

    2013-04-01

    Improved management of grass- and croplands is a win-win strategy resulting in both increased soil fertility and carbon sequestration. We quantified the effect of N fertilization, organic amendments and ley-arable rotations versus continuous annual cropping systems on soil carbon stocks by analyzing data from long-term field experiments in Nordic countries. Increasing net primary production was found to be the main driver for higher soil carbon storage. Mineral N fertilization increased soil carbon stocks by about 1-2 kg C ha-1 for each kg of N applied to cropland. Ley-arable rotations, being a combination of annual and perennial crops, are expected to have C stocks intermediate between continuous grass- and croplands. A summary of data from 15 long-term sites showed that on average 0.5 Mg ha-1 yr-1 (range 0.3 to 1.1; median 0.4 Mg ha-1 yr-1) more carbon was retained in soils in ley-arable compared to exclusively annual systems, depending on species composition, management, soil depth and the duration of the studies. We also quantified the effect of organic amendments on soil carbon stocks. Retention factors calculated for straw, manure, sawdust, peat, sewage sludge and composted household waste varied widely from about 15% for above-ground crop residues to about 90% for composted household waste. We also emphasize that increased soil carbon stocks not always lead to carbon sequestration of atmospheric CO2 and discuss misunderstandings related to mitigation options earlier proposed for carbon sequestration such as organic farming, manure application, residue handling or application of biochar. Finally, the consequences of different land use and management are discussed, taking into account two critical boundaries - the limited area of agricultural land on Earth and requirements to produce sufficient food, fibres and energy for a growing population.

  14. Results of the "Komplast" experiment on the long-term exposure of materials specimens on the ISS surface

    NASA Astrophysics Data System (ADS)

    Shumov, Andrey; Novikov, Lev

    The "Komplast" materials experiment was designed by the Khrunichev State Research and Production Space Center together with Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University and other Russian scientific institutes, and has been carried out since 1998. The aim of the experiment is to study the complex effects of space factors on specimens of various materials. Eight “Komplast” panels fitted with material specimens equipped UV-sensors and temperature sensors were located on the International Space Station (ISS) Functional Cargo Block (FGB) module exterior surface. The panels were sent into orbit with the FGB when it launched on November 20, 1998. Two of these panels were subsequently returned to Earth by Space Shuttle Discovery after 12 years of LEO exposure. The uniqueness of the "Komplast" experiment determined by long duration of open space exposure, which is much longer than in other similar experiments. For example LDEF: 1984-1990, МЕЕР (Space Station «Mir»): 1996-1997, MISSE-1, -2 (ISS): 1,5-2 years. In this work reveals laboratory research results of some materials specimens, which had been exposed on “Komplast” panels. A distinctive feature of this research was additional irradiation of specimens by atomic oxygen and electrons with energies of ~ 1-8 MeV in laboratory. In the interpretation of the experiment results was taken into account the specimens exposure temperature conditions on the ISS exterior surface and the conditions of their sunlit, defined by the above-mentioned sensors readings. Lot of attention was paid to the investigation of rubber materials specimens. The deformation, mechanical and relaxation characteristics were defined for the specimens. Also were investigations the seals-ability of model rubber seals after the long-term outer exposure. It was determined conservation volumetric deformation and relaxation characteristics of the exposed specimens and the localization of structural changes in the thin

  15. 42 CFR 412.541 - Method of payment under the long-term care hospital prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... delay in the hospital's preparation and submittal of bills to the intermediary beyond its normal billing... discharge bill. (b) Periodic interim payments—(1) Criteria for receiving periodic interim payments. (i) A... admitted to the hospital. Payment for the interim bill is determined as if the bill were a final...

  16. The Impact of Na—H+ Exchange on Long-Term Borosilicate Glass Corrosion: Experiments and Field Observations

    SciTech Connect

    Icenhower, Jonathan P; Pierce, Eric M; McGrail, B Peter

    2009-05-01

    New insights from laboratory experiments coupled with field observations indicate that pore water solutions that eventually breach containment materials in disposal systems will interact with sodium-excess borosilicate waste glass in an unexpected way. Because many glass waste forms are relatively sodium-rich, they are especially vulnerable to Na+—H+ exchange (ion exchange or simply, IEX). Although the kinetics of this process has been previously investigated for early-stage glass reactions, the implications of IEX for long-term dissolution resistance have not yet been realized. Non-radioactive glass with major- and minor-element chemical compositions similar to Hanford high-Na waste glass were subjected to dissolution experiments to quantify the rates of matrix dissolution and IEX rates. Single-Pass Flow-Through (SPFT) tests quantified the IEX rate at 40°C pH = 8 and silica saturation and showed a dependence upon the fraction of excess sodium in the glass. The equation for the rate (in moles of sodium released per meter squared per second) dependence on excess sodium is: log10rate[mol/(m2∙s)] = 0.63R + (-11.0); r2 = 0.86 where R = molar Na+/(M3+). Further, rates of Na release are slower by ≥30% in D2O-based solutions compared to those in H2O. These results are the hallmark of IEX reactions. Our results are compared against those from a lysimeter field experiment consisting of glasses buried in Hanford sand and to dissolution experiments conducted with a Pressurized Unsaturated Flow (PUF) apparatus. These longer-term tests indicate an initial decrease in dissolution rate by a factor of 10×, and then a constant steady-state rate thereafter. Thus, these data show that IEX reactions are important at near-saturation conditions and effectively prevent dissolution rates from falling below a minimum value. In sum, IEX modifies the long-term behavior of glass dissolution and models cannot assume that dissolution of Na-rich borosilicate glass will decrease by a

  17. A study of pumps for the Hot Dry Rock Geothermal Energy extraction experiment (LTFT (Long Term Flow Test))

    SciTech Connect

    Tatro, C.A.

    1986-10-01

    A set of specifications for the hot dry rock (HDR) Phase II circulation pumping system is developed from a review of basic fluid pumping mechanics, a technical history of the HDR Phase I and Phase II pumping systems, a presentation of the results from experiment 2067 (the Initial Closed-Loop Flow Test or ICFT), and consideration of available on-site electrical power limitations at the experiment site. For the Phase II energy extraction experiment (the Long Term Flow Test or LTFT) it is necessary to provide a continuous, low maintenance, and highly efficient pumping capability for a period of twelve months at variable flowrates up to 420 gpm and at surface injection pressures up to 5000 psi. The pumping system must successfully withstand attacks by corrosive and embrittling gases, erosive chemicals and suspended solids, and fluid pressure and temperature fluctuations. In light of presently available pumping hardware and electric power supply limitations, it is recommended that positive displacement multiplex plunger pumps, driven by variable speed control electric motors, be used to provide the necessary continuous surface injection pressures and flowrates for LTFT. The decision of whether to purchase the required circulation pumping hardware or to obtain contractor provided pumping services has not been made.

  18. Mineral-microbial interaction in long term experiments with sandstones and reservoir fluids exposed to CO2

    NASA Astrophysics Data System (ADS)

    Kasina, Monika; Morozova, Daria; Pellizzari, Linda; Würdemann, Hilke

    2013-04-01

    Microorganisms represent very effective geochemical catalysts, and may influence the process of the CO2 storage significantly. The goal of this study is to characterize the interactions between minerals and microorganisms during their exposure to the CO2 in a long term experiment in high pressure vessels to better understand the influence of biological processes on the composition of the reservoir sandstones and the long term stability of CO2 storage. The natural gas reservoir, proposed for the CO2 storage is characterized by high salinity (up to 420 g/l) and temperatures around 130°C, at depth of approximately 3.5 km. Microbial community of the reservoir fluid samples was dominated by different H2-oxidising, thiosulfate-oxidising and biocorrosive thermophilic bacteria as well as microorganisms similar to representatives from other deep environments, which have not previously been cultivated. The cells were attached to particles and were difficult to detect because of low cell numbers (Morozova et al., 2011). For the long term experiments, the autoclaved rock core samples from the core deposit were grinded, milled to the size of 0.5 mm and incubated with fresh reservoir fluids as inoculum for indigenous microorganisms in a N2/CH4/H2-atmosphere in high pressure vessels at a temperature of 80°C and pressure of 40 bars. Incubation was performed under lower temperature than in situ in order to favor the growth of the dormant microorganisms. After three months of incubation samples were exposed to high CO2 concentrations by insufflating it into the vessels. The sampling of rock and fluid material was executed 10 and 21 months after start of the experiment. Mineralogical analyses performed using XRD and SEM - EDS showed that main mineral components are quartz, feldspars, dolomite, anhydrite and calcite. Chemical fluid analyses using ICP-MS and ICP-OES showed that after CO2 exposure increasing Si4+ content in the fluid was noted after first sampling (ca. 25 relative

  19. Long-term outcome of infective endocarditis: A study on patients surviving over one year after the initial episode treated in a Finnish teaching hospital during 25 years

    PubMed Central

    Heiro, Maija; Helenius, Hans; Hurme, Saija; Savunen, Timo; Metsärinne, Kaj; Engblom, Erik; Nikoskelainen, Jukka; Kotilainen, Pirkko

    2008-01-01

    Background Only a few previous studies have focused on the long-term prognosis of the patients with infective endocarditis (IE). Our purpose was to delineate factors potentially associated with the long-term outcome of IE, recurrences of IE and requirement for late valve surgery. Methods A total of 326 episodes of IE in 303 patients were treated during 1980–2004 in the Turku University Hospital. We evaluated the long-term outcome and requirement for late valve surgery for 243 of these episodes in 226 patients who survived longer than 1 year after the initial admission. Factors associated with recurrences were analysed both for the 1-year survivors and for all 303 patients. Results The mean (SD) follow-up time for the 1-year survivors was 11.5 (7.3) years (range 25 days to 25.5 years). The overall survival was 95%, 82%, 66%, 51% and 45% at 2, 5, 10, 15 and 20 years. In age and sex adjusted multivariate analyses, significant predictors for long-term overall mortality were heart failure within 3 months of admission (HR 1.97, 95% CI 1.27 to 3.06; p = 0.003) and collagen disease (HR 2.54, 95% CI 1.25 to 5.19; p = 0.010) or alcohol abuse (HR 2.39, 95% CI 1.30 to 4.40; p = 0.005) as underlying conditions, while early surgery was significantly associated with lower overall mortality rates (HR 0.31, 95% CI 0.17 to 0.58; p < 0.001). Heart failure was also significantly associated with the long-term cardiac mortality (p = 0.032). Of all 303 patients, 20 had more than 1 disease episode. Chronic dialysis (p = 0.002), intravenous drug use (p = 0.002) and diabetes (p = 0.015) were significant risk factors for recurrent episodes of IE, but when analysed separately for the 1-year survivors, only chronic dialysis remained significant (p = 0.017). Recurrences and late valve surgery did not confer a poor prognosis. Conclusion Heart failure during the index episode of IE was the complication, which significantly predicted a poor long-term outcome. Patients who underwent surgery

  20. Using historical woodland creation to construct a long-term, large-scale natural experiment: the WrEN project.

    PubMed

    Watts, Kevin; Fuentes-Montemayor, Elisa; Macgregor, Nicholas A; Peredo-Alvarez, Victor; Ferryman, Mark; Bellamy, Chloe; Brown, Nigel; Park, Kirsty J

    2016-05-01

    Natural experiments have been proposed as a way of complementing manipulative experiments to improve ecological understanding and guide management. There is a pressing need for evidence from such studies to inform a shift to landscape-scale conservation, including the design of ecological networks. Although this shift has been widely embraced by conservation communities worldwide, the empirical evidence is limited and equivocal, and may be limiting effective conservation. We present principles for well-designed natural experiments to inform landscape-scale conservation and outline how they are being applied in the WrEN project, which is studying the effects of 160 years of woodland creation on biodiversity in UK landscapes. We describe the study areas and outline the systematic process used to select suitable historical woodland creation sites based on key site- and landscape-scale variables - including size, age, and proximity to other woodland. We present the results of an analysis to explore variation in these variables across sites to test their suitability as a basis for a natural experiment. Our results confirm that this landscape satisfies the principles we have identified and provides an ideal study system for a long-term, large-scale natural experiment to explore how woodland biodiversity is affected by different site and landscape attributes. The WrEN sites are now being surveyed for a wide selection of species that are likely to respond differently to site- and landscape-scale attributes and at different spatial and temporal scales. The results from WrEN will help develop detailed recommendations to guide landscape-scale conservation, including the design of ecological networks. We also believe that the approach presented demonstrates the wider utility of well-designed natural experiments to improve our understanding of ecological systems and inform policy and practice.

  1. The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant Staphylococcus aureus

    PubMed Central

    Senn, Laurence; Clerc, Olivier; Zanetti, Giorgio; Basset, Patrick; Prod’hom, Guy; Gordon, Nicola C.; Sheppard, Anna E.; Crook, Derrick W.; James, Richard; Thorpe, Harry A.; Feil, Edward J.

    2016-01-01

    ABSTRACT Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. PMID:26787833

  2. Combining long term field experiments and nanoscale analysis to enhance process understanding of root litter stabilization by mineral interactions

    NASA Astrophysics Data System (ADS)

    Chabbi, Abad; Baumann, Karen; Remusat, Laurent; Barre, Pierre; Dignac, Marie-France; Rumpel, Cornelia

    2015-04-01

    Mineral interaction may affect the stabilisation of root litter directly or indirectly after microbial decomposition and transformation. The importance of both processes may vary within the soil profile. In this study we studied C stabilisation of isotopically labelled root litter (13C and 15N), which was incubated during 3 year in the field at different soil depth. Samples from this field experiment were recovered and subjected to nanoscale analyses in order to elucidate mineral interactions occurring in different parts of the soil profile. Our results showed enrichment of mineral associated organic matter in subsoil horizons. However, material derived from new plant litter may be stabilised at similar rates in top- and subsoil horizons. N-containing compounds are enriched in the mineral associated fraction of subsoil horizons, indicating enrichment of microbial derived material with depth. Nano scale analyses showed that indeed plant-derived material may be associated with metal oxides in topsoil horizons, whereas the mineral associated organic matter in subsoil horizons may consist of microbial cells. Interestingly, in contrast to short term laboratory analysis, decoupling of C and N through stabilisation with soil minerals was observed during this long term field experiment. Our results indicate that the nature of OM stabilised by mineral interactions is depth specific. Therefore, we suggest, that plant derived lignocellulosic material may be preserved by mineral interactions in topsoil given its incomplete degradation, thereby leading to the formation of functional groups and favouring adsorption to soil minerals. This is consistent with the higher state of lignin-degradation observed in topsoil horizons as compared to subsoil. At depth, where microorganisms are most likely energy limited, degradation of fresh plant litter may be complete, thereby diminishing the formation of lignocellulosic compounds capable of sorption onto metal oxides. As a result

  3. Frictional healing and sealing in anhydrite-filled faults: from short duration experiments to long-term CO2 storage

    NASA Astrophysics Data System (ADS)

    Pluymakers, Anne; Bakker, Elisenda; Samuelson, Jon; Spiers, Christopher

    2014-05-01

    The efficacy of long-term subsurface CO2 storage requires that the stored gas remains isolated from the atmosphere for thousands of years. Faults crosscutting the reservoir and topseal system of storage sites are considered one of the most likely leakage pathways, especially if reactivation leads to fault dilation. For a proper risk assessment it is important to know if CO2 affects the self-sealing potential of fault gouges, as well as how it affects strength recovery after fault slip ceases (frictional healing). A thorough understanding of the physical processes operating in the fault gouge will help to extrapolate the data from short-term experimental time scales to long-term storage time scales. Anhydrite is a common caprock mineral in many hydrocarbon fields worldwide, and particularly in the Netherlands. In cases where faults crosscut the caprock, it is likely that these contain fine-grained, anhydrite-rich, damage material, or "fault gouge". Therefore, we have performed two sets of experiments: 1) fault shearing experiments on simulated anhydrite fault gouge, to investigate the frictional behavior of anhydrite faults, and 2) compaction creep experiments, to investigate the potential for self-sealing. All experiments were performed under pressure and temperature conditions representative for CO2 storage conditions (set 1: T = 80-150°C; normal stress = 25MPa; Pf = 15MPa; set 2: T = 80°C; stress = 5-12MPa and P¬f = 15MPa). The use of different pore fluid phases (air, vacuum, water, CO2 saturated solution, moist CO¬2 and dry CO2), as well as the range in pressures and temperatures, allows us to study the effect of the in-situ conditions on the frictional behavior, and also to identify the mechanisms responsible for the compaction behavior. Our results indicate that in both types of experiments water plays an essential role, by enhancing both fault-healing (type 1) and fault-sealing potential (type 2). The compaction experiments indicate fault sealing in fine

  4. Risk Factors for Long-Term Mortality after Hospitalization for Community-Acquired Pneumonia: A 5-Year Prospective Follow-Up Study

    PubMed Central

    Holter, Jan C.; Ueland, Thor; Jenum, Pål A.; Müller, Fredrik; Brunborg, Cathrine; Frøland, Stig S.; Aukrust, Pål; Husebye, Einar; Heggelund, Lars

    2016-01-01

    Background Contributors to long-term mortality in patients with community-acquired pneumonia (CAP) remain unclear, with little attention paid to pneumonia etiology. We examined long-term survival, causes of death, and risk factors for long-term mortality in adult patients who had been hospitalized for CAP, with emphasis on demographic, clinical, laboratory, and microbiological characteristics. Methods Two hundred and sixty-seven consecutive patients admitted in 2008–2011 to a general hospital with CAP were prospectively recruited and followed up. Patients who died during hospital stay were excluded. Demographic, clinical, and laboratory data were collected within 48 hours of admission. Extensive microbiological work-up was performed to establish the etiology of CAP in 63% of patients. Mortality data were obtained from the Norwegian Cause of Death Registry. Cox regression models were used to identify independent risk factors for all-cause mortality. Results Of 259 hospital survivors of CAP (median age 66 years), 79 (30.5%) died over a median of 1,804 days (range 1–2,520 days). Cumulative 5-year survival rate was 72.9% (95% CI 67.4–78.4%). Standardized mortality ratio was 2.90 for men and 2.05 for women. The main causes of death were chronic obstructive pulmonary disease (COPD), vascular diseases, and malignancy. Independent risk factors for death were the following (hazard ratio, 95% CI): age (1.83 per decade, 1.47–2.28), cardiovascular disease (2.63, 1.61–4.32), COPD (2.09, 1.27–3.45), immunocompromization (1.98, 1.17–3.37), and low serum albumin level at admission (0.75 per 5g/L higher, 0.58–0.96), whereas active smoking was protective (0.32, 0.14–0.74); active smokers were younger than non-smokers (P < 0.001). Microbial etiology did not predict mortality. Conclusions Results largely confirm substantial comorbidity-related 5-year mortality after hospitalization for CAP and the impact of several well-known risk factors for death, and extend

  5. Long term microparticle impact fluxes on LDEF determined from optical survey of Interplanetary Dust Experiment (IDE) sensors

    NASA Technical Reports Server (NTRS)

    Simon, C. G.; Oliver, J. P.; Cooke, W. J.; Downey, K. I.; Kassel, P. C.

    1995-01-01

    leading side during LDEF's first year in orbit.) The overall east/west ratio was 44, but during LDEF's first year in orbit the ratio was 8.5, and during years 2-6 the ratio was 114. Long term microparticle impact fluxes on the space end decreased from 1.12 to 0.55 x 10(exp -4) m(exp -2)/s from the first year in orbit compared to years 2-6. The earth end showed the opposite trend with an increase from 0.16 to 0.38 x 10(exp -4) m(exp -2)/s. Fluxes on rows 6 and 12 decreased from 6.1 to 3.4 and 6.7 to 3.7 x 10(exp -4) m(exp -2)/s, respectively, over the same time periods. This resulted in space/earth microparticle impact flux ratios of 7.1 during the first year and 1.5 during years 2-6, while the south/north, space/north and space/south ratios remained constant at 1.1, 0.16 and 0.17, respectively, during the entire mission. This information indicates the possible identification of long term changes in discrete microparticle orbital debris component contributions to the total impact flux experienced by LDEF. A dramatic decrease in the debris population capable of striking the trailing side was detected that could possibly be attributed to the hiatus of western launch activity experienced from 1986-1989. A significant increase in the debris population that preferentially struck the leading side was also observed and could possibly be attributed to a single breakup event that occurred in September of 1986. A substantial increase in the microparticle debris population that struck the earth end of LDEF, but not the space end, was also detected and could possibly be the result of a single breakup event at low altitude. These results point to the importance of including discrete orbital debris component contribution changes in flux models in order to achieve accurate predictions of the microparticle environment that a particular spacecraft will experience in earth orbit. The only reliable, verified empirical measurements of these changes are reported in this paper. Further time

  6. Can Robotic Gastrectomy Surpass Laparoscopic Gastrectomy by Acquiring Long-Term Experience? A Propensity Score Analysis of a 7-Year Experience at a Single Institution

    PubMed Central

    Hong, Sung-Soo; Shin, Ho-Jung; Cui, Long-Hai; Hur, Hoon; Han, Sang-Uk

    2016-01-01

    Purpose It is hypothesized that robotic gastrectomy may surpass laparoscopic gastrectomy after the operators acquire long-term experience and skills in the manipulation of robotic arms. This study aimed to evaluate the long-term learning curve of robotic distal gastrectomy (RDG) for gastric cancer compared with laparoscopic distal gastrectomy (LDG). Materials and Methods From October 2008 to December 2015, patients who underwent LDG (n=809) were matched to patients who underwent RDG (n=232) at a 1:1 ratio, by using a propensity score matching method after stratification for the operative year. The surgical outcomes, such as trends of operative time, blood loss, and complication rate, were compared between the two groups. Results The RDG group showed a longer operative time (171.3 minutes vs. 147.6 minutes, P<0.001) but less estimated blood loss (77.6 ml vs. 116.6 ml, P<0.001). The complication rate and postoperative recovery did not differ between the two groups. The RDG group showed a longer operative time and similar estimated blood loss compared with the LDG group after 5 years of experience (operative time: 159.2 minutes vs. 136.0 minutes in 2015, P=0.003; estimated blood loss: 72.9 ml vs. 78.1 ml in 2015, P=0.793). Conclusions In terms of short-term surgical outcomes, RDG may not surpass LDG after a long-term experience with the technique. PMID:28053810

  7. Soil wettability, moisture status and CO2 flux in a long term drought and warming simulation experiment

    NASA Astrophysics Data System (ADS)

    Urbanek, Emilia; Bösken, Janina; Titema, Albert; Nunez Pastrana, David; Emmett, Bridget

    2014-05-01

    Current climatic predictions include altered rainfall patterns and increased temperatures which in consequence can enhance the development of soil water repellency (SWR; i.e. hydrophobicity). Soils may become more severely water-repellent or SWR may spread into the environments where it has not been observed before. As the soil moisture dynamics, including restricted infiltration and uneven distribution of water is severely altered in water-repellent soils, so might be the decomposition of organic matter and overall exchange of gases like CO2 between the soil and the atmosphere. Long-term climatic simulation study has been conducted for over a decade at upland heathland sites in Oldebroek (Netherlands) and in Clocaenog (UK) [1]. At each site nine 20 m2-large plots were selected and each three were subjected to: a drought effect created by a rainfall exclusion using an automatic self retracting waterproof curtains; a warming effect using a self retracting curtains reflecting infrared radiation overnight, and control plots. The soil at the sites was a peaty podzol and sandy podzol both highly prone to soil water repellency development. The sites were constantly monitored since the start of the experiment and the range of meteorological and environmental measurements included for example: soil moisture, temperature, vegetation and root zone changes, soil CO2 flux. The observations of soil moisture content have shown that the soil moisture did not recover to the original values in the drought system even after the rainfall exclusion has been stopped for winter time, suggesting the development of soil water repellency [2]. The severe changes in moisture dynamics have also significantly affected the soil CO2 flux. The aim of the study was to investigate whether the long-term drought and warming treatments have any effect on the severity and persistence of SWR and how far the moisture changes and the SWR altered the CO2 flux from these soils. The measurements of the SWR

  8. 42 CFR 412.526 - Payment provisions for a “subclause (II)” long-term care hospital.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... reimbursement rules. Medicare inpatient operating costs are paid based on reasonable cost, subject to a ceiling..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL... payment amount is determined based on reasonable cost, as described at § 412.526(c). (c) Determining...

  9. Impact of weed control on arbuscular mycorrhizal fungi in a tropical agroecosystem: a long-term experiment.

    PubMed

    Ramos-Zapata, José A; Marrufo-Zapata, Denis; Guadarrama, Patricia; Carrillo-Sánchez, Lilia; Hernández-Cuevas, Laura; Caamal-Maldonado, Arturo

    2012-11-01

    Cover crop species represent an affordable and effective weed control method in agroecosystems; nonetheless, the effect of its use on arbuscular mycorrhizal fungi (AMF) has been scantily studied. The goal of this study was to determine root colonization levels and AMF species richness in the rhizosphere of maize plants and weed species growing under different cover crop and weed control regimes in a long-term experiment. The treatment levels used were (1) cover of Mucuna deeringian (Muc), (2) "mulch" of Leucaena leucocephala (Leu), (3) "mulch" of Lysiloma latisiliquum (Lys), (4) herbicide (Her), (5) manual weeding (CD), (6) no weeding (SD), and (7) no maize and no weeding (B). A total of 18 species of AMF belonging to eight genera (Acaulospora, Ambispora, Claroideoglomus, Funneliformis, Glomus, Rhizophagus, Sclerocystis, and Scutellospora) were identified from trap cultures. Muc and Lys treatments had a positive impact on AMF species richness (11 and seven species, respectively), while Leu and B treatments on the other hand gave the lowest richness values (six species each). AMF colonization levels in roots of maize and weeds differed significantly between treatment levels. Overall, the use of cover crop species had a positive impact on AMF species richness as well as on the percentage of root colonized by AMF. These findings have important implications for the management of traditional agroecosystems and show that the use of cover crop species for weed control can result in a more diverse AMF community which should potentially increase crop production in the long run.

  10. Soil ionomic and enzymatic responses and correlations to fertilizations amended with and without organic fertilizer in long-term experiments

    NASA Astrophysics Data System (ADS)

    Feng, Xumeng; Ling, Ning; Chen, Huan; Zhu, Chen; Duan, Yinghua; Peng, Chang; Yu, Guanghui; Ran, Wei; Shen, Qirong; Guo, Shiwei

    2016-04-01

    To investigate potential interactions between the soil ionome and enzyme activities affected by fertilization with or without organic fertilizer, soil samples were collected from four long-term experiments over China. Irrespective of variable interactions, fertilization type was the major factor impacting soil ionomic behavior and accounted for 15.14% of the overall impact. Sampling site was the major factor affecting soil enzymatic profile and accounted for 34.25% of the overall impact. The availabilities of Pb, La, Ni, Co, Fe and Al were significantly higher in soil with only chemical fertilizer than the soil with organic amendment. Most of the soil enzyme activities, including α-glucosidase activity, were significantly activated by organic amendment. Network analysis between the soil ionome and the soil enzyme activities was more complex in the organic-amended soils than in the chemical fertilized soils, whereas the network analysis among the soil ions was less complex with organic amendment. Moreover, α-glucosidase was revealed to generally harbor more corrections with the soil ionic availabilities in network. We concluded that some of the soil enzymes activated by organic input can make the soil more vigorous and stable and that the α-glucosidase revealed by this analysis might help stabilize the soil ion availability.

  11. Determination of longevities, chamber building rates and growth functions for Operculina complanata from long term cultivation experiments

    NASA Astrophysics Data System (ADS)

    Woeger, Julia; Kinoshita, Shunichi; Wolfgang, Eder; Briguglio, Antonino; Hohenegger, Johann

    2016-04-01

    Operculina complanata was collected in 20 and 50 m depth around the Island of Sesoko belonging to Japans southernmost prefecture Okinawa in a series of monthly sampling over a period of 16 months (Apr.2014-July2015). A minimum of 8 specimens (4 among the smallest and 4 among the largest) per sampling were cultured in a long term experiment that was set up to approximate conditions in the field as closely as possible. A set up allowing recognition of individual specimens enabled consistent documentation of chamber formation, which in combination with μ-CT-scanning after the investigation period permitted the assignment of growth steps to specific time periods. These data were used to fit various mathematical models to describe growth (exponential-, logistic-, generalized logistic-, Gompertz-function) and chamber building rate (Michaelis-Menten-, Bertalanffy- function) of Operculina complanata. The mathematically retrieved maximum lifespan and mean chamber building rate found in cultured Operculina complanata were further compared to first results obtained by the simultaneously conducted "natural laboratory approach". Even though these comparisons hint at a somewhat stunted growth and truncated life spans of Operculina complanata in culture, they represent a possibility to assess and improve the quality of further cultivation set ups, opening new prospects to a better understanding of the their theoretical niches.

  12. Soil ionomic and enzymatic responses and correlations to fertilizations amended with and without organic fertilizer in long-term experiments

    PubMed Central

    Feng, Xumeng; Ling, Ning; Chen, Huan; Zhu, Chen; Duan, Yinghua; Peng, Chang; Yu, Guanghui; Ran, Wei; Shen, Qirong; Guo, Shiwei

    2016-01-01

    To investigate potential interactions between the soil ionome and enzyme activities affected by fertilization with or without organic fertilizer, soil samples were collected from four long-term experiments over China. Irrespective of variable interactions, fertilization type was the major factor impacting soil ionomic behavior and accounted for 15.14% of the overall impact. Sampling site was the major factor affecting soil enzymatic profile and accounted for 34.25% of the overall impact. The availabilities of Pb, La, Ni, Co, Fe and Al were significantly higher in soil with only chemical fertilizer than the soil with organic amendment. Most of the soil enzyme activities, including α-glucosidase activity, were significantly activated by organic amendment. Network analysis between the soil ionome and the soil enzyme activities was more complex in the organic-amended soils than in the chemical fertilized soils, whereas the network analysis among the soil ions was less complex with organic amendment. Moreover, α-glucosidase was revealed to generally harbor more corrections with the soil ionic availabilities in network. We concluded that some of the soil enzymes activated by organic input can make the soil more vigorous and stable and that the α-glucosidase revealed by this analysis might help stabilize the soil ion availability. PMID:27079657

  13. Bacteria and virus removal effectiveness of ceramic pot filters with different silver applications in a long term experiment.

    PubMed

    van der Laan, H; van Halem, D; Smeets, P W M H; Soppe, A I A; Kroesbergen, J; Wubbels, G; Nederstigt, J; Gensburger, I; Heijman, S G J

    2014-03-15

    In 2012 more than 4 million people used a ceramic pot filter (CPF) as household water treatment system for their daily drinking water needs. In the normal production protocol most low cost filters are impregnated with a silver solution to enhance the microbial removal efficiency. The aim of this study was to determine the role of silver during the filtration and subsequent storage. Twenty-two CPFs with three different silver applications (non, only outside and both sides) were compared in a long-term loading experiment with Escherichia coli (K12 and WR1) and MS2 bacteriophages in natural challenge water under highly controlled laboratory circumstances. No significant difference in Log Removal Values were found between the filters with different silver applications. The results show that the storage time in the receptacle is the dominant parameter to reach E. coli inactivation by silver, and not the contact time during the filtration phase. The hypothesis that the absence of silver would enhance the virus removal, due to biofilm formation on the ceramic filter element, could not be confirmed. The removal effectiveness for viruses is still of major concern for the CPF. This study suggests that the ceramic pot filter characteristics, such as burnt material content, do not determine E. coli removal efficacies, but rather the contact time with silver during storage is the dominant parameter to reach E. coli inactivation.

  14. Studies of HT and HTO Behavior in the Vicinity of Long-Term Emission Source: Model - Experiment Intercomparison

    SciTech Connect

    Golubev, A. V.; Aleinikov, A. Y.; Golubeva, V. N.; Khabibulin, M. M.; Glagolev, M. V.; Misatyuk, S. E.; Mavrin, S. V.; Belot, Y. A.; Raskob, W.; Tate, P. J.

    2003-02-24

    There are presented in the research results of HT and HTO deposition and the model of HT (HTO) atmosphere concentration in the vicinity of a long-term HT and HTO emission source. Scavenging of HTO by precipitations was studied in 6 field experiments. The site of the scavenging experiments was around a 30 m emission source. The sampling arcs were chosen at 150-300 m from the base of the source to minimize dry deposition on the precipitation collectors. Data of the scavenging experiments are presented. Kinetics of HT deposition to soil through its oxidation has been studied in laboratory conditions. The activity of HTO converted in the soil sample during a certain period of time was used to determine the oxidation rate. This rate varies, depending on the catalytic and/or biological activity of the soil material. Theoretical considerations have shown that the deposition rate can be expressed by the effective rate of oxidation, which formally corresponds to the first-order HT oxidation. HT deposition rates are reported. The model, used for assessments, takes into account atmospheric dispersion, deposition and reemission. The model of HTO wet deposition is taken into account kinetics of HTO exchange between vapor and liquid phase with parameters such as rain drop spectra, rain intensity, condensation-evaporation on drop's interface. Gauss type formulae for continuous emission source is used to calculate HTO atmospheric concentration. Meteorological data are used as input parameters for modeling. The data presented on HT deposition to soil and HTO washout by precipitation is required for assessment of consequences of HT (HTO) release into the atmosphere.

  15. Long-term Engagement in Authentic Research with NASA (LEARN): Lessons Learned from an Innovative Model for Teacher Research Experiences

    NASA Astrophysics Data System (ADS)

    Pippin, M. R.; Kollmeyer, R.; Joseph, J.; Yang, M. M.; Omar, A. H.; Harte, T.; Taylor, J.; Lewis, P. M.; Weisman, A.; Hyater-Adams, S.

    2013-12-01

    The NASA LEARN Project is an innovative program that provides long-term immersion in the practice of atmospheric science for middle and high school in-service teachers. Working alongside NASA scientists and using authentic NASA Science Mission Directorate (SMD) Research and Analysis (R&A) related and mission-based research data, teachers develop individual research topics of interest during two weeks in the summer while on-site at NASA Langley. With continued, intensive mentoring and guidance of NASA scientists, the teachers further develop their research throughout the academic year through virtual group meetings and data team meetings mirroring scientific collaborations. At the end of the first year, the LEARN teachers present scientific posters. During summer 2013, Cohort 1 (7 teachers) presented posters at an open session and discussed their research topics with Cohort 2 (6 teachers) and science and educator personnel at Langley. The LEARN experience has had such an impact that 6 teachers from Cohort 1 have elected to continue a second year of research working alongside Cohort 2 and LEARN scientists. In addition, Cohort 1 teachers have brought their LEARN experiences back to their classrooms in a variety of ways. The LEARN project evaluation has provided insights into the outcomes of this research experience for teachers and particularly effective program elements. In particular, the LEARN evaluation has focused on how an extended research experience for teachers spanning a full year influences teacher views of science and classroom integration of scientific principles. Early findings indicate that teachers' perceptions of the scientific enterprise have changed, and that LEARN provided substantial resources to help them take real-world research to their students. Teachers also valued the teamwork and cohort approach. In addition, the LEARN evaluation focuses on the experiences of scientists involved in the LEARN program and how their experiences working with

  16. Long-Term Burden and Respiratory Effects of Respiratory Syncytial Virus Hospitalization in Preterm Infants—The SPRING Study

    PubMed Central

    Carbonell-Estrany, Xavier; Pérez-Yarza, Eduardo G.; García, Laura Sanchez; Guzmán Cabañas, Juana M.; Bòria, Elena Villarrubia; Atienza, Belén Bernardo

    2015-01-01

    The health status of premature infants born 321-350 weeks’ gestational age (wGA) hospitalized for RSV infection in the first year of life (cases; n = 125) was compared to that of premature infants not hospitalized for RSV (controls; n = 362) through 6 years. The primary endpoints were the percentage of children with wheezing between 2-6 years and lung function at 6 years of age. Secondary endpoints included quality of life, healthcare resource use, and allergic sensitization. A significantly higher proportion of cases than controls experienced recurrent wheezing through 6 years of age (46.7% vs. 27.4%; p = 0.001). The vast majority of lung function tests appeared normal at 6 years of age in both cohorts. In children with pulmonary function in the lower limit of normality (FEV1 Z-score [-2; -1]), wheezing was increased, particularly for cases vs. controls (72.7% vs. 18.9%, p = 0.002). Multivariate analysis revealed the most important factor for wheezing was RSV hospitalization. Quality of life on the respiratory subscale of the TAPQOL was significantly lower (p = 0.001) and healthcare resource utilization was significantly higher (p<0.001) in cases than controls. This study confirms RSV disease is associated with wheezing in 32-35 wGA infants through 6 years of age. PMID:25955487

  17. Characteristics, in-hospital and long-term clinical outcomes of nonagenarian compared with octogenarian acute myocardial infarction patients.

    PubMed

    Lee, Ki Hong; Ahn, Youngkeun; Kim, Sung Soo; Rhew, Si Hyun; Jeong, Young Wook; Jang, Soo Young; Cho, Jae Yeong; Jeong, Hae Chang; Park, Keun-Ho; Yoon, Nam Sik; Sim, Doo Sun; Yoon, Hyun Joo; Kim, Kye Hun; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Cho, Jeong Gwan; Park, Jong Chun; Jeong, Myung Ho; Cho, Myeong-Chan; Kim, Chong Jin; Kim, Young Jo

    2014-04-01

    We compared clinical characteristics, management, and clinical outcomes of nonagenarian acute myocardial infarction (AMI) patients (n=270, 92.3 ± 2.3 yr old) with octogenarian AMI patients (n=2,145, 83.5 ± 2.7 yr old) enrolled in Korean AMI Registry (KAMIR). Nonagenarians were less likely to have hypertension, diabetes and less likely to be prescribed with beta-blockers, statins, and glycoprotein IIb/IIIa inhibitors compared with octogenarians. Although percutaneous coronary intervention (PCI) was preferred in octogenarians than nonagenarians, the success rate of PCI between the two groups was comparable. In-hospital mortality, the composite of in-hospital adverse outcomes and one year mortality were higher in nonagenarians than in octogenarians. However, the composite of the one year major adverse cardiac events (MACEs) was comparable between the two groups without differences in MI or re-PCI rate. PCI improved 1-yr mortality (adjusted hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.36-0.69, P<0.001) and MACEs (adjusted HR, 0.47; 95% CI, 0.37-0.61, P<0.001) without significant complications both in nonagenarians and octogenarians. In conclusion, nonagenarians had similar 1-yr MACEs rates despite of higher in-hospital and 1-yr mortality compared with octogenarian AMI patients. PCI in nonagenarian AMI patients was associated to better 1-yr clinical outcomes.

  18. Long-Term Burden and Respiratory Effects of Respiratory Syncytial Virus Hospitalization in Preterm Infants-The SPRING Study.

    PubMed

    Carbonell-Estrany, Xavier; Pérez-Yarza, Eduardo G; García, Laura Sanchez; Guzmán Cabañas, Juana M; Bòria, Elena Villarrubia; Atienza, Belén Bernardo

    2015-01-01

    The health status of premature infants born 321-350 weeks' gestational age (wGA) hospitalized for RSV infection in the first year of life (cases; n = 125) was compared to that of premature infants not hospitalized for RSV (controls; n = 362) through 6 years. The primary endpoints were the percentage of children with wheezing between 2-6 years and lung function at 6 years of age. Secondary endpoints included quality of life, healthcare resource use, and allergic sensitization. A significantly higher proportion of cases than controls experienced recurrent wheezing through 6 years of age (46.7% vs. 27.4%; p = 0.001). The vast majority of lung function tests appeared normal at 6 years of age in both cohorts. In children with pulmonary function in the lower limit of normality (FEV1 Z-score [-2; -1]), wheezing was increased, particularly for cases vs. controls (72.7% vs. 18.9%, p = 0.002). Multivariate analysis revealed the most important factor for wheezing was RSV hospitalization. Quality of life on the respiratory subscale of the TAPQOL was significantly lower (p = 0.001) and healthcare resource utilization was significantly higher (p<0.001) in cases than controls. This study confirms RSV disease is associated with wheezing in 32-35 wGA infants through 6 years of age.

  19. [An Experience of Providing Palliative Care in a Long-Term Care Facility: Let Good Death in Place Become a Feasible Reality].

