Sample records for long-term operation kontinuierliche

  1. Acute Kidney Injury Classification Underestimates Long-Term Mortality After Cardiac Valve Operations.

    PubMed

    Bouma, Hjalmar R; Mungroop, Hubert E; de Geus, A Fred; Huisman, Daniel D; Nijsten, Maarten W N; Mariani, Massimo A; Scheeren, Thomas W L; Burgerhof, Johannes G M; Henning, Robert H; Epema, Anne H

    2018-03-01

    Perioperative acute kidney injury (AKI) is an important predictor of long-term all-cause mortality after coronary artery bypass (CABG). However, the effect of AKI on long-term mortality after cardiac valve operations is hitherto undocumented. Perioperative renal injury and long-term all-cause mortality after valve operations were studied in a prospective cohort of patients undergoing solitary valve operations (n=2,806) or valve operations combined with CABG (n=1,260) with up to 18 years of follow-up. Postoperative serum creatinine increase was classified according to AKI 0-3. Patients undergoing solitary CABG (n=4,938) with cardiopulmonary bypass served as reference. In both valve and valve+CABG operations, postoperative renal injury of AKI stage 1 or higher was progressively associated with an increase in long-term mortality (HR 2.27, p<0.05 for valve; HR 1.65, p<0.05 for valve operations combined with CABG; HR 1.56, p<0.05 for CABG). Notably, the mortality risk increased already substantially at serum creatinine rises of 10-25%, i.e. far below the threshold for AKI stage 1 after valve operations (HR 1.39, p<0.05), but not after valve operations combined with CABG or CABG only. An increase in serum creatinine by more than 10%during the first week following valve operation is associated with an increased risk for long-term mortality following cardiac valve operation. Thus, AKI-classification clearly underestimates long-term mortality risk in patients undergoing valve operations. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Long-term outcomes and social independence level after arterial switch operation.

    PubMed

    Yamazaki, Akira; Yamamoto, Noboru; Sakamoto, Takahiko; Ishihara, Kazuaki; Iwata, Yusuke; Matsumura, Goki; Kurosawa, Hiromi

    2008-02-01

    Various issues regarding the long-term survivors of arterial switch operation (ASO) have been clarified according to the improvement of surgical mortality. We reviewed the long-term results and social independence level after ASO. Two hundred and four (204) patients who had undergone ASO more than 15 years ago were studied retrospectively. ASO was performed as a primary operation (group I, n=99) or as a secondary operation (group II, n=105). Lecompte procedure was performed in 197 patients, modified Aubert procedure in 5, and original Jatene procedure in 2. There were 11 late deaths. Kaplan-Meier survival rate (not including operative deaths) was 94.9% at 10 years and 94.9% at 15 years in group I, and 96.9% at 10 years and 94.4% at 15 years in group II. Forty-eight reoperations were performed (aortic valve replacement in 6, aortic valvoplasty in 2, Konno procedure in 1, double valve replacement in 1, right ventricular outflow tract reconstruction in 35). The reoperation-free rate including late death was 82.2% at 10 years and 75.7% at 15 years in group I, and 88.2% at 10 years and 78.1% at 15 years in group II. One hundred and seventy-eight patients were classified as NYHA class I and 7 patients as class II. All the patients except those with mental disorder (1) or neurodevelopmental impairment (3) were attending school or working. There was no significant difference in left ventricular function between group I and II, both showing values within the normal range. The long-term (>15 years) outcome of ASO survivors was satisfactory. Most patients showed excellent cardiac function and were socially independent.

  3. Long-term biatrial recordings in post-operative atrial fibrillation.

    PubMed

    Masè, M; Graffigna, A; Sinelli, S; Pallaoro, G; Nollo, G; Ravelli, F

    2010-01-01

    Although atrial fibrillation (AF) is a common complication of cardiac surgery, its pathophysiology remains unclear. The study of post-operative AF demands for the recording of cardiac electrical activity in correspondence of AF onset and progression. Long-term recordings in post-surgery patients could provide this information, but, to date, have been limited to surface signals, which precludes a characterization of the arrhythmic triggers and substrate. In this study we demonstrate the feasibility of a continuous long-term recording of atrial electrical activities from the right and left atria in post-surgery patients. Local atrial epicardial electrograms are acquired by positioning temporary pacing wires in the right and left atria at the end of the intervention, while three day recordings are obtained by a digital holter recorder, adapted to epicardial signal features. The capability of the system to map local atrial activity and the possibility to obtain quantitative information on atrial rate and synchronization from the processed epicardial signals are proven in representative examples. The quantitative description of local atrial properties opens new perspective in the investigation of post-surgery AF.

  4. Reliability of Modern Scores to Predict Long-Term Mortality After Isolated Aortic Valve Operations.

    PubMed

    Barili, Fabio; Pacini, Davide; D'Ovidio, Mariangela; Ventura, Martina; Alamanni, Francesco; Di Bartolomeo, Roberto; Grossi, Claudio; Davoli, Marina; Fusco, Danilo; Perucci, Carlo; Parolari, Alessandro

    2016-02-01

    Contemporary scores for estimating perioperative death have been proposed to also predict also long-term death. The aim of the study was to evaluate the performance of the updated European System for Cardiac Operative Risk Evaluation II, The Society of Thoracic Surgeons Predicted Risk of Mortality score, and the Age, Creatinine, Left Ventricular Ejection Fraction score for predicting long-term mortality in a contemporary cohort of isolated aortic valve replacement (AVR). We also sought to develop for each score a simple algorithm based on predicted perioperative risk to predict long-term survival. Complete data on 1,444 patients who underwent isolated AVR in a 7-year period were retrieved from three prospective institutional databases and linked with the Italian Tax Register Information System. Data were evaluated with performance analyses and time-to-event semiparametric regression. Survival was 83.0% ± 1.1% at 5 years and 67.8 ± 1.9% at 8 years. Discrimination and calibration of all three scores both worsened for prediction of death at 1 year and 5 years. Nonetheless, a significant relationship was found between long-term survival and quartiles of scores (p < 0.0001). The estimated perioperative risk by each model was used to develop an algorithm to predict long-term death. The hazard ratios for death were 1.1 (95% confidence interval, 1.07 to 1.12) for European System for Cardiac Operative Risk Evaluation II, 1.34 (95% CI, 1.28 to 1.40) for the Society of Thoracic Surgeons score, and 1.08 (95% CI, 1.06 to 1.10) for the Age, Creatinine, Left Ventricular Ejection Fraction score. The predicted risk generated by European System for Cardiac Operative Risk Evaluation II, The Society of Thoracic Surgeons score, and Age, Creatinine, Left Ventricular Ejection Fraction scores cannot also be considered a direct estimate of the long-term risk for death. Nonetheless, the three scores can be used to derive an estimate of long-term risk of death in patients who undergo

  5. PKA and PKC Are Required for Long-Term but Not Short-Term in Vivo Operant Memory in "Aplysia"

    ERIC Educational Resources Information Center

    Michel, Maximilian; Green, Charity L.; Lyons, Lisa C.

    2011-01-01

    We investigated the involvement of PKA and PKC signaling in a negatively reinforced operant learning paradigm in "Aplysia", learning that food is inedible (LFI). In vivo injection of PKA or PKC inhibitors blocked long-term LFI memory formation. Moreover, a persistent phase of PKA activity, although not PKC activity, was necessary for long-term…

  6. BIOFILTRATION OF VOLATILE POLLUTANTS: Fundamental Mechanisms for Improved Design, Long-term Operation, Prediction, and Implementation

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

    Davison,Brian H.

    2000-12-31

    Biofiltration systems can be used for treatment of volatile organic compounds (VOCs); however, the systems are poorly understood and are normally operated as ''black boxes''. Common operational problems associated with biofilters include fouling, deactivation, and overgrowth, all of which make them ineffective for continuous, long-term use. The objective of this investigation was to develop generic methods for long-term stable operation, in particular by using selective limitation of supplemental nutrients while maintaining high activity. As part of this effort, we have provided a deeper fundamental understanding of the important biological and transport mechanisms in biodestruction of sparingly soluble VOCs and havemore » extended this approach and mathematical models to additional systems of high priority EM relevance--direct degradation and cometabolic degradation of priority pollutants such as BTEX and chlorinated organics. Innovative aspects of this project included development of a user-friendly two-dimensional predictive model/program for MS Windows 95/98/2000 to elucidate mass transfer and kinetic limitations in these systems, isolation of a unique microorganism capable of using sparingly soluble organic and chloroorganic VOCs as its sole carbon and energy source, and making long-term growth possible by successfully decoupling growth and degradation metabolisms in operating trickle bed bioreactors.« less

  7. BIOFILTRATION OF VOLATILE POLLUTANTS: Fundamental Mechanisms for Improved Design, Long-term Operation, Prediction, and Implementation

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

    Davison, Brian H.; Klasson, K. Thomas; Barton, John W.

    2000-06-01

    Biofiltration systems can be used for treatment of volatile organic compounds (VOCs); however, the systems are poorly understood and are currently operated as ''black boxes''. Common operational problems associated with biofilters include fouling, deactivation, and overgrowth, all of which make them ineffective for continuous, long-term use. The objective of this investigation is to develop generic methods for long-term stable operation, in particular by using selective limitation of supplemental nutrients while maintaining high activity. As part of this effort, we will provide deeper fundamental understanding of the important biological and transport mechanisms in biodestruction of sparingly soluble VOCs and extend thismore » approach and mathematical models to additional systems of high priority EM relevance--direct degradation and cometabolic degradation of priority pollutants such as BTEX and chlorinated organics.« less

  8. The National Long Term Care Demonstration: operational issues encountered in developing the research design.

    PubMed

    Carcagno, G J; Kemper, P

    1983-01-01

    This paper describes the design of the National Long Term Care Demonstration and its evaluation and discusses a number of operational issues encountered in the design process: simultaneous design of research and operations, identification of the target population, randomization, collection of comparable data, development of an assessment instrument, potential changes in existing programs, and termination planning.

  9. Budgeting for International Projects: In-Country Business Operations and Long-Term Residential Assignments.

    ERIC Educational Resources Information Center

    Richey, John B.

    1994-01-01

    A discussion of international sponsored research program administration looks at budgeting, costs, and procedures for both projects with in-country business operations in developing nations and projects with long-term residential assignments. It is intended for university administrators providing new services to faculty working on international…

  10. Acute Sleep Deprivation Blocks Short- and Long-Term Operant Memory in Aplysia

    PubMed Central

    Krishnan, Harini C.; Gandour, Catherine E.; Ramos, Joshua L.; Wrinkle, Mariah C.; Sanchez-Pacheco, Joseph J.; Lyons, Lisa C.

    2016-01-01

    Study Objectives: Insufficient sleep in individuals appears increasingly common due to the demands of modern work schedules and technology use. Consequently, there is a growing need to understand the interactions between sleep deprivation and memory. The current study determined the effects of acute sleep deprivation on short and long-term associative memory using the marine mollusk Aplysia californica, a relatively simple model system well known for studies of learning and memory. Methods: Aplysia were sleep deprived for 9 hours using context changes and tactile stimulation either prior to or after training for the operant learning paradigm, learning that food is inedible (LFI). The effects of sleep deprivation on short-term (STM) and long-term memory (LTM) were assessed. Results: Acute sleep deprivation prior to LFI training impaired the induction of STM and LTM with persistent effects lasting at least 24 h. Sleep deprivation immediately after training blocked the consolidation of LTM. However, sleep deprivation following the period of molecular consolidation did not affect memory recall. Memory impairments were independent of handling-induced stress, as daytime handled control animals demonstrated no memory deficits. Additional training immediately after sleep deprivation failed to rescue the induction of memory, but additional training alleviated the persistent impairment in memory induction when training occurred 24 h following sleep deprivation. Conclusions: Acute sleep deprivation inhibited the induction and consolidation, but not the recall of memory. These behavioral studies establish Aplysia as an effective model system for studying the interactions between sleep and memory formation. Citation: Krishnan HC, Gandour CE, Ramos JL, Wrinkle MC, Sanchez-Pacheco JJ, Lyons LC. Acute sleep deprivation blocks short- and long-term operant memory in Aplysia. SLEEP 2016;39(12):2161–2171. PMID:27748243

  11. Towards Optimal Operation of the Reservoir System in Upper Yellow River: Incorporating Long- and Short-term Operations and Using Rolling Updated Hydrologic Forecast Information

    NASA Astrophysics Data System (ADS)

    Si, Y.; Li, X.; Li, T.; Huang, Y.; Yin, D.

    2016-12-01

    The cascade reservoirs in Upper Yellow River (UYR), one of the largest hydropower bases in China, play a vital role in peak load and frequency regulation for Northwest China Power Grid. The joint operation of this system has been put forward for years whereas has not come into effect due to management difficulties and inflow uncertainties, and thus there is still considerable improvement room for hydropower production. This study presents a decision support framework incorporating long- and short-term operation of the reservoir system. For long-term operation, we maximize hydropower production of the reservoir system using historical hydrological data of multiple years, and derive operating rule curves for storage reservoirs. For short-term operation, we develop a program consisting of three modules, namely hydrologic forecast module, reservoir operation module and coordination module. The coordination module is responsible for calling the hydrologic forecast module to acquire predicted inflow within a short-term horizon, and transferring the information to the reservoir operation module to generate optimal release decision. With the hydrologic forecast information updated, the rolling short-term optimization is iterated until the end of operation period, where the long-term operating curves serve as the ending storage target. As an application, the Digital Yellow River Integrated Model (referred to as "DYRIM", which is specially designed for runoff-sediment simulation in the Yellow River basin by Tsinghua University) is used in the hydrologic forecast module, and the successive linear programming (SLP) in the reservoir operation module. The application in the reservoir system of UYR demonstrates that the framework can effectively support real-time decision making, and ensure both computational accuracy and speed. Furthermore, it is worth noting that the general framework can be extended to any other reservoir system with any or combination of hydrological model

  12. Role of Proteasome-Dependent Protein Degradation in Long-Term Operant Memory in "Aplysia"

    ERIC Educational Resources Information Center

    Lyons, Lisa C.; Gardner, Jacob S.; Gandour, Catherine E.; Krishnan, Harini C.

    2017-01-01

    We investigated the in vivo role of protein degradation during intermediate (ITM) and long-term memory (LTM) in "Aplysia" using an operant learning paradigm. The proteasome inhibitor MG-132 inhibited the induction and molecular consolidation of LTM with no effect on ITM. Remarkably, maintenance of steady-state protein levels through…

  13. PKG-Mediated MAPK Signaling Is Necessary for Long-Term Operant Memory in "Aplysia"

    ERIC Educational Resources Information Center

    Michel, Maximilian; Green, Charity L.; Eskin, Arnold; Lyons, Lisa C.

    2011-01-01

    Signaling pathways necessary for memory formation, such as the mitogen-activated protein kinase (MAPK) pathway, appear highly conserved across species and paradigms. Learning that food is inedible (LFI) represents a robust form of associative, operant learning that induces short- (STM) and long-term memory (LTM) in "Aplysia." We investigated the…

  14. Long-term impacts of unconventional drilling operations on human and animal health.

    PubMed

    Bamberger, Michelle; Oswald, Robert E

    2015-01-01

    Public health concerns related to the expansion of unconventional oil and gas drilling have sparked intense debate. In 2012, we published case reports of animals and humans affected by nearby drilling operations. Because of the potential for long-term effects of even low doses of environmental toxicants and the cumulative impact of exposures of multiple chemicals by multiple routes of exposure, a longitudinal study of these cases is necessary. Twenty-one cases from five states were followed longitudinally; the follow-up period averaged 25 months. In addition to humans, cases involved food animals, companion animals and wildlife. More than half of all exposures were related to drilling and hydraulic fracturing operations; these decreased slightly over time. More than a third of all exposures were associated with wastewater, processing and production operations; these exposures increased slightly over time. Health impacts decreased for families and animals moving from intensively drilled areas or remaining in areas where drilling activity decreased. In cases of families remaining in the same area and for which drilling activity either remained the same or increased, no change in health impacts was observed. Over the course of the study, the distribution of symptoms was unchanged for humans and companion animals, but in food animals, reproductive problems decreased and both respiratory and growth problems increased. This longitudinal case study illustrates the importance of obtaining detailed epidemiological data on the long-term health effects of multiple chemical exposures and multiple routes of exposure that are characteristic of the environmental impacts of unconventional drilling operations.

  15. Consider long-term care as service alternative.

    PubMed

    Loria, L S

    1987-04-01

    The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

  16. Sulfur poisoning of Ni/Gadolinium-doped ceria anodes: A long-term study outlining stable solid oxide fuel cell operation

    NASA Astrophysics Data System (ADS)

    Riegraf, Matthias; Zekri, Atef; Knipper, Martin; Costa, Rémi; Schiller, Günter; Friedrich, K. Andreas

    2018-03-01

    This work presents an analysis of the long-term behavior of nickel/gadolinium-doped ceria (CGO) anode-based solid oxide fuel cells (SOFC) under sulfur poisoning conditions. A parameter study of sulfur-induced irreversible long-term degradation of commercial, high-performance single cells was carried out at 900 °C for different H2/N2/H2S fuel gas atmospheres, current densities and Ni/CGO anodes. The poisoning periods of the cells varied from 200 to 1500 h. The possibility of stable long-term Ni/CGO anode operation under sulfur exposure is established and the critical operating regime is outlined. Depending on the operating conditions, two degradation phenomena can be observed. Small degradation of the ohmic resistance was witnessed for sulfur exposure times of approximately 1000 h. Moreover, degradation of the anode charge transfer resistance was observed to be triggered by the combination of a small anodic potential step and high sulfur coverage on Ni. The microstructural evolution of altered Ni/CGO anodes was examined post-mortem by means of SEM and FIB/SEM, and is correlated to the anode performance degradation under critical operating conditions, establishing Ni depletion, porosity increase and a tripe phase boundary density decrease in the anode functional layer. It is shown that short-term sulfur poisoning behavior can be used to assess long-term stability.

  17. Pre-operative stroke and neurological disability do not independently affect short- and long-term mortality in infective endocarditis patients.

