Science.gov

Sample records for long-term hospitalization experience

  1. People with limiting long-term conditions report poorer experiences and more problems with hospital care

    PubMed Central

    2014-01-01

    Background Long-term conditions have a significant impact on individuals, their families, and the health service. As people with these conditions represent a high proportion of hospital admissions, investigating their experiences of inpatient care has become an important area of investigation. We conducted a secondary analysis of the NHS adult inpatient survey for England to compare the hospital experiences of three groups of patients: those without long-term conditions, those with a single long-term condition, and those with multiple long-term conditions. We were particularly interested in the extent to which these patients received self-management support from hospital staff, so we developed a brief summary tool drawn from salient questions in the survey to aid the comparison. Methods Analysis of data from the 2011 national adult inpatient survey (n = 65,134) to compare the experiences of three groups of patients: those with no limiting long-term conditions (No-LLTC), those with one limiting long-term condition (S-LLTC), and those with two or more limiting long-term conditions (M-LLTC). The main outcome measure was patients’ self-reports of their experience of inpatient care, including staff-patient interactions, information provision, involvement in decisions and support for self-care and overall ratings of care. A short form scale, the Oxford Patient Involvement and Experience scale (OxPIE) was developed from the adult inpatient survey and used to compare the groups using logistic regression. Results There were significant differences between the No-LLTC group in comparison to both the S-LLTC and M-LLTC groups. Patients with limiting long-term conditions reported significantly worse hospital experiences than those without, as measured by OxPIE: S-LLTC odds ratio = 1.23, 95% CI 1.03-1.48; M-LLTC odds ratio = 1.64, 95% CI 1.19 – 2.26. Responses to a single global rating question were more positive but not strongly correlated with Ox

  2. 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

  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. PMID:26808468

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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

  10. 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... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and...

  11. 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 §...

  12. 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 §...

  13. 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 §...

  14. 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 §...

  15. Long-term care and hospital collaboration. To survive in a reformed healthcare system, long-term care facilities can initiate hospital-based SNFs.

    PubMed

    Hume, S K

    1993-06-01

    Establishing relationships with hospitals may be critical for long-term care facilities facing financial pressures and uncertain futures. One option is to initiate collaborative efforts to develop hospital-based skilled nursing facilities (SNFs). Hospitals, under pressure to move patients to less intensive settings and to diversify, are naturally drawn to long-term care as a related business where they can make limited personnel and financial commitments and extend their continuum of care. Before approaching hospitals to initiate collaborative efforts, long-term care providers should understand how they think and what their strengths and weaknesses are. Long-term and acute care providers have many options for collaboration, including management contracts and joint ventures. In a traditional management contract, the long-term care provider furnishes the administrator and a few key staff in exchange for direct reimbursement for those staff plus a management fee. Another option is for the long-term care facility to provide all the staff for a fee or percentage of revenue. Joint venture options are to form a subsidiary corporation to renovate a floor of the hospital or to have the hospital buy a large percentage of the long-term care facility and share the profits. All these options have potential pitfalls, including differing financial expectations and the threat of unionization at the SNF. Nevertheless, for long-term care facilities struggling under reimbursement cutbacks and other pressures, the benefits may outweigh the risks.

  16. The Insider's Experience of Long-Term Peer Victimisation

    ERIC Educational Resources Information Center

    Mackay, Graham J.; Carey, Timothy A.; Stevens, Bruce

    2011-01-01

    Bullying in schools continues to be a problem despite the best efforts of educators, researchers, and clinicians. Of most concern for the present study is that some children experience long-term victimisation by their peers. To improve our understanding in this area, the phenomenology of being bullied over the course of the school year was…

  17. 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.

  18. 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. PMID:23194066

  19. 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

  20. 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…

  1. Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

    PubMed Central

    Cole, Evan S.; Willis, Carla; Rencher, William C; Zhou, Mei

    2016-01-01

    Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes) and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%). Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0), lengths of stay (61 versus 38 days), costs (US$143,898 versus US$115,056), but fewer discharges to the community (28.4% versus 51.8%). Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that state Medicaid

  2. Long-Term Care Insurance: Does Experience Matter?*

    PubMed Central

    Coe, Norma B.; Skira, Meghan M.; Van Houtven, Courtney Harold

    2015-01-01

    We examine whether long-term care (LTC) experience helps explain the low demand for long-term care insurance (LTCI). We test if expectations about future informal care receipt, expectations about inheritance receipt, and LTCI purchase decisions vary between individuals whose parents or in-laws have used LTC versus those who have not. We find parental use of a nursing home decreases expectations that one’s children will provide informal care, consistent with the demonstration effect. Nursing home use by in-laws does not have the same impact, suggesting that individuals are responding to information gained about their own aging trajectory. Nursing home use by either a parent or in-law increases LTCI purchase probability by 0.8 percentage points, with no significant difference in response between parents’ and in-laws’ use. The estimated increase in purchase probability from experience with LTC is about half the previously estimated increase from tax policy-induced price decreases. PMID:25647006

  3. 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.…

  4. Medicaid claims history of Florida long-term care facility residents hospitalized for pressure ulcers.

    PubMed

    Baker, J

    1996-01-01

    The purpose of this study was to identify patterns of admission, discharge, and readmission between hospital and long-term care facility among a group of Florida long-term care facility residents with pressure ulcers whose care was paid for by Medicaid. A patient-specific, longitudinal claims history database was constructed from data provided by the Florida Department of Health and Rehabilitative Services. This database was used to determine and analyze hospital admissions for pressure ulcer care among Medicaid recipients cared for in a long-term care facility. Analysis of the data determined that more than half of the Medicaid-covered long-term care facility residents who formed the target study group (54.57%) had multiple hospital admissions associated with pressure ulcers. Pressure ulcer hospital admissions amounted to a program cost of $9.9 million. PMID:8704846

  5. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.540 Method of payment for preadmission services under the long-term care hospital...

  6. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.540 Method of payment for preadmission services under the long-term care hospital...

  7. 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

    ... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.540 Method of payment for preadmission services under the long-term care hospital...

  8. 42 CFR 412.541 - Method of payment under the long-term care hospital prospective payment system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Method of payment under the long-term care hospital... SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.541 Method of payment under the long-term care hospital prospective payment system. (a) General rule. Subject to the exceptions...

  9. 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

  10. Antibiotic Misuse in Hospital, Outpatient, and Long-Term Care Settings.

    PubMed

    Ashraf, Muhammad Salman; Cook, Paul P

    2016-01-01

    Antibiotic misuse is common in the United States, but the causes of antibiotic misuse may differ from one health care setting to another. In this commentary, we describe the factors associated with inappropriate antibiotic prescriptions in hospital, outpatient, and long-term care settings, along with specific measures that can help prevent antibiotic misuse. PMID:27621347

  11. 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...

  12. 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…

  13. Long-term hospitalizations for schizophrenia in the Czech Republic 1998-2012.

    PubMed

    Winkler, Petr; Mladá, Karolína; Krupchanka, Dzmitry; Agius, Mark; Ray, Manaan Kar; Höschl, Cyril

    2016-08-01

    Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for >20years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36% (n=697) were only administrative in their nature. Out of 2197 truly discharged patients, 14.88% (n=327) were re-hospitalized within 2weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, CI: 3.77-7.35, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe. PMID:27094718

  14. 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

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Method of payment under the long-term care hospital..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.541 Method of payment under the...

  15. 42 CFR 412.505 - Conditions for payment under the prospective payment system for long-term care hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment system for long-term care hospitals. 412.505 Section 412.505 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.505 Conditions...

  16. 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…

  17. A Comparison of Free-Standing versus Co-Located Long-Term Acute Care Hospitals

    PubMed Central

    Kahn, Jeremy M.; Barnato, Amber E.; Lave, Judith R.; Pike, Francis; Weissfeld, Lisa A.; Le, Tri Q.; Angus, Derek C.

    2015-01-01

    Background Long-term acute care hospitals (LTACs) provide specialized treatment for patients with chronic critical illness. Increasingly LTACs are co-located within traditional short-stay hospitals rather than operated as free-standing facilities, which may affect LTAC utilization patterns and outcomes. Methods We compared free-standing and co-located LTACs using 2005 data from the United States Centers for Medicare & Medicaid Services. We used bivariate analyses to examine patient characteristics and timing of LTAC transfer, and used propensity matching and multivariable regression to examine mortality, readmissions, and costs after transfer. Results Of 379 LTACs in our sample, 192 (50.7%) were free-standing and 187 (49.3%) were co-located in a short-stay hospital. Co-located LTACs were smaller (median bed size: 34 vs. 66, p <0.001) and more likely to be for-profit (72.2% v. 68.8%, p = 0.001) than freestanding LTACs. Co-located LTACs admitted patients later in their hospital course (average time prior to transfer: 15.5 days vs. 14.0 days) and were more likely to admit patients for ventilator weaning (15.9% vs. 12.4%). In the multivariate propensity-matched analysis, patients in co-located LTACs experienced higher 180-day mortality (adjusted relative risk: 1.05, 95% CI: 1.00–1.11, p = 0.04) but lower readmission rates (adjusted relative risk: 0.86, 95% CI: 0.75–0.98, p = 0.02). Costs were similar between the two hospital types (mean difference in costs within 180 days of transfer: -$3,580, 95% CI: -$8,720 –$1,550, p = 0.17). Conclusions Compared to patients in free-standing LTACs, patients in co-located LTACs experience slightly higher mortality but lower readmission rates, with no change in overall resource use as measured by 180 day costs. PMID:26440102

  18. Effects of outsourced nursing on quality outcomes in long-term acute-care hospitals.

    PubMed

    Alvarez, M Raymond; Kerr, Bernard J; Burtner, Joan; Ledlow, Gerald; Fulton, Larry V

    2011-03-01

    Use of outsourced nurses is often a stop-gap measure for unplanned vacancies in smaller healthcare facilities such as long-term acute-care hospitals (LTACHs). However, the relationship of utilization levels (low, medium, or high percentages) of nonemployees covering staff schedules often is perceived to have negative relationships with quality outcomes. To assess this issue, the authors discuss the outcomes of their national study of LTACH hospitals that indicated no relationship existed between variations in percentage of staffing by contracted nurses and selected outcomes in this post-acute-care setting.

  19. 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…

  20. 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.

  1. Institutional and Home-Based Long-Term Care Alternatives: The 1965-85 Swedish Experience.

    ERIC Educational Resources Information Center

    Berg, Stig; And Others

    1988-01-01

    Discusses the Swedish experience in which the official old-age care policy has been to substitute home care for institutional care. Found some substitution of the two forms of long-term care which took place from 1965-75, but thereafter the use of long-term care institutions and home care remained stable or contracted. (Author/ABL)

  2. Precipitating Factors for Acute Heart Failure Hospitalization and Long-Term Survival.

    PubMed

    Berkovitch, Anat; Maor, Elad; Sabbag, Avi; Chernomordik, Fernando; Elis, Avishay; Arbel, Yaron; Goldenberg, Ilan; Grossman, Ehud; Klempfner, Robert

    2015-12-01

    Heart failure (HF) patients have frequent exacerbations leading to high consumption of medical services and recurrent hospitalizations.Different precipitating factors have various effects on long-term survival.We investigated 2212 patients hospitalized with a diagnosis of either acute HF or acute exacerbation of chronic HF. Patients were divided into 2 primary precipitant groups: ischemic (N = 979 [46%]) and nonischemic (N = 1233 [54%]). The primary endpoint was all-cause mortality.Multivariate analysis demonstrated that the presence of a nonischemic precipitant was associated with a favorable in-hospital outcome (OR 0.64; CI 0.43-0.94), but with a significant increase in the risk of 10-year mortality (HR 1.12; CI 1.01-1.21). Consistently, the cumulative probability of 10-year mortality was significantly higher among patients with a nonischemic versus ischemic precipitant (83% vs 90%, respectively; Log-rank P value <0.001). Subgroup analysis showed that among the nonischemic precipitant, the presence of renal dysfunction and infection were both associated with poor short-term outcomes (OR 1.56, [P < 0.001] and OR 1.35 [P < 0.001], respectively), as well as long-term (HR 1.59 [P < 0.001] and HR 1.24 [P < 0.001], respectively).Identification of precipitating factors for acute HF hospitalization has important short- and long-term implications that can be used for improved risk stratification and management. PMID:26717369

  3. Seismic experiment paves way for long-term seafloor observatories

    NASA Astrophysics Data System (ADS)

    Stakes, Debra S.; Romanowicz, Barbara; Montagner, Jean-Paul; Tarits, Pascal; Karczewski, Jean-Francois; Etchemendy, Steve; Dawe, Craig; Neuhauser, Doug; McGill, Paul; Koenig, Jean Claude; Savary, Jean; Begnaud, Mike; Pasyanos, Mike

    The Monterey Bay Ocean Bottom International Seismic Experiment (MOISE) has successfully deployed a suite of geophysical and oceanographic instrument packages on the ocean floor using the Monterey Bay Aquarium Research Institute's (MBARI) Ventana, a tethered Remotely Operated Vehicle (ROV).The goal of this international cooperative experiment is to advance the global Seafloor Observatory effort by developing a prototype suite of instruments and installing them on the western side of the San Andreas fault system offshore of central California. The centerpiece of the instrument suite was a digital broadband seismometer package partially buried within the sediment-covered floor of Monterey Bay, 40 km offshore and 10 km west of the San Gregorio fault at a depth of 1015 m (Figure 1).

  4. 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

  5. Predictors of Long-Term Mortality in Patients Hospitalized in an Intensive Cardiac Care Unit.

    PubMed

    Uscinska, Ewa; Sobkowicz, Bożena; Lisowska, Anna; Sawicki, Robert; Dabrowska, Milena; Szmitkowski, Maciej; Musial, Wlodzimierz J; Tycinska, Agnieszka M

    2016-01-01

    Patients admitted to an intensive cardiac care unit (ICCU) are a heterogeneous population with a high mortality rate. The aim of our study was to investigate which clinical, biochemical, and echocardiographic parameters routinely assessed may affect long-term mortality in a non-selected ICCU population.A total of 392 patients hospitalized between 2008-2011 (mean age, 70 ± 13.8 years, 43% women) were consecutively and prospectively assessed with the following admission diagnoses: 168 with acute coronary syndromes (ACS), 122 with acute decompensated heart failure (ADHF), and 102 with other acute cardiac disorders. Patients were treated according to the current European Society of Cardiology (ESC) guidelines.During a mean 29.3 (± 18.9) months of observation, 152 (38.8%) patients died and 7.9% of the patients needed a red blood cell transfusion (RBC Tx). Patients who died were significantly older and had lower baseline levels of hemoglobin (Hb), serum iron concentration (SIC), total iron binding capacity (TIBC), cholesterol, and left ventricular ejection fraction (LVEF), as well as lower eGFR values, and higher white blood cell (WBC) counts and C-reactive protein (CRP) levels (P < 0.05). Predictors of death in multivariate regression analysis were age, Hb, LVEF, WBC, and CRP. The most powerful factor was hospitalization for non-ACS. The risk of long-term mortality increased with decreasing levels of Hb (P < 0.001), SIC (P = 0.001), TIBC (P = 0.009), and the need for RBC Tx (P < 0.001), as well as the diagnosis of ADHF (P < 0.001) and the absence of ACS (P = 0.007).In ICCU patients, age, Hb, parameters of iron status, and LVEF are strong predictors of long-term mortality. Among the ICCU population, patients with ACS diagnosis have better survival. PMID:26673443

  6. [Terminal care for elderly patients with dementia in two long-term care hospitals].

    PubMed

    Hirakawa, Yoshihisa; Masuda, Yuichiro; Kimata, Takaya; Uemura, Kazumasa; Kuzuya, Masafumi; Iguchi, Akihisa

    2004-01-01

    A byproduct of the aging of the population has been a dramatic rise in patients with dementia. The aim of the present study is to clarify the use of aggressive and palliative treatments, artificial nutrition and sedation in long-term care hospitals in Japan. We assessed 123 deaths in people aged 65 and older who died in two long-term care hospitals in and around Nagoya from January 2001 to December 2002. All deceased were divided into two groups according to their diagnosis of dementia. Data on the particular characteristics of the deceased, diagnosis of dementia, aggressive treatments (including CPR, intubation, mechanical ventilation, the use of systemic antibiotics and blood transfusion), palliative treatments (including oxygen, narcotic and nonnarcotic pain medication) artificial nutrition (including hyperalimentation and tube feeding) and sedation during the last six months of their lives were collected from medical charts. The prevalence of aggressive and palliative interventions did not vary significantly with the diagnosis of dementia except for the use of vasopressors. Artificial nutrition was prevalent and few patients received sedatives in either group. Patients with and without dementia received similar treatments in the end-stage. A greater understanding of the course of dementia is needed to further discussions on the terminal care of people with dementia. A national consensus on how to treat end-stage demented patients is also needed.

  7. 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. PMID:26476693

  8. Reduction in hospital stay of chronic schizophrenic patients after long-term clozapine treatment.

    PubMed

    Ahn, Yong Min; Chang, Jae Seung; Kim, Yeni; Lee, Kyu Young; Kim, Jong Hoon; Kim, Seong Chan; Maeng, So Jin; Kim, Yong Sik

    2005-05-01

    The present study aimed to elucidate the effectiveness of clozapine treatment in reducing the disabling period of chronically ill schizophrenic patients by investigating their rehospitalization status. Of 232 schizophrenic patients with a history of clozapine use who were recruited from the clinic at Seoul National University Hospital, 117 were selected who had been followed up for more than 1 year with respect to rehospitalization. To obtain information about the period before the clozapine change, a chart review of these 117 patients was conducted. The number and length of hospitalizations of the patients significantly decreased after clozapine treatment compared to the same period before clozapine treatment. The hospital days per year of the patients were also decreased significantly after clozapine introduction. By analysing 38 patients who were followed up for more than 5 years, it was suggested that the decrease in the number and length of hospitalizations was substantially sustained for up to 5 years after clozapine treatment. This study showed that the number and length of hospitalizations are significantly decreased by long-term clozapine treatment and that this effect can positively affect the social outcome of schizophrenic patients. PMID:15812266

  9. Long-term care and hospital utilisation by older people: an analysis of substitution rates.

    PubMed

    Forder, Julien

    2009-11-01

    Older people are intensive users of hospital and long-term care services. This paper explores the extent to which these services are substitutes. A small area analysis was used with both care home and (tariff cost-weighted) hospital utilisation for older people aggregated to electoral wards in England.Health and social-care structural equations were specified using a theoretical model. The estimation accounted for the skewed and censored nature of the data. For health utilisation, both a fixed effects instrumental variables GMM model and a generalised estimating equations (GEE) model were fitted, the later on a log dependent variable with predicted values of social care utilisation used to account for endogeneity (bootstrapping was used to derive standard errors). In addition to a GMM model, the social-care estimation used both two-part and tobit models (also with predicted health utilisation and bootstrapping).The results indicate that for each additional pound1 spent on care homes, hospital expenditure falls by pound0.35. Also, pound1 additional hospital spend corresponds to just over pound0.35 reduction on care home spend. With these cost substitution effects offsetting, a transfer of resources to care homes is efficient if the resultant outcome gain is greater than the outcome loss from reduced hospital use.

  10. 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.

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

    PubMed

    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.

  12. 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

    ... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement must... extended care services, as specified in § 409.30 of this chapter, and be reimbursed as a swing-bed hospital... eligibility requirements: (1) The facility has fewer than 100 hospital beds, excluding beds for newborns...

  13. 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…

  14. 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.

  15. The Association between Long-Term Care Setting and Potentially Preventable Hospitalizations among Older Dual Eligibles

    PubMed Central

    Wysocki, Andrea; Kane, Robert L; Golberstein, Ezra; Dowd, Bryan; Lum, Terry; Shippee, Tetyana

    2014-01-01

    Objective To compare the probability of experiencing a potentially preventable hospitalization (PPH) between older dual eligible Medicaid home and community-based service (HCBS) users and nursing home residents. Data Sources Three years of Medicaid and Medicare claims data (2003–2005) from seven states, linked to area characteristics from the Area Resource File. Study Design A primary diagnosis of an ambulatory care sensitive condition on the inpatient hospital claim was used to identify PPHs. We used inverse probability of treatment weighting to mitigate the potential selection of HCBS versus nursing home use. Principal Findings The most frequent conditions accounting for PPHs were the same among the HCBS users and nursing home residents and included congestive heart failure, pneumonia, chronic obstructive pulmonary disease, urinary tract infection, and dehydration. Compared to nursing home residents, elderly HCBS users had an increased probability of experiencing both a PPH and a non-PPH. Conclusions HCBS users’ increased probability for potentially and non-PPHs suggests a need for more proactive integration of medical and long-term care. PMID:24628471

  16. 42 CFR 412.541 - Method of payment under the long-term care hospital prospective payment system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Method of payment under the long-term care hospital prospective payment system. 412.541 Section 412.541 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective...

  17. 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.

  18. 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.

  19. 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…

  20. 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,…

  1. 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…

  2. Sustaining School Colleagues' Commitment to a Long-Term Professional Experience Partnership

    ERIC Educational Resources Information Center

    Peters, Judith

    2011-01-01

    This paper presents findings from a qualitative study that investigated school participants' perceptions of the benefits, challenges and supportive factors related to their involvement in a long-term school/university professional experience partnership. Data were collected through interviews with coordinators and a written survey completed by…

  3. 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...

  4. Do managerial efficiency and social responsibility drive long-term financial performance of not-for-profit hospitals before acquisition?

    PubMed

    Phillips, J F

    1999-01-01

    Due to steep declines in charitable support and reduced demand for traditional hospital services, economic goals are increasingly important to not-for-profit hospitals. Effects of efficient management and effective pursuit of not-for-profit status (for example, levels of Medicare, indigent patients, and unprofitable services) on financial viability are explored. While previous research compared hospitals of different ownership status, not-for-profit hospital operations before acquisition by for-profit hospital chains are investigated--"neutral ground" relative to ownership. Results suggest minor links between efficiency and long-term profitability despite effectiveness in pursuit of non taxable status.

  5. After hospital: working with schools and families to support the long term needs of children with brain injuries.

    PubMed

    Savage, R C; Pearson, S; McDonald, H; Potoczny-Gray, A; Marchese, N

    2001-01-01

    Medical and rehabilitation systems care for children who sustain brain injuries. Their much needed services, however, are short in comparison with the long term needs of these children and their families. For the most part, it is schools and families who provide the long term supports to help children make the best outcomes and create a better quality of life. Professionals and families who develop collaborative models find that they can more effectively manage services for these children by carefully crafting Individual Education Plans (IEP's). Through the IEP process students' complex needs; the multiple transitions they experience; and their long term needs can be met.

  6. 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. PMID:20230176

  7. 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

  8. 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.

  9. Georgia Hospital Association leads long-term staff recruiting effort. Reaches wide target audience through innovative media use.

    PubMed

    Botvin, Judith D

    2003-01-01

    The Georgia Hospital Association (GHA), faced with a critical healthcare workforce shortage, created a long-term response to the problem by creating a Workforce Shortage Media Campaign. Its single purpose was to encourage Georgians to pursue careers in healthcare. The four-week campaign took six months to develop and included print, radio and television.

  10. 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.

  11. Bipolar implantable stimulator for long-term denervated-muscle experiments.

    PubMed

    Dennis, R G

    1998-03-01

    A micropower bipolar implantable stimulator has been developed and tested for long-term (four weeks-six months) use in experiments involving the stimulation of denervated skeletal muscle. Implantable stimulators are typically operated from a single lithium battery at 3 V. After the first week of denervation, stimulation of denervated muscles of rats requires voltages in the range of 6-12 V. The stimulator described can deliver voltages up to 15 V, with variable pulsewidth, frequency and duty cycle. All stimulation parameters are set prior to implantation by selection of appropriate resistors and capacitors. Each primary failure mode for implantable stimulators is addressed. Long-term reliability rates in excess of 95% are achievable if the construction details are followed closely. Methods for battery power management, circuit component selection, electrode construction and encapsulation are described in detail. This device is not intended for use in humans. PMID:9684464

  12. 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

  13. 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.

  14. 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. PMID:10313396

  15. 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.

  16. Long-term morbidity and mortality after hospitalization with community-acquired pneumonia: a population-based cohort study.

    PubMed

    Johnstone, Jennie; Eurich, Dean T; Majumdar, Sumit R; Jin, Yan; Marrie, Thomas J

    2008-11-01

    Little is known about the long-term sequelae of community-acquired pneumonia (CAP). Therefore, we describe the long-term morbidity and mortality of patients after pneumonia requiring hospitalization. We specifically hypothesized that the Pneumonia Severity Index (PSI), designed to predict 30-day pneumonia-related mortality, would also be associated with longer-term all-cause mortality. Between 2000 and 2002, 3415 adults with CAP admitted to 6 hospitals in Edmonton, Alberta, Canada, were prospectively enrolled in a population-based cohort. At the time of hospital admission, demographic, clinical, and laboratory data were collected and the PSI was calculated for each patient. Postdischarge outcomes through to 2006 were ascertained using multiple linked administrative databases. Outcomes included all-cause mortality, hospital admissions, and re-hospitalization for pneumonia over a maximum of 5.4 years of follow-up. Follow-up data were available for 3284 (96%) patients; 66%were > or =65 years of age, 53% were male, and according to the PSI fully 63% were predicted to have greater than 18% 30-day pneumonia-related mortality (that is, PSI class IV-V). Median follow-up was 3.8 years. The 30-day, 1-year, and end of study mortality rates were 12%, 28%, and 53%, respectively. Overall, 82(19%) patients aged <45 years died compared with 1456 (67%) patients aged > or =65 years (hazard ratio [HR], 5.07; 95% confidence interval [CI], 4.06-6.34). Male patients were more likely to die than female patients during follow-up (971 [56%] vs. 767 [49%], respectively; HR, 1.20; 95% CI, 1.13-1.37). Initial PSI classification predicted not only 30-day mortality, but also long-term postdischarge mortality, with 92 (15%) of PSI class I-II patients dying compared with 616 (82%) PSI class V patients (HR, 11.80; 95% CI, 4.70-14.70). Of 2950 patients who survived the initial CAP hospitalization, 72% were hospitalized again (median, 2 admissions over follow-up) and 16% were re-hospitalized with

  17. Long-term memory in experiments and numerical simulations of hydrodynamic and magnetohydrodynamic turbulence.

    PubMed

    Mininni, P; Dmitruk, P; Odier, P; Pinton, J-F; Plihon, N; Verhille, G; Volk, R; Bourgoin, M

    2014-05-01

    We analyze time series stemming from experiments and direct numerical simulations of hydrodynamic and magnetohydrodynamic turbulence. Simulations are done in periodic boxes, but with a volumetric forcing chosen to mimic the geometry of the flow in the experiments, the von Kármán swirling flow between two counterrotating impellers. Parameters in the simulations are chosen to (within computational limitations) allow comparisons between the experiments and the numerical results. Conducting fluids are considered in all cases. Two different configurations are considered: a case with a weak externally imposed magnetic field and a case with self-sustained magnetic fields. Evidence of long-term memory and 1/f noise is observed in experiments and simulations, in the case with weak magnetic field associated with the hydrodynamic behavior of the shear layer in the von Kármán flow, and in the dynamo case associated with slow magnetohydrodynamic behavior of the large-scale magnetic field.

  18. 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…

  19. Long-term sick workers experience of professional support for re-integration back to work.

    PubMed

    Landstad, Bodil; Hedlund, Marianne; Wendelborg, Christian; Brataas, Hildfrid

    2009-01-01

    In recent years researchers have tried to identify important factors that can explain re-integration to work for workers on long-term sick leave. The results indicate that multiple factors can explain whether or not people return to work. The aim of the study was to investigate long-term sick workers' experience of professional support for re-integration to work. Participants were drawn from the database of The National Social Insurance Board in Norway. A random sample was selected of persons with mental illness or musculoskeletal disorders (either p- or l-diagnosis/symptoms related to International Classification in Primary Care), who were in receipt of Rehabilitation allowance. The questionnaire was sent to 1 493 persons of whom 740 responded. The most significant finding is that work training/mastering actions were identified by the majority of the rehabilitation benefit recipients as being of slight or moderate use. This highlights the importance of work training/mastering actions being relevant in proportion to the specific situation the individual is presently within. Delays in waiting for treatment attributed to approximately half of the rehabilitation benefit recipient's problems returning to work. This study also highlights that rehabilitation benefit recipients experience loss of co-ordinated measures from those who are supposed to contribute to simplifying their return to work. PMID:19276524

  20. 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

  1. Serotonin deficiency alters susceptibility to the long-term consequences of adverse early life experience.

    PubMed

    Sachs, Benjamin D; Rodriguiz, Ramona M; Tran, Ha L; Iyer, Akshita; Wetsel, William C; Caron, Marc G

    2015-03-01

    Brain 5-HT deficiency has long been implicated in psychiatric disease, but the effects of 5-HT deficiency on stress susceptibility remain largely unknown. Early life stress (ELS) has been suggested to contribute to adult psychopathology, but efforts to study the long-term consequences of ELS have been limited by a lack of appropriate preclinical models. Here, we evaluated the effects of 5-HT deficiency on several long-term cellular, molecular, and behavioral responses of mice to a new model of ELS that combines early-life maternal separation (MS) of pups and postpartum learned helplessness (LH) training in dams. Our data demonstrate that this paradigm (LH/MS) induces depressive-like behavior and impairs pup retrieval in dams. In addition, we show that brain 5-HT deficiency exacerbates anxiety-like behavior induced by LH/MS and blunts the effects of LH/MS on acoustic startle responses in adult offspring. Although the mechanisms underlying these effects remain unclear, following LH/MS, 5-HT-deficient animals had significantly less mRNA expression of the mineralocorticoid receptor in the amygdala than wild-type animals. In addition, 5-HT-deficient mice exhibited reduced mRNA levels of the 5-HT2a receptor and p11 in the hippocampus regardless of stress. LH/MS decreased the number of doublecortin+ immature neurons in the hippocampus in both wild-type (WT) and 5-HT-deficient animals. Our data emphasize the importance of complex interactions between genetic factors and early life experience in mediating long-term changes in emotional behavior. These findings may have important implications for our understanding of the combinatorial roles of 5-HT deficiency, ELS, and postpartum depression in the development of neuropsychiatric disorders.

  2. Serotonin deficiency alters susceptibility to the long-term consequences of adverse early life experience

    PubMed Central

    Sachs, Benjamin D.; Rodriguiz, Ramona M.; Tran, Ha L.; Iyer, Akshita; Wetsel, William C.