    PubMed

    Chen, Ming-Mei; Chou, Chun-Chen; Hsu, Kuei-Ying; Yen, Yung-Feng; Yang, Ya-Ting; Huang, Hsiu-Li

    2017-04-01

    As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs. The present article describes the LTCF nursing process that was used in caring for an EoL resident. Several interventions were used to assist this EoL resident to experience a dignified and peaceful death. These interventions included promoting the advance directive on hospice palliative care, linking community hospice palliative teams, ceating a warm environment, integrating the multidisciplinary team to alleviate the resident's distress symptoms, supporting the resident's psycho-social-spiritual needs, and accompanying family members through the process of anticipatory grief. This experience illustrates the feasibility of maintaining EoL residents in familiar LTCF environs in order to help them experience a good death in place.

  20. The Stratospheric Aerosol and Gas Experiment III - International Space Station: Extending Long-Term Ozone and Aerosol Observations (Invited)

    NASA Astrophysics Data System (ADS)

    Eckman, R.; Zawodny, J. M.; Cisewski, M.; Gasbarre, J.; Flittner, D. E.; Hill, C.; Roell, M.; Moore, J. R.; Hernandez, G.; McCormick, M. P.

    2013-12-01

    The Stratospheric Aerosol and Gas Experiment III - International Space Station (SAGE III on ISS) will extend the global measurements of vertical profiles of ozone, aerosols, water vapor, nitrogen dioxide, and other trace gases begun with SAGE I in 1979, enabling the detection of long-term trends. SAGE III on ISS is the fourth in a series of instruments developed for monitoring these constituents in the stratosphere and troposphere. The SAGE III instrument is a moderate resolution spectrometer covering wavelengths from 290 nm to 1550 nm, using the heritage occultation technique, utilizing both the sun and the moon. Launch to ISS is planned for early 2015 aboard a Falcon 9 spacecraft. SAGE III will investigate the spatial and temporal variability of the measured species in order to determine their role in climatological processes, biogeochemical cycles, the hydrologic cycle, and atmospheric chemistry. It will characterize tropospheric, as well as stratospheric aerosols and upper tropospheric and stratospheric clouds, and investigate their effects on the Earth's environment including radiative, microphysical, and chemical interactions. The multi-decadal SAGE ozone and aerosol data sets have undergone intense scrutiny and are the international standard for accuracy and stability. SAGE data have been used to monitor the effectiveness of the Montreal Protocol. Amongst its key objectives will be to assess the state of the recovery in the distribution of ozone, to reestablish the aerosol measurements needed by both climate and ozone models, and to gain further insight into key processes contributing to ozone and aerosol variability. The ISS is ideal for Earth observing experiments; its mid-inclination orbit allows for a large range in latitude sampling and nearly continuous communications with payloads. In this presentation, we describe the SAGE III on ISS mission, its implementation, current status, and concentrate on its key science objectives.

  1. Effects of landscape transformation on bird colonization and extinction patterns in a large-scale, long-term natural experiment.

    PubMed

    Mortelliti, Alessio; Lindenmayer, David B

    2015-10-01

    Conversion of agricultural land to forest plantations is a major driver of global change. Studies on the impact of forest plantations on biodiversity in plantations and in the surrounding native vegetation have been inconclusive. Consequently, it is not known how to best manage the extensive areas of the planet currently covered by plantations. We used a novel, long-term (16 years) and large-scale (30,000 ha) landscape transformation natural experiment (the Nanangroe experiment, Australia) to test the effects of land conversion on population dynamics of 64 bird species associated with woodland and forest. A unique aspect of our study is that we focused on the effects of plantations on birds in habitat patches within plantations. Our study design included 56 treatment sites (Eucalyptus patches where the surrounding matrix was converted from grazed land to pine plantations), 55 control sites (Eucalyptus patches surrounded by grazed land), and 20 matrix sites (sites within the pine plantations and grazed land). Bird populations were studied through point counts, and colonization and extinction patterns were inferred through multiple season occupancy models. Large-scale pine plantation establishment affected the colonization or extinction patterns of 89% of studied species and thus led to a comprehensive turnover in bird communities inhabiting Eucalyptus patches embedded within the maturing plantations. Smaller bodied species appeared to respond positively to plantations (i.e., colonization increased and extirpation of these species decreased in patches surrounded by plantations) because they were able to use the newly created surrounding matrix. We found that the effects of forest plantations affected the majority of the bird community, and we believe these effects could lead to the artificial selection of one group of species at the expense of another.

  2. Ca. Nitrososphaera and Bradyrhizobium are inversely correlated and related to agricultural practices in long-term field experiments

    PubMed Central

    Zhalnina, Kateryna; de Quadros, Patricia D.; Gano, Kelsey A.; Davis-Richardson, Austin; Fagen, Jennie R.; Brown, Christopher T.; Giongo, Adriana; Drew, Jennifer C.; Sayavedra-Soto, Luis A.; Arp, Dan J.; Camargo, Flavio A. O.; Daroub, Samira H.; Clark, Ian M.; McGrath, Steve P.; Hirsch, Penny R.; Triplett, Eric W.

    2013-01-01

    Agricultural land management, such as fertilization, liming, and tillage affects soil properties, including pH, organic matter content, nitrification rates, and the microbial community. Three different study sites were used to identify microorganisms that correlate with agricultural land use and to determine which factors regulate the relative abundance of the microbial signatures of the agricultural land-use. The three sites included in this study are the Broadbalk Experiment at Rothamsted Research, UK, the Everglades Agricultural Area, Florida, USA, and the Kellogg Biological Station, Michigan, USA. The effects of agricultural management on the abundance and diversity of bacteria and archaea were determined using high throughput, barcoded 16S rRNA sequencing. In addition, the relative abundance of these organisms was correlated with soil features. Two groups of microorganisms involved in nitrogen cycle were highly correlated with land use at all three sites. The ammonia oxidizing-archaea, dominated by Ca. Nitrososphaera, were positively correlated with agriculture while a ubiquitous group of soil bacteria closely related to the diazotrophic symbiont, Bradyrhizobium, was negatively correlated with agricultural management. Analysis of successional plots showed that the abundance of ammonia oxidizing-archaea declined and the abundance of bradyrhizobia increased with time away from agriculture. This observation suggests that the effect of agriculture on the relative abundance of these genera is reversible. Soil pH and NH3 concentrations were positively correlated with archaeal abundance but negatively correlated with the abundance of Bradyrhizobium. The high correlations of Ca. Nitrososphaera and Bradyrhizobium abundances with agricultural management at three long-term experiments with different edaphoclimatic conditions allowed us to suggest these two genera as signature microorganisms for agricultural land use. PMID:23641242

  3. Surgical Experience and Long-term Results of Baroreflex Activation Therapy for Heart Failure With Reduced Ejection Fraction.

    PubMed

    Weaver, Fred A; Abraham, William T; Little, William C; Butter, Christian; Ducharme, Anique; Halbach, Marcel; Klug, Didier; Lovett, Eric G; Madershahian, Navid; Müller-Ehmsen, Jochen; Schafer, Jill E; Senni, Michele; Swarup, Vijay; Wachter, Rolf; Zile, Michael R

    2016-01-01

    The purpose of this publication is to describe the intraoperative experience along with long-term safety and efficacy of the second-generation baroreflex activation therapy (BAT) system in patients with heart failure (HF) and reduced ejection fraction HF (HFrEF). In a randomized trial of New York Heart Association Class III HFrEF, 140 patients were assigned 1:1 to receive BAT plus medical therapy or medical therapy alone. Procedural information along with safety and efficacy data were collected and analyzed over 12 months. Within the cohort of 71 patients randomized to BAT, implant procedure time decreased with experience, from 106 ± 37 minutes on the first case to 83 ± 32 minutes on the third case. The rate of freedom from system- and procedure-related complications was 86% through 12 months, with the percentage of days alive without a complication related to system, procedure, or underlying cardiovascular condition identical to the control group. The complications that did occur were generally mild and short-lived. Overall, 12 months therapeutic benefit from BAT was consistent with previously reported efficacy through 6 months: there was a significant and sustained beneficial treatment effect on New York Heart Association functional Class, quality of life, 6-minute hall walk distance, plasma N-terminal pro-brain natriuretic peptide, and systolic blood pressure. This was true for the full trial cohort and a predefined subset not receiving cardiac resynchronization therapy. There is a rapid learning curve for the specialized procedures entailed in a BAT system implant. BAT system implantation is safe with the therapeutic benefits of BAT in patients with HFrEF being substantial and maintained for at least 1 year.

  4. Elevation in systolic blood pressure during heart failure hospitalization is associated with increased short and long-term mortality

    PubMed Central

    Segal, Omer; Segal, Gad; Leibowitz, Avshalom; Goldenberg, Ilan; Grossman, Ehud; Klempfner, Robert

    2017-01-01

    Abstract The relationship between systolic blood pressure (SBP) change during hospitalization of patients with heart failure (HF) and clinical outcomes has never been thoroughly investigated. A total of 3393 patients hospitalized with HF, from 25 hospitals in Israel, were enrolled. The SBP change was calculated by subtracting the discharge SBP values from the admission values and then divided into quartiles of SBP change. We compared the group with upper quartile SBP change to the lower 3 quartiles of change. Both groups had largely similar demographics and clinical characteristics. All-cause mortality rate was 24% at 1-year and 82.6% at 10-years, whereas patients in the upper SBP change group had significantly higher cumulative mortality probability at 1-year (30% vs 22%; log-rank P <0.001), and at 10-years (86% vs 82%; log-rank P <0.001). Multivariate Cox proportional hazard analysis adjusted for comorbidities demonstrated that patients in the upper SBP change quartile have an independent 17% higher mortality risk at 10-years [hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.08–1.28]. Subgroup analysis demonstrated that mortality risk was more pronounced in patients with preserved ejection fraction and in the subgroup with admission SBP ≥140 mm Hg. SBP change is significantly associated with 1- and 10-year all-cause mortality, as an increased SBP change is associated with worse prognosis. We believe that this readily available marker might facilitate risk stratification of patients and possibly improve care. PMID:28151864

  5. Chemicals associated with site-specific neoplasia in 1394 long-term carcinogenesis experiments in laboratory rodents.

    PubMed

    Huff, J; Cirvello, J; Haseman, J; Bucher, J

    1991-06-01

    The carcinogenicity data base used for this paper originated in the late 1960s by the National Cancer Institute and since 1978 has been continued and made more comprehensive by the National Toxicology Program. The extensive files contain among other sets of information detailed pathology data on more than 400 long-term (most often 24 month) chemical carcinogenesis studies, comprised of nearly 1600 individual experiments having at least 10 million tissue sections that have been evaluated for toxicity and carcinogenicity. Using the current data set of 379 studies made up of 1394 experiments, we have compiled listings of chemicals having like carcinogenic target sites for each of the 34 organs or systems for which histopathology diagnoses have been recorded routinely. The most common tumor site is the liver (15% of all experiments), followed in rank order by: lung, hematopoietic system and kidneys, mammary glands, forestomach, thyroid glands, Zymbal glands, urinary bladder, skin and uterus/cervix, and circulatory system and adrenal glands. These compilations are most useful for maintaining a historic perspective when evaluating the carcinogenicity of contemporary experiments. Equally important, the chemical-tumor-organ connection permits an evaluation of how well chemically induced cancers in a particular organ in one sex or species will predict or correlate with the other sex or species. Using liver cancers as an example, the overall interspecies concordance is 80%. Likewise target site predictions can be made for chemicals selected for study that may be similar to those already evaluated; thereby experimental protocols could be adjusted to allow, for example, more extensive pathology on preselected target organs (i.e., serial sections of the kidney). Further from these observations, one could decide to use two strains of mice to evaluate a short-chain chlorinated aliphatic compound or to study a human carcinogen in a sex-species known to develop chemically induced

  6. Emergence of multidrug-resistant Corynebacterium striatum as a nosocomial pathogen in long-term hospitalized patients with underlying diseases.

    PubMed

    Otsuka, Yoshihito; Ohkusu, Kiyofumi; Kawamura, Yoshiaki; Baba, Shigeyoshi; Ezaki, Takayuki; Kimura, Satoshi

    2006-02-01

    During a 53-month period (March 1994 to August 1998), 48 Corynebacterium striatum isolates recovered from clinical specimens were characterized. The organisms were identified by both phenotypic characteristics and 16S rRNA gene sequence analysis. Thirty-six (75%) were isolated from sputum/bronchial aspirates, 10 (21%) from wound exudates/pus, 1 (2%) from vaginal discharge, and 1 (2%) from an otorrheic specimen. All 48 patients had been hospitalized for treatment of an underlying disease and had received antibiotics previously. The C. striatum isolates were considered pathogenic based on their abundance within polymorphonuclear neutrophils and their dominant growth in culture. Sensitivities of isolates to 11 antibiotics were determined by broth microdilution. MIC90 values of the isolates were 1 microg/mL for vancomycin, 16 microg/mL for penicillin and ampicillin, 32 microg/mL for minocycline, and > or = 32 microg/mL for cephalosporins, imipenem, ofloxacin, and macrolides. Restriction fragment-length polymorphism analysis with pulsed-field gel electrophoresis was used to determine the clonal identity. The pulse-field gel electrophoresis profiles revealed 14 distinct patterns with 20 subtypes. The isolates for the nosocomial outbreaks of C. striatum included 3 types (A, D, and E) with 4 subtypes (A1, A2, D2, and E). All 4 genotypes had broad-spectrum resistance to antimicrobial agents. Furthermore, type E strain isolated from 3 patients in the same ward was sensitive only to vancomycin. We conclude that C. striatum should be considered an emerging multidrug-resistant nosocomial pathogen in patients hospitalized for a prolonged period and/or in immunocompromised patients with such underlying conditions as cerebrovascular disease, pulmonary disease, diabetes, or malignancy.

  7. Water maze experience and prenatal choline supplementation differentially promote long-term hippocampal recovery from seizures in adulthood.

    PubMed

    Wong-Goodrich, Sarah J E; Glenn, Melissa J; Mellott, Tiffany J; Liu, Yi B; Blusztajn, Jan K; Williams, Christina L

    2011-06-01

    Status epilepticus (SE) in adulthood dramatically alters the hippocampus and produces spatial learning and memory deficits. Some factors, like environmental enrichment and exercise, may promote functional recovery from SE. Prenatal choline supplementation (SUP) also protects against spatial memory deficits observed shortly after SE in adulthood, and we have previously reported that SUP attenuates the neuropathological response to SE in the adult hippocampus just 16 days after SE. It is unknown whether SUP can ameliorate longer-term cognitive and neuropathological consequences of SE, whether repeatedly engaging the injured hippocampus in a cognitive task might facilitate recovery from SE, and whether our prophylactic prenatal dietary treatment would enable the injured hippocampus to more effectively benefit from cognitive rehabilitation. To address these issues, adult offspring from rat dams that received either a control (CON) or SUP diet on embryonic days 12-17 first received training on a place learning water maze task (WM) and were then administered saline or kainic acid (KA) to induce SE. Rats then either remained in their home cage, or received three additional WM sessions at 3, 6.5, and 10 weeks after SE to test spatial learning and memory retention. Eleven weeks after SE, the brains were analyzed for several hippocampal markers known to be altered by SE. SUP attenuated SE-induced spatial learning deficits and completely rescued spatial memory retention by 10 weeks post-SE. Repeated WM experience prevented SE-induced declines in glutamic acid decarboxylase (GAD) and dentate gyrus neurogenesis, and attenuated increased glial fibrilary acidic protein (GFAP) levels. Remarkably, SUP alone was similarly protective to an even greater extent, and SUP rats that were water maze trained after SE showed reduced hilar migration of newborn neurons. These findings suggest that prophylactic SUP is protective against the long-term cognitive and neuropathological effects of

  8. Effects of agricultural tillage practise on green house gas balance of an arable soil in a long term field experiment

    NASA Astrophysics Data System (ADS)

    Munch, Jean Charles; Schilling, Rolf; Ruth, Bernhard; Fuss, Roland

    2010-05-01

    Soils are an important part of the global carbon cycle. A large proportion of global carbon dioxide (CO2) emissions is released from soils, though carbon sequestration occurs. Nitrous oxide (N2O) emissions of soils are also believed to contribute significantly to the green house effect as well as the stratospheric ozone depletion. An important source of N2O emissions is denitrification of nitrate from nitrogen fertilized soils. Although it is desirable to minimize these emissions while maintaining high crop yields it is still poorly understood how green house gas emissions may be steered by agricultural management practise, i.e. tillage and fertilization systems . In an ongoing long term field experiment at the research farm Scheyern, Bavaria, a arable field with one homogenous soil formation was transformed into plots in a randomized design 14 years ago. Since then, they are managed using conventional tillage (CT) and no tillage (NT) as well as low and high fertilization. A conventional crop rotation is maintained on the field. Starting 2007, CO2 and N2O emissions were monitored continuously for 2.5 years. Furthermore water content, temperature and redox potential were measured in-situ as they are major factors on microbial activity and denitrification. Soil was sampled from the Ap horizons of the plots about twice a month and extracts from these soil samples were analyzed for dissolved organic carbon (DOC), ammonium, nitrate/nitrite, and dissolved organic nitrogen (DON). According to the results soil density and hydrology are clearly affected by tillage practise. DOC is more affected by tillage while concentration of nitrogen species is controlled mainly by fertilization. There are distinct differences in redox potential between CT and NT plots with CT plots having more anaerobic periods. CO2 and N2O emissions exhibit a clear seasonal pattern and are affected by both tillage system and fertilization

  9. The impact of interventional nephrologists on the growth of a peritoneal dialysis program: Long-term, single-center experience.

    PubMed

    Ros-Ruiz, Silvia; Alonso-Esteve, Ángela; Gutiérrez-Vílchez, Elena; Rudas-Bermúdez, Edisson; Hernández, Domingo

    2016-01-01

    Peritoneal dialysis (PD) is an underutilized form of renal replacement therapy. Although a variety of factors have been deemed responsible, timely insertion of a PD catheter may also be a contributory factor. Furthermore, a good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore the impact of the peritoneal dialysis (PD) catheter insertion by nephrologists compared to surgeons on early catheter complications and on technique survival. We also examine whether PD catheter insertion by nephrologists has a positive impact on the growth in the number of patients using PD. We performed 313 consecutive procedures: 192 catheter insertions and 121 catheter removal from January 1, 2006 to December 31, 2013. The main reasons for catheter removal were: renal transplantation, 52 (43%) follow of transfer to HD, 48 (40%) and catheter malfunction, 16 (13%). The patients were mostly male (63.4%) with the mean age of 50.8±15.1 years and 23.8 were diabetics. We only observed seven (2.5%) early complications (<4 weeks) associated to peritoneal catheter surgery (3 peritonitis episodes, 2 hemoperitoneum episodes, one complicated hernia and one omental entrapment). There were not significant differences in surgery-related complications in both periods. The penetration ratio of PD after 2006 was 117% higher compared with procedures performing before this date. In conclusions, we have demonstrated a positive impact on the growth of the PD population when catheter insertion is performed by nephrologists with a minimal incidence of complications associated.

  10. Depth distribution of glyphosate and AMPA under diferent tillage system and soils in long-term experiments

    NASA Astrophysics Data System (ADS)

    Aparicio, Virginia; Costa, Jose Luis; De Geronimo, Eduardo

    2016-04-01

    Glyphosate (N-(phosphonomethyl glycine) is a post-emergence, non-selective, foliar herbicide. Around 200 million liters of this herbicide are applied every year in Argentina, where the main agricultural practice is no-till (NT), accounting for 78 % of the cultivated land. In this work, we studied the depth distribution of glyphosate in long-term experiments (more than 15 years) at different locations under NT and conventional tillage (CT). Samples from 0-2, 2-5, 5-10, 10-15, and 15-20 cm depth with four replication and two treatments NT CT at three locations: Balcarce (BA) a loam soil, Bordenave (BO) a sandy loam soil y Marcos Juarez a silty loam soil (MJ). The glyphosate concentration in the first 2 cm of soil was, on the average, 70% greater than in the next 2-5 cm. The mass of glyphosate in CT was higher at 2 to 10 cm depth. The depth concentration of AMPA follows the same trend than glyphosate, although its average concentration at 0-2 cm depth is 28 times higher than the glyphosate concentration at 2-5 cm (glyphosate = 147 ppb and AMPA = 4100 ppb). Beside the AMPA concentration at 0-2 cm depth is greater in NT than in CT, the mass of AMPA is higher in CT only for the Balcarce location. To our knowledge, this study is the first dealing with the depth distribution of glyphosate concentration in soils under different soil managements. In the present study, it was demonstrated that glyphosate and AMPA are present in soils under agricultural activity with maximum concentration in the first two cm of soil and the AMPA concentration at this depth is greater in NT than in CT.

  11. The Long-Term Impact of Subtractive Schooling in the Educational Experiences of Secondary English Language Learners

    ERIC Educational Resources Information Center

    Menken, Kate; Kleyn, Tatyana

    2010-01-01

    This study examines a lesser-known population of students, called "long-term English language learners" (LTELLs) in the USA, who now comprise one-third of all English language learners in New York City secondary schools. A major finding from our research, which explores the characteristics and educational needs of this student…

  12. The Long Term Effects of Undergraduate Student Involvement Experiences on Selected Outcome Measures. AIR 1995 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Fischer, Norman M.

    The long-term effects of undergraduate involvement on advanced degree attainment and career choice were studied. The longitudinal study involved 299 freshmen who entered college between 1973 and 1976 and participated in the institutional research program's followup questionnaire 17-20 years later. Astin's Input-Environment Outcomes model and…

  13. Identification of CTX-M beta-lactamases in Escherichia coli from hospitalized patients and residents of long-term care facilities.

    PubMed

    Urban, Carl; Mariano, Noriel; Bradford, Patricia A; Tuckman, Margareta; Segal-Maurer, Sorana; Wehbeh, Wehbeh; Grenner, Louise; Colon-Urban, Rita; Johnston, Brian; Johnson, James R; Rahal, James J

    2010-04-01

    Bacteria harboring CTX-M extended-spectrum beta-lactamases (ESBLs) have been identified worldwide, with most reports coming from regions outside North America. We have identified CTX-M enzymes in 31% of ESBL-positive Escherichia coli isolates from our hospital and more than half (53%) of the isolates from associated long-term care facilities. Approximately 3/4 of all CTX-M-bearing isolates were from urine specimens, with a predominance of CTX-M-15. A large proportion of such isolates were nonsusceptible to levofloxacin, trimethoprim/sulfamethoxazole, and all beta-lactam antimicrobials with the exception of the carbapenems, requiring carbapenem therapy for acute urinary tract infection or urinary tract-related sepsis. CTX-M beta-lactamases have emerged within our location, and detection of bacteria harboring these enzymes in the clinical microbiology laboratory remains problematic because molecular methods are needed for their identification.

  14. A double-blind randomized clinical trial of different doses of transdermal nicotine patch for smoking reduction and cessation in long-term hospitalized schizophrenic patients.

    PubMed

    Chen, Hsing-Kang; Lan, Tsuo-Hung; Wu, Bo-Jian

    2013-02-01

    There have been many studies of smoking cessation using nicotine replacement therapy (NRT) with schizophrenic patients, but none exploring the smoking-reduction effects of varying doses of NRT in long-stay patients with schizophrenia. This study aimed to examine the effect of different doses of the nicotine transdermal patch on smoking-reduction and cessation outcomes in long-term hospitalized schizophrenic patients. A total of 184 subjects participated in a randomized, controlled, double-blind 8-week clinical trial. Participants were randomized into two groups using two different doses of NRT: a high-dose NRT group (31.2 mg for the first 4 weeks, then 20.8 mg for 4 weeks, n = 92) or a low-dose NRT group (20.8 mg for 8 weeks, n = 92). The 7-day point prevalence of abstinence was 2.7 % (5/184). Participants in the low-dose NRT group reduced smoking by 3.1 more cigarettes on average than those in the high-dose group (p = 0.005). However, a repeated measures analysis of variance revealed that the main effect of changes in the number of cigarettes smoked, comparing the two types of treatment across periods, was not significant (p = 0.35, partial eta square = 0.018). In summary, among a cohort of chronic institutionalized schizophrenic patients, smoking cessation and reduction outcomes were not correlated with NRT dose, and the cessation rate was much lower than rates in similar studies. It indicates that long-term hospitalized schizophrenic patients have more difficulties with quitting smoking. More effective integrative smoking cessation programs should be addressed for these patients.

  15. Relation of serum sodium level to long-term outcome after a first hospitalization for heart failure with preserved ejection fraction.

    PubMed

    Rusinaru, Dan; Buiciuc, Otilia; Leborgne, Laurent; Slama, Michel; Massy, Ziad; Tribouilloy, Christophe

    2009-02-01

    Hyponatremia is a predictor of adverse short-term outcomes in patients with acute heart failure (HF). The impact of hyponatremia on long-term survival in patients with HF with preserved ejection fraction (HFPEF) has not been evaluated. Our aim was to prospectively assess the impact of baseline natremia and changes in sodium level during hospitalization on 7-year outcome in 358 patients surviving a first hospitalization for HFPEF. On admission, hyponatremia (sodium <136 mEq/L) was diagnosed in 91 patients (25.4%). Baseline hyponatremia was associated with an increased risk of overall (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.50 to 2.61) and cardiovascular mortality (HR 1.92, 95% CI 1.36 to 2.73). After adjustment for covariates, the relations remained significant. Seven-year relative survival (observed/expected survival) of hyponatremic patients was lower than that of patients with normal baseline natremia (31% vs 63%). The association of sodium and risk of death appeared linear across quartiles of baseline natremia and slightly stronger at the lowest of sodium values. At discharge, 45 patients with low baseline sodium had normal natremia (49%) and 46 had persistent hyponatremia (51%). Patients with normalized natremia at discharge had excess 7-year overall mortality compared with the normonatremic group (HR 1.50, 95% CI 1.03 to 2.19). Patients with persistent hyponatremia had the lowest 7-year survival (HR 2.67, 95% CI 1.89 to 3.78). After adjustment for covariates, patients with persistent hyponatremia had an impressive increase in relative risk of overall mortality compared with patients with normal baseline natremia. In conclusion, hyponatremia is a powerful predictor of long-term mortality in patients with HFPEF. Patients with HFPEF and persistent hyponatremia are at high risk of adverse outcomes.

  16. Long-term follow-up in adult living donors for combined liver/bowel transplant in pediatric recipients: a single center experience.

    PubMed

    Ghafari, Jamie L; Bhati, Chandra; John, Eunice; Tzvetanov, Ivo G; Testa, Giuliano; Jeon, Hoonbae; Oberholzer, Jose; Benedetti, Enrico

    2011-06-01

    Pediatric candidates for combined liver/bowel transplant (LBTx) experience a very high mortality on the cadaver waiting list. Our transplant center has successfully used adult living donors to treat pediatric candidates for LBTx. We report the long-term follow-up of this unique cohort of organ donors. The charts of six adult donors for LBTx performed between 2004 and 2007 were reviewed. All the pertinent clinical data were carefully reviewed and integrated with phone interviews of all donors. A total of six children (average age 13.5 months) received living donor LBTx. Average follow-up for the donors was 42 months (range 29-51). The donors' median age was 25 yr (19-32); five women and one man. The average median hospital stay was nine days. There were no peri-operative complications. At present all donors remain in good health. Three of the five mothers became pregnant after donation. Five of the six children are currently alive and well whereas one died with functioning grafts six months post-transplant due to plasmoblastic lymphoma. Living donor LBTx is an effective therapy for combined hepatic and intestinal failure in children less than five yr. The donor operation can be performed with minimal morbidity.

  17. Effects of biotic and abiotic indices on long term soil moisture data in a grassland biodiversity experiment

    NASA Astrophysics Data System (ADS)

    Fischer, Christine; Hohenbrink, Tobias; Leimer, Sophia; Roscher, Christiane; Ravenek, Janneke; de Kroon, Hans; Kreutziger, Yvonne; Wirth, Christian; Eisenhauer, Nico; Gleixner, Gerd; Weigelt, Alexandra; Mommer, Liesje; Beßler, Holger; Schröder, Boris; Hildebrandt, Anke

    2015-04-01

    Soil moisture is the dynamic link between climate, soil and vegetation and the dynamics and variation are affected by several often interrelated factors such as soil texture, soil structural parameters (soil organic carbon) and vegetation parameters (belowground- and aboveground biomass). For the characterization and estimation of soil moisture and its variability and the resulting water fluxes and solute transports, the knowledge of the relative importance of these factors is of major challenge for hydrology and bioclimatology. Because of the heterogeneity of these factors, soil moisture varies strongly over time and space. Our objective was to assess the spatio-temporal variability of soil moisture and factors which could explain that variability, like soil properties and vegetation cover, in in a long term biodiversity experiment (Jena Experiment). The Jena Experiment consist 86 plots on which plant species richness (0, 1, 2, 4, 8, 16, and 60) and functional groups (legumes, grasses, tall herbs, and small herbs) were manipulated in a factorial design Soil moisture measurements were performed weekly April to September 2003-2005 and 2008-2013 using Delta T theta probe. Measurements were integrated to three depth intervals: 0.0 - 0.20, 0.20 - 0.40 and 0.40 - 0.70 m. We analyze the spatio-temporal patterns of soil water content on (i) the normalized time series and (ii) the first components obtained from a principal component analysis (PCA). Both were correlated with the design variables of the Jena Experiment (plant species richness and plant functional groups) and other influencing factors such as soil texture, soil structural variables and vegetation parameters. For the time stability of soil water content, the analysis showed that plots containing grasses was consistently drier than average at the soil surface in all observed years while plots containing legumes comparatively moister, but only up to the year 2008. In 0.40 - 0.70 m soil deep plots presence of

  18. The End-of-Life Experience in Long-Term Care: Five Themes Identified from Focus Groups with Residents, Family Members, and Staff

    ERIC Educational Resources Information Center

    Munn, Jean C.; Dobbs, Debra; Meier, Andrea; Williams, Christianna S.; Biola, Holly; Zimmerman, Sheryl

    2008-01-01

    Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders. Design and Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff…

  19. Evaluating the Effectiveness of Intervention in Long-Term Aphasia Post-Stroke: The Experience from CHANT (Communication Hub for Aphasia in North Tyneside)

    ERIC Educational Resources Information Center

    Mumby, Katharyn; Whitworth, Anne

    2012-01-01

    Background: Despite recognition of the need for increased long-term support for people with aphasia following stroke, there remains limited evidence for effective service-level interventions. Aims: To evaluate the outcomes and experiences of people participating in the Communication Hub for Aphasia in North Tyneside (CHANT), a 2-year partnership…

  20. Experiences of Followers in the Development of the Leader-Follower Relationship in Long-Term Health Care: A Phenomenological Study

    ERIC Educational Resources Information Center

    Lucia, David

    2010-01-01

    This descriptive phenomenological study explored the perceptions and experiences of followers in the development of the leader-follower relationship, within a long-term health care environment. This study is also framed within the disciplinary context of human resource development (HRD). This study addressed the research question, "During your…

  1. Immigrants' mortality patterns in the short- and long-term point toward origin-related diversities: the Israeli experience.

    PubMed

    Gabbay, Uri; Leshukovits, Yuri; Sadetzki, Siegal

    2014-02-01

    Immigrant mortality studies reveal conflicting results that were attributed to diversity in immigrant definition, different classifications, and lack of appropriate comparisons. This work studied mortality patterns of the immigrations absorbed in Israel. Short-term mortality was evaluated by comparing the Standardized Mortality Rate (SMR) of the first year after immigration to the SMR of the second to fifth years. Long-term mortality was evaluated by comparing recent immigrant cohorts to cohorts of immigrants who have been residents 5 and 10 years. Stratification was made by source country classification and gender. Data were derived from the Israel National Population Registry and were analyzed anonymously. Immigrants from developed and developing countries had the highest SMR in the first year, which considerably decreased in both short and long term. Immigrants from mid-developed countries had stable SMR in the short term followed by only a modest decrease in the long term. Ethiopian immigrants exhibited exceptionally low SMR in the first year, following which it increased but remained relatively low. Mortality patterns of different immigrant groups differ even under similar definitions, conditions, and period. Only immigrants of developed and developing countries presented the expected pattern of excessive short-term mortality, which consistently decreased with time. Unique mortality patterns were discovered among two groups: Immigrants from mid-developed countries presented stable mortality attributable to isolation and delayed adaptation, and Ethiopian low mortality attributable to pre-migration natural selection.

  2. Long-term prognosis of IgA nephropathy presenting with minimal or no proteinuria: A single center experience

    PubMed Central

    Imai, N.; Shirai, S.; Yasuda, T.; Shibagaki, Y.; Kimura, K.

    2016-01-01

    The long-term prognosis of patients with IgA nephropathy (IgAN) who present with preserved renal function and minimal proteinuria is not well described. We investigated the long-term outcomes of IgAN patients with an apparently benign presentation and evaluated prognostic factors for renal survival and clinical remission. We studied Japanese patients with biopsy-proven IgAN who had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and proteinuria <0.5 g/day at the time of renal biopsy. The renal biopsies were reviewed using the Oxford classification. Twenty patients met the inclusion criteria. At diagnosis, the median eGFR (interquartile range) was 76.8 (65.2–91.1) mL/min/1.73 m2, and the median proteinuria level was 0.31 (0.16–0.39) g/day. Only one patient had an increase in serum creatinine of over 50% and no patient progressed to end-stage renal disease. The 15-year renal survival rate was 93.8%. Clinical remission was observed in 9 (45%) patients. Baseline proteinuria was the only factor significantly associated with the absence of clinical remission. The long-term prognosis of Japanese patients with IgAN who presents with minor urinary abnormalities and preserved renal function is excellent. PMID:27051134

  3. Demographics and Clinical Features of Postresuscitation Comorbidities in Long-Term Survivors of Out-of-Hospital Cardiac Arrest: A National Follow-Up Study

    PubMed Central

    Su, Chih-Pei; Wu, Jr-Hau; Yang, Mei-Chueh; Liao, Ching-Hui; Hsu, Hsiu-Ying; Chang, Chin-Fu

    2017-01-01

    The outcome of patients suffering from out-of-hospital cardiac arrest (OHCA) is very poor, and postresuscitation comorbidities increase long-term mortality. This study aims to analyze new-onset postresuscitation comorbidities in patients who survived from OHCA for over one year. The Taiwan National Health Insurance (NHI) Database was used in this study. Study and comparison groups were created to analyze the risk of suffering from new-onset postresuscitation comorbidities from 2011 to 2012 (until December 31, 2013). The study group included 1,346 long-term OHCA survivors; the comparison group consisted of 4,038 matched non-OHCA patients. Demographics, patient characteristics, and risk of suffering comorbidities (using Cox proportional hazards models) were analyzed. We found that urinary tract infections (n = 225, 16.72%), pneumonia (n = 206, 15.30%), septicemia (n = 184, 13.67%), heart failure (n = 111, 8.25%) gastrointestinal hemorrhage (n = 108, 8.02%), epilepsy or recurrent seizures (n = 98, 7.28%), and chronic kidney disease (n = 62, 4.61%) were the most common comorbidities. Furthermore, OHCA survivors were at much higher risk (than comparison patients) of experiencing epilepsy or recurrent seizures (HR = 20.83; 95% CI: 12.24–35.43), septicemia (HR = 8.98; 95% CI: 6.84–11.79), pneumonia (HR = 5.82; 95% CI: 4.66–7.26), and heart failure (HR = 4.88; 95% CI: 3.65–6.53). Most importantly, most comorbidities occurred within the first half year after OHCA. PMID:28286775

  4. Updated Long-Term Outcomes and Prognostic Factors for Patients With Unresectable Locally Advanced Pancreatic Cancer Treated With Intraoperative Radiotherapy at the Massachusetts General Hospital, 1978 to 2010

    PubMed Central

    Cai, Sophie; Hong, Theodore S.; Goldberg, Saveli I.; Castillo, Carlos Fernandez-del; Thayer, Sarah P.; Ferrone, Cristina R.; Ryan, David P.; Blaszkowsky, Lawrence S.; Kwak, Eunice L.; Willett, Christopher G.; Lillemoe, Keith D.; Warshaw, Andrew L.; Wo, Jennifer Y.

    2014-01-01

    BACKGROUND In the current study, the authors evaluated long-term outcomes, intraoperative radiotherapy (IORT)-related toxicity, and prognostic factors for overall survival (OS) among patients with unresectable locally advanced pancreatic cancer (LAPC) who received IORT as part of their treatment at the Massachusetts General Hospital (MGH). METHODS Medical records were reviewed for 194 consecutive patients with unresectable LAPC who were treated with IORT at MGH between 1978 and 2010. OS was calculated using the Kaplan-Meier method. Prognostic factors were evaluated at the univariate level by the log-rank test and at the multivariate level by the Cox proportional hazards model. Rates of disease progression and treatment toxicity were calculated. RESULTS The 1-year, 2-year, and 3-year survival rates were 49%, 16%, and 6%, respectively. Six patients (3%) survived for > 5 years. The median OS was 12.0 months. Among 183 patients with known post-IORT disease status, the 2-year local progression-free survival and distant metastasis-free survival rates were 41% and 28%, respectively. On multivariate analysis, an IORT applicator diameter ≤ 8 cm (hazards ratio [HR], 0.51; 95% confidence interval [95% CI], 0.30–0.84 [P = .009]), a Charlson age-comorbidity index ≤3 (HR, 0.47; 95% CI, 0.31–0.73 [P = .001]), and receipt of chemotherapy (HR, 0.46; 95% CI, 0.33–0.66 [P < .001]) predicted improved OS. The median OS for patients with all 3 positive prognostic factors was 21.2 months. CONCLUSIONS Well-selected patients with LAPC with small tumors and low Charlson age-comorbidity indices can achieve good long-term survival outcomes with a treatment regimen that incorporates chemotherapy and IORT. PMID:24006012

  5. Response of soil carbon dioxide efflux to fire disturbance in a long-term grassland global change experiment

    NASA Astrophysics Data System (ADS)

    Strong, A. L.; Chiariello, N.; Tobeck, T.; Field, C. B.

    2012-12-01

    How terrestrial biosphere-atmosphere carbon dioxide exchange responds to global change is an important component to understanding global feedbacks of the carbon cycle. Soils represent a global store of organic carbon on the order of 3000 Pg C. Increased carbon dioxide release from increased respiration of soil C in response to climate warming and other direct and indirect anthropogenic factors could create a positive carbon cycle feedback to climate change. Numerous studies have demonstrated that soil respiration increases under experimental warming and elevated CO2, although the long-term, multi-year dynamics of this feedback remain poorly constrained. Punctuated disturbances, such as fire, are also likely to affect soil C responses, and understanding how fire and other global change factors interact in their influence on soil respiration is important in order to fully characterize climate-carbon cycle feedbacks. Previous studies have found that fire disturbance in semi-arid grasslands reduces soil CO2. The Jasper Ridge Global Change Experiment is a thirteen-year continuous full-factorial global change manipulation (elevated carbon dioxide, temperature, precipitation, and nitrogen deposition) located in a clay-loam soil grassland in central coastal California. In summer 2011, an additional treatment condition -- a controlled burn -- was applied to half the experimental plots to provide a fire treatment, and in the following growing season, soil carbon dioxide effluxes were measured at peak aboveground plant biomass (April 2012) and after summer senescence (June 2012) using a LiCOR-6400 soil respiration chamber and infrared gas analyzer. Across all plots and other treatments, CO2 fluxes were greater in burned grassland soils than in non-burned grassland soils (p < 0.01). CO2 fluxes were also greater in grassland plots with N addition than in grassland plots without additional nutrients (p < 0.01). These two effects appear to be additive, as CO2 fluxes were greater

  6. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals' resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

    PubMed

    2012-08-31

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2012. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes made by the Affordable Care Act. Generally, these changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. In addition, we are implementing changes relating to determining a hospital's full-time equivalent (FTE) resident cap for the purpose of graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We also are establishing new administrative, data completeness, and extraordinary circumstance waivers or extension requests requirements, as well as a reconsideration process, for quality reporting by ambulatory surgical centers

  7. Long-term results of immunomodulatory treatment in children and adolescents with multiple sclerosis: the Italian experience.