    PubMed

    Diab, Mahmoud; Guenther, Albrecht; Sponholz, Christoph; Lehmann, Thomas; Faerber, Gloria; Matz, Anna; Franz, Marcus; Witte, Otto W; Pletz, Mathias W; Doenst, Torsten

    2016-10-01

    Infective endocarditis (IE) is still associated with high morbidity and mortality. The impact of pre-operative stroke on mortality and long-term survival is controversial. In addition, data on the severity of neurological disability due to pre-operative stroke are scarce. We analysed the impact of pre-operative stroke and the severity of its related neurological disability on short- and long-term outcome. We retrospectively reviewed our data from patients operated for left-sided IE between 01/2007 and 04/2013. We performed univariate (Chi-Square and independent samples t test) and multivariate analyses. Among 308 consecutive patients who underwent cardiac surgery for left-sided IE, pre-operative stroke was present in 87 (28.2 %) patients. Patients with pre-operative stroke had a higher pre-operative risk profile than patient without it: higher Charlson comorbidity index (8.1 ± 2.6 vs. 6.6 ± 3.3) and higher incidence of Staphylococcus aureus infection (43 vs. 17 %) and septic shock (37 vs. 19 %). In-hospital mortality was equal but 5-year survival was significantly worse with pre-operative stroke (33.1 % vs. 45 %, p = 0.006). 5-year survival was worst in patients with severe neurological disability compared to mild disability (19.0 vs. 0.58 %, p = 0.002). However, neither pre-operative stroke nor the degree of neurological disability appeared as an independent risk factor for short or long-term mortality by multivariate analysis. Pre-operative stroke and the severity of neurological disability do not independently affect short- and long-term mortality in patients with infective endocarditis. It appears that patients with pre-operative stroke present with a generally higher risk profile. This information may substantially affect decision-making.

  18. Insulin dependence and pancreatic enzyme replacement therapy are independent prognostic factors for long-term survival after operation for chronic pancreatitis.

    PubMed

    Winny, Markus; Paroglou, Vagia; Bektas, Hüseyin; Kaltenborn, Alexander; Reichert, Benedikt; Zachau, Lea; Kleine, Moritz; Klempnauer, Jürgen; Schrem, Harald

    2014-02-01

    This retrospective, single-center, observational study on postoperative long-term results aims to define yet unknown factors for long-term outcome after operation for chronic pancreatitis. We analyzed 147 consecutive patients operated for chronic pancreatitis from 2000 to 2011. Mean follow-up was 5.3 years (range, 1 month to 12.7 years). Complete long-term survival data were provided by the German citizen registration authorities for all patients. A quality-of-life questionnaire was sent to surviving patients after a mean follow-up of 5.7 years. Surgical principles were resection (n = 86; 59%), decompression (n = 29; 20%), and hybrid procedures (n = 32; 21%). No significant influences of different surgical principles and operative procedures on survival, long-term quality of life and pain control could be detected. Overall 30-day mortality was 2.7%, 1-year survival 95.9%, and 3-year survival 90.8%. Multivariate Cox regression analysis revealed that only postoperative insulin dependence at the time of hospital discharge (P = .027; Exp(B) = 2.111; 95% confidence interval [CI], 1.089-4.090) and the absence of pancreas enzyme replacement therapy at the time of hospital discharge (P = .039; Exp(B) = 2.102; 95% CI, 1.037-4.262) were significant, independent risk factors for survival with significant hazard ratios for long-term survival. Long-term improvement in quality of life was reported by 55 of 76 long-term survivors (73%). Pancreatic enzyme replacement should be standard treatment after surgery for chronic pancreatitis at the time of hospital discharge, even when no clinical signs of exocrine pancreatic failure exist. This study underlines the potential importance of early operative intervention in chronic pancreatitis before irreversible endocrine dysfunction is present. Copyright © 2014 Mosby, Inc. All rights reserved.

  19. Long-term Outcomes of Operative and Nonoperative Treatment of Congenital Coxa Vara.

    PubMed

    Roberts, David W; Saglam, Yavuz; De La Rocha, Adriana; Frasquillo, Brigid N; Tulchin-Francis, Kirsten; Kim, Harry K W

    2018-04-01

    Congenital coxa vara (CCV) is a rare hip condition with few long-term studies. The purpose of this study was to assess clinical, radiographic, and functional outcomes after operative and nonoperative treatment of CCV, assess reliability of radiographic parameters, and investigate risk factors for recurrence after surgery. Retrospective review was performed of all CCV patients treated at 1 institution from 1980 to 2010. In addition, patients were recalled for additional follow-up x-rays, modified Harris Hip Score (mHHS), and gait analysis. Radiographic measurements [neck-shaft angle (NSA), head-shaft angle (HSA), Hilgenreiner-epiphyseal angle (HEA), and femoral neck length (FNL)] were assessed for reliability using intraclass correlation coefficients. Multivariate analysis was performed to identify risk factors for recurrence after surgery. Forty-six hips in 32 patients were reviewed. Mean age at presentation was 5.4±4.9 years. Mean follow-up was 11.8±5.8 years. Valgus proximal femoral osteotomy was performed in 27 hips (20 patients). Initial deformity was greater in the operative group (NSA 90±17 degrees, HEA 68±19 degrees) versus nonoperative patients (NSA 122±19 degrees, HEA 34±14 degrees) (P<0.0001), but radiographic outcomes were similar at follow-up. Most nonoperative hips had normal FNL growth rates (80%), but resolution of varus NSA occurred in only 21%. In contrast, 56% of operative hips showed decreased FNL growth rates. Interobserver reliability was excellent for HEA (0.98), NSA (0.90), and FNL (0.89), and good for HSA (0.79). Repeat osteotomy was performed in 6 cases (22%). No significant predictors for recurrence were identified. At long-term follow-up for recalled patients, 72% had significantly abnormal gait, and 50% had fair-poor functional outcomes (mHHS<79). Valgus osteotomy corrects severe deformity in CCV with improved clinical and radiographic outcomes. HEA and NSA are the most reliable radiographic measurements of proximal femoral

  20. Mobile dental operations: capital budgeting and long-term viability.

    PubMed

    Arevalo, Oscar; Chattopadhyay, Amit; Lester, Harold; Skelton, Judy

    2010-01-01

    The University of Kentucky College of Dentistry (UKCD) runs a large mobile dental operation. Economic conditions dictate that as the mobile units age it will be harder to find donors willing or able to provide the financial resources for asset replacement. In order to maintain current levels of access for the underserved, consideration of replacement is paramount. A financial analysis for a new mobile unit was conducted to determine self-sustainability, return on investment (ROI), and feasibility of generating a cash reserve for its replacement in 12 years. Information on clinical income, operational and replacement costs, and capital costs was collected. A capital budgeting analysis (CBA) was conducted using the Net Present Value (NPV) methodology in four different scenarios. Depreciation funding was calculated by transferring funds from cash inflows and reinvested to offset depreciation at fixed compound interest. A positive ROI was obtained for two scenarios. He depreciation fund did not generate a cash reserve sufficient to replace the mobile unit. Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful financial viability and CBA based on sound assumptions are excellent decision-making tools.

  1. Long-term energy capture and the effects of optimizing wind turbine operating strategies

    NASA Technical Reports Server (NTRS)

    Miller, A. H.; Formica, W. J.

    1982-01-01

    Methods of increasing energy capture without affecting the turbine design were investigated. The emphasis was on optimizing the wind turbine operating strategy. The operating strategy embodies the startup and shutdown algorithm as well as the algorithm for determining when to yaw (rotate) the axis of the turbine more directly into the wind. Using data collected at a number of sites, the time-dependent simulation of a MOD-2 wind turbine using various, site-dependent operating strategies provided evidence that site-specific fine tuning can produce significant increases in long-term energy capture as well as reduce the number of start-stop cycles and yawing maneuvers, which may result in reduced fatigue and subsequent maintenance.

  2. Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations.

    PubMed

    Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil

    2010-01-01

    little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

  3. A security/safety survey of long term care facilities.

    PubMed

    Acorn, Jonathan R

    2010-01-01

    What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

  4. Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival.

    PubMed

    Al-Ameri, Mamdoh; Bergman, Per; Franco-Cereceda, Anders; Sartipy, Ulrik

    2017-02-01

    The aim was to analyze the association between baseline self-reported health-related quality of life and long-term survival after thoracic operations. In a prospective population-based cohort study, we included patients scheduled for thoracic operations and obtained information about preoperative health-related quality of life using the validated quality-of-life instrument Short Form-36. Patients were categorized according to higher or lower physical and mental component scores, compared with an age- and sex-matched reference population. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. We used Cox regression for estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preoperative physical/mental quality of life and long-term survival while adjusting for differences in baseline characteristics, cancer stage, histopathologic process, and other factors. We included 249 patients between 2006 and 2008. During a median follow-up time of 8.0 years, 119 patients (48%) died. Having a physical component summary score less than reference was significantly associated with mortality (multivariable adjusted HR 2.02, 95% CI: 1.34 to 3.06, p = 0.001). A mental component summary score less than reference was not associated with mortality (adjusted HR 1.32, 95% CI: 0.84 to 3.06, p = 0.233). In patients who underwent thoracic operations, a self-reported physical quality of life lower than reference value was associated with significantly worse survival independent of histopathologic process, cancer stage, extent of operations, and other patient-related factors. The preoperative mental component of quality of life was not associated with long-term survival. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Determining effective forecast horizons for multi-purpose reservoirs with short- and long-term operating objectives

    NASA Astrophysics Data System (ADS)

    Luchner, Jakob; Anghileri, Daniela; Castelletti, Andrea

    2017-04-01

    Real-time control of multi-purpose reservoirs can benefit significantly from hydro-meteorological forecast products. Because of their reliability, the most used forecasts range on time scales from hours to few days and are suitable for short-term operation targets such as flood control. In recent years, hydro-meteorological forecasts have become more accurate and reliable on longer time scales, which are more relevant to long-term reservoir operation targets such as water supply. While the forecast quality of such products has been studied extensively, the forecast value, i.e. the operational effectiveness of using forecasts to support water management, has been only relatively explored. It is comparatively easy to identify the most effective forecasting information needed to design reservoir operation rules for flood control but it is not straightforward to identify which forecast variable and lead time is needed to define effective hedging rules for operational targets with slow dynamics such as water supply. The task is even more complex when multiple targets, with diverse slow and fast dynamics, are considered at the same time. In these cases, the relative importance of different pieces of information, e.g. magnitude and timing of peak flow rate and accumulated inflow on different time lags, may vary depending on the season or the hydrological conditions. In this work, we analyze the relationship between operational forecast value and streamflow forecast horizon for different multi-purpose reservoir trade-offs. We use the Information Selection and Assessment (ISA) framework to identify the most effective forecast variables and horizons for informing multi-objective reservoir operation over short- and long-term temporal scales. The ISA framework is an automatic iterative procedure to discriminate the information with the highest potential to improve multi-objective reservoir operating performance. Forecast variables and horizons are selected using a feature

  6. Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

    PubMed

    Pugliese, Raffaele; Forgione, Antonello; Sansonna, Fabio; Ferrari, Giovanni Carlo; Di Lernia, Stefano; Magistro, Carmelo

    2010-03-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series of hybrid transvaginal cholecystectomy. Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a hybrid technique in 18 women (mean age 54 years), including four women with a body mass index >30 kg/m(2). Dissection was conducted in the first four cases by a round-tip unipolar electrode (UE) introduced through the operative channel of the endoscope coming from the vagina and in the last 14 cases by a ultrasonic scalpel (US) introduced through a 5-mm abdominal port. The short-term outcomes and the long-term results of the two methods were compared. The transvaginal approach entailed no intraoperative complication and no conversion. The overall mean duration of procedures was 75 min (range 40-190). In the first four cases (UE), the operating time was 148 min (range 140-190), whilst in the last 14 (US), it was considerably shorter, 53 min (range 40-60, p < 0.01). We experienced one biliary leak in the UE group, whilst morbidity with US was nil (p < 0.005). The biliary leak healed in 7 days with nasobiliary drainage. No other complications were encountered in either group. The mean follow-up was 12 months (range 1-22), and none of the patients has complained of dyspareunia or other colpotomy-related complications so far. Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.

  7. Long-term associative learning predicts verbal short-term memory performance.

    PubMed

    Jones, Gary; Macken, Bill

    2018-02-01

    Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

  8. Management training in long-term care.

    PubMed

    Evashwick, Connie

    2002-01-01

    The education of health care administrators faces its most dramatic change since the inception of the field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students for evidence-based practice. This paper presents recommendations for incorporating training about chronic and long-term care into health care management curricula. It asserts that all health care management students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care. The majority of people using the health care delivery system today, and increasingly in the future, suffer from chronic conditions. Long-term care services, although less expansive in structure, far outnumber acute care services and health plans. They will grow in the future to meet the portending demand. To maximize job opportunities and to optimize performance in any job, health care administrators need to know about the long-term care delivery system. This paper delineates critical topics pertaining to long-term care, organized according to 11 fundamental management areas in which the field is developing core competencies. The contents were derived from a year-long process of asking stakeholders in the various facets of long-term care what topics they thought were essential for administrators to know. The topics delineated in this document represent the consensus about essential knowledge that all health care administrators should have about long-term care, whether specializing in long-term care or following a more general management career. The education of health care administrators faces its most dramatic change since the inception ofthe field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students to perform according to evidence-based practice. It is thus timely to consider content, as

  9. 46 CFR 356.43 - Long-term or exclusive sales contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the vessel or the vessel's operation, management and harvesting activities. (b) Provisions of a long... control over the operation, management or harvesting activities of the vessel, vessel owner, or bareboat... DOCUMENTATION Charters, Management Agreements and Exclusive or Long-Term Contracts § 356.43 Long-term or...

  10. Long-term data archiving

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

    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 recreatemore » 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

  11. Long-term outcomes of epilepsy surgery in Sweden

    PubMed Central

    Edelvik, Anna; Rydenhag, Bertil; Olsson, Ingrid; Flink, Roland; Kumlien, Eva; Källén, Kristina

    2013-01-01

    Objective: To investigate prospective, population-based long-term outcomes concerning seizures and antiepileptic drug (AED) treatment after resective epilepsy surgery in Sweden. Methods: Ten- and 5-year follow-ups were performed in 2005 to 2007 for 278/327 patients after resective epilepsy surgery from 1995 to 1997 and 2000 to 2002, respectively. All patients had been prospectively followed in the Swedish National Epilepsy Surgery Register. Ninety-three patients, who were presurgically evaluated but not operated, served as controls. Results: In the long term (mean 7.6 years), 62% of operated adults and 50% of operated children were seizure-free, compared to 14% of nonoperated adults (p < 0.001) and 38% of nonoperated children (not significant). Forty-one percent of operated adults and 44% of operated children had sustained seizure freedom since surgery, compared to none of the controls (p < 0.0005). Multivariate analysis identified ≥30 seizures/month at baseline and long epilepsy duration as negative predictors and positive MRI to be a positive predictor of long-term seizure-free outcome. Ten years after surgery, 86% of seizure-free children and 43% of seizure-free adults had stopped AEDs in the surgery groups compared to none of the controls (p < 0.0005). Conclusions: This population-based, prospective study shows good long-term seizure outcomes after resective epilepsy surgery. The majority of the patients who are seizure-free after 5 and 10 years have sustained seizure freedom since surgery. Many patients who gain seizure freedom can successfully discontinue AEDs, more often children than adults. Classification of evidence: This study provides Class III evidence that more patients are seizure-free and have stopped AED treatment in the long term after resective epilepsy surgery than nonoperated epilepsy patients. PMID:23966252

  12. Evaluation of a long-term operation of a submerged nanofiltration membrane bioreactor (NF MBR) for advanced wastewater treatment.

    PubMed

    Choi, J H; Fukushi, K; Ng, H Y; Yamamoto, K

    2006-01-01

    Nanofiltration (NF) is considered as one of the most promising separation technologies to obtain a very good-quality permeate in water and wastewater treatment. A submerged NF membrane bioreactor (NF MBR) using polyamide membranes was tested for a long-term operation and the performance of the NF MBR was compared with that of a microfiltration MBR (MF MBR). Total organic carbon (TOC) concentration in the permeate of the NF MBR ranged from 0.5 to 2.0 mg/L, whereas that of the MF MBR showed an average of 5 mg/L. This could be explained by the tightness of the NF membrane. Although the concentration of organic matter in the supernatant of the NF MBR was higher than that in the permeate due to high rejection by the NF membrane, the NF MBR showed excellent treatment efficiency and satisfactory operational stability for a long-term operation.

  13. Measurement of intraoperative parathyroid hormone predicts long-term operative success.

    PubMed

    Westerdahl, Johan; Lindblom, Pia; Bergenfelz, Anders

    2002-02-01

    A decrease in the intraoperative parathyroid hormone (PTH) level predicts long-term operative success. A case series of consecutive patients undergoing parathyroidectomy with intraoperative PTH measurement. A university hospital. One hundred two patients with sporadic primary hyperparathyroidism underwent parathyroidectomy according to the principles of unilateral exploration with intraoperative PTH measurement. Longitudinal effects on levels of serum calcium and PTH. In 94 of 98 patients who underwent primary exploration because of a solitary adenoma, intraoperative PTH decreased at least 60% 15 minutes after gland excision. The 4 cases in which PTH fell to less than 60% were classified as false negatives. Patients examined for multiglandular disease (n = 4) were correctly predicted not to have an adenoma. Twenty-two patients (22%) were unavailable for 5-year follow-up. These patients were followed up for 2 months to 48 months (median, 24 months), and none developed recurrent primary hyperparathyroidism. Of the remaining 80 patients (78%), all but 1 patient had normal or slightly decreased serum calcium levels (mean +/- SD, 9.24 +/- 0.4 mg/dL [2.31 +/- 0.10 mmol/L]) at 5-year follow-up. One patient with hypercalcemia (10.6 mg/dL [2.65 mmol/L]) was interpreted to have developed renal failure with secondary hyperparathyroidism. Thirty-four patients had elevated serum PTH levels at least once during the postoperative study period, with normal or slightly decreased calcium concentrations. The prediction of late postoperative normocalcemia by means of intraoperative PTH measurement had an overall accuracy of 95%. The measurement of intraoperative PTH during surgery for primary hyperparathyroidism accurately differentiates between single- and multiple-gland disease and ensures good long-term results.