    2015-01-01

    Brain 5-HT deficiency has long been implicated in psychiatric disease, but the effects of 5-HT deficiency on stress susceptibility remain largely unknown. Early life stress (ELS) has been suggested to contribute to adult psychopathology, but efforts to study the long-term consequences of ELS have been limited by a lack of appropriate preclinical models. Here, we evaluated the effects of 5-HT deficiency on several long-term cellular, molecular, and behavioral responses of mice to a new model of ELS that combines early-life maternal separation (MS) of pups and postpartum learned helplessness (LH) training in dams. Our data demonstrate that this paradigm (LH/MS) induces depressive-like behavior and impairs pup retrieval in dams. In addition, we show that brain 5-HT deficiency exacerbates anxiety-like behavior induced by LH/MS and blunts the effects of LH/MS on acoustic startle responses in adult offspring. Although the mechanisms underlying these effects remain unclear, following LH/MS, 5-HT-deficient animals had significantly less mRNA expression of the mineralocorticoid receptor in the amygdala than wild-type animals. In addition, 5-HT-deficient mice exhibited reduced mRNA levels of the 5-HT2a receptor and p11 in the hippocampus regardless of stress. LH/MS decreased the number of doublecortin+ immature neurons in the hippocampus in both wild-type (WT) and 5-HT-deficient animals. Our data emphasize the importance of complex interactions between genetic factors and early life experience in mediating long-term changes in emotional behavior. These findings may have important implications for our understanding of the combinatorial roles of 5-HT deficiency, ELS, and postpartum depression on the development of neuropsychiatric disorders. PMID:25602134

  3. Relation of Worsened Renal Function during Hospitalization for Heart Failure to Long-Term Outcomes and Rehospitalization

    PubMed Central

    Lanfear, David E.; Peterson, Edward L.; Campbell, Janis; Phatak, Hemant; Wu, David; Wells, Karen; Spertus, John A.; Williams, L. Keoki

    2010-01-01

    Worsened renal function (WRF) during heart failure (HF) hospitalization is associated with in-hospital mortality, but there are limited data regarding its relationship to long-term outcomes after discharge. The influence of WRF resolution is also unknown. This retrospective study analyzed patients who received care from a large health system and had a primary hospital discharge diagnosis of HF between 1/2000 and 6/2008. Renal function was estimated from creatinine levels during hospitalization. The first available value was considered baseline. WRF was defined a creatinine increase of ≥0.3mg/dl on any subsequent hospital day compared to baseline. Persistent WRF was defined as having WRF at discharge. Proportional hazards regression, adjusting for baseline renal function and potential confounding factors, was used to assess time to re-hospitalization or death. Among 2465 patients who survived to discharge, 887 (36%) developed WRF. Median follow up was 2.1 years. In adjusted models, WRF was associated with higher rates of post-discharge death or re-hospitalization (HR 1.12, 95%CI 1.02 – 1.22). Among those with WRF, 528 (60%) had persistent WRF while 359 (40%) recovered. Persistent WRF was significantly associated with higher post-discharge event rates (HR 1.14, 95%CI 1.02 – 1.27), whereas transient WRF showed only a non-significant trend towards risk (HR 1.09 95%CI 0.96-1.24). In conclusion, among patients surviving hospitalization for HF, WRF was associated with increased long-term mortality and re-hospitalization, particularly if renal function did not recover by the time of discharge. PMID:21146690

  4. 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

  5. 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

  6. 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.

  7. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care hospital to an acute care hospital, IRF, SNF, or the patient's home and readmitted to the same... is discharged from the long-term care hospital to an acute care hospital, an IRF, or a SNF for a...-term care hospital and ends on the 27th day after discharge. (iii) For a discharge to a SNF,...

  8. 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

    ... care hospital to an acute care hospital, IRF, SNF, or the patient's home and readmitted to the same... is discharged from the long-term care hospital to an acute care hospital, an IRF, or a SNF for a...-term care hospital and ends on the 27th day after discharge. (iii) For a discharge to a SNF,...

  9. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... care hospital to an acute care hospital, IRF, SNF, or the patient's home and readmitted to the same... is discharged from the long-term care hospital to an acute care hospital, an IRF, or a SNF for a...-term care hospital and ends on the 27th day after discharge. (iii) For a discharge to a SNF,...

  10. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... care hospital to an acute care hospital, IRF, SNF, or the patient's home and readmitted to the same... is discharged from the long-term care hospital to an acute care hospital, an IRF, or a SNF for a...-term care hospital and ends on the 27th day after discharge. (iii) For a discharge to a SNF,...

  11. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care hospital to an acute care hospital, IRF, SNF, or the patient's home and readmitted to the same... is discharged from the long-term care hospital to an acute care hospital, an IRF, or a SNF for a...-term care hospital and ends on the 27th day after discharge. (iii) For a discharge to a SNF,...

  12. 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

  13. Do admissions and discharges to long-term care facilities influence hospital burden of Clostridium difficile infection?

    PubMed Central

    Ricciardi, R.; Nelson, J.; Griffith, J.L.; Concannon, T.W.

    2011-01-01

    SUMMARY Background Substantial geographical clustering of Clostridium difficile infection (CDI) outbreaks in hospitals in the USA have previously been demonstrated. Aim To test the hypothesis that hospital burden of CDI is associated with admission from and discharge to long-term care facilities (LTCFs). Methods Hospital discharge data from 19 states in the USA were used to identify all patients discharged with a diagnosis of CDI from 1 January 2002 to 31 December 2004. For every hospital, the proportion of discharges with a diagnosis of CDI was calculated, and those above the 90th percentile were classified as ‘high CDI’ hospitals. We tested the association between this measure of hospital burden of CDI and the rates of admission from and discharges to LTCFs. We adjusted for other hospital level characteristics, case-complexity and local population characteristics. Findings We identified 38,372,951 discharges during the three-year study period. Of all discharges, 274,311 (0.71%) had a primary or secondary diagnosis of CDI. Hospitals had a mean CDI burden of 7.8 cases per 1000 discharges. High CDI hospitals (N = 610; 10.0%) had a mean CDI burden of 34.8 cases per 1000 discharges. Compared to other hospitals, high CDI hospitals were more likely to have a high proportion of admissions from or discharges to LTCFs. This association persisted after adjustments for other hospital characteristics, case-complexity, and area population characteristics. Conclusion A high rate of admission from or discharge to LTCFs is associated with an increased hospital burden of CDI. PMID:22137065

  14. 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. PMID:18399445

  15. 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.

  16. Long-term experiment with orchard floor management systems: influence on apple yield and chemical composition.

    PubMed

    Slatnar, Ana; Licznar-Malanczuk, Maria; Mikulic-Petkovsek, Maja; Stampar, Franci; Veberic, Robert

    2014-05-01

    The study focuses on the response of apple primary and secondary metabolism and some important quality parameters to three living mulch treatments, classical herbicide fallow, and black polypropylene strip application in two apple cultivars. Primary and secondary metabolites were analyzed after 10 years of ground cover experiments. Soluble solids, firmness, and color measurements indicate differences among orchard floor management treatments. Significantly, lower levels of individual sugars have been measured in fruit of different living mulch treatments compared with fruit harvested from trees subjected to the herbicide strip treatment. Total sugar content was higher in fruit of the herbicide strip treatment in both cultivars analyzed. Significantly higher levels of total organic acids were only detected in 'Pinova' fruit of the Festuca ovina L. treatment. Long-term response of both cultivars to living mulch treatments indicated that apples increase the accumulation of almost all analyzed individual phenolic compounds. PMID:24730550

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

    PubMed

    Chamak, Brigitte; Bonniau, Béatrice

    2016-03-01

    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 better outcome. In adulthood, the majority were in residential accommodation. None were living independently. The trajectories of people with Asperger syndrome or high-functioning autism were more positive since all of them attended school for a long time and some went to university. All of them had a good outcome but they remained dependent on aging parents who had few available supports. PMID:26572660

  18. Fathers' everyday experiences of having an adult child who suffers from long-term mental illness.

    PubMed

    Johansson, Anita; Anderzen-Carlsson, Agneta; Ahlin, Arne; Andershed, Birgitta

    2012-02-01

    The purpose of this study is to describe the everyday life experiences of fathers of adult children who have various forms of long-term mental illness. Ten fathers were interviewed. Content analysis revealed one main theme: Maintaining a strong façade while balancing on a thin line, and two sub-themes: (1) A constant struggle and (2) A feeling of powerlessness. The fathers demonstrated great engagement and good will to participate in their child's life. A sense of powerlessness and frustration at not having or being allowed freedom of action emerged. Cooperation between children, parents, the care service providers, and the authorities could increase the parents' abilities to provide adequate support to the child as well as helping them to understand and make the incomprehensible manageable. PMID:22273345

  19. Long-term experiment with orchard floor management systems: influence on apple yield and chemical composition.

    PubMed

    Slatnar, Ana; Licznar-Malanczuk, Maria; Mikulic-Petkovsek, Maja; Stampar, Franci; Veberic, Robert

    2014-05-01

    The study focuses on the response of apple primary and secondary metabolism and some important quality parameters to three living mulch treatments, classical herbicide fallow, and black polypropylene strip application in two apple cultivars. Primary and secondary metabolites were analyzed after 10 years of ground cover experiments. Soluble solids, firmness, and color measurements indicate differences among orchard floor management treatments. Significantly, lower levels of individual sugars have been measured in fruit of different living mulch treatments compared with fruit harvested from trees subjected to the herbicide strip treatment. Total sugar content was higher in fruit of the herbicide strip treatment in both cultivars analyzed. Significantly higher levels of total organic acids were only detected in 'Pinova' fruit of the Festuca ovina L. treatment. Long-term response of both cultivars to living mulch treatments indicated that apples increase the accumulation of almost all analyzed individual phenolic compounds.

  20. 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

  1. Prior contest experience exerts a long-term influence on subsequent winner and loser effects

    PubMed Central

    2011-01-01

    Introduction Animals are capable of using information from recent experiences to modify subsequent behavioral responses. Animals' ability or propensity to modify their behavior in the light of new information has repeatedly been shown to correlate with, or be influenced by, either their intrinsic competitive ability or their dominance experience - an influence which can be long-lasting. Using a mangrove killifish, Kryptolebias marmoratus, as the study organism, we investigated whether and if so how the effect of a winning or a losing experience one day prior to a dyadic contest was modulated by both competitive ability measured two months previously and a winning or losing experience forced on the contestants one month previously. Results Winning/losing experience forced on the fish one month previously affected how they utilized information from their winning/losing experience one day before Test Day: Individuals that were randomly assigned a losing experience one month previously were more susceptible to the influence of their 1-day winning/losing experience than those assigned a winning experience. Competitive ability measured two months previously, winning/losing experience from one month previously and the winning/losing experience received one day previously all significantly influenced the fish's contest behaviors on Test Day, although only 2-month competitive ability significantly influenced escalation duration, indicating that it was still a good index for the fish's competitive ability two months later. Conclusions These results suggest that the value to the fish of information from a recent win or loss depends on the outcome of their past contests and show that contest experience has a long-term effect on contest behavior. PMID:22051441

  2. 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

  3. 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.

  4. 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…

  5. 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

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

    PubMed

    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

  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. PMID:17390822

  8. Effect of fertilization on the weediness of maize in a long-term field experiment.

    PubMed

    Kismányoky, A; Lehoczky, E; Kismányoky, T

    2006-01-01

    We carried our examination in a long-term fertilization field experiment in 2005. In the experiment we had opportunity to compare the weediness in NPK and NPK + FYM1 treatments, and we could study the effect of increasing N dosis on the weeds and maize. The bi-factorial trial was arranged in split plot design with three replications. The weed survey was made 25 days after seeding in the 27th of may. For the weed survey the Balázs-Ujvárosi method was applied. After the weed survey we collected all the weed species from the plots per 1-1 m2. We counted, mesured the fresh and dry matter weight of aerial shoots. We collected maize too, five pieces per plots. In the experiment were found 12 weed species, 9 annual: Abutilon theophrasti, Amaranthus chlorostachys, Ambrosia artemisiifolia, Chenopodium album, Chenopodium hybridum, Echinochloa crus-galli, Polygonum lapathifolium, Xantium strumarium, Veronica hederi-folia, and 3 perennial: Cirsium arvense, Convolvulus arvensis, Lathyrus tuberosus. On the NPK plots the Ch. album, on NPK + FYM treatments the A. theophrasti was the first in order of the dominance. The biomass production of weeds in the NPK + FYM treatments were 3 times higher than in the only NPK treatments. PMID:17390821

  9. Effect of fertilization on the weediness of maize in a long-term field experiment.

    PubMed

    Kismányoky, A; Lehoczky, E; Kismányoky, T

    2006-01-01

    We carried our examination in a long-term fertilization field experiment in 2005. In the experiment we had opportunity to compare the weediness in NPK and NPK + FYM1 treatments, and we could study the effect of increasing N dosis on the weeds and maize. The bi-factorial trial was arranged in split plot design with three replications. The weed survey was made 25 days after seeding in the 27th of may. For the weed survey the Balázs-Ujvárosi method was applied. After the weed survey we collected all the weed species from the plots per 1-1 m2. We counted, mesured the fresh and dry matter weight of aerial shoots. We collected maize too, five pieces per plots. In the experiment were found 12 weed species, 9 annual: Abutilon theophrasti, Amaranthus chlorostachys, Ambrosia artemisiifolia, Chenopodium album, Chenopodium hybridum, Echinochloa crus-galli, Polygonum lapathifolium, Xantium strumarium, Veronica hederi-folia, and 3 perennial: Cirsium arvense, Convolvulus arvensis, Lathyrus tuberosus. On the NPK plots the Ch. album, on NPK + FYM treatments the A. theophrasti was the first in order of the dominance. The biomass production of weeds in the NPK + FYM treatments were 3 times higher than in the only NPK treatments.

  10. 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. PMID:25570379

  11. 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. PMID:18593229

  12. A Smart Homecage System with 3D Tracking for Long-Term Behavioral Experiments

    PubMed Central

    Lee, Byunghun; Kiani, Mehdi; Ghovanloo, Maysam

    2015-01-01

    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. PMID:25570379

  13. [Using focus groups to explore the group music therapy experience of long term care elderly].

    PubMed

    Lin, Hui-Chuan; Chen, Shu-Ling

    2007-04-01

    The purpose of this study was to explore the elderly's experience and perceptions of group music therapy. The residents of a long term care institution received group music therapy for one year. Afterwards, three interviews were conducted in focus groups of between six and eight of the elderly. Their ages ranged from 64 to 90. Ninety-five percent of these elderly subjects participated in the therapy for over ten months. The tape-recorded interviews were transcribed and analyzed using content analysis. Six themes emerged regarding the elderly subjects' experiences and perceptions of group music therapy, as follows: (1) becoming more willing to participate; (2) feeling pain relief and more controlled moods; (3) getting physically better; (4) being more motivated to live; (5) learning positive personal interaction and obedience to the rules of the group; and (6) learning skills to improve personal health. This information might be used as a helpful and valuable reference in nursing education and by administrative organizations involved in the planning of therapeutic programs for the elderly.

  14. Long term pH-static experiments in combination with computer modelling

    SciTech Connect

    Baeverman, C.; Neretnieks, I.

    1996-12-31

    Large quantities of MSWI bottom ash are produced in the world today, and has to be taken care of. According to the physical properties of the ash it can be used, instead of gravel, as filling material in, for example, road construction. For environmental reasons this is acceptable only if the leaching from the construction does not affect the surroundings. In Sweden the bottom ash has so far been placed in landfills and even there the environmental impact has to be minimized. Long term pH-static experiments have been performed on municipal solid waste (MSWI) bottom ash between pH 6 and 9.25. Most of the reactions take place within the first 50 days of the experiment. The experiments resulted in a pH titration curve that can be used for determining the pH buffering capacity at different pH levels. The curve is used to assess the different pK{sub a}-values of the ash. These can be used to identify the main pH buffering minerals in the ash as the pK{sub a}-values are mineral specific. The buffering capacity at the different pK{sub a}-values gives the amount of the mineral present in the ash. The information obtained by the pH-static experiments can be used for long time computer simulations with geochemical transport programs. Both laboratory experiments and computer simulations have shown that the pH buffering capacity is the key variable that controls the leaching of many metals e.g. copper. Simulations have shown that the copper in a pile of ash can be accumulated at a pH front, where the pH changes rapidly because the buffering capacity is depleted, and later leached all at the same time with very high concentration.

  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. 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

  17. Long-term experience with ZENPEP in infants with exocrine pancreatic insufficiency associated with cystic fibrosis.

    PubMed

    Wooldridge, Jamie L; Schaeffer, David; Jacobs, David; Thieroff-Ekerdt, Ruth

    2014-11-01

    The objective of our study was to determine whether infants with cystic fibrosis who developed exocrine pancreatic insufficiency in early infancy would tolerate long-term treatment with ZENPEP (pancrelipase) delayed-release capsules, containing 3000 US Pharmacopeia units of lipase/capsule, and demonstrate consistent long-term growth. The most common treatment-emergent adverse events were diarrhea, vomiting, and constipation (mild or moderate). At study completion, median weight-for-age percentiles increased from 22nd to 49th, median length-for-age percentiles increased from 36.5th to 42nd, and median weight-for-length percentiles increased from 41.5th to 55.5th. Long-term treatment (up to 12 months) of infants with exocrine pancreatic insufficiency owing to cystic fibrosis with ZENPEP was well tolerated and associated with improved growth parameters. This is the first long-term study of pancreatic enzyme replacement therapy conducted in this patient population.

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

    PubMed

    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 x 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.

  19. Towards A Smart Experimental Arena for Long-Term Electrophysiology Experiments

    PubMed Central

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

    2011-01-01

    Advancements in wireless power and data transmission have raised the prospects of using a variety of low power microelectronic devices such as biosensors, stimulators, and actuators in long-term uninterrupted electrophysiology experiments on small freely behaving animal subjects in large experimental arenas. This paper presents our progress towards developing such a system, called the EnerCage. This system includes a stationary unit for inductive power transmission through a scalable array of overlapping hexagonal coils, which are optimized using an accurate inductive link model and an iterative optimization process. Furthermore, the EnerCage system is equipped with an array of 3-D magnetic sensors and a smart tracking algorithm for non-line-of-sight positioning of the animal subject. EnerCage also has a small mobile unit, which is either attached to or implanted in the subject’s body. This unit includes a magnetic tracer and an efficient power management block, which is capable of closed-loop regulated inductive power delivery to the experimental device(s) of interest. An early prototype of the EnerCage system with six coils has been presented here. The coil array achieves a power efficiency of 17.8% at the worst-case horizontal misalignment of 42 mm (half of the coil radius) at a coupling distance of 70 mm with the mobile unit coil of 20 mm in radius. PMID:23853228

  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. Long-term selection experiment produces breakdown of horizontal transmissibility in parasite with mixed transmission mode.

    PubMed

    Dusi, Eike; Gougat-Barbera, Claire; Berendonk, Thomas U; Kaltz, Oliver

    2015-04-01

    Evolutionary transitions from parasitism toward beneficial or mutualistic associations may encompass a change from horizontal transmission to (strict) vertical transmission. Parasites with both vertical and horizontal transmission are amendable to study factors driving such transitions. In a long-term experiment, microcosm populations of the protozoan Paramecium caudatum and its bacterial parasite Holospora undulata were exposed to three growth treatments, manipulating vertical transmission opportunities over ca. 800 host generations. In inoculation tests, horizontal transmission propagules produced by parasites from a "high-growth" treatment, with elevated host division rates increasing levels of parasite vertical transmission, showed a near-complete loss of infectivity. A similar reduction was observed for parasites from a treatment alternating between high growth and low growth (i.e., low levels of population turn-over). Parasites from a low-growth treatment had the highest infectivity on all host genotypes tested. Our results complement previous findings of reduced investment in horizontal transmission and increased vertical transmissibility of high-growth parasites. We explain the loss of horizontal transmissibility by epidemiological feedbacks and resistance evolution, reducing the frequency of susceptible hosts in the population and thereby decreasing the selective advantage of horizontal transmission. This illustrates how environmental conditions may push parasites with a mixed transmission mode toward becoming vertically transmitted nonvirulent symbionts. PMID:25756600

  2. Long-Term Surveillance and Maintenance at Rocky Flats: Early Experiences and Lessons Learned

    SciTech Connect

    Surovchak, S.; Kaiser, L.; DiSalvo, R.; Boylan, J.; Squibb, G.; Nelson, J.; Darr, B.; Hanson, M.

    2008-07-01

    The U.S. Department of Energy's (DOE's) Rocky Flats Site was established in 1951 as part of the United States' nationwide nuclear weapons complex to manufacture nuclear weapons components. In 1992 weapons production halted, and the Rocky Flats mission changed to include environmental investigations, cleanup, and site closure. In October 2005, DOE and its contractor completed an accelerated 10-year, $7 billion cleanup of chemical and radiological contamination left from nearly 50 years of production. The cleanup required the decommissioning, decontamination, demolition, and removal of more than 800 structures; removal of more than 500,000 cubic meters of low-level radioactive waste; and remediation of more than 360 potentially contaminated environmental sites. The final remedy for the site was selected in September 2006 and included institutional controls, physical controls, and continued monitoring for the former industrial portion of the site. The remainder of the site, which served as a buffer zone surrounding the former industrial area, was transferred to the U.S. Fish and Wildlife Service in July 2007 for a national wildlife refuge. DOE's Office of Legacy Management is responsible for the long-term surveillance and maintenance of Rocky Flats, which includes remedy implementation activities and general site maintenance. Several factors have complicated the transition from closure to post-closure at Rocky Flats. The early experiences associated with the two years since the physical cleanup and closure work were completed have led to several valuable lessons learned. (authors)

  3. Towards a wireless optical stimulation system for long term in-vivo experiments.

    PubMed

    Mirbozorgi, S A; Ameli, R; Sawan, M; Gosselin, B

    2014-01-01

    This paper presents our recent progresses towards the development of a wirelessly powered head mountable optical stimulator for enabling long-term optogenetic experiments with small freely moving transgenic models. The proposed system includes a wireless power transmission chamber with uniform power distribution in 3D and a wireless head mountable optical stimulator prototype with power recovery. The wireless power link, which includes the inductive chamber and power recovery circuits, is robust against subject movements in all directions, and against angular misalignment. Such link provides uniform power distribution without the need for a closed-loop control system, and can localize the transmitted power towards the receiver, without using additional detection and control circuitry compared to other systems. Additionally, the chamber is equipped with a camera for capturing the animal motion and behavior after applying optical stimulation patterns. A low-power microcontroller unit is embedded with the stimulator prototype to generate arbitrary light stimulation patterns. Measurement results show that the inductive chamber can continuously deliver 70 mW to the stimulator prototype with a power efficiency of 59%. PMID:25570381

  4. Long-term selection experiment produces breakdown of horizontal transmissibility in parasite with mixed transmission mode.

    PubMed

    Dusi, Eike; Gougat-Barbera, Claire; Berendonk, Thomas U; Kaltz, Oliver

    2015-04-01

    Evolutionary transitions from parasitism toward beneficial or mutualistic associations may encompass a change from horizontal transmission to (strict) vertical transmission. Parasites with both vertical and horizontal transmission are amendable to study factors driving such transitions. In a long-term experiment, microcosm populations of the protozoan Paramecium caudatum and its bacterial parasite Holospora undulata were exposed to three growth treatments, manipulating vertical transmission opportunities over ca. 800 host generations. In inoculation tests, horizontal transmission propagules produced by parasites from a "high-growth" treatment, with elevated host division rates increasing levels of parasite vertical transmission, showed a near-complete loss of infectivity. A similar reduction was observed for parasites from a treatment alternating between high growth and low growth (i.e., low levels of population turn-over). Parasites from a low-growth treatment had the highest infectivity on all host genotypes tested. Our results complement previous findings of reduced investment in horizontal transmission and increased vertical transmissibility of high-growth parasites. We explain the loss of horizontal transmissibility by epidemiological feedbacks and resistance evolution, reducing the frequency of susceptible hosts in the population and thereby decreasing the selective advantage of horizontal transmission. This illustrates how environmental conditions may push parasites with a mixed transmission mode toward becoming vertically transmitted nonvirulent symbionts.

  5. Long-term rearrangements of hippocampal mossy fiber terminal connectivity in the adult regulated by experience.

    PubMed

    Galimberti, Ivan; Gogolla, Nadine; Alberi, Stefano; Santos, Alexandre Ferrao; Muller, Dominique; Caroni, Pico

    2006-06-01

    We investigated rearrangements of connectivity between hippocampal mossy fibers and CA3 pyramidal neurons. We found that mossy fibers establish 10-15 local terminal arborization complexes (LMT-Cs) in CA3, which exhibit major differences in size and divergence in adult mice. LMT-Cs exhibited two types of long-term rearrangements in connectivity in the adult: progressive expansion of LMT-C subsets along individual dendrites throughout life, and pronounced increases in LMT-C complexities in response to an enriched environment. In organotypic slice cultures, subsets of LMT-Cs also rearranged extensively and grew over weeks and months, altering the strength of preexisting connectivity, and establishing or dismantling connections with pyramidal neurons. Differences in LMT-C plasticity reflected properties of individual LMT-Cs, not mossy fibers. LMT-C maintenance and growth were regulated by spiking activity, mGluR2-sensitive transmitter release from LMTs, and PKC. Thus, subsets of terminal arborization complexes by mossy fibers rearrange their local connectivities in response to experience and age throughout life.

  6. 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.

  7. 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).

  8. Control and driving of pneumatic total artificial hearts TNS-BRNO-II and -III in long-term experiments.

    PubMed

    Vasků, J; Urbánek, P; Vasků, J; Cerný, J; Smutný, M; Urbánek, E; Suchánek, J; Gregor, Z; Dostál, M; Guba, P

    1986-04-01

    Hemodynamic analysis was carried out during long-term experiments with the pneumatic total artificial hearts TNS-BRNO-II and TNS-BRNO-III to determine standard methods of starting artificial hearts and criteria for their long-term operation in vivo. In long-term experiments, regulatory mechanisms automatically regulating the systole length and diastolic aspiration pressure have also been verified. Comparison of hemodynamic variables obtained from invasive measurements with pneumatic pressure curves permitted the control and monitoring of the experiment in its entirety by noninvasive methods only. The control of the artificial heart using the Chirasist TN 3 and Chirasist TN 4 was adapted to specific properties of the pumps, above all to the functions of the atypical inlet valves. The terminal stages of the experiments have shown that a 100-ml pump can ensure survival of experimental calves up to 210 kg body weight.

  9. Increased frequency of chromosome translocations in airline pilots with long-term flying experience

    PubMed Central

    Yong, L C; Sigurdson, A J; Ward, E M; Waters, M A; Whelan, E A; Petersen, M R; Bhatti, P; Ramsey, M J; Ron, E; Tucker, J D

    2008-01-01

    Background Chromosome translocations are an established biomarker of cumulative exposure to external ionising radiation. Airline pilots are exposed to cosmic ionising radiation, but few flight crew studies have examined translocations in relation to flight experience. Methods We determined the frequency of translocations in the peripheral blood lymphocytes of 83 airline pilots and 50 comparison subjects (mean age 47 and 46 years, respectively). Translocations were scored in an average of 1039 cell equivalents (CE) per subject using fluorescence in situ hybridisation (FISH) whole chromo-some painting and expressed per 100 CE. Negative binomial regression models were used to assess the relationship between translocation frequency and exposure status and flight years, adjusting for age, diagnostic x ray procedures, and military flying. Results There was no significant difference in the adjusted mean translocation frequency of pilots and comparison subjects (0.37 (SE 0.04) vs 0.38 (SE 0.06) translocations/100 CE, respectively). However, among pilots, the adjusted translocation frequency was significantly associated with flight years (p = 0.01) with rate ratios of 1.06 (95% CI 1.01 to 1.11) and 1.81 (95% CI 1.16 to 2.82) for a 1- and 10-year incremental increase in flight years, respectively. The adjusted rate ratio for pilots in the highest compared to the lowest quartile of flight years was 2.59 (95% CI 1.26 to 5.33). Conclusions This data suggests that pilots with long-term flying experience may be exposed to biologically significant doses of ionising radiation. Epidemiological studies with longer follow-up of larger cohorts of pilots with a wide range of radiation exposure levels are needed to clarify the relationship between cosmic radiation exposure and cancer risk. PMID:19074211

  10. 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.

  11. 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. PMID:27111686

  12. Lower Barthel Index Is Associated with Higher Risk of Hospitalization-Requiring Pneumonia in Long-Term Care Facilities.

    PubMed

    Shiao, Chih-Chung; Hsu, Hsiu-Chuan; Chen, I-Ling; Weng, Ching-Yi; Chuang, Jui-Chu; Lin, Su-Chiu; Tsai, Fong-Fong; Chen, Zen-Yong

    2015-01-01

    Pneumonia is an important infectious entity that affects residents in long-term care facilities (LTCFs), whereas hospitalization-requiring pneumonia (HRP) represents a more critical patient condition with worse outcomes. The evidence addressing the association between Barthel index and risk of HRP among LTCF residents is lacking. A multicenter, retrospective cohort study was conducted in three LTCFs enrolling adult patients who resided for 3 months or more and ever underwent Barthel index evaluation within a study period of January 1 to December 31, 2010. The endpoint was HRP after enrollment. A total of 299 patients (169 women; age, 79.0 ± 12.2 years) were enrolled and categorized into HRP Group (n = 68; 36 women; age, 79.1 ± 11.3 years) and Non-HRP Group (n = 231; 133 women; age, 79.0 ± 12.4 years) by the endpoint. The patients in HRP Group had significantly lower Barthel index (8.6 versus 25.8 points, p < 0.001) but higher proportion of chronic obstructive pulmonary disease (13.2% versus 3.9%, p = 0.004). By the multivariate analysis of logistic regression, we found that lower Barthel index (odds ratio (OR), 0.967; p < 0.001), existence of chronic obstructive pulmonary disease (OR, 4.192; p = 0.015), and feeding route (percutaneous endoscopic gastrostomy comparing with oral feeding; OR, 0.177; p = 0.012) were independently associated with HRP. In conclusion, a lower Barthel index is significantly associated with the occurrence of pneumonia that requires hospitalization in long-term care residents. Barthel index is a useful and reliable tool for risk evaluation in this population.

  13. Long-term care: dignity, autonomy, family integrity, and social sustainability: the Hong Kong experience.

    PubMed

    Chan, Ho Mun; Pang, Sam

    2007-01-01

    This article reveals the outcome of a study on the perceptions of elders, family members, and healthcare professionals and administration providing care in a range of different long-term care facilities in Hong Kong with primary focus on the concepts of autonomy and dignity of elders, quality and location of care, decision making, and financing of long term care. It was found that aging in place and family care were considered the best approaches to long term care insofar as procuring and balancing the values of dignity, autonomy, family integrity and social sustainability were concerned. An elder having the final say was generally accepted. The results also initiated the importance of sharing of financial responsibility among elders, children and government albeit the emphasis was placed on individuals. Furthermore, dignity of elders was not considered purely a synonym of autonomy, but it had also to do with respect, family and social connections.

  14. 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

  15. 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

  16. The long term prognosis in patients following thrombolysis for acute myocardial infarction: a view from a community hospital.

    PubMed

    Brophy, J M; Boulerice, M; Kerouac, M

    1996-08-01

    Thrombolysis in patients with acute myocardial infarction has been established to improve hospital survival. Less information is available about the long term evolution of unselected patients seen in community hospitals. Consequently, consecutive patients treated with thrombolysis for acute myocardial infarction and surviving until hospital discharge (n = 129) were followed for an average of 22 months. Mortality, recurrent ischemic events, coronary angiography and re-vascularizations were recorded for all patients. Two-year total and cardiovascular survival rates of 95 and 98% respectively were obtained with a conservative approach to early re-vascularization (n = 17, 13%). A history of prior myocardial infarction and early recurrent myocardial ischemia were significant predictors of increased cardiac events, while thallium stress testing provided no incremental value. Angiography and re-vascularizations were more frequently performed in younger patients (under 65 years old), anterior vs. inferior infarction and those with early residual ischemia. Women received less aggressive investigation and therapy then men and this may represent a gender bias, unmeasured residual confounding or the play of chance in a small sample size. Further studies are needed to confirm or refute these findings.

  17. 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

  18. 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.

  19. 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.