    PubMed

    Ghezzi, Angelo; Amato, Maria Pia; Annovazzi, Pietro; Capobianco, Marco; Gallo, Paolo; La Mantia, Loredana; Marrosu, Maria Giovanna; Martinelli, Vittorio; Milani, Nicoletta; Moiola, Lucia; Patti, Francesco; Pozzilli, Carlo; Trojano, Maria; Zaffaroni, Mauro; Comi, Giancarlo

    2009-06-01

    The main objective of this study is to evaluate the effect of immunomodulatory agents (IMAs) (Interferon-Beta, Glatiramer Acetate) in a large cohort of multiple sclerosis (MS) patients with disease onset in childhood or adolescence, treated before 16 years of age, after a long-term follow-up. A total of 130 patients were identified, 77 were treated with Avonex, 39 with Rebif/Betaferon, 14 with Copaxone. After a mean (SD) treatment duration of 53.6 +/- 27.0, 59.9 +/- 39.5 and 74.6 +/- 35.5 months, respectively, the relapse rate decreased significantly. The final EDSS score was unchanged with respect to the initial score. Similar results were also observed in subjects who continued a long-term follow-up after they were included in an observational study in 2004, and in subjects who were treated before 12 years of age. The frequency of clinical and laboratory adverse events was similar to that observed in adult patients. To conclude, IMAs were effective and well tolerated in paediatric patients with MS.

  8. Seasonal dynamics of the microbiome of chernozems of the long-term agrochemical experiment in Kamennaya Steppe

    NASA Astrophysics Data System (ADS)

    Chernov, T. I.; Tkhakakhova, A. K.; Ivanova, E. A.; Kutovaya, O. V.; Turusov, V. I.

    2015-12-01

    The seasonal variability (spring-summer-autumn) of the taxonomic structure of prokaryotic microbiomes in chernozems of Kamennaya Steppe was studied using sequencing of the 16S rRNA gene. The samples were collected from the topsoil (0-20 cm) horizons of a long-term fallow and croplands differing in the rates of application of mineral fertilizers (NPK). The seasonal dynamics of the prokaryotic community in the soils of the fallow and croplands were similar: the summer samples significantly differed from the spring ones; in autumn, the microbiome structure approached that in spring; these changes were probably related to corresponding changes in the temperature and moisture conditions of the growing season. For all the plots, significant seasonal changes in the proportions of Thaumarchaeota (Cranarchaeota), Acidobacteria, Bacteroidetes, Firmicutes, and V errucomicrobia phylogenetic groups were observed. The significant changes in the structure of the microbiomes (especially in the number of representatives of the Firmicutes, Cemmatiomonadetes, and Verrucomicrobia phyla) were revealed in the arable and fallow soils irrespectively of the season. The phylogenetic diversity estimated by the Shannon index, the number of the operating taxonomic units found, and the Chao1 index differed little in the soils of the studies plots. The long-term application of mineral fertilizers at different rates had little effect on the taxonomic structure and diversity of prokaryotic communities in the agrochernozems.

  9. Modifiable Risk Factors for the Spread of Klebsiella pneumoniae Carbapenemase-Producing Enterobacteriaceae Among Long-Term Acute-Care Hospital Patients.

    PubMed

    Okamoto, Koh; Lin, Michael Y; Haverkate, Manon; Lolans, Karen; Moore, Nicholas M; Weiner, Shayna; Lyles, Rosie D; Blom, Donald; Rhee, Yoona; Kemble, Sarah; Fogg, Louis; Hines, David W; Weinstein, Robert A; Hayden, Mary K

    2017-04-11

    OBJECTIVE To identify modifiable risk factors for acquisition of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae (KPC) colonization among long-term acute-care hospital (LTACH) patients. DESIGN Multicenter, matched case-control study. SETTING Four LTACHs in Chicago, Illinois. PARTICIPANTS Each case patient included in this study had a KPC-negative rectal surveillance culture on admission followed by a KPC-positive surveillance culture later in the hospital stay. Each matched control patient had a KPC-negative rectal surveillance culture on admission and no KPC isolated during the hospital stay. RESULTS From June 2012 to June 2013, 2,575 patients were admitted to 4 LTACHs; 217 of 2,144 KPC-negative patients (10.1%) acquired KPC. In total, 100 of these patients were selected at random and matched to 100 controls by LTACH facility, admission date, and censored length of stay. Acquisitions occurred a median of 16.5 days after admission. On multivariate analysis, we found that exposure to higher colonization pressure (OR, 1.02; 95% CI, 1.01-1.04; P=.002), exposure to a carbapenem (OR, 2.25; 95% CI, 1.06-4.77; P=.04), and higher Charlson comorbidity index (OR, 1.14; 95% CI, 1.01-1.29; P=.04) were independent risk factors for KPC acquisition; the odds of KPC acquisition increased by 2% for each 1% increase in colonization pressure. CONCLUSIONS Higher colonization pressure, exposure to carbapenems, and a higher Charlson comorbidity index independently increased the odds of KPC acquisition among LTACH patients. Reducing colonization pressure (through separation of KPC-positive patients from KPC-negative patients using strict cohorts or private rooms) and reducing carbapenem exposure may prevent KPC cross transmission in this high-risk patient population. Infect Control Hosp Epidemiol 2017;1-8.

  10. Pre- and post-surgery treatments in rectal cancer: a long-term single-centre experience

    PubMed Central

    Ozyurt, H.; Ozden, A.S.; Ozgen, Z.; Gemici, C.; Yaprak, G.

    2017-01-01

    Background Our study evaluated long-term survival outcomes in rectal cancer patients treated with preoperative radiotherapy, and the impact on survival of concomitant and postoperative adjuvant chemotherapy (ctx), among other prognostic factors. Methods The study included 196 patients [median age: 58 years (range: 20–86 years); 63.0% men] with locally advanced rectal carcinoma and, in some cases, resectable liver metastasis. Rates of distant metastasis and local recurrence and of 5-year distant metastasis-free survival (dmfs) and overall survival (os) were determined. Results The 5-year os rate was 57.0%, with a median duration of 81.5 months (95% confidence interval: 73.7 months to 89.4 months), and the 5-year dmfs rate was 54.1%, with a median duration of 68.4 months (95% confidence interval: 40.4 months to 96.4 months). Prognostic factors for higher os and dmfs rates were downstaging (p = 0.013 and p = 0.005 respectively), radiotherapy dose (50 Gy vs. 56 Gy or 45–46 Gy, both p = 0.002), and concomitant ctx use (p = 0.004 and p = 0.001) and type (5-fluorouracil–leucovorin–folinic acid vs. tegafur–folinic acid, p = 0.034 and p = 0.043). Adjuvant ctx after neoadjuvant long-term concomitant chemoradiotherapy (ccrt) and surgery was associated with better 5-year os rates for postoperative T0–T3 disease (p = 0.003) and disease at all lymph node stages (p = 0.001). Conclusions Our findings revealed a favourable survival outcome with long-term fractionated irradiation and concomitant 5-fluorouracil–based ctx, achieving 5-year os and dmfs rates of 57.0% and 54.1% respectively. Preoperative administration of radiotherapy (50 Gy) and postoperative adjuvant ctx were associated with a significant survival benefit. Radiation doses above 50 Gy and the interval between ccrt and surgery had no significant effect on survival. PMID:28270729

  11. Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial

    PubMed Central

    Hovi, Sirpa-Liisa; Veerus, Piret; Rahu, Mati; Hemminki, Elina

    2008-01-01

    Background Preventive drugs require long-term trials to show their effectiveness or harms and often a lot of changes occur during post-marketing studies. The purpose of this article is to describe the research process in a long-term randomized controlled trial and discuss the impact and consequences of changes in the research environment. Methods The Estonian Postmenopausal Hormone Therapy trial (EPHT), originally planned to continue for five years, was planned in co-operation with the Women's International Study of Long-Duration Oestrogen after Menopause (WISDOM) in the UK. In addition to health outcomes, EPHT was specifically designed to study the impact of postmenopausal hormone therapy (HT) on health services utilization. Results After EPHT recruited in 1999–2001 the Women's Health Initiative (WHI) in the USA decided to stop the estrogen-progestin trial after a mean of 5.2 years in July 2002 because of increased risk of breast cancer and later in 2004 the estrogen-only trial because HT increased the risk of stroke, decreased the risk of hip fracture, and did not affect coronary heart disease incidence. WISDOM was halted in autumn 2002. These decisions had a major influence on EPHT. Conclusion Changes in Estonian society challenged EPHT to find a balance between the needs of achieving responses to the trial aims with a limited budget and simultaneously maintaining the safety of trial participants. Flexibility was the main key for success. Rapid changes are not limited only to transiting societies but are true also in developed countries and the risk must be included in planning all long-term trials. The role of ethical and data monitoring committees in situations with emerging new data from other studies needs specification. Longer funding for preventive trials and more flexibility in budgeting are mandatory. Who should prove the effectiveness of an (old) drug for a new preventive indication? In preventive drug trials companies may donate drugs but they take a

  12. Long-Term Outcomes of Radio-Frequency Catheter Ablation on Ventricular Tachycardias Due to Arrhythmogenic Right Ventricular Cardiomyopathy: A Single Center Experience

    PubMed Central

    Xue, Yumei; Fang, Xianhong; Huang, Jun; Liu, Yang; Deng, Hai; Liang, Yuanhong; Liao, Zili; Liu, Fangzhou; Lin, Weidong; Zhan, Xianzhang; Wu, Shulin

    2017-01-01

    Aims To summarize our experience of radiofrequency catheter ablation (RFCA) for recurrent drug-refractory ventricular tachycardias (VTs) due to arrhythmogenic right ventricular cardiomyopathy (ARVC) in our center over the past 11 years and its related factors. Methods and Results We reviewed 48 adults (mean age 39.9 ± 12.9 years, range: 14 to 65) who met the present ARVC diagnostic criteria and accepted RFCA for VTs from December 2004 to April 2016. The patients received a total of 70 procedures using two ablation approaches, the endocardial approach in 52 RFCAs, and the combined epicardial and endocardial approach (the combined approach) in 18 RFCAs. Kaplan-Meier survival analysis showed that the combined approach achieved better acute procedural success (p = 0.003) and better long-term outcomes (p = 0.028) than the endocardial approach. Patients who obtained acute procedural success with non-inducibility had better long-term outcomes (p < 0.001). COX regression of multivariate analysis showed that procedural success was the only factor that benefited long-term outcome, irrespective of the endocardial or the combined approach (p = 0.001). The rate of sudden cardiac death (SCD) in patients without procedural success was significantly higher than that in patients with procedural success (p = 0.005). All patients without implantable cardioverter defibrillator (ICD) implantation who had successful final RFCA survived. Conclusions The combined approach resulted in better procedural success and long-term VT-free survival compared with the endocardial approach in ARVC patients with recurrent VTs. Acute procedural success with non-inducibility was strongly related to better long-term VT-free survival and reduced SCD, irrespective of whether this was achieved by the endocardial approach or the combined approach. PMID:28122031

  13. Autonomy, Choice, Patient-Centered Care, and Hip Protectors: The Experience of Residents and Staff in Long-Term Care

    PubMed Central

    Sims-Gould, Joanie; McKay, Heather A.; Feldman, Fabio; Scott, Victoria; Robinovitch, Stephen N.

    2013-01-01

    The purpose of this study was to examine long-term care (LTC) resident and staff perceptions on the decision to use hip protectors and identify the factors that influence attitudes toward hip protector use. Staff (N = 39) and residents (N = 27) at two residential care facilities in British Columbia, Canada were invited to participate in focus groups on fall prevention and hip protector use. A total of 11 focus groups were conducted. Using framework analysis results show that residents and staff shared concerns on aesthetic and comfort issues with hip protectors. Residents also generally felt they did not need, or want to use, hip protectors. However, they also had desire to be cooperative within the LTC environment. Staff underscored their role in advocating for hip protector use and their desire to protect residents from harm. Practice considerations for facilities wishing to promote hip protectors within a patient centered framework are highlighted. PMID:24652886

  14. PERSISTENT PSYCHOLOGICAL DISTRESS IN LONG-TERM SURVIVORS OF PEDIATRIC SARCOMA: THE EXPERIENCE AT A SINGLE INSTITUTION

    PubMed Central

    WIENER, LORI; BATTLES, HAVEN; BERNSTEIN, DONNA; LONG, LAUREN; DERDAK, JOANNE; MACKALL, CRYSTAL L.; MANSKY, PATRICK J.

    2008-01-01

    Background The long-term psychological impact of pediatric sarcoma is largely unknown. As part of a cross-sectional study examining the late effects of pediatric sarcoma therapy, we examined whether psychological distress or posttraumatic stress symptoms are present in an adult cohort of pediatric sarcoma survivors. Method Thirty-four patients participated in the study, an average of 17 years after their treatment ended, each completing the SCID module for Posttraumatic Stress Disorder, Impact of Events Scale, Brief Symptom Inventory (BSI) and a questionnaire assessing sociodemographic variables and psychosocial issues. Results Significant persistent psychological distress characterized this cohort of patients. Seventy-seven percent scored in the clinical range on the BSI. Twelve percent met diagnostic criteria for PTSD. Current psychological distress was associated with intrusive thoughts and avoidant behaviors, male gender, employment, difficulty readjusting to work/school after treatment, and enduring worries about health. No differences were found based on age, presence of metastatic disease or time since diagnosis. Conclusions This is the first report of a clinical evaluation of psychological distress in a cohort of pediatric sarcoma survivors treated with intensive multimodal cancer therapy. The results suggest that survivors of pediatric sarcoma might be at high risk for adverse psychological outcomes. Appropriate interventions are proposed. PMID:16402373

  15. Long-Term Outcomes of Homografts in the Aortic Valve and Root Position: A 20-Year Experience

    PubMed Central

    Kim, Joo Yeon; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2016-01-01

    Background The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position. Methods This is a retrospective study of 33 patients (>20 years old) who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years) and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months). Results Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were 80.0%±7.3% and 60.8%±10.1%, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were 92.3%±5.2%, 68.9%±10.2%, and 50.3%±13.6%, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were 91.7%±8.0%, 41.7%±14.2%, and 25.0%±12.5%, respectively. Conclusion Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis. PMID:27525234

  16. Long-term outcomes of living-related small intestinal transplantation in children: A single-center experience.

    PubMed

    Garcia Aroz, Sandra; Tzvetanov, Ivo; Hetterman, Elizabeth Anne; Jeon, Hoonbae; Oberholzer, Jose; Testa, Giuliano; John, Eunice; Benedetti, Enrico

    2017-03-12

    Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6). The immunosuppression protocol consisted of induction with thymoglobulin and maintenance therapy with tacrolimus and steroids. Seven of 10 children are currently alive with a functioning graft and good quality of life. Six of the seven children who are alive have a follow-up longer than 10 years. The average time to initiation of oral diet was 32 days (range, 13-202 days). The median day for ileostomy takedown was 77 (range, 18-224 days). Seven children are on an oral diet, and one of them is on supplements at night through a g-tube. We observed an improvement in growth during the first 3 years post-transplant and progressive weight gain throughout the first year post-transplantation. Growth catch-up and weight gain plateaued after these time periods. We concluded that living donor intestinal transplantation potentially offers a feasible, alternative strategy for long-term treatment of irreversible intestinal failure in children.

  17. Urinary tract re-functionalization after long-term diversion. A 20-year experience with 177 patients.

    PubMed Central

    Hendren, W H

    1990-01-01

    From 1969 to 1990, previously diverted urinary tracts were 'undiverted' in 177 patients whose ages ranged from 1 to 31 years. Fifty-six of the patients (32%) had been diverted for 10 years or longer. There were 67 female and 110 male patients. Forty-four patients had only one kidney and in two of those patients it was a previous renal transplant. One patient was anephric at the time of reconstruction, having had two unsuccessful transplants. Most of the diversions had been considered permanent. Types of diversions that were reversed include ileal loop, colon conduit, loop ureterostomy or pyelostomy, end ureterostomy, cystostomy or vesicostomy, long-term nephrostomy, and ureterosigmoidostomy. Images Fig. 6. Figs. 8A and B. Figs 10A and B. Figs. 12A and B. Figs. 14A and B. Figs. 16A-D. Figs 20A and B. Figs.22A and B. Figs. 24A and B. Figs. 25A and B. Figs. 28A-D. PMID:2222014

  18. Our experience of liver Epithelioid Hemangioendothelioma: from a misdiagnosis to liver transplantation with long term follow-up

    PubMed Central

    Giuliani, Antonio; Amato, Bruno; Marsilia, Giuseppina Marino; Tafuri, Domenico; Ceriello, Antonio; Santaniello, Walter; Sodano, Loredana; Rocca, Aldo

    2015-01-01

    Malignant Hepatic Epithelioid hemangioendothelioma (HEHE) is an uncommon vascular tumor of intermediate malignant potential. HEHE is a rare tumor and it is difficult to diagnose for surgeons, hepatologists, radiologists and pathologists. So, misdiagnosis with a delay of the treatment is not uncommon. We describe a case of a young woman with a diagnosis of HEHE made 6 years after the first evidence of liver mass with a very long term follow-up after surgical treatment. She had two diagnoses of Hepatocellurar carcinoma (HCC) and a diagnosis of Cholangiocarcinoma after three different fine needle biopsies. After clinical observation, a new laparoscopic core biopsy was performed. In a first time approach, considering clinical and radiological patterns, a diagnosis of Budd-Chiari Syndrome was finally made. For that the patient underwent an orthotopicliver transplantation (OLTx). The surgical sample histological analysis allowed a definitive diagnosis of HEHE. At last, at follow up 7 years after three OLTx the patient is still alive and in good health with no evidence of recurrence. PMID:28352745

  19. Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry

    PubMed Central

    Choi, Dong-Ju; Han, Seongwoo; Jeon, Eun-Seok; Cho, Myeong-Chan; Kim, Jae-Joong; Yoo, Byung-Su; Shin, Mi-Seung; Seong, In-Whan; Ahn, Youngkeun; Kang, Seok-Min; Kim, Yung-Jo; Kim, Hyung Seop; Chae, Shung Chull; Oh, Byung-Hee; Lee, Myung-Mook

    2011-01-01

    Background and Objectives Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea. Subjects and Methods We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female. Results Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death. Conclusion We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that

  20. Long-term {alpha}- and spontaneous fission measurement of a Rf/Db sample chemically prepared in a {sup 48}Ca on {sup 243}Am experiment

    SciTech Connect

    Dressler, Rugard; Eichler, Robert; Schumann, Dorothea; Shishkin, Sergey

    2009-05-15

    Results from long-term measurements of a chemically separated Db/Rf sample prepared from the products of a {sup 48}Ca on {sup 243}Am irradiation are presented. The sample with the highest spontaneous fission activity out of eight samples produced in the course of chemical experiments performed in 2004 was selected for these measurements. We conclude that there is no evidence for SF-decay originating from heavy actinide isotopes in this sample. Hence, it is appropriate to assign the SF-events observed in this experiment to decay products of {sup 288}115.

  1. Fingolimod in the treatment of relapsing–remitting multiple sclerosis: long-term experience and an update on the clinical evidence

    PubMed Central

    Khatri, Bhupendra O.

    2016-01-01

    Since the approval in 2010 of fingolimod 0.5 mg (Gilenya; Novartis Pharma AG, Basel, Switzerland) in the USA as an oral therapy for relapsing forms of multiple sclerosis, long-term clinical experience with this therapy has been increasing. This review provides a summary of the cumulative dataset from clinical trials and their extensions, plus postmarketing studies that contribute to characterizing the efficacy and safety profile of fingolimod in patients with relapsing forms of multiple sclerosis. Data from the controlled, phase III, pivotal studies [FREEDOMS (FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Sclerosis), FREEDOMS II and TRANSFORMS (Trial Assessing Injectable Interferon versus FTY720 Oral in Relapsing–Remitting Multiple Sclerosis)] in relapsing–remitting multiple sclerosis have shown that fingolimod has a robust effect on clinical and magnetic resonance imaging outcomes. The respective study extensions show that effects on annualized relapse rates are sustained with continued fingolimod treatment. Consistent, significant reductions in magnetic resonance imaging lesion counts and brain volume loss have also been sustained with long-term treatment. The safety profile of fingolimod is also examined, particularly in light of its long-term use. A summary of the adverse events of interest that are associated with fingolimod treatment and associated label guidelines are also considered, which include cardiac effects following first-dose administration, infections, lymphopenia, macular edema and pregnancy. Historic hurdles to the prescription of fingolimod and how these challenges are being met are also discussed. PMID:27006700

  2. Early environments drive diversity and floristic composition in Mediterranean old fields: Insights from a long-term experiment

    NASA Astrophysics Data System (ADS)

    Cayuela, Luis; Rey Benayas, José María; Maestre, Fernando T.; Escudero, Adrián

    2008-11-01

    While many studies have explored how previous and current environmental conditions affect the performance of individual organisms, their relative importance as drivers of current diversity and composition of communities is virtually unknown. We evaluated the response of herbaceous communities to previous (experienced during early establishment) and current environmental conditions by comparing their composition and diversity in an abandoned Mediterranean cropland planted with Quercus ilex subsp. ballota L. seedlings. These seedlings received different experimental treatments (summer irrigation and artificial shading) during the first three years after planting, and were interrupted from then on. We tested two complementary hypotheses: (i) the previous environments experienced by the herbaceous communities during their establishment have a long-term carry-over effect on diversity and composition of species assemblages and (ii) these communities are influenced by their current environment, particularly by the woody layer and the soil conditions. Overall, we observed an important contribution of initial environmental conditions in determining the current diversity and composition of herbaceous communities. Amelioration of environmental conditions, particularly water stress, during community establishment resulted in a decrease in alpha and beta diversity, possibly as a consequence of decreasing environmental heterogeneity. Previous environments accounted for 26.3% of the explained variance in current community composition. Annuals, legumes and forbs also responded significantly to previous environments, which explained 27.9%, 36.2% and 30.1%, respectively, of the variance in their composition. Our results suggest that those species present at a particular site early in succession pre-empt the site and influence vegetation dynamics on that site for a long time. This study provides important insights for understanding the mechanisms underlying the ecological effects of

  3. Long-term results of combined liver-kidney transplantation for primary hyperoxaluria type 1: the French experience.

    PubMed

    Compagnon, Philippe; Metzler, Philippe; Samuel, Didier; Camus, Christophe; Niaudet, Patrick; Durrbach, Antoine; Lang, Philippe; Azoulay, Daniel; Duvoux, Christophe; Bayle, Francois; Rivalan, Joseph; Merville, Pierre; Pascal, Gerard; Thervet, Eric; Bensman, Albert; Rostaing, Lionel; Deschenes, Georges; Morcet, Jeff; Feray, Cyrille; Boudjema, Karim

    2014-12-01

    Primary hyperoxaluria type 1 (PH1) is a hepatic metabolic defect leading to end-stage renal failure. The posttransplant recurrence of kidney disease can suggest a need for combined liver-kidney transplantation (LKT). However, the risk of LKT is theoretically far higher than the risk of kidney-alone transplantation (KAT). An unselected consecutive series of 54 patients with PH1 was analyzed according to the type of transplantation initially performed between May 1979 and June 2010 at 10 French centers. The duration of dialysis, extrarenal lesions, age, and follow-up were similar between the groups. Postoperative morbidity and mortality did not differ between the groups, and 10-year patient survival rates were similar for the LKT (n = 33) and KAT groups (n = 21; 78% versus 70%). Kidney graft survival at 10 years was better after LKT (87% versus 13%, P < .001) . Four patients (12.1%) lost their first kidney graft in the LKT group, whereas 19 (90%) did in the KAT group (P < .001). The recurrence of oxalosis occurred in 11 renal grafts (52%) in the KAT group but in none in the LKT group (P < .001). End-stage renal failure resulting from rejection was also higher in the KAT group (19% versus 9%, P < 0.0001). A second kidney transplant was performed for 15 patients (71%) in the KAT group versus 4 patients (12%) in the LKT group (P < 0.001). In conclusion, LKT for PH1 provides better kidney graft survival, less rejection, and similar long-term patient survival and is not associated with an increased short-term mortality risk. LKT must be the first-line treatment for PH1 patients with end-stage renal disease.

  4. Long-term outcome after liver transplantation for hepatic schistosomiasis: a single-center experience over 15 years.

    PubMed

    El Moghazy, Walid; Kashkoush, Samy; O'hali, Wael; Abdallah, Khalid

    2015-01-01

    Our objective was to study the long-term outcomes of patients who had undergone liver transplantation because of schistosomiasis at our institute over the last 15 years. Four hundred forty-one patients underwent liver transplantation at our institute, and 14 did so for schistosomiasis. The survival of patients who underwent transplantation for schistosomiasis was compared with that of patients who underwent transplantation for other liver diseases. Survival curves were drawn via the Kaplan-Meier method and were compared with the log-rank test. P < 0.05 was considered significant. All 14 patients were male, and the average age was 56.8 ± 8.4 years. The average Model for End-Stage Liver Disease score was 18.2 ± 5.6, and the average Child-Pugh score was 10.6 ± 1.2. All patients had splenomegaly; pretransplant variceal bleeding occurred in 7 patients (50%), and portal vein thrombosis was diagnosed in 5 patients (36%). Patient survival was 75% 1 year after transplantation and 75% at the end of follow-up because no patients were lost after the first year. Patients who underwent transplantation for other causes achieved survival rates of 86% and 76% 1 and 10 years after transplantation, respectively. There was no significant survival difference between the 2 groups (P = 0.66). All patients who survived the early posttransplant period had functioning liver grafts with no reported diagnoses of schistosomiasis in the new grafts. In conclusion, liver transplantation for patients with schistosomiasis has a favorable outcome with no risk of reactivation.

  5. Experimental fire increases soil carbon dioxide efflux in a grassland long-term multifactor global change experiment.

    PubMed

    Strong, Aaron L; Johnson, Tera P; Chiariello, Nona R; Field, Christopher B

    2017-05-01

    Numerous studies have demonstrated that soil respiration rates increase under experimental warming, although the long-term, multiyear dynamics of this feedback are not well constrained. Less is known about the effects of single, punctuated events in combination with other longer-duration anthropogenic influences on the dynamics of soil carbon (C) loss. In 2012 and 2013, we assessed the effects of decadal-scale anthropogenic global change - warming, increased nitrogen (N) deposition, elevated carbon dioxide (CO2 ), and increased precipitation - on soil respiration rates in an annual-dominated Mediterranean grassland. We also investigated how controlled fire and an artificial wet-up event, in combination with exposure to the longer-duration anthropogenic global change factors, influenced the dynamics of C cycling in this system. Decade-duration surface soil warming (1-2 °C) had no effect on soil respiration rates, while +N addition and elevated CO2 concentrations increased growing-season soil CO2 efflux rates by increasing annual aboveground net primary production (NPP) and belowground fine root production, respectively. Low-intensity experimental fire significantly elevated soil CO2 efflux rates in the next growing season. Based on mixed-effects modeling and structural equation modeling, low-intensity fire increased growing-season soil respiration rates through a combination of three mechanisms: large increases in soil temperature (3-5 °C), significant increases in fine root production, and elevated aboveground NPP. Our study shows that in ecosystems where soil respiration has acclimated to moderate warming, further increases in soil temperature can stimulate greater soil CO2 efflux. We also demonstrate that punctuated short-duration events such as fire can influence soil C dynamics with implications for both the parameterization of earth system models (ESMs) and the implementation of climate change mitigation policies that involve land-sector C accounting.

  6. Are The Large-Scale Biosphere-Atmosphere Experiment In Amazonia (LBA) Representative Of Long-Term Climatology? A Study Using Climate Weather Stations In Brazil.

    NASA Astrophysics Data System (ADS)

    Rosolem, R.; Shuttleworth, W. J.; Goncalves, L. G.

    2007-12-01

    The Large-Scale Biosphere-Atmosphere Experiment in Amazonia has already contributed understanding of the flux exchange between the Amazonian rainforest and atmosphere and other significant components of the ecohydrometeorological system, and it will continue to do so. However, when considering LBA-derived information on whether the Amazon is a source or sink of carbon, or whether land use changes in the Amazon are affecting the local and perhaps global climate, it is important to characterize the period during which the LBA project has been carried out in terms of its climatological context. In other words, to address the question "How does the climate during the LBA data collection period compare with the long-term climatology in Amazon." Such information is not only useful for future project planning but is crucial information for modeling purposes: the calibration or validation of models using LBA data may be influenced by the climate conditions prevalent when these data were collected. This investigates the extent to which the actual period of data collection at LBA sites is representative of the long-term climatology for the sites. The research uses long-term weather station data taken from the databases of Brazilian National Water Agency (Agencia Nacional de Aguas - ANA) and National Oceanic and Atmospheric Administration - National Climatic Data Center division (NOAA-NCDC) for stations located near the Sao Gabriel da Cachoeira, Manaus, Santarem, Caxiuana, Jaru, Sinop, and Bananal LBA sites, and compares these weather station data during the LBA data collection period with the entire dataset available for each weather station. Analysis of the precipitation records demonstrates that the precipitation climate during the LBA study period was not significant different from the long- term climatology at all the LBA sites but that at a few sites the temperature climate during LBA was statistically different.

  7. Exotoxin gene backgrounds in bloodstream and wound Staphylococcus aureus isolates from geriatric patients attending a long-term care Spanish hospital.

    PubMed

    Argudín, M Ángeles; Mendoza, M Carmen; Vázquez, Fernando; Rodicio, M Rosario

    2011-11-01

    The exotoxin gene content was established for 62 Staphylococcus aureus isolates causing bloodstream (n = 31) and wound (n = 31) infections in geriatric patients attending a long-term care Spanish hospital from 1996 to 2006. Content was determined based on PCR screening of genes encoding five haemolysins, three exfoliatins, three leukotoxins and 21 pyrogenic toxin superantigens (PTSAgs), in addition to markers of genomic (νSaβ) and pathogenicity (SaPIs) islands. Exotoxin genes were abundant in both bloodstream (11-23 genes) and wound (8-19 genes) isolates, and they were arranged in 55 combinations with only two represented in both groups. All isolates were positive for genes encoding haemolysins (hl; 3-5) and PTSAgs (tst, se and sel; 5-14), whereas exfoliatin (et) and leukotoxin (luk) genes appeared in 98.4 and 51.6 % of isolates, respectively. The hlg, lukPV, tst, sec and selu genes were found significantly more frequently in bloodstream than in wound isolates, whereas hlg-variant, sea, seb, see and selk-selq were more frequent in wound isolates (P<0.05). Distinctive exotoxin gene combinations could potentially be associated with specific mobile genetic elements, including genomic islands [lukED, egc1 (seg, seln, sei, selm, selo) and egc2 (seg, seln, selu, sei, selm, selo)]; pathogenicity islands (etd, seb, sec, sell, selq, selk and tst); bacteriophages (eta, lukPV, sea, selp, selk, selq and see); and plasmids (sed, selj, ser, ses and set). The abundance of exotoxin genes and variety of arrangements shown by S. aureus from geriatric patients could play a role in the adaptation of the pathogen.

  8. Caffeine consumption in a long-term psychiatric hospital: Tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use.

    PubMed

    Arrojo-Romero, Manuel; Armas Barbazán, Carmen; López-Moriñigo, Javier D; Ramos-Ríos, Ramón; Gurpegui, Manuel; Martínez-Ortega, José M; Jurado, Dolores; Diaz, Francisco J; de Leon, Jose

    2015-05-01

    This study further explores the association between schizophrenia and caffeine use by combining two prior published Spanish samples (250 schizophrenia outpatients and 290 controls from the general population) with two Spanish long-term inpatient samples from the same hospital (145 with schizophrenia and 64 with other severe mental illnesses). The specific aims were to establish whether or not, after controlling for confounders including tobacco smoking, the association between schizophrenia and caffeine is consistent across schizophrenia samples and across different definitions of caffeine use. The frequency of caffeine use in schizophrenia inpatients was not significantly higher than that in non-schizophrenia inpatients (77%, 111/145 vs. 75%, 48/64) or controls but was significantly higher than in schizophrenia outpatients. The frequency of high caffeine users among caffeine users in schizophrenia inpatients was not significantly higher than in non-schizophrenia inpatients (45%, 50/111 vs. 52%, 25/48) or controls, but was significantly lower than in schizophrenia outpatients. Smoking was significantly associated with caffeine use across all samples and definitions. Between 2 and 3% of schizophrenia inpatients, schizophrenia outpatients and non-schizophrenia inpatients showed caffeinism (>700 mg/day in smokers). Several of these smoking patients with caffeinism were also taking other inducers, particularly omeprazole. The lack of consistent association between schizophrenia and caffeine use is surprising when compared with the very consistent association between tobacco smoking and caffeine use across all of our analyses (use and high use in users) and all our samples. The confounding effects of tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use.

  9. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and Fiscal Year 2014 rates; quality reporting requirements for specific providers; hospital conditions of participation; payment policies related to patient status. Final rules.

    PubMed

    2013-08-19

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2013. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes that were applied to the LTCH PPS by the Affordable Care Act. Generally, these updates and statutory changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or have revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program. In addition, we are revising the conditions of participation (CoPs) for hospitals relating to the

  10. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    PubMed

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  11. Colonization of residents and staff of a long-term-care facility and adjacent acute-care hospital geriatric unit by multiresistant bacteria.

    PubMed

    March, A; Aschbacher, R; Dhanji, H; Livermore, D M; Böttcher, A; Sleghel, F; Maggi, S; Noale, M; Larcher, C; Woodford, N

    2010-07-01

    Long-term-care facilities (LTCFs) are reservoirs of resistant bacteria. We undertook a point-prevalence survey and risk factor analysis for specific resistance types among residents and staff of a Bolzano LTCF and among geriatric unit patients in the associated acute-care hospital. Urine samples and rectal, inguinal, oropharyngeal and nasal swabs were plated on chromogenic agar; isolates were typed by pulsed-field gel electrophoresis; resistance genes and links to insertion sequences were sought by PCR; plasmids were analysed by PCR, restriction fragment length polymorphism and incompatibility grouping. Demographic data were collected. Of the LTCF residents, 74.8% were colonized with ≥1 resistant organism, 64% with extended-spectrum β-lactamase (ESBL) producers, 38.7% with methicillin-resistant Staphylococcus aureus (MRSA), 6.3% with metallo-β-lactamase (MBL) producers, and 2.7% with vancomycin-resistant enterococci. Corresponding rates for LTCF staff were 27.5%, 14.5%, 14.5%, 1.5% and 0%, respectively. Colonization frequencies for geriatric unit patients were lower than for those in the LTCF. Both clonal spread and plasmid transfer were implicated in the dissemination of MBL producers that harboured IncN plasmids bearing bla(VIM-1), qnrS, and bla(SHV-12). Most (44/45) ESBL-producing Escherichia coli isolates had bla(CTX-M) genes of group 1; a few had bla(CTX-M) genes of group 9 or bla(SHV-5); those with bla(CTX-M-15) or bla(SHV-5) were clonal. Risk factors for colonization of LTCF residents with resistant bacteria included age ≥86 years, antibiotic treatment in the previous 3 months, indwelling devices, chronic obstructive pulmonary disease, physical disability, and the particular LTCF unit; those for geriatric unit patients were age and dementia. In conclusion, ESBL-producing and MBL-producing Enterobacteriaceae and MRSA were prevalent among the LTCF residents and staff, but less so in the hospital geriatric unit. Education of LTCF employees and better

  12. Successful peroral endoscopic myotomy performed in Endoscopy Department as a radical, long-term treatment for esophageal achalasia – the Greek experience

    PubMed Central

    Eleftheriadis, Nikolas; Eleftheriadou, Eleni Damianos

    2017-01-01

    Introduction Peroral endoscopic myotomy (POEM) has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders. Patients and methods We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus), with an age range of 32–92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015. The Eckardt score was 7–12 (type III). Seventeen (85%) POEM procedures were performed in the Endoscopy Department, according to a previous study. During POEM, CO2 insufflation was mandatory, while the Triangle Tip knife was the only knife used in all procedures. Eckardt score, esophagogram and manometry before and after performing POEM were used for evaluation of our results. The follow-up period was 6 months to 3 years. Results Selective circular myotomy, 10–13 cm in length, was successfully completed in all patients without severe acute or late complications. Three patients (15%) showed moderate pneumomediastinum and pneumoperitoneum, which was successfully managed by abdominal needle drainage during the procedure. One patient showed mild pleural collection, and in one patient the clip–endoloop technique was used to successfully close the mucosal entry after the completion of POEM. The outcome was uneventful without any further clinical consequences. No other short- or long-term serious complications were reported. Patients were discharged after 1–3 days of hospitalization. Six months to 3 years after the POEM procedure, all patients were alive; the majority (90%) had complete clinical improvement, while two patients with sigmoid-type achalasia showed moderate-to-significant clinical improvement. Erosive esophagitis was reported in 15%. Conclusion Our results are in accordance with international data, and proved the safety and efficacy

  13. Striving to live a normal life: a review of children and young people's experience of feeling different when living with a long term condition.

    PubMed

    Lambert, Veronica; Keogh, Deborah

    2015-01-01

    This paper presents a review of findings from qualitative studies on children's experience of feeling different when living with the long term conditions; diabetes, epilepsy and asthma. Following electronic database and hand searches of reference lists of identified papers, eighteen studies were selected for inclusion in the review. These studies revealed three common themes; participation in everyday life-restrictions and adjustments; treatment regimens-constraining and enabling; and communication-disclosure, stigma and support. Across these themes it was evident that children felt different physically and socially and they grappled constantly with balancing the dilemma of feeling and acting normal or feeling, being and revealing difference.

  14. Long-Term Student Experiences in a Hybrid, Open-Ended and Problem Based Adventure Learning Program

    ERIC Educational Resources Information Center

    Veletsianos, George; Doering, Aaron

    2010-01-01

    In this paper we investigate the experiences of elementary school children over a two-year period during which they engaged with a hybrid Adventure Learning program. In addition to delineating Adventure Learning experiences, we report on educational technology implementations in ecologically valid and complex environments, while drawing inferences…

  15. Long-Term Effects of Individual Development Accounts on Postsecondary Education: Follow-Up Evidence from a Randomized Experiment

    ERIC Educational Resources Information Center

    Grinstein-Weiss, Michal; Sherraden, Michael; Gale, William G.; Rohe, William M.; Schreiner, Mark; Key, Clinton

    2013-01-01

    This paper presents evidence from a randomized field experiment testing the impact of a 3-year matched savings program on educational outcomes 10 years after the start of the experiment. We examine the effect of an Individual Development Account (IDA) program on (1) educational enrollment, (2) degree completion, and (3) increased education level.…

  16. Experience of media presentations for the alleviation of agitation and emotional distress among dementia patients in a long-term nursing facility.

    PubMed

    Chung, Joohyun; Choi, Seong-In; Kim, Jun

    2016-09-01

    Although the cause and the cure for dementia remain unknown, it is clear that environmental factors can offer relief of cognitive impairment and encourage emotional stability. The purpose was to explore dementia patients' experiences of a media presentation including images of nature. Combining a qualitative approach with quantitative data analysis, the project exposed 23 participants to slide show presentations of fascinating natural scenes over 4 weeks. The patients' feelings and experiences of the media presentations were investigated using semistructured interviews and daily chart reviews in which weekly behavioral changes. The experience of natural scenes in dementia patients' everyday atmosphere became a new and positive aspect of life at the long-term nursing facility, although the quantitative data did not significantly change during the project. This treatment could provide dementia patients with a nurturing relationship, making nature a supportive part of their everyday experience.

  17. Results of the Komplast experiment on the long-term exposure of materials specimens on the ISS surface

    NASA Astrophysics Data System (ADS)

    Shumov, A. E.; Novikov, L. S.; Shaevich, S. K.; Aleksandrov, N. G.; Smirnova, T. N.; Nikishin, E. F.; Chernik, V. N.; Petukhov, V. P.; Voronina, E. N.; Sedov, V. V.; Salnikova, I. A.; Babaevskiy, P. G.; Kozlov, N. A.; Deev, I. S.; Startsev, O. V.; Shindo, D. J.; Golden, J. L.; Kravchenko, M.