  14. Differential role of calpain-dependent protein cleavage in intermediate and long-term operant memory in Aplysia.

    PubMed

    Lyons, Lisa C; Gardner, Jacob S; Lentsch, Cassidy T; Gandour, Catherine E; Krishnan, Harini C; Noakes, Eric J

    2017-01-01

    In addition to protein synthesis, protein degradation or protein cleavage may be necessary for intermediate (ITM) and long-term memory (LTM) to remove molecular constraints, facilitate persistent kinase activity and modulate synaptic plasticity. Calpains, a family of conserved calcium dependent cysteine proteases, modulate synaptic function through protein cleavage. We used the marine mollusk Aplysia californica to investigate the in vivo role of calpains during intermediate and long-term operant memory formation using the learning that food is inedible (LFI) paradigm. A single LFI training session, in which the animal associates a specific netted seaweed with the failure to swallow, generates short (30min), intermediate (4-6h) and long-term (24h) memory. Using the calpain inhibitors calpeptin and MDL-28170, we found that ITM requires calpain activity for induction and consolidation similar to the previously reported requirements for persistent protein kinase C activity in intermediate-term LFI memory. The induction of LTM also required calpain activity. In contrast to ITM, calpain activity was not necessary for the molecular consolidation of LTM. Surprisingly, six hours after LFI training we found that calpain activity was necessary for LTM, although this is a time at which neither persistent PKC activity nor protein synthesis is required for the maintenance of long-term LFI memory. These results demonstrate that calpains function in multiple roles in vivo during associative memory formation. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Long-Term Characterization of 6H-SiC Transistor Integrated Circuit Technology Operating at 500 C

    NASA Technical Reports Server (NTRS)

    Neudeck, Philip G.; Spry, David J.; Chen, Liang-Yu; Chang, Carl W.; Beheim, Glenn M.; Okojie, Robert S.; Evans, Laura J.; Meredith Roger D.; Ferrier, Terry L.; Krasowski, Michael J.; hide

    2008-01-01

    NASA has been developing very high temperature semiconductor integrated circuits for use in the hot sections of aircraft engines and for Venus exploration. This paper reports on long-term 500 C electrical operation of prototype 6H-SiC integrated circuits based on epitaxial 6H-SiC junction field effect transistors (JFETs). As of this writing, some devices have surpassed 4000 hours of continuous 500 C electrical operation in oxidizing air atmosphere with minimal change in relevant electrical parameters.

  16. Tricuspid valve replacement with mechanical prostheses: Short and long-term outcomes.

    PubMed

    Rossello, Xavier; Muñoz-Guijosa, Christian; Mena, Elisabet; Camprecios, Marta; Mendez, Ana B; Borras, Xavier; Padro, Josep M

    2017-09-01

    Tricuspid valve replacement has been associated with high mortality and poor long-term outcomes. We report the preoperative risk factors associated with short and long-term outcomes following tricuspid valve replacement with mechanical prostheses. In 62 patients who underwent mechanical tricuspid valve replacement, clinical, laboratory, and echocardiographic findings were analyzed using both univariate and multivariate analyses to describe operative and long-term mortality. In our population (mean age 59 ± 9.7 years, 82.3% female), most common causes of tricuspid valve disease were rheumatic fever (69.4%) and functional regurgitation (19.4%). Operative and long-term mortality were 17.7 and 33.9%, respectively. Age, diabetes mellitus, and coronary artery disease were independently associated with increased long-term mortality. New York Heart Association (NYHA) class and right heart failure symptoms significantly improved during follow-up. In this series of mechanical tricuspid valve replacements in patients with predominately rheumatic heart disease, operative and long-term mortality were increased; however, survivors had significant improvement in their NYHA class and freedom from right heart failure symptoms. Three preoperative factors (age, diabetes mellitus, and coronary artery disease) were independently associated with long-term mortality. © 2017 Wiley Periodicals, Inc.

  17. Acute Sleep Deprivation Blocks Short- and Long-Term Operant Memory in Aplysia.

    PubMed

    Krishnan, Harini C; Gandour, Catherine E; Ramos, Joshua L; Wrinkle, Mariah C; Sanchez-Pacheco, Joseph J; Lyons, Lisa C

    2016-12-01

    Insufficient sleep in individuals appears increasingly common due to the demands of modern work schedules and technology use. Consequently, there is a growing need to understand the interactions between sleep deprivation and memory. The current study determined the effects of acute sleep deprivation on short and long-term associative memory using the marine mollusk Aplysia californica , a relatively simple model system well known for studies of learning and memory. Aplysia were sleep deprived for 9 hours using context changes and tactile stimulation either prior to or after training for the operant learning paradigm, learning that food is inedible (LFI). The effects of sleep deprivation on short-term (STM) and long-term memory (LTM) were assessed. Acute sleep deprivation prior to LFI training impaired the induction of STM and LTM with persistent effects lasting at least 24 h. Sleep deprivation immediately after training blocked the consolidation of LTM. However, sleep deprivation following the period of molecular consolidation did not affect memory recall. Memory impairments were independent of handling-induced stress, as daytime handled control animals demonstrated no memory deficits. Additional training immediately after sleep deprivation failed to rescue the induction of memory, but additional training alleviated the persistent impairment in memory induction when training occurred 24 h following sleep deprivation. Acute sleep deprivation inhibited the induction and consolidation, but not the recall of memory. These behavioral studies establish Aplysia as an effective model system for studying the interactions between sleep and memory formation. © 2016 Associated Professional Sleep Societies, LLC.

  18. A flash from the past: a case on long term follow-up of a "corridor" operation.

    PubMed

    Ricciardi, Danilo; Sarkozy, Andrea; Wauters, Kristel; Brugada, Pedro

    2013-01-01

    An electrophysiological study in a patient with a previous corridor operation was performed because of syncope. The atrial electrograms showed the persistence of the sinus rhythm in the right atrial corridor despite an organized atrial fibrillation in the left atrium. The first case described of a long term follow-up in a corridor operation, one of the first described surgical approach for the treatment of atrial fibrillation, that gave the beginning to the non-pharmacological approach of this arrhythmia. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. 77 FR 18858 - Remanded Biological Opinions on the Coordinated Long-Term Operation of the Central Valley Project...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Long-Term Operation of the Central Valley Project and State Water Project: Notice of Intent To Prepare... Central Valley Project, in a coordinated manner with the State Water Project, that are likely to avoid... Department of Water Resources, California Department of Fish and Game, State and Federal Contractors Water...

  20. A Raman Lidar as Operational Tool for Long-Term Water Vapor, Temperature and Aerosol Profiling in the Swiss Meteorological Office

    NASA Astrophysics Data System (ADS)

    Simeonov, Dr; Dinoev, Dr; Serikov, Dr; Calpini, Dr; Bobrovnikov, Dr; Arshinov, Dr; Ristori, Dr; van den Bergh, Dr; Parlange, Dr

    2010-09-01

    To satisfy the rising demands on the quality and frequency of atmospheric water vapor, temperature and aerosol measurements used for numerical weather prediction models, climate change observations and special events (volcanoes, dust and smoke transport) monitoring, MeteoSwiss decided to implement a lidar at his main aerological station in Payerne. The instrument is narrow field of view, narrowband UV Raman lidar designed for continuous day and night operational profiling of tropospheric water vapor, aerosol and temperature The lidar was developed and built by the Swiss Federal Institute of Technology- Lausanne (EPFL) within a joint project with MeteoSwiss. To satisfy the requirements for operational exploitation in a meteorological network the lidar had to satisfy a number of criteria, the most important of which are: accuracy and precision, traceability of the measurement, long-term data consistency, long-term system stability, automated operation, requiring minimal maintenance by a technician, and eye safety. All this requirements were taken into account during the design phase of the lidar. After a ten months test phase of the lidar at Payerne it has been in regular operation since August 2008. Selected data illustrating interesting atmospheric phenomena captured by the lidar as well as long-term intercomparison with collocated microwave radiometer, GPS, radiosonding and an airborne DIAL will be presented and discussed. The talk will address also the technical availability, alignment and calibration stabilities of the instrument.

  1. Biofiltration of volatile pollutants: Engineering mechanisms for improved design, long-term operation, prediction and implementation. 1998 annual progress report

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

    Davison, B.H.; Klasson, K.T.; Barton, J.W.

    1998-06-01

    'Biofiltration systems can be used for treatment of volatile organic compounds (VOCs); however, the systems are poorly understood and are currently operated as black boxes. Common operational problems associated with biofilters include fouling, deactivation, and overgrowth, all of which make them ineffective for continuous, long-term use. The objective of this investigation is to develop generic methods for long-term stable operation, in particular by using selective limitation of supplemental nutrients while maintaining high activity. As part of this effort, the author will provide deeper fundamental understanding of the important biological and transport mechanisms in biodestruction of sparingly soluble VOCs and extendmore » this approach and mathematical models to additional systems of high priority EM relevance--direct degradation and cometabolic degradation of priority pollutants such as BTEX and chlorinated organics. This report summarizes work after 2 years of a 3-year project. Major results are enumerated and discussed'« less

  2. Optimizing the Long-Term Operating Plan of Railway Marshalling Station for Capacity Utilization Analysis

    PubMed Central

    Zhou, Wenliang; Yang, Xia; Deng, Lianbo

    2014-01-01

    Not only is the operating plan the basis of organizing marshalling station's operation, but it is also used to analyze in detail the capacity utilization of each facility in marshalling station. In this paper, a long-term operating plan is optimized mainly for capacity utilization analysis. Firstly, a model is developed to minimize railcars' average staying time with the constraints of minimum time intervals, marshalling track capacity, and so forth. Secondly, an algorithm is designed to solve this model based on genetic algorithm (GA) and simulation method. It divides the plan of whole planning horizon into many subplans, and optimizes them with GA one by one in order to obtain a satisfactory plan with less computing time. Finally, some numeric examples are constructed to analyze (1) the convergence of the algorithm, (2) the effect of some algorithm parameters, and (3) the influence of arrival train flow on the algorithm. PMID:25525614

  3. Long Term, Operational Monitoring Of Enhanced Oil Recovery In Harsh Environments With INSAR

    NASA Astrophysics Data System (ADS)

    Sato, S.; Henschel, M. D.

    2012-01-01

    Since 2004, MDA GSI has provided ground deformation measurements for an oil field in northern Alberta, Canada using InSAR technology. During this period, the monitoring has reliably shown the slow rise of the oil field due to enhanced oil recovery operations. The InSAR monitoring solution is essentially based on the observation of point and point-like targets in the field. Ground conditions in the area are almost continuously changing (in their reflectivity characteristics) making it difficult to ob- serve coherent patterns from the ground. The extended duration of the oil operations has allowed us to continue InSAR monitoring and transition from RADARSAT-1 to RADARSAT-2. With RADARSAT-2 and the enhancement of the satellite resolution capability has provided more targets of opportunity as identified by a differential coherence method. This poster provides an overview of the long term monitoring of the oil field in northern Alberta, Canada.

  4. LONG TERM OPERATION ISSUES FOR ELECTRICAL CABLE SYSTEMS IN NUCLEAR POWER PLANTS

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

    Fifield, Dr Leonard S; Duckworth, Robert C; Glass III, Dr. Samuel W.

    conditions, but extension of behavior to long term degradation under more mild conditions, such as those experienced by most installed cables in nuclear power plants, is complicated by the fact that different degradation mechanisms may be involved in extreme and mild scenarios. The discrepancy in predicted results from short term, more extreme exposure and actual results from longer term, more mild exposures can be counter intuitive. For instance, due to the attenuation of oxidation penetration in material samples rapidly aged through exposure to high temperatures, the bulk of the samples may be artificially protected from thermal aging. In another example, simultaneous exposure of cable insulation material to heat and radiation may actually lead to less damage at higher temperatures than may be observed at lower temperatures. The Light Water Reactor Sustainability program of the United States (US) Department of Energy Office (DOE) of Nuclear Energy is funding research to increase the predictive understanding of electrical cable material aging and degradation in existing nuclear power plants in support of continued safe operation of plants beyond their initial license periods. This research includes the evaluation and development of methods to assess installed cable condition.« less

  5. Biofiltration of Volatile Pollutants: Engineering Mechanisms for Improved Design, Long-term Operation, Prediction and Implementation

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

    Davison, Brian H.

    1999-06-01

    Biofiltration systems can be used for treatment of volatile organic compounds (VOCs); however, the systems are poorly understood and are currently operated as ''black boxes''. Common operational problems associated with biofilters include fouling, deactivation, and overgrowth, all of which make them ineffective for continuous, long-term use. The objective of this investigation is to develop generic methods for longterm stable operation, in particular by using selective limitation of supplemental nutrients while maintaining high activity. As part of this effort, we will provide deeper fundamental understanding of the important biological and transport mechanisms in biodestruction of sparingly soluble VOCs and extend thismore » approach and mathematical models to additional systems of high priority EM relevance--direct degradation and cometabolic degradation of priority pollutants such as BTEX and chlorinated organics.« less

  6. OECD/NEA study on the economics of the long-term operation of nuclear power plants

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

    Lokhov, A.; Cameron, R.

    2012-07-01

    The OECD Nuclear Energy Agency (NEA) established the Ad hoc expert group on the Economics of Long-term Operation (LTO) of Nuclear Power Plants. The primary aim of this group is to collect and analyse technical and economic data on the upgrade and lifetime extension experience in OECD countries, and to assess the likely applications for future extensions. This paper describes the key elements of the methodology of economic assessment of LTO and initial findings for selected NEA member countries. (authors)

  7. Thermophilic treatment of acidified and partially acidified wastewater using an anaerobic submerged MBR: Factors affecting long-term operational flux.

    PubMed

    Jeison, D; van Lier, J B

    2007-09-01

    The long-term operation of two thermophilic anaerobic submerged membrane bioreactors (AnSMBRs) was studied using acidified and partially acidified synthetic wastewaters. In both reactors, cake formation was identified as the key factor governing critical flux. Even though cake formation was observed to be mostly reversible, particle deposition proceeds fast once the critical flux is exceeded. Very little irreversible fouling was observed during long-term operation, irrespective of the substrate. Critical flux values at the end of the reactors operation were 7 and 3L/m(2)h for the AnSMBRs fed with acidified and partially acidified wastewaters, respectively, at a gas superficial velocity of 70m/h. Small particle size was identified as the responsible parameter for the low observed critical flux values. The degree of wastewater acidification significantly affected the physical properties of the sludge, determining the attainable flux. Based on the fluxes observed in this research, the membrane costs would be in the range of 0.5euro/m(3) of treated wastewater. Gas sparging was ineffective in increasing the critical flux values. However, preliminary tests showed that cross-flow operation may be a feasible alternative to reduce particle deposition.

  8. Long-term outcome in elderly patients after operation for traumatic intracranial hemorrhage.

    PubMed

    Cipolle, Mark D; Geffe, Kevin; Getchell, John; Reed, James F; Fulda, Gerard; Sugarman, Michael; Tinkoff, Glen H

    2014-08-01

    This study examined outcomes in elderly TBI patients who underwent a cranial operation. We identified TBI patients > or = 65 who underwent a cranial operation from January 1, 2004 to December 31, 2008. Data collected included: age, admission GCS, mechanism of injury, ISS, Head AIS, type of operation, hemorrhage acuity, time to operation, pre-hospital warfarin or clopidogrel, and in-hospital death. Survivors were contacted by phone to determine an Extended Glasgow Outcome Score (GOSE). A favorable outcome was defined as having a GOSE of > or = 5 at follow-up, an unfavorable outcome was defined as: in-hospital death, death within one year of injury, and a GOSE < 5 at follow-up. Chi-square and student's t-test were used. One hundred sixty-four elderly TBI patients underwent cranial surgery. Mean age was 79.2 +/- 7.6 years. Most patients: had a ground level fall (86.0%), suffered a subdural hematoma (95.1%), and underwent craniotomy (89.0%). Twenty-eight percent died in the hospital and another 20.1% died within one year. Fifty-six patients were eligible for a GOSE interview of these: 17 were lost to follow-up, seven refused the GOSE interview, 22 had a GOSE > or = 5, and ten had a GOSE < 5. Mean follow-up was 42.6 +/- 14.9 months. Of all the factors analyzed, only older age was associated with an unfavorable outcome. While age was associated with outcome, we were unable to demonstrate any other early factors that were associated with long-term functional outcome in elderly patients that underwent a cranial operation for TBI.

  9. Long-Term Hearing Results After Ossiculoplasty.

    PubMed

    Cox, Matthew D; Trinidade, Aaron; Russell, James Shep; Dornhoffer, John L

    2017-04-01

    To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. Case series with retrospective chart review. Tertiary care otology practice. Adult and pediatric patients (3-88 years of age). Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9 dB vs. 19.8 dB, respectively; p = 0.544), long-term hearing results (average final PTA-ABG was 19.3 dB vs. 19.4 dB, respectively; p = 0.922), or rate of ABG closure to less than 20 dB (63.1% vs. 58.0%, p = 0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρ = 0.983; p < 0.001; 2-tailed), as well as average long-term PTA-ABG (ρ = 0.950, p < 0.001; 2-tailed). The OOPS index makes it possible to accurately prognosticate hearing outcomes in adult and pediatric patients undergoing ossiculoplasty in both the short term and the long term.

  10. Long-term stability of nanostructured thin film electrodes at operating potentials

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

    Ahluwalia, Rajesh K.; Peng, J. -K.; Wang, X.