  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. PMID:26705967

  1. 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…

  2. 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…

  3. Teacher Experience, Learning, and Change: An Investigation of the Effects of Long-Term Professional Development

    ERIC Educational Resources Information Center

    Coffino, Kara Lee

    2012-01-01

    As US public schools become increasingly diverse and teachers are expected to teach across cultural differences, teacher educators must consider how different professional development models shape teacher learning and practice. This study explores how a cohort of 55 P-12 teachers experienced and perceived long-term professional development focused…

  4. Phylogenetic Distribution of Virulence Genes Among ESBL-producing Uropathogenic Escherichia coli Isolated from Long-term Hospitalized Patients

    PubMed Central

    Zhao, Ruike; Shi, Jinfang; Shen, Yimin; Li, Yanmeng; Han, Qingzhen; Zhang, Xianfeng; Gu, Guohao

    2015-01-01

    Objectives The present study was aimed to investigate the antibiotic resistance, virulence potential and phylogenetic grouping of ESBL-producing uropathogenic Escherichia coli (EP-UPEC) isolated from long-term hospitalized patients. Materials and Methods EP-UPEC isolates from September 2013 to June 2014 at a tertiary care hospital of China were screened for ESBL-production by the double disk diffusion test. Isolates with ESBL-phenotype were further characterized by antibiotic resistance testing, PCR of different ESBL and virulence genes, and phylogenetic grouping. Results One hundred and twenty EP-UPEC were isolated from long-term hospitalized patients. All EP-UPEC isolates were resistant to Ampicillin, Cefazolin, Cefuroxime, Cefotaxime, Cefoperazone and Ceftriaxone, and the majority of EP-UPEC isolates were resistant to Piperacillin (82.5%), Ciprofloxacin (81.2%), Trimethoprim-Sulfamethoxazole (72.5%). The isolates showed the highest sensitivity against Imipenem (98.4%), Piperacillin/tazobactam (96.7%), Cefoperazone/sulbactam (91.7%), Amikacin (90.8%) and Cefepime (75.8%). Nine different ESBL genotype patterns were observed and CTX-M type was the most prevalent ESBL genotype (42.5%, 51/120). Majority of EP-UPEC isolates possess more than one ESBL genes. EP-UPEC isolates belonged mainly to phylogenetic group B2(36.7%) and D(35.0%). The prevalence of traT, ompT, iss, PAI, afa, fimH and papC were 75.8%, 63.3%, 63.3%, 60.8%, 40.8%, 19.2% and 6.7%, respectively. The number of virulence genes (VGs) detected was significantly higher in group B2 than in group A (ANOVA, p<0.001), group B1(ANOVA, p= 0.012) and D (ANOVA, p<0.001). Conclusions EP-UPEC strains showed multidrug resistance and co-resistance to other non β-lactam antibiotics. CTX-M was the most prevalent ESBL genotype and majority of EP-UPEC strains more than one ESBL genes. EP-UPEC strains belonged mainly to phylogenetic group B2 and D, and most of the virulence genes were more prevalent in group B2. PMID

  5. 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

  6. Early experiences of the use of remote patient monitoring for the long term management of chronic disease.

    PubMed

    Clarke, Malcolm; Fursse, Joanna; Jones, Russell W

    2008-01-01

    We describe our experiences of using remote patient monitoring to support the long term management and clinical intervention in patients with chronic disease. Within the project we developed new algorithms to determine from vital signs collected on a daily basis, those patients requiring clinical investigation for their condition. Our aim was for patients to achieve and sustain clinically recommended values for parameters. In our study, the telemonitoring prompted clinical intervention in 37% of patients. Our approach proved particularly effective for the newly diagnosed, and for those with long term issues of management. PMID:19164051

  7. 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...

  8. The long-term agroecological research (LTAR) experiment supports organic yields, soil quality, and economic performance in Iowa

    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 main goals of the project are to evalua...

  9. The Long-Term Effects of College Diversity Experiences: Well-Being and Social Concerns 13 Years after Graduation

    ERIC Educational Resources Information Center

    Bowman, Nicholas A.; Brandenberger, Jay W.; Hill, Patrick L.; Lapsley, Daniel K.

    2011-01-01

    Many college administrators and researchers assert that diversity interactions are critical for preparing young adults for a diverse society, but very little research has examined the long-term impact of these experiences. This study examines a longitudinal sample of college students (n = 416) who were followed into their mid-30s. Structural…

  10. 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…

  11. 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,…

  12. "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…

  13. Adult Supratentorial Low-Grade Glioma: Long-Term Experience at a Single Institution

    SciTech Connect

    Bauman, Glenn; Fisher, Barbara; Watling, Christopher; Cairncross, J. Gregory; Macdonald, David

    2009-12-01

    Purpose: To report the long-term follow-up of a cohort of adult patients with supratentorial low-grade glioma treated at a single institution. Methods and Materials: A cohort of 145 adult patients treated at the London Regional Cancer Program between 1979 and 1995 was reviewed. Results: With a median follow-up of 105 months, the median progression-free survival was 61 months (95% confidence interval, 53-77), and the median overall survival was 118 months (95% confidence interval, 93-129). The 10- and 20-year progression-free and overall survival rate was 18% and 0% and 48% and 22%, respectively. Cox regression analysis confirmed the importance of age, histologic type, presence of seizures, Karnofsky performance status, and initial extent of surgery as prognostic variables for overall and cause-specific survival. Function among long-term survivors without tumor progression was good to excellent for most patients. Conclusion: Low-grade glioma is a chronic disease, with most patients dying of their disease. However, long-term survival with good function is possible. Survival is determined primarily by the disease factors with selection and timing of adjuvant treatments having less influence on outcome.

  14. Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results

    PubMed Central

    Lee, Jae-Hong; Yeom, Sang Yoon; Hwang, Ho Young; Choi, Jae-Woong; Cho, Hyun-Jai; Lee, Hae-Young; Huh, Jae-Hak; Kim, Ki-Bong

    2016-01-01

    Background We evaluated early and long-term results after heart transplantation (HTPL). Methods One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients. PMID:27525232

  15. 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.

  16. Long-Term Survival and Outcome in Children Admitted to Kilifi District Hospital with Convulsive Status Epilepticus

    PubMed Central

    Mung'ala Odera, Victor; Seaton, Claire; Holding, Penny; Newton, Charles R.

    2014-01-01

    Objectives. The incidence of convulsive status epilepticus (CSE) is high in Africa but the long-term outcome is unknown. We examined the neurocognitive outcome and survival of children treated for CSE in a Kenyan hospital 3 to 4 years after discharge. Methods. The frequency and nature of neurological deficits among this group of children were determined and compared to a control group. The children were screened with the Ten Questions Questionnaire for neurodevelopmental impairment if alive and those that screened positive were invited for further assessment to determine the pattern and extent of their impairment. A verbal autopsy was performed to determine the cause of death in those that died. Results. In the 119 cases followed-up, 9 (8%) died after discharge, with the majority having seizures during their fatal illness. The 110 survivors (median age 5 years) had significantly more neurological impairments on the screening compared to 282 controls (34/110 (30.9%) versus 11/282 (3.9%), OR = 11.0, 95% CI 5.3–22.8). Fifteen percent of the cases had active epilepsy. Conclusions. This study demonstrates the considerable burden of CSE in African children. Strategies to manage children with CSE that are acceptable to the community need to be explored to improve the longer-term outcome. PMID:24627807

  17. 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.

  18. [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.

  19. The Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Colonization and Infection among Long-Term Acute Care Hospital Residents.

    PubMed

    Mills, John P; Talati, Naasha J; Alby, Kevin; Han, Jennifer H

    2016-01-01

    OBJECTIVE An improved understanding of carbapenem-resistant Klebsiella pneumoniae (CRKP) in long-term acute care hospitals (LTACHs) is needed. The objective of this study was to assess risk factors for colonization or infection with CRKP in LTACH residents. METHODS A case-control study was performed at a university-affiliated LTACH from 2008 to 2013. Cases were defined as all patients with clinical cultures positive for CRKP and controls were those with clinical cultures positive for carbapenem-susceptible K. pneumoniae (CSKP). A multivariate model was developed to identify risk factors for CRKP infection or colonization. RESULTS A total of 222 patients were identified with K. pneumoniae clinical cultures during the study period; 99 (45%) were case patients and 123 (55%) were control patients. Our multivariate analysis identified factors associated with a significant risk for CRKP colonization or infection: solid organ or stem cell transplantation (OR, 5.05; 95% CI, 1.23-20.8; P=.03), mechanical ventilation (OR, 2.56; 95% CI, 1.24-5.28; P=.01), fecal incontinence (OR, 5.78; 95% CI, 1.52-22.0; P=.01), and exposure in the prior 30 days to meropenem (OR, 3.55; 95% CI, 1.04-12.1; P=.04), vancomycin (OR, 2.94; 95% CI, 1.18-7.32; P=.02), and metronidazole (OR, 4.22; 95% CI, 1.28-14.0; P=.02). CONCLUSIONS Rates of colonization and infection with CRKP were high in the LTACH setting, with nearly half of K. pneumoniae cultures demonstrating carbapenem resistance. Further studies are needed on interventions to limit the emergence of CRKP in LTACHs, including targeted surveillance screening of high-risk patients and effective antibiotic stewardship measures. Infect. Control Hosp. Epidemiol. 2015;37(1):55-60. PMID:26455382

  20. Long-term Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma at Farabi Eye Hospital, Tehran, Iran

    PubMed Central

    Zarei, Reza; Amini, Heidar; Daneshvar, Ramin; Nabi, Fahimeh Naderi; Moghimi, Sasan; Fakhraee, Ghasem; Eslami, Yadollah; Mohammadi, Masoud; Amini, Nima

    2016-01-01

    Purpose: To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran. Materials and Methods: This retrospective cohort study evaluated patient records of all subjects with refractory glaucoma who had undergone AGV implantation up to January 2013. The main outcome measure was the surgical success rate. Complete success was defined as intraocular pressure (IOP) <22 mmHg, without anti-glaucoma medications or additional surgery. Qualified success was IOP <22 mmHg regardless of number of anti-glaucoma medications. In all cases, loss of vision (no light perception) was considered an independent indicator of failure. Data were also collected on intraoperative and postoperative complications. Results: Twenty-eight eyes were included in the study. With a mean follow-up of 48.2 ± 31.7 months (median: 40.50 months; range: 3–124 months), the IOP decreased from a mean preoperative value of 30.8 ± 5.6 mmHg to 20.0 ± 6.4 mmHg at last visit. The number of medications decreased from 3.7 ± 0.4 preoperatively to 2.5 ± 1.1 postoperatively. Cumulative qualified success was achieved in 69% of eyes. Mean time to failure according to qualified success criteria was 92.3 ± 9.4 months. Postoperative complications were recorded in 16 (57.1%) eyes. The most common complication was focal endothelial corneal decompensation at the site of tube-cornea touch. Conclusion: AGV implantation with adjunctive topical anti-glaucoma drops controlled IOP in approximately 70% of eyes with refractory glaucoma with a median of 40.5 months of follow-up. However, complication rates were higher. PMID:26957848

  1. 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.

  2. 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.

  3. Climate Effects and Feedback Structure Determining Weed Population Dynamics in a Long-Term Experiment

    PubMed Central

    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. PMID:22272362

  4. 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. PMID:26953041

  5. 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.

  6. 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.

  7. Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center.

    PubMed

    Casigliani Rabl, S; Della Rossa, A; Pepe, P; D'Ascanio, A; Mosca, M; Di Vita, A; Bombardieri, S

    2012-01-01

    The aim of the present study was to retrospectively evaluate response to therapy in 73 patients affected by systemic sclerosis (SSc) who underwent long-term cyclic treatment with intravenous iloprost for peripheral vascular involvement (average duration of treatment 54.12±41.04 months). Seventy-three SSc patients were enrolled. Data were collected by reviewing clinical records and by phone or direct interview. Patients underwent a thorough physical examination at the end of follow up. The incidence of severe vascular manifestations was also assessed. Statistical analysis was performed by Wilcoxon's signed rank test and descriptive statistics using Statview software. In this study cohort, 55 of 73 (75.2%) patients had a history of ischemic digital ulcers (DUs); 28 patients (38.4%) had active DUs at the beginning of treatment. Skin ulcers healed completely in 25 of 28 patients (89.3%) at the end of the first treatment. However, 40 of 55 patients (72.6%) relapsed after an average of 24 months. There was a significant correlation between relapse rate and/or number of ulcers and clinical factors (diffuse subset, changes in results of Allen's test, NT-pro BNP levels). The annual incidence of pulmonary arterial hypertension (PAH) was 2.34 (95%CI: 0.94-4.83) per 100 person years, the rate of gangrene was 2.7%, and no cases of scleroderma renal crisis were recorded. The incidence of PAH and of digital gangrene was higher than that observed in unselected SSc case series. These data suggest that our patients treated with iloprost have a higher vascular involvement than large case series of unselected SSc patients. A number of clinical factors are correlated to the severity of vascular involvement and could have an impact on the response to therapy. The clinical significance of these findings requires clarification and further investigation is needed. PMID:22842299

  8. The reality of returning to work and training: experiences from a long-term unemployment project.

    PubMed

    Juvonen-Posti, Pirjo; Piirainen, Keijo; Kallanranta, Tapani; Keinänen-Kiukaanniemi, Sirkka

    2004-09-01

    A project called Pathway-to-Work was carried out in northern Finland between 1995 and 1998. In the course of this project, tailored return-to-work paths were planned for 140 long-term unemployed people with disabilities. The present study, based on that project, had three research objectives: (i) to describe how the participants experienced and defined their opportunities of employment and training at the beginning of the project and how the opportunities were eventually realized; (ii) to form a model of the issues that influenced the participants' decision making on the basis of their descriptions of their life situation; and (iii) to look for elements in the progression of the project that could explain the outcome in terms of the participants' situation in the labour market. The research design was composed of three parts: eight in-depth interviews, a register follow-up, and comparison with a matched control group. Comparative content analysis was used to process the in-depth interviews. The outcome was evaluated according to the following variables: (i) the changes in the participants' labour market situation during the 2-year follow-up; (ii) the changes in the participants' distress level, perceived competence, and sense of coherence during the intervention. We found that the participants had not decided whether to return to work but had left this decision to the professional working on the project. The way participants described their life situations and opportunities made it clear that they placed high expectations on the project. However, although they could realistically estimate their own potential, the labour-market situation was beyond their predictive vision. We conclude that, when targeting services to groups such as described here, more attention should be paid to understanding the clients' behaviour and the social circumstances in which they live. PMID:15319692

  9. 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

  10. Long-Term Influence of the BOREAS Field Experiment on Carbon Cycle and Ecosystem Research in Canada

    NASA Astrophysics Data System (ADS)

    Margolis, H. A.

    2015-12-01

    The NASA-led Boreal Ecosystem-Atmosphere Study (BOREAS) field experiment brought together an interdisciplinary team of scientists during the mid-1990's to study biosphere-atmosphere interactions of the boreal forest biome in Saskatchewan and Manitoba, Canada. It represented the beginning of coordinated, long-term eddy covariance flux tower measurements of the exchanges of carbon dioxide, water, and energy at the ecosystem scale in Canada and initiated research on how to upscale these processes to larger spatial domains using remote sensing. The focus of this presentation will be on the long-term impacts of BOREAS on carbon cycle and ecosystems research in Canada. The BOREAS flux tower effort was expanded to the national level in Canada through the Fluxnet-Canada and Canadian Carbon Program research networks (2002-2011). Within these two research networks, many of the Canadian scientists brought together during BOREAS continued their close scientific collaborations and maintained their links to related programs in the US such as the North American Carbon Program. These Canadian efforts allowed us to improve greatly our understanding of the impacts of inter-annual climate variability and ecological disturbance on carbon, water and energy dynamics of northern forests and allowed us to use these flux data for calibration and validation of a wide-range of ecosystem modelling and analysis efforts. Many of the flux tower measurements continue to this day and they assure the long-term legacy of the NASA Terrestrial Ecology Program's initial investment in the BOREAS field campaign.

  11. 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

  12. Long term outcomes of cardiac transplant for immunoglobulin light chain amyloidosis: The Mayo Clinic experience

    PubMed Central

    Grogan, Martha; Gertz, Morie; McCurdy, Arleigh; Roeker, Lindsey; Kyle, Robert; Kushwaha, Sudhir; Daly, Richard; Dearani, Joseph; Rodeheffer, Richard; Frantz, Robert; Lacy, Martha; Hayman, Suzanne; McGregor, Christopher; Edwards, Brooks; Dispenzieri, Angela

    2016-01-01

    rejection at a median of 1.8 mo post OHT (range 0.4 to 4.9 mo); only one patient died of rejection. Median survival of seven patients who achieved a complete hematologic response to either chemotherapy or autologous hematopoietic stem cell transplantation was 10.8 years. CONCLUSION: Our data demonstrate that long term survival after heart transplant is feasible in AL patients with limited extra-cardiac involvement who achieve complete hematologic response. PMID:27358783

  13. Does long-term care use within primary health care reduce hospital use among older people in Norway? A national five-year population-based observational study

    PubMed Central

    2011-01-01

    Background Population ageing may threaten the sustainability of future health care systems. Strengthening primary health care, including long-term care, is one of several measures being taken to handle future health care needs and budgets. There is limited and inconsistent evidence on the effect of long-term care on hospital use. We explored the relationship between the total use of long-term care within public primary health care in Norway and the use of hospital beds when adjusting for various effect modifiers and confounders. Methods This national population-based observational study consists of all Norwegians (59% women) older than 66 years (N = 605676) (13.2% of total population) in 2002-2006. The unit of analysis was defined by municipality, age and sex. The association between total number of recipients of long-term care per 1000 inhabitants (LTC-rate) and hospital days per 1000 inhabitants (HD-rate) was analysed in a linear regression model. Modifying and confounding effects of socioeconomic, demographic and geographic variables were included in the final model. We defined a difference in hospitalization rates of more than 1000 days per 1000 inhabitants as clinically important. Results Thirty-one percent of women and eighteen percent of men were long-term care users. Men had higher HD-rates than women. The crude association between LTC-rate and HD-rate was weakly negative. We identified two effect modifiers (age and sex) and two strong confounders (travel time to hospital and mortality). Age and sex stratification and adjustments for confounders revealed a positive statistically significant but not clinically important relationship between LTC-rates and hospitalization for women aged 67-79 years and all men. For women 80 years and over there was a weak but negative relationship which was neither statistically significant nor clinically important. Conclusions We found a weak positive adjusted association between LTC-rates and HD-rates. Opposite to common

  14. 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

  15. Rotary Blood Pumps as Long-Term Mechanical Circulatory Support: A Review of a 15-Year Berlin Experience.

    PubMed

    Hetzer, Roland; Kaufmann MEng, Friedrich; Potapov, Evgenij; Krabatsch, Thomas; Delmo Walter, Eva Maria

    2016-01-01

    This article reports our 15-year single-center experience with rotary blood pumps (RBPs) as long-term mechanical circulatory support (MCS) with emphasis on outcomes. For more than 15-year period, we have used various RBPs as bridge to transplantation or to myocardial recovery. Our group performed the first human implantation worldwide of RBCs, the MicroMed DeBakey ventricular assist device in November 1998 in a patient with end-stage heart failure who was supported for 47 days until his death. Based on this initial experience, we recognized the feasibility of providing long-term support and since then it has been our primary armamentarium in treating patients with heart failure. Between 1987 and September 2013, we have implanted 2208 ventricular assist devices ranging from pulsatile to continuous-flow systems, as short-term, long-term, or permanent support in patients with end-stage heart failure. In total, 1009 RBPs were implanted on 908 patients, and their outcomes are reported here. We have shared some milestones in MCS including the first implantation of Jarvik 2000 on the oldest patient (81-year old) in 2008 and the first worldwide implantation of a biventricular HeartWare. Over time, implantation techniques, anticoagulation, and postoperative care have been modified and individualized. A relevant aspect of our experience has been the incidence of pump thrombosis. This is particularly frustrating because the problem has occurred in the setting of full anticoagulation and antiplatelet therapy, guided by strict anticoagulation monitoring. It has become clear to us that the devices are still not perfect. Technical pump failures such as cable breaks also occur, prompting urgent pump exchange, and infection. A 15-year cumulative mortality rate is 46.9%. This report emphasizes that MCS with RBPs has evolved into a routine treatment in heart failure and is a highly feasible option for permanent therapy particularly for elderly patients. PMID:27568128

  16. Rotary Blood Pumps as Long-Term Mechanical Circulatory Support: A Review of a 15-Year Berlin Experience.

    PubMed

    Hetzer, Roland; Kaufmann MEng, Friedrich; Potapov, Evgenij; Krabatsch, Thomas; Delmo Walter, Eva Maria

    2016-01-01

    This article reports our 15-year single-center experience with rotary blood pumps (RBPs) as long-term mechanical circulatory support (MCS) with emphasis on outcomes. For more than 15-year period, we have used various RBPs as bridge to transplantation or to myocardial recovery. Our group performed the first human implantation worldwide of RBCs, the MicroMed DeBakey ventricular assist device in November 1998 in a patient with end-stage heart failure who was supported for 47 days until his death. Based on this initial experience, we recognized the feasibility of providing long-term support and since then it has been our primary armamentarium in treating patients with heart failure. Between 1987 and September 2013, we have implanted 2208 ventricular assist devices ranging from pulsatile to continuous-flow systems, as short-term, long-term, or permanent support in patients with end-stage heart failure. In total, 1009 RBPs were implanted on 908 patients, and their outcomes are reported here. We have shared some milestones in MCS including the first implantation of Jarvik 2000 on the oldest patient (81-year old) in 2008 and the first worldwide implantation of a biventricular HeartWare. Over time, implantation techniques, anticoagulation, and postoperative care have been modified and individualized. A relevant aspect of our experience has been the incidence of pump thrombosis. This is particularly frustrating because the problem has occurred in the setting of full anticoagulation and antiplatelet therapy, guided by strict anticoagulation monitoring. It has become clear to us that the devices are still not perfect. Technical pump failures such as cable breaks also occur, prompting urgent pump exchange, and infection. A 15-year cumulative mortality rate is 46.9%. This report emphasizes that MCS with RBPs has evolved into a routine treatment in heart failure and is a highly feasible option for permanent therapy particularly for elderly patients.

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

    PubMed

    Roth, John R; Maisnier-Patin, Sophie

    2016-04-01

    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. [Metabolism, intensity of lipid peroxidation and the antioxidant defense system in humans during chamber experiments with long-term isolation].

    PubMed

    Markin, A A; Stroganova, L B; Vostrikova, L V; Balashov, O I; Nichiporuk, I A

    1997-01-01

    Blood biochemical parameters of lipid, protein, carbohydrate and energy metabolism were measured in a 135-day chamber experiment. Also, dynamics of the intensity of lipid peroxidation and status of the antioxidant defence system were evaluated. Results of the investigation showed that extended chamber isolation led to modifications of several biochemical parameters including hemoglobin, bilirubin, cholesterol and its fractions, elevated transaminase activity which are typical for long-term space mission. However, these were not accompanied by substantive changes in protein, energy and carbohydrate metabolisms, or intensity of free radical processes. Effects of prolonged stay in chamber was successfully counterbalanced by organism.

  19. The long-term consequences of war: the experience of World War II.

    PubMed

    Hunt, N; Robbins, I

    2001-05-01

    Seven hundred and thirty-one World War II and Korean War veterans completed a questionnaire about their experiences and their current psychological reactions to the war. Nineteen percent scored above the cut-off points for both the General Health Questionnaire and the (war-related) Impact of Event Scale, demonstrating that, even over 50 years after the event, many veterans still experience problems relating to their war experiences. Psychological distress was in part directly related to particular experiences, but intrusion and avoidance both played an important role as mediating variables. Other factors, such as prisoner of war (POW) status, type of service, rank, and illness were also considered. The findings indicate that the effects of a traumatic experience such as war can persist into later life.

  20. 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.

  1. 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. PMID:25970382

  2. Global environmental change and the nature of aboveground net primary productivity responses: insights from long-term experiments.

    PubMed

    Smith, Melinda D; La Pierre, Kimberly J; Collins, Scott L; Knapp, Alan K; Gross, Katherine L; Barrett, John E; Frey, Serita D; Gough, Laura; Miller, Robert J; Morris, James T; Rustad, Lindsey E; Yarie, John

    2015-04-01

    Many global change drivers chronically alter resource availability in terrestrial ecosystems. Such resource alterations are known to affect aboveground net primary production (ANPP) in the short term; however, it is unknown if patterns of response change through time. We examined the magnitude, direction, and pattern of ANPP responses to a wide range of global change drivers by compiling 73 datasets from long-term (>5 years) experiments that varied by ecosystem type, length of manipulation, and the type of manipulation. Chronic resource alterations resulted in a significant change in ANPP irrespective of ecosystem type, the length of the experiment, and the resource manipulated. However, the pattern of ecosystem response over time varied with ecosystem type and manipulation length. Continuous directional responses were the most common pattern observed in herbaceous-dominated ecosystems. Continuous directional responses also were frequently observed in longer-term experiments (>11 years) and were, in some cases, accompanied by large shifts in community composition. In contrast, stepped responses were common in forests and other ecosystems (salt marshes and dry valleys) and with nutrient manipulations. Our results suggest that the response of ANPP to chronic resource manipulations can be quite variable; however, responses persist once they occur, as few transient responses were observed. Shifts in plant community composition over time could be important determinants of patterns of terrestrial ecosystem sensitivity, but comparative, long-term studies are required to understand how and why ecosystems differ in their sensitivity to chronic resource alterations.

  3. Trace element concentration in wheat grain: results from the Swedish long-term soil fertility experiments and national monitoring program.

    PubMed

    Kirchmann, Holger; Mattsson, Lennart; Eriksson, Jan

    2009-10-01

    Concentrations of trace elements in wheat grain sampled between 1967 and 2003 from the Swedish long-term soil fertility experiments were analyzed using ICP-MS. The long-term effect of inorganic and organic fertilization on trace metal concentrations was investigated including the impact of atmospheric deposition and myccorhiza, whereas other factors such as soil conditions, crop cultivar, etc. are not discussed in this paper. Mean values derived from 10 experimental sites were reported. Significantly declining Pb and Cd concentrations in wheat grain could be explained by lower atmospheric deposition. Mean Se contents in all samples were 0.031 mg kg(-1) grain dry weight. No samples had sufficiently high Se concentrations for human (0.05 mg Se kg(-1)) or animal demand (0.1 mg Se kg(-1)). Concentrations of Co in wheat grain were extremely low, 0.002-0.005 mg Co kg(-1) grain dry weight, and far below the minimum levels required by animals, which applied to all fertilizer treatments. A doubling of Mo concentrations in grain since 1975 resulted in Cu/Mo ratios often below one, which may cause molybdenosis in ruminants. The increase in Mo concentrations in crops correlated with the decline in sulfur deposition. Concentrations of Cu and Fe declined in NPK-fertilized wheat as compared to unfertilized or manure-treated wheat. Very low concentrations of Se and Co and low concentrations of Fe and Cu require attention to counteract risks for deficiencies. The main characteristic of the study is that there are few significant changes over time between different fertilizer treatments, but throughout there are low concentrations of most trace elements in all treatments. In general, good agreement between concentrations in wheat from the long-term fertility experiments and the national monitoring program indicate that values are representative. PMID:19263225

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. Rapid quantification of soilborne pathogen communities in wheat-based long-term field experiments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Traditional isolation and quantification of inoculum density is difficult for most soilborne pathogens. Quantitative PCR methods have been developed to rapidly identify and quantify many of these pathogens using a single DNA extract from soil. Rainfed experiments operated continuously for up to 84 y...

  9. 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…

  10. 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…

  11. Adult-Age Inflammatory Pain Experience Enhances Long-Term Pain Vigilance in Rats

    PubMed Central

    Li, Sheng-Guang; Wang, Jin-Yan; Luo, Fei

    2012-01-01

    Background Previous animal studies have illustrated a modulatory effect of neonatal pain experience on subsequent pain-related behaviors. However, the relationship between chronic pain status in adulthood and future pain perception remains unclear. Methodology/Principal Findings In the current study, we investigated the effects of inflammatory pain experience on subsequent formalin-evoked pain behaviors and fear conditioning induced by noxious stimulation in adult rats. Our results demonstrated an increase of the second but not the first phase of formalin-induced pain behaviors in animals with a history of inflammatory pain that have recovered. Similarly, rats with persistent pain experience displayed facilitated acquisition and prolonged retention of pain-related conditioning. These effects of prior pain experience on subsequent behavior were prevented by repeated morphine administration at an early stage of inflammatory pain. Conclusions/Significance These results suggest that chronic pain diseases, if not properly and promptly treated, may have a long-lasting impact on processing and perception of environmental threats. This may increase the susceptibility of patients to subsequent pain-related disorders, even when chronic pain develops in adulthood. These data highlight the importance of treatment of chronic pain at an early stage. PMID:22574223

  12. Examining the Long-Term Impact of a One-Semester Technology-Rich Classroom Experience.

    ERIC Educational Resources Information Center

    Tiene, Drew; Luft, Pamela

    2002-01-01

    Explored how a semester-long experience in a technology-rich classroom at Kent State University affected middle school teachers over the last two years in their use of technology in the classroom. Highlights include access to technology; technology utilization; benefits of technology; and impact on teaching style. (Author/LRW)

  13. 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…

  14. Mixtures of Uncaria and Tabebuia extracts are potentially chemopreventive in CBA/Ca mice: a long-term experiment.

    PubMed

    Budán, Ferenc; Szabó, István; Varjas, Tímea; Nowrasteh, Ghodratollah; Dávid, Tamás; Gergely, Péter; Varga, Zsuzsa; Molnár, Kornélia; Kádár, Balázs; Orsós, Zsuzsa; Kiss, István; Ember, István

    2011-04-01

    A long-term experimental animal model was developed by our research group for the evaluation of potential chemopreventive effects. The inhibitory effects of agents on carcinogen (7,12-dimethylbenz[a]anthracene (DMBA) induced molecular epidemiological biomarkers, in this case the expression of key onco/suppressor genes were investigated. The expression pattern of c-myc, Ha-ras, Bcl-2, K-ras protooncogene and p53 tumour suppressor gene were studied to elucidate early carcinogenic and potential chemopreventive effects. The consumption of so-called Claw of Dragon tea (CoD™ tea) containing the bark of Uncaria guianensis, Cat's Claw (Uncaria sp. U. tomentosa) and Palmer trumpet-tree (Tabebuia sp. T. avellanedae) was able to decrease the DMBA-induced onco/suppressor gene overexpression in a short-term animal experiment. In a following study CBA/Ca mice were treated with 20 mg/kg bw DMBA intraperitoneally (i.p.) and the expression patterns of onco/suppressor genes were examined at several time intervals. According to the examined gene expression patterns in this long-term experiment the chemopreventive effect of CoD™ tea consumption could be confirmed.

  15. Long term temperature sensitivity of soil carbon pools in a prairie warming experiment

    NASA Astrophysics Data System (ADS)

    Hopkins, F. M.; Brennan, A. L.; Pendall, E.