    2015-11-01

    The Komplast materials experiment was designed by Khrunichev State Research and Production Space Center together with Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University and other Russian scientific institutes, and has been carried out by Mission Control Moscow since 1998. The purpose of this experiment is to study the complex effect of the low Earth orbit environment on samples of various spacecraft materials. On November 20, 1998 the Komplast experiment began with the launch of the first International Space Station module Zarya, or Functional Cargo Block (FGB). Eight Komplast panels with samples of materials and sensors were installed on the outer surface of FGB module. Two of eight experiment panels were retrieved during Russian extravehicular activity in February 2011 after 12 years of space exposure and were subsequently returned to Earth by Space Shuttle "Discovery" on the STS-133/ULF-5 mission in March 2011. The article presents the results obtained from this unique long-duration experiment on board of the International Space Station.

  18. Challenging terrestrial biosphere models with data from the long-term multifactor Prairie Heating and CO2 Enrichment experiment.

    PubMed

    De Kauwe, Martin G; Medlyn, Belinda E; Walker, Anthony P; Zaehle, Sönke; Asao, Shinichi; Guenet, Bertrand; Harper, Anna B; Hickler, Thomas; Jain, Atul K; Luo, Yiqi; Lu, Xingjie; Luus, Kristina; Parton, William J; Shu, Shijie; Wang, Ying-Ping; Werner, Christian; Xia, Jianyang; Pendall, Elise; Morgan, Jack A; Ryan, Edmund M; Carrillo, Yolima; Dijkstra, Feike A; Zelikova, Tamara J; Norby, Richard J

    2017-02-01

    Multifactor experiments are often advocated as important for advancing terrestrial biosphere models (TBMs), yet to date, such models have only been tested against single-factor experiments. We applied 10 TBMs to the multifactor Prairie Heating and CO2 Enrichment (PHACE) experiment in Wyoming, USA. Our goals were to investigate how multifactor experiments can be used to constrain models and to identify a road map for model improvement. We found models performed poorly in ambient conditions; there was a wide spread in simulated above-ground net primary productivity (range: 31-390 g C m(-2)  yr(-1) ). Comparison with data highlighted model failures particularly with respect to carbon allocation, phenology, and the impact of water stress on phenology. Performance against the observations from single-factors treatments was also relatively poor. In addition, similar responses were predicted for different reasons across models: there were large differences among models in sensitivity to water stress and, among the N cycle models, N availability during the experiment. Models were also unable to capture observed treatment effects on phenology: they overestimated the effect of warming on leaf onset and did not allow CO2 -induced water savings to extend the growing season length. Observed interactive (CO2  × warming) treatment effects were subtle and contingent on water stress, phenology, and species composition. As the models did not correctly represent these processes under ambient and single-factor conditions, little extra information was gained by comparing model predictions against interactive responses. We outline a series of key areas in which this and future experiments could be used to improve model predictions of grassland responses to global change.

  19. Challenging terrestrial biosphere models with data from the long-term multifactor Prairie Heating and CO2 enrichment experiment

    DOE PAGES

    De Kauwe, Martin G.; Medlyn, Belinda E.; Walker, Anthony P.; ...

    2017-02-01

    Multi-factor experiments are often advocated as important for advancing terrestrial biosphere models (TBMs), yet to date such models have only been tested against single-factor experiments. We applied 10 TBMs to the multi-factor Prairie Heating and CO2 Enrichment (PHACE) experiment in Wyoming, USA. Our goals were to investigate how multi-factor experiments can be used to constrain models, and to identify a road map for model improvement. We found models performed poorly in ambient conditions; there was a wide spread in simulated above-ground net primary productivity (range: 31-390 g C m-2 yr-1). Comparison with data highlighted model failures particularly in respect tomore » carbon allocation, phenology, and the impact of water stress on phenology. Performance against single-factors was also relatively poor. In addition, similar responses were predicted for different reasons across models: there were large differences among models in sensitivity to water stress and, among the nitrogen cycle models, nitrogen availability during the experiment. Models were also unable to capture observed treatment effects on phenology: they over-estimated the effect of warming on leaf onset and did not allow CO2-induced water savings to extend growing season length. Observed interactive (CO2 x warming) treatment effects were subtle and contingent on water stress, phenology and species composition. Since the models did not correctly represent these processes under ambient and single-factor conditions, little extra information was gained by comparing model predictions against interactive responses. Finally, we outline a series of key areas in which this and future experiments could be used to improve model predictions of grassland responses to global change.« less

  20. Different subtypes of epithelioid sarcoma and their clinical implication: long-term multi-institutional experience with a rare sarcoma.

    PubMed

    Kim, Chan; Yoo, Kwai Han; Kim, Min Hwan; Chon, Hong Jae; Lee, Soon Il; Lee, Hyo Jin; Koh, Sujin; Lee, Ha Yeon; Lee, Hye Ran; Kim, Kyung Sik; Choi, Young Deuk; Rha, Sun Young; Lee, Su Jin; Kim, Hyo Song

    2017-03-01

    Epithelioid sarcoma (ES) is a very rare soft-tissue sarcoma with a high tendency of recurrence and metastasis. We analyzed clinical features of ES and aimed to identify the potential role of radio- and chemotherapy in ES. Fifty-five patients diagnosed with ES between 1997 and 2014 were enrolled from seven tertiary hospitals in Korean Cancer Research Group. The clinical variables were retrospectively reviewed and analyzed. Forty-six (84%) patients underwent surgical resection of ES, and among them, 27 experienced recurrence. In these patients, resection margin status and adjuvant radiotherapy were independent prognostic factors for longer recurrence-free survival (RFS), while adjuvant chemotherapy did not influence RFS. Twenty-two (40%) patients received palliative chemotherapy for metastatic or recurrent ES, and in these patients, palliative chemotherapy was the only independent prognostic factor for longer overall survival. Intriguingly, the clinical benefit of radio- and chemotherapy was observable only in proximal ES, but not in extremity ES, indicating that subtypes of ES might respond to radio- or chemotherapy differently. Proximal ES seems to benefits more from active anticancer treatment than conventional extremity ES. The aggressive characteristics of proximal ES could be overcome with an optimal multimodal treatment.

  1. The Short- and Long-Term Effects of a Short Study Abroad Experience: The Case of Children

    ERIC Educational Resources Information Center

    Llanes, Angels

    2012-01-01

    This study examines to what extent L2 gains obtained during a study abroad (SA) experience are durable. Participants were 16 Catalan/Spanish bilingual children, learning English as an L2, who were distributed into two groups depending on their learning context (SA vs. at home [AH]). Participants completed a pre-test before the SA participants'…

  2. "It was an education in portion size". Experience of eating a healthy diet and barriers to long term dietary change.

    PubMed

    Macdiarmid, J I; Loe, J; Kyle, J; McNeill, G

    2013-12-01

    The aim of the study was to explore the expectations and experience of actually eating a healthy diet and using this experience to identify barriers to healthy eating and sustainable dietary change. Fifty participants (19-63 yrs) were provided with a healthy diet (i.e. complied with dietary recommendations) for three consecutive days. Afterwards a semi-structured interview was carried out to explore expectations, experience and barriers to healthy eating. Using a thematic analysis approach eight dominant themes emerged from the interviews. Four related to expectations and experience of healthy eating; realisation of what are appropriate portion sizes, an expectation to feel hungry, surprise that healthy diets comprised normal food, the desire for sweet snacks (e.g. chocolate). This demonstrated there are some misconception about healthy eating and distorted views of portion size. Four more themes emerged relating to barriers to healthy eating; competing priorities, social, peer and time pressure, importance of value for money, a lack of desire to cook. Poor knowledge of healthy eating or a lack of cooking skills were the least common barrier, suggesting that future interventions and policy to improve dietary intakes need to focus on social, cultural and economic issues rather than on lack of knowledge or skills.

  3. Engaging students in dedicated research and scholarship during medical school: the long-term experiences at Duke and Stanford.

    PubMed

    Laskowitz, Daniel T; Drucker, Robert P; Parsonnet, Julie; Cross, Patricia C; Gesundheit, Neil

    2010-03-01

    For more than 40 years, the faculties of Duke University School of Medicine (SOM) and Stanford University SOM have encouraged or required students to engage in scholarship as a way to broaden their education and attract them to careers in academic medicine. A dedicated period of research was first integrated into the Duke curriculum in 1959 to provide an opportunity for students to develop into physician leaders through a rigorous scholarly experience in biomedically related research. Originally designed to foster experience in laboratory-based basic research, the third-year program has evolved in response to the changing landscape of medicine and shifting needs and career interests of the medical student population. Stanford University SOM also has a long-standing commitment to biomedical research and currently requires each student to complete an in-depth, mentored "scholarly concentration." In contrast to Duke, where most of the scholarly research experiences take place in an immersive third year, the Stanford program encourages a longitudinal, multiyear exposure over all four (or five) years of medical school. Although the enduring effects of embedding a rigorous research program are not yet fully known, preliminary data suggest that these experiences instill an appreciation for research, impart research rigor and methodologies, and may motivate students to pursue careers in academic medicine. The authors discuss the histories, evolution, logistics, and ongoing challenges of the research programs at Duke University SOM and Stanford University SOM.

  4. The Long Term Impacts of Compulsory Schooling: Evidence from a Natural Experiment in School Leaving Dates. CEE DP 74

    ERIC Educational Resources Information Center

    Del Bono, Emilia; Galindo-Rueda, Fernando

    2007-01-01

    This paper investigates a unique feature of the English educational system to estimate the causal effect of compulsory schooling on labour market outcomes. We examine school leaving rules that allow for discrete variation in exit dates by date of birth within school cohorts. This natural experiment enables a regression discontinuity design that…

  5. Modeling long term Enhanced in situ Biodenitrification and induced heterogeneity in column experiments under different feeding strategies

    NASA Astrophysics Data System (ADS)

    Rodríguez-Escales, Paula; Folch, Albert; van Breukelen, Boris M.; Vidal-Gavilan, Georgina; Sanchez-Vila, Xavier

    2016-07-01

    Enhanced In situ Biodenitrification (EIB) is a capable technology for nitrate removal in subsurface water resources. Optimizing the performance of EIB implies devising an appropriate feeding strategy involving two design parameters: carbon injection frequency and C:N ratio of the organic substrate nitrate mixture. Here we model data on the spatial and temporal evolution of nitrate (up to 1.2 mM), organic carbon (ethanol), and biomass measured during a 342 day-long laboratory column experiment (published in Vidal-Gavilan et al., 2014). Effective porosity was 3% lower and dispersivity had a sevenfold increase at the end of the experiment as compared to those at the beginning. These changes in transport parameters were attributed to the development of a biofilm. A reactive transport model explored the EIB performance in response to daily and weekly feeding strategies. The latter resulted in significant temporal variation in nitrate and ethanol concentrations at the outlet of the column. On the contrary, a daily feeding strategy resulted in quite stable and low concentrations at the outlet and complete denitrification. At intermediate times (six months of experiment), it was possible to reduce the carbon load and consequently the C:N ratio (from 2.5 to 1), partly because biomass decay acted as endogenous carbon to respiration, keeping the denitrification rates, and partly due to the induced dispersivity caused by the well-developed biofilm, resulting in enhancement of mixing between the ethanol and nitrate and the corresponding improvement of denitrification rates. The inclusion of a dual-domain model improved the fit at the last days of the experiment as well as in the tracer test performed at day 342, demonstrating a potential transition to anomalous transport that may be caused by the development of biofilm. This modeling work is a step forward to devising optimal injection conditions and substrate rates to enhance EIB performance by minimizing the overall supply of

  6. A serendipitous, long-term infiltration experiment: Water and tritium circulation beneath the CAMBRIC trench at the Nevada Test Site

    NASA Astrophysics Data System (ADS)

    Maxwell, Reed M.; Tompson, Andrew F. B.; Kollet, Stefan

    2009-08-01

    Underground nuclear weapons testing at the Nevada Test Site introduced numerous radionuclides that may be used subsequently to characterize subsurface hydrologic transport processes in arid climates. In 1965, a unique, 16-year pumping experiment designed to examine radionuclide migration away from the CAMBRIC nuclear test, conducted in the saturated zone beneath Frenchman Flat, Nevada, USA, gave rise to an unintended second experiment involving radionuclide infiltration through the vadose zone, as induced by seepage of pumping effluents beneath an unlined discharge trench. The combined experiments have been reanalyzed using a detailed, three-dimensional numerical model of transient, variably saturated flow and mass transport in a heterogeneous subsurface, tailored specifically for large-scale and efficient calculations. Simulations have been used to estimate tritium travel and residence times in various parts of the system for comparison with observations in wells. Model predictions of mass transport were able to clearly demonstrate radionuclide recycling behavior between the trench and pumping well previously suggested by isotopic age dating information; match travel time estimates for radionuclides moving between the trench, the water table, and monitoring and pumping wells; and provide more realistic ways in which to interpret the pumping well elution curves. Collectively, the results illustrate the utility of integrating detailed numerical modeling with diverse observational data in developing more accurate interpretations of contaminant migration processes.

  7. A serendipitous, long-term infiltration experiment: water and tritium circulation beneath the CAMBRIC trench at the Nevada Test Site.

    PubMed

    Maxwell, Reed M; Tompson, Andrew F B; Kollet, Stefan

    2009-08-11

    Underground nuclear weapons testing at the Nevada Test Site introduced numerous radionuclides that may be used subsequently to characterize subsurface hydrologic transport processes in arid climates. In 1965, a unique, 16-year pumping experiment designed to examine radionuclide migration away from the CAMBRIC nuclear test, conducted in the saturated zone beneath Frenchman Flat, Nevada, USA, gave rise to an unintended second experiment involving radionuclide infiltration through the vadose zone, as induced by seepage of pumping effluents beneath an unlined discharge trench. The combined experiments have been reanalyzed using a detailed, three-dimensional numerical model of transient, variably saturated flow and mass transport in a heterogeneous subsurface, tailored specifically for large-scale and efficient calculations. Simulations have been used to estimate tritium travel and residence times in various parts of the system for comparison with observations in wells. Model predictions of mass transport were able to clearly demonstrate radionuclide recycling behavior between the trench and pumping well previously suggested by isotopic age dating information; match travel time estimates for radionuclides moving between the trench, the water table, and monitoring and pumping wells; and provide more realistic ways in which to interpret the pumping well elution curves. Collectively, the results illustrate the utility of integrating detailed numerical modeling with diverse observational data in developing more accurate interpretations of contaminant migration processes.

  8. Contribution of long-term hydrothermal experiments for understanding the smectite-to-chlorite conversion in geological environments

    NASA Astrophysics Data System (ADS)

    Mosser-Ruck, Régine; Pignatelli, Isabella; Bourdelle, Franck; Abdelmoula, Mustapha; Barres, Odile; Guillaume, Damien; Charpentier, Delphine; Rousset, Davy; Cathelineau, Michel; Michau, Nicolas

    2016-11-01

    The smectite-to-chlorite conversion is investigated through long-duration experiments (up to 9 years) conducted at 300 °C. The starting products were the Wyoming bentonite MX80 (79 % smectite), metallic iron and magnetite in contact with a Na-Ca chloride solution. The predominant minerals in the run products were an iron-rich chlorite (chamosite like) and interstratified clays interpreted to be chlorite/smectite and/or corrensite/smectite, accompanied by euhedral crystals of quartz, albite and zeolite. The formation of pure corrensite was not observed in the long-duration experiments. The conversion of smectite into chlorite over time appears to take place in several steps and through several successive mechanisms: a solid-state transformation, significant dissolution of the smectite and direct precipitation from the solution, which is over-saturated with respect to chlorite, allowing the formation of a chamosite-like mineral. The reaction mechanisms are confirmed by X-ray patterns and data obtained on the experimental solutions (pH, contents of Si, Mg, Na and Ca). Because of the availability of some nutrients in the solution, total dissolution of the starting smectite does not lead to 100 % crystallization of chlorite but to a mixture of two dominant clays: chamosite and interstratified chlorite/smectite and/or corrensite/smectite poor in smectite. The role of Fe/(Fe + Mg) in the experimental medium is highlighted by chemical data obtained on newly formed clay particles alongside previously published data. The newly formed iron-rich chlorite has the same composition as that predicted by the geothermometer for diagenetic to low-grade metamorphic conditions, and the quartz + Fe-chlorite + albite experimental assemblage in the 9-year experiment is close to that fixed by water-rock equilibrium.

  9. Do Ground-Dwelling Vertebrates Promote Diversity in a Neotropical Forest? Results from a Long-Term Exclosure Experiment

    PubMed Central

    Kurten, Erin L.; Carson, Walter P.

    2015-01-01

    Using a decade-long exclosure experiment in Panama, we tested the hypothesis that ground-dwelling vertebrate herbivores and seed predators are crucial determinants of tropical tree diversity and abundance within the understory. Our exclosure experiment is a community-level test of the Janzen–Connell hypothesis. Therefore, we predicted that vertebrate exclusion would (a) increase plant densities and (b) lower richness, diversity, and evenness. Excluding vertebrates caused a 38%–46% increase in plant densities, which, in contrast to our predictions, caused species richness to increase by 12%–15%. Because vertebrate exclusion causes plant species richness to increase, not decrease, vertebrates are unlikely to be causal agents of Janzen–Connell effects. We synthesized this and previous studies to explore why plant richness responds differently to defaunation and exclosures in tropical forests worldwide. Likely because of their contrasting effects on mesoconsumers, defaunation and exclosures cause decreases and increases in plant density respectively, which in turn cause corresponding changes in richness. PMID:26955084

  10. Microstructure and Property Evolution in Advanced Cladding and Duct Materials Under Long-Term Irradiation at Elevated Temperature: Critical Experiments

    SciTech Connect

    Was, Gary; Jiao, Zhijie; Allen, Todd; Yang, Yong

    2013-12-20

    The in-service degradation of reactor core materials is related to underlying changes in the irradiated microstructure. During reactor operation, structural components and cladding experience displacement of atoms by collisions with neutrons at temperatures at which the radiation-induced defects are mobile, leading to microstructure evolution under irradiation that can degrade material properties. At the doses and temperatures relevant to fast reactor operation, the microstructure evolves by microchemistry changes due to radiation-induced segregation, dislocation loop formation and growth, radiation induced precipitation, destabilization of the existing precipitate structure, as well as the possibility for void formation and growth. These processes do not occur independently; rather, their evolution is highly interlinked. Radiation-induced segregation of Cr and existing chromium carbide coverage in irradiated alloy T91 track each other closely. The radiation-induced precipitation of Ni-Si precipitates and RIS of Ni and Si in alloys T91 and HCM12A are likely related. Neither the evolution of these processes nor their coupling is understood under the conditions required for materials performance in fast reactors (temperature range 300-600°C and doses to 200 dpa and beyond). Further, predictive modeling is not yet possible, as models for microstructure evolution must be developed along with experiments to characterize these key processes and provide tools for extrapolation. To extend the range of operation of nuclear fuel cladding and structural materials in advanced nuclear energy and transmutation systems to that required for the fast reactor, the irradiation-induced evolution of the microstructure, microchemistry, and the associated mechanical properties at relevant temperatures and doses must be understood. This project builds upon joint work at the proposing institutions, under a NERI-C program that is scheduled to end in September, to understand the effects of

  11. Porosity and permeability development in compacting chalks during flooding of nonequilibrium brines: Insights from long-term experiment

    NASA Astrophysics Data System (ADS)

    Nermoen, Anders; Korsnes, Reidar I.; Hiorth, Aksel; Madland, Merete V.

    2015-05-01

    We report the complete chemical alteration of a Liège outcrop chalk core resulting from a 1072 flow-through experiment performed during mechanical compaction at 130°C. Chemical rock-fluid interactions alter the volumetric strain, porosity, and permeability in a nontrivial way. The porosity reduced only from 41.32% to 40.14%, even though the plug compacted more than 25%. We present a novel analysis of the experimental data, which demonstrates that the geochemical alteration does not conserve the volume of the solids, and therefore, the strain is partitioned additively into a pore volume and solid volume component. At stresses beyond yield, the observed deformation can be explained by grain reorganization reducing the pore space between grains and solid volume changes from the rock-fluid interactions. The mechanical and chemical effects are discussed in relation to the observed permeability development.

  12. Numerical modeling of a long-term in situ chemical osmosis experiment in the Pierre Shale, South Dakota

    USGS Publications Warehouse

    Garavito, A.M.; Kooi, H.; Neuzil, C.E.

    2006-01-01

    We have numerically modeled evolving fluid pressures and concentrations from a nine-year in situ osmosis experiment in the Pierre Shale, South Dakota. These data were obtained and recently interpreted by one of us (C.E.N.) as indicating a potentially significant role for chemical osmosis in media like the Pierre Shale. That analysis considered only the final pressure differentials among boreholes that were assumed to represent osmotic equilibrium. For this study, the system evolution was modeled using a recently developed transient model for membrane transport. The model simulates hydraulically and chemically driven fluid and solute transport. The results yield an estimate of the thickness of the water film between the clay platelets b of 40 A??, which corresponds to an osmotic efficiency ?? of 0.21 for the ambient pore water salinity of 3.5 g/l TDS. These values largely confirm the results of the earlier equilibrium analysis. However, the new model analysis provides additional constraints suggesting that intrinsic permeability k = 1.4 ?? 10-19 m2, specific storage Ss = 1.7 ?? 10-5 m-1, and diffusion coefficient D* = 6 ?? 10-11 m2/s. The k value is larger than certain independent estimates which range from 10-21 to 10-20; it may indicate opening of microcracks during the experiments. The fact that the complex transient pressure and concentration behavior for the individual wells could be reproduced quite accurately, and the inferred parameter values appear to be realistic for the Pierre Shale, suggests that the new model is a useful tool for modeling transient coupled flows in groundwater systems. ?? 2005 Elsevier Ltd. All rights reserved.

  13. Long-term experiment on physiological responses to synergetic effects of ocean acidification and photoperiod in the Antarctic sea ice algae Chlamydomonas sp. ICE-L.

    PubMed

    Xu, Dong; Wang, Yitao; Fan, Xiao; Wang, Dongsheng; Ye, Naihao; Zhang, Xiaowen; Mou, Shanli; Guan, Zheng; Zhuang, Zhimeng

    2014-07-15

    Studies on ocean acidification have mostly been based on short-term experiments of low latitude with few investigations of the long-term influence on sea ice communities. Here, the combined effects of ocean acidification and photoperiod on the physiological response of the Antarctic sea ice microalgae Chlamydomonas sp. ICE-L were examined. There was a general increase in growth, PSII photosynthetic parameters, and N and P uptake in continuous light, compared to those exposed to regular dark and light cycles. Elevated pCO2 showed no consistent effect on growth rate (p=0.8) and N uptake (p=0.38) during exponential phrase, depending on the photoperiod but had a positive effect on PSII photosynthetic capacity and P uptake. Continuous dark reduced growth, photosynthesis, and nutrient uptake. Moreover, intracellular lipid, mainly in the form of PUFA, was consumed at 80% and 63% in low and high pCO2 in darkness. However, long-term culture under high pCO2 gave a more significant inhibition of growth and Fv/Fm to high light stress. In summary, ocean acidification may have significant effects on Chlamydomonas sp. ICE-L survival in polar winter. The current study contributes to an understanding of how a sea ice algae-based community may respond to global climate change at high latitudes.

  14. Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions

    PubMed Central

    He, Yong; Gao, Yang; Zhang, Cuiping; Chen, Chuansheng; Bi, Suyu; Yang, Pin; Wang, Yiwen; Wang, Wenjing

    2017-01-01

    Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions. PMID:28129407

  15. Interactions between two human-induced stresses in aquatic ecosystems: Examining links between acidification and ultraviolet radiation using long-term data from a whole-lake experiment

    SciTech Connect

    Frost, T.M.; Williamson, C.E.; Montz, P.K. |

    1995-06-01

    Acidification and increased amounts of ultraviolet radiation are two of the most widespread human-caused stresses on the biosphere. Although they have not previously been thought to be linked, we have been able to examine their interaction using long-term data collected during a whole-lake acidification experiment in Little Rock Lake, Wisconsin. Our analyses have indicated that recorded changes in DOC during the acidification stage when the pH was reduced below 5 (1989-90) were sufficient to decrease the attenuation of UV-B radiation markedly. One percent of surface radiation reached greater than 1.5m in depth in the lake`s treatment basin compared with less than 0.6m in the reference basin. Attenuation has increased back to pre-acidification levels with recovery since acid additions were completed in 1990. Here we use an extensive, long-term data base to examine the vertical distribution of zooplankton with the decreased attenuation of UV-radiation. UV effects may drive some of the previously unexplained zooplankton responses that we had observed with acidification.

  16. Evaluating soil quality under a long-term integrated tillage-water-nutrient experiment with intensive rice-wheat rotation in a semi-arid Inceptisol, India.

    PubMed

    Bhaduri, Debarati; Purakayastha, T J; Patra, A K; Chakraborty, Debashis

    2014-04-01

    Long-term sustainability and a declining trend in productivity of rice-wheat rotation in the Indo-Gangetic plain, often direct towards the changes in soil quality parameters. Soil quality is decided through few sensitive soil physical, chemical and biological indicators as it cannot be measured directly. The present investigation was carried out to develop a valid soil quality index through some chosen indicators under long-term influences of tillage, water and nutrient-management practices in a rice-wheat cropping system. The experiment consisted of two tillage treatments, three irrigation treatments, and nine nutrient management treatments for both rice and wheat, was continued for 8 years. The index was developed using expert-opinion based conceptual framework model. After harvest of rice, the CFSQI-P (productivity) was higher under puddled situation, whereas CFSQI-EP (environmental protection) was more under non-puddled condition and 3-days of drainage was found promising for all the indices. No-tillage practice always showed higher soil quality index. The treatments either receiving full organics (100% N) or 25% substitution of fertilizer N with organics showed higher soil quality indices. Puddling, irrigation after 3 days of drainage and substitution of 25% recommended fertilizer N dose with FYM in rice could be practiced for maintaining or enhancing soil quality. No-tillage, two irrigations, and domestic sewage sludge in wheat can safely be recommended for achieving higher soil quality.

  17. Biochar amendment reduces rice Cd uptake in polluted and unpolluted paddy soils: a long term field experiment

    NASA Astrophysics Data System (ADS)

    Bian, R.; Cui, L.; Pan, G.; Li, L.

    2012-04-01

    The bioavailability of Cd in agricultural soils has been a great health concern due to the potential risk through exposure of agro-food produced in Cd-contaminated fields. Yet, rice subject to Cd contamination appears to have expanded at the last decade due to irrigation with waste water and chemical fertilization in south china. This is supposed to raise the Cd accumulation of rice grain. Therefore, techniques to reduce Cd mobility and plant uptake have been a urgent demand for food safety in China.A field experiment was performed in a high-polluted (HP), mid-pollute (MP) and unpolluted (UP) paddy soil with biochar(BC) amendment in 2011. BC was applied in HP, MP and UP in 2008, 2009, 2009 with the rates of 0, 10, 20, 40t ha-1 in HP, MP and 0, 40t ha-1 in UP. The experiment was monitored in 2011. It was observed that BC amendment did not affect rice grain yield but significantly increased soil pH by 0.58-0.77, 1.30 units in MP, UP and there was no difference in HP. The Cacl2 extracted Cd in soil was decreased by 18.1%-28.9% in HP, 49.3%-67.5% in MP and 83.1% in UP, respectively. Meanwhile, H2O extractable Cd in soil was decreased by 20.0%-31.7% in HP, 32.7%-44.2% in MP and 25.0% in UP, respectively. With the BC treatment, rice grain Cd concentration was decreased 4.7%-17.6% in HP, 35.9%-53.4% in MP. Especially in UP field, the rice grain Cd concentration was decreased from 0.22mg kg-1 to 0.07mg kg-1 which was below National standard (0.20mg kg-1) in China. The straw and root Cd contents were also significantly decreased with BC application. Therefore, BC amendment in polluted and unpolluted fields can sustainably reduce rice Cd uptake and it may offer a basic option to reduce Cd levels in rice. Keywords: Biochar, Cd, bioavailability, paddy soil, food safety

  18. Long-term monitoring of growth in the Eastern Elliptio, Elliptio complanata (Bivalvia: Unionidae), in Rhode Island: A transplant experiment

    USGS Publications Warehouse

    Kesler, D.H.; Newton, T.J.; Green, L.

    2007-01-01

    The lengths of marked specimens of the freshwater mussel, Eastern Elliptio (Elliptio complanata [Lightfoot 1786]), were monitored annually in 3 lakes in Rhode Island, USA, from 1991 to 2005. Mussels growing in Worden Pond showed a change in mean shell length of only 4.3 mm over 14 y, whereas mussel growth in 2 nearby lakes was 3 to 8x greater than growth in Worden Pond over the same time period. L???, the length at which shell growth stops, was significantly different (p < 0.001) among lakes and ranged from 60.5 to 87.4 mm. Transplant experiments revealed that mussels moved to Worden Pond stopped growing, whereas mussels moved from Worden Pond to the 2 other lakes grew at rates similar to the rates observed for resident mussels in the 2 lakes. Standard water-quality measures did not explain the observed growth cessation and lower condition indices of mussels in Worden Pond. Our growth data are consistent with food limitation. The consistent slow growth of E. complanata in Worden Pond, without high mortality, and its ability to increase growth when placed in environments more favorable than Worden Pond, suggests both growth plasticity and longevity in these animals. ?? 2007 by The North American Benthological Society.

  19. Younger Stroke Survivors' Experiences of Family Life in a Long-Term Perspective: A Narrative Hermeneutic Phenomenological Study

    PubMed Central

    Martinsen, Randi; Kirkevold, Marit; Sveen, Unni

    2012-01-01

    The psychosocial consequences following a stroke are known to be challenging, influencing the stroke survivors' ability to participate in and carry out the taken-for-granted roles and activities in family life. This study explored how living with the consequences of stroke impacted on family life in the late recovery phase, that is, six months or more after stroke onset. Twenty-two stroke survivors aged 20–61 years were interviewed in-depth six months to nine years after stroke onset. The interviews were analyzed applying a narrative, hermeneutic phenomenological approach. The findings revealed challenges that varied with time, from an initial struggle to suffice in and balance the relationships and roles within the family early after the stroke, towards a more resigned attitude later on in the stroke trajectory. The struggles are summarized in two main themes: “struggling to reenter the family” and “screaming for acceptance.” Nonestablished people living with stroke and stroke survivors in parental roles seem to be particularly vulnerable. Being provided with opportunities to narrate their experiences to interested and qualified persons outside the home context might be helpful to prevent psychosocial problems. PMID:23304485

  20. Comparative Effectiveness of Intervention Components for Producing Long-Term Abstinence from Smoking: A Factorial Screening Experiment

    PubMed Central

    Schlam, Tanya R.; Fiore, Michael C.; Smith, Stevens S.; Fraser, David; Bolt, Daniel M.; Collins, Linda M.; Mermelstein, Robin; Piper, Megan E.; Cook, Jessica W.; Jorenby, Douglas E.; Loh, Wei-Yin; Baker, Timothy B.

    2015-01-01

    Aims To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. Design A 2×2×2×2×2 randomized factorial experiment. Setting Eleven primary care clinics in Wisconsin, USA. Participants 544 smokers (59% women, 86% White) recruited during primary care visits and motivated to quit. Interventions Five intervention components designed to help smokers attain and maintain abstinence: 1) extended medication (26 vs. 8 weeks of nicotine patch + nicotine gum); 2) maintenance (phone) counseling versus none; 3) medication adherence counseling versus none; 4) automated (medication) adherence calls versus none; and 5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. Measurements The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day. Findings Only extended medication produced a main effect. Twenty-six versus eight weeks of medication improved point-prevalence abstinence rates (43% vs. 34% at 6 months; 34% versus 27% at 1 year; p =.01 for both). There were four interaction effects at 1 year, showing that an intervention component’s effectiveness depended upon the components with which it was combined. Conclusions Twenty-six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment. PMID:26581819

  1. A long-term static immersion experiment on the leaching behavior of heavy metals from waste printed circuit boards.

    PubMed

    Zhao, Guo-Hua; Luo, Xing-Zhang; Chen, Gui; Zhao, Yong-Jun

    2014-08-01

    Printed circuit boards (PCBs) are the main components of electrical and electronic equipment (EEE). Waste PCBs contain several kinds of heavy metals, including Cu, Pb and Zn. We characterize the leaching of heavy metals (Cu, Pb, Zn and Ni) from waste PCBs in a pH range of 3.0 to 5.6 using a novel approach based on batch pH-static leaching experiments in this work. The results indicate that the leaching behavior of Cu, Pb, Zn and Ni is strongly dependent on pH. Leaching behavior also varies with different pH values and leaching times. The maximum concentrations of Cu, Pb, Zn and Ni in leachate from waste PCBs were 335.00, 17.57, 2.40 and 2.33 mg L(-1), respectively. The highest Pb, Ni, and Cu concentrations leached significantly exceeded the European Union waste-acceptance limit values with respect to inert waste landfills. The leaching of metals follows the shrinking core model with surface reaction control.

  2. Pre-learning stress differentially affects long-term memory for emotional words, depending on temporal proximity to the learning experience.

    PubMed

    Zoladz, Phillip R; Clark, Brianne; Warnecke, Ashlee; Smith, Lindsay; Tabar, Jennifer; Talbot, Jeffery N

    2011-07-06

    Stress exerts a profound, yet complex, influence on learning and memory and can enhance, impair or have no effect on these processes. Here, we have examined how the administration of stress at different times before learning affects long-term (24-hr) memory for neutral and emotional information. Participants submerged their dominant hand into a bath of ice cold water (Stress) or into a bath of warm water (No stress) for 3 min. Either immediately (Exp. 1) or 30 min (Exp. 2) after the water bath manipulation, participants were presented with a list of 30 words varying in emotional valence. The next day, participants' memory for the word list was assessed via free recall and recognition tests. In both experiments, stressed participants exhibited greater blood pressure, salivary cortisol levels, and subjective pain and stress ratings than non-stressed participants in response to the water bath manipulation. Stress applied immediately prior to learning (Exp. 1) enhanced the recognition of positive words, while stress applied 30 min prior to learning (Exp. 2) impaired free recall of negative words. Participants' recognition of positive words in Experiment 1 was positively associated with their heart rate responses to the water bath manipulation, while participants' free recall of negative words in Experiment 2 was negatively associated with their blood pressure and cortisol responses to the water bath manipulation. These findings indicate that the differential effects of pre-learning stress on long-term memory may depend on the temporal proximity of the stressor to the learning experience and the emotional nature of the to-be-learned information.

  3. Reactivation of a cryptobiotic stream ecosystem in the McMurdo Dry Valleys, Antarctica: A long-term geomorphological experiment

    USGS Publications Warehouse

    McKnight, Diane M.; Tate, C.M.; Andrews, E.D.; Niyogi, D.K.; Cozzetto, K.; Welch, K.; Lyons, W.B.; Capone, D.G.

    2007-01-01

    The McMurdo Dry Valleys of Antarctica contain many glacial meltwater streams that flow for 6 to 12??weeks during the austral summer and link the glaciers to the lakes on the valley floors. Dry valley streams gain solutes longitudinally through weathering reactions and microbial processes occurring in the hyporheic zone. Some streams have thriving cyanobacterial mats. In streams with regular summer flow, the mats are freeze-dried through the winter and begin photosynthesizing with the onset of flow. To evaluate the longer term persistence of cyanobacterial mats, we diverted flow to an abandoned channel, which had not received substantial flow for approximately two decades. Monitoring of specific conductance showed that for the first 3??years after the diversion, the solute concentrations were greater in the reactivated channel than in most other dry valley streams. We observed that cyanobacterial mats became abundant in the reactivated channel within a week, indicating that the mats had been preserved in a cryptobiotic state in the channel. Over the next several years, these mats had high rates of productivity and nitrogen fixation compared to mats from other streams. Experiments in which mats from the reactivated channel and another stream were incubated in water from both of the streams indicated that the greater solute concentrations in the reactivated channel stimulated net primary productivity of mats from both streams. These stream-scale experimental results indicate that the cryptobiotic preservation of cyanobacterial mats in abandoned channels in the dry valleys allows for rapid response of these stream ecosystems to climatic and geomorphological change, similar to other arid zone stream ecosystems. ?? 2006 Elsevier B.V. All rights reserved.

  4. Long Term Thawing Experiments on Intact Cores of Arctic Mineral Cryosol: Implications for Greenhouse Gas Feedbacks from Global Warming

    NASA Astrophysics Data System (ADS)

    Onstott, T. C.; Stackhouse, B. T.; Lau, C. Y. M.; Whyte, L. G.; Pfiffner, S. M.; Vishnivetskaya, T. A.

    2015-12-01

    Mineral cryosols comprise >87% of Arctic tundra. Much attention has focused on high-organic carbon cryosols and how they will respond to global warming. The biogeochemical processes related to the greenhouse gas release from mineral cryosols, however, have not been fully explored. To this end, seventeen intact cores of active layer and underlying permafrost of mineral cryosol from Axel Heiberg Island, Nunavut, Canada, were subjected to 85 weeks of thawing at 4.5°C under various treatment regimes. The fluxes of CO2 and CH4 across the atmosphere-soil boundary and vertical profiles of the gas and water chemistry and the metagenomes were determined. The flux measurements were compared to those of microcosms and field measurements. The main conclusions were as follows: 1) CO2 emission rates from the intact cores do not behave in the typical fast to slow carbon pool fashion that typify microcosm experiments. The CO2 emission rates from the intact cores were much slower than those from the microcosm initially, but steadily increased with time, overtaking and then exceeding microcosm release rates after one year. 2) The increased CO2 flux from thawing permafrost could not be distinguished from that of control cores until after a full year of thawing. 3) Atmospheric CH4 oxidation was present in all intact cores regardless of whether they are water saturated or not, but after one year it had diminished to the point of being negligible. Over that same time the period the metagenomic data recorded a significant decline in the proportion of high-affinity methanotrophs. 4) Thaw slumps in the cores temporarily increased the CH4 oxidation and the CO2 emission rates. 5) The microbial community structures varied significantly by depth with methanotrophs being more abundant in above 35 cm depth than below 35 cm depth. 6) Other than the diminishment of Type II methanotrophs, the microbial community structure varied little after one week of thawing, nor even after 18 months of thaw.

  5. Microbial carbon recycling - an underestimated process controlling soil carbon dynamics - Part 1: A long-term laboratory incubation experiment

    NASA Astrophysics Data System (ADS)

    Basler, A.; Dippold, M.; Helfrich, M.; Dyckmans, J.

    2015-10-01

    Independent of its chemical structure carbon (C) persists in soil for several decades, controlled by stabilization and recycling. To disentangle the importance of the two factors on the turnover dynamics of soil sugars, an important compound of soil organic matter (SOM), a 3-year incubation experiment was conducted on a silty loam soil under different types of land use (arable land, grassland and forest) by adding 13C-labelled glucose. The compound-specific isotope analysis of soil sugars was used to examine the dynamics of different sugars during incubation. Sugar dynamics were dominated by a pool of high mean residence times (MRT) indicating that recycling plays an important role for sugars. However, this was not substantially affected by soil C content. Six months after label addition the contribution of the label was much higher for microbial biomass than for CO2 production for all examined land use types, corroborating that substrate recycling was very effective within the microbial biomass. Two different patterns of tracer dynamics could be identified for different sugars: while fucose and mannose showed highest label contribution at the beginning of the incubation with a subsequent slow decline, galactose and rhamnose were characterized by slow label incorporation with subsequently constant levels, which indicates that recycling is dominating the dynamics of these sugars. This may correspond to (a) different microbial growing strategies (r and K-strategist) or (b) location within or outside the cell membrane (lipopolysaccharides vs. exopolysaccharides) and thus be subject of different re-use within the microbial food web. Our results show how the microbial community recycles substrate very effectively and that high losses of substrate only occur during initial stages after substrate addition. This study indicates that recycling is one of the major processes explaining the high MRT observed for many SOM fractions and thus is crucial for understanding the

  6. Functional Sensory-Motor Performance Following Long Term Space Flight: The First Results of "Field Test" Experiment

    NASA Technical Reports Server (NTRS)

    Tomilovskaya, E. S.; Rukavishnikov, I. V.; Kofman, I. S.; Kitov, V. V.; Grishin, A. P.; Yu, N.; Lysova.; Cerisano, J. M.; Kozlovskaya, I. B.; Reschke, M. F.