    Long-term stability of nanostructured thin film (NSTF) catalysts at operating potentials has been investigated. Compared to high surface area Pt/C catalysts, NSTF electrodes show 20–50x smaller F – emission rates (FER) because of their high specific activity for oxygen reduction reaction (ORR), but are susceptible to poisoning by the products of membrane degradation because of their low electrochemically active surface area (ECSA). The observed voltage degradation rates at potentials corresponding to 1–1.5 A/cm 2 current density are much higher than the allowable 13–14 μV/h. Although F – is not itself responsible for performance decay, cumulative fluoride release (CFR) is amore » good marker for catalyst surface contamination. The observed performance decay is not only due to loss of active Pt sites but also adsorbed impurities impeding ORR kinetics. There is a strong correlation between measured CFR and observed decrease in specific ORR activity and limiting current density and increase in mass transfer overpotentials. Furthermore, the correlations indicate that the target of <10% lifetime performance degradation can be achieved by restricting CFR in NSTF electrodes to 0.7 μg/cm 2, as may be possible with more stable membranes, higher surface area NSTF catalysts, and cell operation at lower temperatures and higher relative humidities.« less

  11. Long-term stability of nanostructured thin film electrodes at operating potentials

    DOE PAGES

    Ahluwalia, Rajesh K.; Peng, J. -K.; Wang, X.; ...

    2017-02-09

    Long-term stability of nanostructured thin film (NSTF) catalysts at operating potentials has been investigated. Compared to high surface area Pt/C catalysts, NSTF electrodes show 20–50x smaller F – emission rates (FER) because of their high specific activity for oxygen reduction reaction (ORR), but are susceptible to poisoning by the products of membrane degradation because of their low electrochemically active surface area (ECSA). The observed voltage degradation rates at potentials corresponding to 1–1.5 A/cm 2 current density are much higher than the allowable 13–14 μV/h. Although F – is not itself responsible for performance decay, cumulative fluoride release (CFR) is amore » good marker for catalyst surface contamination. The observed performance decay is not only due to loss of active Pt sites but also adsorbed impurities impeding ORR kinetics. There is a strong correlation between measured CFR and observed decrease in specific ORR activity and limiting current density and increase in mass transfer overpotentials. Furthermore, the correlations indicate that the target of <10% lifetime performance degradation can be achieved by restricting CFR in NSTF electrodes to 0.7 μg/cm 2, as may be possible with more stable membranes, higher surface area NSTF catalysts, and cell operation at lower temperatures and higher relative humidities.« less

  12. Transient post-operative atrial fibrillation predicts short and long term adverse events following CABG

    PubMed Central

    Becker, Matthew; Galla, John; Blackstone, Eugene; Kapadia, Samir R.

    2014-01-01

    Objective To assess the relationship between the development of transient post-operative atrial fibrillation (TPOAF) following coronary artery bypass graft (CABG) surgery and risk of long-term mortality. Background Atrial fibrillation (AF) following CABG is common and associated with increased morbidity and mortality in the perioperative period. However the impact of TPOAF and its management on long-term morbidity and mortality in patients undergoing first time, isolated CABG surgery remains unclear. Methods The Cleveland Clinic Cardiovascular Information Registry was used to identify 5,205 consecutive patients who underwent CABG between January 1993 and December 2005. Patients with TPOAF (n=1,490) were compared to those without post-operative AF (n=3,645) for the endpoints of death, myocardial infarction (MI), or stroke at 1 year. Results Overall rates of 1-year mortality, MI and stroke were 3.7%, 0.8%, and 2.6%, respectively. Patients with TPOAF had an increased risk of death at 1 year as compared to patients without POAF (6.4% vs. 2.7%; P<0.001), but there was not an increased risk of stroke or MI. Multivariate analysis identified TPOAF as an independent predictor of death at 1 year (HR 1.89, 95% CI, 1.42-2.53; P<0.001). After propensity matching, patients who developed TPOAF experienced a significantly increased risk of death compared with those without TPOAF (HR 1.96, 95% CI, 1.34-2.86; P<0.001). Conclusions In patients undergoing first time, isolated CABG, the presence of TPOAF identifies a subgroup of patients at increased risk for all-cause mortality. Future prospective studies to determine potential beneficial interventions in this large population are warranted. PMID:25414823

  13. Startup and long term operation of enhanced biological phosphorus removal in continuous-flow reactor with granules.

    PubMed

    Li, Dong; Lv, Yufeng; Zeng, Huiping; Zhang, Jie

    2016-07-01

    The startup and long term operation of enhanced biological phosphorus removal (EBPR) in a continuous-flow reactor (CFR) with granules were investigated in this study. Through reducing the settling time from 9min to 3min gradually, the startup of EBPR in a CFR with granules was successfully realized in 16days. Under continuous-flow operation, the granules with good phosphorus and COD removal performance were stably operated for more than 6months. And the granules were characterized with particle size of around 960μm, loose structure and good settling ability. During the startup phase, polysaccharides (PS) was secreted excessively by microorganisms to resist the influence from the variation of operational mode. Results of relative quantitative PCR indicated that granules dominated by polyphosphate-accumulating organisms (PAOs) were easier accumulated in the CFR because more excellent settling ability was needed in the system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. SBUV/2 Long-Term Measurements of Solar Spectral Variability

    NASA Technical Reports Server (NTRS)

    DeLand, Matthew T.; Cebula, Richard P.

    1997-01-01

    The NOAA-11 SBUV/2 spectral solar data have been corrected for long-term instrument changes to produce a 5.5 year data record during solar cycle 22 (December 1988 - October 1994). Residual drifts in the data at long wavelengths are +/- 1% or less. At 200-205 nm, where solar variations drive stratospheric photochemistry, these data indicate long-term solar changes of 5-7% from the maximum of Cycle 22 in April 1991 through the end of the NOAA-11 data record. Comparisons of NOAA-11 data with UARS SUSIM and SOLSTICE for the period October 1991 - October 1994, when all 3 instruments were operating simultaneously, show that the observed long-term variations in 200-205 nm irradiance agree to within 2%. This result is consistent with predictions from the Mg-2 proxy index. The SBUV/2 instruments represent a valuable resource for long-term solar UV activity studies because of their overlapping data records. In addition to the NOAA-11 data presented here, the NOAA-9 SBUV/2 instrument began taking data in March 1985 and is still operating, providing a complete record of Cycle 22 behavior from a single instrument. Three additional SBUV/2 instruments are scheduled to be launched between 1997 and 2003, which should permit full coverage of solar cycle 23.

  15. Physical nature of surface structure degradation in long term operated rails

    NASA Astrophysics Data System (ADS)

    Gromov, V. E.; Yuriev, A. A.; Peregudov, O. A.; Konovalov, S. V.; Ivanov, Yu. F.; Glezer, A. M.; Semin, A. P.

    2017-12-01

    Here we present research data on the structural-phase state and surface properties of rails after long-term operation with a transported tonnage of gross weight 500 and 1000 mln tons. Using optical, scanning, and transmission electron diffraction microscopy, and measurements of microhardness and tribological parameters, it is shown that the wear rate of the material after transport of 500 and 1000 mln tons increases 3 and 3.4 times, respectively, and the friction coefficient decreases 1.4 and 1.1 times. After transport of 500 mln tons, complete failure of cementite plates occurs resulting in round cementite particles of size 10-50 nm. After transport of 1000 mln tons, dynamic recrystallization develops in the material. Two competitive mechanisms are suggested for such evolution: (1) decomposition of cementite particles with their transfer to the volume of ferrite grains or plates in pearlite and (2) decomposition and dissolution of cementite particles, transition of carbon atoms to dislocations (to Cottrell atmospheres), transfer of carbon atoms by dislocations to the volume of ferrite grains or plates, and formation of nano-sized cementite particles.

  16. Simulation of long-term influence from technical systems on permafrost with various short-scale and hourly operation modes in Arctic region

    NASA Astrophysics Data System (ADS)

    Vaganova, N. A.

    2017-12-01

    Technogenic and climatic influences have a significant impact on the degradation of permafrost. Long-term forecasts of such changes during long-time periods have to be taken into account in the oil and gas and construction industries in view to development the Arctic and Subarctic regions. There are considered constantly operating technical systems (for example, oil and gas wells) that affect changes in permafrost, as well as the technical systems that have a short-term impact on permafrost (for example, flare systems for emergency flaring of associated gas). The second type of technical systems is rather complex for simulation, since it is required to reserve both short and long-scales in computations with variable time steps describing the complex technological processes. The main attention is paid to the simulation of long-term influence on the permafrost from the second type of the technical systems.

  17. Durability and regeneration of activated carbon air-cathodes in long-term operated microbial fuel cells

    NASA Astrophysics Data System (ADS)

    Zhang, Enren; Wang, Feng; Yu, Qingling; Scott, Keith; Wang, Xu; Diao, Guowang

    2017-08-01

    The performance of activated carbon catalyst in air-cathodes in microbial fuel cells was investigated over one year. A maximum power of 1722 mW m-2 was produced within the initial one-month microbial fuel cell operation. The air-cathodes produced a maximum power >1200 mW m-2 within six months, but gradually became a limiting factor for the power output in prolonged microbial fuel cell operation. The maximum power decreased by 55% when microbial fuel cells were operated over one year due to deterioration in activated carbon air-cathodes. While salt/biofilm removal from cathodes experiencing one-year operation increased a limiting performance enhancement in cathodes, a washing-drying-pressing procedure could restore the cathode performance to its original levels, although the performance restoration was temporary. Durable cathodes could be regenerated by re-pressing activated carbon catalyst, recovered from one year deteriorated air-cathodes, with new gas diffusion layer, resulting in ∼1800 mW m-2 of maximum power production. The present study indicated that activated carbon was an effective catalyst in microbial fuel cell cathodes, and could be recovered for reuse in long-term operated microbial fuel cells by simple methods.

  18. The value of long-term silvicultural research studies

    Treesearch

    Wayne D. Shepperd; Carleton B. Edminster

    1997-01-01

    Reductions in research operating budgets and recent trends in research management philosophy have in many instances forced Forest Service scientists to realign their research programs to compete for short-term grants and other sources of funding. This approach may prove detrimental in silviculture, a discipline where long-term research is critical for: (1) research in...

  19. Automated Long - Term Scheduling for the SOFIA Airborne Observatory

    NASA Technical Reports Server (NTRS)

    Civeit, Thomas

    2013-01-01

    The NASA Stratospheric Observatory for Infrared Astronomy (SOFIA) is a joint US/German project to develop and operate a gyro-stabilized 2.5-meter telescope in a Boeing 747SP. SOFIA's first science observations were made in December 2010. During 2011, SOFIA accomplished 30 flights in the "Early Science" program as well as a deployment to Germany. The new observing period, known as Cycle 1, is scheduled to begin in 2012. It includes 46 science flights grouped in four multi-week observing campaigns spread through a 13-month span. Automation of the flight scheduling process offers a major challenge to the SOFIA mission operations. First because it is needed to mitigate its relatively high cost per unit observing time compared to space-borne missions. Second because automated scheduling techniques available for ground-based and space-based telescopes are inappropriate for an airborne observatory. Although serious attempts have been made in the past to solve part of the problem, until recently mission operations staff was still manually scheduling flights. We present in this paper a new automated solution for generating SOFIA long-term schedules that will be used in operations from the Cycle 1 observing period. We describe the constraints that should be satisfied to solve the SOFIA scheduling problem in the context of real operations. We establish key formulas required to efficiently calculate the aircraft course over ground when evaluating flight schedules. We describe the foundations of the SOFIA long-term scheduler, the constraint representation, and the random search based algorithm that generates observation and instrument schedules. Finally, we report on how the new long-term scheduler has been used in operations to date.

  20. Overseas Contingency Operations: OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the Costs Likely to Endure Long Term

    DTIC Science & Technology

    2017-01-01

    OVERSEAS CONTINGENCY OPERATIONS OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the... CONTINGENCY OPERATIONS OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the Costs Likely to Endure Long Term Why GAO...billion in funding for OCO. While DOD’s OCO budget request has included amounts for contingency operations primarily in Iraq and Afghanistan, more

  1. Evaluation of effects of an operational multidisciplinary team on antibiotic use in the medium to long term at a French university hospital.

    PubMed

    Demoré, Béatrice; Humbert, Pauline; Boschetti, Emmanuelle; Bevilacqua, Sibylle; Clerc-Urmès, Isabelle; May, Thierry; Pulcini, Céline; Thilly, Nathalie

    2017-10-01

    Background Antibiotic-resistant bacteria are a major public health problem throughout the world. In 2006, in accordance with the national guidelines for antibiotic use, the CHRU of Nancy created an operational multidisciplinary antibiotic team at one of its sites. In 2011, a cluster-controlled trial showed that the operational multidisciplinary antibiotic team (the intervention) had a favourable short-term effect on antibiotic use and costs. Objective Our objective was to determine whether these effects continued over the medium to long term (that is, 2-7 years after creation of the operational multidisciplinary antibiotic team, 2009-2014). Setting The 1800-bed University Hospital of Nancy (France). Method The effect in the medium to long term is measured according to the same criteria and assessed by the same methods as the first study. A cluster controlled trial was performed on the period 2009-2014. The intervention group comprised 11 medical and surgical wards in settings where the operational multidisciplinary antibiotic team was implemented and the control group comprised 6 wards without this operational team. Main outcome measure Consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1000 patient-days) and costs savings (in €). Results The reduction in antibiotic use and costs continued, but at a lower rate than in the short term (11% between 2009 and 2014 compared with 33% between 2007 and 2009) at the site of the intervention. The principal decreases concerned fluoroquinolones and glycopeptides. At the site without an operational multidisciplinary antibiotic team (the control group), total antibiotic use remained stable. Between 2009 and 2014, costs fell 10.5% in the intervention group and 5.7% in the control group. Conclusion This study shows that it is possible to maintain the effectiveness over time of such an intervention and demonstrates its role in defining a hospital's antibiotic policy.

  2. Automated Long-Term Monitoring of Parallel Microfluidic Operations Applying a Machine Vision-Assisted Positioning Method

    PubMed Central

    Yip, Hon Ming; Li, John C. S.; Cui, Xin; Gao, Qiannan; Leung, Chi Chiu

    2014-01-01

    As microfluidics has been applied extensively in many cell and biochemical applications, monitoring the related processes is an important requirement. In this work, we design and fabricate a high-throughput microfluidic device which contains 32 microchambers to perform automated parallel microfluidic operations and monitoring on an automated stage of a microscope. Images are captured at multiple spots on the device during the operations for monitoring samples in microchambers in parallel; yet the device positions may vary at different time points throughout operations as the device moves back and forth on a motorized microscopic stage. Here, we report an image-based positioning strategy to realign the chamber position before every recording of microscopic image. We fabricate alignment marks at defined locations next to the chambers in the microfluidic device as reference positions. We also develop image processing algorithms to recognize the chamber positions in real-time, followed by realigning the chambers to their preset positions in the captured images. We perform experiments to validate and characterize the device functionality and the automated realignment operation. Together, this microfluidic realignment strategy can be a platform technology to achieve precise positioning of multiple chambers for general microfluidic applications requiring long-term parallel monitoring of cell and biochemical activities. PMID:25133248

  3. Developing Evidence for Football (Soccer) Reminiscence Interventions Within Long-term Care: A Co-operative Approach Applied in Scotland and Spain.

    PubMed

    Coll-Planas, Laura; Watchman, Karen; Doménech, Sara; McGillivray, David; O'Donnell, Hugh; Tolson, Debbie

    2017-04-01

    Loneliness is a common experience within long-term care and, to promote well-being and quality of life among people with dementia, it is important to draw upon a repertoire of strategies that provide social stimulation, companionship, and enjoyment. This paper describes and reflects on a program of co-operative social participatory research that sought to introduce football-focused (ie, soccer-based) reminiscence based in 4 community settings within Spain and Scotland. Findings are reported and inform an original conceptual model that supports the introduction of sustainable approaches to the development of football-focused reminiscence with and for people with dementia. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  4. [Long-term psychiatric hospitalizations].

    PubMed

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  5. Biofiltration of volatile pollutants: Engineering mechanisms for improved design, long-term operation, prediction, and implementation. 1997 annual progress report

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

    Davison, B.H.; Klasson, K.T.; Barton, J.W.

    1997-09-01

    'Biofiltration systems can be used to treat volatile organic compounds (VOCs); however, the systems are poorly understood and are currently operated as black boxes. Common operational problems associated with biofilters include fouling, deactivation, and overgrowth, all of which make biofilters ineffective for continuous, long-term use. The objective of this investigation is to develop generic methods for long-term stable operation, in particular by using selective limitation of supplemental nutrients while maintaining high activity and the ability to regenerate biofilter activity. As part of this effort, the authors will provide a deeper fundamental understanding of the important biological and transport mechanisms inmore » biodestruction of sparingly soluble VOCs and will extend this engineering approach and developed mathematical models to two additional systems of high-priority environmental management (EM) relevance-direct degradation and cometabolic degradation of priority pollutants such as BTEX (benzene, toluene, ethylbenzene, and xylene) and TCE (trichioroethylene), respectively. Preliminary results indicate that the author can control overgrowth of the biofilm while sustaining high degradation rates and develop basic predictive models that elucidate mass transfer and kinetic limitations in this system for alkanes. The alkanes are degraded into CO, and waterwith minimal biomass (due to the methodology proposed). This system will be used to test and model additional supplemental nutrient feeding strategies as well as methods to increase the fundamental driving forces by modification of the system. Models will be extended to non-steady-state, long-term operation. The author will examine the nature of the mixed microbial community in the VOC-degrading biofilm and test for new degradative activities. He will use cosolvents with surfactant properties to enhance hydrocarbon solubility in the biofilm and evaluate their impact on mass transfer and reaction rate

  6. Modeling heat exchange characteristics of long term space operations: Role of skin wettedness and exercise

    NASA Technical Reports Server (NTRS)

    Gonzalez, Richard R.

    1994-01-01

    The problems of heat exchange during rest and exercise during long term space operations are covered in this report. Particular attention is given to the modeling and description of the consequences of requirement to exercise in a zero-g atmosphere during Space Shuttle flights, especially long term ones. In space environments, there exists no free convection therefore only forced convection occurring by movement, such as pedalling on a cycle ergometer, augments required heat dissipation necessary to regulate body temperature. The requirement to exercise at discrete periods of the day is good practice in order to resist the deleterious consequences of zero-gravity problems and improve distribution of body fluids. However, during exercise (ca. 180 to 250W), in zero-g environments, the mass of eccrine sweating rests as sheets on the skin surface and the sweat cannot evaporate readily. The use of exercise suits with fabrics that have hydrophobic or outwicking properties somewhat distributes the mass of sweat to a larger surface from which to evaporate. However, with no free convection, increased skin wettedness throughout the body surface induces increasing thermal discomfort, particularly during continuous exercise. This report presents several alternatives to aid in this problem: use of intermittent exercise, methods to quantify local skin wettedness, and introduction of a new effective temperature that integrates thermal stress and heat exchange avenues in a zero-g atmosphere.