    2012-12-01

    The temperature sensitivity of microbial respiration fluxes of CO2 from soil is a critical determinant of soil carbon stocks in a warming climate. While short-term effects of temperature on soil microbial metabolism are well known, the effects of warming on longer-lived soil carbon pools and under the altered substrate conditions that result from warming are less well understood, and critical to predicting future soil carbon stocks. We used a combination of carbon isotopes and experimental treatments to examine the temperature sensitivity of soil C pools of different ages. We sampled soils from the Wyoming Prairie Heating and CO2 Enrichment (PHACE) experiment, where addition of a carbon isotope tracer in elevated CO2 plots allowed us to separate the effect of temperature on respiration of C fixed prior to the experiment (> 5 years old) from carbon fixed more recently. We incubated soils at three temperatures in the laboratory to compare the temperature sensitivity of soil carbon pools from a combination of field treatments; vegetated vs. non-vegetated, and field warmed vs. ambient temperature. For the vegetated treatment, C residing in soil for at least 5 years (fixed prior to the experiment) contributed less than 10% of the total CO2 flux, with the majority of CO2 coming from soil C deposited more recently. However, pre-experiment C was about twice as temperature sensitive as newer C. In contrast, there was no difference in the temperature sensitivity of pre-experiment and younger C from the non-vegetated plots, where application of herbicide prevented new plant inputs for 4 growing seasons previous. A field warming treatment allowed us to investigate the effect of labile C depletion on temperature sensitivity. Specifically, field warmed soils were more substrate-depleted, with lower CO2 fluxes, and ~2/3 of respiration coming from pre-experiment C, compared to ~1/4 from the ambient temperature control. Despite the relative depletion of labile substrate

  16. Hoe Creek No. 3 - First long-term underground coal gasification experiment with oxygen-steam injection

    NASA Astrophysics Data System (ADS)

    1980-05-01

    The paper describes the first long-term underground coal gasification experiment with oxygen-steam injection. In the Hoe Creek No. 3 underground experiment, linkage paths were established between the injection and production wells by drilling a horizontal borehole between them near the bottom of the coal seam. The drilled linkage hole was enlarged by reverse burning, and then the forward gasification process was started - first with air injection for one week, then with oxygen-steam injection for the remainder of the experiment. During the oxygen-steam injection period, about 3900 tons of coal were gasified in 47 days, at an average rate of 83 tons per day. The heating value of the dry product gas averaged 218 Btu/scf, suitable for input to a processing plant for upgrading to pipeline quality, which is about 900 Btu/scf.

  17. 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.

  18. Perspectives and experiences related to physical activity of elders in long-term-care settings.

    PubMed

    Phillips, Lorraine J; Flesner, Marcia

    2013-01-01

    This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA. Staying active meant walking indoors and out, attending chair-exercise programs, performing professionally prescribed home exercises, and using available exercise equipment. Past PA experiences shaped current preferences and practices. Participants agreed that exercise helped maintain physical functioning but recounted cognitive and situational barriers to PA. Lack of dedicated exercise space and short corridors hampered efforts to stay active. Participants wished for individualized home exercise programs and supervised exercise sessions. Future research should examine the extent to which the physical environment and PA programming in RC/AL communities affect elders' PA.

  19. Experience gained during the long term cultivation of keratinocytes for treatment of burns patients.

    PubMed

    Dragúňová, Jana; Kabát, Peter; Koller, Ján; Jarabinská, Valéria

    2012-08-01

    Both allogenic and autologous cultured skin cells have been used clinically on burn patients. In vitro cultivation of human keratinocytes has been routinely provided by the Central Tissue Bank in Bratislava since 1996, with an average annual production of around 7,000 cm(2). Keratinocytes have been cultivated using a version of the original by Rheinwald and Green (Cell 6:317-330, 1975) methodology which has been modified over time in our laboratory as we gained more experience with this serial passage system. We have observed that the growth of cultured keratinocytes depends on several important factors, including the timing of skin sample procurement, the method of skin sample procurement, the general condition of the patient, the quality and composition of the culture media and, to a lesser extent, the age of the patient. We aim to share our experience with other cell cultivation facilities. PMID:21847560

  20. Long-term experiments to investigate irreversibility in sorption of pesticides to soil.

    PubMed

    Suddaby, L A; Beulke, S; van Beinum, W; Oliver, R G; Kuet, S; Brown, C D

    2016-11-01

    Experiments investigated irreversibility in pesticide sorption to soil. Sorption behaviour under abiotic conditions was quantified for chlorotoluron, prometryn and hexaconazole in three soils over periods of up to 274 days. An isotope-exchange procedure was used whereby sorption of (12)C- and (14)C-pesticide isotopes in shaken suspensions of three soils (56-168 days shaking) was followed by substitution of the isotopes in the liquid phase and a 14-day exchange phase. This was followed by forced isotope exchange where the sorbed (14)C material was exchanged by adding an excess of non-radiolabelled compound. Experiments were concluded with solvent extraction and soil combustion to determine remaining radioactivity. Under conditions of continuous shaking, the pesticide-soil systems took around four months to approach sorption equilibrium, resulting in strong asymmetry between the profiles of exchange for isotopes of all three compounds. Physically entrapped residues were released back into solution under the steep concentration gradient of forced isotope exchange and small amounts of radioactivity were still being released at the termination of the experiment. The profiles of exchange did not deviate markedly from ideal behaviour based on the assumption that sorption is fully reversible. Whilst the timescales for release of sorbed residues back into solution were very long, soil combustion at study termination only yielded <1-2% of applied radioactivity; this confirms that sorption processes under abiotic soil conditions were overwhelmingly reversible for this set of compounds and soils. PMID:27479454

  1. Long-term experiments to investigate irreversibility in sorption of pesticides to soil.

    PubMed

    Suddaby, L A; Beulke, S; van Beinum, W; Oliver, R G; Kuet, S; Brown, C D

    2016-11-01

    Experiments investigated irreversibility in pesticide sorption to soil. Sorption behaviour under abiotic conditions was quantified for chlorotoluron, prometryn and hexaconazole in three soils over periods of up to 274 days. An isotope-exchange procedure was used whereby sorption of (12)C- and (14)C-pesticide isotopes in shaken suspensions of three soils (56-168 days shaking) was followed by substitution of the isotopes in the liquid phase and a 14-day exchange phase. This was followed by forced isotope exchange where the sorbed (14)C material was exchanged by adding an excess of non-radiolabelled compound. Experiments were concluded with solvent extraction and soil combustion to determine remaining radioactivity. Under conditions of continuous shaking, the pesticide-soil systems took around four months to approach sorption equilibrium, resulting in strong asymmetry between the profiles of exchange for isotopes of all three compounds. Physically entrapped residues were released back into solution under the steep concentration gradient of forced isotope exchange and small amounts of radioactivity were still being released at the termination of the experiment. The profiles of exchange did not deviate markedly from ideal behaviour based on the assumption that sorption is fully reversible. Whilst the timescales for release of sorbed residues back into solution were very long, soil combustion at study termination only yielded <1-2% of applied radioactivity; this confirms that sorption processes under abiotic soil conditions were overwhelmingly reversible for this set of compounds and soils.

  2. 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

  3. 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

  4. Microwave snow emission model using a long-term field experiment

    NASA Astrophysics Data System (ADS)

    Munoz-Barreto, Jonathan

    Microwave remote sensing has shown great potential in estimating snowpack properties such as: snow depth and Snow Water Equivalent (SWE). However, other snow properties like density, wetness and grain size, which are variable in space and time, largely impact the microwave signal scattering, still need to be investigated and understood. With the objective to improve our understanding of the effect of changing snow characteristics (grain size, snow wetness, density, temperature) under various meteorological conditions on the microwave emission of snow, the CREST-Snow Analysis and Field Experiment (CREST-SAFE) was established at the research site of the National Weather Service office, Caribou, ME, USA. In this ground experiment, 37 and 89 GHz dual polarized microwave observations are conducted continuously, along with detailed synchronous observations of snowpack physical properties. The first part of this work provides an overview of the field experiment, the snow pack and other environmental parameters which are routinely measured at the station both automatically and manually. The measurement programme includes microwave observations, meteorological observations (air temperature, snow skin-temperature, humidity, wind speed and direction, precipitation, incoming and outgoing radiations), along with the measurements of the snow pack bulk physical properties (snow depth, grain size, shape, hardness, and density) and vertical temperature profiles. The detailed analysis of microwave observations collected during the last three years along with the observed and simulated snowpack properties are presented. The second component of this work focuses on the development of a new approach to estimate the snow wetness (liquid water content) using information on the snow grain size and temperature. The objective of these efforts is to directly assimilate the predicted snow wetness in the HUT (Helsinki University of Technology) microwave emission model. The modified version of

  5. [Long-term experiences following extracorporeal shockwave lithotripsy in patients with urinary calculi].

    PubMed

    Jocham, D; Liedl, B; Lunz, C; Schuster, C; Chaussy, C

    1989-05-01

    A report is given on the experience we have had over a period of up to 7 years following ESWL treatment in urinary stone patients. 131I-hippuran clearance studies were conducted on 19 patients prior to and 6.6 years subsequent to ESWL. There was no evidence of any degree of deterioration in total renal function or of any form of dysfunction in the kidney treated. Follow-up examinations on 247 patients showed a 7% recurrent stone rate within a period of 3.6 years following ESWL. In 16% of the cases, residual concretions were found 6 months after ESWL, only 4% of which were larger than 5 mm in diameter. In 22%, concretions were discovered 3.6 years after ESWL 36% of which were larger than 5 mm. This size increase in the fragments accounts for the stone growth.

  6. Long-term functional outcomes after bladder exstrophy repair: A single, low-volume centre experience

    PubMed Central

    Alsowayan, Ossamah; Capolicchio, John Paul; Jednak, Roman; El-Sherbiny, Mohamed

    2016-01-01

    Introduction: In this study, we present our experience managing bladder exstrophy (BE) in a low-volume centre over 24 years. Methods: Charts of patients with BE between 1990 and 2014 were retrospectively reviewed. Patients with BE closure and ≥5 years followup were included. BE closure was carried out in the first two days of life using either complete primary repair (CPRE) or modern-staged repair (MSRE). Daytime urinary continence (UC) was evaluated by the age of five years. Patients were considered continent if completely dry for ≥3 hours using no or one pad/day. Incontinent patients with bladder capacity (BC) ≥100 ml underwent bladder neck reconstruction (BNR) and bilateral ureteric reimplantation (BUR), while patients with BC <100ml underwent simultaneous augmentation cystoplasty (ACP). Results: Sixteen (16) patients met our inclusion criteria with a mean followup time of 18±5 years. Ten (10) underwent CPRE, while six underwent MSRE. Four surgeons were involved in patients’ management. Two surgeons had previous experience in BE surgery while working in other institutions. Complications included dehiscence in five patients, vesicocutanous fistula in three and breakthrough UTI in eight. Continence was achieved in 15/16 patients: two after BE closure only, seven with BNR, and six who required ACP and BNR. Conclusions: Despite the small number of patients and the reterospective nature of the study, some observations are noteworthy. Although continence rate post-primary BE closure was initially low, it rose to 93.8% after auxiliary continence procedures. This might be at the cost of urethral voiding, which was achieved in 60% of patients. Our small cohort did not show clear advantage of CPRE vs. MSRE. Our outcomes may not be different from high-volume centres due to the fact that two exstrophy-experienced surgeons performed most primary or subsequent surgeries. For this reason, we recommend assigning designated centres for BE repair for both new and repeat

  7. 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.

  8. 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

  9. Microbial borehole observatories deployed within the oceanic crust: Design considerations and initial results from long-term colonization experiments (Invited)

    NASA Astrophysics Data System (ADS)

    Orcutt, B. N.; Bach, W.; Becker, K.; Fisher, A. T.; Hulme, S.; Toner, B. M.; Wheat, C. G.; Edwards, K. J.; Iodp Expedition 327 Shipboard Party

    2010-12-01

    Borehole observatories developed for long-term sampling and monitoring in the subseafloor of the deep ocean must satisfy design and operation requirements that are similar to systems deployed on land. Many of these systems are used to achieve simultaneous hydrologic, geochemical and microbiological goals, requiring innovative design, installation, and operation. There are major logistical challenges for subseafloor observatories, the foremost being having to remotely access sites kilometers underwater using multiple oceanographic platforms (drill ship, surface ship, submersible, remotely-operated vehicle) and reliance on autonomous devices that are serviced only after several years. Contamination of the analytical environment is probable during installation operations, requiring vigilance during analysis for interpretation. Subseafloor observatories also require self-contained and robust instrumentation that can withstand long-term exposure to seawater at high pressures, elevated temperatures, a variety of redox conditions, and little to no access to external power. Although subseafloor borehole observatories have been in development for hydrologic monitoring for two decades, the inclusion of experimentation to examine the deep biosphere in the marine subsurface has only recently been developed. Results from some of the first microbial colonization experiments in young basaltic rocks on the eastern flank of the Juan de Fuca Ridge demonstrate in situ microbial-mineral interactions that can be identified using complementary geochemical and microbiological techniques. Mineral surfaces were first colonized by iron oxidizing bacteria, and as fluid composition changed, the microbial community became dominated by Firmicutes bacteria, some of which are phylogenetically similar to microbial communities observed in the terrestrial deep biosphere.

  10. Long-term nursing care of elderly people: identifying ethically problematic experiences among patients, relatives and nurses in Finland.

    PubMed

    Teeri, Sari; Leino-Kilpi, Helena; Välimäki, Maritta

    2006-03-01

    The aim of this study was to explore ethically problematic situations in the long-term nursing care of elderly people. It was assumed that greater awareness of ethical problems in caring for elderly people helps to ensure ethically high standards of nursing care. To obtain a broad perspective on the current situation, the data for this study were collected among elderly patients, their relatives and nurses in one long-term care institution in Finland. The patients (n = 10) were interviewed, while the relatives, (n = 17) and nurses (n = 9) wrote an essay. Interpretation of the data was based on qualitative content analysis. Problematic experiences were divided into three categories concerning patients' psychological, physical and social integrity. In the case of psychological integrity, the problems were seen as being related to treatment, self-determination and obtaining information; for physical integrity, they were related to physical abuse and lack of individualized care; and for social integrity, to loneliness and social isolation. This study provided no information on the prevalence of ethical problems. However, it is clear from the results that patient integrity warrants more attention in the nursing care of elderly patients.

  11. 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.

  12. GAS-GENERATION EXPERIMENTS FOR LONG-TERM STORAGE OF TRU WASTES AT WIPP

    SciTech Connect

    Felicione, F.S.; Carney, K.P.; Dwight, C.C.; Cummings, D.G.; Foulkrod, L.E.

    2003-02-27

    An experimental investigation was conducted for gas generation in contact-handled transuranic (CH-TRU) wastes subjected for several years to conditions similar to those expected to occur at the Waste Isolation Pilot Plant (WIPP) should the repository eventually become inundated with brine. Various types of actual CH-TRU wastes were placed into 12 corrosion-resistant vessels. The vessels were loosely filled with the wastes, which were submerged in synthetic brine having the same chemical composition as that in the WIPP vicinity. The vessels were also inoculated with microbes found in the Salado Formation at WIPP. The vessels were sealed, purged, and the approximately 750-ml headspace was pressurized with nitrogen gas to approximately 146 atmospheres to create anoxic conditions at the lithostatic pressure expected in the repository were it inundated. The temperature was maintained at the expected 30 C. The test program objective was to measure the quantities and species of gases generate d by metal corrosion, radiolysis, and microbial activity. These data will assist in the specification of the rates at which gases are produced under inundated repository conditions for use in the WIPP Performance Assessment computer models. These experiments were very carefully designed, constructed, instrumented, and performed. Approximately 6-1/2 years of continuous, undisturbed testing were accumulated. Several of the vessels showed significantly elevated levels of generated gases, virtually all of which was hydrogen. One vessel measured over 4.2% hydrogen, by volume. Two other vessels generated well over 1% hydrogen, and another was at nearly 1%. Only small quantities of other gases, principally carbon dioxide, were detected. Gas generation was found to depend strongly on the waste composition. The maximum hydrogen generation occurred in tests containing carbon steel. Average corrosion penetration rates in carbon-steel of up to 2.3 microns per year were deduced. Conversion of

  13. 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.

  14. 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

  15. A preliminary experiment for the long-term regional reanalysis over Japan assimilating conventional observations with NHM-LETKF

    NASA Astrophysics Data System (ADS)

    Fukui, Shin; Iwasaki, Toshiki; Saito, Kazuo; Seko, Hiromu; Kunii, Masaru

    2016-04-01

    Several long-term global reanalyses have been produced by major operational centres and have contributed to the advance of weather and climate researches considerably. Although the horizontal resolutions of these global reanalyses are getting higher partly due to the development of computing technology, they are still too coarse to reproduce local circulations and precipitation realistically. To solve this problem, dynamical downscaling is often employed. However, the forcing from lateral boundaries only cannot necessarily control the inner fields especially in long-term dynamical downscaling. Regional reanalysis is expected to overcome the difficulty. To maintain the long-term consistency of the analysis quality, it is better to assimilate only the conventional observations that are available in long period. To confirm the effectiveness of the regional reanalysis, some assimilation experiments are performed. In the experiments, only conventional observations (SYNOP, SHIP, BUOY, TEMP, PILOT, TC-Bogus) are assimilated with the NHM-LETKF system, which consists of the nonhydrostatic model (NHM) of the Japan Meteorological Agency (JMA) and the local ensemble transform Kalman filter (LETKF). The horizontal resolution is 25 km and the domain covers Japan and its surroundings. Japanese 55-year reanalysis (JRA-55) is adopted as the initial and lateral boundary conditions for the NHM-LETKF forecast-analysis cycles. The ensemble size is 10. The experimental period is August 2014 as a representative of warm season for the region. The results are verified against the JMA's operational Meso-scale Analysis, which is produced with assimilating observation data including various remote sensing observations using a 4D-Var scheme, and compared with those of the simple dynamical downscaling experiment without data assimilation. Effects of implementation of lateral boundary perturbations derived from an EOF analysis of JRA-55 over the targeted domain are also examined. The comparison

  16. Use of videophones for distant caregiving: an enriching experience for families and residents in long-term care.

    PubMed

    Demiris, George; Oliver, Debra R Parker; Hensel, Brian; Dickey, Geraldine; Rantz, Marilyn; Skubic, Marjorie

    2008-07-01

    The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants-4 residents of an independent retirement facility and 6 family members-were recruited. A videophone was installed in each resident's apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance. PMID:18649824

  17. 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.

  18. 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.

  19. Long-Term Regional Shifts in Plant Community Composition Are Largely Explained by Local Deer Impact Experiments

    PubMed Central

    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. PMID:25551827

  20. 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 ...

  1. Effect of coronary artery revascularization on in-hospital outcomes and long-term prognoses in acute myocardial infarction patients with prior ischemic stroke

    PubMed Central

    Li, Bo-Yu; Li, Xiao-Ming; Zhang, Yan; Wei, Zhan-Yun; Li, Jing; Hua, Qi

    2016-01-01

    Objective To investigate whether coronary artery revascularization therapies (CART), including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), can improve the in-hospital and long-term outcomes for acute myocardial infarction (AMI) patients with prior ischemic stroke (IS). Methods A total of 387 AMI patients with prior IS were enrolled consecutively from January 15, 2005 to December 24, 2011 in this cohort study. All patients were categorized into the CART group (n = 204) or the conservative medications (CM) group (n = 183). In-hospital cardiocerebral events and long-term mortality of the two groups after an average follow-up of 36 months were recorded by Kaplan-Meier survival curves and compared by Logistic regression and the Cox regression model. Results The CART patients were younger (66.5 ± 9.7 years vs. 71.7 ± 9.7 years, P < 0.01), had less non-ST segment elevation myocardial infarction (11.8% vs. 20.8%, P = 0.016) and more multiple-vascular coronary lesions (50% vs. 69.4%, P = 0.031). The hospitalization incidence of cardiocerebral events in the CART group was 9.3% while 26.2% in the CM group (P < 0.01). CART significantly reduced the risk of in-hospital cardiocerebral events by 65% [adjusted odds ratio (OR) = 0.35, 95% CI: 0.13–0.92]. By the end of follow-up, 57 cases (41.6%) died in CM group (n = 137) and 24 cases (12.2%) died in CART group (n = 197). Cox regression indicated that CART decreased the long-term mortality by 72% [adjusted hazard ratio (HR) = 0.28, 95% CI: 0.06–0.46], while categorical analysis indicated no significant difference between PCI and CABG. Conclusions CART has a significant effect on improving the in-hospital and long-term prognoses for AMI patients with prior IS. PMID:27168740

  2. What works to prevent falls in older adults dwelling in long term care facilities and hospitals? An umbrella review of meta-analyses of randomised controlled trials.

    PubMed

    Stubbs, Brendon; Denkinger, Michael D; Brefka, Simone; Dallmeier, Dhayana

    2015-07-01

    Preventing falls in long term care facilities (LTCF) and hospitals is an international priority. Many interventions have been investigated and summarised in meta-analyses (MA) and there is a need to synthesise the top of the hierarchy of evidence in one place. Therefore we conducted an umbrella review of MA of randomised controlled trials (RCTs) of falls prevention interventions LTCF and hospitals. Two independent reviewers searched major electronic databases from inception till October 2014 for MA containing ≥3 RCTs investigating any intervention to prevent falls in LTCF or hospitals in older adults aged ≥60 years. Methodological quality was assessed by the AMSTAR tool and data were narratively synthesised. The methodological quality of the MA was moderate to high across the 10 included MA. Nine MA provided data for LTCF and only two considered hospital settings. Only one MA defined a fall and two reported adverse events (although minor). Consistent evidence suggests that multifactorial interventions reduce falls (including the rate, risk and odds of falling) in LTCF and hospitals. Inconsistent evidence exists for exercise and vitamin D as single interventions in LTCF, whilst no MA has investigated this in hospitals. No evidence exists for hip protectors and medication review on falls in LTCF. In conclusion, multifactorial interventions appear to be the most effective interventions to prevent falls in LTCF and hospital settings. This is not without limitations and more high quality RCTs are needed in hospital settings in particular. Future RCTs and MA should clearly report adverse events.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. Prior morphine experience induces long-term increases in social interest and in appetitive behavior for natural reward.

    PubMed

    Nocjar, Christine; Panksepp, Jaak

    2007-08-01

    Brain opioids regulate social emotional responsivity. One neuro-evolutionary theory of addiction suggests that exogenous opiates may induce addiction via opioid-controlled emotional changes; with the drug eventually fulfilling the need for social comfort that is normally provided by endogenous opioids. This view predicts that past opiate experience may enduringly alter social responsivity. Although the acute social effects of opiates are well known, little evidence is available concerning the enduring effects of past opiate experience on social motivation aside from copulatory behaviors. This study evaluated the long-term effects of 10 daily morphine (10mg/kg/day) or saline injections on social and non-social motivated behaviors. Following 3 days or 2 weeks drug abstinence, social interest, food-seeking, and sexual pursuit were assessed. After 2-weeks opiate withdrawal, sexual pursuit and food-seeking behaviors were significantly increased. After a shorter 3-day withdrawal, these effects were not seen. Importantly, social interest was consistently magnified, even after short-term 3-day opiate withdrawal, and it was magnified more than sexual or food pursuit. These findings indicate that the incentive for social and non-social natural rewards were increased following withdrawal from intermittent opiate treatment, but that different morphine-induced neuroadaptations may regulate their expression.

  9. Considerations in use of microspheres for myocardial blood-flow measurements in long-term experiments on rats

    SciTech Connect

    Medvedev, O.S.; Martynova, E.R.; Akchurin, R.S.; Khalatov, V.Y.

    1988-09-01

    The loss of 15-micron radioactive microspheres from rat myocardium was determined in long-term experiments. Heterotopic heart transplantation was used for the evaluation of microsphere losses. Microspheres were injected into the left ventricle of a donor rat, and the number of microspheres entrapped in the heart was measured after its isolation. The heart was transplanted into the abdominal cavity of a recipient rat and left there for 1-3 wk. The number of microspheres entrapped in the donor heart before the transplantation was compared with the number of microspheres remaining there after 1-3 wk. The losses of radioactivity from the myocardium over 1-3 wk did not exceed 10%. In a control series of experiments, the loss of radioactivity from the microspheres placed in microporous capillaries implanted subcutaneously into rats was determined. The measured leach criterion in vivo was 0.58% instead of 0.30% indicated by the manufacturer for in vitro conditions. The loss of 15-micron microspheres from the rat myocardium taking into account the leach criterion in vivo was 1.54 +/- 1.64%.

  10. Is natural experiment a cure? Re-examining the long-term health effects of China's 1959-1961 famine.

    PubMed

    Xu, Hongwei; Li, Lydia; Zhang, Zhenmei; Liu, Jinyu

    2016-01-01

    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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Long-term experience with subcutaneous ICD leads: a comparison among three different types of subcutaneous leads.

    PubMed

    Kettering, Klaus; Mewis, Christian; Dörnberger, Volker; Vonthein, Reinhard; Bosch, Ralph F; Seipel, Ludger; Kühlkamp, Volker

    2004-10-01

    ICDs provide protection against sudden cardiac death in patients with life-threatening arrhythmias. Nevertheless, efficacy of defibrillation remains an important issue to guarantee the future safety of patients who receive an ICD. There is a significant number of patients who need an additional subcutaneous lead to obtain a defibrillation safety margin of at least 10 J between the maximum output of the ICD and the energy needed for ventricular defibrillation. However, few data exists about the long-term performance of different types of subcutaneous leads. Therefore, the aim of this study was to analyze the long-term experience with three different types of subcutaneous leads. The study included 132 patients (109 men, 23 women; mean age 59.8 years [SD +/- 10.7 years]). All of them received a subcutaneous lead in addition to a single chamber or dual chamber ICD between October 1990 and April 2002. Two patients received a second subcutaneous lead after the first lead had been removed so that a total of 134 subcutaneous leads were evaluated. Inclusion criteria for the implantation of an additional subcutaneous lead were (1) unsuccessful ventricular defibrillation at implant without a subcutaneous lead, (2) insufficient safety margin (< 10 J) between the maximum output of the ICD and the energy needed for ventricular defibrillation, or (3) clinical evaluation of a new subcutaneous lead (Medtronic 13014). There were no significant differences between the three study groups with regard to age, sex, underlying cardiac disease, left ventricular ejection fraction, NYHA class assessment and clinical arrhythmia. The results of the DFT testing during follow-up (prehospital discharge test and 1 and 3 years) were compared to the baseline value obtained during the implantation procedure. All lead related complications were analyzed. Eighty-two single element subcutaneous array electrodes (SQ-A1), 31 subcutaneous three-finger electrodes (SQ-A3), and 21 subcutaneous patch

  16. 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.

  17. 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

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

    PubMed

    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

  19. 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.

  20. 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.

  1. Evaluating the long-term performance of low-cost adsorbents using small-scale adsorption column experiments.

    PubMed

    Callery, O; Healy, M G; Rognard, F; Barthelemy, L; Brennan, R B

    2016-09-15

    This study investigated a novel method of predicting the long-term phosphorus removal performance of large-scale adsorption filters, using data derived from short-term, small-scale column experiments. The filter media investigated were low-cost adsorbents such as aluminum sulfate drinking water treatment residual, ferric sulfate drinking water treatment residual, and fine and coarse crushed concretes. Small-bore adsorption columns were loaded with synthetic wastewater, and treated column effluent volume was plotted against the mass of phosphorus adsorbed per unit mass of filter media. It was observed that the curve described by the data strongly resembled that of a standard adsorption isotherm created from batch adsorption data. Consequently, it was hypothesized that an equation following the form of the Freundlich isotherm would describe the relationship between filter loading and media saturation. Moreover, the relationship between filter loading and effluent concentration could also be derived from this equation. The proposed model was demonstrated to accurately predict the performance of large-scale adsorption filters over a period of up to three months with a very high degree of accuracy. Furthermore, the coefficients necessary to produce said model could be determined from just 24 h of small-scale experimental data. PMID:27295617

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

    PubMed

    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.

  3. 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.

  4. 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.

  5. 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

  6. 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. PMID:22584877

  7. 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.

  8. Transport of Cryptosporidium parvum in porous media: Long-term elution experiments and continuous time random walk filtration modeling

    NASA Astrophysics Data System (ADS)

    Cortis, Andrea; Harter, Thomas; Hou, Lingling; Atwill, E. Robert; Packman, Aaron I.; Green, Peter G.

    2006-12-01

    Complex transport behavior other than advection-dispersion, simple retardation, and first-order removal has been observed in many biocolloid transport experiments in porous media. Such nonideal transport behavior is particularly evident in the late time elution of biocolloids at low concentrations. Here we present a series of saturated column experiments that were designed to measure the breakthrough and long-term elution of Cryptosporidium parvum in medium sand for a few thousand pore volumes after the initial source of oocysts was removed. For a wide range of ionic strengths, I, we consistently observe slower-than-Fickian, power law tailing. The slope of the tail is flatter for higher I. At very high ionic strength the slope decays to a rate slower than t-1. To explain this behavior, we propose a new filtration model based on the continuous time random walk (CTRW) theory. Our theory upscales heterogeneities at both the pore-scale geometry of the flow field and the grain surface physicochemical properties that affect biocolloid attachment and detachment. Pore-scale heterogeneities in fluid flow are shown to control the breakthrough of a conservative tracer but are shown to have negligible effect on oocyst transport. In our experiments, C. parvum transport is dominated by the effects of physicochemical heterogeneities. The CTRW model provides a parsimonious theory of nonreactive and reactive transport. The CTRW filtration process is controlled by three parameters, Λ, β, and c, which are related to the overall breakthrough retardation (R = 1 + Λ), the slope of the power law tail (β), and the transition to a slower than t-1 decay (c).

  9. Long-term course of cognitive function in chronically hospitalized patients with schizophrenia transitioning to community-based living.

    PubMed

    Nemoto, Takahiro; Niimura, Hidehito; Ryu, Yonosuke; Sakuma, Kei; Mizuno, Masafumi

    2014-05-01

    Schizophrenia is associated with impairments in social interactions, and the conditions under which patients live and undergo treatment appear to have an important role in the course of the disease. However, the influences of care settings on the course of cognition remain controversial. The closure of psychiatric hospitals and the transition to community-based living is a golden opportunity to address this issue. The aims of the present study were to examine (1) the longitudinal course of cognition as well as the psychopathology and social functioning of schizophrenia patients who had been chronically hospitalized and then discharged, and (2) the key cognitive predictors of the functional outcome of such patients. Seventy-eight patients were transferred to the community after the closure of a psychiatric hospital. These patients were followed-up for 5 years and underwent annual examinations that included measures of cognition, psychiatric symptoms, and social functioning. Fifty-six patients completed all the assessments. Although consistent improvements were shown in the cognitive domains for attention and memory, the initial improvements in global cognition and processing speed ultimately began to decline. Symptoms and global functioning improved almost consistently over the course of the follow-up period. Stepwise multiple regressions revealed category fluency at baseline predicted social functioning at 5 years. However, this correlation was no longer significant when psychopathological variables were included as predictors. These results suggest that care settings affect the course of cognition, and addressing these conditions may lead to a certain degree of cognitive improvement even among schizophrenia patients who have been chronically institutionalized. PMID:24725850

  10. Long-Term Carriage of Vancomycin-Resistant Enterococci in Patients Discharged from Hospitals: a 12-Year Retrospective Cohort Study

    PubMed Central

    Karki, Surendra; Land, Gillian; Aitchison, Stacey; Kennon, Jacqueline; Johnson, Paul D. R.; Ballard, Susan A.; Leder, Karin

    2013-01-01

    Contact precautions are recommended in hospitals to prevent the transmission of vancomycin-resistant enterococci (VRE); however, there is no clear policy for how long patients should be under contact precautions due to a lack of information on the duration of carriage of these organisms. We conducted a retrospective cohort study to understand the duration of carriage of VRE (by screening of a single stool culture) and associated factors among patients who had been identified with VRE infection and/or colonization since the year 2000 at our health facilities. Of the 345 eligible participants, 136 did not respond, 90 declined to participate, and 16 did not send in the required specimens. Of the 103 remaining participants, 13 were found to have current VRE fecal carriage. The proportion of colonized patients fell from 40% (2/5) in the first year to 23.3% (7/30) in year 4. None of the 40 patients who had VRE detected >4 years prior were found to be colonized at the time of the study. The longest duration of detected VRE positivity was 46.5 months. Univariate analysis revealed that recent exposure to any antibiotics (P = 0.016), multiple antibiotics (P = 0.001), amoxicillin-clavulanic acid (P = 0.021), piperacillin-tazobactam (P = 0.007), glycopeptides (P < 0.001), meropenem (P = 0.007), aminoglycosides (P = 0.021), or fluoroquinolones (P = 0.021), being the index case in a clinical specimen (P = 0.016), and recent hospitalization (P < 0.001) were significantly associated with continued carriage on follow-up. In the surviving outpatients, a significant proportion appeared to clear VRE carriage. Our results suggest that in the absence of recent risk factors, such as hospitalization or antibiotic use, patients with a remote history of colonization (>4 years) may no longer require contact isolation precautions. PMID:23926167

  11. Long-term carriage of vancomycin-resistant enterococci in patients discharged from hospitals: a 12-year retrospective cohort study.