    2014-01-01

    quantifying the coordination and timing of relatively simple basic movements - transition from seated and prone positions to standing, walking, stepping over obstacles, tandem walking, muscle compliance, as well as characteristics of postural sway and orthostatic tolerance. Testing for changes in these parameters have been initiated in the medical tent at the landing site. The first set of experiments showed that during the first hour after landing, cosmonauts and astronauts were able to execute (although slower and with more effort than preflight) simple movements such as egress from a seated or prone position and also to remain standing for 3.5 minutes without exhibiting pronounced cardiovascular changes. More challenging tests, however, demonstrated a prominent reduction in coordination - the obstacle task, for example, was performed at much slower speed and with a marked overestimation of the obstacle height and tandem walking was greatly degraded suggesting significant changes in proprioception, brainstem and vestibular function. There is some speculation that the neural changes, either from the bottom-up or top down may be long lasting; requiring compensatory responses that will modify or mask the adverse responses we have observed. Furthermore, these compensatory responses may actually be beneficial, helping achieve a more rapid adaptation to both weightlessness and a return to earth.

  7. The Sabah Biodiversity Experiment: a long-term test of the role of tree diversity in restoring tropical forest structure and functioning

    PubMed Central

    Hector, Andy; Philipson, Christopher; Saner, Philippe; Chamagne, Juliette; Dzulkifli, Dzaeman; O'Brien, Michael; Snaddon, Jake L.; Ulok, Philip; Weilenmann, Maja; Reynolds, Glen; Godfray, H. Charles J.

    2011-01-01

    Relatively, little is known about the relationship between biodiversity and ecosystem functioning in forests, especially in the tropics. We describe the Sabah Biodiversity Experiment: a large-scale, long-term field study on the island of Borneo. The project aims at understanding the relationship between tree species diversity and the functioning of lowland dipterocarp rainforest during restoration following selective logging. The experiment is planned to run for several decades (from seed to adult tree), so here we focus on introducing the project and its experimental design and on assessing initial conditions and the potential for restoration of the structure and functioning of the study system, the Malua Forest Reserve. We estimate residual impacts 22 years after selective logging by comparison with an appropriate neighbouring area of primary forest in Danum Valley of similar conditions. There was no difference in the alpha or beta species diversity of transect plots in the two forest types, probably owing to the selective nature of the logging and potential effects of competitive release. However, despite equal total stem density, forest structure differed as expected with a deficit of large trees and a surfeit of saplings in selectively logged areas. These impacts on structure have the potential to influence ecosystem functioning. In particular, above-ground biomass and carbon pools in selectively logged areas were only 60 per cent of those in the primary forest even after 22 years of recovery. Our results establish the initial conditions for the Sabah Biodiversity Experiment and confirm the potential to accelerate restoration by using enrichment planting of dipterocarps to overcome recruitment limitation. What role dipterocarp diversity plays in restoration only will become clear with long-term results. PMID:22006970

  8. Paying for long-term care.

    PubMed Central

    Estes, C L; Bodenheimer, T

    1994-01-01

    Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage. PMID:8128712

  9. Correction of the equilibrium temperature caused by slight evaporation of water in protein crystal growth cells during long-term space experiments at International Space Station

    NASA Astrophysics Data System (ADS)

    Fujiwara, Takahisa; Suzuki, Yoshihisa; Yoshizaki, Izumi; Tsukamoto, Katsuo; Murayama, Kenta; Fukuyama, Seijiro; Hosokawa, Kouhei; Oshi, Kentaro; Ito, Daisuke; Yamazaki, Tomoya; Tachibana, Masaru; Miura, Hitoshi

    2015-08-01

    The normal growth rates of the {110} faces of tetragonal hen egg-white lysozyme crystals, R, were measured as a function of the supersaturation σ parameter using a reflection type interferometer under μG at the International Space Station (NanoStep Project). Since water slightly evaporated from in situ observation cells during a long-term space station experiment for several months, equilibrium temperature Te changed, and the actual σ, however, significantly increased mainly due to the increase in salt concentration Cs. To correct σ, the actual Cs and protein concentration Cp, which correctly represent the measured Te value in space, were first calculated. Second, a new solubility curve with the corrected Cs was plotted. Finally, the revised σ was obtained from the new solubility curve. This correction method successfully revealed that the 2.8% water was evaporated from the solution, leading to 2.8% increase in the Cs and Cp of the solution.

  10. Distribution of heavy metals by the molecular-weight fractions of humic acids in the soils of long-term field experiments

    NASA Astrophysics Data System (ADS)

    Karpukhin, A. I.; Bushuev, N. N.

    2007-03-01

    The influence of different agricultural treatments on the contents of Cd, Zn, and Co in the organic matter and humic acids of soddy-podzolic and dark gray forest soils was studied in long-term field experiments. The use of gel chromatography proved the complicated molecular-weight composition of the humic acids in all the studied soils. The contents of heavy metals and their distribution by the molecular-weight fractions of humic acids were determined in the experimental soils and in the virgin podzolic soils. The complex nature of organomineral compounds of Cd and Zn with humic acids was shown by means of gel filtration. The thermodynamic stability of the organomineral complexes increased with the increasing weight of the initial molecular-weight fractions of humic acids.

  11. Evaluating litter decomposition in earth system models with long-term litterbag experiments: an example using the Community Land Model version 4 (CLM4).

    PubMed

    Bonan, Gordon B; Hartman, Melannie D; Parton, William J; Wieder, William R

    2013-03-01

    Decomposition is a large term in the global carbon budget, but models of the earth system that simulate carbon cycle-climate feedbacks are largely untested with respect to litter decomposition. We tested the litter decomposition parameterization of the community land model version 4 (CLM4), the terrestrial component of the community earth system model, with data from the long-term intersite decomposition experiment team (LIDET). The LIDET dataset is a 10-year study of litter decomposition at multiple sites across North America and Central America. We performed 10-year litter decomposition simulations comparable with LIDET for 9 litter types and 20 sites in tundra, grassland, and boreal, conifer, deciduous, and tropical forest biomes using the LIDET-provided climatic decomposition index to constrain temperature and moisture effects on decomposition. We performed additional simulations with DAYCENT, a version of the CENTURY model, to ask how well an established ecosystem model matches the observations. The results show large discrepancy between the laboratory microcosm studies used to parameterize the CLM4 litter decomposition and the LIDET field study. Simulated carbon loss is more rapid than the observations across all sites, and nitrogen immobilization is biased high. Closer agreement with the observations requires much lower decomposition rates, obtained with the assumption that soil mineral nitrogen severely limits decomposition. DAYCENT better replicates the observations, for both carbon mass remaining and nitrogen, independent of nitrogen limitation. CLM4 has low soil carbon in global earth system simulations. These results suggest that this bias arises, in part, from too rapid litter decomposition. More broadly, the terrestrial biogeochemistry of earth system models must be critically tested with observations, and the consequences of particular model choices must be documented. Long-term litter decomposition experiments such as LIDET provide a real

  12. Effects of initial iron corrosion rate on long-term performance of iron permeable reactive barriers: column experiments and numerical simulation.

    PubMed

    suk O, Jin; Jeen, Sung-Wook; Gillham, Robert W; Gui, Lai

    2009-01-26

    Column experiments and numerical simulation were conducted to test the hypothesis that iron material having a high corrosion rate is not beneficial for the long-term performance of iron permeable reactive barriers (PRBs) because of faster passivation of iron and greater porosity loss close to the influent face of the PRBs. Four iron materials (Connelly, Gotthart-Maier, Peerless, and ISPAT) were used for the column experiments, and the changes in reactivity toward cis-dichloroethene (cis-DCE) degradation in the presence of dissolved CaCO3 were evaluated. The experimental results showed that the difference in distribution of the accumulated precipitates, resulting from differences in iron corrosion rate, caused a difference in the migration rate of the cis-DCE profiles and a significant difference in the pattern of passivation, indicating a faster passivation in the region close to the influent end for the material having a higher corrosion rate. For the numerical simulation, the accumulation of secondary minerals and reactivity loss of iron were coupled using an empirically-derived relationship that was incorporated into a multi-component reactive transport model. The simulation results provided a reasonable representation of the evolution of iron reactivity toward cis-DCE treatment and the changes in geochemical conditions for each material, consistent with the observed data. The simulations for long-term performance were also conducted to further test the hypothesis and predict the differences in performance over a period of 40 years under typical groundwater conditions. The predictions showed that the cases of higher iron corrosion rates had earlier cis-DCE breakthrough and more reduction in porosity starting from near the influent face, due to more accumulation of carbonate minerals in that region. Therefore, both the experimental and simulation results appear to support the hypothesis and suggest that reactivity changes of iron materials resulting from

  13. Intensity-Modulated Radiotherapy for Complex-Shaped Meningioma of the Skull Base: Long-Term Experience of a Single Institution

    SciTech Connect

    Milker-Zabel, Stefanie . E-mail: Stefanie_Milker-Zabel@med.uni-heidelberg.de; Zabel-du Bois, Angelika; Huber, Peter; Schlegel, Wolfgang; Debus, Juergen

    2007-07-01

    Purpose: We analyzed our long-term experience with intensity-modulated radiotherapy (IMRT) in patients with complex-shaped meningioma of the skull base. Patients and Methods: Between January 1998 and December 2004, 94 patients with complex-shaped meningioma were treated using IMRT at our institution. Tumor distribution was: World Health Organization (WHO) Grade 1 in 54.3%, WHO Grade 2 in 9.6%, and WHO Grade 3 in 4.2%. In 31.9% of patients, the clinical and radiologic characteristics of the tumor were consistent with the diagnosis of meningioma. Twenty-six patients received radiotherapy as primary treatment and 14 patients postoperative for residual disease. Fifty-four patients were treated after local recurrence. Median target volume was 81.4 mL, median total dose was 57.6 Gy given in 32 fractions. Results: Median follow-up was 4.4 years. Overall local control was 93.6%. Sixty-nine patients had stable disease based on computed tomography/magnetic resonance imaging (MRI), whereas 19 had a tumor volume reduction after IMRT. Six patients showed local tumor progression on MRI 22.3 months' median after IMRT. Three patients died from non-treatment-related conditions after IMRT. In 39.8% of the patients, preexisting neurologic deficits improved. Worsening of preexisting neurologic symptoms was seen in 4 patients and 2 patients developed new clinical symptoms from local tumor progression. Transient side effects such as headache were seen in 7 patients. Treatment-induced loss of vision was seen in 1 of 53 reirradiated patients with a Grade 3 meningioma 9 months after retreatment with IMRT. Conclusion: These data demonstrate that IMRT is an effective and safe treatment modality for long-term local control of complex-shaped and otherwise difficult to treat meningioma.

  14. Influence of cover crops and crop residue treatment on soil organic carbon stocks evaluated in Swedish long-term field experiments

    NASA Astrophysics Data System (ADS)

    Poeplau, Christopher; Bolinder, Martin A.; Börjesson, Gunnar; Kätterer, Thomas

    2015-04-01

    Soil organic carbon (SOC) stocks in agricultural soils are strongly controlled by management. In this study we quantified the effect of cover crops and crop residue management on SOC stocks in Swedish long-term experiments. Eight pairs of cover crop (undersown ryegrass) vs. no cover crop were investigated in Swedish long-term field experiments (16 to 24 years). Yields of the main crop were not affected by the cover crop. Cover crops significantly increased SOC stocks, with a mean carbon sequestration rate in all experiments (excluding one) of 0.32±0.29 Mg C ha-1 yr-1. Interestingly, this sequestration is similar to that estimated for a U.S.experiment, where ryegrass growth is much less temperature- and light-limited than under Swedish conditions. This sequestration rate is also the same as that recently reported for many other cover crops in a global meta-analysis but less than SOC changes in ley-dominated rotations which under Nordic conditions were shown to accumulate in average 0.5 Mg C ha-1 yr-1 more carbon compared to exclusively annual cropping systems. Thus, originally introduced in agricultural rotations to reduce nitrate leaching, cover crops are also an effective practice to increase SOC stocks, even at relatively high latitudes. The effect of crop residue treatment was studied in 16 pairs of straw incorporated (SI) vs. straw removed (SR) treatments in six Swedish long-term field experiments. Data series on SOC with 5-28 sampling dates during 27-53 years were analysed using ICBM, a dynamic SOC model. At five out of six sites, the humification coefficient for straw (hlitter; the fraction of straw C that is entering the slow C pool) was much smaller (0-0.09) than the ICBM default h-value for plant material estimated in previous studies (0.125). The derived hlitter-values and thus the stabilization of straw-derived carbon increased significantly with clay content. For an Italian site (with five pairs of SI vs. SR) that was used for model validation we found

  15. Positive and negative early life experiences differentially modulate long term survival and amyloid protein levels in a mouse model of Alzheimer's disease

    PubMed Central

    Lesuis, Sylvie L.; Maurin, Herve; Borghgraef, Peter; Lucassen, Paul J.; Leuven, Fred Van; Krugers, Harm J.

    2016-01-01

    Stress has been implicated as a risk factor for the severity and progression of sporadic Alzheimer's disease (AD). Early life experiences determine stress responsivity in later life, and modulate age-dependent cognitive decline. Therefore, we examined whether early life experiences influence AD outcome in a bigenic mouse model which progressively develops combined tau and amyloid pathology (biAT mice). Mice were subjected to either early life stress (ELS) or to ‘positive’ early handling (EH) postnatally (from day 2 to 9). In biAT mice, ELS significantly compromised long term survival, in contrast to EH which increased life expectancy. In 4 month old mice, ELS-reared biAT mice displayed increased hippocampal Aβ levels, while these levels were reduced in EH-reared biAT mice. No effects of ELS or EH were observed on the brain levels of APP, protein tau, or PSD-95. Dendritic morphology was moderately affected after ELS and EH in the amygdala and medial prefrontal cortex, while object recognition memory and open field performance were not affected. We conclude that despite the strong transgenic background, early life experiences significantly modulate the life expectancy of biAT mice. Parallel changes in hippocampal Aβ levels were evident, without affecting cognition of young adult biAT mice. PMID:27259247

  16. Hydrothermal interaction of solid wafers of Topopah Spring Tuff with J-13 water at 90 and 150{degree}C using Dickson-type, gold-bag rocking autoclaves: Long-term experiments

    SciTech Connect

    Knauss, K.G.; Beiriger, W.J.; Peifer, D.W.

    1987-05-01

    The Nevada Nuclear Waste Storage Investigations Project conducted long-term experiments to study the hydrothermal interaction of rock and water representative of a potential high-level waste repository at Yucca Mountain, Nevada. The results of these experiments complement those obtained previously in short-term experiments at similar and higher temperatures. These long-term experiments also help in assessing the effects of kinetic inhibition in the precipitation of secondary minerals at the lower temperatures and allow a more complete determination of the approach of the fluid toward a steady-state composition. Considered collectively, the results of both short- and long-term experiments provide information useful in defining the near-field repository environment during and shortly after the thermal period caused by the emplacement of nuclear waste. These long-term experiments were conducted using solid wafers cut from drillcore samples of Topopah Spring tuff. A natural ground water was used as the reacting fluid. Analytical techniques for determining the composition of fluids and solids were similar to those used in previous short-term experiments. All experiments were run in Dickson-type, gold-bag rocking autoclaves that were periodically sampled under in situ conditions. Two long-term (304-day) experiments were run at temperatures of 90 and 150{degree}C and 50-bar pressure. 21 refs., 8 figs., 5 tabs.

  17. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.

    PubMed

    2015-08-17

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the

  18. Long-Term Engagement in Authentic Research with NASA (LEARN): Innovative Practices Suggested By a New Model for Teacher Research Experiences

    NASA Astrophysics Data System (ADS)

    Pippin, M. R.; Joseph, J. D.; Yang, M. M.; Omar, A. H.; Crecelius, S.; Harte, T.; Lewis, P. M., Jr.; Taylor, J.; Bujosa, R.; Moulton, C.; Haggard, C. S.; Hyater-Adams, S.; Kollmeyer, R.; Weisman, A.

    2014-12-01

    NASA's LEARN Project is an innovative program that provides long-term immersion in the practice of atmospheric science for middle and high school in-service teachers. Working alongside NASA scientists and using authentic NASA Science Mission Directorate research data, teachers develop individual research topics of interest during two weeks in the summer while on-site at NASA Langley. With continued, intensive mentoring by NASA scientists, the teachers further develop their research throughout the academic year through virtual group meetings and data team meetings mirroring scientific collaborations. At the end of the first year, LEARN teachers present scientific posters. The LEARN experience has had such an impact that multiple teachers from the first two cohorts have elected to continue their research. The LEARN project evaluation has provided insights into particularly effective elements of this new approach. Findings indicate that teachers' perceptions of the scientific enterprise have changed, and that LEARN provided substantial resources to help them take real-world research to their students. This presentation will focus on key factors from LEARN's implementation that inform best practices for the incorporation of authentic scientific research into teacher professional development experiences. We suggest that these factors should be considered in the development of other such experiences, including: (1) The involvement of a single scientist as both the project leader/manager and the project scientist, to ensure that the project can meet teachers' needs. (2) An emphasis on framing and approaching scientific research questions, so that teachers can learn to evaluate the feasibility of studies based on scope, scale, and availability of data. (3) Long term, ongoing relationships where teachers and scientists work as collaborators, beyond the workshop "mold." (4) A focus on meeting the needs of individual teachers, whether their needs relate to elements of

  19. Consider long-term care as service alternative.

    PubMed

    Loria, L S

    1987-04-01

    The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

  20. Long-term cement corrosion in chloride-rich solutions relevant to radioactive waste disposal in rock salt - Leaching experiments and thermodynamic simulations

    NASA Astrophysics Data System (ADS)

    Bube, C.; Metz, V.; Bohnert, E.; Garbev, K.; Schild, D.; Kienzler, B.

    Low- and intermediate-level radioactive wastes are frequently solidified in a cement matrix. In a potential repository for nuclear wastes, the cementitious matrix is altered upon contact with solution and the resulting secondary phases may provide for significant retention of the radionuclides incorporated in the wastes. In order to assess the secondary phases formed upon corrosion in chloride-rich solutions, which are relevant for nuclear waste disposal in rock salt, leaching experiments were performed. Conventional laboratory batch experiments using powdered hardened cement paste in MgCl2-rich solutions were left to equilibrate for up to three years and full-scale cemented waste products were exposed to NaCl-rich and MgCl2-rich solutions for more than twenty years, respectively. Solid phase analyses revealed that corrosion of hardened cement in MgCl2-rich solutions advanced faster than in NaCl-rich solutions due to the extensive exchange of Mg from solution against Ca from the cementitious solid. Thermodynamic equilibrium simulations compared well to results at the final stages of the respective experiments indicating that close to equilibrium conditions were reached. At high cement product to brine ratios (>0.65 g mL-1), the solution composition in the laboratory-scale experiments was close to that of the full-scale experiments (cement to brine ratio of 2.5 g mL-1) in the MgCl2 systems. The present study demonstrates the applicability of thermodynamic methods used in this approach to adequately describe full-scale long-term experiments with cemented waste simulates.

  1. A spatio-temporal model for estimating the long-term effects of air pollution on respiratory hospital admissions in Greater London.

    PubMed

    Rushworth, Alastair; Lee, Duncan; Mitchell, Richard

    2014-07-01

    It has long been known that air pollution is harmful to human health, as many epidemiological studies have been conducted into its effects. Collectively, these studies have investigated both the acute and chronic effects of pollution, with the latter typically based on individual level cohort designs that can be expensive to implement. As a result of the increasing availability of small-area statistics, ecological spatio-temporal study designs are also being used, with which a key statistical problem is allowing for residual spatio-temporal autocorrelation that remains after the covariate effects have been removed. We present a new model for estimating the effects of air pollution on human health, which allows for residual spatio-temporal autocorrelation, and a study into the long-term effects of air pollution on human health in Greater London, England. The individual and joint effects of different pollutants are explored, via the use of single pollutant models and multiple pollutant indices.

  2. [Long-term follow-up of nosocomial rotavirus infections at the Infectious Diseases Clinic of the Medical School Hospital in Plzen (1987-1994)].

    PubMed

    Pazdiora, P; Táborská, J; Svecová, M

    1996-09-01

    The authors evaluated in 1987-1994 the incidence of nosocomial rotavirus infections during hospitalization in 1718 junior children, 450 senior children and adults admitted with diarrhoeal diseases. Rotavirus infection was revealed in 6.2 and 1.3% of the patients resp. During hospitalization the rotaviruses were the most frequent causal agent of nosocomial infections. Hospital infection was contracted regardless of the initial diagnosis most frequently by patients aged 0-12 months. The majority of nosocomial rotavirus infections was associated with symptoms of diarrhoeal disease, on average symptomatic infections prolonged the hospitalization period by 4.2 days. The authors discuss the possibility to influence the incidence of these infections.

  3. Long-term Formation of Aggressive Bony Lesions in Dogs with Mid-Diaphyseal Fractures Stabilized with Metallic Plates: Incidence in a Tertiary Referral Hospital Population

    PubMed Central

    Gilley, Robert S.; Hiebert, Elizabeth; Clapp, Kemba; Bartl-Wilson, Lara; Nappier, Michael; Werre, Stephen; Barnes, Katherine

    2017-01-01

    The incidence of complications secondary to fracture stabilization, particularly osteolytic lesions and bony tumor formation, has long been difficult to evaluate. The objective of this study was to describe the long-term incidence of aggressive bony changes developing in dogs with long bone diaphyseal fractures stabilized by metallic bone plates compared to a breed-, sex-, and age-matched control group. The medical records of a tertiary referral center were retrospectively reviewed for dogs that matched each respective criterion. Signalment, history, cause of death (if applicable), and aggressive bony changes at previous fracture sites were recorded. Ninety dogs met the criteria for inclusion in the fracture group and were matched with appropriate control dogs. Four of the dogs in the fracture group developed aggressive bony changes at the site of previous fracture repairs most consistent with osseous neoplasia. One lesion was confirmed with cytology as neoplastic. The population of dogs was mixed with regard to breed and body weight, but all dogs with aggressive bony lesions were male. Incidence of aggressive bony lesion formation in the fracture group was 4 (4.4%) and was 0 (0%) in the control group; three (75%) of the affected dogs in the fracture group included cerclage as a component of their primary fracture stabilizations. Incidence of aggressive bony lesions in the fracture group compared to the control group was determined to be statistically significant (p = 0.0455), as was the incidence of cerclage among dogs affected by aggressive bony lesions compared to the rest of the fracture group (p = 0.0499). Development of aggressive bony lesions is an uncommon complication of fracture fixation. Additional research is needed to further identify and elucidate the long-term effects of metallic implants in dogs. PMID:28197406

  4. Long-term Formation of Aggressive Bony Lesions in Dogs with Mid-Diaphyseal Fractures Stabilized with Metallic Plates: Incidence in a Tertiary Referral Hospital Population.

    PubMed

    Gilley, Robert S; Hiebert, Elizabeth; Clapp, Kemba; Bartl-Wilson, Lara; Nappier, Michael; Werre, Stephen; Barnes, Katherine

    2017-01-01

    The incidence of complications secondary to fracture stabilization, particularly osteolytic lesions and bony tumor formation, has long been difficult to evaluate. The objective of this study was to describe the long-term incidence of aggressive bony changes developing in dogs with long bone diaphyseal fractures stabilized by metallic bone plates compared to a breed-, sex-, and age-matched control group. The medical records of a tertiary referral center were retrospectively reviewed for dogs that matched each respective criterion. Signalment, history, cause of death (if applicable), and aggressive bony changes at previous fracture sites were recorded. Ninety dogs met the criteria for inclusion in the fracture group and were matched with appropriate control dogs. Four of the dogs in the fracture group developed aggressive bony changes at the site of previous fracture repairs most consistent with osseous neoplasia. One lesion was confirmed with cytology as neoplastic. The population of dogs was mixed with regard to breed and body weight, but all dogs with aggressive bony lesions were male. Incidence of aggressive bony lesion formation in the fracture group was 4 (4.4%) and was 0 (0%) in the control group; three (75%) of the affected dogs in the fracture group included cerclage as a component of their primary fracture stabilizations. Incidence of aggressive bony lesions in the fracture group compared to the control group was determined to be statistically significant (p = 0.0455), as was the incidence of cerclage among dogs affected by aggressive bony lesions compared to the rest of the fracture group (p = 0.0499). Development of aggressive bony lesions is an uncommon complication of fracture fixation. Additional research is needed to further identify and elucidate the long-term effects of metallic implants in dogs.

  5. Is Natural Experiment A Cure? Re-examing the Long-Term Health Effects of China’s 1959–1961 Famine

    PubMed Central

    Xu, Hongwei; Li, Lydia; Zhang, Zhenmei; Liu, Jinyu

    2015-01-01

    The fetal origins hypothesis posits that adverse prenatal exposures, particularly malnutrition, increase the risk of poor adult health. Studies using famine as a natural experiment to test the fetal origins hypothesis present conflicting findings, partly because of data limitations and modeling flaws. Capitalizing on the biomarker data and prefecture-level geographic information from the 2011 China Health and Retirement Longitudinal Study, this study estimates the effects of prenatal exposure to China’s 1959–61 famine on later-life risks of cardiovascular and metabolic diseases. Our analysis addresses the problems of measurement error and intrinsic cohort differences that challenge prior studies. We use provincial and prefecture-level geographic variations in famine severity, a proxy for prenatal malnutrition, for model identification. We construct instrumental variables from geocoded newspaper archive data to adjust for measurement error in famine exposure. We find that estimates of the famine effects are highly sensitive to the choices of health indicators, measures of famine severity, and regression model specifications. Overall, we find little evidence supporting the fetal origins hypothesis. In fact, it appears that prenatal exposure to famine reduces later-life disease risks in certain cases. We interpret this finding as evidence of mortality selection among the famine survivors at work. We conclude that using famine as a natural experiment in itself does not guarantee correct statistical inference about the long-term health impacts of prenatal malnutrition when other analytical challenges remain unresolved. PMID:26692092

  6. Visual experience regulates the development of long-term synaptic modifications induced by low-frequency stimulation in mouse visual cortex.

    PubMed

    Sugimura, Taketoshi; Yamamoto, Mariko; Yamada, Kazumasa; Komatsu, Yukio; Yoshimura, Yumiko

    2017-03-08

    Manipulation of visual experience can considerably modify visual responses of visual cortical neurons even in adulthood in the mouse, although the modification is less profound than that observed during the critical period. Our previous studies demonstrated that low-frequency (2Hz) stimulation for 15min applied to layer 4 induces T-type Ca(2+) channel-dependent long-term potentiation (LTP) at excitatory synapses in layer 2/3 neurons of visual cortex during the critical period. In this study, we investigated whether low-frequency stimulation could induce synaptic plasticity in adult mice. We found that 2Hz stimulation induced LTP of extracellular field potentials evoked by stimulation of layer 4 in layer 2/3 in adulthood as during the critical period. LTP in adulthood was blocked by L-type, but not T-type, Ca(2+) channel antagonists, whereas LTP during the critical period was blocked by T-type, but not L-type, Ca(2+) channel antagonists. This developmental change in LTP was prevented by dark rearing. Under pharmacological blockade of GABAA receptors, T-type Ca(2+) channel-dependent LTP occurred, whereas L-type Ca(2+) channel-dependent LTP did not occur. These results suggest that different forms of synaptic plasticity can contribute separately to experience-dependent modification of visual responses during the critical period and in adulthood.

  7. Studies on nutrient uptake of rice and characteristics of soil microorganisms in a long-term fertilization experiments for irrigated rice.

    PubMed

    Zhang, Qi-chun; Wang, Guang-huo

    2005-02-01

    The ecosystem characteristics of soil microorganism and the nutrient uptake of irrigated rice were investigated in a split-block experiment with different fertilization treatments, including control (no fertilizer application), PK, NK, NP, NPK fertilization, in the main block, and conventional rice and hybrid rice comparison, in the sub block. Average data of five treatments in five years indicated that the indigenous N supply (INS) capacity ranged from 32.72 to 93.21 kg/ha; that indigenous P supply (IPS) capacity ranged from 7.42 to 32.25 kg/ha; and that indigenous K supply (IKS) capacity ranged from 16.24 to 140.51 kg/ha, which showed that soil available nutrient pool depletion might occur very fast and that P, K deficiency has become a constraint to increasing yields of consecutive crops grown without fertilizer application. It was found that soil nutrient deficiency and unbalanced fertilization to rice crop had negative effect on the diversity of the microbial community and total microbial biomass in the soil. The long-term fertilizer experiment (LTFE) also showed that balanced application of N, P and K promoted microbial biomass growth and improvement of community composition. Unbalanced fertilization reduced microbial N and increased C/N ratio of the microbial biomass. Compared with inbred rice, hybrid rice behavior is characterized by physiological advantage in nutrient uptake and lower internal K use efficiency.

  8. Carbon sequestration in croplands is mainly driven by management leading to increased net primary production - evidence from long-term field experiments in Northern Europe

    NASA Astrophysics Data System (ADS)

    Kätterer, Thomas; Bolinder, Martin Anders; Börjesson, Gunnar; Kirchmann, Holger; Poeplau, Christopher

    2014-05-01

    Sustainable intensification of agriculture in regions with high production potential is a prerequisite for providing services for an increasing human population, not only food, animal feed, fiber and biofuel but also to promote biodiversity and the beauty of landscapes. We investigated the effect of different management practices on soil fertility and carbon sequestration in long-term experiments, mainly from Northern Europe. In addition, a meta-analysis on the effect of catch crops was conducted. Improved management of croplands was found to be a win-win strategy resulting in both increased soil fertility and carbon sequestration. We quantified the effect of different management practices such as N fertilization, organic amendments, catch crops and ley-arable rotations versus continuous annual cropping systems on soil carbon stocks. Increasing net primary productivity (NPP) was found to be the main driver for higher soil carbon storage. Mineral N fertilization increased soil carbon stocks by 1-2 kg C ha-1 for each kg of N applied to cropland. Ley-arable rotations, being a combination of annual and perennial crops, are expected to have C stocks intermediate between those of continuous grass- and croplands. A summary of data from 15 long-term sites showed that on average 0.5 Mg ha-1 yr-1 (range 0.3 to 1.1; median 0.4 Mg ha-1 yr-1) more carbon was retained in soils in ley-arable compared to exclusively annual systems, depending on species composition, management, soil depth and the duration of the studies. The annual C accumulation rate for catch crops determined in the meta-analysis was well within that range (0.32±0.08 Mg C ha-1 yr-1). Retention factors calculated for straw, manure, sawdust, peat, sewage sludge and composted household waste varied widely in a decadal time scale. Retention of root and rhizodeposit carbon was higher than for above-ground crop residues. We conclude that NPP is the major driver for C sequestration and emphasize that increased soil

  9. Correction of the equilibrium temperature caused by slight evaporation of water in protein crystal growth cells during long-term space experiments at International Space Station.

    PubMed

    Fujiwara, Takahisa; Suzuki, Yoshihisa; Yoshizaki, Izumi; Tsukamoto, Katsuo; Murayama, Kenta; Fukuyama, Seijiro; Hosokawa, Kouhei; Oshi, Kentaro; Ito, Daisuke; Yamazaki, Tomoya; Tachibana, Masaru; Miura, Hitoshi

    2015-08-01

    The normal growth rates of the {110} faces of tetragonal hen egg-white lysozyme crystals, R, were measured as a function of the supersaturation σ parameter using a reflection type interferometer under μG at the International Space Station (NanoStep Project). Since water slightly evaporated from in situ observation cells during a long-term space station experiment for several months, equilibrium temperature T(e) changed, and the actual σ, however, significantly increased mainly due to the increase in salt concentration C(s). To correct σ, the actual C(s) and protein concentration C(p), which correctly represent the measured T(e) value in space, were first calculated. Second, a new solubility curve with the corrected C(s) was plotted. Finally, the revised σ was obtained from the new solubility curve. This correction method successfully revealed that the 2.8% water was evaporated from the solution, leading to 2.8% increase in the C(s) and C(p) of the solution.

  10. Upscaling SOC changes from long term field experiments to regional level - evaluation of agri-environmental measures on their contribution to mitigate climate change

    NASA Astrophysics Data System (ADS)

    Freudenschuss, Alexandra; Sedy, Katrin; Spiegel, Heide; Zethner, Gerhard

    2010-05-01

    Several agri-environment measures in Austria are presumed to also mitigate climate change. These are mainly measures that lead to an increase or stabilization of soil organic carbon (SOC) in arable soils, like e.g. organic farming, legumes and cover crops in the crop rotation as well as the application of organic fertilizers. A reduction of mineral fertiliser application may also reduce greenhouse gas emissions. The results of the study aim to evaluate different agricultural practices on their impact on SOC changes. Data from long term field experiments in Austria with different tillage systems and incorporation rates of crop residues and manure are used to determine effects of agricultural practices on SOC changes. Management factors that compare results from different activities on cropland are calculated and compared with international data. Furthermore these data are used to verify results gained from the application of humus balance model (VDLUFA). For the upscaling of potential SOC changes at regional level (federal states of Austria) data of the IACS - Integrated Administrative Control System are applied in the humus balance model. In order to cover the range of possible SOC changes three different approaches of the humus balance model are introduced and the results will be presented.

  11. A Smart Cage With Uniform Wireless Power Distribution in 3D for Enabling Long-Term Experiments With Freely Moving Animals.

    PubMed

    Mirbozorgi, S Abdollah; Bahrami, Hadi; Sawan, Mohamad; Gosselin, Benoit

    2016-04-01

    This paper presents a novel experimental chamber with uniform wireless power distribution in 3D for enabling long-term biomedical experiments with small freely moving animal subjects. The implemented power transmission chamber prototype is based on arrays of parallel resonators and multicoil inductive links, to form a novel and highly efficient wireless power transmission system. The power transmitter unit includes several identical resonators enclosed in a scalable array of overlapping square coils which are connected in parallel to provide uniform power distribution along x and y. Moreover, the proposed chamber uses two arrays of primary resonators, facing each other, and connected in parallel to achieve uniform power distribution along the z axis. Each surface includes 9 overlapped coils connected in parallel and implemented into two layers of FR4 printed circuit board. The chamber features a natural power localization mechanism, which simplifies its implementation and ease its operation by avoiding the need for active detection and control mechanisms. A single power surface based on the proposed approach can provide a power transfer efficiency (PTE) of 69% and a power delivered to the load (PDL) of 120 mW, for a separation distance of 4 cm, whereas the complete chamber prototype provides a uniform PTE of 59% and a PDL of 100 mW in 3D, everywhere inside the chamber with a size of 27×27×16 cm(3).

  12. De Novo Transcriptome Assembly and Identification of Gene Candidates for Rapid Evolution of Soil Al Tolerance in Anthoxanthum odoratum at the Long-Term Park Grass Experiment.

    PubMed

    Gould, Billie; McCouch, Susan; Geber, Monica

    2015-01-01

    Studies of adaptation in the wild grass Anthoxanthum odoratum at the Park Grass Experiment (PGE) provided one of the earliest examples of rapid evolution in plants. Anthoxanthum has become locally adapted to differences in soil Al toxicity, which have developed there due to soil acidification from long-term experimental fertilizer treatments. In this study, we used transcriptome sequencing to identify Al stress responsive genes in Anthoxanhum and identify candidates among them for further molecular study of rapid Al tolerance evolution at the PGE. We examined the Al content of Anthoxanthum tissues and conducted RNA-sequencing of root tips, the primary site of Al induced damage. We found that despite its high tolerance Anthoxanthum is not an Al accumulating species. Genes similar to those involved in organic acid exudation (TaALMT1, ZmMATE), cell wall modification (OsSTAR1), and internal Al detoxification (OsNRAT1) in cultivated grasses were responsive to Al exposure. Expression of a large suite of novel loci was also triggered by early exposure to Al stress in roots. Three-hundred forty five transcripts were significantly more up- or down-regulated in tolerant vs. sensitive Anthoxanthum genotypes, providing important targets for future study of rapid evolution at the PGE.

  13. De Novo Transcriptome Assembly and Identification of Gene Candidates for Rapid Evolution of Soil Al Tolerance in Anthoxanthum odoratum at the Long-Term Park Grass Experiment

    PubMed Central

    Gould, Billie; McCouch, Susan; Geber, Monica

    2015-01-01

    Studies of adaptation in the wild grass Anthoxanthum odoratum at the Park Grass Experiment (PGE) provided one of the earliest examples of rapid evolution in plants. Anthoxanthum has become locally adapted to differences in soil Al toxicity, which have developed there due to soil acidification from long-term experimental fertilizer treatments. In this study, we used transcriptome sequencing to identify Al stress responsive genes in Anthoxanhum and identify candidates among them for further molecular study of rapid Al tolerance evolution at the PGE. We examined the Al content of Anthoxanthum tissues and conducted RNA-sequencing of root tips, the primary site of Al induced damage. We found that despite its high tolerance Anthoxanthum is not an Al accumulating species. Genes similar to those involved in organic acid exudation (TaALMT1, ZmMATE), cell wall modification (OsSTAR1), and internal Al detoxification (OsNRAT1) in cultivated grasses were responsive to Al exposure. Expression of a large suite of novel loci was also triggered by early exposure to Al stress in roots. Three-hundred forty five transcripts were significantly more up- or down-regulated in tolerant vs. sensitive Anthoxanthum genotypes, providing important targets for future study of rapid evolution at the PGE. PMID:26148203

  14. Soil Parameter Mapping and Ad Hoc Power Analysis to Increase Blocking Efficiency Prior to Establishing a Long-Term Field Experiment.

    PubMed

    Collins, Doug; Benedict, Chris; Bary, Andy; Cogger, Craig

    2015-01-01

    The spatial heterogeneity of soil and weed populations poses a challenge to researchers. Unlike aboveground variability, below-ground variability is more difficult to discern without a strategic soil sampling pattern. While blocking is commonly used to control environmental variation, this strategy is rarely informed by data about current soil conditions. Fifty georeferenced sites were located in a 0.65 ha area prior to establishing a long-term field experiment. Soil organic matter (OM) and weed seed bank populations were analyzed at each site and the spatial structure was modeled with semivariograms and interpolated with kriging to map the surface. These maps were used to formulate three strategic blocking patterns and the efficiency of each pattern was compared to a completely randomized design and a west to east model not informed by soil variability. Compared to OM, weeds were more variable across the landscape and had a shorter range of autocorrelation, and models to increase blocking efficiency resulted in less increase in power. Weeds and OM were not correlated, so no model examined improved power equally for both parameters. Compared to the west to east blocking pattern, the final blocking pattern chosen resulted in a 7-fold increase in power for OM and a 36% increase in power for weeds.

  15. Living on the edge: adaptive and plastic responses of the tree Nothofagus pumilio to a long-term transplant experiment predict rear-edge upward expansion.

    PubMed

    Mathiasen, Paula; Premoli, Andrea C

    2016-06-01

    Current climate change affects the competitive ability and reproductive success of many species, leading to local extinctions, adjustment to novel local conditions by phenotypic plasticity or rapid adaptation, or tracking their optima through range shifts. However, many species have limited ability to expand to suitable areas. Altitudinal gradients, with abrupt changes in abiotic conditions over short distances, represent "natural experiments" for the evaluation of ecological and evolutionary responses under scenarios of climate change. Nothofagus pumilio is the tree species which dominates as pure stands the montane forests of Patagonia. We evaluated the adaptive value of variation in quantitative traits of N. pumilio under contrasting conditions of the altitudinal gradient with a long-term reciprocal transplant experimental design. While high-elevation plants show little response in plant, leaf, and phenological traits to the experimental trials, low-elevation ones show greater plasticity in their responses to changing environments, particularly at high elevation. Our results suggest a relatively reduced potential for evolutionary adaptation of high-elevation genotypes, and a greater evolutionary potential of low-elevation ones. Under global warming scenarios of forest upslope migration, high-elevation variants may be outperformed by low-elevation ones during this process, leading to the local extinction and/or replacement of these genotypes. These results challenge previous models and predictions expected under global warming for altitudinal gradients, on which the leading edge is considered to be the upper treeline forests.