  7. Long-term potentiation and long-term depression: a clinical perspective

    PubMed Central

    Bliss, Timothy V.P.; Cooke, Sam F

    2011-01-01

    Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke. PMID:21779718

  8. An ionization pressure gauge with LaB6 emitter for long-term operation in strong magnetic fields

    NASA Astrophysics Data System (ADS)

    Wenzel, U.; Pedersen, T. S.; Marquardt, M.; Singer, M.

    2018-03-01

    We report here on a potentially significant improvement in the design of neutral pressure gauges of the so-called ASDEX-type which were first used in the Axially Symmetric Divertor EXperiment (ASDEX). Such gauges are considered state-of-the-art and are in wide use in fusion experiments, but they nonetheless suffer from a relatively high failure rate when operated at high magnetic field strengths for long times. This is therefore a significant concern for long-pulse, high-field experiments such as Wendelstein 7-X (W7-X) and ITER. The new design is much more robust. The improvement is to use a LaB6 crystal instead of a tungsten wire as the thermionic emitter of electrons in the gauge. Such a LaB6 prototype gauge was successfully operated for a total of 60 h in B = 3.1 T, confirming the significantly improved robustness of the new design and qualifying it for near-term operation in W7-X. With the LaB6 crystal, an order of magnitude reduction in heating current is achieved, relative to the tungsten filament based gauges, from 15-20 A to 1-2 A. This reduces the Lorenz forces and the heating power by an order of magnitude also and is presumably the reason for the much improved robustness. The new gauge design, test environment setup at the superconducting magnet, and results from test operation are described.

  9. Functional Analysis in Long-Term Operation of High Power UV-LEDs in Continuous Fluoro-Sensing Systems for Hydrocarbon Pollution

    PubMed Central

    Arques-Orobon, Francisco Jose; Nuñez, Neftali; Vazquez, Manuel; Gonzalez-Posadas, Vicente

    2016-01-01

    This work analyzes the long-term functionality of HP (High-power) UV-LEDs (Ultraviolet Light Emitting Diodes) as the exciting light source in non-contact, continuous 24/7 real-time fluoro-sensing pollutant identification in inland water. Fluorescence is an effective alternative in the detection and identification of hydrocarbons. The HP UV-LEDs are more advantageous than classical light sources (xenon and mercury lamps) and helps in the development of a low cost, non-contact, and compact system for continuous real-time fieldwork. This work analyzes the wavelength, output optical power, and the effects of viscosity, temperature of the water pollutants, and the functional consistency for long-term HP UV-LED working operation. To accomplish the latter, an analysis of the influence of two types 365 nm HP UV-LEDs degradation under two continuous real-system working mode conditions was done, by temperature Accelerated Life Tests (ALTs). These tests estimate the mean life under continuous working conditions of 6200 h and for cycled working conditions (30 s ON & 30 s OFF) of 66,000 h, over 7 years of 24/7 operating life of hydrocarbon pollution monitoring. In addition, the durability in the face of the internal and external parameter system variations is evaluated. PMID:26927113

  10. Functional Analysis in Long-Term Operation of High Power UV-LEDs in Continuous Fluoro-Sensing Systems for Hydrocarbon Pollution.

    PubMed

    Arques-Orobon, Francisco Jose; Nuñez, Neftali; Vazquez, Manuel; Gonzalez-Posadas, Vicente

    2016-02-26

    This work analyzes the long-term functionality of HP (High-power) UV-LEDs (Ultraviolet Light Emitting Diodes) as the exciting light source in non-contact, continuous 24/7 real-time fluoro-sensing pollutant identification in inland water. Fluorescence is an effective alternative in the detection and identification of hydrocarbons. The HP UV-LEDs are more advantageous than classical light sources (xenon and mercury lamps) and helps in the development of a low cost, non-contact, and compact system for continuous real-time fieldwork. This work analyzes the wavelength, output optical power, and the effects of viscosity, temperature of the water pollutants, and the functional consistency for long-term HP UV-LED working operation. To accomplish the latter, an analysis of the influence of two types 365 nm HP UV-LEDs degradation under two continuous real-system working mode conditions was done, by temperature Accelerated Life Tests (ALTs). These tests estimate the mean life under continuous working conditions of 6200 h and for cycled working conditions (30 s ON & 30 s OFF) of 66,000 h, over 7 years of 24/7 operating life of hydrocarbon pollution monitoring. In addition, the durability in the face of the internal and external parameter system variations is evaluated.

  11. Operational improvements of long-term predicted ephemerides of the Tracking and Data Relay Satellites (TDRSs)

    NASA Technical Reports Server (NTRS)

    Kostoff, J. L.; Ward, D. T.; Cuevas, O. O.; Beckman, R. M.

    1995-01-01

    Tracking and Data Relay Satellite (TDRS) orbit determination and prediction are supported by the Flight Dynamics Facility (FDF) of the Goddard Space Flight Center (GSFC) Flight Dynamics Division (FDD). TDRS System (TDRSS)-user satellites require predicted TDRS ephemerides that are up to 10 weeks in length. Previously, long-term ephemerides generated by the FDF included predictions from the White Sands Complex (WSC), which plans and executes TDRS maneuvers. TDRSs typically have monthly stationkeeping maneuvers, and predicted postmaneuver state vectors are received from WSC up to a month in advance. This paper presents the results of an analysis performed in the FDF to investigate more accurate and economical long-term ephemerides for the TDRSs. As a result of this analysis, two new methods for generating long-term TDRS ephemeris predictions have been implemented by the FDF. The Center-of-Box (COB) method models a TDRS as fixed at the center of its stationkeeping box. Using this method, long-term ephemeris updates are made semiannually instead of weekly. The impulse method is used to model more maneuvers. The impulse method yields better short-term accuracy than the COB method, especially for larger stationkeeping boxes. The accuracy of the impulse method depends primarily on the accuracy of maneuver date forecasting.

  12. Pediatric Bulbar and Posterior Urethral Injuries: Operative Outcomes and Long-Term Follow-Up.

    PubMed

    Trachta, Jan; Moravek, Jiri; Kriz, Jan; Padr, Radek; Skaba, Richard

    2016-02-01

    stress incontinence. All patients had uroflowmetry maximum flow above 20 mL/s on their last follow-up except for two (12 and 15 mL/s). None have any lower urinary tract dysfunction symptoms in adulthood; one suffers from mild ED and two report moderate ED due to penile shortening. Delayed end-to-end anastomosis for pediatric urethral injury is a safe operational option. However, high rate of short-term complications and reoperations should be expected. Penile shortening is one of the most severe long-term complications. Georg Thieme Verlag KG Stuttgart · New York.

  13. Semantic and phonological contributions to short-term repetition and long-term cued sentence recall.

    PubMed

    Meltzer, Jed A; Rose, Nathan S; Deschamps, Tiffany; Leigh, Rosie C; Panamsky, Lilia; Silberberg, Alexandra; Madani, Noushin; Links, Kira A

    2016-02-01

    The function of verbal short-term memory is supported not only by the phonological loop, but also by semantic resources that may operate on both short and long time scales. Elucidation of the neural underpinnings of these mechanisms requires effective behavioral manipulations that can selectively engage them. We developed a novel cued sentence recall paradigm to assess the effects of two factors on sentence recall accuracy at short-term and long-term stages. Participants initially repeated auditory sentences immediately following a 14-s retention period. After this task was complete, long-term memory for each sentence was probed by a two-word recall cue. The sentences were either concrete (high imageability) or abstract (low imageability), and the initial 14-s retention period was filled with either an undemanding finger-tapping task or a more engaging articulatory suppression task (Exp. 1, counting backward by threes; Exp. 2, repeating a four-syllable nonword). Recall was always better for the concrete sentences. Articulatory suppression reduced accuracy in short-term recall, especially for abstract sentences, but the sentences initially recalled following articulatory suppression were retained better at the subsequent cued-recall test, suggesting that the engagement of semantic mechanisms for short-term retention promoted encoding of the sentence meaning into long-term memory. These results provide a basis for using sentence imageability and subsequent memory performance as probes of semantic engagement in short-term memory for sentences.

  14. Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

    PubMed

    Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

    2011-01-01

    A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

  15. Near-Term Actions to Address Long-Term Climate Risk

    NASA Astrophysics Data System (ADS)

    Lempert, R. J.

    2014-12-01

    Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

  16. The long-term carbon cycle, fossil fuels and atmospheric composition.

    PubMed

    Berner, Robert A

    2003-11-20

    The long-term carbon cycle operates over millions of years and involves the exchange of carbon between rocks and the Earth's surface. There are many complex feedback pathways between carbon burial, nutrient cycling, atmospheric carbon dioxide and oxygen, and climate. New calculations of carbon fluxes during the Phanerozoic eon (the past 550 million years) illustrate how the long-term carbon cycle has affected the burial of organic matter and fossil-fuel formation, as well as the evolution of atmospheric composition.

  17. Related Studies in Long Term Lithium Battery Stability

    NASA Technical Reports Server (NTRS)

    Horning, R. J.; Chua, D. L.

    1984-01-01

    The continuing growth of the use of lithium electrochemical systems in a wide variety of both military and industrial applications is primarily a result of the significant benefits associated with the technology such as high energy density, wide temperature operation and long term stability. The stability or long term storage capability of a battery is a function of several factors, each important to the overall storage life and, therefore, each potentially a problem area if not addressed during the design, development and evaluation phases of the product cycle. Design (e.g., reserve vs active), inherent material thermal stability, material compatibility and self-discharge characteristics are examples of factors key to the storability of a power source.

  18. [Long-term treatment results and quality of life of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice].

    PubMed

    Gagua, A K; Zagaĭnov, V E; Evtikhova, E Iu

    2013-01-01

    Methods of surgical treatment of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice, were comparatively analyzed. 25 patients received pancreatoduodenal resection, 19 patients had the Bern variant of Beger operation. The quality of life was assessed with the use of MOS-SF-36. The duodenum preserving resection of the head of the pancreas showed better long-term results then pancreatoduodenal resection. Those patients, who received biliodigestive anastomosis as the basic operation, showed no good results at all.

  19. Operant conditioning of the soleus H-reflex does not induce long-term changes in the gastrocnemius H-reflexes and does not disturb normal locomotion in humans.

    PubMed

    Makihara, Yukiko; Segal, Richard L; Wolpaw, Jonathan R; Thompson, Aiko K

    2014-09-15

    In normal animals, operant conditioning of the spinal stretch reflex or the H-reflex has lesser effects on synergist muscle reflexes. In rats and people with incomplete spinal cord injury (SCI), soleus H-reflex operant conditioning can improve locomotion. We studied in normal humans the impact of soleus H-reflex down-conditioning on medial (MG) and lateral gastrocnemius (LG) H-reflexes and on locomotion. Subjects completed 6 baseline and 30 conditioning sessions. During conditioning trials, the subject was encouraged to decrease soleus H-reflex size with the aid of visual feedback. Every sixth session, MG and LG H-reflexes were measured. Locomotion was assessed before and after conditioning. In successfully conditioned subjects, the soleus H-reflex decreased 27.2%. This was the sum of within-session (task dependent) adaptation (13.2%) and across-session (long term) change (14%). The MG H-reflex decreased 14.5%, due mainly to task-dependent adaptation (13.4%). The LG H-reflex showed no task-dependent adaptation or long-term change. No consistent changes were detected across subjects in locomotor H-reflexes, EMG activity, joint angles, or step symmetry. Thus, in normal humans, soleus H-reflex down-conditioning does not induce long-term changes in MG/LG H-reflexes and does not change locomotion. In these subjects, task-dependent adaptation of the soleus H-reflex is greater than it is in people with SCI, whereas long-term change is less. This difference from results in people with SCI is consistent with the fact that long-term change is beneficial in people with SCI, since it improves locomotion. In contrast, in normal subjects, long-term change is not beneficial and may necessitate compensatory plasticity to preserve satisfactory locomotion. Copyright © 2014 the American Physiological Society.

  20. Assessment of segregation kinetics in water-moderated reactors pressure vessel steels under long-term operation

    NASA Astrophysics Data System (ADS)

    Kuleshova, E. A.; Gurovich, B. A.; Lavrukhina, Z. V.; Saltykov, M. A.; Fedotova, S. V.; Khodan, A. N.

    2016-08-01

    In reactor pressure vessel (RPV) bcc-lattice steels temper embrittlement is developed under the influence of both operating temperature of ∼300 °C and neutron irradiation. Segregation processes in the grain boundaries (GB) begin to play a special role in the assessment of the safe operation of the RPV in case of its lifetime extension up to 60 years or more. The most reliable information on the RPV material condition can be obtained by investigating the surveillance specimens (SS) that are exposed to operational factors simultaneously with the RPV itself. In this paper the GB composition in the specimens with different thermal exposure time at the RPV operating temperature as well as irradiated by fast neutrons (E ≥ 0.5 MeV) to different fluences (20-71)·1022 m-2 was studied by means of Auger electron spectroscopy (AES) including both impurity and main alloying elements content. The data obtained allowed to trace the trend of the operating temperature and radiation-stimulated diffusion influence on the overall segregants level in GB. The revealed differences in the concentration levels of GB segregants in different steels, are due to the different chemical composition of the steels and also due to different grain boundary segregation levels in initial (unexposed) state. The data were used to estimate the RPV steels working capacity for 60 years. The estimation was carried out using both the well-known Langmuir-McLean model and the one specially developed for RPV steels, which takes into account the structure and phase composition of VVER-1000 RPV steels, as well as the long-term influence of operational factors.

  1. Excellent Long-Term Outcomes of the Arterial Switch Operation in Patients With Intramural Coronary Arteries.

    PubMed

    Fricke, Tyson A; Bulstra, Anne Eva; Naimo, Phillip S; Bullock, Andrew; Robertson, Terry; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E

    2016-02-01

    Intramural coronary arteries may complicate coronary artery transfer during the arterial switch operation. We sought to determine the long-term outcomes of 28 patients with intramural coronary arteries who underwent an arterial switch operation at a single institution. All patients who had intramural coronary arteries and underwent an arterial switch operation were identified from the hospital database and retrospectively reviewed. From 1983 to 2009, 720 patients underwent an arterial switch operation at our institution. Twenty-eight (3.9%, 28 of 720) had intramural coronary arteries. Patients with intramural coronary arteries had transposition of the great arteries (96%, n = 27) or Taussig-Bing anomaly (4%, n = 1). There were no deaths. Follow-up was 100% complete. Mean follow-up was 16.3 years (median, 15.5 years; range, 5.6 to 26.9 years). No patient required reoperation or catheter reintervention on the coronary arteries. Freedom from reoperation was 93% at 10 years. No patient had more than mild aortic regurgitation at last follow-up. Nine (32%, 9 of 28) patients had coronary angiograms at median 16 months (range, 14 months to 17 years) after arterial switch operation. All patients were asymptomatic at the time of angiogram. One patient had mild stenosis of the circumflex coronary artery demonstrated on a routine coronary angiogram 14 months postoperatively. All 28 patients were asymptomatic and in New York Heart Association functional class I at last follow-up. Patients with intramural coronary arteries are not at increased risk of death or coronary reinterventions and have excellent late outcomes after the arterial switch operation. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Painless motor radiculopathy of the cervical spine: clinical and radiological characteristics and long-term outcomes after operative decompression.

    PubMed

    Siller, Sebastian; Kasem, Rami; Witt, Thomas-Nikolaus; Tonn, Joerg-Christian; Zausinger, Stefan

    2018-03-23

    OBJECTIVE Various neurological diseases are known to cause progressive painless paresis of the upper limbs. In this study the authors describe the previously unspecified syndrome of compression-induced painless cervical radiculopathy with predominant motor deficit and muscular atrophy, and highlight the clinical and radiological characteristics and outcomes after surgery for this rare syndrome, along with its neurological differential diagnoses. METHODS Medical records of 788 patients undergoing surgical decompression due to degenerative cervical spine diseases between 2005 and 2014 were assessed. Among those patients, 31 (3.9%, male to female ratio 4.8 to 1, mean age 60 years) presented with painless compressive cervical motor radiculopathy due to neuroforaminal stenosis without signs of myelopathy; long-term evaluation was available in 23 patients with 49 symptomatic foraminal stenoses. Clinical, imaging, and operative findings as well as the long-term course of paresis and quality of life were analyzed. RESULTS Presenting symptoms (mean duration 13.3 months) included a defining progressive flaccid radicular paresis (median grade 3/5) without any history of radiating pain (100%) and a concomitant muscular atrophy (78%); 83% of the patients were smokers and 17% patients had diabetes. Imaging revealed a predominantly anterior nerve root compression at the neuroforaminal entrance in 98% of stenoses. Thirty stenoses (11 patients) were initially decompressed via an anterior surgical approach and 19 stenoses (12 patients) via a posterior surgical approach. Overall reoperation rate due to new or recurrent stenoses was 22%, with time to reoperation shorter in smokers (p = 0.033). Independently of the surgical procedure chosen, long-term follow-up (mean 3.9 years) revealed a stable or improved paresis in 87% of the patients (median grade 4/5) and an excellent general performance and quality of life. CONCLUSIONS Painless cervical motor radiculopathy predominantly occurs

  3. Identifying the limitations of conventional biofiltration of diffuse methane emissions at long-term operation.

    PubMed

    Gómez-Cuervo, S; Hernández, J; Omil, F

    2016-08-01

    There is growing international concern about the increasing levels of greenhouse gases in the atmosphere, particularly CO2 and methane. The emissions of methane derived from human activities are associated with large flows and very low concentrations, such as those emitted from landfills and wastewater treatment plants, among others. The present work was focused on the biological methane degradation at diffuse concentrations (0.2% vv(-1)) in a conventional biofilter using a mixture of compost, perlite and bark chips as carrier. An extensive characterization of the process was carried out at long-term operation (250 days) in a fully monitored pilot plant, achieving stable conditions during the entire period. Operational parameters such as waterings, nitrogen addition and inlet loads and contact time influences were evaluated. Obtained results indicate that empty bed residence times within 4-8 min are crucial to maximize elimination rates. Waterings and the type of nitrogen supplied in the nutrient solution (ammonia or nitrate) have a strong impact on the biofilter performance. The better results compatible with a stable operation were achieved using nitrate, with elimination capacities up to 7.6 ± 1.1 g CH4 m(-3 )h(-1). The operation at low inlet concentrations (IC) implied that removal rates obtained were quite limited (ranging 3-8 g CH4 m(-3 )h(-1)); however, these results could be significantly increased (up to 20.6 g CH4 m(-3) h(-1)) at higher IC, which indicates that the mass transfer from the gas to the liquid layer surrounding the biofilm is a key limitation of the process.