    PubMed

    Karki, Surendra; Land, Gillian; Aitchison, Stacey; Kennon, Jacqueline; Johnson, Paul D R; Ballard, Susan A; Leder, Karin; Cheng, Allen C

    2013-10-01

    Contact precautions are recommended in hospitals to prevent the transmission of vancomycin-resistant enterococci (VRE); however, there is no clear policy for how long patients should be under contact precautions due to a lack of information on the duration of carriage of these organisms. We conducted a retrospective cohort study to understand the duration of carriage of VRE (by screening of a single stool culture) and associated factors among patients who had been identified with VRE infection and/or colonization since the year 2000 at our health facilities. Of the 345 eligible participants, 136 did not respond, 90 declined to participate, and 16 did not send in the required specimens. Of the 103 remaining participants, 13 were found to have current VRE fecal carriage. The proportion of colonized patients fell from 40% (2/5) in the first year to 23.3% (7/30) in year 4. None of the 40 patients who had VRE detected >4 years prior were found to be colonized at the time of the study. The longest duration of detected VRE positivity was 46.5 months. Univariate analysis revealed that recent exposure to any antibiotics (P = 0.016), multiple antibiotics (P = 0.001), amoxicillin-clavulanic acid (P = 0.021), piperacillin-tazobactam (P = 0.007), glycopeptides (P < 0.001), meropenem (P = 0.007), aminoglycosides (P = 0.021), or fluoroquinolones (P = 0.021), being the index case in a clinical specimen (P = 0.016), and recent hospitalization (P < 0.001) were significantly associated with continued carriage on follow-up. In the surviving outpatients, a significant proportion appeared to clear VRE carriage. Our results suggest that in the absence of recent risk factors, such as hospitalization or antibiotic use, patients with a remote history of colonization (>4 years) may no longer require contact isolation precautions. PMID:23926167

  12. 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

  13. 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.

  14. 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.

  15. 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. PMID:25926353

  16. Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

    PubMed Central

    Gravensteen, Ida Kathrine; Helgadóttir, Linda Björk; Jacobsen, Eva-Marie; Rådestad, Ingela; Sandset, Per Morten; Ekeberg, Øivind

    2013-01-01

    Objectives (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome. Design A retrospective study. Setting Two university hospitals. Participants The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5–18 years previously. 101 women completed a comprehensive questionnaire in two parts. Primary and secondary outcome measures The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES). Results The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS. Conclusions The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5–18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS. Trial registration The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076. PMID:24154514

  17. Comparison of Asymptomatic Bacteriuria Escherichia coli Isolates from Healthy Individuals versus Those from Hospital Patients Shows that Long-Term Bladder Colonization Selects for Attenuated Virulence Phenotypes

    PubMed Central

    Salvador, Ellaine; Wagenlehner, Florian; Köhler, Christian-Daniel; Mellmann, Alexander; Hacker, Jörg; Svanborg, Catharina

    2012-01-01

    Asymptomatic bacteriuria (ABU) is a condition where bacteria stably colonize the urinary tract, in a manner closely resembling commensalism at other mucosal sites. The patients carry >105 CFU/ml for extended periods of time and rarely develop symptoms. Contrasting the properties of ABU strains to those of uropathogenic isolates causing symptomatic infection is therefore highly relevant to understand mechanisms of bacterial adaptation. The prototype ABU strain Escherichia coli 83972 has a smaller genome than uropathogenic E. coli (UPEC) strains with deletions or point mutations in several virulence genes, suggesting that ABU strains undergo a programmed reductive evolution within human hosts. This study addressed if these observations can be generalized. Strains causing ABU in outpatients or hospitalized patients after catheterization or other invasive procedures were compared to commensal E. coli isolates from the intestinal flora of healthy individuals. Notably, clonal complex 73 (CC73) was a prominent phylogenetic lineage dominated by ABU isolates. ABU isolates from outpatients and hospitalized patients had a similar overall virulence gene repertoire, which distinguished them from many commensals, but typical UPEC virulence genes were less frequently attenuated in hospital strains than in outpatient strains or commensals. The decreased virulence potential of outpatient ABU isolates relative to that of ABU strains from hospitalized patients supports the hypothesis that loss of expression or decay of virulence genes facilitates long-term carriage and adaptation to host environments. PMID:22104113

  18. Influenza and Seasonal Patterns of Hospital Use by Older Adults in Long-Term Care and Community Settings in Ontario, Canada

    PubMed Central

    Kwong, Jeff C.; Campitelli, Michael A.; Newman, Alice; Anderson, Geoffrey M.; Rochon, Paula A.; Mor, Vincent

    2014-01-01

    Objectives. We compared seasonal influenza hospital use among older adults in long-term care (LTC) and community settings. Methods. We used provincial administrative data from Ontario to identify all emergency department (ED) visits and hospital admissions for pneumonia and influenza among adults older than 65 years between 2002 and 2008. We used sentinel laboratory reports to define influenza and summer seasons and estimated mean annual event rates and influenza-associated rates. Results. Mean annual pneumonia and influenza ED visit rates were higher in LTC than the community (rate ratio [RR] for influenza season = 3.9; 95% confidence interval [CI] = 3.8, 4.0; for summer = 4.9; 95% CI = 4.8, 5.1) but this was attenuated in influenza-associated rates (RR = 2.4; 95% CI = 2.1, 2.8). The proportion of pneumonia and influenza ED visits attributable to seasonal influenza was 17% (15%–20%) in LTC and 28% (27%–29%) in the community. Results for hospital admissions were comparable. Conclusions. We found high rates of hospital use from LTC but evidence of lower impact of circulating influenza in the community. This differential impact of circulating influenza between the 2 environments may result from different influenza control policies. PMID:24328631

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. Plant diversity induces a shift of DOC concentration over time - results from long term and large scale experiment

    NASA Astrophysics Data System (ADS)

    Lange, Markus; Gleixner, Gerd

    2016-04-01

    Plant diversity has been demonstrated as a crucial factor for soil organic carbon (SOC) storage. The horizontal SOC formation in turn is strongly impacted by the relative small but consistent flow of dissolved organic carbon (DOC) in soils. In this process, pore water leaches plant material and already stored SOC while simultaneously these leachates are transported downwards. However, there is a big uncertainty about the drivers of DOC flux; in particular about the importance of biological processes. We investigated the impact of plant diversity and other biotic drivers on DOC concentrations and total DOC fluxes (concentration × sampled water amount). In addition, we considered abiotic factors such as weather and soil conditions to assess the relative importance of biotic and abiotic drivers and how their importance changes over time. We used a comprehensive data set, gathered in the frame of the long-term biodiversity experiment "The Jena Experiment". Permanent monitoring started directly after establishment of the field site in 2002 and is still running. This enabled us to trace the impact of plant communities with their increasing establishment over the time on DOC concentration. We found the amount of sampled pore water best explained by rainfall, while it was not related to plant associated variables. Directly after establishing the experimental site, DOC concentrations were highest and then decreasing with time. In the first period of the experiment plant diversity had no or even a slightly negative impact on DOC concentrations. The direction of the plant diversity effect on DOC concentrations changed over time; namely in later phases we observed highest DOC concentrations on plots with high plant diversity. Moreover, DOC concentrations were negatively affected by increased amounts of sampled pore water indicating a dilution effect. Even though this impact was highly significant; its effect size was even less pronounced at later time points. In summary

  4. 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 population, is that…

  5. Long-Term Consequences of Vietnam-Era Conscription: Schooling, Experience, and Earnings. NBER Working Paper No. 13411

    ERIC Educational Resources Information Center

    Angrist, Joshua D.; Chen, Stacey H.

    2007-01-01

    This paper uses the 2000 Census 1-in-6 sample to look at the long-term impact of Vietnam-era military service. Instrumental Variables estimates using draft-lottery instruments show post-service earnings losses close to zero in 2000, in contrast with earlier results showing substantial earnings losses for white veterans in the 1970s and 1980s. The…

  6. 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.

  7. 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

  8. Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors

    SciTech Connect

    Milker-Zabel, Stefanie . E-mail: stefanie_milker-zabel@med.uni-heidelberg.de; Zabel, Angelika; Schulz-Ertner, Daniela; Schlegel, Wolfgang; Wannenmacher, Michael; Debus, Juergen

    2005-03-01

    Purpose: To analyze our long-term experience and prognostic factors after fractionated stereotactic radiotherapy (FSRT) in patients with benign or atypical intracranial meningioma. Methods and materials: Between January 1985 and December 2001, 317 patients with a median age of 55.7 years were treated with FSRT for intracranial meningioma. The tumor distribution was World Health Organization (WHO) Grade 1 in 48.3%, WHO Grade 2 in 8.2%, and unknown in 43.5%. Of the 317 patients, 97 underwent RT as their primary treatment, 79 underwent postoperative RT (subtotal resection in 38 and biopsy only in 41), and 141 were treated for recurrent disease. The median target volume was 33.6 cm{sup 3} (range, 1.0-412.6 cm{sup 3}). The median total dose was 57.6 Gy at 1.8 Gy/fraction five times weekly. Results: The median follow-up was 5.7 years (range, 1.2-14.3 years). The overall local tumor control rate was 93.1% (295 of 317). Of the 317 patients, 72 had a partial response on CT/MRI and 223 (70.4%) remained stable. At a median of 4.5 years after FSRT, 22 patients (6.9%) had local tumor progression on MRI. Local tumor failure was significantly greater in patients with WHO Grade 2 meningioma (p < 0.002) than in patients with WHO Grade 1 or unknown histologic features. Patients treated for recurrent meningioma showed a trend toward decreased progression-free survival compared with patients treated with primary therapy, after biopsy, or after subtotal resection (p < 0.06). Patients with a tumor volume >60 cm{sup 3} had a recurrence rate of 15.5% vs. 4.3% for those with a tumor volume of {<=}60 cm{sup 3} (p < 0.001). In 42.9% of the patients, preexisting neurologic deficits improved. Worsening of preexisting neurologic symptoms occurred in 8.2%. Eight patients developed new clinical symptoms, such as reduced vision, trigeminal neuralgia, and intermittent tinnitus located at the side of the irradiated meningioma after FSRT. Conclusion: These data have demonstrated that FSRT is an

  9. 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…

  10. 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…

  11. Long term non-invasive ventilation in the community for patients with musculoskeletal disorders: 46 year experience and review

    PubMed Central

    Baydur, A.; Layne, E.; Aral, H.; Krishnareddy, N.; Topacio, R.; Frederick, G.; Bodden, W.

    2000-01-01

    BACKGROUND—A study was undertaken to assess the long term physiological and clinical outcome in 79 patients with musculoskeletal disorders (73 neuromuscular, six of the chest wall) who received non-invasive ventilation for chronic respiratory failure over a period of 46years.
METHODS—Vital capacity (VC) and carbon dioxide tension (PCO2) before and after initiation of ventilation, type and duration of ventilatory assistance, the need for tracheostomy, and mortality were retrospectively studied in 48 patients who were managed with mouth/nasal intermittent positive pressure ventilation (M/NIPPV) and 31 who received body ventilation. The two largest groups analysed were 45 patients with poliomyelitis and 15 with Duchenne's muscular dystrophy. Twenty five patients with poliomyelitis received body ventilation (for a mean of 290 months) and 20 were supported by M/NIPPV (mean 38 months). All 15 patients with Duchenne's muscular dystrophy were ventilated by NIPPV (mean 22months).
RESULTS—Fourteen patients with poliomyelitis on body ventilation (56%) but only one on M/NIPPV, and 10 of 15 patients (67%) with Duchenne's muscular dystrophy eventually received tracheostomies for ventilatory support. Five patients with other neuromuscular disorders required tracheostomies. Twenty of 29 tracheostomies (69%) were provided because of progressive disease and hypercarbia which could not be controlled by non-invasive ventilation; the remaining nine were placed because of bulbar dysfunction and aspiration related complications. Nine of 10 deaths occurred in patients on body ventilation (six with poliomyelitis), although the causes of death were varied and not necessarily related to respiratory complications. A proportionately greater number of patients on M/NIPPV (67%) reported positive outcomes (improved sense of wellbeing and independence) than did those on body ventilation (29%, p<0.01). However, other than tracheostomies and deaths, negative outcomes in the form of machine

  12. 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.

  13. 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. PMID:23765036

  14. Do gerontology nurse specialists make a difference in hospitalization of long-term care residents? Results of a randomized comparison trial.

    PubMed

    Boyd, Michal; Armstrong, Delwyn; Parker, Janet; Pilcher, Carole; Zhou, Lifeng; McKenzie-Green, Barbara; Connolly, Martin J

    2014-10-01

    Residents of long-term care facilities have highly complex care needs and quality of care is of international concern. Maintaining resident wellness through proactive assessment and early intervention is key to decreasing the need for acute hospitalization. The Residential Aged Care Integration Program (RACIP) is a quality improvement intervention to support residential aged care staff and includes on-site support, education, clinical coaching, and care coordination provided by gerontology nurse specialists (GNSs) employed by a large district health board. The effect of the outreach program was evaluated through a randomized comparison of hospitalization 1 year before and after program implementation. The sample included 29 intervention facilities (1,425 residents) and 25 comparison facilities (1,128 residents) receiving usual care. Acute hospitalization rate unexpectedly increased for both groups after program implementation, although the rate of increase was significantly less for the intervention facilities. The hospitalization rate after the intervention increased 59% for the comparison group and 16% for the intervention group (rate ratio (RR) = 0.73, 95% confidence interval (CI) = 0.61-0.86, P < .001). Subgroup analysis showed a significantly lower rate change for those admitted for medical reasons for the intervention group (13% increase) than the comparison group (69% increase) (RR = 0.67, 95% CI = 0.56-0.82, P < .001). Conversely, there was no significant difference in the RR for surgical admissions between the intervention and comparison groups (RR = 1.0, 95% CI = 0.68-1.46, P = .99). The integration of GNS expertise through the RACIP intervention may be one approach to support staff to provide optimal care and potentially improve resident health. PMID:25283552

  15. Immediate and long-term outcome of left-sided infective endocarditis. A 12-year prospective study from a contemporary cohort in a referral hospital.

    PubMed

    Fernández-Hidalgo, N; Almirante, B; Tornos, P; González-Alujas, M T; Planes, A M; Galiñanes, M; Pahissa, A

    2012-12-01

    The aim of this study was to describe the immediate and long-term prognosis of a contemporary cohort of patients with left-sided infective endocarditis (LSIE). A prospective observational cohort study was conducted in a referral centre. Between January 2000 and December 2011, all consecutive adult patients with LSIE were followed-up until death, relapse, recurrence, need for late surgery, or last control. During the active phase of IE, 174 of 438 patients underwent surgery (40% overall; 43% native valve (NVIE), 30% prosthetic valve (PVIE)) and 125 died (29% overall; 26% NVIE, 39% PVIE). The median follow-up in survivors was 3.2 years (interquartile range (IQR) 1.0-6.0 years). Relapses occurred in seven patients (2.2%; 95% CI, 1.1-4.5) and recurrences in eight (2.6%; 95% CI, 1.3-5.0), with an incidence density of 0.0067 per patient-year (95% CI, 0.0029-0.0133) and high mortality (75% of recurrences). Only four of 130 survivors (3.1%; 95% CI, 1.2-7.6) who were treated surgically during the active phase of the disease, and 14/183 (7.7%; 95% CI, 4.6-12.4) of those not undergoing surgery needed operation during follow-up (p 0.09). In the 313 survivors, actuarial survival was 86% at 1 year (87% NVIE, 83% PVIE), 79% at 2 years (81% NVIE, 72% PVIE) and 68% at 5 years (71% NVIE, 57% PVIE). At 1 year, 115 of 397 patients (29.0%; 95% CI, 24.7-33.6) remained alive, with no surgery requirement, relapse or recurrence. LSIE is associated with considerable in-hospital and long-term mortality, especially PVIE. However, relapses, recurrences and the need for late surgery are uncommon.

  16. 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

  17. Large-sized Fetal Striatal Grafts in Huntington's Disease Do Stop Growing: Long-term Monitoring in the Florence Experience.

    PubMed

    Mascalchi, Mario; Diciotti, Stefano; Paganini, Marco; Bianchi, Andrea; Ginestroni, Andrea; Lombardini, Letizia; Porfirio, Berardino; Conti, Renato; Di Lorenzo, Nicola; Vannelli, Gabriella Barbara; Gallina, Pasquale

    2014-08-04

    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.

  18. Large-sized Fetal Striatal Grafts in Huntington's Disease Do Stop Growing: Long-term Monitoring in the Florence Experience.

    PubMed

    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

  19. Emergence of blaKPC-containing Klebsiella pneumoniae in a long-term acute care hospital: a new challenge to our healthcare system

    PubMed Central

    Endimiani, Andrea; DePasquale, John M.; Forero, Sandra; Perez, Federico; Hujer, Andrea M.; Roberts-Pollack, Daneshia; Fiorella, Paul D.; Pickens, Nancy; Kitchel, Brandon; Casiano-Colón, Aida E.; Tenover, Fred C.; Bonomo, Robert A.

    2009-01-01

    Objectives To characterize isolates of Klebsiella pneumoniae producing KPC carbapenemase (KPC-Kp) associated with an outbreak in a long-term acute care hospital (LTACH) in South Florida. Methods During 21 March to 20 April 2008, 241 K. pneumoniae isolates detected at Integrated Regional Laboratories (Ft. Lauderdale, FL) for which the ertapenem MICs were ≥4 mg/L were studied. PCR, cloning and sequence analysis were used to detect blaKPC and to characterize the β-lactamase and outer membrane proteins (Omps). The expression level of KPC enzymes was studied by immunoblotting. Genetic relatedness of isolates was investigated with rep-PCR and PFGE. Clinical records of patients were investigated. Results Seven KPC-Kp strains were isolated from different patients located at a single LTACH, with a further three isolates being recovered from patients at different hospitals. All KPC-Kp isolates in patients from the LTACH and from one hospital patient were genetically related and shared PFGE patterns that clustered with known sequence type (ST) 258 strains. These strains were highly resistant to carbapenems (MICs ≥ 32 mg/L) due to an increased level of KPC expression and loss of Omps. Rectal colonization was documented in all LTACH patients with KPC-Kp isolates. Treatment failures were common (crude mortality rate of 69%). Active surveillance and enhanced infection control practices terminated the KPC-Kp outbreak. Conclusions The detection of KPC-Kp in an LTACH represents a serious infection control and therapeutic challenge in a new clinical setting. The speed at which the epidemic of KPC-Kp is spreading in our healthcare system mandates urgent action. PMID:19740911

  20. 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. PMID:19387545

  1. 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.

  2. Healthcare-associated infections and antimicrobial use in long-term care facilities: the Irish experience with the HALT surveys.

    PubMed

    Burns, K; Roche, F; Donlon, S

    2015-04-01

    In the context of an ageing European population, point prevalence surveys (PPS) of healthcare-associated infection and antimicrobial use in long-term care facilities (HALT) in Europe were commissioned by the European Centre for Disease Prevention and Control. Sixty-nine Irish long-term care facilities (LTCFs) took part in the first survey in 2010. A series of interventions to raise the profile of infection prevention and control and antimicrobial stewardship in Irish LTCFs followed. HALT was repeated in Ireland in 2011, with 108 participating LTCFs, and again in 2013 as part of the second European HALT survey, with 190 participating LTCFs. The latest Irish HALT report incorporates data from the three PPSs to date, and discusses the findings and the national implementation priorities recommended by the Irish multi-disciplinary steering group. Ireland contributed ∼10% of the total resident population in both of the European HALT PPSs. This, and the growing number of participating LTCFs, shows that healthcare professionals in Irish LTCFs are committed to improving the quality and safety of resident care.

  3. Healthcare-associated infections and antimicrobial use in long-term care facilities: the Irish experience with the HALT surveys.

    PubMed

    Burns, K; Roche, F; Donlon, S

    2015-04-01

    In the context of an ageing European population, point prevalence surveys (PPS) of healthcare-associated infection and antimicrobial use in long-term care facilities (HALT) in Europe were commissioned by the European Centre for Disease Prevention and Control. Sixty-nine Irish long-term care facilities (LTCFs) took part in the first survey in 2010. A series of interventions to raise the profile of infection prevention and control and antimicrobial stewardship in Irish LTCFs followed. HALT was repeated in Ireland in 2011, with 108 participating LTCFs, and again in 2013 as part of the second European HALT survey, with 190 participating LTCFs. The latest Irish HALT report incorporates data from the three PPSs to date, and discusses the findings and the national implementation priorities recommended by the Irish multi-disciplinary steering group. Ireland contributed ∼10% of the total resident population in both of the European HALT PPSs. This, and the growing number of participating LTCFs, shows that healthcare professionals in Irish LTCFs are committed to improving the quality and safety of resident care. PMID:25638357

  4. 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

  5. Long-Term Outcomes After Transcatheter Aortic Valve Implantation from a Single High-Volume Center (The Milan Experience).

    PubMed

    Ruparelia, Neil; Latib, Azeem; Buzzatti, Nicola; Giannini, Francesco; Figini, Filippo; Mangieri, Antonio; Regazzoli, Damiano; Stella, Stefano; Sticchi, Alessandro; Kawamoto, Hiroyoshi; Tanaka, Akihito; Agricola, Eustachio; Monaco, Fabrizio; Castiglioni, Alessandro; Ancona, Marco; Cioni, Micaela; Spagnolo, Pietro; Chieffo, Alaide; Montorfano, Matteo; Alfieri, Ottavio; Colombo, Antonio

    2016-03-01

    Transcatheter aortic valve implantation (TAVI) is now the treatment of choice for patients with symptomatic aortic stenosis who are inoperable or with high surgical risk. Data with regards to contemporary clinical practice and long-term outcomes are sparse. To evaluate temporal changes in TAVI practice and explore procedural and long-term clinical outcomes of patients in a contemporary "real-world" population, outcomes of 829 patients treated from November 2007 to May 2015, at the San Raffaele Scientific Institute, Milan, Italy, were retrospectively analyzed. Median follow-up was 568 days, with the longest follow-up of 2,677 days. Overall inhospital mortality was 3.5%. During the study period, there was a trend toward treating younger, lower risk patients. Overall mortality rates were 3.5% (30 days), 14% (1 year), 22% (2 years), 29% (3 years), 37% (4 years), 47% (5 years), 53% (6 years), and 72% (7 years). The survival probability at 5 years was significantly higher in patients treated through the transfemoral (TF) route compared to other vascular access sites (log rank p <0.001). Non-TF vascular access and residual paravalvular leak ≥2 (after TAVI) were identified as independent predictors for both all-cause and cardiovascular mortality. No patient required further aortic valve intervention for TAVI prosthesis degeneration. In conclusion, there is a trend toward treating younger, lower-risk patients. Non-TF vascular access approach and ≥2 PVL after TAVI were identified as independent predictors for both overall and cardiovascular mortality with no cases of prosthesis degeneration suggesting acceptable durability.

  6. Comparison of long-term mortality after acute myocardial infarction treated by percutaneous coronary intervention in patients living alone versus not living alone at the time of hospitalization.

    PubMed

    Nakatsuma, Kenji; Shiomi, Hiroki; Watanabe, Hiroki; Morimoto, Takeshi; Taniguchi, Tomohiko; Toyota, Toshiaki; Furukawa, Yutaka; Nakagawa, Yoshihisa; Horie, Minoru; Kimura, Takeshi

    2014-08-15

    Living alone was reported to be associated with increased risk of cardiovascular disease. There are, however, limited data on the relation between living alone and all-cause mortality in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The Coronary REvascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) AMI registry was a cohort study of patients with AMI enrolled in 26 hospitals in Japan from 2005 through 2007. For the current analysis, we included those patients who underwent PCI within 24 hours of symptom onset, and we assessed their living status to determine if living alone would be an independent prognostic risk factor. Among 4,109 patients eligible for the current analysis of 5,429 patients enrolled in the CREDO-Kyoto AMI registry, 515 patients (12.5%) were living alone at the time of hospital admission. The cumulative 5-year incidence of all-cause death was 18.3% in the living alone group and 20.1% in the not living alone group (log-rank p = 0.77). After adjusting for potential confounders, risk of the living alone group relative to the not living alone group for all-cause death was not significantly different (adjusted hazard ratio 0.82, 95% confidence interval 0.65 to 1.02, p = 0.08). In a subgroup analysis stratified by age, the adjusted risk for all-cause death was also not different between the living alone group and the not living alone group both in the older population (aged ≥75 years) and the younger population (aged <75 years). In conclusion, living alone was not associated with higher long-term mortality in patients with AMI who underwent PCI.

  7. Spread of Escherichia coli Strains with High-Level Cefotaxime and Ceftazidime Resistance between the Community, Long-Term Care Facilities, and Hospital Institutions

    PubMed Central

    Oteo, Jesús; Navarro, Carmen; Cercenado, Emilia; Delgado-Iribarren, Alberto; Wilhelmi, Isabel; Orden, Beatriz; García, Carmen; Miguelañez, Silvia; Pérez-Vázquez, María; García-Cobos, Silvia; Aracil, Belén; Bautista, Verónica; Campos, José

    2006-01-01

    A total of 151 Escherichia coli strains resistant to cefotaxime and ceftazidime were isolated during a prospective surveillance study. These strains were characterized by clinical, microbiological, and molecular analyses and were distributed into four clusters of 103, 11, 6, and 5 isolates, along with 25 unrelated strains. The principal cluster was isolated from urine, wound, blood, and other samples in three hospitals, eight nursing homes, and a community healthcare center. This cluster was associated with both nosocomial (65%) and community-acquired (35%) infections. Most strains were resistant to ciprofloxacin, gentamicin, tobramycin, cefepime, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole but were susceptible to imipenem. All isolates from the four clusters expressed the extended-spectrum β-lactamase (ESBL) CTX-M-15. This enzyme was also present in 8 (30.8%) of the 26 unrelated isolates. The other ESBLs, CTX-M-14 and CTX-M-32, were detected in five and seven cases, respectively, but they were detected in individual E. coli isolates only. In three clusters, blaCTX-M-15 alleles were linked to an ISEcp1-like element, while in eight strains of cluster II an IS26 element preceded the blaCTX-M-15 allele. An additional pool of resistance genes included tetA, drfA14 or dfrA17, sul1 or sul2, aac(6′)Ib, and aac(3)IIb. All except one of the 27 isolates tested for genetic virulence markers harbored the same three virulence genes: iutA and fyuA (siderophores), and traT (serum survival factor). Epidemic or occasional isolates of cefotaxime- and ceftazidime-resistant E. coli can spread between distinct health facilities including hospitals, community health centers, and long-term care centers. PMID:16825350

  8. A demonstration study comparing “role-emergent” versus “role-established” pharmacy clinical placement experiences in long-term care facilities

    PubMed Central

    2013-01-01

    Background Increasing challenges to recruit hospital sites with full-time on-site pharmacy preceptors for institutional-based Advanced Pharmacy Practice Experiences (APPE) has made it necessary to consider alternate experiential models. Sites with on-site discipline specific preceptors to supervise students have typically been referred to in the literature as “role-established” sites. In British Columbia, long-term care (LTC) facilities offered a unique opportunity to address placement capacity issues. However, since the majority of these facilities are serviced by off-site community pharmacists, this study was undertaken to explore the viability of supervising pharmacy students remotely – a model referred to in the literature as “role-emergent” placements. This paper’s objectives are to discuss pharmacy preceptors’ and LTC non-pharmacist staff experiences with this model. Methods The study consisted of three phases: (1) the development phase which included delivery of a training program to create a pool of potential LTC preceptors, (2) an evaluation phase to test the viability of the LTC role-emergent model with seven pharmacists (two role-established and five role-emergent) together with their LTC staff, and (3) expansion of LTC role-emergent sites to build capacity. Both qualitative and quantitative methods were used to obtain feedback from pharmacists and staff and t-tests and Mann–Whitney U tests were used to examine equivalency of survey outcomes from staff representing both models. Results The 76 pharmacists who completed the training program survey rated the modules as “largely” meeting their learning needs. All five role-emergent pharmacists and 29 LTC participating staff reported positive experiences with the pharmacy preceptor-student-staff collaboration. Preceptors reported that having students work side-by-side with facility staff promoted inter-professional collaboration. The staff viewed students’ presence as a mutually

  9. A Multicentre Prospective Evaluation of the Impact of Renal Insufficiency on In-hospital and Long-term Mortality of Patients with Acute ST-elevation Myocardial Infarction

    PubMed Central

    Li, Chao; Hu, Dayi; Shi, Xubo; Li, Li; Yang, Jingang; Song, Li; Ma, Changsheng

    2015-01-01

    Background: Numerous previous studies have shown that renal insufficiency (RI) in patients with acute coronary syndrome is associated with poor cardiovascular outcomes. These studies do not well address the impact of RI on the long-term outcome of patients with acute ST-elevation myocardial infarction (STEMI) in China. The aim of this study was to investigate the association of admission RI and inhospital and long-term mortality of patients with acute STEMI. Methods: This was a multicenter, observational, prospective-cohort study. 718 consecutive patients were admitted to 19 hospitals in Beijing within 24 hours of onset of STEMI, between January 1,2006 and December 31,2006. Estimation of glomerular filtration rate (eGFR) was calculated using the modified abbreviated modification of diet in renal disease equation-based on the Chinese chronic kidney disease patients. The patients were categorized according to eGFR, as normal renal dysfunction (eGFR ≥ 90 ml∙min-1∙1.73 m-2), mild RI (60 ml∙min-1∙1.73 m-2 ≤ eGFR < 90 ml∙min-1∙1.73 m-2) and moderate or severe RI (eGFR < 60 ml∙min-1∙1.73 m-2). The association between RI and inhospital and 6-year mortality of was evaluated. Results: Seven hundred and eighteen patients with STEMI were evaluated. There were 551 men and 167 women with a mean age of 61.0 ± 13.0 years. Two hundred and eighty patients (39.0%) had RI, in which 61 patients (8.5%) reached the level of moderate or severe RI. Patients with RI were more often female, elderly, hypertensive, and more patients had heart failure and stroke with higher killip class. Patients with RI were less likely to present with chest pain. The inhospital mortality (1.4% vs. 5.9% vs. 22.9%, P < 0.001), 6-year all-cause mortality (9.5% vs. 19.8 vs. 45.2%, P < 0.001) and 6-year cardiac mortality (2.9% vs. 12.2% vs. 23.8%, P < 0.001) were markedly increased in patients with RI. After adjusting for other confounding factors, classification of admission renal function

  10. A job description for the effective self-management of a long-term condition: experiences of living with difficult asthma.