  16. A security/safety survey of long term care facilities.

    PubMed

    Acorn, Jonathan R

    2010-01-01

    What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

  17. HOW DO WORK HIERARCHIES AND STRICT DIVISIONS OF LABOUR IMPACT CARE WORKERS’ EXPERIENCES OF HEALTH AND SAFETY? CASE STUDIESOF LONG TERM CARE IN TORONTO

    PubMed Central

    SYED, I.; DALY, T.; ARMSTRONG, P.; LOWNDES, R.; CHADOIN, M.; NAIDOO, V.

    2016-01-01

    Background According to the Canadian Health Care Association (1), there are 2,577 long-term care (“LTC”) facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents’ health, with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario LTC facilities is very gendered, increasingly racialized, task-oriented, and with strict divisions of labour, this paper explores in what ways some of these factors impact workers’ experiences of health and safety. Objectives The study objectives included the following research question: How are work hierarchies and task orientation experienced by staff? Design and Setting This paper draws on data from rapid team-based ethnographies of the shifting division of labour in LTC due to use of informal carers in six non-profit LTC facilities located in Toronto, Ontario. Methods Our method involved conducting observations and key informant interviews (N=167) with registered nurses, registered practical nurses, personal support workers, dietary aides, recreation therapists, families, privately paid companions, students, and volunteers. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. For observations, researchers were paired and covered shifts between 7 a.m. and 11 p.m., as well as into the late night over six days, at each of the six sites. Detailed ethnographic field notes were written during and immediately following observational fieldwork. Results Our results indicate that employee stress is linked to the experiences of care work hierarchies, task orientation, and strict divisions of labour between and among various staff designations. Conclusion Findings from this project confirm and extend current research that demonstrates there are challenging working conditions in LTC, which can result in occupational health and safety problems, as well as stress for individual workers. PMID:28066839

  18. Long-Term Clinical Outcome of Intensity-Modulated Radiotherapy for Inoperable Non-Small Cell Lung Cancer: The MD Anderson Experience

    SciTech Connect

    Jiang Zhiqin; Yang Kunyu; Komaki, Ritsuko; Wei Xiong; Tucker, Susan L.; Zhuang Yan; Martel, Mary K.; Vedam, Sastray; Balter, Peter; Zhu Guangying; Gomez, Daniel; Lu, Charles; Mohan, Radhe; Cox, James D.; Liao Zhongxing

    2012-05-01

    Purpose: In 2007, we published our initial experience in treating inoperable non-small-cell lung cancer (NSCLC) with intensity-modulated radiation therapy (IMRT). The current report is an update of that experience with long-term follow-up. Methods and Materials: Patients in this retrospective review were 165 patients who began definitive radiotherapy, with or without chemotherapy, for newly diagnosed, pathologically confirmed NSCLC to a dose of {>=}60 Gy from 2005 to 2006. Early and late toxicities assessed included treatment-related pneumonitis (TRP), pulmonary fibrosis, esophagitis, and esophageal stricture, scored mainly according to the Common Terminology Criteria for Adverse Events 3.0. Other variables monitored were radiation-associated dermatitis and changes in body weight and Karnofsky performance status. The Kaplan-Meier method was used to compute survival and freedom from radiation-related acute and late toxicities as a function of time. Results: Most patients (89%) had Stage III to IV disease. The median radiation dose was 66 Gy given in 33 fractions (range, 60-76 Gy, 1.8-2.3 Gy per fraction). Median overall survival time was 1.8 years; the 2-year and 3-year overall survival rates were 46% and 30%. Rates of Grade {>=}3 maximum TRP (TRP{sub max}) were 11% at 6 months and 14% at 12 months. At 18 months, 86% of patients had developed Grade {>=}1 maximum pulmonary fibrosis (pulmonary fibrosis{sub max}) and 7% Grade {>=}2 pulmonary fibrosis{sub max}. The median times to maximum esophagitis (esophagitis{sub max}) were 3 weeks (range, 1-13 weeks) for Grade 2 and 6 weeks (range, 3-13 weeks) for Grade 3. A higher percentage of patients who experienced Grade 3 esophagitis{sub max} later developed Grade 2 to 3 esophageal stricture. Conclusions: In our experience, using IMRT to treat NSCLC leads to low rates of pulmonary and esophageal toxicity, and favorable clinical outcomes in terms of survival.

  19. Long-Term Lessons

    ERIC Educational Resources Information Center

    Gettelman, Alan

    2006-01-01

    Public or private, K-12, college or university, no one knows their facilities better than school maintenance and operations staff--from the front-line custodians to facility managers. When it comes to planning restrooms for new construction and renovation, operational experience is especially critical. Applying best practices in advance can save…

  20. Geochemical changes and microbial activities during CO2 storage - Long-term experiments under in situ conditions within the frame of CO2SINK

    NASA Astrophysics Data System (ADS)

    Wandrey, Maren; Scherf, Ann-Kathrin; Vieth, Andrea; Zettlitzer, Michael; Würdemann, Hilke

    2010-05-01

    Within the frame of the CO2SINK project, CO2 is injected into a saline aquifer of the Stuttgart formation (Triassic, Middle Keuper) at a depth of about 640 m below surface near Ketzin (Northeast German Basin, about 40 km west of Berlin) (Schilling et al., 2009). The injection of CO2 may induce a variety of geochemical changes in the reservoir system. Inorganic components may be dissolved from mineral phases (Wigand et al., 2008) and mineral precipitation from fluid components (Ketzer et al., 2009) may occur. In addition, organic molecules may be relocated, since supercritical CO2 is an excellent solvent for organic components. These geochemical shifts probably affect the microbial community composition and activity. The dissolution and precipitation of minerals, as well as corresponding microbial processes (Bennet et al., 2001) can affect reservoir permeability. In order to detect and quantify changes in geochemical characteristics and microbial processes during CO2storage and to estimate their impact on storage efficiency long-term experiments under in situ P-T conditions are performed. Freshly drilled sandstone sections from the target reservoir at Ketzin from a depth of about 630 m were incubated together with synthetic brine (20 % lower total dissolved solids than the Ketzin reservoir fluid) in high pressure vessels at 5.5 MPa and 40 ° C since September 2007. Since outer core sections were contaminated with drilling mud, as shown with fluorescein tracer detection (Wandrey et al., 2010), only clean inner core sections were used for long-term experiments to avoid contamination with microorganisms, as well as organic and inorganic mud components. After 15, 21 and 24 month fluid and rock samples were taken for chemical, microbial, mineralogical and petrophysical analyses. In fluid samples the concentrations of Ca2+, Mg2+, and K+ were found to exceed those of the Ketzin reservoir fluid. Assuming chemical equilibrium between mineral and formation brine, observed

  1. Soil microbial biomass and community structure affected by repeated additions of sewage sludge in four Swedish long-term field experiments

    NASA Astrophysics Data System (ADS)

    Börjesson, G.; Kätterer, T.; Kirchmann, H.

    2012-04-01

    Soil organic matter is a key attribute of soil fertility. The pool of soil organic C can be increased, either by mineral fertilisers or by adding organic amendments such as sewage sludge. Sewage sludge has positive effects on agricultural soils through the supply of organic matter and essential plant nutrients, but sludge may also contain unwanted heavy metals, xenobiotic substances and pathogens. One obvious effect of long-term sewage sludge addition is a decrease in soil pH, caused by N mineralisation followed by nitrification, sulphate formation and presence of organic acids with the organic matter added. The objective of this study was to investigate the effect of sewage sludge on the microbial biomass and community structure. Materials and methods We analysed soil samples from four sites where sewage sludge has been repeatedly applied in long-term field experiments situated in different parts of Sweden; Ultuna (59°49'N, 17°39'E, started 1956), Lanna (58°21'N, 13°06'E, started 1997-98), Petersborg (55°32'N, 13°00'E, started 1981) and Igelösa (55°45'N, 13°18'E, started 1981). In these four experiments, at least one sewage sludge treatment is included in the experimental design. In the Ultuna experiment, all organic fertilisers, including sewage sludge, are applied every second year, corresponding to 4 ton C ha-1. The Lanna experiment has a similar design, with 8 ton dry matter ha-1 applied every second year. Lanna also has an additional treatment in which metal salts (Cd, Cu, Ni and Zn) are added together with sewage sludge. At Petersborg and Igelösa, two levels of sewage sludge (4 or 12 ton dry matter ha-1 every 4th year) are compared with three levels of NPK fertiliser (0 N, ½ normal N and normal N). Topsoil samples (0-20 cm depth) from the four sites were analysed for total C, total N, pH and PLFAs (phospholipid fatty acids). In addition, crop yields were recorded. Results At all four sites, sewage sludge has had a positive effect on crop yields

  2. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  3. Long-term urethral catheterisation.

    PubMed

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  4. Long-term outcomes after severe shock.

    PubMed

    Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

    2015-02-01

    Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P < 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely

  5. Two-stage system based on a software-defined radio for stabilizing of optical frequency combs in long-term experiments.

    PubMed

    Cížek, Martin; Hucl, Václav; Hrabina, Jan; Smíd, Radek; Mikel, Břetislav; Lazar, Josef; Cíp, Ondřej

    2014-01-20

    A passive optical resonator is a special sensor used for measurement of lengths on the nanometer and sub-nanometer scale. A stabilized optical frequency comb can provide an ultimate reference for measuring the wavelength of a tunable laser locked to the optical resonator. If we lock the repetition and offset frequencies of the comb to a high-grade radiofrequency (RF) oscillator its relative frequency stability is transferred from the RF to the optical frequency domain. Experiments in the field of precise length metrology of low-expansion materials are usually of long-term nature so it is required that the optical frequency comb stay in operation for an extended period of time. The optoelectronic closed-loop systems used for stabilization of combs are usually based on traditional analog electronic circuits processing signals from photodetectors. From an experimental point of view, these setups are very complicated and sensitive to ambient conditions, especially in the optical part, therefore maintaining long-time operation is not easy. The research presented in this paper deals with a novel approach based on digital signal processing and a software-defined radio. We describe digital signal processing algorithms intended for keeping the femtosecond optical comb in a long-time stable operation. This need arose during specialized experiments involving measurements of optical frequencies of tunable continuous-wave lasers. The resulting system is capable of keeping the comb in lock for an extensive period of time (8 days or more) with the relative stability better than 1.6 × 10(-11).

  6. Two-Stage System Based on a Software-Defined Radio for Stabilizing of Optical Frequency Combs in Long-Term Experiments

    PubMed Central

    Čížek, Martin; Hucl, Václav; Hrabina, Jan; Šmíd, Radek; Mikel, Břetislav; Lazar, Josef; Číp, Ondřej

    2014-01-01

    A passive optical resonator is a special sensor used for measurement of lengths on the nanometer and sub-nanometer scale. Astabilized optical frequency comb can provide an ultimate reference for measuring the wavelength of a tunable laser locked to the optical resonator. If we lock the repetition and offset frequencies of the comb to a high-grade radiofrequency (RF) oscillator its relative frequency stability is transferred from the RF to the optical frequency domain. Experiments in the field of precise length metrology of low-expansion materials are usually of long-term nature so it is required that the optical frequency comb stay in operation for an extended period of time. The optoelectronic closed-loop systems used for stabilization of combs are usually based on traditional analog electronic circuits processing signals from photodetectors. From an experimental point of view, these setups are very complicated and sensitive to ambient conditions, especially in the optical part, therefore maintaining long-time operation is not easy. The research presented in this paper deals with a novel approach based on digital signal processing and a software-defined radio. We describe digital signal processing algorithms intended for keeping the femtosecond optical comb in a long-time stable operation. This need arose during specialized experiments involving measurements of optical frequencies of tunable continuous-wave lasers. The resulting system is capable of keeping the comb in lock for an extensive period of time (8 days or more) with the relative stability better than 1.6 × 10−11. PMID:24448169

  7. Adjuvant Hypofractionated Versus Conventional Whole Breast Radiation Therapy for Early-Stage Breast Cancer: Long-Term Hospital-Related Morbidity From Cardiac Causes

    SciTech Connect

    Chan, Elisa K.; Woods, Ryan; McBride, Mary L.; Virani, Sean; Nichol, Alan; Speers, Caroline; Wai, Elaine S.; Tyldesley, Scott

    2014-03-15

    Purpose: The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Methods and Materials: Between 1990 and 1998, 5334 women ≤80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. Results: The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). Conclusions: There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast

  8. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  9. Do Health Reforms to Improve Quality Have Long-Term Effects? Results of a Follow-Up on a Randomized Policy Experiment in the Philippines.

    PubMed

    Quimbo, Stella; Wagner, Natascha; Florentino, Jhiedon; Solon, Orville; Peabody, John

    2016-02-01

    We tracked doctors who had previously participated in a randomized policy experiment in the Philippines. The original experiment involved 30 district hospitals divided equally into one control site and two intervention sites that increased insurance payments (full insurance support for children under 5 years old) or made bonus payments to hospital staff. During the 3 years of the intervention, quality-as measured by clinical performance and value vignettes-improved and was sustained in both intervention sites compared with controls. Five years after the interventions were discontinued, we remeasured the quality of care of the doctors. We found that the intervention sites continued to have significantly higher quality compared with the control sites. The previously documented quality improvement in intervention sites appears to be sustained; moreover, it was subject to a very low (less than 1% per year) rate of decay in quality scores.

  10. Medicare program; prospective payment system for long-term care hospitals RY 2009: annual payment rate updates, policy changes, and clarifications; and electronic submission of cost reports: revision to effective date of cost reporting period. Final rule.

    PubMed

    2008-05-09

    This final rule updates the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs). We are also consolidating the annual July 1 update for payment rates and the October 1 update for Medicare severity long-term care diagnosis-related group (MS-LTC-DRG) weights to a single rulemaking cycle that coincides with the Federal fiscal year (FFY). In addition, we are clarifying various policy issues. This final rule also finalizes the provisions from the Electronic Submission of Cost Reports: Revision to Effective Date of Cost Reporting Period interim final rule with comment period that was published in the May 27, 2005 Federal Register which revises the existing effective date by which all organ procurement organizations (OPOs), rural health clinics (RHCs), Federally qualified health centers (FQHCs), and community mental health centers (CMHCs) are required to submit their Medicare cost reports in a standardized electronic format from cost reporting periods ending on or after December 31, 2004 to cost reporting periods ending on or after March 31, 2005. This final rule does not affect the current cost reporting requirement for hospices and end-stage renal disease (ESRD) facilities. Hospices and ESRD facilities are required to continue to submit cost reports under the Medicare regulations in a standardized electronic format for cost reporting periods ending on or after December 31, 2004.

  11. Out of sight - Profiling soil characteristics, nutrients and microbial communities affected by organic amendments down to one meter in a long-term maize cultivation experiment

    NASA Astrophysics Data System (ADS)

    Lehtinen, Taru; Mikkonen, Anu; Zavattaro, Laura; Grignani, Carlo; Baumgarten, Andreas; Spiegel, Heide

    2016-04-01

    Soil characteristics, nutrients and microbial activity in the deeper soil layers are topics not of-ten covered in agricultural studies since the main interest lies within the most active topsoils and deep soils are more time-consuming to sample. Studies have shown that deep soil does matter, although biogeochemical cycles are not fully understood yet. The main aim of this study is to investigate the soil organic matter dynamics, nutrients and microbial community composition in the first meter of the soil profiles in the long-term maize cropping system ex-periment Tetto Frati, in the vicinity of the Po River in Northern Italy. The trial site lies on a deep, calcareous, free-draining soil with a loamy texture. The following treatments have been applied since 1992: 1) maize for silage with 250 kg mineral N ha-1 (crop residue removal, CRR), 2) maize for grain with 250 kg mineral N ha-1 (crop residue incorporation, CRI), 3) maize for silage with 250 kg bovine slurry N ha-1 (SLU), 4) maize for silage with 250 kg farm yard manure N ha-1 (FYM). Soil characteristics (pH, carbonate content, soil organic carbon (SOC), aggregate stability (WSA)), and nutrients (total nitrogen (Nt), CAL-extractable phos-phorous (P) and potassium (K), potential N mineralisation) were investigated. Bacteri-al community composition was investigated with Ion PGM high-throughput sequencing at the depth of 8000 sequences per sample. Soil pH was moderately alkaline in all soil samples, in-creasing with increasing soil depth, as the carbonate content increased. SOC was significantly higher in the treatments with organic amendments (CRI, SLU and FYM) compared to CRR in 0-25 cm (11.1, 11.6, 14.7 vs. 9.8 g kg-1, respectively), but not in the deeper soil. At 50-75 cm soil depth FYM treatment revealed higher WSA compared to CRR, as well as higher CAL-extractable K (25 and 15 mg kg-1, respectively) and potential N mineralisation (11.30 and 8.78 mg N kg-1 7d-1, respectively). At 75-100 cm soil depth, SLU and

  12. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

    PubMed

    2014-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Protecting Access to Medicare Act of 2014, and other legislation. These changes are applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2014. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014. In addition, we discuss our proposals on the interruption of stay policy for LTCHs and on retiring the "5 percent" payment adjustment for collocated LTCHs. While many of the statutory mandates of the Pathway for SGR Reform Act apply to discharges occurring on or after October 1, 2014, others will not begin to apply until 2016 and beyond. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revising requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, and LTCHs) that

  13. EFFECTS OF LONG-TERM ROUX-EN-Y GASTRIC BYPASS ON BODY WEIGHT AND CLINICAL METABOLIC COMORBIDITIES IN BARIATRIC SURGERY SERVICE OF A UNIVERSITY HOSPITAL

    PubMed Central

    da SILVA, Cátia Ferreira; COHEN, Larissa; SARMENTO, Luciana d'Abreu; ROSA, Felipe Monnerat Marino; ROSADO, Eliane Lopes; CARNEIRO, João Régis Ivar; de SOUZA, Antônio Augusto Peixoto; MAGNO, Fernanda Cristina Carvalho Mattos

    2016-01-01

    ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia. PMID:27683769

  14. Long-term, High Frequency, High Precision pH Measurements on the MBARI deep-water FOCE Experiment at the MARS Cabled Observatory in Monterey Bay, CA

    NASA Astrophysics Data System (ADS)

    Peltzer, E. T.; Maughan, T.; Barry, J. P.; Brewer, P. G.; Headley, K. L.; Herlien, R.; Kirkwood, W. J.; Matsumoto, G. I.; O'Reilly, T. C.; Salamy, K. A.; Scholfield, J.; Shane, F. F.; Walz, P. M.

    2012-12-01

    -situ calibration techniques used to compensate for long term sensor drift associated with the reference electrode.

  15. Soil organic carbon dynamics in wheat-maize cropping systems of north China: application of isotope approach to long-term experiments

    NASA Astrophysics Data System (ADS)

    Wang, J.; Wang, X.; Xu, M.; Zhang, W.

    2013-12-01

    Soil organic carbon (SOC) in agro-ecosystem is largely influencedby agricultural practices such as croppingand fertilization. However, quantifying the contributions of various crops has been lacking. Here, we applied isotopic approachto study SOC dynamics under wheat-maize rotation with variousfertilization treatments atthree long-term experiment sites innorth China. Three treatments were chosen: no fertilizer (control), chemical nitrogen-phosphorus-potassium (NPK) and NPK plus straw (NPKS).Soil samples were collected from0-20, 20-40, 40-60, 60-80 and 80-100cm after 13 and 20 years of treatment, and SOC and its stable 13C compositions were determined. Generally, SOC content significantly decreased with depths, from 8.2 ×1.4 g kg-1 (in 0-20 cm) to 3.3×1.0 g kg-1 (in 80-100 cm) across all treatments and sites. Soil δ13C values at all depths, treatments and sites ranged from -24.2‰ to -21.6‰, averaged -22.8‰, indicating that ~70% of SOC was derived from wheat and previous C3 plant, and ~30% from maize and previous C4 plant.Both SOC and soil δ13C were significantly affected by fertilization managements, especiallyin 0-40 cm where linear relationship occurred between SOC and estimated C input. Overall, the slop of the linear equation, i.e., conversion efficiency, was four times greater for wheat-derived C relative to that for maize residue C. Our study indicated that maize-derived C contributed less to C sequestration in wheat-maize rotation system of north China. Figure 1. Relationships between SOC stock (0-40 cm) and accumulated C input for wheat (C3), maize (C4) and total. Significance is marked with one (P < 0.05), two (P < 0.01) and three (P < 0.001) asterisks.

  16. Human factor observations of the Biosphere 2, 1991-1993, closed life support human experiment and its application to a long-term manned mission to Mars.

    PubMed

    Alling, Abigail; Nelson, Mark; Silverstone, Sally; Van Thillo, Mark

    2002-01-01

    Human factors are a key component to the success of long-term space missions such as those necessitated by the human exploration of Mars and the development of bioregenerative and eventually self-sufficient life support systems for permanent space outposts. Observations by participants living inside the 1991-1993 Biosphere 2 closed system experiment provide the following insights. (1) Crew members should be involved in the design and construction of their life support systems to gain maximum knowledge about the systems. (2) Individuals living in closed life support systems should expect a process of physiological and psychological adaptation to their new environment. (3) Far from simply being a workplace, the participants in such extended missions will discover the importance of creating a cohesive and satisfying life style. (4) The crew will be dependent on the use of varied crops to create satisfying cuisine, a social life with sufficient outlets of expression such as art and music, and to have down-time from purely task-driven work. (5) The success of the Biosphere 2 first 2-year mission suggests that crews with high cultural diversity, high commitment to task, and work democracy principles for individual responsibility may increase the probability of both mission success and personal satisfaction. (6) Remaining challenges are many, including the need for far more comprehensive real-time modeling and information systems (a "cybersphere") operating to provide real-time data necessary for decision-making in a complex life support system. (7) And, the aim will be to create a noosphere, or sphere of intelligence, where the people and their living systems are in sustainable balance.

  17. Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India

    PubMed Central

    Babu, K. Govind; Suresh Babu, M. C.; Lokanatha, D.; Bhat, Gita R.

    2016-01-01

    Introduction: Prolonged treatment, frequent administration of chemotherapy, antibiotics and blood products in cancer patients requires long term venous access. Central venous catheters (CVC) inserted into the subclavian vein or internal jugular vein, peripherally inserted central venous catheters (PICC) and chemoport (CP) are the commonly used central venous access devices (CVAD). Aim: This study was envisaged to review our experience of CVADs over a one year period and analyze the outcome with regard to catheter life, reasons for removal, complications, patient satisfaction and cost comparison between the CVAD types in the Indian setting. Settings and Design: This was a prospective, observational study carried out in a tertiary care cancer institute. Materials and Methods: 180 CVADs placed in patients with hematological malignancies and solid tumors from January 2014 to December 2014 were included. Statistical Analysis Used: Data was analyzed using descriptive statistics, Mann Whitney U test. P <0.05 was taken as statistically significant. Results: 180 CVADs were placed in 160 patients. The median catheter indwelling period was 76 days (16 days to 313 days) for CVC, 59 days (20days – 313 days) for PICC and 137 days (70 days – 258 days) for CP. 66 out of 160 patients developed complications (41.2%). 108 complication events were noted in 66 patients. There were 40 episodes of CRBSI. Out of the 68 mechanical complications, 37 were encountered during insertion of the CVAD and 31 were during the catheter indwelling period. Out of 160 patients, 138 (86.25%) were satisfied with the CVAD. The cost incurred for CVC/PICC (INR 4,480) was lower than that for CP (INR 24,150) and it was statistically significant (P < 0.0001). Our patients were highly satisfied with the CVAD. Conclusion: Use of CVC and PICC is a safe, reliable and cost saving way of administration of chemotherapy in developing countries. The incidence of complications and catheter loss was acceptable. Our

  18. Impact of Local Management on Long-Term Outcomes in Ewing Tumors of the Pelvis and Sacral Bones: University of Florida Experience

    SciTech Connect

    Indelicato, Daniel J. Keole, Sameer R.; Shahlaee, Amir H.; Gibbs, C. Parker; Scarborough, Mark T.; Marcus, Robert B.

    2008-09-01

    Purpose: This retrospective analysis describes our 35-year experience with respect to disease control and functional status. Patients and Methods: Thirty-five patients with localized Ewing tumors of the pelvis and sacral bones were treated from 1970 to 2005. Twenty-six patients were treated with definitive radiotherapy (RT), and 9 patients were treated with combined local therapy in the form of surgery + RT. The median RT dose was 55.2 Gy. The patients who received RT alone were more likely to be older men with larger tumors exhibiting soft-tissue extension. Patients in the definitive RT group were more likely to receive etoposide and ifosfamide or undergo bone marrow transplant. Median potential follow-up was 19.4 years. Results: The 15-year actuarial cause-specific survival, freedom from relapse rate, and local control rates were 26% vs. 76% (p = 0.016), 28% vs. 78% (p = 0.015), and 64% vs. 100% (p = 0.087), respectively, for patients treated with definitive RT and combined therapy. Overall, tumors <8 cm had significantly better cause-specific survival, but this was unrelated to local control. The median Toronto Extremity Salvage Score for the definitive RT and combined therapy groups were 99 and 94, respectively (p = 0.19). Seven definitive RT patients (27%) had serious complications. Conclusion: Combined modality local therapy should be considered if pelvic Ewing tumors are resectable. However, because of the extent of local disease, most patients have unresectable or partially resectable tumors and therefore require RT in some capacity. For this reason, innovative RT strategies are needed to improve long-term disease outcomes and minimize side effects while maintaining an acceptable functional result.

  19. A long-term field experiment of soil transplantation demonstrating the role of contemporary geographic separation in shaping soil microbial community structure.

    PubMed

    Sun, Bo; Wang, Feng; Jiang, Yuji; Li, Yun; Dong, Zhixin; Li, Zhongpei; Zhang, Xue-Xian

    2014-04-01

    The spatial patterns of microbial communities are largely determined by the combined effects of historical contingencies and contemporary environmental disturbances, but their relative importance remains poorly understood. Empirical biogeographic data currently available are mostly based on the traditional method of observational survey, which typically involves comparing indigenous microbial communities across spatial scales. Here, we report a long-term soil transplantation experiment, whereby the same two soils (red Acrisol and purple Cambisol from Yingtan) were placed into two geographic locations of ∼1000 km apart (i.e., Yingtan in the mid-subtropical region and Fengqiu in warm-temperate region; both located in China). Twenty years after the transplantation, the resulting soil microbial communities were subject to high-throughput 454 pyrosequencing analysis of 16S and 18S rRNA genes. Additionally, bacteria and archaea involved in nitrogen cycling were estimated using clone library analysis of four genes: archaeal amoA, bacterial amoA,nirK, and nifH. Data of subsequent phylogenetic analysis show that bacteria, fungi, and other microbial eukaryotes, as well as the nitrogen cycling genes, are grouped primarily by the factor of geographic location rather than soil type. Moreover, a shift of microbial communities toward those in local soil (i.e., Chao soil in Fengqiu) has been observed. The results thus suggest that the historical effects persistent in the soil microbial communities can be largely erased by contemporary disturbance within a short period of 20 years, implicating weak effects of historical contingencies on the structure and composition of microbial communities in the soil.

  20. A long-term field experiment of soil transplantation demonstrating the role of contemporary geographic separation in shaping soil microbial community structure

    PubMed Central

    Sun, Bo; Wang, Feng; Jiang, Yuji; Li, Yun; Dong, Zhixin; Li, Zhongpei; Zhang, Xue-Xian

    2014-01-01

    The spatial patterns of microbial communities are largely determined by the combined effects of historical contingencies and contemporary environmental disturbances, but their relative importance remains poorly understood. Empirical biogeographic data currently available are mostly based on the traditional method of observational survey, which typically involves comparing indigenous microbial communities across spatial scales. Here, we report a long-term soil transplantation experiment, whereby the same two soils (red Acrisol and purple Cambisol from Yingtan) were placed into two geographic locations of ∼1000 km apart (i.e., Yingtan in the mid-subtropical region and Fengqiu in warm-temperate region; both located in China). Twenty years after the transplantation, the resulting soil microbial communities were subject to high-throughput 454 pyrosequencing analysis of 16S and 18S rRNA genes. Additionally, bacteria and archaea involved in nitrogen cycling were estimated using clone library analysis of four genes: archaeal amoA, bacterial amoA,nirK, and nifH. Data of subsequent phylogenetic analysis show that bacteria, fungi, and other microbial eukaryotes, as well as the nitrogen cycling genes, are grouped primarily by the factor of geographic location rather than soil type. Moreover, a shift of microbial communities toward those in local soil (i.e., Chao soil in Fengqiu) has been observed. The results thus suggest that the historical effects persistent in the soil microbial communities can be largely erased by contemporary disturbance within a short period of 20 years, implicating weak effects of historical contingencies on the structure and composition of microbial communities in the soil. PMID:24772284

  1. Long-term influence of manure and mineral nitrogen applications on plant and soil 15N and 13C values from the Broadbalk Wheat Experiment.

    PubMed

    Senbayram, Mehmet; Dixon, Liz; Goulding, Keith W T; Bol, Roland

    2008-06-01

    The Broadbalk Wheat Experiment at Rothamsted Research in the UK provides a unique opportunity to investigate the long-term impacts of environmental change and agronomic practices on plants and soils. We examined the influence of manure and mineral fertiliser applications on temporal trends in the stable N ((15)N) and C ((13)C) isotopes of wheat collected during 1968-1979 and 1996-2005, and of soil collected in 1966 and 2000. The soil delta(15)N values in 1966 and 2000 were higher in manure than the mineral N supplied soil; the latter had similar or higher delta(15)N values than non-fertilised soil. The straw delta(15)N values significantly decreased in all N treatments during 1968 to 1979, but not for 1996-2005. The straw delta(15)N values decreased under the highest mineral N supply (192 kg N ha(-1) year(-1)) by 3 per thousand from 1968 to 1979. Mineral N supply significantly increased to straw delta(13)C values in dry years, but not in wet years. Significant correlations existed between wheat straw delta(13)C values with cumulative rainfall (March to June). The cultivar Hereward (grown 1996-2005) was less affected by changes in environmental conditions (i.e. water stress and fertiliser regime) than Cappelle Desprez (1968-1979). We conclude that, in addition to fertiliser type and application rates, water stress and, importantly, plant variety influenced plant delta(13)C and delta(15)N values. Hence, water stress and differential variety response should be considered in plant studies using plant delta(13)C and delta(15)N trends to delineate past or recent environmental or agronomic changes.

  2. Biodegradation of natural organic matter in long-term, continuous-flow experiments simulating artificial ground water recharge for drinking water production.

    PubMed

    Kolehmainen, Reija E; Kortelainen, Nina M; Langwaldt, Jörg H; Puhakka, Jaakko A

    2009-01-01

    The role of biodegradation in the attenuation of natural organic matter (NOM) was investigated in long-term experiments that simulate artificial ground water recharge (AGR) for drinking water production. Lake water containing 5.8 mg L(-1) total organic carbon (TOC) was continuously fed into an 18.5-m-long sand column. During the 941 d of operation, on average 76 and 81% of TOC was removed within the first 0.6 m and the entire column length, respectively. Large molecular size fractions (approximately 1800-2200 Da) of NOM were removed more efficiently than smaller ones (approximately 250-1400 Da). The biodegradation of dissolved organic carbon (DOC) within the first 0.6 m, measured by the stable inorganic carbon isotope (delta13C) method, depended on temperature and hydraulic load: The extent of mineralization was 32% at 6 degrees C (Day 442) and 38% at 23 degrees C (Day 708) with a 0.3 m3 (m2d)(-1) hydraulic load and 52% at 5.5 degrees C (Day 883) with a 3.1 m3 (m2d) (-1) hydraulic load. The rest of the DOC removal was likely due to entrapment or sorption onto the sand particles. Decreases in DOC and the total cell counts in the water along the column were positively correlated (r = 0.99; P = 0.001). The accumulation of biomass was minor, with the highest concentration amounting to 7.2 mg g(-1) dw of sand. In summary, this study demonstrated that biodegradation has a key role in NOM removal in AGR and is dependent on temperature.

  3. Long-Term Effects of Interparental Violence and Child Physical Maltreatment Experiences on PTSD and Behavior Problems: A National Survey of Taiwanese College Students

    ERIC Educational Resources Information Center

    Shen, April Chiung-Tao

    2009-01-01

    Objectives: This study investigated the joint long-term impact of witnessing interparental violence and experiencing child physical maltreatment on young adults' trauma symptoms and behavior problems. It also explored Chinese traditional beliefs as a possible contributor to young adults' trauma and behavior. Methods: This study used self-reporting…

  4. Long term complications of diabetes

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000327.htm Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  5. Phosphorus fertilisation under nitrogen limitation can deplete soil carbon stocks: evidence from Swedish meta-replicated long-term field experiments

    NASA Astrophysics Data System (ADS)

    Poeplau, Christopher; Bolinder, Martin A.; Kirchmann, Holger; Kätterer, Thomas

    2016-02-01

    Increasing soil organic carbon (SOC) in agricultural soils can mitigate atmospheric CO2 concentration and also contribute to increased soil fertility and ecosystem resilience. The role of major nutrients in SOC dynamics is complex, due to simultaneous effects on net primary productivity (NPP) that influence crop residue carbon inputs and in the rate of heterotrophic respiration (carbon outputs). This study investigated the effect on SOC stocks of three different levels of phosphorus and potassium (PK) fertilisation rates in the absence of nitrogen fertilisation and of three different levels of nitrogen fertiliser in the absence of PK fertiliser. This was done by analysing data from 10 meta-replicated Swedish long-term field experiments (> 45 years). With N fertilisation, SOC stocks followed yield increases. However, for all PK levels, we found average SOC losses ranging from -0.04 ± 0.09 Mg ha-1 yr-1 (ns) for the lowest to -0.09 ± 0.07 Mg ha-1 yr-1 (p = 0.008) for the highest application rate, while crop yields as a proxy for carbon input increased significantly with PK fertilisation by 1, 10 and 15 %. We conclude that SOC dynamics are mainly output-driven in the PK-fertilised regime but mostly input-driven in the N-fertilised regime, due to the much more pronounced response of NPP to N than to PK fertilisation. It has been established that P rather than K is the element affecting ecosystem carbon fluxes, where P fertilisation has been shown to (i) stimulate heterotrophic respiration, (ii) reduce the abundance of arbuscular mycorrhizal fungi and (iii) decrease the crop root : shoot ratio, leading to higher root-derived carbon input. The higher export of N in the PK-fertilised plots in this study could (iv) have led to increased N mining and thus mineralisation of organic matter. More integrated experiments are needed to gain a better understanding of the relative importance of each of the above-mentioned mechanisms leading to SOC losses after P addition.

  6. Results from a Long-term Litter Decomposition Experiment in Canadian Forests and Their Use in Soil Carbon Model Verification and Development.

    NASA Astrophysics Data System (ADS)

    Trofymow, J. A.; Smyth, C.; Moore, T.; Prescott, C.; Titus, B.; Siltanen, M.; Visser, S.; Preston, C.; Nault, J.; Camire', C.; Fyles, J.; Kozak, L.; Kranabetter, M.; Kutny, L.; Morrison, I.; Smith, S.; Wein, R.; White, D.

    2007-12-01

    Climate and substrate quality have been shown to be key determinants of rates of litter decomposition, though other site factors can be important under certain conditions. The Canadian Intersite Decomposition Experiment (CIDET) was established in 1992 with the objective of providing data on the long-term rates of litter decomposition and nutrient mineralization for a range of forested ecoclimatic regions in Canada. Such data were needed to help verify the Carbon Budget Model - Canadian Forest Sector (CBM-CFS) used for national C accounting, as well as aid in the development of other soil C models. CIDET examined the annual decay, over a 12-year period from 1993 to 2004, of 10 standard foliar litters and 2 wood substrates at 18 forested upland and 3 wetland sites ranging from the cool temperate to subarctic regions. On a subset of sites and litter types, changes in litter C chemistry over time were also determined. Over the first 6 years, C/N ratio and iron increased, NMR showed an overall decline in O-alkyl C (carbohydrates) and increase in alkyl, aromatic, phenolic, and carboxyl C. Proximate analysis showed the acid unhydrolyzable residue (AUR) increases, but true lignin does not accumulate, in contrast to the conceptual ligno-cellulose model of decomposition. Overall litter decay during first phase of decomposition was related to initial litter quality (AUR and water soluble extract), winter precipitation, but not temperature. Decay rate "k" during second phase was related to temperature, initial litter quality (AUR and AUR/N), summer precipitation, but not soil N. In most cases decay had approached an asymptote before end of experiment, although decay rates during this semistable phase were low and difficult to quantify. However, the asymptotes were related to temperature suggesting decay in this phase is temperature dependant. Asymptotes were also related to summer precipitation and forest floor pH and C/N ratio. Comparisons of CIDET 12 year C mass remaining

  7. Agronomic measures of P, Q/I parameters and lysimeter-collectable P in subsurface soil horizons of a long-term slurry experiment.

    PubMed

    Anderson, R; Xia, L

    2001-01-01

    Soils from a long-term slurry experiment established in 1970 at Hillsborough, Northern Ireland, were used in the experiment. The site has a clay loam soil overlying Silurian shale. Seven treatments were used with three replicate plots per treatment under the following manurial regimes: (1) mineral fertiliser supplying 200 kg N, 32 kg P and 160 kg K ha(-1) yr(-1); (2)-(4) pig slurry applied at 50, 100 or 200 m3 ha(-1) yr(-1); (5)-(7) cow slurry applied at 50, 100 or 200 m3 ha(-1) yr(-1). Agronomic measures of P determined on subsurface layers down to 90 cm were compared with sorption isotherm data and rates of desorption. Adsorption isotherms were fitted using a standard Langmuir model. Data were compared with soluble (molybdate-reactive) P levels in soil water collected at 35 and 90 cm using PTFE suction cup lysimeters. Agronomically available P was concentrated in the top 30 cm of soil in all treatments. The accumulation of P in surface layers of the plots was significantly greater in the pig slurry treatments compared to the cow slurry, reflecting the history of P amendments. Nevertheless, over a period of a year, molybdate-reactive phosphorus (MRP) concentrations in lysimeter collections was consistently higher at 35 cm depth in the highest cow slurry treatment (7) compared to the equivalent pig slurry treatment (4). Either the movement of soluble P down the profile is facilitated by the higher organic content of cow slurry or P movement is not directly related to P accumulation in the soils. In addition, it is hypothesised that P movement down the soil profile depends upon two separate mechanisms. First, a 'break' point above which the accumulated P in the surface horizons is less strongly held and therefore amenable to dissolution and movement down the profile. Second, a mechanism by which some solute P from the surface horizons can travel rapidly through horizons of low P status to greater depth in the soil, i.e., by preferential flow.

  8. Impact of tillage intensity on carbon and nitrogen pools in surface and subsurface soils of three long-term field experiments

    NASA Astrophysics Data System (ADS)

    Kaiser, Michael; Piegholdt, Christiane; Andruschkewitsch, Rouven; Linsler, Deborah; Koch, Heinz-Josef; Ludwig, Bernard

    2014-05-01

    Management options such as the intensity of tillage are known to influence amount and turnover of soil organic matter. However, less information is available about the influence of the tillage intensity on individual soil organic matter pools of different turnover dynamics analyzed for surface and subsurface soils. We took surface (0-5 cm) and subsurface (5-25 cm) soil samples from no tillage (NT), reduced tillage (RT), and conventional tillage (CT) systems of three long-term field experiments in Germany. The labile, intermediate and stable C and N pool sizes were determined based on the combined application of a decomposition experiment and a physical-chemical separation procedure. For the surface soils, we found higher stocks of the labile C and N pool under NT and RT compared to CT. In case of a change from conventional to no-tillage systems, our results indicate an increase of labile C and N pools for the analyzed agricultural surface soils from 8 to 18% of the organic C and from 10% to 21% of the total N after 19 to 21 years. This timespan should be taken into consideration within the evaluation of potential benefits from an increase in labile OM for nutrient supply and productivity especially within the development of more sustainably managed agro-ecosystems. The reverse effect was observed for the labile C pool in subsurface soils where an increase from 6 to 10% of the organic C with increasing tillage intensity was observed. Such increase might contribute to an improved nutrient supply in subsurface soils under intensive tillage systems. The intermediate C and N pools in the surface and the subsurface soils are with 76 to 84% of the organic C and with 75 to 83% of the total N quantitatively much more important for the OM dynamics than the stable or labile pools. However, only for the surface soils were the stocks of the intermediate N and C pools distinctly larger for NT than for CT. The stocks of the stable C and N pools were not affected by the tillage

  9. Phosphorus fertilisation under nitrogen limitation can deplete soil carbon stocks - evidence from Swedish meta-replicated long-term field experiments

    NASA Astrophysics Data System (ADS)

    Poeplau, C.; Bolinder, M. A.; Kirchmann, H.; Kätterer, T.