  4. Characterization and long term operation of a novel superconducting undulator with 15 mm period length in a synchrotron light source

    NASA Astrophysics Data System (ADS)

    Casalbuoni, S.; Cecilia, A.; Gerstl, S.; Glamann, N.; Grau, A. W.; Holubek, T.; Meuter, C.; de Jauregui, D. Saez; Voutta, R.; Boffo, C.; Gerhard, Th.; Turenne, M.; Walter, W.

    2016-11-01

    A new cryogen-free full scale (1.5 m long) superconducting undulator with a period length of 15 mm (SCU15) has been successfully tested in the ANKA storage ring. This represents a very important milestone in the development of superconducting undulators for third and fourth generation light sources carried on by the collaboration between the Karlsruhe Institute of Technology and the industrial partner Babcock Noell GmbH. SCU15 is the first full length device worldwide that with beam reaches a higher peak field than what expected with the same geometry (vacuum gap and period length) with an ideal cryogenic permanent magnet undulator built with the best material available PrFeB. After a summary on the design and main parameters of the device, we present here the characterization in terms of spectral properties and the long term operation of the SCU15 in the ANKA storage ring.

  5. High Temperature Steam Electrolysis: Demonstration of Improved Long-Term Performance

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

    J. E. O'Brien; X. Zhang; R. C. O'Brien

    2011-11-01

    Long-term performance is an ongoing issue for hydrogen production based on high-temperature steam electrolysis (HTSE). For commercial deployment, solid-oxide electrolysis stacks must achieve high performance with long-term degradation rates of {approx}0.5%/1000 hours or lower. Significant progress has been achieved toward this goal over the past few years. This paper will provide details of progress achieved under the Idaho National Laboratory high temperature electrolysis research program. Recent long-term stack tests have achieved high initial performance with degradation rates less than 5%/khr. These tests utilize internally manifolded stacks with electrode-supported cells. The cell material sets are optimized for the electrolysis mode ofmore » operation. Details of the cells and stacks will be provided along with details of the test apparatus, procedures, and results.« less

  6. Mortality and recurrence rate after pressure ulcer operation for elderly long-term bedridden patients.

    PubMed

    Kuwahara, Masamitsu; Tada, Hideyuki; Mashiba, Kumi; Yurugi, Satoshi; Iioka, Hiroshi; Niitsuma, Katsunori; Yasuda, Yukiko

    2005-06-01

    We operated on 16 sacral pressure ulcers in elderly and long-term residential patients who were immobile as a result of cerebral vascular disease. The mean age of patients was 76 years. Eight ulcers were treated with local fascial flaps and 8 by simple closure. The follow-up period was from 1 to 4 years. Recurrence and mortality rates were examined retrospectively. In the 16 patients, recurrence occurred in 37.5%, and 43.8% died without recurrence. The recurrence rate was 37.5% for local fascial flaps and 37.5% for simple closure. Overall mortality was 68.8% in the follow-up period. Because postoperative death was common, we should not only focus on reducing local pressure but also pay attention to any underlying disease. Because of this high mortality rate, the least invasive procedure possible should be used. Because the recurrence rate of simple closure was the same as for local fascial flaps, simple closure should be considered as a reconstructive method.

  7. Possible nutrient limiting factor in long term operation of closed aquatic ecosystem

    NASA Astrophysics Data System (ADS)

    Hao, Zongjie; Li, Yanhui; Cai, Wenkai; Wu, Peipei; Liu, Yongding; Wang, Gaohong

    2012-03-01

    To investigate nutrient limitation effect on the community metabolism of closed aquatic ecosystem and possible nutrient limiting factors in the experimental food chains, depletion of inorganic chemicals including carbon, nitrogen and phosphorous was tested. A closed aquatic ecosystem lab module consisting of Chlorella pyrenoidosa and Chlamydomonas reinhardtii, Daphnia magna and associated unidentified microbes was established. Closed ecological systems receive no carbon dioxide; therefore, we presumed carbon as a first limiting factor. The results showed that the algae population in the nutrient saturated group was statistically higher than that in the nutrient limited groups, and that the chlorophyll a content of algae in the phosphorus limited group was the highest among the limited groups. However, the nitrogen limited group supported the most Daphnia, followed by the carbon limited group, the nutrient saturated group and the phosphorus limited group. Redundancy analysis showed that the total phosphorus contents were correlated significantly with the population of algae, and that the amount of soluble carbohydrate as feedback of nutrient depletion was correlated with the number of Daphnia. Thus, these findings suggest that phosphorus is the limiting factor in the operation of closed aquatic ecosystem. The results presented herein have important indications for the future construction of long term closed ecological system.

  8. Evaluation of performance of a BLSS model in long-term operation in dynamic and steady states

    NASA Astrophysics Data System (ADS)

    Gros, Jean-Bernard; Tikhomirov, Alex; Ushakova, Sofya; Velitchko, Vladimir; Tikhomirova, Natalia; Lasseur, Christophe

    Evaluation of performance of a BLSS model, including higher plants for food production and biodegradation of human waste, in long-term operation in dynamic and steady states was performed. The model system was conceived for supplying vegetarian food and oxygen to 0.07 human. The following data were obtained in steady-state operating conditions. Average rate of wheat, chufa, radish, lettuce and Salicornia edible biomass accumulation were 8.7, 5.5, 0.6, 0.6 and metricconverterProductID2.5 g2.5 g per day respectively. Thus, to mimic the vegetarian edible biomass consumption by a human it was necessary to withdraw 17.9 g/d from total mass ex-change. Simultaneously, human mineralized exometabolites (artificial mineralized urine, AMU) in the amount of approximately 7% of a daily norm were introduced into the nutrient solu-tion for irrigation of the plants cultivated on a neutral substrate (expanded clay aggregate). The estimated value of 5.8 g/d of wheat and Salicornia inedible biomass was introduced in the soil-like substrate (SLS) to fully meet the plants need in nitrogen. The rest of wheat and Salicornia inedible biomass, 5.7 g/d, was stored. Thus in all, 23.6g of vegetarian dry matter had been stored. Assuming edible biomass is eaten up by the human, the closure coefficient of the vegetarian biomass inclusion into matter recycling amounted to 88%. The analysis of the long-term model operation showed that the main factors limiting increase of recycling processes were the following: a) Partly unbalanced mineral composition of daily human waste with daily needs of plants culti-` vated in the system. Thus, when fully satisfied with respect to nitrogen, the plants experienced a lack of macro elements such as P, Mg and Ca by more than 50%; b) Partly unbalanced mineral composition of edible biomass of the plants cultivated in the SLS with that of inedible biomass of the plants cultivated by hydroponic method on neutral substrate introduced in the SLS; c) Accumulation of

  9. [Factors Affecting Long-Term Cosmetic Results after Minimally Invasive Video-Assisted Thyroidectomy and Conventional Thyroid Surgery].

    PubMed

    Sahm, Maik; Otto, Ronny; Pross, Matthias; Mantke, Rene

    2018-06-25

    Approximately 90,000 thyroid operations are performed in Germany each year. Minimally invasive video-assisted thyroidectomy (MIVAT) accounts for 5 - 10% of these operations. There are few data that compare long-term cosmetic results after MIVAT to those after conventional surgery. Current systematic reviews show no advantage for MIVAT. The goal of this study was to analyse the long-term postoperative results in both procedures and the evaluation of relevant factors. The analysis of the long-term results is based on follow-up examinations using a validated method for scar appraisal (POSAS). Cohort analysis was performed on MIVAT operations in our hospital between 2004 and 2011 and conventional thyroid operations in 2011. Follow-up examination data were analysed from 117 patients from the MIVAT group and 102 patients from the conventional group. The follow-up examination was performed with a mean of 23.1 vs. 23.6 months postoperatively (MIVAT vs. conventional). The Friedman Test showed that scar pigmentation (mean rank 4.79) and scar surface structure (mean rank 3.62) were the deciding factors influencing the long-term cosmetic results. Both MIVAT and conventional surgery gave very good long-term cosmetic results. From the patient's perspective, there is no significant advantage with conventional surgery. The evaluation of the long-term results largely depends on factors such as scar pigmentation and surface structure that can only be influenced to a limited extent by the surgical procedure. Georg Thieme Verlag KG Stuttgart · New York.

  10. Long-Term Pavement Performance Program falling weight deflectometer maintenance manual

    DOT National Transportation Integrated Search

    2006-12-01

    The Federal Highway Administrations (FHWA) Long-Term Pavement Performance (LTPP) program operates eight Dynatest Model 8000 FWDs to collect deflection data on in-service pavement test sections across North America. LTPP has collected pavement defl...

  11. Long-term urethral catheterisation.

    PubMed

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  12. Long-term solar-terrestrial observations

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

  13. Long-Term Survival in Patients With Acute Kidney Injury After Acute Type A Aortic Dissection Repair.

    PubMed

    Sasabuchi, Yusuke; Kimura, Naoyuki; Shiotsuka, Junji; Komuro, Tetsuya; Mouri, Hideyuki; Ohnuma, Tetsu; Asaka, Kayo; Lefor, Alan K; Yasunaga, Hideo; Yamaguchi, Atsushi; Adachi, Hideo; Sanui, Masamitsu

    2016-12-01

    Although acute kidney injury (AKI) is known as a serious complication after operation for acute type A aortic dissection (AAAD), the long-term impact of AKI remains unclear. The aim of the present study is to investigate the long-term survival in patients with AKI after operation for AAAD. This study included 403 patients who underwent operation for AAAD from 1990 to 2011 at Jichi Medical University, Saitama Medical Center. Postoperative AKI was identified according to the Kidney Disease Improving Global Outcomes criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression were modeled to analyze the association between the AKI stage and postoperative long-term survival. Of 403 patients, 181 (44.9%) experienced postoperative AKI. Kaplan-Meier estimates for long-term survival were significantly different among patients without AKI and patients with stage 1, 2, and 3 AKI (p < 0.001). Hazard ratios of long-term survival for patients with stages 1, 2, and 3 AKI compared with patients without AKI were 1.38 (95% confidence interval [CI]: 0.84 to 2.26), 1.82 (95% CI: 0.95 to 3.51), and 3.79 (95% CI: 1.95 to 7.37), respectively. More patients with AKI died because of cardiovascular disease after discharge than patients without AKI (1.8% versus 6.0%, p = 0.03). Stage 3 AKI is significantly associated with lower long-term survival after operation for AAAD. Patient follow-up after discharge that focuses on cardiovascular issues may benefit patients who survive AKI after AAAD operation. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Long-term care: long-term care insurance--2005. End of Year Issue Brief.

    PubMed

    Tanner, Rachel; Bercaw, Lawren

    2005-12-31

    As the "Baby Boom" generation approaches retirement, state and federal lawmakers are struggling to ensure that the nation's long-term care system will provide adequate services for the growing number of senior citizens. A 2003 Administration on Aging report predicted that the elderly population will double by 2030. Accordingly, policymakers must prepare for the impending squeeze on public health and Medicaid resources. Many consumers are exploring private long-term care insurance options as a means of preparing for the cost of eldercare. Yet, a lack of market uniformity has rendered the long-term care insurance industry somewhat difficult for consumers to decipher. In addition, senior care insurance is often costly, particularly for those over age 50.

  15. Managing Records for the Long Term - 12363

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

    Montgomery, John V.; Gueretta, Jeanie

    The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship andmore » long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the Office of Legacy

  16. Acute aortic dissection involving the root: operative and long-term outcome after curative proximal repair†

    PubMed Central

    Urbanski, Paul P.; Lenos, Aristidis; Irimie, Vadim; Bougioukakis, Petros; Zacher, Michael; Diegeler, Anno

    2016-01-01

    OBJECTIVES The aim of the study was to evaluate operative and long-term results after surgery of acute aortic dissection involving the root, in which the proximal repair consisted of curative resection of all dissected aortic sinuses and was performed using either valve-sparing root repair or complete root replacement with a valve conduit. METHODS Between August 2002 and March 2013, 162 consecutive patients (mean age 63 ± 14 years) underwent surgery for acute type A aortic dissection. Eighty-six patients with an involvement of the aortic root underwent curative surgery of the proximal aorta consisting of valve-sparing root repair (n = 54, 62.8%) or complete valve and root replacement using composite valve grafts (n = 32, 37.2%). In patients with root repair, all dissected aortic walls were resected and root remodelling using the single patch technique (n = 53) or root repair with valve reimplantation (n = 1) was performed without the use of any glue. All perioperative data were collected prospectively and retrospective statistical examination was performed using univariate and multivariate analyses. RESULTS The mean follow-up was 5.2 ± 3.5 years for all patients (range 0–12 years) and 6.1 ± 3.3 years for survivors. The 30-day mortality rate was 5.8% (5 patients), being considerably lower in the repair sub-cohort (1.9 vs 12.5%). The estimated survival rate at 5 and 10 years was 80.0 ± 4.5 and 69.1 ± 6.7%, respectively. No patient required reoperation on the proximal aorta and/or aortic valve during the follow-up time and there were only two valve-related events (both embolic, one in each group). Among those patients with repaired valves, the last echocardiography available showed no insufficiency in 40 and an irrelevant insufficiency (1+) in 14. CONCLUSIONS Curative repair of the proximal aorta in acute dissection involving the root provides favourable operative and long-term outcome with very low risk of aortic complications and/or reoperations, regardless

  17. Asthma Medicines: Long-Term Control

    MedlinePlus

    ... Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic versions of ... form, they are used exclusively for long-term control; they are not very effective for acute symptoms. ...

  18. Chronic sleep deprivation differentially affects short and long-term operant memory in Aplysia.

    PubMed

    Krishnan, Harini C; Noakes, Eric J; Lyons, Lisa C

    2016-10-01

    The induction, formation and maintenance of memory represent dynamic processes modulated by multiple factors including the circadian clock and sleep. Chronic sleep restriction has become common in modern society due to occupational and social demands. Given the impact of cognitive impairments associated with sleep deprivation, there is a vital need for a simple animal model in which to study the interactions between chronic sleep deprivation and memory. We used the marine mollusk Aplysia californica, with its simple nervous system, nocturnal sleep pattern and well-characterized learning paradigms, to assess the effects of two chronic sleep restriction paradigms on short-term (STM) and long-term (LTM) associative memory. The effects of sleep deprivation on memory were evaluated using the operant learning paradigm, learning that food is inedible, in which the animal associates a specific netted seaweed with failed swallowing attempts. We found that two nights of 6h sleep deprivation occurring during the first or last half of the night inhibited both STM and LTM. Moreover, the impairment in STM persisted for more than 24h. A milder, prolonged sleep deprivation paradigm consisting of 3 consecutive nights of 4h sleep deprivation also blocked STM, but had no effect on LTM. These experiments highlight differences in the sensitivity of STM and LTM to chronic sleep deprivation. Moreover, these results establish Aplysia as a valid model for studying the interactions between chronic sleep deprivation and associative memory paving the way for future studies delineating the mechanisms through which sleep restriction affects memory formation. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Chronic Sleep Deprivation Differentially Affects Short and Long-term Operant Memory in Aplysia

    PubMed Central

    Krishnan, Harini C.; Noakes, Eric J.; Lyons, Lisa C.