    PubMed

    Deacon, Maureen; Rickards, Emma

    2013-04-01

    This paper concerns a study exploring the salience of a 'job description' for the effective self-management of a long-term condition to the experiences of a group of women living with difficult asthma. This is a life-threatening disease. It has been claimed that sufferers are a marginalised, misunderstood, mistreated and vulnerable group. The method involved secondary analysis of focus group data. The job description has been developed as a tool to enable nurses to facilitate and support effective self-management. This study was designed to examine the application of this tool to a particular case. Long-term conditions are a growing feature of the developed world and are strongly implicated in health inequalities. They are more prevalent in socially and economically disadvantaged populations and therefore add further burden to already vulnerable people. Effective self-management is critical to adapting and adjusting to the experience of a long-term condition and nurses have a responsibility to promote this process.

  11. Long-term treatment of hereditary angioedema with attenuated androgens: a survey of a 13-year experience.

    PubMed

    Cicardi, M; Bergamaschini, L; Cugno, M; Hack, E; Agostoni, G; Agostoni, A

    1991-04-01

    Fifty-six patients affected with hereditary angioedema have been followed during long-term prophylaxis with attenuated androgens. The treatment was started in patients who had one or more severe attacks per month. In 24 patients, the therapy lasted for more than 5 years. The minimal effective dose usually did not exceed 2 mg/day of stanozolol or 200 mg/day of danazol. Only in two patients were these doses not sufficient to achieve the complete disappearance of symptoms. Irregular menstruation, but rarely amenorrhea, was the only significant side effect. One patient had to stop the therapy because of laboratory signs of hepatic cell necrosis. In one patient, danazol was administered during the last 8 weeks of pregnancy without side effects for the mother but with transient signs of virilization for the female baby. To find a biochemical marker for the minimal effective dose of androgen derivatives, we measured the plasma levels of C1 C1 INH complexes at different doses of stanozolol in four patients with hereditary angioedema. We found that these complexes, elevated before treatment, promptly reverted to normal values during androgen therapy and remained normal with any reduction of the dose of the drug as long as the patient remained symptom free. Therefore, the measurement of C1 C1 INH complexes appears to reflect the activity of the disease and not the amount of androgen that is administered.

  12. 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

  13. 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

  14. 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

  15. Adapting the ABCDEF Bundle to Meet the Needs of Patients Requiring Prolonged Mechanical Ventilation in the Long-Term Acute Care Hospital Setting: Historical Perspectives and Practical Implications.

    PubMed

    Balas, Michele C; Devlin, John W; Verceles, Avelino C; Morris, Peter; Ely, E Wesley

    2016-02-01

    When robust clinical trials are lacking, clinicians are often forced to extrapolate safe and effective evidence-based interventions from one patient care setting to another. This article is about such an extrapolation from the intensive care unit (ICU) to the long-term acute care hospital (LTACH) setting. Chronic critical illness is an emerging, disabling, costly, and yet relatively silent epidemic that is central to both of these settings. The number of chronically critically ill patients requiring prolonged mechanical ventilation is expected to reach unprecedented levels over the next decade. Despite the prevalence, numerous distressing symptoms, and exceptionally poor outcomes associated with chronic critical illness, to date there is very limited scientific evidence available to guide the care and management of this exceptionally vulnerable population, particularly in LTACHs. Recent studies conducted in the traditional ICU setting suggest interprofessional, multicomponent strategies aimed at effectively assessing, preventing, and managing pain, agitation, delirium, and weakness, such as the ABCDEF bundle, may play an important role in the recovery of the chronically critically ill. This article reviews what is known about the chronically critically ill, provide readers with some important historical perspectives on the ABCDEF bundle, and address some controversies and practical implications of adopting the ABCDEF bundle into the everyday care of patients requiring prolonged mechanical ventilation in the LTACH setting. We believe developing new and better ways of addressing both the science and organizational aspects of managing the common and distressing symptoms associated with chronic critical illness and prolonged mechanical ventilation will ultimately improve the quality of life for the many patients and families admitted to LTACHs annually. PMID:26820279

  16. 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.

  17. Experiments of dike-induced deformation: Insights on the long-term evolution of divergent plate boundaries

    NASA Astrophysics Data System (ADS)

    Trippanera, D.; Ruch, J.; Acocella, V.; Rivalta, E.

    2015-10-01

    The shallow transport of magma occurs through dikes causing surface deformation. Our understanding of the effects of diking at the surface is limited, especially on the long term, for repeated intrusive episodes. We use analogue models to study the upper crustal deformation induced by dikes. We insert metal plates within cohesive sand with three setups: in setup A, the intrusion rises upward with constant thickness and in setups B and C, the intrusion thickens at a fixed depth, with final rectangular (setup B) or triangular (setup C) shape in section. Setup A creates a doming delimited by reverse faults, with secondary apical graben, without close correspondence in nature. In setups B and C, a depression flanked by two uplifted areas is bordered by inward dipping normal faults propagating downward and, for deeper intrusions in setup B, also by inner faults, reverse at the surface; this deformation is similar to what is observed in nature, suggesting a consistent physical behavior. Dikes in nature initially propagate developing a mode I fracture at the tip, subsequently thickened by magma intrusion, without any host rock translation in the propagation direction (as in setup A). The deformation pattern in setups B and C depends on the intrusion depth and thickness, consistently to what is observed along divergent plate boundaries. The early deformation in setups B and C is similar to that from a single rifting episode (i.e., Lakagigar, Iceland, and Dabbahu, Afar), whereas the late stages resemble the structure of mature rifts (i.e., Krafla, Iceland), confirming diking as a major process in shaping divergent plate boundaries.

  18. Numerical simulation experiments on the long-term evolution of a CO2 plume under a sloping caprock

    SciTech Connect

    Pruess, Karsten

    2009-08-15

    We have used the TOUGH2-MP/ECO2N code to perform numerical simulation studies of the long-term behavior of CO{sub 2} stored in an aquifer with a sloping caprock. This problem is of great practical interest, and is very challenging due to the importance of multi-scale processes. We find that the mechanism of plume advance is different from what is seen in a forced immiscible displacement, such as gas injection into a water-saturated medium. Instead of pushing the water forward, the plume advances because the vertical pressure gradients within the plume are smaller than hydrostatic, causing the water column to collapse at the plume tip. Gas saturations and updip CO{sub 2} fluxes are nearly constant, independent of time and position, in the upper, mobile portions of the plume. The CO{sub 2} plume becomes thinner as it advances, yet the speed of advancement remains constant over the entire simulation period of up to 400 years, with migration distances of more than 80 km. Our simulation includes dissolution of CO{sub 2} into the aqueous phase and associated density increase, and molecular diffusion. However, no convection develops in the aqueous phase because it is suppressed by the relatively coarse (sub-)horizontal gridding required in a regional-scale model. A first crude sub-grid-scale model was implemented to represent convective enhancement of CO{sub 2} dissolution. This process is found to greatly reduce the thickness of the CO{sub 2} plume, but does not affect the speed of plume advancement.

  19. Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea

    PubMed Central

    Kim, Hee Kyung; Ham, Jun Soo; Byeon, Seonggyu; Yoo, Kwai Han; Jung, Ki Sun; Song, Haa-Na; Cho, Jinhyun; Lee, Ji Yun; Lim, Sung Hee; Kim, Hae Su; Kim, Ji-Yeon; Lee, Jeong Eon; Kim, Seok Won; Nam, Seok Jin; Lee, Se Kyung; Bae, Soo Youn; Ahn, Jin Seok; Im, Young-Hyuck; Park, Yeon Hee

    2016-01-01

    Purpose The purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older. Materials and Methods Patients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables. Results Among 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer–specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS. Conclusion Elderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients. PMID:26987392

  20. LONG-TERM EFFECTS OF COCAINE EXPERIENCE ON NEUROPLASTICITY IN THE NUCLEUS ACCUMBENS CORE OF ADDICTION-PRONE RATS

    PubMed Central

    Waselus, Maria; Flagel, Shelly B.; Jedynak, Jakub P.; Akil, Huda; Robinson, Terry E.; Watson, Stanley J.

    2013-01-01

    Repeated exposure to drugs of abuse is associated with structural plasticity in brain reward pathways. Rats selectively bred for locomotor response to novelty differ on a number of neurobehavioral dimensions relevant to addiction. This unique genetic animal model was used here to examine both pre-existing differences and long-term consequences of repeated cocaine treatment on structural plasticity. Selectively bred high-responder (bHR) and low-responder (bLR) rats received repeated saline or cocaine injections for 9 consecutive days. Escalating doses of cocaine (7.5, 15 and 30 mg/kg) were administered on the first (day 1) and last (day 9) days of treatment and a single injection of the intermediate dose (15 mg/kg) was given on days 2-8. Motor activity in response to escalating doses of cocaine was compared on the first and last days of treatment to assess the acute and sensitized response to the drug. Following prolonged cocaine abstinence (28 days), spine density was examined on terminal dendrites of medium spiny neurons in the nucleus accumbens core. Relative to bLRs, bHRs exhibited increased psychomotor activation in response to both the acute and repeated effects of cocaine. There were no differences in spine density between bHR and bLR rats under basal conditions or following repeated saline treatment. However, spine density differed markedly between these two lines following prolonged cocaine abstinence. All spine types were decreased in cocaine-treated bHRs, while only mushroom spines were decreased in bLRs that received cocaine. Changes in spine density occurred specifically near the branch point of terminal dendrites. These findings indicate that structural plasticity associated with prolonged cocaine abstinence varies markedly in two selected strains of rats that vary on numerous traits relevant to addiction. Thus, genetic factors that contribute to individual variation in the behavioral response to cocaine also influence cocaine-induced structural

  1. 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.

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

    PubMed

    Khatri, Bhupendra O

    2016-03-01

    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.

  3. 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

  4. CUMAS: a seafloor multi-sensor module for volcanic hazard monitoring - First long-term experiment and performance assessment

    NASA Astrophysics Data System (ADS)

    Iannaccone, G.; Guardato, S.; Vassallo, M.; Stabile, T. A.; Elia, L.; Beranzoli, L.

    2009-12-01

    providing continuous geophysical data to the Monitoring Center of the Campi Flegrei volcanic areas, managed by the Istituto Nazionale di Geofisica e Vulcanologia. The long-term operational performance of CUMAS is presented here, together with the first results from the analysis of the geophysical long time-series acquired. Examples of the acquired signals, especially geophysical data, will be presented to point out the high quality in term of signal-to-noise ratio. In particular, earthquake recordings obtained from the hydrophone resulted of comparable quality to the seismic data acquired on land by the permanent network, thus demonstrating the suitability of hydrophones to monitor the seismic activity of the caldera.

  5. 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.…

  6. 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…

  7. Long-term clinical studies of varicella vaccine at a regional hospital in Japan and proposal for a varicella vaccination program.

    PubMed

    Ozaki, Takao

    2013-12-01

    In 1974, a live varicella vaccine (Oka strain) was developed in Japan for the prevention of varicella. It has been commercially available since 1987 for the voluntary vaccination program, in which children over the age of 1 year with no history of previous varicella infection receive a single dose. From before approval up to the present, we have been carrying out long-term studies in healthy children at a regional hospital to assess the immunogenicity, safety, and efficacy of the varicella vaccine. This vaccine is very safe, and serious adverse reactions have not been observed since the year 2000 when it changed gelatin-free. In the past three studies, seroconversion was detected in around 95% of subjects by the immune adherence hemagglutination (IAHA) test, and this high rate was considered to indicate good immunogenicity. Breakthrough varicella is observed in approximately 20-30% of children who receive a single dose of the vaccine, but most cases are mild. Although recent vaccination has generally been effective, the IAHA test has shown that immunogenicity is somewhat lower than was previously demonstrated. The sensitivity of the IAHA test has been shown to be adequate when compared with the neutralization test, so the current testing system is sufficient for the maintenance of immunity levels. An additional vaccination increased the IAHA antibody level in subjects who failed to seroconvert after a single dose vaccination. According to another clinical study, additional varicella vaccination at 3-5 years after the initial vaccination achieved stronger immunogenicity. Because it is administered as part of the voluntary vaccination program, the varicella vaccination coverage rate has remained low in Japan, with no sign of a decrease in the number of varicella patients. We consider that implementation of routine varicella vaccination program based on the Preventive Vaccination Law would be the most effective approach for improvement of the coverage rate. Along with

  8. 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.

  9. 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'…

  10. Synonymous Genetic Variation in Natural Isolates of Escherichia coli Does Not Predict Where Synonymous Substitutions Occur in a Long-Term Experiment.

    PubMed

    Maddamsetti, Rohan; Hatcher, Philip J; Cruveiller, Stéphane; Médigue, Claudine; Barrick, Jeffrey E; Lenski, Richard E

    2015-11-01

    Synonymous genetic differences vary by more than 20-fold among genes in natural isolates of Escherichia coli. One hypothesis to explain this heterogeneity is that genes with high levels of synonymous variation mutate at higher rates than genes with low synonymous variation. If so, then one would expect to observe similar mutational patterns in evolution experiments. In fact, however, the pattern of synonymous substitutions in a long-term evolution experiment with E. coli does not support this hypothesis. In particular, the extent of synonymous variation across genes in that experiment does not reflect the variation observed in natural isolates of E. coli. Instead, gene length alone predicts with high accuracy the prevalence of synonymous changes in the experimental populations. We hypothesize that patterns of synonymous variation in natural E. coli populations are instead caused by differences across genomic regions in their effective population size that, in turn, reflect different histories of recombination, horizontal gene transfer, selection, and population structure.

  11. Long term outcomes in patients with intracranial germinomas: a single institution experience of irradiation with or without chemotherapy.

    PubMed

    Kawabata, Yasuhiro; Takahashi, Jun A; Arakawa, Yoshiki; Shirahata, Mitsuaki; Hashimoto, Nobuo

    2008-06-01

    Complete remission can be achieved soon after irradiation in patients with intracranial germinoma. This study aimed to analyze the follow-up outcome of intracranial germinoma patients. About 39 intracranial germinoma patients (29 males and 10 females; average age, 15 years; range, 7-27 years) treated at Kyoto University Hospital from 1978 to 2004 were included in the study group. Six patients had multifocal disease at initial diagnosis, and 10 had human chorionic gonadotropin (HCG)-producing tumors. Thirteen patients were treated with craniospinal axis irradiation, 6 with whole-brain irradiation, 17 with whole-ventricle irradiation, and 3 with local field irradiation. Since 1997, 15 patients were treated with reduced-dose whole-ventricle irradiation (median, 23.4 Gy; range, 20.4-27 Gy) followed by a local boost (median, 40.8 Gy; range, 36-54 Gy) combined with chemotherapy. The median follow-up was 94 months (18 months to 25 years). The 5- and 10-year overall survival (OS) rates of the entire group were 97 and 90%, respectively. The 5- and 10-year progression-free survival (PFS) rates of the entire group were 91 and 87%, respectively. The 8-year OS and PFS in 15 patients treated by whole-ventricle irradiation combined with chemotherapy were 100% and 92%, respectively. Four patients had recurrences within a median period of 59.5 months (51-85 months). All relapses occurred outside the radiation fields. Tumor site, tumor size, HCG production, multifocal disease and radiation dose to the primary site or whole ventricle did not significantly affect PFS. All initial recurrences of intracranial germinoma occurred at the distant site out of the radiation field. Our data suggested that reduced doses to the whole ventricle, combined with chemotherapy, should be sufficiently effective in patients with intracranial germinoma.

  12. Long-term prednisone in doses of less than 5 mg/day for treatment of rheumatoid arthritis: personal experience over 25 years.

    PubMed

    Pincus, T; Castrejón, I; Sokka, T

    2011-01-01

    This article summarises the experience of one academic rheumatologist in treatment of patients with rheumatoid arthritis (RA) over 25 years from 1980-2004 with low-dose prednisone, most with <5 mg/day over long periods. A database was available which included medications and multidimensional health assessment questionnaire (MDHAQ) scores for physical function, pain, and routine assessment of patient index data (RAPID3), completed by all patients at all visits in the infrastructure of care. Most patients were treated with long-term low-dose prednisone, often from the initial visit and indefinitely, and with methotrexate after 1990. The mean initial prednisone dose declined from 10.3 mg/day in 1980-1984 to 3.6 mg/day in 2000-2004. Although no formal criteria were used to determine the initial dose, prednisone doses were higher in patients who had more severe MDHAQ/RAPID3 scores, as expected, reflecting confounding by indication. Similar improvements were seen in clinical status over 12 months in patients treated with <5 vs. ≥ 5 mg/day prednisone, and maintained for >8 years. Adverse effects were primarily bruising and skin-thinning, with low levels of hypertension, diabetes, and cataracts, although this information was based only on self-report rather than systematic assessment by a health professional. These data reflect limitations of observational data. However, a consecutive patient database may provide long-term information not available from clinical trials. The data document that prednisone at doses <5 mg/day over long periods appears acceptable and effective for many patients with RA at this time. Further clinical trials and long-term observational studies are needed to develop optimal treatment strategies for patients with RA with low-dose prednisone. PMID:22018199

  13. 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

  14. 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. PMID:19501933

  15. A Serendipitous, Long-Term Infiltration Experiment: Water and Tritium Circulation Beneath the CAMBRIC Ditch at the Nevada Test Site

    SciTech Connect

    Maxwell, R M; Tompson, A B; Kollet, S J

    2008-11-20

    Underground nuclear weapons testing at the Nevada Test Site introduced numerous radionuclides that may be used to characterize subsurface hydrologic transport processes in arid climates. A sixteen year pumping experiment designed to examine radionuclide migration away from the CAMBRIC nuclear test, conducted in groundwater beneath Frenchman Flat in 1965, 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, tailored specifically for large scale and efficient calculations. Simulations have been used to estimate radionuclide 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 ditch and pumping well previously suggested by isotopic age dating information; match travel time estimates for radionuclides moving between the ditch, the water table, and monitoring 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 accurate interpretations and forecasts of contaminant migration processes.

  16. 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.

  17. NanoRocks: A Long-Term Microgravity Experiment to Stydy Planet Formation and Planetary Ring Particles

    NASA Astrophysics Data System (ADS)

    Brisset, J.; Colwell, J. E.; Dove, A.; Maukonen, D.; Brown, N.; Lai, K.; Hoover, B.

    2015-12-01

    We report on the results of the NanoRocks experiment on the International Space Station (ISS), which simulates collisions that occur in protoplanetary disks and planetary ring systems. A critical stage of the process of early planet formation is the growth of solid bodies from mm-sized chondrules and aggregates to km-sized planetesimals. To characterize the collision behavior of dust in protoplanetary conditions, experimental data is required, working hand in hand with models and numerical simulations. In addition, the collisional evolution of planetary rings takes place in the same collisional regime. The objective of the NanoRocks experiment is to study low-energy collisions of mm-sized particles of different shapes and materials. An aluminum tray (~8x8x2cm) divided into eight sample cells holding different types of particles gets shaken every 60 s providing particles with initial velocities of a few cm/s. In September 2014, NanoRocks reached ISS and 220 video files, each covering one shaking cycle, have already been downloaded from Station. The data analysis is focused on the dynamical evolution of the multi-particle systems and on the formation of cluster. We track the particles down to mean relative velocities less than 1 mm/s where we observe cluster formation. The mean velocity evolution after each shaking event allows for a determination of the mean coefficient of restitution for each particle set. These values can be used as input into protoplanetary disk and planetary rings simulations. In addition, the cluster analysis allows for a determination of the mean final cluster size and the average particle velocity of clustering onset. The size and shape of these particle clumps is crucial to understand the first stages of planet formation inside protoplanetary disks as well as many a feature of Saturn's rings. We report on the results from the ensemble of these collision experiments and discuss applications to planetesimal formation and planetary ring

  18. 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

  19. 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

  20. EXPERTS 1—experiences of long-term life-limiting conditions among patients and carers: protocol for a qualitative meta-synthesis and conceptual modelling study

    PubMed Central

    May, Carl R; Masters, Jayne; Welch, Lindsay; Hunt, Katherine; Pope, Catherine; Myall, Michelle; Griffiths, Peter; Roderick, Paul; Glanville, Julie; Richardson, Alison

    2015-01-01

    Introduction Increasing numbers of the population are living with long-term life-limiting conditions with a significant proportion characterised by multimorbidity. Patients with these conditions often experience high volumes of clinical interaction involving them, their caregivers and healthcare providers in complex patterns of organising, coordinating, negotiating and managing care. A better understanding of the sources of experienced complexity and multimorbidity, from the patient perspective is paramount to improve capacity and manage workload to promote improved experience of illness, more effective healthcare utilisation and improved healthcare outcomes. To better understand the sources of complexity we will undertake an evidence synthesis of qualitative studies of patient and informal carer experiences of three common long-term life-limiting conditions. We will investigate what is known about these diseases at different stages in disease progression, treatment regimens and places of care. Method and analysis We will include qualitative studies of patients’ and carers’ (aged >18) accounts of their experiences of healthcare provision in a range of settings and healthcare systems. We will conduct an extensive electronic database search of publications in English between 2000 and 2014. Results and discussions sections of the papers will be regarded as formal data using the constant comparison method of qualitative analysis. From the meta-synthesis results, we will build a conceptual model of mechanisms and processes that shape patients’ journeys towards end of life to suggest where in the patient journey new interventions to improve patient and carer experience can be developed and delivered. The study is being conducted between 1 December 2014 and 31 December 2015. Ethics and dissemination No human subjects or personal data are involved and no ethical issues are anticipated. An important element of dissemination is informing user communities about the

  1. 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.

  2. From selection to complementarity: shifts in the causes of biodiversity–productivity relationships in a long-term biodiversity experiment

    PubMed Central

    Fargione, Joseph; Tilman, David; Dybzinski, Ray; Lambers, Janneke Hille Ris; Clark, Chris; Harpole, W. Stanley; Knops, Johannes M.H; Reich, Peter B; Loreau, Michel

    2007-01-01

    In a 10-year (1996–2005) biodiversity experiment, the mechanisms underlying the increasingly positive effect of biodiversity on plant biomass production shifted from sampling to complementarity over time. The effect of diversity on plant biomass was associated primarily with the accumulation of higher total plant nitrogen pools (N g m−2) and secondarily with more efficient N use at higher diversity. The accumulation of N in living plant biomass was significantly increased by the presence of legumes, C4 grasses, and their combined presence. Thus, these results provide clear evidence for the increasing effects of complementarity through time and suggest a mechanism whereby diversity increases complementarity through the increased input and retention of N, a commonly limiting nutrient. PMID:17251113

  3. From selection to complementarity: shifts in the causes of biodiversity-productivity relationships in a long-term biodiversity experiment.

    PubMed

    Fargione, Joseph; Tilman, David; Dybzinski, Ray; Lambers, Janneke Hille Ris; Clark, Chris; Harpole, W Stanley; Knops, Johannes M H; Reich, Peter B; Loreau, Michel

    2007-03-22

    In a 10-year (1996-2005) biodiversity experiment, the mechanisms underlying the increasingly positive effect of biodiversity on plant biomass production shifted from sampling to complementarity over time. The effect of diversity on plant biomass was associated primarily with the accumulation of higher total plant nitrogen pools (N g m-2) and secondarily with more efficient N use at higher diversity. The accumulation of N in living plant biomass was significantly increased by the presence of legumes, C4 grasses, and their combined presence. Thus, these results provide clear evidence for the increasing effects of complementarity through time and suggest a mechanism whereby diversity increases complementarity through the increased input and retention of N, a commonly limiting nutrient.

  4. 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.

  5. 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. PMID:24310369

  6. 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.

  7. 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. PMID:24922067

  8. 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.

  9. 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

  10. [Long-term neurorehabilitation].

    PubMed

    Barolin, G S

    1988-05-01

    Our slogan of rehabilitation to be "holistic and permanent", in terms of its holistic aspect, expresses inclusion of the patient's total environment--relatives, politics, administration, legislation. The aspect of permanence may involve periods of many years, and is not amenable to standardization; meaningful limitation is subject to the individual needs, based on critical scientific follow-along of rehabilitation. The emergence of "rehabilitation hospitalism" may best be prevented by proper attention to the patient's emotional situation and social environment, with special regard also to experiences of frustration, to regressive tendencies, "associated depression". Well-versed rehabilitative management should therefore include the dimensions of pleasure and diversity. We have been able to realize some of the above in the "Vorarlberg Rehabilitation Model", in terms, on the one hand, of the scientific identity of rehabilitation, and of individualized, optimum patient-orientedness on the other. An important step forward has moreover been the inauguration of a "Ludwig Boltzmann Institute for Neuro-Rehabilitation and -Prevention" at the Landes-Nervenkrankenhaus Valduna, of Rankweil, Austria.

  11. 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

  12. 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.

  13. 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.

  14. How the mechanisms of long-term synaptic potentiation and depression serve experience-dependent plasticity in primary visual cortex.

    PubMed

    Cooke, Sam F; Bear, Mark F

    2014-01-01

    Donald Hebb chose visual learning in primary visual cortex (V1) of the rodent to exemplify his theories of how the brain stores information through long-lasting homosynaptic plasticity. Here, we revisit V1 to consider roles for bidirectional 'Hebbian' plasticity in the modification of vision through experience. First, we discuss the consequences of monocular deprivation (MD) in the mouse, which have been studied by many laboratories over many years, and the evidence that synaptic depression of excitatory input from the thalamus is a primary contributor to the loss of visual cortical responsiveness to stimuli viewed through the deprived eye. Second, we describe a less studied, but no less interesting form of plasticity in the visual cortex known as stimulus-selective response potentiation (SRP). SRP results in increases in the response of V1 to a visual stimulus through repeated viewing and bears all the hallmarks of perceptual learning. We describe evidence implicating an important role for potentiation of thalamo-cortical synapses in SRP. In addition, we present new data indicating that there are some features of this form of plasticity that cannot be fully accounted for by such feed-forward Hebbian plasticity, suggesting contributions from intra-cortical circuit components. PMID:24298166

  15. Nitrogen regulation of the climate-carbon feedback: evidence from a long-term global change experiment.

    PubMed

    Niu, Shuli; Sherry, Rebecca A; Zhou, Xuhui; Wan, Shiqiang; Luo, Yiqi

    2010-11-01

    Modeling studies have shown that nitrogen (N) strongly regulates ecosystem responses and feedback to climate warming. However, it remains unclear what mechanisms underlie N regulation of ecosystem-climate interactions. To examine N regulation of ecosystem feedback to climate change, we have conducted a warming and clipping experiment since November 1999 in a tallgrass prairie of the Great Plains, USA. Infrared heaters were used to elevate soil temperature by an average of 1.96 degrees C at a depth of 2.5 cm from 2000 to 2008. Yearly biomass clipping mimicked hay or biofuel feedstock harvest. We measured carbon (C) and N concentrations, estimated their content and C:N ratio in plant, root, litter, and soil pools. Warming significantly stimulated C storage in aboveground plant, root, and litter pools by 17%, 38%, and 29%, respectively, averaged over the nine years (all P < 0.05) but did not change soil C content or N content in any pool. Plant C:N ratio and nitrogen use efficiency increased in the warmed plots compared to the control plots, resulting primarily from increased dominance of C4 plants in the community. Clipping significantly decreased C and N storage in plant and litter pools (all P < 0.05) but did not have interactive effects with warming on either C or N pools over the nine years. Our results suggest that increased ecosystem nitrogen use efficiency via a shift in species composition toward C4 dominance rather than plant N uptake is a key mechanism underlying warming stimulation of plant biomass growth. PMID:21141187

  16. 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.

  17. Nitrogen regulation of the climate-carbon feedback: evidence from a long-term global change experiment.

    PubMed

    Niu, Shuli; Sherry, Rebecca A; Zhou, Xuhui; Wan, Shiqiang; Luo, Yiqi

    2010-11-01

    Modeling studies have shown that nitrogen (N) strongly regulates ecosystem responses and feedback to climate warming. However, it remains unclear what mechanisms underlie N regulation of ecosystem-climate interactions. To examine N regulation of ecosystem feedback to climate change, we have conducted a warming and clipping experiment since November 1999 in a tallgrass prairie of the Great Plains, USA. Infrared heaters were used to elevate soil temperature by an average of 1.96 degrees C at a depth of 2.5 cm from 2000 to 2008. Yearly biomass clipping mimicked hay or biofuel feedstock harvest. We measured carbon (C) and N concentrations, estimated their content and C:N ratio in plant, root, litter, and soil pools. Warming significantly stimulated C storage in aboveground plant, root, and litter pools by 17%, 38%, and 29%, respectively, averaged over the nine years (all P < 0.05) but did not change soil C content or N content in any pool. Plant C:N ratio and nitrogen use efficiency increased in the warmed plots compared to the control plots, resulting primarily from increased dominance of C4 plants in the community. Clipping significantly decreased C and N storage in plant and litter pools (all P < 0.05) but did not have interactive effects with warming on either C or N pools over the nine years. Our results suggest that increased ecosystem nitrogen use efficiency via a shift in species composition toward C4 dominance rather than plant N uptake is a key mechanism underlying warming stimulation of plant biomass growth.

  18. 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

  19. 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

    2011-07-01

    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.

  20. 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.

  1. The Sabah Biodiversity Experiment: a long-term test of the role of tree diversity in restoring tropical forest structure and functioning.

    PubMed

    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

    2011-11-27

    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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention

    PubMed Central

    Tabakci, Mehmet M.; Simsek, Zeki; Arslantas, Ugur; Durmus, Halil I.; Ocal, Lutfi; Demirel, Muhittin; Ozturkeri, Burak; Ozal, Ender; Kargin, Ramazan

    2015-01-01

    Introduction Platelet/lymphocyte ratio (PLR) has been shown to be an inflammatory and thrombotic biomarker for coronary heart disease, but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. Aim To investigate the relationship between PLR and no-reflow, along with the in-hospital and long-term outcomes in patients with STEMI. Material and methods In the present study, we included 304 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI). Patients were stratified according to PLR tertiles based on the blood samples obtained in the emergency room upon admission. No-reflow after p-PCI was defined as a coronary thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2 after vessel recanalization, or TIMI flow grade 3 together with a final myocardial blush grade (MBG) < 2. Results The mean follow-up period was 24 months (range: 22–26 months). The number of patients characterized with no-reflow was counted to depict increments throughout successive PLR tertiles (14% vs. 20% vs. 45%, p < 0.001). In-hospital major adverse cardiovascular events and death increased as the PLR increased (p < 0.001, p < 0.001). Long-term MACE and death also increased as the PLR increased (p < 0.001, p < 0.001). Multivariable logistic regression analysis revealed that PLR remained an independent predictor for both in-hospital (OR = 1.01, 95% CI: 1.00–1.01; p = 0.002) and major long-term (OR = 1.01, 95% CI: 1.00–1.01; p < 0.001) adverse cardiac events. Conclusions Platelet/lymphocyte ratio on admission is a strong and independent predictor of both the no-reflow phenomenon and long-term prognosis following p-PCI in patients with STEMI. PMID:26677378

  8. The long-term effects of training interventions on transfusion practice: a follow-up audit of red cell concentrate utilisation at Kimberley Hospital, South Africa.

    PubMed

    Joubert, Jaco; Joubert, Sunette; Raubenheimer, Jacques; Louw, Vernon

    2014-12-01

    This audit in chronically anaemic adult patients assesses whether red cell concentrate is transfused according to guidelines, and evaluates the impact of training interventions, compared with a similar audit conducted in 2010. Retrospectively, 25 transfusion episodes were audited for appropriateness, the investigation of anaemia, threshold achievement, wastage, and informed consent. After training interventions, a further 25 episodes were prospectively analysed. The effects of current training interventions were not shown to have a statistically significant impact. Compared to a 2010 audit, however, a statistically significant improvement was demonstrated in transfusion practice, suggesting that training interventions may lead to sustainable long-term improvements.