    2015-10-01

    Increasing soil organic carbon (SOC) in agricultural soils can mitigate atmospheric CO2 concentration and also contribute to increase soil fertility and ecosystem resilience. The role of major nutrients on SOC dynamics is complex, due to simultaneous effects on net primary productivity (NPP) that influence crop residue carbon inputs and on the rate of heterotrophic respiration (carbon outputs). This study investigated the effect on SOC stocks of three different levels of phosphorus and potassium (PK) fertilisation rates in the absence of nitrogen fertilisation and of three different levels of nitrogen in the absence of PK. This was done by analysing data from 10 meta-replicated Swedish long-term field experiments (> 45 years). With N fertilisation, SOC stocks followed yield increases. However, for all PK levels, we found average SOC losses ranging from -0.04 ± 0.09 Mg ha-1 yr-1 (ns) for the lowest to -0.09 ± 0.07 Mg ha-1 yr-1 (p = 0.008) for the highest application rate, while crop yields as a proxy for carbon input increased significantly with PK fertilization by 1, 10 and 15 %. We conclude that SOC dynamics are mainly output-driven in the PK fertilised regime but mostly input-driven in the N fertilised regime, due to the much more pronounced response of NPP to N than to PK fertilisation. It has been established that P rather than K is the element affecting ecosystem carbon fluxes, where P fertilisation has been shown to: (i) stimulate heterotrophic respiration, (ii) reduce the abundance of arbuscular mycorrhizal fungi and (iii) decrease crop root : shoot ratio, leading to lower root-derived carbon input. The higher export of N in the PK fertilised plots in this study could (iv) have led to increased N mining and thus mineralisation of organic matter. More integrated experiments are needed to gain a better understanding of the relative importance of each of the above-mentioned mechanisms leading to SOC losses after P addition.

  10. Clinicopathological characteristics and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014)

    PubMed Central

    Wang, Chang-Jun; You, Shan-Shan; Zhang, Jing; Xu, Qian-Qian; Cai, Feng; Shi, Jie; Zhou, Yi-Dong; Mao, Feng; Lin, Yan; Guan, Jing-Hong; Shen, Song-Jie; Liang, Zhi-Yong; Jiang, Yu-Xin; Sun, Qiang

    2016-01-01

    Purpose The mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. There is little data about the ultrasound (US) detected non-palpable breast cancer (NPBC) in Chinese population. Methods We analyzed 699 consecutive NPBC from 1.8-2.3 million asymptomatic women from 2001 to 2014, including 572 US-detected NPBC from 3,786 US-positive women and 127 mammography (MG) detected NPBC from 788 MG-positive women. The clinicopathological features, disease-free survival (DFS) and overall survival (OS) were compared between the US- and MG-detected NPBC. Prognostic factors of NPBC were identified. Results Compared to MG, US could detect more invasive NPBC (83.6% vs 54.3%, p<0.001), lymph node positive NPBC (19.1% vs 10.2%, p=0.018), lower grade (24.8% vs 16.5%, p<0.001), multifocal (19.2% vs 6.3%, p<0.001), PR positive (71.4% vs 66.9%, p=0.041), Her2 negative (74.3% vs 54.3%, p<0.001), Ki67 high (defined as >14%, 46.3% vs 37.0%, p=0.031) cancers and more NPBC who received chemotherapy (40.7% vs 21.3%, p<0.001). There was no significant difference in 10-year DFS and OS between US-detected vs MG-detected NPBC, DCIS and invasive NPBC. For all NPBC and the US-detected NPBC, the common DFS-predictors included pT, pN, p53 and bilateral cancers. Conclusion US could detect more invasive, node-positive, multifocal NPBC in hospital-based asymptomatic Chinese female, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US would not delay early detection of NPBC with improved cost-effectiveness, thus could serve as the feasible initial imaging modality in hospital-based opportunistic screening among Chinese women. PMID:27689334

  11. Decision tree model for predicting long-term outcomes in children with out-of-hospital cardiac arrest: a nationwide, population-based observational study

    PubMed Central

    2014-01-01

    Introduction At hospital arrival, early prognostication for children after out-of-hospital cardiac arrest (OHCA) might help clinicians formulate strategies, particularly in the emergency department. In this study, we aimed to develop a simple and generally applicable bedside tool for predicting outcomes in children after cardiac arrest. Methods We analyzed data of 5,379 children who had undergone OHCA. The data were extracted from a prospectively recorded, nationwide, Utstein-style Japanese database. The primary endpoint was survival with favorable neurological outcome (Cerebral Performance Category (CPC) scale categories 1 and 2) at 1 month after OHCA. We developed a decision tree prediction model by using data from a 2-year period (2008 to 2009, n = 3,693), and the data were validated using external data from 2010 (n = 1,686). Results Recursive partitioning analysis for 11 predictors in the development cohort indicated that the best single predictor for CPC 1 and 2 at 1 month was the prehospital return of spontaneous circulation (ROSC). The next predictor for children with prehospital ROSC was an initial shockable rhythm. For children without prehospital ROSC, the next best predictor was a witnessed arrest. Use of a simple decision tree prediction model permitted stratification into four outcome prediction groups: good (prehospital ROSC and initial shockable rhythm), moderately good (prehospital ROSC and initial nonshockable rhythm), poor (prehospital non-ROSC and witnessed arrest) and very poor (prehospital non-ROSC and unwitnessed arrest). By using this model, we identified patient groups ranging from 0.2% to 66.2% for 1-month CPC 1 and 2 probabilities. The validated decision tree prediction model demonstrated a sensitivity of 69.7% (95% confidence interval (CI) = 58.7% to 78.9%), a specificity of 95.2% (95% CI = 94.1% to 96.2%) and an area under the receiver operating characteristic curve of 0.88 (95% CI = 0.87 to 0.90) for predicting 1-month

  12. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    PubMed Central

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo

    2011-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Social and Occupational Functioning Assessment Scale, Beck Depression Inventory-Second Edition, Scale for Suicide Ideation, and World Health Organization Quality of Life assessment instruments-abbreviated version. Also, personal histories of medical and psychiatric illnesses and the range of socio-epidemiologic and clinical data were collected from each participant. Results One thousand one hundred eighty three participants were recruited from 18 hospitals. The mean age of the participants was 47.9±15.9 year-old, 74.4% were female, 82.9% had been diagnosed of major depressive disorder, 40.9% were experiencing their first depressive episode, and 21.4% had a past history of suicide attempts. The majority (85.3%) of the participants were moderately to severely ill. The average HDRS-17 was 19.8±6.1. Significant gender differences at baseline were shown in age, education, marriage, employment, religion, and first depressive episode. Conclusion The baseline findings in the CRESCEND study showed some different characteristics of depression in Korea, suggesting a possibility of ethnic and cultural factors in depression. PMID:21519530

  13. AB055. Long term NIV

    PubMed Central

    Siopi, Dimitra

    2016-01-01

    role of long term NIV remains controversial in patients with chronic hypercapnic respiratory failure attributed to COPD. This happens because RCTs haven’t been able to prove benefits in survival, although the settings used in those trials seem to be insufficient to correct hypercapnia. According to more recent data higher pressure (high-intensity NIV) with the goal of achieving normocapnia can improve exercise tolerance, quality of life and survival. Obesity hypoventilation syndrome on the other hand is gradually receiving clinical interest and is recognized as a significant cause of morbidity and mortality, with a beneficial role of NIV in improving survival, hospitalizations and health related quality of life, thus reducing healthcare cost. Despite the improved awareness of the medical world dealing with the obesity epidemic, the syndrome is still under-diagnosed. Any medical specialty should perceive the value of controlling those patients in order to offer the optimal type of mechanical ventilation, depending on the underlying type of the respiratory disorder (obstructive episodes or pure hypoventilation). Patients with congestive heart failure can suffer from central sleep apnoea, OSA and Cheyne-Stokes respiration with a negative impact in their clinical outcome. CPAP therapy is indicated in resolving obstructive apnea, but is ineffective in case of central sleep apnea or Cheyne-Stokes breathing. The initial enthusiasm for assisted servo ventilation (ASV) use in this group of patients was not confirmed by a multicentre RCT (which showed increased mortality) and this type of ventilation is no longer recommended in heart failure patients with CSA and ejection fraction <45%. Scarce data exist regarding long-term NIV in patients with Cystic Fibrosis, bronchiectasis and interstitial lung diseases .It seems though that with careful patient selection NIV can play an important role in the management of those patients, even serving as a bridge to transplantation

  14. Climate Change and Potassium Effects Under Different N-Fertilization Input on Potato (Solanum tuberosum L.) Yield in a Long Term Field Experiment

    NASA Astrophysics Data System (ADS)

    László, Márton, ,, Dr.

    2010-05-01

    Climate change of Hungary was initiated about of 1850. Nowadays among the natural catastrophes, drought and flooding caused by over-abundant rainfall cause the greatest problems in field crop production. The droughts and the floods were experienced in the early eighties as well as today have drawn renewed attention to the analysis of this problem. The potato is demanding indicator crop of climate factors (temperature, rainfall) and soil nutrient status. Has a particularly high requirement for quantity of precipitation and for supply of soil potassium, nitrogen, phosphorus and magnesium. This paper reports the results achieved in the period from 1962 to 2001 of a long term small- plot fertilization experiment set up on acidic sandy brown forest soil at Nyírlugos in the Nyírség region in North- Eastern Hungary. Characteristics of the experiment soil were a pH (KCl) 4.5, humus 0.5%, CEC 5-10 mgeq 100g-1 in the ploughed layer. The topsoil was poor in all four macronutrient N, P, K and Mg. The mineral fertilization experiment involved 2 (genotype: Gülbaba and Aranyalma) x 2 (ploughed depth: 20 and 40 cm) x 16 (fertilizations: N, P, K, Mg) = 64 treatments in 8 replications, giving a total of 512 plots. The gross and net plot sizes were 10x5=50 m2 and 35.5 m2. The experimental designe was split-split-plot. The N levels were 0, 50, 100, 150 kg ha-1 year-1 and the P, K, Mg levels were 48, 150, 30 kg ha-1 year-1 P2O5, K2O, MgO in the form of 25% calcium ammonium nitrate, 18% superphosphate, 40% potassium chloride, and technological powdered magnesium sulphate. The forecrop every second year was rye. The groundwater level was at a depth of 2-3 m. From the 64 treatments, eight replications, altogether 512- experimental plots with 7 treatments and their 16 combinations are summarised of experiment period from 1962 to 1979. The main conclusions were as follows: 1. The experiment years (1962-1963, 1964-1965, 1966-1967, 1968-1969, 1970-1971, 1972-1973, 1974-1975, 1976

  15. [Fetal pain: immediate and long term consequences].

    PubMed

    Houfflin Debarge, Véronique; Dutriez, Isabelle; Pusniak, Benoit; Delarue, Eléonore; Storme, Laurent

    2010-06-01

    Several situations are potentially painful for fetuses, such as malformations and invasive procedures. Nociceptive pathways are known to be functional at 26 weeks. Even if it is not possible to evaluate the fetal experience of pain, it is essential to examine its immediate and long-term consequences. As early as the beginning of the second trimester, hemodynamic and hormonal responses are observed following fetal nociceptive stimulation, In experimental studies, long-term changes have been noted in the corticotrop axis, subsequent responses to pain, and behavior after perinatal nociceptive stimulation.

  16. Carbon sequestration efficiency of organic amendments in a long-term experiment on a vertisol in Huang-Huai-Hai Plain, China.

    PubMed

    Hua, Keke; Wang, Daozhong; Guo, Xisheng; Guo, Zibin

    2014-01-01

    Soil organic carbon (SOC) sequestration is important for improving soil fertility of cropland and for the mitigation of greenhouse gas emissions to the atmosphere. The efficiency of SOC sequestration depends on the quantity and quality of the organic matter, soil type, and climate. Little is known about the SOC sequestration efficiency of organic amendments in Vertisols. Thus, we conducted the research based on 29 years (1982-2011) of long-term fertilization experiment with a no fertilizer control and five fertilization regimes: CK (control, no fertilizer), NPK (mineral NPK fertilizers alone), NPK+1/2W (mineral NPK fertilizers combined with half the amount of wheat straw), NPK+W (mineral NPK fertilizers combined with full the amount of wheat straw), NPK+PM (mineral NPK fertilizers combined with pig manure) and NPK+CM (mineral NPK fertilizers combined cattle manure). Total mean annual C inputs were 0.45, 1.55, 2.66, 3.71, 4.68 and 6.56 ton/ha/yr for CK, NPK, NPKW1/2, NPKW, NPKPM and NPKCM, respectively. Mean SOC sequestration rate was 0.20 ton/ha/yr in the NPK treatment, and 0.39, 0.50, 0.51 and 0.97 ton/ha/yr in the NPKW1/2, NPKW, NPKPM, and NPKCM treatments, respectively. A linear relationship was observed between annual C input and SOC sequestration rate (SOCsequestration rate  = 0.16 Cinput -0.10, R = 0.95, P<0.01), suggesting a C sequestration efficiency of 16%. The Vertisol required an annual C input of 0.63 ton/ha/yr to maintain the initial SOC level. Moreover, the C sequestration efficiencies of wheat straw, pig manure and cattle manure were 17%, 11% and 17%, respectively. The results indicate that the Vertisol has a large potential to sequester SOC with a high efficiency, and applying cattle manure or wheat straw is a recommendable SOC sequestration practice in Vertisols.

  17. Uncertainty functions of modelled soil organic carbon changes in response to crop management derived from a French long term experiments dataset

    NASA Astrophysics Data System (ADS)

    Dimassi, Bassem; Guenet, Bertrand; Mary, Bruno; Trochard, Robert; Bouthier, Alain; Duparque, Annie; Sagot, Stéphanie; Houot, Sabine; Morel, Christian; Martin, Manuel

    2016-04-01

    The land use, land-use change and forestry (LULUCF) activities and crop management (CM) in Europe could be an important carbon sink through soil organic carbon (SOC) sequestration. Recently, the (EU decision 529/2013) requires European Union's member states to assess modalities to include greenhouse gas (GHG) emissions and removals resulting from activities relating to LULUCF and CM into the Union's (GHG) emissions reduction commitment and their national inventories reports (NIR). Tier 1, the commonly used method to estimate emissions for NIR, provides a framework for measuring SOC stocks changes. However, estimations have high uncertainty, especially in response to crop management at regional and specific national contexts. Understanding and quantifying this uncertainty with accurate confidence interval is crucial for reliably reporting and support decision-making and policies that aims to mitigate greenhouse gases through soil C storage. Here, we used the Tier 3 method, consisting of process-based modelling, to address the issue of uncertainty quantification at national scale in France. Specifically, we used 20 Long-term croplands experiments (LTE) in France with more than 100 treatments taking into account different agricultural practices such as tillage, organic amendment, inorganic fertilization, cover crops, etc. These LTE were carefully selected because they are well characterized with periodic SOC stocks monitoring overtime and covered a wide range of pedo-climatic conditions. We applied linear mixed effect model to statistically model, as a function of soil, climate and cropping system characteristics, the uncertainty resulting from applying this Tier 3 approach. The model was fitted on the dataset yielded by comparing the simulated (with the Century model V 4.5) to the observed SOC changes on the LTE at hand. This mixed effect model will then be used to derive uncertainty related to the simulation of SOC stocks changes of the French Soil Monitoring

  18. Estimation of internal and external nitrogen for corals with a long-term 15N-labelling experiment and subsequent model calculations

    NASA Astrophysics Data System (ADS)

    Tanaka, Yasuaki; Grottoli, Andréa; Matsui, Yohei; Suzuki, Atsushi; Sakai, Kazuhiko

    2014-05-01

    Coral reef ecosystems maintain high primary productivity though the seawater is extremely oligotrophic. One of the hypotheses to explain this paradox is the recycling of nutrients in animal-algal symbiotic organisms such as corals. It is relatively easy to measure nutrient uptake rates by corals from seawater, but the proportion of internally circulating nutrients between the coral host and the endosymbiotic algae (zooxanthellae) is more challenging. Here, we performed a long-term and continuous 15N-labelling experiment to quantify the proportionate contribution of seawater (external N source) and the animal host (internal N source) to the total N influx in the endosymbiotic algae. Branches from the scleractinian corals Porites cylindrica and Montipora digitata from Okinawa, Japan, were cultured for 2 months in indoor, flow-through, filtered seawater tanks with the continuous supply of 15N-labelled nitrate. At the initial and after 2, 4, and 9 weeks of the study, coral branches were collected and the algal and animal fractions were separated for isotopic analyses. In both corals, the N isotope ratio of symbiotic algae exponentially increased and the values were much higher than those of the host tissue, suggesting that the algae had a faster turnover N time than the animal host. Algal and host N biomass normalized to the coral surface area slowly decreased in both coral species over the study period. To calculate the contribution of internal and external N, a simple mixing model of algal N metabolism was designed. Using differential equations of 15N balance and N biomass balance, F1 and F2 (external and internal N fluxes to symbiotic algae, respectively) were expressed as the functions of time. The model calculations showed that F2 was much higher than F1 in P. cylindrica and the percentage of internal N to the total influx N (PIN) was >70%. On the other hand, the contribution of F1 and F2 was comparable in M. digitata and the PIN was 40-70%. These results

  19. Soil-atmosphere fluxes of the greenhouse gases N2O, CO2 and CH4 from a long term compost experiment in Austria.

    NASA Astrophysics Data System (ADS)

    Spann, Caroline; Spiegel, Heide; Kitzler, Barbara

    2016-04-01

    The application of composts as fertilizers is becoming increasingly important to achieve a closed-loop economy. However, greenhouse gas (GHG) emissions, especially N2O, from agricultural fields may increase as well. In this study different compost types and N amounts were investigated, especially in terms of their GHG fluxes. We used the closed chamber method to estimate GHG flux rates over one vegetation period from an agricultural soil fertilized with different compost types. The study was conducted on a long term compost experiment site near Linz (Austria) with a crop rotation. The soil is a loamy silt and in 2015 maize was planted. Six different compost treatments were investigated. Organic waste compost (OWC) and farmyard manure compost (FMC) was applied with nitrogen concentrations of 175 (OWC1, FYC1) and 525 kg N ha-1 (OWC3, FYC3). Two compost treatments were fertilized additionally with 80 kg N ha.1 mineral fertilizer (OWC2, FYC2). One treatment (TN) was fertilized only with mineral fertilizer (120 kg N ha-1) and one treatment was not fertilized at all (C). Additionally to the GHG flux rates, ammonium and nitrate content, microbial biomass C and N and different enzyme activities were analysed in the top soil. Nitrous oxide (N2O) was emitted over the entire vegetation period with highest fluxes from April until June, until the plants have been established sufficiently. Overall, at the FMC treatments (FYC2, FYC3) highest fluxes were measured. Compared to FMC, lower N2O emissions were measured from the OWC treatments. The combination of compost and mineral N fertilization resulted in the highest N2O emissions, especially after precipitation events. The treatments OWC1 and FYC1 were not different from the control. Methane (CH4) was mainly taken up at all treatments, but uptake rates were lower at the high N input sites (OWC3, FYC3) with no differences between the compost types. No significant differences were found in the soil respiration rates.

  20. Factors Affecting Long-Term Abstinence from Substances Use

    ERIC Educational Resources Information Center

    Elsheikh, Salah Elgaily

    2008-01-01

    Objective: The purpose of this study is to explore the attitudes of abstainers from drug use that relate to the factors leading to long-term abstinence. Materials and Methods: Cross-sectional study was carried out in Al-Amal Hospital to examine, which attitudes of abstainers related to long-term abstinence. A random survey was conducted on 62…

  1. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    SciTech Connect

    Fitzek, Markus M.; Linggood, Rita M.; Adams, Judy; Munzenrider, John E. . E-mail: jmunzenrider@partners.org

    2006-04-01

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory.

  2. Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experience

    PubMed Central

    Khalil, Fahd; Fellahi, Saad; Ouslim, Hicham; Mhanna, Tarik; El Houmaidi, Amine; Aynaou, Mohammed; Boteng, Paapa Dua; Barki, Ali; Nouini, Yassine

    2015-01-01

    Objective To assess the long-term follow-up after ileocaecal continent cutaneous reservoir (ICCR) and to review the late complications. Patients and methods In all, 756 patients underwent an ICCR in our department, with long-term follow-up data available in 50 patients. The inclusion criterion was ICCR regardless of the indication and the exclusion criteria were orthotopic neobladder or other continent urinary diversions not performed with the ileocaecum. Patients were followed to record primary outcomes and late complications. Complications were stratified according to the Clavien–Dindo classification. Results The mean patient age was 44 years and pelvic malignancies were the first indication for urinary diversion. The mean (range) follow-up was 19 (9–36) years. A stoma stenosis was the most frequent outlet-related complication requiring re-intervention, followed by ischaemic outlet degeneration, and stoma incontinence. Six renal units (RUs) developed obstruction at the anastomotic site and were managed by open surgery. Three RUs had to be removed due to deterioration. A dederivation was necessary in three patients (6%). Conclusion The ICCR is a safe and established technique when an orthotopic pouch is impossible. The long-term follow-up shows acceptable complication rates and satisfactory continence conditions. However, large population studies are necessary to confirm this observation. PMID:26609442

  3. Effects of harvesting forest biomass on water and climate regulation services: A synthesis of long-term ecosystem experiments in eastern North America

    USGS Publications Warehouse

    Caputo, Jesse; Beier, Colin D; Groffman, Peter M; Burns, Douglas A.; Beall, Frederick D; Hazlett, Paul W.; Yorks, Thad E

    2016-01-01

    Demand for woody biomass fuels is increasing amidst concerns about global energy security and climate change, but there may be negative implications of increased harvesting for forest ecosystem functions and their benefits to society (ecosystem services). Using new methods for assessing ecosystem services based on long-term experimental research, post-harvest changes in ten potential benefits were assessed for ten first-order northern hardwood forest watersheds at three long-term experimental research sites in northeastern North America. As expected, we observed near-term tradeoffs between biomass provision and greenhouse gas regulation, as well as tradeoffs between intensive harvest and the capacity of the forest to remediate nutrient pollution. In both cases, service provision began to recover along with the regeneration of forest vegetation; in the case of pollution remediation, the service recovered to pre-harvest levels within 10 years. By contrast to these two services, biomass harvesting had relatively nominal and transient impacts on other ecosystem services. Our results are sensitive to empirical definitions of societal demand, including methods for scaling societal demand to ecosystem units, which are often poorly resolved. Reducing uncertainty around these parameters can improve confidence in our results and increase their relevance for decision-making. Our synthesis of long-term experimental studies provides insights on the social-ecological resilience of managed forest ecosystems to multiple drivers of change.

  4. The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake.

    PubMed

    Kim, Bok Hee; Kim, Mi-Ju; Lee, Yoonna

    2012-02-01

    This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.

  5. Medicare program: changes to the hospital inpatient prospective payment systems and fiscal year 2009 rates; payments for graduate medical education in certain emergency situations; changes to disclosure of physician ownership in hospitals and physician self-referral rules; updates to the long-term care prospective payment system; updates to certain IPPS-excluded hospitals; and collection of information regarding financial relationships between hospitals. Final rules.

    PubMed

    2008-08-19

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs to implement changes arising from our continuing experience with these systems, and to implement certain provisions made by the Deficit Reduction Act of 2005, the Medicare Improvements and Extension Act, Division B, Title I of the Tax Relief and Health Care Act of 2006, the TMA, Abstinence Education, and QI Programs Extension Act of 2007, and the Medicare Improvements for Patients and Providers Act of 2008. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are generally applicable to discharges occurring on or after October 1, 2008. We also are setting forth the update to the rate-of-increase limits for certain hospitals and hospital units excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2008. In addition to the changes for hospitals paid under the IPPS, this document contains revisions to the patient classifications and relative weights used under the long-term care hospital prospective payment system (LTCH PPS). This document also contains policy changes relating to the requirements for furnishing hospital emergency services under the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). In this document, we are responding to public comments and finalizing the policies contained in two interim final rules relating to payments for Medicare graduate medical education to affiliated teaching hospitals in certain emergency situations. We are revising the regulatory requirements relating to disclosure to patients of physician ownership or investment interests in hospitals and responding to public comments on a

  6. Case presentation: long-term treatment.

    PubMed

    Glucksman, Myron L

    2013-01-01

    The long-term (14 years) psychodynamic psychotherapy and pharmacotherapy of a depressed, suicidal, self-mutilating female patient is described. Her diagnoses included Chronic Posttraumatic Stress Disorder, Borderline Personality Disorder, and Recurrent Major Depression. Treatment was punctuated with repeated hospitalizations for self-mutilation (cutting) and suicidal ideation. A major determinant for her psychopathology was sexual abuse by her father from ages 6 to 14. This resulted in feelings of guilt and rage that she repressed and acted out through self-mutilating and suicidal behavior. A prolonged negative transference gradually became ambivalent, then positive. This was associated with her internalization of the healing qualities of the therapeutic relationship. She also gained insight into the reasons for her need to punish herself. Her initial self-representation as unworthy and bad was transformed into perceiving herself as a worthwhile, loving person. This case illustrates the role of long-term treatment for a complex, life-threatening, psychiatric disorder.

  7. Large-sized Fetal Striatal Grafts in Huntington’s Disease Do Stop Growing: Long-term Monitoring in the Florence Experience

    PubMed Central

    Mascalchi, Mario; Diciotti, Stefano; Paganini, Marco; Bianchi, Andrea; Ginestroni, Andrea; Lombardini, Letizia; Porfirio, Berardino; Conti, Renato; Di Lorenzo, Nicola; Vannelli, Gabriella Barbara; Gallina, Pasquale

    2014-01-01

    Development of six large nodules of solid tissue after bilateral human fetal striatal transplantation in four Huntington’s disease patients has raised concern about the safety of this experimental therapy in our setting. We investigated by serial MRI-based volumetric analysis the growth behaviour of such grafts. After 33-73 months from transplantation the size of five grafts was stable and one graft showed a mild decrease in size. Signs neither of intracranial hypertension nor of adjuctive focal neurological deficit have ever been observed. This supports long-term safety of the grafting procedure at our Institution. PMID:25642368

  8. Long-term biological investigations in space.

    PubMed

    Lotz, R G; Fuchs, H; Bertsche, U

    1975-01-01

    Missions in space within the next two decades will be of longer duration than those carried out up to the present time, and the effects of such long-term flights on biological organisms are unknown. Results of biological experiments that have been performed to date cannot be extrapolated to results in future flights because of the unknown influence of adaptation over a long period of time. Prior experiments with Axolotl, fishes, and vertebrates by our research team (in part with sounding rockets) showed that these specimens did not appear to be suitable for long-term missions on which minimization of expense, technique, and energy is required. Subsequent investigations have shown the suitability of the leech (Hirudo medicinalis), which consumes blood of mammals up to ten times its own weight (1 g) and can live more than 2 years without further food supply. Emphasis in the experiments with Hirudo medicinalis is placed on metabolic rhythm and motility. Resorption and diffusion in tissue, development, and growth under long-term effects of cosmic proton radiation and zero-gravity are other focal points. The constancy of cellular life in the mature animals is a point in favor of these specimens. We have also taken into account the synergistic effects of the space environment on the problems just mentioned. The life-support system constructed for the leech has been tested successfully in four sounding rocket flights and, on that basis, has been prepared for a long-term mission. Long-term investigations out of the terrestrial biosphere will provide us with information concerning the degree of adaptation of certain physiological and biochemical functions and as to what extent biological readjustment or repair processes can occur under the specific stress conditions of space flight.

  9. Long-term parenteral nutrition

    PubMed Central

    Ladefoged, Karin; Jarnum, Stig

    1978-01-01

    Nineteen patients (11 women and eight men) aged 20-68 received long-term parenteral nutrition, mostly at home, for six to 63 months (mean 19 months). Indications for LTPN were extensive, active Crohn's disease in three patients, intestinocutaneous fistulas in three, and short-bowel syndrome in the remaining 13 patients. Subclavian or intra-atrial (Broviac) catheters were most commonly used, for which the average life was four and seven months respectively. Complications of long-term parenteral nutrition included pneumothorax in four out of 48 subclavian vein punctures. Catheter-induced thrombosis of central veins was shown by phlebography 17 times in nine patients, and eight episodes of total occlusion occurred. Two of these patients had pulmonary infarction. Nineteen episodes of catheter sepsis occurred in 11 patients, but only one was fatal. Complications related to intestinal disease included intra-abdominal abscesses and intestinal fistulas, and disturbances of liver function. Five patients died, though in only two was death related to long-term parenteral nutrition. One of these patients died from catheter sepsis, the other had subdural haematoma possibly caused by anticoagulant treatment. Eight of the 14 surviving patients still needed parenteral nutrition. All received a disability pension, but six had an acceptable quality of life with almost normal social activities. Despite problems such as difficulties in maintaining standardised infusion programmes, it was concluded that long-term parenteral nutrition at home is practicable and consistent with an acceptable quality of life. ImagesFIG 2 PMID:98199

  10. Telemetry and Telestimulation via Implanted Devices Necessary in Long-Term Experiments Using Conscious Untethered Animals for the Development of New Medical Treatments

    NASA Astrophysics Data System (ADS)

    Sugimachi, Masaru; Kawada, Toru; Uemura, Kazunori

    Effective countermeasures against explosive increase in healthcare expenditures are urgently needed. A paradigm shift in healthcare is called for, and academics and governments worldwide are working hard on the application of information and communication technologies (ICT) as a feasible and effective measure for reducing medical cost. The more prevalent the disease and the easier disease outcome can be improved, the more efficient is medical ICT in reducing healthcare cost. Hypertension and diabetes mellitus are such examples. Chronic heart failure is another disease in which patients may benefit from ICT-based medical practice. It is conceivable that daily monitoring of hemodynamics together with appropriate treatments may obviate the expensive hospitalization. ICT potentially permit continuous monitoring with wearable or implantable medical devices. ICT may also help accelerate the development of new therapeutic devices. Traditionally effectiveness of treatments is sequentially examined by sacrificing a number of animals at a given time point. These inefficient and inaccurate methods can be replaced by applying ICT to the devices used in chronic animal experiments. These devices allow researchers to obtain biosignals and images from live animals without killing them. They include implantable telemetric devices, implantable telestimulation devices, and imaging devices. Implanted rather than wired monitoring and stimulation devices permit experiments to be conducted under even more physiological conditions, i.e., untethered, free-moving states. Wireless communication and ICT are indispensible technologies for the development of such telemetric and telestimulation devices.

  11. Identifying qualitative effects of different grazing types on below-ground communities and function in a long-term field experiment.

    PubMed

    Macdonald, Catriona A; Crawley, Michael J; Wright, Denis J; Kuczynski, Justin; Robinson, Lucinda; Knight, Rob; Al-Soud, Waleed Abu; Sørensen, Søren J; Deng, Ye; Zhou, Jizhong; Singh, Brajesh K

    2015-03-01

    Herbivory is an important modulator of plant biodiversity and productivity in grasslands, but our understanding of herbivore-induced changes on below-ground processes and communities is limited. Using a long-term (17 years) experimental site, we evaluated impacts of rabbit and invertebrate grazers on some soil functions involved in carbon cycling, microbial diversity, structure and functional composition. Both rabbit and invertebrate grazing impacted soil functions and microbial community structure. All functional community measures (functions, biogeochemical cycling genes, network association between different taxa) were more strongly affected by invertebrate grazers than rabbits. Furthermore, our results suggest that exclusion of invertebrate grazers decreases both microbial biomass and abundance of genes associated with key biogeochemical cycles, and could thus have long-term consequences for ecosystem functions. The mechanism behind these impacts are likely to be driven by both direct effects of grazing altering the pattern of nutrient inputs and by indirect effects through changes in plant species composition. However, we could not entirely discount that the pesticide used to exclude invertebrates may have affected some microbial community measures. Nevertheless, our work illustrates that human activity that affects grazing intensity may affect ecosystem functioning and sustainability, as regulated by multi-trophic interactions between above- and below-ground communities.

  12. The Effect of Modality on Long-Term Recognition Memory.

    ERIC Educational Resources Information Center

    Dean, Raymond S.; And Others

    1988-01-01

    The effects of visual and auditory modes of input on long-term memory were examined in two experiments, each with 40 and 80 undergraduates, respectively. In both experiments, visual stimulus attributes were a more salient dimension than were auditory features in the long-term encoding and retrieval process. (SLD)

  13. Long-term data archiving

    SciTech Connect

    Moore, David Steven

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  14. Infective endocarditis: determinants of long term outcome

    PubMed Central

    Netzer, R O M; Altwegg, S C; Zollinger, E; Täuber, M; Carrel, T; Seiler, C

    2002-01-01

    Objective: To evaluate predictors of long term prognosis in infective endocarditis. Design: Retrospective cohort study. Setting: Tertiary care centre. Patients: 212 consecutive patients with infective endocarditis between 1980 and 1995 Main outcome measures: Overall and cardiac mortality; event-free survival; and the following events: recurrence, need for late valve surgery, bleeding and embolic complications, cerebral dysfunction, congestive heart failure. Results: During a mean follow up period of 89 months (range 1–244 months), 56% of patients died. In 180 hospital survivors, overall and cardiac mortality amounted to 45% and 24%, respectively. By multivariate analysis, early surgical treatment, infection by streptococci, age < 55 years, absence of congestive heart failure, and > 6 symptoms or signs of endocarditis during active infection were predictive of improved overall long term survival. Independent determinants of event-free survival were infection by streptococci and age < 55 years. Event-free survival was 17% at the end of follow up both in medically–surgically treated patients and in medically treated patients. Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis. PMID:12067947

  15. Evaluation of pesticide monitoring strategies in agricultural streams based on the toxic-unit concept--experiences from long-term measurements.

    PubMed

    Bundschuh, Mirco; Goedkoop, Willem; Kreuger, Jenny

    2014-06-15

    The European Water Framework Directive requires surface water bodies to have a good chemical and ecological status. Although relatively few pesticides are included in the list of priority pollutants, they pose, due to their intrinsic biological activity, a significant risk for the integrity of aquatic ecosystems. In this context, the pesticide (up to 128 pesticides including some transformation products) exposure pattern in four agricultural streams and two rivers was determined from 2002 to 2011 under the umbrella of the Swedish national monitoring program employing time-proportional and grab sampling strategies, respectively. After transforming the measured pesticide concentrations into toxic units, the European Uniform Principles for algae (chronic), invertebrates and fish (both acute), which are partly employed as benchmark for pesticide regulation, were only occasionally (<2%) exceeded. Moreover, this evaluation showed no long-term trends over the years. However, recent publications suggested that those thresholds are not protective for ecosystem structure and function, indicating a risk of up to 20% and 35% of the samples from the agricultural streams and the rivers, respectively. Moreover, the monitoring data show a continuous but rather low toxic potential of pesticides for all three trophic levels throughout the year, which suggests pesticides as an evolutionary force in agriculturally impacted aquatic ecosystems. However, the flow-triggered sampling, which was implemented as an additional sampling strategy in one of the agricultural streams starting in 2006, displayed an up to 7-fold underestimation of the maximum concentration in terms of toxic units for daphnids and fish during run-off events. The present study thus underpins that the optimal sampling design for pesticide monitoring strongly depends on its overall purpose. If the long-term exposure pattern is of concern a time-proportional composite sampling strategy is recommended, while for an

  16. Californium versus cobalt brachytherapy combined with external-beam radiotherapy for IIB stage cervical cancer: long-term experience of a single institute

    PubMed Central

    Janulionis, Ernestas; Valuckas, Konstantinas Povilas; Samerdokiene, Vitalija; Atkocius, Vydmantas

    2015-01-01

    Purpose The purpose of this paper was to observe and compare long-term curative effects and complications of FIGO stage IIB cervical cancer patients (n = 232) treated with high-dose-rate (HDR) californium (252Cf) neutron or cobalt (60Co) photon intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT). Material and methods The EBRT dose to the small pelvis was 50 Gy in both groups. The brachytherapy component of 252Cf or 60Co was added in the 3rd week of EBRT, 5 fractions were performed once per week resulting in a total ICBT dose of 40 Gy/Gyeq (point A). Results Overall survival (OS) at 5, 10 and 15 years was 63.6%, 50.4% and 38.8% in the 252Cf group and 62.2%, 50.5%, 39.9%, in the 60Co group, respectively (p = 0.74). The percentage of tumour recurrence was statistically significantly lower in the 252Cf group with 7.4% versus 17.1% in the 60Co group (p = 0.02). Second primary cancers have developed similarly 9.1% and 8.1% cases for 252Cf and 60Co groups, respectively. Conclusions Our long-term retrospective study comparing 252Cf and 60Co isotopes with brachytherapy in combined treatment of FIGO IIB stage cervix carcinoma patients shows, that overall survival in the both groups are similar. However, the recurrence of tumour was significantly lower in the 252Cf group. The incidence of second primary cancers was similar in both groups. PMID:26622239

  17. Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

    SciTech Connect

    Das, Neelan Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

    2011-10-15

    Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa{sup Registered-Sign}, Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4-270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

  18. Triticale (XTriticosecale W.) Heavy Metal Upptake as a Possibility of Food Chain Pollution in a Long-Term Field Experiment in Hungary

    NASA Astrophysics Data System (ADS)

    László Phd, M., ,, Dr.