    2016-01-01

    The induction, formation and maintenance of memory represent dynamic processes modulated by multiple factors including the circadian clock and sleep. Chronic sleep restriction has become common in modern society due to occupational and social demands. Given the impact of cognitive impairments associated with sleep deprivation, there is a vital need for a simple animal model in which to study the interactions between chronic sleep deprivation and memory. We used the marine mollusk Aplysia californica, with its simple nervous system, nocturnal sleep pattern and well-characterized learning paradigms, to assess the effects of two chronic sleep restriction paradigms on short-term (STM) and long-term (LTM) associative memory. The effects of sleep deprivation on memory were evaluated using the operant learning paradigm, learning that food is inedible, in which the animal associates a specific netted seaweed with failed swallowing attempts. We found that two nights of 6 h sleep deprivation occurring during the first or last half of the night inhibited both STM and LTM. Moreover, the impairment in STM persisted for more than 24 hours. A milder, prolonged sleep deprivation paradigm consisting of 3 consecutive nights of 4 h sleep deprivation also blocked STM, but had no effect on LTM. These experiments highlight differences in the sensitivity of STM and LTM to chronic sleep deprivation. Moreover, these results establish Aplysia as a valid model for studying the interactions between chronic sleep deprivation and associative memory paving the way for future studies delineating the mechanisms through which sleep restriction affects memory formation. PMID:27555235

  20. Long-term results of small-diameter proximal splenorenal venous shunt: A retrospective study

    PubMed Central

    Chen, Hao; Yang, Wei-Ping; Yan, Ji-Qi; Li, Qin-Yu; Ma, Di; Li, Hong-Wei

    2011-01-01

    AIM: To investigate recurrent variceal hemorrhage and long-term survival rates of patients treated with partial proximal splenorenal venous shunt. METHODS: Patients with variceal hemorrhage who were treated with small-diameter proximal splenorenal venous shunt in Ruijin Hospital between 1996 and 2009 were included in this study. Shunt diameter was determined before operation using Duplex Doppler ultrasonography. Peri-operative and long-term results in term of rehemorrhage, encephalopathy and mortality were followed up. RESULTS: Ninety-eight patients with Child A and B variceal hemorrhage received small-diameter proximal splenorenal venous shunt with a diameter of 7-10 mm. After operation, the patients’ mean free portal pressure (P < 0.01) and the flow rate of main portal vein (P < 0.01) decreased significantly compared with that before operation. The rates of rebleeding and mortality were 6.12% (6 cases) and 2.04% (2 cases), respectively. Ninety-one patients were followed up for 7 mo-14 years (median, 48.57 mo). Long-term rates of rehemorrhage and encephalopathy were 4.40% (4 cases) and 3.30% (3 cases), respectively. Thirteen patients (14.29%) died mainly due to progressive hepatic dysfunction. Five- and ten-year survival rates were 82.12% and 71.24%, respectively. CONCLUSION: Small-diameter proximal splenorenal venous shunt affords protection against variceal rehemorrhage with a low occurrence of encephalopathy in patients with normal liver function. PMID:21876638

  1. Biofiltration of high formaldehyde loads with ozone additions in long-term operation.

    PubMed

    Maldonado-Diaz, G; Arriaga, S

    2015-01-01

    Formaldehyde (FA) biofiltration was evaluated over 310 days with and without ozone addition. Without ozone, the biofilter was able to treat formaldehyde at inlet loads (ILs) lower than 40 g m(-3) h(-1), maintaining, under this condition, an average removal efficiency (RE) of 88 % for a few days before collapsing to zero. The continuous addition of ozone (90 ppbv) helped to recover the RE from zero to 98 ± 2 % and made it possible to operate at an IL of 40 g m(-3) h(-1) for long periods of operation (107 days). Furthermore, the ozone addition aided in operating the biofilter at a formaldehyde IL of up to 120 g m(-3) h(-1) values that have never before been reached. GC-mass spectrometry (MS) analysis showed that dimethoxymethane was the common compound in leachate during the performance decay. Also, the addition of ozone aided in maintaining an optimal pH in the biofilter with values between 7.5 and 8.2, due to the carbonate species formed during the ozone reactions with formaldehyde and its by-products. Thus, the pH control was confirmed and the alkalinity of the biofilter increased from 334.1 ± 100.3 to 1450 ± 127 mg CaCO3 L(-1) when ozone was added. Ozone addition diminished the exopolymeric substances (EPS) content of biofilm and biofilm thickness without affecting cell viability. Kinetic parameters suggested that the best conditions for carrying out FA biofiltration were reached under ozone addition. The addition of ozone during formaldehyde biofiltration could be a good strategy to maintain the pH and the steady state of the system under high ILs and for long periods of operation.

  2. Long-term follow-up results of umbilical hernia repair.

    PubMed

    Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

    2017-12-01

    Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

  3. Long-term pavement performance program manual for profile measurements and processing

    DOT National Transportation Integrated Search

    2008-11-01

    This manual describes operational procedures for measuring longitudinal pavement profiles for the Long-Term Pavement Performance (LTPP) Program using the International Cybernetics Corporation (ICC) road profiler, Face Company Dipstick, and the rod an...

  4. Preoperative sclerotherapy of facial venous malformations: impact on surgical parameters and long-term follow-up.

    PubMed

    James, Charles A; Braswell, Leah E; Wright, Lonnie B; Roberson, Paula K; Moore, Mary B; Waner, Milton; Buckmiller, Lisa M

    2011-07-01

    To analyze the operative benefit of preoperative sclerotherapy of facial venous malformations and assess long-term patient outcome. Preoperative sclerotherapy was performed in 24 consecutive patients referred before resection of facial venous malformation. Pretreatment imaging was reviewed for malformation dimensions (length, width, and height), and volumes were estimated. Sclerotherapy was performed with 3% sodium tetradecyl in the first 15 patients and 98% dehydrated alcohol in the remaining 9 patients. Operative blood loss, operative time, transfusion requirement, and hospital stay were recorded. Operative time per lesion volume and operative blood loss per lesion volume were calculated. Results were compared with 15 historical control patients who underwent resection of facial venous malformations without preoperative sclerotherapy. Long-term follow-up of study and control patients was performed. Compared with controls, patients undergoing preoperative venous sclerotherapy were significantly older (P = .0206) and had larger lesions in all three dimensions (height, P = .0002; length, P = .0010; width, P = .0004). Patients receiving sclerotherapy had shorter operative time per lesion volume (P < .0001) and reduced blood loss per lesion volume (P < .0001). Neither hospital stay nor the need for blood transfusion differed from the control patients (P = .2449 and P = .6857). Mild periprocedural complications were encountered in 12.5% of cases, and nerve paresis occurred in 8.3% of cases. Long-term follow-up revealed retreatment was required in 2 of 24 patients (8.3%). Preoperative sclerotherapy of venous malformations was associated with less operative time per lesion volume and less operative blood loss per lesion volume. Long-term follow-up revealed a low need for retreatment. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  5. Reforming long-term care financing through insurance

    PubMed Central

    Meiners, Mark R.

    1988-01-01

    Until recently, insurance for long-term care was not viewed as feasible. This perception has changed dramatically in the past few years. Several models of long-term care insurance have begun to be tested. Although the application of insurance principles to long-term care is still new, the emergence of private market interest in developing long-term care insurance has been a catalyst to renewed public-policy support for reforming the way we pay for long-term care. States, in particular, have become interested in developing public-private partnerships to support the emergence of long-term care insurance that could help relieve the mounting pressure on Medicaid budgets. PMID:10312962

  6. Long-term survival after sporadic and delayed metastases of conventional osteosarcoma

    PubMed Central

    Kubo, Tadahiko; Furuta, Taisuke; Johan, Muhammad P.; Yoshizuka, Masaaki; Ochi, Mitsuo; Adachi, Nobuo

    2017-01-01

    Abstract Histologically conventional osteosarcoma, once metastasized to the lung, generally causes a rapid and fatal outcome. Osteosarcoma metastasis to the gastrointestinal tract is extremely rare. We report herein a case of osteoblastic osteosarcoma with exceptionally unique features: sporadic lung metastases and delayed metastases to the stomach and the jejunum with long-term survival. She received multiple operations and chemotherapies, but consequently died of peritoneal dissemination. A review of the literature on osteosarcoma metastasis to the gastrointestinal tract is presented. This patient was very unusual in terms of a long-term survival and metastatic sites, suggesting the importance of vigilance and thorough follow-up for patients with conventional osteosarcoma. PMID:28471986

  7. An update of Penile Fractures: Long-term significance of the number of hours elapsed till surgical repair on long-term outcomes.

    PubMed

    Kozacıoğlu, Zafer; Ceylan, Yasin; Aydoğdu, Özgü; Bolat, Deniz; Günlüsoy, Bülent; Minareci, Süleyman

    2017-03-01

    We updated our data on penile fractures and investigated the significance of the time interval from the incident of the fracture until the operation on the erectile functions and long-term complications. Between January 2001 and June 2014, 64 patients were operated on with a preoperative diagnosis of penile fracture. We could evaluate 54 of these patients. The patients were classified into 3 groups according to the time interval from the time of fracture until surgery. The validated Turkish version of the erectile components of International Index of Erectile Function (IIEF) was answered by every patient 3 times after the surgery; before the incident of fracture, at first postoperative year, and at the time of the study (IIEF-5 and question #15 were used). The complications were noted and an erectile function index score was calculated for every patient. Mean follow up period was 44.9 (±2.8) months for all patients There was no statistically significant difference between the 3 groups in terms of the erectile components of IIEF questionnaire scores for the time periods and for individual patients in each separate group. Complications for all groups were also similar. In consideration of long-term results, neither serious deformities nor erectile dysfunction occur as a consequence of a delay in surgery performed within the first 24 hours in patients without urethral involvement.

  8. ISS Regenerative Life Support: Challenges and Success in the Quest for Long-Term Habitability in Space

    NASA Technical Reports Server (NTRS)

    Bazley, Jesse

    2015-01-01

    The International Space Station's (ISS) Regenerative Environmental Control and Life Support System (ECLSS) was launched in 2008 to continuously recycle urine and crew sweat into drinking water and oxygen using brand new technologies. This functionality was highly important to the ability of the ISS to transition to the long-term goal of 6-crew operations as well as being critical tests for long-term space habitability. Through the initial activation and long-term operations of these systems, important lessons were learned about the importance of system redundancy and operational workarounds that allow Systems Engineers to maintain functionality with limited on-orbit spares. This presentation will share some of these lessons learned including how to balance water through the different systems, store and use water for use in system failures and creating procedures to operate the systems in ways that they were not initially designed to do.

  9. Placenta previa and long-term morbidity of the term offspring.

    PubMed

    Walfisch, Asnat; Beharier, Ofer; Shoham-Vardi, Ilana; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

    2016-08-01

    The long-term impact of placenta previa on term infants is unknown. We aimed to investigate whether abnormal placentation increases the risk for long-term morbidity of the term offspring. A population-based cohort study compared the incidence of long-term hospitalizations up to the age of 18 due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of children born at term in pregnancies diagnosed with placenta previa and those without. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence over time. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 233,123 term deliveries met the inclusion criteria; 0.2% (n=502) of the children were born to mothers with placenta previa. During the follow-up period, children born to mothers with placenta previa did not have an increased risk for long-term cardiovascular, endocrine, hematological, neurological, respiratory, and urinary morbidity. Term offsprings of mothers diagnosed with placenta previa do not appear to be at an increased risk for long-term morbidity up to the age of 18. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Quick fix or long-term cure? Pros and cons of bariatric surgery

    PubMed Central

    Madura, James A.

    2012-01-01

    The past decade has seen an enormous increase in the number of bariatric, or weight loss, operations performed. This trend is likely to continue, mirroring the epidemic of obesity around the world and its rising prevalence among children. Bariatric surgery is considered by many to be the most effective treatment for obesity in terms of maintenance of long-term weight loss and improvement in obesity-related comorbid conditions. Although overly simplified, the primary mechanisms of the surgical interventions currently utilized to treat obesity are the creation of a restrictive or malabsorptive bowel anatomy. Operations based on these mechanisms include the laparoscopic adjustable gastric band and laparoscopic vertical sleeve gastrectomy (considered primarily restrictive operations), the laparoscopic biliopancreatic diversion with or without a duodenal switch (primarily malabsorptive operation), and the laparoscopic Roux-en-Y gastric bypass (considered a combination restrictive and selective malabsorptive procedure). Each operation has pros and cons. Important considerations, for the patient and surgeon alike, in the decision to proceed with bariatric surgery include the technical aspects of the operation, postoperative complications including long-term nutritional problems, magnitude of initial and sustained weight loss desired, and correction of obesity-related comorbidities. Herein, the pros and cons of the contemporary laparoscopic bariatric operations are reviewed and ongoing controversies relating to bariatric surgery are discussed: appropriate patient selection, appropriate operation selection for an individual patient, surgeon selection, and how to measure success after surgery. PMID:23091563

  11. Long-Term Control Medications for Lung Diseases

    MedlinePlus

    ... Asthma Medications Long-Term Control Medications Long-Term Control Medications Make an Appointment Ask a Question Refer Patient Long-term control medications are taken daily to control and prevent ...

  12. Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation.

    PubMed

    Hövels-Gürich, Hedwig H; Seghaye, Marie-Christine; Schnitker, Ralph; Wiesner, Magdalene; Huber, Walter; Minkenberg, Ralf; Kotlarek, Franz; Messmer, Bruno J; Von Bernuth, Götz

    2002-09-01

    Neurodevelopmental status of children between 8 and 14 years of age after neonatal arterial switch operation for transposition of the great arteries has not previously been systematically evaluated. Within a longitudinal study, 60 unselected children operated on as neonates with combined deep hypothermic circulatory arrest and low-flow cardiopulmonary bypass were reevaluated at the age of 7.9 to 14.3 years (mean +/- SD 10.5 +/- 1.6 years). Clinical neurologic status and standardized tests to assess gross motor function, intelligence, acquired abilities, language, and speech were carried out, and the results were related to preoperative, perioperative, and postoperative status, to management, and to neurodevelopmental status at a mean age of 5.4 years. Neurologic and speech impairments were evidently more frequent (27% and 40%, respectively) than in the general population. Intelligence and socioeconomic status were not different (P =.29 and P =.11), whereas motor function, acquired abilities, and language were reduced (P < or =.04 for each). Overall rate of developmental impairment in one or more domains was 55%, compared with 26% at age 5.4 years. Multivariable analysis showed that severe preoperative acidosis and hypoxia predicted reduced motor function (mean deficit 52.7 points, P <.001), whereas longer bypass duration predicted both neurologic (odds ratio per 10 minutes of bypass duration 1.8, P =.04) and speech (odds ratio per 10 minutes of bypass duration 1.9, P =.02) dysfunction, and perioperative and postoperative cardiocirculatory insufficiency predicted neurologic (odds ratio 6.5, P =.04) and motor (mean deficit 6.8 points, P =.03) dysfunction. The neonatal arterial switch operation with combined circulatory arrest and low-flow bypass is associated increasingly with age, with reduced neurodevelopmental outcome but not with cognitive dysfunction. In our experience, the risk of long-term neurodevelopmental impairment after neonatal corrective cardiac surgery

  13. Reforming Long-Term Care Funding in Alberta.

    PubMed

    Crump, R Trafford; Repin, Nadya; Sutherland, Jason M

    2015-01-01

    Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

  14. Long-term outcomes of laparoscopic adjustable gastric banding.

    PubMed

    Khoraki, Jad; Moraes, Marilia G; Neto, Adriana P F; Funk, Luke M; Greenberg, Jacob A; Campos, Guilherme M

    2018-01-01

    Laparoscopic adjustable gastric banding (LAGB) is an option for the treatment of severe obesity. Few US studies have reported long-term outcomes. We aimed to present long-term outcomes with LAGB. Retrospective study of patients who underwent LAGB at an academic medical center in the US from 1/2005 to 2/2012. Outcomes included weight loss, complications, re-operations, and LAGB failure. 208 patients underwent LAGB. Mean BMI was 45.4 ± 6.4 kg/m 2 . Mean follow-up was 5.6 (0.5-10.7) years. Complete follow-up was available for 90% at one year (186/207), 80% at five years (136/171), and 71% at ten years (10/14). Percentage of excess weight loss at one, five, and ten years was 29.9, 30, and 16.9, respectively. Forty-eight patients (23.1%) required a reoperation. LAGB failure occurred in 118 (57%) and higher baseline BMI was the only independently associated factor (OR 1.1; 95%CI 1.0-1.1; p = 0.016). LAGB was associated with poor short and long-term weight loss outcomes and a high failure rate. With the increased safety profile and greater efficacy of other surgical techniques, LAGB utilization should be discouraged. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Psychrophilic dry anaerobic digestion of dairy cow feces: Long-term operation

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

    Massé, Daniel I., E-mail: Daniel.masse@agr.gc.ca; Cata Saady, Noori M.

    2015-02-15

    Highlights: • Psychrophilic dry anaerobic digestion (PDAD) of cow feces (CF) is feasible. • PDAD of CF is as efficient as mesophilic and thermophilic AD at TCL 21 days. • CF (13–16% TS at OLR 5.0 g TCOD{sub fed} kg{sup −1} inoculum d{sup −1}) yielded 222 ± 27 {sub N}L CH{sub 4} kg{sup −1} VS fed. - Abstract: This paper reports experimental results which demonstrate psychrophilic dry anaerobic digestion of cow feces during long-term operation in sequence batch reactor. Cow feces (13–16% total solids) has been anaerobically digested in 12 successive cycles (252 days) at 21 days treatment cycle lengthmore » (TCL) and temperature of 20 °C using psychrotrophic anaerobic mixed culture. An average specific methane yield (SMY) of 184.9 ± 24.0, 189.9 ± 27.3, and 222 ± 27.7 {sub N}L CH{sub 4} kg{sup −1} of VS fed has been achieved at an organic loading rate of 3.0, 4.0, and 5.0 g TCOD kg{sup −1} inoculum d{sup −1} and TCL of 21 days, respectively. The corresponding substrate to inoculum ratio (SIR) was 0.39 ± 0.06, 0.48 ± .02, 0.53 ± 0.05, respectively. Average methane production rate of 10 ± 1.4 {sub N}L CH{sub 4} kg{sup −1} VS fed d{sup −1} has been obtained. The low concentration of volatile fatty acids indicated that hydrolysis was the reaction limiting step.« less

  16. Long-term follow-up results of umbilical hernia repair

    PubMed Central

    Venclauskas, Linas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

    2017-01-01

    Introduction Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. Aim To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. Material and methods A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. Results One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m2, diabetes and wound infection were independent risk factors for umbilical hernia recurrence. Conclusions The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m2, diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence. PMID:29362649

  17. Long-term efficient organic photovoltaics based on quaternary bulk heterojunctions

    NASA Astrophysics Data System (ADS)

    Nam, Minwoo; Cha, Minjeong; Lee, Hyun Hwi; Hur, Kahyun; Lee, Kyu-Tae; Yoo, Jaehong; Han, Il Ki; Kwon, S. Joon; Ko, Doo-Hyun

    2017-01-01

    A major impediment to the commercialization of organic photovoltaics (OPVs) is attaining long-term morphological stability of the bulk heterojunction (BHJ) layer. To secure the stability while pursuing optimized performance, multi-component BHJ-based OPVs have been strategically explored. Here we demonstrate the use of quaternary BHJs (q-BHJs) composed of two conjugated polymer donors and two fullerene acceptors as a novel platform to produce high-efficiency and long-term durable OPVs. A q-BHJ OPV (q-OPV) with an experimentally optimized composition exhibits an enhanced efficiency and extended operational lifetime than does the binary reference OPV. The q-OPV would retain more than 72% of its initial efficiency (for example, 8.42-6.06%) after a 1-year operation at an elevated temperature of 65 °C. This is superior to those of the state-of-the-art BHJ-based OPVs. We attribute the enhanced stability to the significant suppression of domain growth and phase separation between the components via kinetic trapping effect.