  9. 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

  10. 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

  11. Long-term safety, efficacy and side-effects of continuous subcutaneous insulin infusion treatment for type 1 (insulin-dependent) diabetes mellitus: a one centre experience.

    PubMed

    Chantelau, E; Spraul, M; Mühlhauser, I; Gause, R; Berger, M

    1989-07-01

    A follow-up study of 116 Type 1 (insulin-dependent) diabetic patients on long-term continuous subcutaneous insulin infusion was conducted after 4.5 +/- 0.2 years. The average HbA1c-value of these patients decreased by 1% to 6.7 +/- 0.1% during this observation period. Typical side effects of continuous subcutaneous insulin infusion such as skin inflammation at the catheter insertion site occurred with similar frequency as has been reported previously by other authors. Diabetic ketoacidosis (0.14 per patient year) and disabling hypoglycaemia (0.1 per patient year, including 0.05 hypoglycaemic coma per patient-year) occurred at substantially lower rates than in other comparable studies with Type 1 diabetic patients at a similar degree of metabolic control. Subgroup evaluation suggested that a normal (less than 5.6%) HbA1c-value at follow-up was associated with increased incidence of disabling hypoglycaemia, whereas poor metabolic control (HbA1c greater than 7.5%) was associated with increased rates of skin complications and hospital treatment for ketoacidosis. Thus, under the policies of this diabetes centre, continuous subcutaneous insulin infusion has proved to be beneficial to a large proportion of experienced adult Type 1 diabetic patients, who voluntarily had opted for, and continued with, this particular mode of insulin treatment.

  12. 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.

  13. Declining body, institutional life, and making home-are they at odds? The lived experiences of moving through staged care in long-term care settings.

    PubMed

    Shin, Jung-hye

    2015-06-01

    This study examines elderly residential life in long-term care settings, focusing on the ways residents interact with their physical and social environments. It further proposes that the residential environment is an important player for everyday ethics in long-term care settings, and is also an important factor in enhancing the quality of life for residents. By employing the theories of place identity and environmental meanings and listening to the voices of the elderly collected through an ethnographic field study in elderly homes of life care, the study reveals the residents' experiences of going through declining health and moving through the stages of care. Two major themes were identified. The first theme of liminal life portrays the elders' fears as they move through the stages of care. This theme includes four sub-themes: (1) the loss of home and the loss of autonomy; (2) impending loss and its constant reminders; (3) the social classification of "us" and "them"; (4) the irreversibility of moving. The second theme of relational life describes the keys to successful transitions as experienced and told by the residents. The second theme includes three sub-themes: (1) shifting identity and the acceptance of old age; (2) human interdependence and building trust; (3) an accompanied death. Study implications are further discussed, including specific suggestions for social programs and revisions to the physical environments. A more fundamental question about place-based staged care is also raised so as to serve as a point of departure for reflections and discussions amongst health professionals, planners and designers, and other decision-makers.

  14. Increase in soil stable carbon isotope ratio relates to loss of organic carbon: results from five long-term bare fallow experiments.

    PubMed

    Menichetti, Lorenzo; Houot, Sabine; van Oort, Folkert; Kätterer, Thomas; Christensen, Bent T; Chenu, Claire; Barré, Pierre; Vasilyeva, Nadezda A; Ekblad, Alf

    2015-03-01

    Changes in the (12)C/(13)C ratio (expressed as δ(13)C) of soil organic C (SOC) has been observed over long time scales and with depth in soil profiles. The changes are ascribed to the different reaction kinetics of (12)C and (13)C isotopes and the different isotopic composition of various SOC pool components. However, experimental verification of the subtle isotopic shifts associated with SOC turnover under field conditions is scarce. We determined δ(13)C and SOC in soil sampled during 1929-2009 in the Ap-horizon of five European long-term bare fallow experiments kept without C inputs for 27-80 years and covering a latitudinal range of 11°. The bare fallow soils lost 33-65% of their initial SOC content and showed a mean annual δ(13)C increase of 0.008-0.024‰. The (13)C enrichment could be related empirically to SOC losses by a Rayleigh distillation equation. A more complex mechanistic relationship was also examined. The overall estimate of the fractionation coefficient (ε) was -1.2 ± 0.3‰. This coefficient represents an important input to studies of long-term SOC dynamics in agricultural soils that are based on variations in (13)C natural abundance. The variance of ε may be ascribed to site characteristics not disclosed in our study, but the very similar kinetics measured across our five experimental sites suggest that overall site-specific factors (including climate) had a marginal influence and that it may be possible to isolate a general mechanism causing the enrichment, although pre-fallow land use may have some impact on isotope abundance and fractionation.

  15. The Long-Term Effects of Childhood Bullying Experiences on Female Adults as It Relates to Their Perception of Themselves and Their Relationships with Women

    ERIC Educational Resources Information Center

    Barcalow, Julia M.

    2013-01-01

    Childhood bullying is a phenomenon that affects many individuals well beyond their childhood. This study looked specifically at female adults, and how the bullying they experienced in their childhood continues to have long-term effects on them in their adult lives. The purpose of this study was to explore the long-term effects that bullying has on…

  16. 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

  17. 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.

  18. [Classification of long-term clinical course of 'atypical psychosis': a 20-year follow-up study at a medical school hospital].

    PubMed

    Otsuka, Koichiro; Kato, Satoshi; Abe, Takaaki; Sugiyama, Hisashi; Watanabe, Yoshihiro; Kobayashi, Toshiyuki; Okajima, Yoshiro

    2002-01-01

    To study the long-term clinical course and outcomes of atypical psychosis, 8 patients diagnosed with atypical psychosis were observed for more than 12 years (mean, 20 years). Retrospective examination was performed, particularly with respect to clinical features at each episode. The overall course of each case was classified as one of the following three types: Type I--"Recurrent confused state" type. Patients frequently repeated acute transient confused or dream-like states in a similar way, sometimes and/or for part of the episode accompanied by a floating paranoid-hallucinatory state. Duration of psychotic episode was short, persisting for a few days to about one month. Type II--"Manic-depressive illness similar" type. After a long course of disease, the predominantly early middle-aged patients (30- to 40 years-old) demonstrated fewer original characteristic features of acute confused or dream-like states. Instead, manic or depressive episodes tended to predominate. Duration of psychotic episodes exceeded the duration of type I episodes, to a maximum of about 3 months. Type III--"Appearance of residual state" type. After several episodes characterized by transient confused state during middle age, residual states consisting of a slight depressive state, reduced spontaneity and flattening of emotions appear. These states become durable and the periodicity of the disease disappeared. We conclude that the core group of atypical psychosis patients presents with confused symptoms as a clinical feature of episodes, and with the recurrent confused state type representing the long-term clinical course. "Shift to manic-depressive illness similar" and "appearance of residual state" types were considered to be derived from the core group, according to the interplay of personality structure and viable dynamics.

  19. 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

  20. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    PubMed Central

    Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cataudella, Salvatore; Martini, Nello

    2016-01-01

    Purpose Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Results Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Conclusion Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period

  1. 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. PMID:15633252

  2. Comparison of long terms follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in Rasoul Akram Hospital

    PubMed Central

    Mollahoseini, Reza; Khajoo, Ashkan; Motiei, Mir Abolfazl

    2012-01-01

    Background Anterior interbody fusion of the cervical spine have become the gold standard for treating spinal diseases, hence the aim of this study was to compare long term follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in anterior approach. Methods Retrospectively 63 patients with known cervical discogenic disorders who went under surgery with and without cage implantation were enrolled. The neurological examination and neurologic function were assessed by using the Japanese Orthopedic Association (JOA) scoring system and neurological cervical spine scale (NCSS) before and 8 years after surgery in each patient and at the end all complications were recorded. Results In the first group, there were 15 males and 14 females (mean age: 49±10 years) and in the second group there were 27 male and 7 female (mean age: 47±9 years). The NCSS score was significantly different between two groups after surgery (p = 0.035) but there was no significant difference before surgery (p = 0.163). No statistical significance difference was also observed in JOA score and complications before and after procedure, but JOA post surgery score between two groups had significant difference (p = 0.047). Conclusion In conclusion, present study showed that PEEK cage implantation is a highly useful alternative to the conventional treatment methods. PMID:23482426

  3. 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

  4. 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). PMID:26011866

  5. Effect of phosphorus availability on the selection of species with different ploidy levels and genome sizes in a long-term grassland fertilization experiment.

    PubMed

    Šmarda, Petr; Hejcman, Michal; Březinová, Alexandra; Horová, Lucie; Steigerová, Helena; Zedek, František; Bureš, Petr; Hejcmanová, Pavla; Schellberg, Jürgen

    2013-11-01

    Polyploidy and increased genome size are hypothesized to increase organismal nutrient demands, namely of phosphorus (P), which is an essential and abundant component of nucleic acids. Therefore, polyploids and plants with larger genomes are expected to be selectively disadvantaged in P-limited environments. However, this hypothesis has yet to be experimentally tested. We measured the somatic DNA content and ploidy level in 74 vascular plant species in a long-term fertilization experiment. The differences between the fertilizer treatments regarding the DNA content and ploidy level of the established species were tested using phylogeny-based statistics. The percentage and biomass of polyploid species clearly increased with soil P in particular fertilizer treatments, and a similar but weaker trend was observed for the DNA content. These increases were associated with the dominance of competitive life strategy (particularly advantageous in the P-treated plots) in polyploids and the enhanced competitive ability of dominant polyploid grasses at high soil P concentrations, indicating their increased P limitation. Our results verify the hypothesized effect of P availability on the selection of polyploids and plants with increased genome sizes, although the relative contribution of increased P demands vs increased competitiveness as causes of the observed pattern requires further evaluation. PMID:23819630

  6. 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. PMID:26329200

  7. 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. PMID:26868524

  8. 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.

  9. Soil Parameter Mapping and Ad Hoc Power Analysis to Increase Blocking Efficiency Prior to Establishing a Long-Term Field Experiment

    PubMed Central

    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. PMID:26247056

  10. Organic and mineral fertilization, respectively, increase and decrease the development of external mycelium of arbuscular mycorrhizal fungi in a long-term field experiment.

    PubMed

    Gryndler, M; Larsen, J; Hrselová, H; Rezácová, V; Gryndlerová, H; Kubát, J

    2006-05-01

    Effects of long-term mineral fertilization and manuring on the biomass of arbuscular mycorrhizal fungi (AMF) were studied in a field experiment. Mineral fertilization reduced the growth of AMF, as estimated using both measurements of hyphal length and the signature fatty acid 16:1omega5, whereas manuring alone increased the growth of AMF. The results of AMF root colonization followed the same pattern as AMF hyphal length in soil samples, but not AMF spore densities, which increased with increasing mineral and organic fertilization. AMF spore counts and concentration of 16:1omega5 in soil did not correlate positively, suggesting that a significant portion of spores found in soil samples was dead. AMF hyphal length was not correlated with whole cell fatty acid (WCFA) 18:2omega6,9 levels, a biomarker of saprotrophic fungi, indicating that visual measurements of the AMF mycelium were not distorted by erroneous involvement of hyphae of saprotrophs. Our observations indicate that the measurement of WCFAs in soil is a useful research tool for providing information in the characterization of soil microflora.

  11. Effect of phosphorus availability on the selection of species with different ploidy levels and genome sizes in a long-term grassland fertilization experiment.

    PubMed

    Šmarda, Petr; Hejcman, Michal; Březinová, Alexandra; Horová, Lucie; Steigerová, Helena; Zedek, František; Bureš, Petr; Hejcmanová, Pavla; Schellberg, Jürgen

    2013-11-01

    Polyploidy and increased genome size are hypothesized to increase organismal nutrient demands, namely of phosphorus (P), which is an essential and abundant component of nucleic acids. Therefore, polyploids and plants with larger genomes are expected to be selectively disadvantaged in P-limited environments. However, this hypothesis has yet to be experimentally tested. We measured the somatic DNA content and ploidy level in 74 vascular plant species in a long-term fertilization experiment. The differences between the fertilizer treatments regarding the DNA content and ploidy level of the established species were tested using phylogeny-based statistics. The percentage and biomass of polyploid species clearly increased with soil P in particular fertilizer treatments, and a similar but weaker trend was observed for the DNA content. These increases were associated with the dominance of competitive life strategy (particularly advantageous in the P-treated plots) in polyploids and the enhanced competitive ability of dominant polyploid grasses at high soil P concentrations, indicating their increased P limitation. Our results verify the hypothesized effect of P availability on the selection of polyploids and plants with increased genome sizes, although the relative contribution of increased P demands vs increased competitiveness as causes of the observed pattern requires further evaluation.

  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. PMID:26148203

  13. 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).

  14. 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.

  15. 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.

  16. 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

  17. Long-Term Outcomes after Stroke in Elderly Patients with Atrial Fibrillation: A Hospital-Based Follow-Up Study in China

    PubMed Central

    Zhao, Yuguang; Zou, Chunying; Wang, Cui; Zhang, Yongbo; Wang, Shuang

    2016-01-01

    Background: Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden; it is an established predictor of poor outcomes after stroke. However, reported differences in outcomes after stroke among elderly patients between AF and non-AF group are conflicting. We aimed to compare differences in outcomes at 1 year and 3 years after stroke among elderly patients (aged ≥ 75 years old) between AF group and non-AF group. Methods: We recruited 1070 consecutive elderly patients who experienced acute ischemic stroke between January 2008 and December 2013 in Jiamusi University First Hospital, China in this study. Information regarding stroke subtype, severity, risk factors, and outcome (mortality, dependency, and recurrence) at 3 and 12 months after stroke were recorded and assessed between AF group and non-AF group. Results: The prevalence of AF was 16.1% overall, with a similar trend in the prevalence of AF between men and women. The AF group were more likely to experience severe stroke compared to the non-AF group (32.0 vs. 11.9%, respectively; P < 0.001). There were no obvious differences between groups regarding the prevalence of hypertension, dyslipidemia, obesity, current smoking, and alcohol drinking but there was a higher prevalence of diabetes in the non-AF group (20.3 vs. 30.1%, P = 0.010). Mortality and dependency rates were significantly higher in the AF group than in the non-AF group at 1 year after stroke (29.6 vs. 17.8%, P = 0.001 for mortality; and 59.5 vs. 36.1%, P = 0.010 for dependency) and 3 years after stroke (46.1 vs. 33.2%, P = 0.032 for mortality; and 70.7 vs. 49.2%, P = 0.010 for dependency); however, there was no significant between-groups differences in rates of recurrence across the follow-up periods. The results for dependency remained stable after adjustment for sex, stroke severity, and stroke risk factors at 3 years after stroke (OR, 2.26; 95% CI, 1.06–4.81; P = 0.034); however, the relationship between AF and

  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. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. Phosphorus quantity-intensity relationships and agronomic measures of P in surface layers of soil from a long-term slurry experiment.

    PubMed

    Anderson, R; Wu, Y

    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. Control plots were treated with mineral fertiliser supplying 200 kg N, 32 kg P and 160 kg K ha(-1) yr(-1). Slurry treatment plots were in two blocks and treated with either pig or cow slurry supplied at 50, 100 or 200 m3 ha(-1) yr(-1). Agronomic measures of P determined on 10-cm soil cores were compared with measured P quantity/intensity (Q/I) parameters from fitted sorption and desorption isotherms. Phosphorus affinity constant was found to be significantly and negatively correlated with P loading of soils. Desorption rate coefficient also increased significantly with increase in P loading from slurry, although there was no significant difference between slurry types (cow vs. pig). In contrast, while agronomic measures of P (water-soluble P, Olsen P, calcium chloride-extractable P, degree of P saturation (DPS)) also correlated significantly with P loading and total P (TP) in the soils, there was a separation and significant differences between the cow and pig slurry treatment blocks, with the former being much lower. Phosphorus inputs to pig slurry treated plots were much higher than to equivalent cow slurry plots over the first 15 years of the study but declined sharply over the most recent 10 years to more or less par. Conventional measures of agronomic P such as Olsen P and DPS, measure only P accumulation over the longer term and indicated only the higher content of P accumulating in soil of pig slurry treatments. Risk of P loss estimated by Q/I parameters appeared to show very similar behaviour between the two slurry types in line with more recent manurial additions but in contradiction of P accumulation statistics.

  10. 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.

  11. 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

  12. Acquisition of antibiotic-resistant Enterococcus faecium strains during long-term hospitalization and fast adaptation of enterococcal flora to antibiotic treatment: a case report.

    PubMed

    Schulte, Berit; Wolz, Christiane; Schumacher, Ulrike; Beyser, Kurt; Heeg, Peter; Borgmann, Stefan

    2009-01-01

    Recently, it has been suspected that long durations of hospitalization might be a possible risk factor to get colonized by multiple VRE strains. Here we present the case of a patient who underwent stem cell transplantation and subsequently stayed at the hospital for about 4 months until death. At least four different Enterococcus faecium strains were identified from routinely taken microbiological specimens as demonstrated by pulsed-field gel-electrophoresis. Additionally, these strains showed variable susceptibility to quinupristine/dalfopristine, vancomycin, and/or linezolid depending on different antibiotic administrations. These findings indicate that patients might be colonized with multiple Enterococcus faecium strains and that the enterococcal flora quickly adapts due to antibiotic exposure.

  13. Altababa medical volunteer group mission to Almanagil hospital, Sudan: new ideas for long-term partnership, success factors and guidelines for other groups.

    PubMed

    Ahmed, G Y; Hassan, I; Jafar, S; Alawad, M; Jameel, A; Abdullah, M; Suror, M

    2015-06-01

    Sudanese medical volunteers have a long history of working in districts with poor health-care infrastructure. Altababa medical volunteer group (AMVG) was established by Sudanese physicians working in Saudi Arabia who desired to contribute to improving clinical services and training in their country of origin. This paper documents steps in the planning and evaluation of AMVG's first mission to Almanagil hospital in Sudan in 2013. Over a 3-day period the visiting team of 4 physicians performed 25 laparoscopic surgical and obstetric/ gynaecological procedures and 36 echocardiogram tests-all with hands-on training-presented 11 lectures and consulted with 137 patients. A total of 247 trainees and patients completed a 22-item evaluation survey. The first mission was highly rated by both trainees (health-care providers) and patients. The results provided a road map for volunteers to accomplish cost-effective goals in small hospitals with modest facilities.

  14. 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

  15. 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

  16. 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.

  17. Effects of plant diversity, N fertilization, and elevated carbon dioxide on grassland soil N cycling in a long-term experiment.

    PubMed

    Mueller, Kevin E; Hobbie, Sarah E; Tilman, David; Reich, Peter B

    2013-04-01

    The effects of global environmental changes on soil nitrogen (N) pools and fluxes have consequences for ecosystem functions such as plant productivity and N retention. In a 13-year grassland experiment, we evaluated how elevated atmospheric carbon dioxide (CO2 ), N fertilization, and plant species richness alter soil N cycling. We focused on soil inorganic N pools, including ammonium and nitrate, and two N fluxes, net N mineralization and net nitrification. In contrast with existing hypotheses, such as progressive N limitation, and with observations from other, often shorter, studies, elevated CO2 had relatively static and small, or insignificant, effects on soil inorganic N pools and fluxes. Nitrogen fertilization had inconsistent effects on soil N transformations, but increased soil nitrate and ammonium concentrations. Plant species richness had increasingly positive effects on soil N transformations over time, likely because in diverse subplots the concentrations of N in roots increased over time. Species richness also had increasingly positive effects on concentrations of ammonium in soil, perhaps because more carbon accumulated in soils of diverse subplots, providing exchange sites for ammonium. By contrast, subplots planted with 16 species had lower soil nitrate concentrations than less diverse subplots, especially when fertilized, probably due to greater N uptake capacity of subplots with 16 species. Monocultures of different plant functional types had distinct effects on N transformations and nitrate concentrations, such that not all monocultures differed from diverse subplots in the same manner. The first few years of data would not have adequately forecast the effects of N fertilization and diversity on soil N cycling in later years; therefore, the dearth of long-term manipulations of plant species richness and N inputs is a hindrance to forecasting the state of the soil N cycle and ecosystem functions in extant plant communities. PMID:23504900

  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. 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. PMID:11987306

  1. 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.

  2. Effects of plant diversity, N fertilization, and elevated carbon dioxide on grassland soil N cycling in a long-term experiment.

    PubMed

    Mueller, Kevin E; Hobbie, Sarah E; Tilman, David; Reich, Peter B

    2013-04-01

    The effects of global environmental changes on soil nitrogen (N) pools and fluxes have consequences for ecosystem functions such as plant productivity and N retention. In a 13-year grassland experiment, we evaluated how elevated atmospheric carbon dioxide (CO2 ), N fertilization, and plant species richness alter soil N cycling. We focused on soil inorganic N pools, including ammonium and nitrate, and two N fluxes, net N mineralization and net nitrification. In contrast with existing hypotheses, such as progressive N limitation, and with observations from other, often shorter, studies, elevated CO2 had relatively static and small, or insignificant, effects on soil inorganic N pools and fluxes. Nitrogen fertilization had inconsistent effects on soil N transformations, but increased soil nitrate and ammonium concentrations. Plant species richness had increasingly positive effects on soil N transformations over time, likely because in diverse subplots the concentrations of N in roots increased over time. Species richness also had increasingly positive effects on concentrations of ammonium in soil, perhaps because more carbon accumulated in soils of diverse subplots, providing exchange sites for ammonium. By contrast, subplots planted with 16 species had lower soil nitrate concentrations than less diverse subplots, especially when fertilized, probably due to greater N uptake capacity of subplots with 16 species. Monocultures of different plant functional types had distinct effects on N transformations and nitrate concentrations, such that not all monocultures differed from diverse subplots in the same manner. The first few years of data would not have adequately forecast the effects of N fertilization and diversity on soil N cycling in later years; therefore, the dearth of long-term manipulations of plant species richness and N inputs is a hindrance to forecasting the state of the soil N cycle and ecosystem functions in extant plant communities.

  3. 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

  4. 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.

  5. [Taiwan long-term care insurance and the evolution of long-term care in Japan].

    PubMed

    Huang, Hui-Wen; Liu, Shu-Hui; Pai, Yu-Chu

    2010-08-01

    The proportion of elderly (65 years of age and older) in Taiwan has exceeded 10% since 2008. With more elderly, the number of patients suffering from dementia and disabilities has also been rapidly increasing. Japan also has been facing increasing demand for long-term care due to an aging society. Prior to 2000, social welfare programs in Japan, working to cope with changing needs, typically provided insufficient services, and geriatric patients were hospitalized unnecessarily, wasting medical resources and causing undue patient hardship. In response, Japan launched its long-term care insurance program in April 2000. Under the program, city, town and village-based organizations should take responsibility for providing care to the elderly in their place of residence. The program significantly improved previous financial shortfalls and long-term care supply and demand has been met by existing social welfare organization resources. In Taiwan, the provision of long-term care by county / city authorities has proven inconsistent, with performance deemed poor after its first decade of long-term care operations. Service was found to be affected by differences in available resources and insufficient long-term care administration. The cultures of Taiwan and Japan are similar. The authors visited the Japan Long-Term Care Insurance Institute in August 2009. Main issues involved in the implementation and evolution of the Japan long-term Care Insurance are reported on in this paper. We hope such may be useful information to those working to develop long-term care programs in Taiwan. PMID:20661859

  6. Scenarios for long-term analysis

    SciTech Connect

    Wolbers, Stephen; /Fermilab

    2009-01-01

    Data Preservation and Long-Term Analysis of High Energy Physics (HEP) Experiments data is described and summarized in this talk. The summary covers information presented at the First Workshop on Data Preservation and Long-Term Analysis. Experiments representing e{sup +}e{sup -} collisions (LEP, B Factories and CLEO), ep collisions (H1 and ZEUS), p{bar p} collisions (CDF and D0) and others presented interesting information related to utilizing the large datasets collected over many years at these HEP facilities. Many questions and issues remain to be explored.

  7. 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…

  8. Long-term results of high-dose imatinib in children and adolescents with chronic myeloid leukaemia in chronic phase: the Italian experience.

    PubMed

    Giona, Fiorina; Putti, Maria C; Micalizzi, Concetta; Menna, Giuseppe; Moleti, Maria L; Santoro, Nicola; Iaria, Grazia; Ladogana, Saverio; Burnelli, Roberta; Consarino, Caterina; Varotto, Stefania; Tucci, Francesca; Messina, Chiara; Nanni, Mauro; Diverio, Daniela; Biondi, Andrea; Pession, Andrea; Locatelli, Franco; Piciocchi, Alfonso; Gottardi, Enrico; Saglio, Giuseppe; Foà, Robin

    2015-08-01

    Imatinib mesylate (IM) is used for the management of childhood chronic myeloid leukaemia (CML). The most effective dosage of IM and its long-term efficacy in children are not well defined. The purpose of this multicentre study is to report on the long-term results of high-dose IM (340 mg/m2 /d) in CML patients in chronic phase (CP-CML) aged <18 years at diagnosis. A total of 47 CP-CML patients with a median age at diagnosis of 11 years 9 months were enrolled in nine Italian centres. Complete cytogenetic response was achieved in 91.5% of the evaluable patients at a median time of 6 months. BCR-ABL1 International Scale ≤ 0.1% (major molecular response; MMR) and ≤0.01% (molecular response; MR) at 12 months were 66.6% and 33%, respectively. During follow-up, MMR and MR were achieved in 78.6% and 61% of children, respectively. IM was safely discontinued in 3 long-term treated children with a durable MR. Twelve patients (eight cytogenetic/molecular responders) underwent stem cell transplantation. The progression-free survival probabilities at 96 months for responding patients who continued IM and for those transplanted were 60% and 50%, respectively. After a median follow-up of 52 months (range 3-146), all patients are alive. High-dose IM is a long-term effective therapy in children and adolescents with CP-CML.

  9. GES-11-producing Acinetobacter baumannii clinical isolates from Tunisian hospitals: Long-term dissemination of GES-type carbapenemases in North Africa.

    PubMed

    Chihi, H; Bonnin, R A; Bourouis, A; Mahrouki, S; Besbes, S; Moussa, M Ben; Belhadj, O; Naas, T

    2016-06-01

    Acinetobacter baumannii is an emerging threat in healthcare facilities owing to its ability to be multidrug-resistant (MDR) and to be involved in outbreaks. GES-type extended-spectrum β-lactamases (ESBLs) have been increasingly identified in A. baumannii. In this study, clinical A. baumannii isolates were characterised using standard biochemical methods and antibiotic susceptibility testing. Antibiotic resistance genes were sought by PCR and sequencing. Genetic support was characterised using S1 nuclease pulsed-field gel electrophoresis (PFGE) mapping, conjugation and electroporation assays. The genetic environment was investigated by PCR, and genetic relatedness was investigated by PFGE. Two MDR A. baumannii clinical isolates susceptible only to colistin and rifampicin were isolated from a tracheal aspirate of a 49-year-old woman hospitalised in 2006 at the Military Hospital of Tunis, Tunisia, and from a tracheal aspirate of a 53-year-old man hospitalised in 2010 at the Institut Orthopédique Mohamed El Kassab of Tunis, Tunisia. PCR revealed that the two isolates harboured the acquired carbapenemase blaOXA-23 and ESBL blaGES-11 genes along with chromosomally-encoded blaOXA-51 and blaADC-like genes. PFGE revealed that these A. baumannii isolates were unrelated; nevertheless, plasmid analysis revealed a similar sized plasmid following electrophoresis of the isolates. In addition, A. baumannii CIP70.10 transformants displayed similar resistance patterns. blaGES-11 was integron-borne and the ISAbaI element was identified upstream of blaOXA-23 and blaADC-like. Here we described two unrelated clinical A. baumannii isolates producing GES-11 ESBL and OXA-23 carbapenemase from two Tunisian hospitals. This work further illustrates the emergence of GES-type β-lactamases in A. baumannii in North Africa as early as 2006. PMID:27436466

  10. Long term complications of diabetes

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000327.htm Long term complications of diabetes To use the sharing ... sores and infections. If it goes on too long, your toes, foot, or leg may need to ...

  11. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  12. Long-term biomass research

    SciTech Connect

    Not Available

    1981-03-01

    Some of DOE's long term R and D programs for biomass are summarized in this article. These include research efforts in the fields of anaerobic digestion, energy farming, short rotation cultivation and aquatic farming. (DMC)

  13. 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. PMID:11237295

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. Long-term home care research.

    PubMed

    Green, J H

    1989-11-01

    The population of seniors is growing and health service reimbursement is shrinking. Long-term home health care services were developed with an assumption that the services would decrease costs. This assumption has not been validated. What has been recognized is that long-term home health care targets a new and growing population of frail seniors who need services but are probably not at risk for institutionalization. The impact of long-term home care services on the health status and quality of life of seniors and caregivers has been limited by outcome measurement problems. There are indications that the services improved life satisfaction and reduced services needs, but further evaluations need to replicate the outcomes. In effect, long-term outcomes have not been sufficiently explored. Further research also needs to assist us in identifying outcomes for certain services with precise target populations. Public policy questions are ahead. Should a program that can increase costs, has demonstrated some but not dramatic impacts on quality of life and health status, and has the possibility of expansion, be funded? The question is obviously debatable. From a nursing perspective of health promotion and prevention, the answer is "yes." Funding should be continued in conjunction with increased research on the program impacts. In Kane's (1988) analysis of the Channeling experiments, she summarized the situation effectively: Knowing these facts, we are now in a position to reformulate public policies to design a system of long-term care that satisfies the preferences of consumers and protects them from catastrophic long-term expenses, while promoting the triple virtues of acceptable, quality, equitable access, and defensible costs. . . Nothing in the Channeling results should prevent us from going ahead and trying to develop both community based and institutionally based long-term services in which this country can take pride.

  19. Clinical evaluation of osseointegrated implants in Tokyo Dental College Hospital (third report): long-term observation of functioning survival rate of fixtures.

    PubMed

    Miyashita, Yuko; Arataki, Tomohiko; Nomura, Takao; Suzuki, Hiroki; Atsuta, Syunichi; Hotta, Hiromi; Shimamura, Ichiro; Adachi, Yasushi; Kishi, Masataka

    2003-08-01

    The objective of this report was to review 365 cases of Brånemark Implant Bridge including 1,444 fixtures in patients of Tokyo Dental College Chiba Hospital. The term of implantation was divided into several phases; less than 1 year, from 1 year to 3 years, from 3 years to 5 years, from 5 years to 7 years, from 7 years to 10 years, more than 10 years, and the survival rate was calculated for each phase. The removal rate of fixture after connecting the superstructure was 13% in maxillary cases and 2% in mandibular cases. The functioning survival rate in maxillary cases slightly decreased from 91% in less than 1 year to 87% after more than 10 years; however, the functioning survival rate in mandibular cases was about 99% in all periods. The removal rate of fixtures per patient was 23% in maxillary cases and 6% in mandibular ones. The average removal number of fixtures was 1.8 in maxillary cases and 1.2 in mandibular ones. The removal of the fixture occurred most frequently at less than 1 year in maxillary cases, but there was no tendency for a pattern of removal of fixture in mandibular cases.

  20. 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

  1. 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. PMID:25265095

  2. 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.

  3. 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

  4. Carbon Sequestration Efficiency of Organic Amendments in a Long-Term Experiment on a Vertisol in Huang-Huai-Hai Plain, China

    PubMed Central

    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. PMID:25265095

  5. 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

  6. 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.

  7. 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…

  8. 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.

  9. 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

  10. Incidence, management, and outcome of high-grade transformation of nodular lymphocyte predominant Hodgkin lymphoma: long-term outcomes from a 30-year experience.