    2009-04-01

    Some trace elements are dangerous because they tend to bioaccumulate in food chain. Bioaccumulation means an increase in the concentration of a chemical in a biological organism over time, compared to the chemical's concentration in they environment. Compounds accumulate in living things any time they are taken up and stored faster han they are broken down (metabolize) or extreted. Triticale is the stabilized man-made hybrid of wheat (Triticum eastivum L.) and rye (Secale cereale L.). Wheat-rye hybrids date back to 1875, it was only in 1953 that the first North American triticale breeding programme was initiated at the University Manitoba. Globally, triticale is used primary for livestock feed today. NPKCaMg fertilization effects were estimated on trace element bioavailability by Triticale in a long-term field experiment on a Haplic Luvisol (acidic sandy brown forest soil) at Nyírlugos in East-Hungary in 1998. Soil geochemical parameters were as follow: humus 0.6%, pH (H2O) 5.8, pH (KCl) 4.6, total N 32.8 mg . kg-1, AL (ammonium lactate soluble)- P2O5 43 mg . kg-1, AL-K2O 52 mg . kg-1. The experiments involved 32 NPKCaMg treatments and their combinations in 4 replications giving a total of 128 plots from 1980. N levels were 0, 50, 100, 150 kg . ha-1 . yr-1, P2O5 and K2O 0, 60, 120, 180 kg . ha-1 . yr-1, CaCO3 0, 250, 500, 1000 kg . ha-1 . yr-1 and MgCO3 doses were 0, 140, 280 kg . ha-1 . yr-1. Plot brutto size was 50 m2. The main results were as follows. Main soil chemical parameters depend on NPKCaMg treatments. Soil pH (H2O) and pH (KCl) values ranged from 4.6 to 6.3 and from 3.5 to 5.8 indicating wide range from extremely acidic to slightly acidic. Ca, Fe, Mg, Mn and Al element concentrations shown a large variability too in interaction with fertilization doses and pH values (Ca 36-594 mg . kg-1, Fe 61-90 mg . kg-1, Mg 5-42 mg . kg-1, Mn 16-36 mg . kg-1, Al 79-118 mg . kg-1). The better soil pH (H2O), pH (KCl) and Ca parameters resulted by NPKCaMg combinations

  19. First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up.

    PubMed

    Gersey, Zachary C; Burks, S Shelby; Anderson, Kim D; Dididze, Marine; Khan, Aisha; Dietrich, W Dalton; Levi, Allan D

    2017-03-01

    OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were

  20. Trends in clinical features, postoperative outcomes, and long-term survival for gastric cancer: a Western experience with 1,278 patients over 30 years

    PubMed Central

    2014-01-01

    Background The aim of the present study was to identify temporal trends in long-term survival and postoperative outcomes and to analyze prognostic factors influencing the prognosis of patients with gastric cancer (GC) treated in a 30-year interval in a tertiary referral Western institution. Methods Between January 1980 and December 2010, 1,278 patients who were diagnosed with GC at the Digestive Surgery Department, Catholic University of Rome, Italy, were identified. Among them, 936 patients underwent surgical resection and were included in the analysis. Results Over time there was a significant improvement in postoperative outcomes. Morbidity and mortality rates decreased to 19.4% and 1.6%, respectively, in the last decade. By contrast, the multivisceral resection rate steadily increased from 12.7% to 29.6%. The overall five-year survival rate steadily increased over time, reaching 51% in the last decade, and 64.5% for R0 resections. Multivariate analysis showed a higher probability of overall survival for early stages (I and II), extended lymphadenectomy, and R0 resections. Conclusions Over three decades there was a significant improvement in perioperative and postoperative care and a steady increase in overall survival. PMID:25030691

  1. Long-term ELBARA-II Assistance to SMOS Land Product and Algorithm Validation at the Valencia Anchor Station (MELBEX Experiment 2010-2013)

    NASA Astrophysics Data System (ADS)

    Lopez-Baeza, Ernesto; Wigneron, Jean-Pierre; Schwank, Mike; Miernecki, Maciej; Kerr, Yann; Casal, Tania; Delwart, Steven; Fernandez-Moran, Roberto; Mecklenburg, Susanne; Coll Pajaron, M. Amparo; Salgado Hernanz, Paula

    The main activity of the Valencia Anchor Station (VAS) is currently now to support the validation of SMOS (Soil Moisture and Ocean Salinity) Level 2 and 3 land products (soil moisture, SM, and vegetation optical depth, TAU). With this aim, the European Space Agency (ESA) has provided the Climatology from Satellites Group of the University of Valencia with an ELBARA-II microwave radiometer under a loan agreement since September 2009. During this time, brightness temperatures (TB) have continuously been acquired, except during normal maintenance or minor repair interruptions. ELBARA-II is an L-band dual-polarization radiometer with two channels (1400-1418 MHz, 1409-1427 MHz). It is continuously measuring over a vineyard field (El Renegado, Caudete de las Fuentes, Valencia) from a 15 m platform with a constant protocol for calibration and angular scanning measurements with the aim to assisting the validation of SMOS land products and the calibration of the L-MEB (L-Band Emission of the Biosphere) -basis for the SMOS Level 2 Land Processor- over the VAS validation site. One of the advantages of using the VAS site is the possibility of studying two different environmental conditions along the year. While the vine cycle extends mainly between April and October, during the rest of the year the area remains under bare soil conditions, adequate for the calibration of the soil model. The measurement protocol currently running has shown to be robust during the whole operation time and will be extended in time as much as possible to continue providing a long-term data set of ELBARA-II TB measurements and retrieved SM and TAU. This data set is also showing to be useful in support of SMOS scientific activities: the VAS area and, specifically the ELBARA-II site, offer good conditions to control the long-term evolution of SMOS Level 2 and Level 3 land products and interpret eventual anomalies that may obscure sensor hidden biases. In addition, SM and TAU that are currently

  2. Long-term outcomes of high dose treatment and autologous stem cell transplantation in follicular and mantle cell lymphomas – a single centre experience

    PubMed Central

    Boltezar, Lucka; Pintaric, Karlo; Pretnar, Jože; Pohar Perme, Maja

    2017-01-01

    Abstract Background Advanced follicular lymphoma (FL) and mantle cell lymphoma (MCL) are incurable diseases with conventional treatment. The high dose treatment (HDT) with autologous stem cell transplantation (ASCT), however, offers a certain proportion of these patients the prospect of a prolonged disease-free and overall survival. The aim of this study was to investigate the event free survival (EFS) and overall survival (OS) in patients with FL and MCL treated with ASCT. Patients and methods Seventeen patients with FL and 29 patients with MCL were included, 15 of them were transplanted to consolidate the response to second line treatment and 24 to consolidate their first remission, respectively. All were conditioned with total body irradiation (TBI) and high dose cyclophosphamide between 2006 and 2014 and all were transplanted with peripheral blood stem cells. Results The estimated 5-year OS for FL was 87.8% (95% confidence interval [CI] 59.5%–96.8%) and for MCL 79.3% (95% CI 56.1%–91.1%), respectively. The estimated 5-year EFS for FL was 76.0% (95% CI 48.0%–90.3%) and for MCL 69.8% (95% CI 45.5%–84.8%), respectively. There were no secondary hematological malignancies observed in either group. Conclusions Based on above results, the ASCT with TBI is a good treatment option in terms of long-term survival for patients with follicular and mantle cell lymphoma demonstrating a relatively low rate of late toxicities and secondary malignancies.

  3. Endovascular parent-artery occlusion of large or giant unruptured internal carotid artery aneurysms. A long-term single-center experience.

    PubMed

    Shimizu, Kampei; Imamura, Hirotoshi; Mineharu, Yohei; Adachi, Hidemitsu; Sakai, Chiaki; Tani, Shoichi; Arimura, Koichi; Beppu, Mikiya; Sakai, Nobuyuki

    2017-03-01

    The development of stent-like devices has increased treatment options for complex internal carotid artery (ICA) aneurysms, but the optimal treatment remains unclear. The purpose of this study was to evaluate the safety and efficacy of endovascular parent-artery occlusion (PAO) for ICA aneurysms. We retrospectively reviewed 28 patients with unruptured ICA aneurysms ⩾10mm treated with PAO between April 2002 and March 2015 at our institution. Patients who developed neurologic symptoms or with venous-phase delay >2s during balloon test occlusion were not treated by PAO. Patients with venous-phase delays of 1-2s underwent superficial temporal artery to middle cerebral artery (STA-MCA) bypass prior to PAO. The median patient age was 65 (range, 26-84)years. Nineteen aneurysms (68%) were located in the cavernous segment. The median aneurysm size was 25 (range 11-40)mm. Venous-phase delay of 1-2s was observed in five patients. Perioperative ischemic complications (N=9, 32%), which occurred within 30days after treatment, were significantly associated with venous-phase delays of 1-2s (p<0.01) and history of hypertension (p<0.01). Six-month morbidity was observed in one (3.6%) patient. Complete occlusion at final follow-up and delayed (i.e. ⩾31days after treatment) ischemic events were observed in 100% and 0% of patients, respectively, over a median period of 63 (range, 6-147) months. Despite the high frequency of perioperative ischemic episodes, endovascular PAO with selective use of STA-MCA bypass showed excellent long-term outcomes in patients with unruptured ICA aneurysms ⩾10mm.

  4. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.

    PubMed

    2016-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and

  5. A year of more and less. Number of hospital deals drops, but more facilities change hands. 1998 hospital mergers, acquisitions, joint ventures, long-term leases and other partnerships.

    PubMed

    Bellandi, D

    1999-01-11

    1998 wasn't quite as busy a year for hospital dealmakers as 1997, but those who went shopping bought in volume. Although the number of deals decreased by almost 9%, 687 hospitals changed hands last year, according to our fifth annual tally of merger and acquisition activity.

  6. Sex Differences among the Long-Term Mentally Disabled.

    ERIC Educational Resources Information Center

    Mowbray, Carol T.; Chamberlain, Philip

    1986-01-01

    Describes the experientially determined problems of long-term mentally disabled women. Reviews of 320 hospital records of patients in hospitals throughout Michigan showed significant sex differences for client age, marital status, living arrangement, diagnosis, functioning level, voluntary/involuntary status, admission information, medications,…

  7. Soil organic carbon (SOC) accumulation in rice paddies under long-term agro-ecosystem experiments in southern China - VI. Changes in microbial community structure and respiratory activity

    NASA Astrophysics Data System (ADS)

    Liu, D.; Liu, X.; Liu, Y.; Li, L.; Pan, G.; Crowley, D.; Tippkötter, R.

    2011-02-01

    Biological stabilization within accumulated soil organic carbon (SOC) has not been well understood, while its role in physical and chemical protection as well as of chemical recalcitrance had been addressed in Chinese rice paddies. In this study, topsoil samples were collected and respiratory activity measured in situ following rice harvest under different fertilization treatments of three long-term experimental sites across southern China in 2009. The SOC contents, microbial biomass carbon (SMBC) and nitrogen (SMBN) were analysed using chemical digestion and microbial community structure assessment via clony dilute plate counting methods. While SOC contents were consistently higher under compound chemical fertilization (Comp-Fert) or combined organic and inorganic fertilization (Comb-Fert) compared to N fertilization only (N-Fert), there was significantly higher fungal-bacterial ratio under Comb-Fert than under N-Fert and Comp-Fert. When subtracting the background effect under no fertilization treatment (Non-Fert), the increase both in SMBC and SMBN under fertilization treatment was found very significantly correlated to the increase in SOC over controls across the sites. Also, the ratio of culturable fungal to bacterial population numbers (F/B ratio) was well correlated with soil organic carbon contents in all samples across the sites studied. SOC accumulation favoured a build-up the microbial community with increasing fungal dominance in the rice paddies under fertilization treatments. While soil respiration rates were high under Comb-Fert as a result of enhanced microbial community build-up, the specific soil respiratory activity based on microbial biomass carbon was found in a significantly negatively correlation with the SOC contents for overall samples. Thus, a fungal-dominated microbial community seemed to slow SOC turnover, thereby favouring SOC accumulation under Comp-Fert or under Comb-Fert in the rice paddies. Therefore, the biological stabilization

  8. Seasonal influenza vaccine (A/New York/39/2012) effectiveness against influenza A virus of health care workers in a long term care facility attached with the hospital, Japan, 2014/15: A cohort study.

    PubMed

    Ishikane, Masahiro; Kamiya, Hajime; Kawabata, Kunio; Higashihara, Masahiko; Sugihara, Motohiro; Tabuchi, Ayako; Kuwabara, Masao; Yahata, Yuichiro; Yamagishi, Takuya; Odagiri, Takato; Sugiki, Yuko; Ohmagari, Norio; Matsui, Tamano; Oishi, Kazunori

    2016-11-01

    The 2014/15 influenza season started earlier than usual, and intense activity was reflection of circulation of antigenically-drifted and vaccine-mismatched dominant A(H3N2) viruses. Although inpatients and health-care workers (HCWs) had a high influenza vaccination coverage rate well prior to the beginning of influenza season, numerous outbreaks of influenza A(H3N2) infection with fatal cases were reported in long-term care facilities (LTCFs) in Japan during 2014/15 influenza season. In January 2015, we were given opportunity to conduct outbreak investigation of influenza A at facility A (LTCF attached with hospital) in Western part of Japan. We evaluated overall and occupation-stratified influenza vaccine effectiveness (VE) among HCWs at facility A using a retrospective cohort design. Overall VE, occupation-stratified VE and adjusted VE (AVE) with 95% confidence intervals (CIs) were estimated using the following formula: (1-relative risks (RR) or 1-adjusted RR) × 100%. Overall vaccine coverage rate among HCWs was 85%. Overall VE for HCWs was 28% (95% CI: -70 to 67) and overall AVE was 3% (95% CI: -34 to 30). Although there was no severe cases, our results indicated that even with high vaccination coverage rate with appropriate vaccination timing, the VE was low for HCWs, which echoes with previously reported VE from other northern hemisphere countries. However, rehabilitation group who had high awareness against influenza as a group and carried out intensive precautions from early influenza season had no cases. We conclude that multiple preventive measures in addition to high vaccination rate is necessary for preventing influenza of HCWs working at LCTFs.

  9. Long-Term Outcomes of Young Adults Exposed to Maltreatment: The Role of Educational Experiences in Promoting Resilience to Crime and Violence in Early Adulthood

    ERIC Educational Resources Information Center

    Smith, Carolyn A.; Park, Aely; Ireland, Timothy O.; Elwyn, Laura; Thornberry, Terence P.

    2013-01-01

    This study investigates whether positive educational experiences in midadolescence mitigate the impact of exposure to substantiated maltreatment and reduces young adult antisocial behavior. While there is theoretical and empirical support for the mediating or moderating role of educational experiences on maltreatment and antisocial outcomes, few…

  10. Long-term Impact of Environmental Public Health Disaster on Health System Performance: Experiences from the Graniteville, South Carolina Chlorine Spill

    PubMed Central

    Runkle, Jennifer R; Zhang, Hongmei; Karmaus, Wilfried; Brock-Martin, Amy; Svendsen, Erik R.

    2014-01-01

    Objective In the aftermath of an Environmental Public Health Disaster (EPHD) a healthcare system may be the least equipped to respond. Preventable visits for ambulatory care sensitive conditions (ACSCs) may be used as a population-based indicator to monitor health system access post-disaster. The objective of this study was to examine whether ACSCs rates among vulnerable sub-populations are sensitive to the impact of a disaster. Methods We conducted a retrospective analysis using Poisson regression with generalized estimating equations to calculate change in monthly ACSC visits at the disaster site in the post-disaster period compared to the pre-disaster period after adjusting for parallel changes in two control groups. Results The adjusted rate of an ACSC hospital visit pre-disaster for the direct group was 1.68 times the rate for the primary control group (95% CI: 1.47, 1.93), while the adjusted ACSC hospital rate post-disaster for the direct group was 3.10 times the rate for the primary control group (95% CI: 1.97, 5.18). For emergency department ACSC visits, the adjusted rate among those directly affected pre-disaster were 1.82 times the rate for the primary control group (95% CI: 1.61, 2.08), while the adjusted ACSC rate post-disaster was 2.81 times the rate for the primary control group (95% CI: 1.92, 5.17). Conclusions Results revealed increased demand on the health system altered health services delivery for vulnerable populations directly impacted by the disaster. Preventable visits for ACSCs may advance meaningful use practice and public health surveillance by identifying and characterizing healthcare disparities during disaster recovery. PMID:23263318

  11. Sleep facilitates long-term face adaptation.

    PubMed

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-10-22

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

  12. Sleep facilitates long-term face adaptation

    PubMed Central

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as ‘storage’. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation—which are usually not considered to play a relevant role in mnemonic processes—with learning and memory, and at the same time reveal a new function of sleep in cognition. PMID:23986109

  13. Asthma Medicines: Long-Term Control

    MedlinePlus

    ... Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic versions of ... form, they are used exclusively for long-term control; they are not very effective for acute symptoms. ...

  14. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)

    Schmitt, Raymond W.; Brown, Neil L.

    2005-01-01

    Our long-term goal is to establish a reliable system for monitoring surface salinity around the global ocean. Salinity is a strong indicator of the freshwater cycle and has a great influence on upper ocean stratification. Global salinity measurements have potential to improve climate forecasts if an observation system can be developed. This project is developing a new internal field conductivity cell that can be protected from biological fouling for two years. Combined with a temperature sensor, this foul-proof cell can be deployed widely on surface drifters. A reliable in-situ network of surface salinity sensors will be an important adjunct to the salinity sensing satellite AQUARIUS to be deployed by NASA in 2009. A new internal-field conductivity cell has been developed by N Brown, along with new electronics. This sensor system has been combined with a temperature sensor to make a conductivity - temperature (UT) sensor suitable for deployment on drifters. The basic sensor concepts have been proven on a high resolution CTD. A simpler (lower cost) circuit has been built for this application. A protection mechanism for the conductivity cell that includes antifouling protection has also been designed and built. Mr. A.Walsh of our commercial partner E-Paint has designed and delivered time-release formulations of antifoulants for our application. Mr. G. Williams of partner Clearwater Instrumentation advised on power and communication issues and supplied surface drifters for testing.

  15. Metagenomic Analysis of the Dynamic Changes in the Gut Microbiome of the Participants of the MARS-500 Experiment, Simulating Long Term Space Flight.

    PubMed

    Mardanov, A V; Babykin, M M; Beletsky, A V; Grigoriev, A I; Zinchenko, V V; Kadnikov, V V; Kirpichnikov, M P; Mazur, A M; Nedoluzhko, A V; Novikova, N D; Prokhortchouk, E B; Ravin, N V; Skryabin, K G; Shestakov, S V

    2013-07-01

    A metagenomic analysis of the dynamic changes of the composition of the intestinal microbiome of five participants of the MARS-500 experiment was performed. DNA samples were isolated from the feces of the participants taken just before the experiment, upon 14, 30, 210, 363 and 510 days of isolation in the experimental module, and two weeks upon completion of the experiment. The taxonomic composition of the microbiome was analyzed by pyrosequencing of 16S rRNA gene fragments. Both the taxonomic and functional gene content of the microbiome of one participant were analyzed by whole metagenome sequencing using the SOLiD technique. Each participant had a specific microbiome that could be assigned to one of three recognized enterotypes. Two participants had enterotype I microbiomes characterized by the prevalence of Bacteroides, while the microbiomes of two others, assigned to type II, were dominated by Prevotella. One participant had a microbiome of mixed type. It was found that (1) changes in the taxonimic composition of the microbiomes occurred in the course of the experiment, but the enterotypes remained the same; (2) significant changes in the compositions of the microbiomes occurred just 14-30 days after the beginning of the experiment, presumably indicating the influence of stress factors in the first stage of the experiment; (3) a tendency toward a reversion of the microbiomes to their initial composition was observed two weeks after the end of the experiment, but complete recovery was not achieved. The metagenomic analysis of the microbiome of one of the participants showed that in spite of variations in the taxonomic compositions of microbiomes, the "functional" genetic composition was much more stable for most of the functional gene categories. Probably in the course of the experiment the taxonomic composition of the gut microbiome was adaptively changed to reflect the individual response to the experimental conditions. A new, balanced taxonomic composition

  16. Long-Term Planning in Higher Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This report presents the concepts and issues discussed at a Regional Symposium on Long-term Planning in Higher Education held in Dhaka, Bangladesh, September 21-30, 1986. Chapter 1 explores some fundamental issues about the rationale for the objectives of long-term planning. It defines long-term planning in higher education, considers its…

  17. Long Term TOA - M Data and Information

    Atmospheric Science Data Center

    2015-06-30

    A Long-Term TOA and Constrained Surface Radiation Budget Project A Long-Term TOA and Constrained Surface Readiation Budget Dataset Using Merged CERES, ... and apply the knowledge to existing data to develop long-term (nearly 30 years) consistent and calibrated data product (TOA irradiances ...

  18. Behavior and reproduction of invertebrate animals during and after a long-term microgravity: space experiments using an Autonomous Biological System (ABS).

    PubMed

    Ijiri, K; Mizuno, R; Narita, T; Ohmura, T; Ishikawa, Y; Yamashita, M; Anderson, G; Poynter, J; MacCallum, T

    1998-12-01

    Aquatic invertebrate animals such as Amphipods, Gastropods (pond snails), Ostracods and Daphnia (water flea) were placed in water-filled cylindrical vessels together with water plant (hornwort). The vessels were sealed completely and illuminated with a fluorescent lamp to activate the photosynthesis of the plant for providing oxygen within the vessels. Such ecosystem vessels, specially termed as Autonomous Biological System or ABS units, were exposed to microgravity conditions, and the behavior of the animals and their reproduction capacity were studied. Three space experiments were carried out. The first experiment used a Space shuttle only and it was a 10-day flight. The other two space experiments were carried out in the Space station Mir (Shuttle/Mir mission), and the flight units had been kept in microgravity for 4 months. Daphnia produced their offspring during a 10-day Shuttle flight. In the first Mir experiment, no Daphnia were detected when recovered to the ground. However, they were alive in the second Mir experiment. Daphnia were the most fragile species among the invertebrate animals employed in the present experiments. All the animals, i.e., Amphipods, pond snails, Ostracods and Daphnia had survived for 4 months in space, i.e., they had produced their offspring or repeated their life-cycles under microgravity. For the two Mir experiments, in both the flight and ground control ecosystem units, an inverse relationship was noted between the number of Amphipods and pond snails in each unit. Amphipods at 10 hours after the recovery to the ground frequently exhibited a movement of dropping straight-downward to the bottom of the units. Several Amphipods had their legs bent abnormally, which probably resulted from some physiological alterations during their embryonic development under microgravity. From the analysis of the video tape recorded in space, for Ostracods and Daphnia, a half of their population were looping under microgravity. Such looping animals

  19. The neuronal response at extended timescales: long-term correlations without long-term memory

    PubMed Central

    Soudry, Daniel; Meir, Ron

    2014-01-01

    Long term temporal correlations frequently appear at many levels of neural activity. We show that when such correlations appear in isolated neurons, they indicate the existence of slow underlying processes and lead to explicit conditions on the dynamics of these processes. Moreover, although these slow processes can potentially store information for long times, we demonstrate that this does not imply that the neuron possesses a long memory of its input, even if these processes are bidirectionally coupled with neuronal response. We derive these results for a broad class of biophysical neuron models, and then fit a specific model to recent experiments. The model reproduces the experimental results, exhibiting long term (days-long) correlations due to the interaction between slow variables and internal fluctuations. However, its memory of the input decays on a timescale of minutes. We suggest experiments to test these predictions directly. PMID:24744724

  20. Long-term outcomes of young adults exposed to maltreatment: the role of educational experiences in promoting resilience to crime and violence in early adulthood.

    PubMed

    Smith, Carolyn A; Park, Aely; Ireland, Timothy O; Elwyn, Laura; Thornberry, Terence P

    2013-01-01

    This study investigates whether positive educational experiences in midadolescence mitigate the impact of exposure to substantiated maltreatment and reduces young adult antisocial behavior. While there is theoretical and empirical support for the mediating or moderating role of educational experiences on maltreatment and antisocial outcomes, few prospective studies exist. In this exploratory study, data are from the Rochester Youth Development Study (RYDS), a longitudinal panel study of 1,000 adolescents. The original sample included 73% males, and 85% African American or Hispanic youth of whom about 20% were maltreated. Measures in this study are from a combination of interview data and official records collected through age 23. Outcomes include self-reported crime and violence, arrest, and partner violence perpetration. Educational variables include midadolescent self-report of high school graduation, educational aspiration, college expectation, school commitment, teacher attachment, self-reported grades, school GPA, attendance, and an additive index of all school assets. Multivariate path analysis controlled for gender, race/ethnicity, poverty, and early antisocial behavior. Path analysis examined whether educational experiences mediated the impact of maltreatment on antisocial outcomes. Although maltreatment was significantly predictive of criminal and violent behaviors, it only was weakly associated with educational experiences. The impact of maltreatment on arrest was weakly mediated (reduced) by educational GPA and by high school graduation. The additive index also mediated the impact of maltreatment on crime and violence. Maltreatment's impact on partner violence was also weakly mediated by school GPA. Interaction terms were used to test for moderation: only one significant effect was found: school GPA protects maltreated youth from perpetration of partner violence as young adults. Although there are few significant effects in a number of models, the

  1. An assessment of the long-term drift in SBUV total ozone data, based on comparison with the Dobson network. [Solar Backscatter UltraViolet experiment

    NASA Technical Reports Server (NTRS)

    Fleig, Albert J.; Bhartia, Pawan K.; Silberstein, David S.

    1986-01-01

    Six years of total ozone data derived from the Nimbus 7 Solar Backscatter Ultraviolet (SBUV) experiment are compared with results from 41 Dobson stations to determine year-to-year changes in addition to the monthly bias change for individual stations and for the network. The SBUV measurements are found to drift against the Dobson stations with a linear trend of .38 + or - .13 percent/yr. The cause of the drift could not be separated between residual uncorrected drift in the SBUV instrument, limited sensitivity of the SBUV to increases in tropospheric ozone, and the effect of local increases in pollution level on individual Dobson stations.

  2. Is Early Experience Destiny? Review of Research on Long-Term Outcomes following International Adoption with Special Reference to the British Chinese Adoption Study

    PubMed Central

    Grant, Margaret; Rushton, Alan; Simmonds, John

    2016-01-01

    The pathway from adverse early experience to adulthood for internationally adopted children is complex in identifying key influences, impacts, and outcomes. This review arose from the authors' involvement in the British Chinese Adoption Study, a recent outcomes study that explored the links between early orphanage care, adoptive experiences, and midadulthood. It differs from previous reviews in focusing on a greater length of time since adoption. Both quantitative and qualitative studies were included to allow for examination of a fuller range of adult-related outcomes rather than mental health scores alone. The sampling, methods, and results of reviewed articles are summarised and a critical commentary is provided. Despite methodological differences and identified strengths and weaknesses, conclusions are drawn on the basis of the evidence available. Special attention is paid to the interpretation of negative outcomes. Findings identify areas that should be explored further in order to gain a fuller understanding of midlife outcomes of people who experienced a poor start in life followed by international adoption. Such studies help in refining lifespan developmental theories. PMID:27247964

  3. Sources of variation in growth, form, and survival in dwarf and normal-stature pitch pines (Pinus rigida, Pinaceae) in long-term transplant experiments.

    PubMed

    Fang, Wei; Taub, Daniel R; Fox, Gordon A; Landis, R Matthew; Natali, Susan; Gurevitch, Jessica

    2006-08-01

    Determining the relative contributions of genetic and environmental factors to phenotypic variation is critical for understanding the evolutionary ecology of plant species, but few studies have examined the sources of phenotypic differentiation between nearby populations of woody plants. We conducted reciprocal transplant experiments to examine sources of variation in growth rate, form, survival, and maturation in a globally rare dwarf population of pitch pine (Pinus rigida) and in surrounding populations of normal-stature pitch pines on Long Island, New York. Transplants were monitored over a 6-yr period. The influence of seedling origin on height, growth rate, survival, and form (single-stemmed vs. multi-stemmed growth habit) was much smaller than the effect of transplanting location. Both planting site and seed origin were important factors in determining time to reproduction; seedlings originating from dwarf populations and seedlings planted at the normal-stature site reproduced earliest. These results suggest that many of the differences between dwarf and normal-stature pitch pines may be due more to plastic responses to environmental factors than to genetic differentiation among populations. Therefore, preservation of the dwarf pine habitat is essential for preserving dwarf pine communities; the dwarf pines cannot be preserved ex situ.

  4. Mid-term and long-term follow-up of intracranial aneurysms treated by the p64 Flow Modulation Device: a multicenter experience

    PubMed Central

    Briganti, Francesco; Leone, Giuseppe; Ugga, Lorenzo; Marseglia, Mariano; Macera, Antonio; Manto, Andrea; Delehaye, Luigi; Resta, Maurizio; Resta, Mariachiara; Burdi, Nicola; Nuzzi, Nunzio Paolo; Divenuto, Ignazio; Caranci, Ferdinando; Muto, Mario; Solari, Domenico; Cappabianca, Paolo; Maiuri, Francesco

    2017-01-01

    Background Experience with the endovascular treatment of cerebral aneurysms using the p64 Flow Modulation Device is still limited. This study discusses the results and complications of this new flow diverter device. Methods 40 patients (30 women, 10 men) with 50 cerebral aneurysms treated in six Italian neurointerventional centers with the p64 Flow Modulation Device between April 2013 and September 2015 were retrospectively reviewed. Results Complete occlusion was obtained in 44/50 aneurysms (88%) and partial occlusion in 3 (6%). In the other three aneurysms (6%), two cases of asymptomatic in-stent thrombosis and one intraprocedural occlusion of the parent vessel occurred. Technical complications were observed in eight procedures (16%). Permanent morbidity due to acute in-stent thrombosis and consequent ischemic stroke occurred in one patient (2.5%). No delayed aneurysm rupture, subarachnoid or intraparenchymal hemorrhage, or ischemic complications occurred and there were no deaths. Conclusions Endovascular treatment with the p64 Flow Modulation Device is a safe treatment for unruptured cerebral aneurysms, resulting in a high rate of occlusion. As with other flow diverter devices, we recommend this treatment mainly for large-necked aneurysms of the internal carotid artery siphon. However, endovascular treatment with the p64 device should also be encouraged in difficult cases such as aneurysms of the posterior circulation and beyond the circle of Willis. PMID:27439887

  5. Phenotypic response of plants to simulated climate change in a long-term rain-manipulation experiment: a multi-species study.

    PubMed

    Hänel, Sabine; Tielbörger, Katja

    2015-04-01

    Many species will need to adapt to the observed climate change in order to persist. However, research about adaptation or phenotypic plasticity in response to climate change is rare. In particular, field studies are lacking that impose artificial selection for a sufficiently long time to elicit changes in phenotypic and genotypic structure of populations. Here, we present findings for an 8-year field experiment with 16 annual plant species that tested potentially adaptive phenotypic responses to precipitation change. In both a Mediterranean and a semi-arid site, annual precipitation was manipulated (±30%) and phenotypic response was recorded. We measured flowering time as a key trait related to climatic conditions and biomass and survival as fitness correlates. Differences in traits among treatments were compared to trait shifts between sites, according to space-for-time approaches. In the drier site, phenology was accelerated, but within that site, experimental drought delayed phenology, probably as a plastic response to delayed ontogenetic development. Biomass was smaller in the dry treatments of that site, but it was also reduced in irrigated plots in both sites, indicating more intense competition. The shifts from limitation by drought to limitation by competition corresponded to patterns along the gradient. This also implies a larger negative impact of climate change in the drier site. Our results suggest that experimental selection in the field caused directional responses in most species, but these were not necessarily adaptive. Furthermore, competitive release imposed by climate change may revert direct negative effects of rainfall change in determining plant performance.

  6. Long-term effects of hydrated lime and quicklime on the decay of human remains using pig cadavers as human body analogues: Field experiments.

    PubMed

    Schotsmans, Eline M J; Fletcher, Jonathan N; Denton, John; Janaway, Robert C; Wilson, Andrew S

    2014-05-01

    An increased number of police enquiries involving human remains buried with lime have demonstrated the need for more research into the effect of different types of lime on cadaver decomposition and its micro-environment. This study follows previous studies by the authors who have investigated the effects of lime on the decay of human remains in laboratory conditions and 6 months of field experiments. Six pig carcasses (Sus scrofa), used as human body analogues, were buried without lime with hydrated lime (Ca(OH)2) and quicklime (CaO) in shallow graves in sandy-loam soil in Belgium and recovered after 17 and 42 months of burial. Analysis of the soil, lime and carcasses included entomology, pH, moisture content, microbial activity, histology and lime carbonation. The results of this study demonstrate that despite conflicting evidence in the literature, the extent of decomposition is slowed down by burial with both hydrated lime and quicklime. The more advanced the decay process, the more similar the degree of liquefaction between the limed and unlimed remains. The end result for each mode of burial will ultimately result in skeletonisation. This study has implications for the investigation of clandestine burials, for a better understanding of archaeological plaster burials and potentially for the interpretation of mass graves and management of mass disasters by humanitarian organisation and DVI teams.

  7. Climate Predictability and Long Term Memory

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Blender, R.; Fraedrich, K.; Liu, Z.

    2010-09-01

    The benefit of climate Long Term Memory (LTM) for long term prediction is assessed using data from a millennium control simulation with the atmosphere ocean general circulation model ECHAM5/MPIOM. The forecast skills are evaluated for surface temperature time series at individual grid points. LTM is characterised by the Hurst exponent in the power-law scaling of the fluctuation function which is determined by detrended fluctuation analysis (DFA). LTM with a Hurst exponent close to 0.9 occurs mainly in high latitude oceans, which are also characterized by high potential predictability. Climate predictability is diagnosed in terms of potentially predictable variance fractions. Explicit prediction experiments for various time steps are conducted on a grid point basis using an auto-correlation (AR1) predictor: in regions with LTM, prediction skills are beyond that expected from red noise persistence; exceptions occur in some areas in the southern oceans and over the northern hemisphere continents. Extending the predictability analysis to the fully forced simulation shows large improvement in prediction skills.

  8. The effect of levodopa-carbidopa intestinal gel infusion long-term therapy on motor complications in advanced Parkinson's disease: a multicenter Romanian experience.

    PubMed

    Băjenaru, O; Ene, A; Popescu, B O; Szász, J A; Sabău, M; Mureşan, D F; Perju-Dumbrava, L; Popescu, C D; Constantinescu, A; Buraga, I; Simu, M

    2016-04-01

    Chronic treatment with oral levodopa is associated with an increased frequency of motor complications in the late stages of Parkinson's disease (PD). Continuous administration of levodopa-carbidopa intestinal gel (LCIG-Duodopa(®), Abbott Laboratories), which has been available in Romania since 2009, represents an option for treating patients with advanced PD. Our primary objective was to report changes in motor complications after initiation of LCIG therapy. The secondary objectives were as follows: to determine the impact of LCIG therapy on the daily levodopa dose variation before/and after LCIG, to collect patient self-assessments of quality of life (QoL), and to study the overall tolerability and safety of LCIG administration. A retrospective analysis (2009-2013) of LCIG therapy and the experience in nine neurology centers in Romania was performed. The impact of LCIG therapy was evaluated by analyzing changes in motor fluctuations, dyskinesia and the patients' QoL after initiating therapy. The safety of LCIG therapy was estimated by noting agent-related adverse events (AEs) and medical device-related AEs. In the 113 patients included, we observed a significant improvement in PD symptoms after initiation of LCIG therapy. The "on" period increased, with a mean value of 6.14 h, and the dyskinesia period was reduced, with a mean value of 29.4 %. The quantified non-motor symptoms subsided. The patients exhibited significant improvements in QoL scores. There were few AEs and few cases of LCIG therapy discontinuation. LCIG is an important and available therapeutic option for managing patients with advanced PD.

  9. Umbilical cord blood transplantation in hematologic diseases in patients over 15 years old: long-term experience at the Pontificia Universidad Católica de Chile.

    PubMed

    Ramirez, P; Nervi, B; Bertin, P; Poggi, H; Lagos, M; Selman, C; Pizarro, I; Jara, V; Wiestruck, A; Barriga, F

    2013-01-01

    Most patients who require a sibling stem cell transplantation do not have a matched donor. In our experience, only 1/3 patients have a matched unrelated donor (MUD); therefore, the majority of the patients will require umbilical cord blood (UCB). Patients treated for hematologic diseases with UCB transplants were included. UCB selection and conditioning regimens were performed according to the Minnesota group. Graft-versus-host disease (GVHD) prophylaxis, infection prevention, and patient care were performed according to institutional guidelines. We analyzed patients and graft demography, neutrophil and platelet recovery, chimerism kinetics, GVHD incidence, overall (OS), progression-free survival (PFS) and transplant-related mortality (TRM). We included 29 patients with a median age of 34.8 years (range 15-55). Eighteen were male and the median weight was 72.6 kg (range 54-100). Nineteen patients had acute leukemia. Myeloablative (MA) conditioning was used in 27 patients. Seventeen received double UCB (DUCB) grafts. Median total nucleated cell (10(7)/kg) was 4.2 (range 3.9-4.9) and 4.4 (range 2.8-6.3) for single UCB (SUCB) and DUCB transplants, respectively. Median time for neutrophil engraftment was 24.7 (range 14-43) and 25.8 days (range 14-52) after SUCB and DUCB transplants, respectively. Median time for platelet engraftment was 147 (range 30-516) and 81 days (range 37-200) after SUCB and DUCB transplants, respectively. All the patients receiving MA conditioning had >95% chimerism shortly after transplant. Cumulative incidence of grades II-IV and III-IV acute GVHD was 41% and 20%, respectively. Localized chronic GVHD was seen in 14% of the patients. Median follow-up was 16.7 months (range 1-63). Five-year OS and PFS were 38% and 39%, respectively. One-year TRM was 42%. UCB transplantation is associated with potential cure of hematologic malignancies and our results are similar to other series. Studies are needed to decrease mortality and improve immune

  10. Maintaining Engagement in Long-term Interventions with Relational Agents

    PubMed Central

    Bickmore, Timothy; Schulman, Daniel; Yin, Langxuan

    2011-01-01

    We discuss issues in designing virtual humans for applications which require long-term voluntary use, and the problem of maintaining engagement with users over time. Concepts and theories related to engagement from a variety of disciplines are reviewed. We describe a platform for conducting studies into long-term interactions between humans and virtual agents, and present the results of two longitudinal randomized controlled experiments in which the effect of manipulations of agent behavior on user engagement was assessed. PMID:21318052

  11. Understanding the Long-Term Spectral Variability of Cygnus X-1 with Burst and Transient Source Experiment and All-Sky Monitor Observations

    NASA Technical Reports Server (NTRS)

    Zdziarski, Andrzej A.; Poutanen, Juri; Paciesas, William S.; Wen, Lin-Qing

    2002-01-01

    We present a comprehensive analysis of all observations of Cyg X-1 by the Compton Gamma Ray Observatory Burst and Transient Source Experiment (BATSE; 20-300 keV) and by the Rossi X-Ray Timing Explorer all-sky monitor (ASM; 1.5-12 keV) until 2002 June, including approximately 1200 days of simultaneous data. We find a number of correlations between fluxes and hardnesses in different energy bands. In the hard (low) spectral state, there is a negative correlation between the ASM 1.5-12 keV flux and the hardness at any energy. In the soft (high) spectral state, the ASM flux is positively correlated with the ASM hardness but uncorrelated with the BATSE hardness. In both spectral states, the BATSE hardness correlates with the flux above 100 keV, while it shows no correlation with the 20-100 keV flux. At the same time, there is clear correlation between the BATSE fluxes below and above 100 keV. In the hard state, most of the variability can be explained by softening the overall spectrum with a pivot at approximately 50 keV. There is also another, independent variability pattern of lower amplitude where the spectral shape does not change when the luminosity changes. In the soft state, the variability is mostly caused by a variable hard (Comptonized) spectral component of a constant shape superposed on a constant soft blackbody component. These variability patterns are in agreement with the dependencies of the rms variability on the photon energy in the two states. We also study in detail recent soft states from late 2000 until 2002. The last of them has lasted thus far for more than 200 days. Their spectra are generally harder in the 1.5-5 keV band and similar or softer in the 3-12 keV band than the spectra of the 1996 soft state, whereas the rms variability is stronger in all the ASM bands. On the other hand, the 1994 soft state transition observed by BATSE appears very similar to the 1996 one. We interpret the variability patterns in terms of theoretical Comptonization

  12. Utilisation of young and old soil carbon sources by microbial groups differ during the growing season and between experimental treatments in a long-term field experiment

    NASA Astrophysics Data System (ADS)

    Börjesson, Gunnar; Menichetti, Lorenzo; Thornton, Barry; Campbell, Colin; Kätterer, Thomas

    2014-05-01

    Soil organic matter (SOM)is the largest active carbon pool in the terrestrial environment. SOM is a key factor for soil fertility, but is also important for the sequestration of atmospheric CO2. In agricultural soils, management of plant residues and the use of organic fertilisers play important roles for maintaining SOM. Switching from C3 plants to C4 plants such as maize, enables a natural labelling in situ; when coupled with compound specific 13C isotope analysis of phospholipid fatty acids (PLFAs) it allows the proportion of new C (fixed after the switch added to soil from above- and belowground litter and root exudates) and the proportion of old C (fixed prior to the switch derived from turnover of organic matter) utilised by the soil microbial community to be determined. (new paragraph) A field experiment in Sweden, amended with different mineral and organic fertilisers since 1956, was grown with C3 plants, mainly cereals until 1999. From the year 2000 silage maize was grown every year. In 2012, soil from four replicate plots of five experimental treatments, N fertilised, N fertilised amended with straw and sewage sludge, and two controls (bare fallow and cropped unfertilised) were sampled three times, at the start, middle and end of the growing season. Phospholipid fatty acids (PLFAs) were extracted from all soil samples and analysed for concentrations and 13C content. (new paragraph) Total PLFA concentrations and also the PLFA/SOM ratios increased with SOM in the different treatments. Seasonal variation in total PLFA was small except for the most SOM-rich treatment (sewage sludge) where concentrations significantly decreased during the growing season indicating the depletion of a labile SOM pool. Weighted mean values of δ13C in PLFAs show that the plots fertilised with only calcium nitrate had the highest δ13C-values in PLFAs before (-20.24 o) and after the vegetation period (-20.37 o), due to a large input of 13C-enriched plant material. However, during