    PubMed

    Eyre, Toby A; Gatter, Kevin; Collins, Graham P; Hall, Georgina W; Watson, Caroline; Hatton, Chris S R

    2015-06-01

    Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare form of Hodgkin lymphoma that typically presents as early stage, indolent disease in young adult males. The relationship between NLPHL and DLBCL is incompletely understood, and there remains a paucity of data with regard the incidence and management of high-grade transformation. We report the largest study to date describing the incidence, management and long-term outcome of 26 cases of high-grade transformation of NLPHL over a 30-year period. We report a transformation incidence of 17.0%. Bone marrow, splenic, and liver infiltration with DLBCL was frequent. Patients with an aa-IPI 2-3 have poorer OS and PFS (P = 0.034 and P = 0.009, respectively). Although the approach to treatment was somewhat variable, typically young, otherwise fit patients received anthracycline-based induction, platinum-based consolidation with stem cell harvesting, followed by autologous SCT with BEAM conditioning. Long-term (5 year) PFS was over 60% with this approach, and comparable to our de novo DLBCL historical age and time period-matched cohort largely treated with CHOP-like chemotherapy alone. The transformation rate of 17.0% highlights the importance of accurate initial diagnosis, long-term follow-up, and re-biopsy at relapse. PMID:25715900

  11. Petrophysical characterization of first ever drilled core samples from an active CO2 storage site, the German Ketzin Pilot Site - Comparison with long term experiments

    NASA Astrophysics Data System (ADS)

    Zemke, Kornelia; Liebscher, Axel

    2014-05-01

    Petrophysical properties like porosity and permeability are key parameters for a safe long-term storage of CO2 but also for the injection operation itself. These parameters may change during and/or after the CO2 injection due to geochemical reactions in the reservoir system that are triggered by the injected CO2. Here we present petrophysical data of first ever drilled cores from a newly drilled well at the active CO2 storage site - the Ketzin pilot site in the Federal State of Brandenburg, Germany. By comparison with pre-injection baseline data from core samples recovered prior to injection, the new samples provide the unique opportunity to evaluate the impact of CO2 on pore size related properties of reservoir and cap rocks at a real injection site under in-situ reservoir conditions. After injection of 61 000 tons CO2, an additional well was drilled and new rock cores were recovered. In total 100 core samples from the reservoir and the overlaying caprock were investigated by NMR relaxation. Permeability of 20 core samples was estimated by nitrogen and porosity by helium pycnometry. The determined data are comparable between pre-injection and post-injection core samples. The lower part of the reservoir sandstone is unaffected by the injected CO2. The upper part of the reservoir sandstone shows consistently slightly lower NMR porosity and permeability values in the post-injection samples when compared to the pre-injection data. This upper sandstone part is above the fluid level and CO2 present as a free gas phase and a possible residual gas saturation of the cores distorted the NMR results. The potash-containing drilling fluid can also influence these results: NMR investigation of twin samples from inner and outer parts of the cores show a reduced fraction of larger pores for the outer core samples together with lower porosities and T2 times. The drill mud penetration depth can be controlled by the added fluorescent tracer. Due to the heterogeneous character of the

  12. 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

  13. Long-term prognosis of patients with acute myocardial infarction due to unprotected left main coronary artery disease: a single-centre experience over 14 years

    PubMed Central

    Xu, Li; Sun, Hao; Wang, Le-Feng; Yang, Xin-Chun; Li, Kui-Bao; Zhang, Da-Peng; Wang, Hong-Shi; Li, Wei-Ming

    2016-01-01

    INTRODUCTION Acute myocardial infarction (AMI) due to unprotected left main coronary artery (ULMCA) disease is clinically catastrophic although it has a low incidence. Studies on the long-term prognosis of these patients are rare. METHODS From January 1999 to September 2013, 55 patients whose infarct-related artery was the ULMCA were enrolled. Clinical, angiographic and interventional data was collected. Short-term and long-term clinical follow-up results as well as prognostic determinants during hospitalisation and follow-up were analysed. RESULTS Cardiogenic shock (CS) occurred in 30 (54.5%) patients. During hospitalisation, 22 (40.0%) patients died. Multivariate logistic regression analysis showed that CS (odds ratio [OR] 5.86; p = 0.03), collateral circulation of Grade 2 or 3 (OR 0.14; p = 0.02) and final flow of thrombolysis in myocardial infarction (TIMI) Grade 3 (OR 0.05; p = 0.03) correlated with death during hospitalisation. 33 patients survived to discharge; another seven patients died during the follow-up period of 44.6 ± 31.3 (median 60, range 0.67–117.00) months. The overall mortality rate was 52.7% (n = 29). Kaplan-Meier analysis showed that the total cumulative survival rate was 30.7%. Cox multivariate regression analysis showed that CS during hospitalisation was the only predictor of overall mortality (hazard ratio 4.07, 95% confidence interval 1.40–11.83; p = 0.01). CONCLUSION AMI caused by ULMCA lesions is complicated by high incidence of CS and mortality. CS, poor collateral blood flow and failure to restore final flow of TIMI Grade 3 correlated with death during hospitalisation. CS is the only predictor of long-term overall mortality. PMID:27439434

  14. 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

  15. 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

  16. 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

  17. 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.

  18. Long-Term Results of Fludarabine/Melphalan as a Reduced-Intensity Conditioning Regimen in Mantle Cell Lymphoma: The GELTAMO Experience

    PubMed Central

    Cruz, Jorge Gayoso; Martino, Rodrigo; Balsalobre, Pascual; Heras, Inmaculada; Piñana, José Luis; Serrano, David; de la Serna, Javier; Tomás, José Francisco; Díez-Martíin, Joséa Luis; Caballero, Dolores

    2011-01-01

    Background: We herein report the long-term results of an allogeneic reduced-intensity conditioning (allo-RIC) protocol used in 21 consecutive patients (16 males, median age 56 years, 71% in complete remission) diagnosed with mantle cell lymphoma (MCL). Methods: The allo-RIC consisted of fludarabine plus melphalan and peripheral blood hematopoietic stem cells (PBSCs) from human leukocyte antigen (HLA)-identical siblings were used in all cases. Median CD34+ infused cells was 5.8 times 106/kg. All patients engrafted promptly. Results: Early toxicity included mild/moderate mucositis (43%), febrile neutropenia (33%) and bacterial infections (19%). With a median follow up of 48 months, four deaths were reported, all due to infections and/or graft-versus-host disease (GVHD), yielding a 3-year cumulative incidence of nonrelapse mortality of 19.5%. Grade III—IV acute GVHD occurred in 15% and chronic GVHD in 78%, being extensive in 39%. The 5-year progression-free survival (PFS) and overall survival (OS) were both 80% (95% CI: 63-97%). Age was the only possible prognostic factor for OS, which was 43% for those aged more than 60 years and 100% for those younger (p < 0.001). Conclusions: Our data confirm that allo-RIC offers a low toxicity profile and a chance for prolonged long-term disease-free survival in MCL, particularly in younger patients. PMID:23556071

  19. Long-term oncologic outcomes of neoadjuvant concurrent chemoradiotherapy with capecitabine and radical surgery in locally advanced rectal cancer: 10-year experiences at a single institution

    PubMed Central

    Lee, Kyung Ha; Kim, Jin Soo

    2016-01-01

    Purpose Oral capecitabine has demonstrated to be safe and efficient as neoadjuvant concurrent chemoradiotherapy (NCRT) for locally advanced rectal cancers. The aim of this study was to evaluate the long-term oncologic outcomes of NCRT with capecitabine and radical surgery. Methods From January 2000 to June 2010, 238 patients were treated at our center for locally advanced rectal cancers using conventional NCRT with capecitabine and radical surgery. Univariate and multivariate analyses were used to evaluate the factors associated with oncologic outcomes with log rank and Cox regression tests. Results The incidence of grade >3 capecitabine-related toxicity was found to be 4.6%. A pathologic complete response was observed in 14.7% of patients. The 5-year overall and 5-year disease-free survival rate, local and systemic recurrence rate were 82.8%, 75.1%, 4.8%, and 20.3%. Abdominoperineal resection and node-positive disease were independent prognostic factors of 5-year overall survival, 5-year disease-free survival, and systemic recurrence. Conclusion NCRT with capecitabine and radical surgery showed favorable long-term oncologic outcomes with benefits of acceptable toxicity and convenience. We suggest that capecitabine can be one of the favorable therapeutic options for NCRT in rectal cancer. PMID:27757395

  20. 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.

  1. 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

  2. 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

  3. 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

  4. Early and Long-Term Results of Stent Implantation for Aortic Coarctation in Pediatric Patients Compared to Adolescents: A Single Center Experience

    PubMed Central

    Bondanza, Sara; Calevo, Maria Grazia; Marasini, Maurizio

    2016-01-01

    Background. Stents have become the treatment of choice for native aortic coarctation in adults and adolescents, but in pediatric patients insufficient data are currently available to identify the best therapeutic option. Methods. To compare the outcomes of pediatric and adolescent patients, we retrospectively evaluated early and long-term results of stenting for aortic coarctation in 34 patients divided into 2 groups (A and B) composed, respectively, of 17 children (mean age 8.2 ± 2.3, weight ≤30 kg) and 17 adolescents (mean age 14.3 ± 1.7, weight >30 kg). Results. No significant differences in outcome were found between groups immediately after the procedure. In all of our patients, peak systolic gradient pressure significantly decreased after stenting from 43.7 ± 12 to 1.7 ± 3.1 mmHg in group A and from 39.4 ± 16.8 to 1.6 ± 3 in group B (p < 0.0001). We observed early and late adverse events in both groups: early femoral vessel injury or thrombosis was more frequent in younger patients, as well as restenosis due to vessel growth requiring stent redilatations, often complicated by stent fractures. Data from long-term follow-up showed that, in younger patients, stress-related hypertension was more frequent. Conclusions. The procedure was immediately safe and effective in both groups. Pediatric patients must be accurately selected before stenting because they could probably need reinterventions and stents could impact on their future therapeutic perspectives. PMID:26925287

  5. 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.

  6. Long-term follow-up of 100 high-risk renal transplant recipients converted from calcineurin inhibitors to sirolimus: a single center experience.

    PubMed

    Halim, M A; Al-Otaibi, T; Johny, K V; Hamid, M H; Tawab, K A; Balaha, M A; Abraham, M; Said, T; Nair, M P; Al-Waheeb, S; Al-Muzairai, I; Nampoory, M R N

    2009-06-01

    While conversion of stable renal transplant recipients (RTR) from calcineurin inhibitors (CNI) to sirolimus (SRL) is safe and effective, it is still under investigation for recent, high-risk cases. We studied the long-term effects of conversion of high-risk subjects maintained on a CNI, mycophenolate mofetil, plus steroid regimen to SRL, mycophenolate mofetil, plus steroid on graft and patient outcomes. We retrospectively reviewed the first 100 RTR converted to SRL treatment over approximately 5 years. The main indications for conversion were biopsy-proven acute rejection (BPAR), CNI toxicity, CNI elimination, and acute-tubular necrosis (ATN). Exclusion criteria were limited to bone marrow suppression. The overall mean +/- SD age was 38.5 +/- 15.6 years, including pediatric and geriatric age groups. Mean +/- SD body mass index (BMI) was 28.99 +/- 8.0 and 40% had a BMI > 30. There were 40% RTR from deceased donors and 60% showed 4 to 6 HLA mismatches. Preconversion total BPAR and steroid-resistant rejection incidences were 35% and 14%, respectively. Mean +/- SD time to start of SRL was 11.9 +/- 22.8 months posttransplantation. Proteinuria > 2 g/d, leukopenia, and hyperlipidemia increased significantly after conversion (P = .001, P = .0003, and P = .0001, respectively). Patient and graft survivals were 95% and 90%, respectively. There was significant improvement in graft function postconversion (P < .0001). There was a high incidence of side effects and cases of SRL discontinuation. Multivariate analysis demonstrated the influence of bone marrow suppression, obesity, hyperlipidemia, nutritional status, proteinuria, and graft function on graft and patient outcomes. We concluded that conversion from CNI to SRL was effective among high-risk RTR, but with a high incidence of adverse events during long-term follow-up.

  7. 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

  8. 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

  9. A Multidimensional Prognostic Index (MPI) based on a comprehensive geriatric assessment predicts short- and long-term all-cause mortality in older hospitalized patients with transient ischemic attack.

    PubMed

    Sancarlo, Daniele; Pilotto, Andrea; Panza, Francesco; Copetti, Massimiliano; Longo, Maria Grazia; D'Ambrosio, Piero; D'Onofrio, Grazia; Ferrucci, Luigi; Pilotto, Alberto

    2012-04-01

    A multidimensional impairment may influence the clinical outcome of acute diseases in older patients. The aim of the current study was to evaluate whether a Multidimensional Prognostic Index (MPI) based on a comprehensive geriatric assessment (CGA) predicts short- and long-term all-cause mortality in older patients hospitalized for transient ischemic attack (TIA). In this prospective study with 1-year follow-up, 654 patients aged 65 and older with a diagnosis of TIA according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM 435.x) were enrolled. A standardized CGA that included information on functional (activities of daily living, ADL, and Instrumental ADL), cognitive status (Short Portable Mental Status Questionnaire), nutrition (Mini Nutritional Assessment), risk of pressure sores (Exton-Smith Scale), comorbidities (Cumulative Illness Rating Scale), medications and co-habitation status was used to calculate the MPI for mortality using a previously validated algorithm. Higher MPI values were significantly associated with higher 1-month all-cause mortality (incidence rates: MPI-1 low risk = 0.32%, MPI-2 moderate risk = 5.36%, MPI-3 high risk = 10.42%; p < 0.001), 6-month all-cause mortality (MPI-1 = 1.95%, MPI-2 = 9.77%, MPI-3 = 27.22%; p < 0.001) and 12-month all-cause mortality (MPI-1 = 5.19%, MPI-2 = 16.47%, MPI-3 = 44.32%; p < 0.001). Age- and gender-adjusted Cox regression analyses demonstrated that MPI was a significant predictor of all-cause mortality. MPI showed a significant high discriminatory power with an area under the receiver operating characteristics (ROC) curve of 0.819, 95% CI = 0.749-0.888 for 1-month mortality, 0.799, 95% CI = 0.738-0.861 for 6-month mortality and 0.770, 95% CI = 0.716-0.824 for 12-month mortality. The MPI, calculated from information collected in a standardized CGA, appeared to be effective in estimating short- and long-term all-cause mortality in

  10. 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

  11. Predictors of Pegylated Interferon Alpha and Ribavirin Efficacy and Long-Term Assessment of Relapse in Patients With Chronic Hepatitis C: A One-Center Experience From China

    PubMed Central

    Wu, Qin; Zhan, Feng Yu; Chen, En Qiang; Wang, Cong; Li, Zhen Zhen; Lei, Xue Zhong

    2015-01-01

    Background: Sustained virological response (SVR) and virological relapse maintain pivotal roles in the management of chronic hepatitis C (CHC); however, there is little data regarding the long-term outcomes of patients with CHC in China. Objectives: We aimed to investigate the predictive factors of therapeutic effect and viral relapse in patients who achieved end-of-treatment response (ETR). Patients and Methods: We retrospectively analyzed clinical, biochemical and virological data of 169 adult patients with CHC from China who were not treated with pegylated interferon-alpha (PEG IFN-α) and ribavirin, of which 142 achieved ETR and with a follow-up period ranging from six months to six years. Statistical analysis was performed by SPSS 20.0. Results: Of the 169 patients, 124 (73.4%) achieved SVR and 23 (16.2%) experienced relapses post-therapy in cases of ETR patients. We considered sex, age, alanine aminotransferase, aspartate transaminase, baseline hepatitis C virus RNA level, HCV genotypes, IL28B rs12979860 genotype, rapid virological response (RVR), and early virological response (EVR). For antiviral effect in patients with CHC, HCV genotypes (2, 3) (χ2 = 11.285, P = 0.001), IL28B genotype (rs12979860 CC) (χ2 = 16.552, P < 0.001), RVR (χ2 = 37.339, P < 0.001), and EVR (χ2 = 70.265, P < 0.001) were significantly correlated with achieving SVR. For ETR patients with long-term follow-up, the relapse rate within six months was significantly higher than within other periods during six-year follow-up (χ2 = 7.792, P = 0.005). Relapse was virtually not observed after therapy ceased for 48 weeks. The IL28B genotype (rs12979860 CT/TT) (OR = 0.102; 95% CI, 0.031-0.339; P < 0.001), lower RVR (OR = 0.239; 95% CI, 0.078-0.738; P = 0.013), and EVR (OR = 0.102; 95% CI, 0.016-0.661; P = 0.017) were independent risk factors for relapse. Conclusions: Our study comprehensively explored the predictive factors of therapeutic effect of administered drugs and analyzed viral

  12. 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

  13. 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

  14. Long-term follow-up after percutaneous closure of patent foramen ovale with Amplatzer PFO Occluder: a single center experience

    PubMed Central

    Grygier, Marek; Iwańczyk, Sylwia; Trojnarska, Olga; Lesiak, Maciej; Grajek, Stefan

    2016-01-01

    Introduction Patent foramen ovale (PFO) is associated with the occurrence of cryptogenic strokes, transient neurological ischemic attacks (TIA) and migraine. Therefore despite the recent ambiguous results of prospective controlled trials, percutaneous closure of PFO is still performed in many centers. Aim To evaluate the safety and effectiveness of percutaneous PFO closure in the prevention of recurrence of neurologic events and migraine symptoms in long-term observation. Material and methods In 70 patients (31 male, age: 38 ±18 years) percutaneous PFO closure was successfully performed with the Amplatzer PFO Occluder. An interview in conjunction with neurological follow-up was performed in all patients to reveal recurrence of embolism such as TIA or stroke and the presence of migraine symptoms before and after the procedure. Results The mean follow-up period was 857 ±363 days (median: 571 days). No serious complications of the procedure and no death were observed. Neurological events recurred in 5 (7.1%) patients – stroke in 1 patient, TIA in 3 patients, ocular embolism in 1 patient. All of these patients were over 40 years old or had other cardiovascular risk factors. Migraine was observed in 21 (30%) patients before the procedure and in 11 (15.7%) after the procedure (p = 0.04). Conclusions The complication rate and recurrence of neurological events in young patients after PFO closure are low. However, careful qualification and postprocedural monitoring of the patients are necessary. Patent foramen ovale closure seems to result in attenuation of migraine symptoms. PMID:26966449

  15. Seasonal and annual variations in physiological and biochemical responses from transplanted marine bioindicator species Mytilus spp. during a long term field exposure experiment.

    PubMed

    Helmholz, Heike; Ruhnau, Christiane; Pröfrock, Daniel; Erbslöh, Hans-Burkhard; Prange, Andreas

    2016-09-15

    In a pilot field study the long term response of transplanted bioindicator organisms Mytilus spp. was analyzed on the basis of physiological indices and biochemical measurements related to the energy budget. Three different time series with deployment times of eight to twelve months were compared according to seasonality and repeatability of the responses. Test organisms were incubated at a coastal station in the anthropogenically impacted estuary of the river Elbe and at a North Sea station located in vicinity to the Island of Helgoland in the German Bight. The stations differ in their hydrological as well as chemical characteristics. They can be discriminated by statistical factor analysis based on the measured biochemical parameter. Levels of all energy budget biomarker varied between seasons; however, the degree of variation of the specific response was differently expressed. The mussels deployed at Helgoland showed a reproducible high Condition Index in each sampling series and an oscillating Gonadosomatic Index representing the reproduction cycle. The lowest available energy was recorded in mussels at the estuarine sampling station compared to the off-shore station. This may be caused by the energetically costly maintenance of osmotic balance and consequently result in a lower amount of energy available for defense again chemical stress, growth and reproduction. PMID:27203523

  16. [Autoimmune processes after long-term low-level exposure to electromagnetic fields (the results of an experiment). Part 2. General scheme and conditions of the experiment. Development of RF exposure conditions complying with experimental tasks. Animal's status during the long-term exposure].

    PubMed

    Grigor'ev, Iu G; Grigor'ev, O A; Merkulov, A V; Shafirkin, A V; Vorob'ev, A A

    2010-01-01

    This paper describes the conditions for handling and exposure of experimental animals (Wistar rats) and methods used in the study of immunological effects of long-term low-level (500 microW/cm2) exposure to radiofrequency (2450 MHz) electromagnetic fields, performed under auspices of the World Health Organization.

  17. 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

  18. Deferasirox for iron chelation in multitransfused children with sickle cell disease; long-term experience in the East London clinical haemoglobinopathy network.

    PubMed

    Tsouana, Eva; Kaya, Banu; Gadong, Nimze; Hemmaway, Claire; Newell, Heather; Simmons, Andrea; Whitmarsh, Simon; Telfer, Paul

    2015-04-01

    Deferasirox (DFX) has been licensed for iron chelation in patients with sickle cell disease (SCD), but there is limited data on its long-term efficacy and safety in children. This retrospective study included 62 regularly transfused children managed in the East London and Essex Clinical Haemoglobinopathy Network (mean age 9.2 ± 3.2 yr). Efficacy measurements consisted of monthly serum ferritin (SF) and annual R2 MRI-estimated liver iron concentration (LIC), and safety markers included serum creatinine and alanine aminotransferase (ALT). The mean duration of DFX treatment was 2.5 ± 1.4 yr, and mean dose at 36 months was 25 mg/kg/d. Mean SF at initiation of treatment was 2542 ± 952 ng/mL and increased to 4691 ± 2255 ng/mL at 36 months (P = 0.05). Mean LIC on first scan was 10.3 mg/g dry weight and did not decrease significantly on follow-up scans. There was a significant correlation between relative change in LIC and in SF (R(2) = 0.66, P < 0.001). Reversible transaminitis episodes, probably due to drug-induced hepatitis, were noted in 53% of patients. Responses to an adherence and acceptability questionnaire indicated that more than 50% of children had difficulties in taking DFX, commonly because of unpleasant taste. Our results show that more than 50% of children with SCD have inadequate control of iron overload with DFX. It is not clear whether this is because of frequent dose interruptions, poor tolerability and adherence, or poor efficacy of the drug. We recommend further studies to confirm these findings and to optimise iron chelation in this population.

  19. Estimation of autotrophic maximum specific growth rate constant--experience from the long-term operation of a laboratory-scale sequencing batch reactor system.

    PubMed

    Su, Yu-min; Makinia, Jacek; Pagilla, Krishna R

    2008-04-01

    The autotrophic maximum specific growth rate constant, muA,max, is the critical parameter for design and performance of nitrifying activated sludge systems. In literature reviews (i.e., Henze et al., 1987; Metcalf and Eddy, 1991), a wide range of muA,max values have been reported (0.25 to 3.0 days(-1)); however, recent data from several wastewater treatment plants across North America revealed that the estimated muA,max values remained in the narrow range 0.85 to 1.05 days(-1). In this study, long-term operation of a laboratory-scale sequencing batch reactor system was investigated for estimating this coefficient according to the low food-to-microorganism ratio bioassay and simulation methods, as recommended in the Water Environment Research Foundation (Alexandria, Virginia) report (Melcer et al., 2003). The estimated muA,max values using steady-state model calculations for four operating periods ranged from 0.83 to 0.99 day(-1). The International Water Association (London, United Kingdom) Activated Sludge Model No. 1 (ASM1) dynamic model simulations revealed that a single value of muA,max (1.2 days(-1)) could be used, despite variations in the measured specific nitrification rates. However, the average muA,max was gradually decreasing during the activated sludge chlorination tests, until it reached the value of 0.48 day(-1) at the dose of 5 mg chlorine/(g mixed liquor suspended solids x d). Significant discrepancies between the predicted XA/YA ratios were observed. In some cases, the ASM1 predictions were approximately two times higher than the steady-state model predictions. This implies that estimating this ratio from a complex activated sludge model and using it in simple steady-state model calculations should be accepted with great caution and requires further investigation.

  20. Primary Infrarenal Aortic Stenting With or Without Iliac Stenting for Isolated and Aortoiliac Stenoses: Single-Centre Experience With Long-Term Follow-Up

    SciTech Connect

    Tapping, C. R.; Ahmed, M.; Scott, P. M.; Lakshminarayan, R.; Robinson, G. J.; Ettles, D. F.; Shrivastava, V.

    2013-02-15

    The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 {+-} 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 {+-} -0.15 (right) and 0.61 {+-} -0.16 (left). After the procedure they were 0.86 {+-} -0.07 (right) and 0.90 {+-} -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic

  1. Deferasirox for iron chelation in multitransfused children with sickle cell disease; long-term experience in the East London clinical haemoglobinopathy network.

    PubMed

    Tsouana, Eva; Kaya, Banu; Gadong, Nimze; Hemmaway, Claire; Newell, Heather; Simmons, Andrea; Whitmarsh, Simon; Telfer, Paul

    2015-04-01

    Deferasirox (DFX) has been licensed for iron chelation in patients with sickle cell disease (SCD), but there is limited data on its long-term efficacy and safety in children. This retrospective study included 62 regularly transfused children managed in the East London and Essex Clinical Haemoglobinopathy Network (mean age 9.2 ± 3.2 yr). Efficacy measurements consisted of monthly serum ferritin (SF) and annual R2 MRI-estimated liver iron concentration (LIC), and safety markers included serum creatinine and alanine aminotransferase (ALT). The mean duration of DFX treatment was 2.5 ± 1.4 yr, and mean dose at 36 months was 25 mg/kg/d. Mean SF at initiation of treatment was 2542 ± 952 ng/mL and increased to 4691 ± 2255 ng/mL at 36 months (P = 0.05). Mean LIC on first scan was 10.3 mg/g dry weight and did not decrease significantly on follow-up scans. There was a significant correlation between relative change in LIC and in SF (R(2) = 0.66, P < 0.001). Reversible transaminitis episodes, probably due to drug-induced hepatitis, were noted in 53% of patients. Responses to an adherence and acceptability questionnaire indicated that more than 50% of children had difficulties in taking DFX, commonly because of unpleasant taste. Our results show that more than 50% of children with SCD have inadequate control of iron overload with DFX. It is not clear whether this is because of frequent dose interruptions, poor tolerability and adherence, or poor efficacy of the drug. We recommend further studies to confirm these findings and to optimise iron chelation in this population. PMID:25138173

  2. Long-term care offers opportunity for revenue.

    PubMed

    Dixon, R D

    1991-06-01

    Hospital administrators already know that diversification will be a key to success in the future. Applying that philosophy to long-term care of the elderly is just one way to capture a growing consumer market. In the following article, the author addresses three potential variations for delivering such care by the hospital to this group. PMID:10113608

  3. 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

  4. The treatment with pasireotide in Cushing's disease: effects of long-term treatment on tumor mass in the experience of a single center.

    PubMed

    Simeoli, Chiara; Auriemma, Renata Simona; Tortora, Fabio; De Leo, Monica; Iacuaniello, Davide; Cozzolino, Alessia; De Martino, Maria Cristina; Pivonello, Claudia; Mainolfi, Ciro Gabriele; Rossi, Riccardo; Cirillo, Sossio; Colao, Annamaria; Pivonello, Rosario

    2015-12-01

    Pasireotide is the first medical therapy officially approved for the treatment of adult patients with Cushing's disease (CD) who experienced a failure of pituitary surgery or are not candidates for surgery and require medical therapeutic intervention. The current study aimed at investigating the effects of long-term treatment with pasireotide (up to 24 months) on tumor mass in a group of patients with CD, participating to a phase III study. Fourteen CD patients entered the phase III clinical trial CSOM230B2305 at Naples Center, and eight (seven women, one man, aged 38.9 ± 17.6 years), including seven with a microadenoma and one with a macroadenoma, received treatment with pasireotide at the dose of 600-1200 µg bid for at least 6 months, and were considered for the analysis of the study. These eight patients were subjected to the evaluation of pituitary tumor volume by pituitary MRI, together with the evaluation of urinary cortisol levels, at baseline and every 6 months for the entire period of treatment. Pasireotide treatment induced full disease control in 37.5 % and partial disease control in 37.5 % after 6 months, whereas full and partial disease control after 12 months was obtained in 28.6 % and in 57.1 % of patients, respectively. A significant (>25 %) reduction in tumor volume was found in 62.5 % and in 100 % of patients, after 6 and 12 months, respectively. In particular, after 6 months, a slight tumor shrinkage (between 25.1 and 50 %) was observed in 25 %, moderate (50.1-75 %) in 25 %, and marked (>75 %) in 12.5 % of patients, whereas after 12 months, a slight tumor shrinkage was observed in 43 %, moderate in 14 %, and marked in 43 % of patients. In 25 % of patients (two patients), a marked tumor shrinkage was recorded, with tumor mass disappearance in one case; this tumor shrinkage was associated to rapid and sustained biochemical remission up to 24 months of continuous pasireotide treatment. These two cases represent the first cases with a documentation

  5. Continuity and change?: Exploring reactions to a guided self-management intervention in a randomised controlled trial for IBS with reference to prior experience of managing a long term condition

    PubMed Central

    Rogers, Anne; Lee, Victoria; Kennedy, Anne

    2007-01-01

    Self-care interventions are promoted as effective strategies for improving the quality of life and health outcomes for individuals with long-term health conditions. Outcome measures used in evaluations using Randomised Controlled Trials (RCTs) are not designed to consider patients' prior management strategies and experience of illness. Yet the experience of illness literature suggests that adjusting to living with chronic illness, together with broader contextual influences, are likely to be relevant to understanding responses to self-management initiatives. Using group and individual interview data we attempt to illuminate the transposition of IBS from a condition unsatisfactorily managed by medicine to one successfully managed within the life worlds of individuals. If routine embedding of complex interventions depends on the accomplishment of integration and workability in patients' everyday lives then the design and evaluation of such interventions should view participation as part of a process of continuity as well as change. Responses to formal self-management can be extended beyond psychological and other quantitatively measured outcomes. A useful addendum to trial outcomes for self-management education is an understanding of change as being inextricably linked to people's previous attempts to, and experience of, managing long-term conditions. We suggest that the benefits of understanding the prior experience of managing illness and contact with health services include the acceptability and workability of complex interventions in patients' everyday lives. PMID:17316438

  6. 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…

  7. Long-term space flights - personal impressions

    NASA Astrophysics Data System (ADS)

    Polyakov, V. V.

    During a final 4-month stage of a 1-year space flight of cosmonauts Titov and Manarov, a physician, Valery Polyakov was included on a crew for the purpose of evaluating their health, correcting physical status to prepare for the spacecraft reentry and landing operations. The complex program of scientific investigations and experiments performed by the physician included an evaluation of adaptation reactions of the human body at different stages of space mission using clinicophysiological and biochemical methods; testing of alternative regimes of exercise and new countermeasures to prevent an unfavourable effect of long-term weightlessness.

  8. Malaria prophylaxis in long-term expatriate mineworkers in Ghana.

    PubMed

    Fegan, D; Glennon, J

    1993-08-01

    The role of malaria chemoprophylaxis for long-term expatriates has not been re-evaluated since the emergence of widespread multidrug resistance. A survey of 106 expatriates working in a mine in Ghana (holoendemic for malaria) was conducted to determine the compliance with malaria chemoprophylaxis. Overall 64 per cent took regular chemoprophylaxis. Of the long-term expatriates (5 or more years in areas with holoendemic malaria), 48.4 per cent either took malaria prophylaxis very irregularly or not at all. The main reasons for failing to comply were fear of long-term side effects and conflicting advice on prophylaxis. This reluctance to take long-term chemoprophylaxis highlights the need to re-emphasise the importance of anti-mosquito measures, prompt treatment of fevers, and perhaps consider abandoning chemoprophylaxis in those expatriate workers with ready access to hospital care.

  9. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)</