  18. Mersilene mesh sling: short- and long-term clinical and urodynamic outcomes.

    PubMed

    Young, S B; Howard, A E; Baker, S P

    2001-07-01

    We sought to determine the long-term efficacy, safety, and urodynamic effects of the Mersilene mesh suburethral sling in treating complicated forms of genuine stress incontinence. Two hundred women diagnosed with genuine stress incontinence, complicated by recurrence, intrinsic sphincter deficiency, or chronically increased intraabdominal pressure underwent a suburethral mesh sling procedure (Mersilene; Ethicon Inc, Somerville, NJ). They were monitored with yearly clinical examinations plus short- and long-term postoperative urodynamic evaluations; statistical analysis was carried out by use of the Friedman 2-way analysis by rank, Fischer-Freeman-Halton exact testing, analysis of variance for repeated measures, Wilcoxon, exact Mann-Whitney U test, and Bonferroni paired t test. Of 176 patients who were 5 months or more postop, 127 (72%) had preoperative and short-term postoperative urodynamic evaluations (range 5 to 23 months, mean 12.6 months). Fifty-two of 117 women who were more than 19 months postop (44%) completed preoperative and long-term postoperative urodynamic evaluations at a mean of 63 months (range 20 to 107). One hundred thirty-six of 176 patients (77%) who were more than 4 months postop had a short- and/or long- term postoperative urodynamic evaluation (range 5 to 107 months, mean 30 months). Objective cure rate by stress test was 93% (126 of 136 patients) at a mean of 30 months follow-up. The long-term objective cure rate was 94% (49 of 52). Subjectively, the short- and long-term cure rates were 95.3% and 90.4%, respectively. The cotton swab angle deflection decreased by a mean of 54 degrees at 1 year and 50 degrees at 5 years. Of the 10 failures, the mean preoperative cotton swab straining angle was 19.6 degrees, with 6 being < 30 degrees. Nineteen patients had a negative preoperative cotton swab angle test result (mean straining angle 15 degrees before operation, -6 degrees after operation) and a long-term cure rate of 67%. The objective cure rate

  19. Long-term result after rubber band ligation for haemorrhoids.

    PubMed

    Forlini, Antonio; Manzelli, Antonio; Quaresima, Silvia; Forlini, Massimo

    2009-09-01

    Rubber band ligation (RBL) is a well-known and recognised outpatient procedure utilised for the treatment of symptomatic internal haemorrhoids. This paper describes a retrospective study which analyses the short- and long-term results of a personal series of patients. A consecutive group of 206 patients with symptomatic internal second- and third-degree haemorrhoids were treated with RBL as outpatients from 1982 to 1989. Two or three piles were legated in a single session. All patients were systematically visited after 1 month and 1 year. Respectively after 10 and 17 years, all the patients were contacted to obtain a telephone follow-up. The short-term follow-up at 1 month and at 1 year showed that 46% of the patients experienced moderate anal pain for 24 h post procedure. Two patients had severe pain (1%) and were admitted in the hospital to be submitted to an operative haemorrhoidectomy within a few days. Only 2.4% of the patients experienced rectal bleeding after a week, and 20% had a second session of RBL after 1 month. At 1 year follow-up, 90% of the patients with second-degree piles and 75% of patients with third-degree piles reported no residual symptoms. The long-term telephone follow-up at 10 and 17 years collected the history of 138 patients (67%). A group of 69% was asymptomatic, 28% had residual symptoms, and 3% needed further surgery. RBL is a safe and effective treatment for symptomatic internal haemorrhoids. Our long-term follow-up demonstrated good long-term results for internal second- and third-degree haemorrhoids.

  20. The Long-Term Budget Outlook

    DTIC Science & Technology

    2005-12-01

    Revenues Under CBO’s Long-Term Budget Scenarios 56A-8. Real Gross Domestic Product Under CBO’s Long-Term Budget Scenarios 57A-9. Total Surplus or...scenarios suggest that total federal spending for Medicare and Medicaid in 2050 could range anywhere from 7 percent of gross domestic product (GDP)—a...see the Congressional Budget Office’s glossary of budgetary and economic terms, available at www.cbo.gov. 2. The future path of productivity growth

  1. 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

  2. Long-Term Stability of Oxide Nanowire Sensors via Heavily Doped Oxide Contact.

    PubMed

    Zeng, Hao; Takahashi, Tsunaki; Kanai, Masaki; Zhang, Guozhu; He, Yong; Nagashima, Kazuki; Yanagida, Takeshi

    2017-12-22

    Long-term stability of a chemical sensor is an essential quality for long-term collection of data related to exhaled breath, environmental air, and other sources in the Internet of things (IoT) era. Although an oxide nanowire sensor has shown great potential as a chemical sensor, the long-term stability of sensitivity has not been realized yet due to electrical degradation under harsh sensing conditions. Here, we report a rational concept to accomplish long-term electrical stability of metal oxide nanowire sensors via introduction of a heavily doped metal oxide contact layer. Antimony-doped SnO 2 (ATO) contacts on SnO 2 nanowires show much more stable and lower electrical contact resistance than conventional Ti contacts for high temperature (200 °C) conditions, which are required to operate chemical sensors. The stable and low contact resistance of ATO was confirmed for at least 1960 h under 200 °C in open air. This heavily doped oxide contact enables us to realize the long-term stability of SnO 2 nanowire sensors while maintaining the sensitivity for both NO 2 gas and light (photo) detections. The applicability of our method is confirmed for sensors on a flexible polyethylene naphthalate (PEN) substrate. Since the proposed fundamental concept can be applied to various oxide nanostructures, it will give a foundation for designing long-term stable oxide nanomaterial-based IoT sensors.

  3. 76 FR 64104 - Notice To Solicit Comments and Hold Public Scoping Meetings on the Adoption of a Long-term...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... Long-term Experimental and Management Plan (LTEMP) for the operation of Glen Canyon Dam. This Federal... and Hold Public Scoping Meetings on the Adoption of a Long-term Experimental and Management Plan for the Operation of Glen Canyon Dam AGENCY: Bureau of Reclamation and National Park Service, Interior...

  4. Short-term Action Intentions Overrule Long-Term Semantic Knowledge

    ERIC Educational Resources Information Center

    van Elk, M.; van Schie, H.T.; Bekkering, H.

    2009-01-01

    In the present study, we investigated whether the preparation of an unusual action with an object (e.g. bringing a cup towards the eye) could selectively overrule long-term semantic representations. In the first experiment it was found that unusual action intentions activated short-term semantic goal representations, rather than long-term…

  5. Long term pavement performance program protocol for calibrating traffic data collection equipment

    DOT National Transportation Integrated Search

    1998-05-10

    This document describes the procedures that the Long Term Pavement Performance (LTPP) program recommends for ensuring that traffic data collection equipment used for LTPP traffic monitoring efforts operates correctly and collects valid data.

  6. Long-term variations in the gamma-ray background on SMM

    NASA Technical Reports Server (NTRS)

    Kurfess, J. D.; Share, G. H.; Kinzer, R. L.; Johnson, W. N.; Adams, J. H., Jr.

    1989-01-01

    Long-term temporal variations in the various components of the background radiation detected by the gamma-ray spectrometer on the Solar Maximum Mission are presented. The SMM gamma-ray spectrometer was launched in February, 1980 and continues to operate normally. The extended period of mission operations has provided a large data base in which it is possible to investigate a variety of environmental and instrumental background effects. In particular, several effects associated with orbital precession are introduced and discussed.

  7. Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice.

    PubMed

    Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

    2016-05-17

    PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice.

  8. High-Performing, Low-Temperature-Operating, Long-Lifetime Aerospace Lubricants

    NASA Technical Reports Server (NTRS)

    Joshi, Prakash

    2015-01-01

    Long-duration space exploration will require spacecraft systems that can operate effectively over several years with minimal or no maintenance. Aerospace lubricants are key components of spacecraft systems. Physical Sciences Inc., has synthesized and characterized novel ionic liquids for use in aerospace lubricants that contribute to decreased viscosity, friction, and wear in aerospace systems. The resulting formulations offer low vapor pressure and outgassing properties and thermal stability up to 250 C. They are effective for use at temperatures as low as -70 C and provide long-term operational stability in aerospace systems. In Phase II, the company scaled several new ionic liquids and evaluated a novel formulation in a NASA testbed. The resulting lubricant compounds will offer lower volatility, decreased corrosion, and better tribological characteristics than standard liquid lubricants, particularly at lower temperatures.

  9. Estimating long-term multivariate progression from short-term data.

    PubMed

    Donohue, Michael C; Jacqmin-Gadda, Hélène; Le Goff, Mélanie; Thomas, Ronald G; Raman, Rema; Gamst, Anthony C; Beckett, Laurel A; Jack, Clifford R; Weiner, Michael W; Dartigues, Jean-François; Aisen, Paul S

    2014-10-01

    Diseases that progress slowly are often studied by observing cohorts at different stages of disease for short periods of time. The Alzheimer's Disease Neuroimaging Initiative (ADNI) follows elders with various degrees of cognitive impairment, from normal to impaired. The study includes a rich panel of novel cognitive tests, biomarkers, and brain images collected every 6 months for as long as 6 years. The relative timing of the observations with respect to disease pathology is unknown. We propose a general semiparametric model and iterative estimation procedure to estimate simultaneously the pathological timing and long-term growth curves. The resulting estimates of long-term progression are fine-tuned using cognitive trajectories derived from the long-term "Personnes Agées Quid" study. We demonstrate with simulations that the method can recover long-term disease trends from short-term observations. The method also estimates temporal ordering of individuals with respect to disease pathology, providing subject-specific prognostic estimates of the time until onset of symptoms. When the method is applied to ADNI data, the estimated growth curves are in general agreement with prevailing theories of the Alzheimer's disease cascade. Other data sets with common outcome measures can be combined using the proposed algorithm. Software to fit the model and reproduce results with the statistical software R is available as the grace package. ADNI data can be downloaded from the Laboratory of NeuroImaging. Copyright © 2014 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  10. Risk Factors of Anastomotic Leakage and Long-Term Survival After Colorectal Surgery

    PubMed Central

    Park, Jong Seob; Huh, Jung Wook; Park, Yoon Ah; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong

    2016-01-01

    Abstract Anastomotic leakage (AL) is one of the most serious complications of colorectal surgery. It can affect long-term oncologic outcomes, but the impact on long-term survival remains uncertain. The aim of this study is to evaluate the operative characteristics of leakage and no leakage groups and to analyze long-term oncologic outcomes. We prospectively enrolled 10,477 patients from 2000 to 2011 and retrospectively reviewed the data. Male sex (odds ratio [OR], 3.90; P < 0.001), intraoperative transfusion (OR, 2.31; P = 0.042), and operative time (OR, 1.73; P = 0.032) were independent risk factors of AL in the colon. In the rectum, male sex (OR, 2.37; P < 0.001), neoadjuvant chemoradiotherapy (OR, 2.26; P < 0.001), and regional lymph node metastasis (OR, 1.43; P = 0.012) were independent risk factors of AL, and diverting stoma (OR, 0.24; P < 0.001) was associated with a deceased risk of AL. AL in the rectum without a diverting stoma was associated with disease-free survival (DFS, OR, 1.47; P = 0.037). Colonic leakage was not associated with 5-year DFS (leakage group vs nonleakage group, 72.4% vs 80.9%, P = 0.084); however, in patients undergoing rectal resection, there was a significant difference in 5-year DFS (67.0% vs 76.6%, P = 0.005, respectively). AL in the rectum is associated with worse long-term DFS and overall survival. A diverting stoma was shown to protect against this effect and was associated with long-term survival in rectal surgery. Therefore, creating a diverting stoma should be considered in high-risk patients undergoing rectal surgery. PMID:26937928

  11. Long-term outcome study of growth factor-treated pressure ulcers.

    PubMed

    Payne, W G; Ochs, D E; Meltzer, D D; Hill, D P; Mannari, R J; Robson, L E; Robson, M C

    2001-01-01

    Exogenous application of growth factors have been reported in an attempt to accelerate healing of chronic wounds. Most of the trials were of brief duration with short to no follow-up periods. Long-term outcome studies are sparse for pressure ulcer therapies with success rates around 30% for both operative and nonoperative treatments. Follow-up evaluations were performed serially up to 12 months for patients completing a 35 day blinded, placebo-controlled cytokine clinical trial of pressure ulcers. Fifty-four of 61 patients completed the follow-up period with 68.5% of the patients (37 of 54) being healed after 1 year. Of patients healing > or =85% during the active treatment phase, 84.6% were healed after 1 year compared with 61% of those that healed <85% during treatment (P <0.05). Long-term outcome was better in this growth factor trial than with surgical or standard nonoperative treatment of pressure ulcers. Since only patients receiving exogenously applied cytokines achieved >85% closure during the treatment phase of the trial, the excellent long-term outcome appears attributable to the cytokine therapy.

  12. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    NASA Astrophysics Data System (ADS)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  13. Long-Term Opioid Therapy Reconsidered

    PubMed Central

    Von Korff, Michael; Kolodny, Andrew; Deyo, Richard A.; Chou, Roger

    2012-01-01

    In the past 20 years, primary care physicians have greatly increased prescribing of long-term opioid therapy. However, the rise in opioid prescribing has outpaced the evidence regarding this practice. Increased opioid availability has been accompanied by an epidemic of opioid abuse and overdose. The rate of opioid addiction among patients receiving long-term opioid therapy remains unclear, but research suggests that opioid misuse is not rare. Recent studies report increased risks for serious adverse events, including fractures, cardiovascular events, and bowel obstruction, although further research on medical risks is needed. New data indicate that opioid-related risks may increase with dose. From a societal perspective, higher-dose regimens account for the majority of opioids dispensed, so cautious dosing may reduce both diversion potential and patient risks for adverse effects. Limiting long-term opioid therapy to patients for whom it provides decisive benefits could also reduce risks. Given the warning signs and knowledge gaps, greater caution and selectivity are needed in prescribing long-term opioid therapy. Until stronger evidence becomes available, clinicians should err on the side of caution when considering this treatment. PMID:21893626

  14. GATEWAY Report Brief: SSL Demonstration: Long-Term Evaluation of Indoor Field Performance

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

    None, None

    Report brief summarizing a GATEWAY program evaluation of the long-term performance characteristics (chromaticity change, maintained illuminance, and operations and maintenance) of LED lighting systems in four field installations previously documented in separate DOE GATEWAY reports.

  15. From Sky to Archive: Long Term Management of Sky Survey Data

    NASA Astrophysics Data System (ADS)

    Darch, Peter T.; Sands, Ashley E.; Borgman, Christine; Golshan, Milena S.; Traweek, Sharon

    2017-01-01

    Sky survey data may remain scientifically valuable long beyond the end of a survey’s operational period, both for continuing inquiry and for calibrating and testing instruments for subsequent generations of surveys. Astronomy infrastructure has many stakeholders, including those concerned with data management. Research libraries are increasingly partnering with scholars to sustain access to data.The Sloan Digital Sky Survey (SDSS) was among the first major scientific projects to partner with libraries in this way, embarking on a data transfer process with two university libraries. We report on a qualitative case study of this process.Ideally, long-term sustainability of sky survey data would be a key part of planning and construction, but rarely does this occur. Teams are under pressure to deliver a project on time and on budget that produces high-quality data during its operational period, leaving few resources available to plan long-term data management. The difficulty of planning is further compounded by the complexity of predicting circumstances and needs of the astronomy community in future decades. SDSS team members regarded libraries, long-lived institutions concerned with access to scholarship, as a potential solution to long-term data sustainability.As the SDSS data transfer was the first of this scale attempted - 160 TB of data - astronomers and library staff were faced with scoping the range of activities involved. They spent two years planning this five-year process. While successful overall as demonstration projects, the libraries encountered many obstacles. We found all parties experienced difficulty in articulating their notions of “scientific data,” “archiving,” “serving,” and “providing access” to the datasets. Activities and interpretations of the data transfer process varied by institutional motivations for participation and by available infrastructure. We conclude several, rather than a single, “library solutions” for long-term

  16. Very long-term sequelae of craniopharyngioma.

    PubMed

    Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

    2017-06-01

    Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

  17. Ultra-low power wireless sensing for long-term structural health monitoring

    NASA Astrophysics Data System (ADS)

    Bilbao, Argenis; Hoover, Davis; Rice, Jennifer; Chapman, Jamie

    2011-04-01

    Researchers have made significant progress in recent years towards realizing long-term structural health monitoring (SHM) utilizing wireless smart sensor networks (WSSNs). These efforts have focused on improving the performance and robustness of such networks to achieve high quality data acquisition and in-network processing. One of the primary challenges still facing the use of smart sensors for long-term monitoring deployments is their limited power resources. Periodically accessing the sensor nodes to change batteries is not feasible or economical in many deployment cases. While energy harvesting techniques show promise for prolonging unattended network life, low-power design and operation are still critically important. This research presents a new, fully integrated ultra-low power wireless smart sensor node and a flexible base station, both designed for long-term SHM applications. The power consumption of the sensor nodes and base station has been minimized through careful hardware selection and the implementation of power-aware network software, without sacrificing flexibility and functionality.

  18. Long-term care in international perspective.

    PubMed

    Doty, P

    1988-12-01

    The findings of a study of long-term care policies in 18 countries are reported in this article. Initial data were collected by a questionnaire survey under the auspices of the International Social Security Association. These data were supplemented by published documents and government statistics obtained while researching long-term care for the International Social Security Association and, subsequently, for the Organization for Economic Cooperation and Development. The principal focus is a cross-national comparison of institutionalization rates for the elderly. Differences in use rates for medically oriented facilities are less than those for nonmedical residential long-term care facilities. Only a small amount of variation is related to demographic differences, such as older or more female elderly populations in those countries with higher institutionalization rates. Included also is a description of the modes of financing long-term care.

  19. Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice

    PubMed Central

    Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

    2016-01-01

    PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice. DOI: http://dx.doi.org/10.7554/eLife.14846.001 PMID:27187150

  20. Competitive short-term and long-term memory processes in spatial habituation.

    PubMed

    Sanderson, David J; Bannerman, David M

    2011-04-01

    Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

  1. [Perioperative management of long-term medication].

    PubMed

    Vogel Kahmann, I; Ruppen, W; Lurati Buse, G; Tsakiris, D A; Bruggisser, M

    2011-01-01

    Anesthesiologists and surgeons are increasingly faced with patients who are under long-term medication. Some of these drugs can interact with anaesthetics or anaesthesia and/or surgical interventions. As a result, patients may experience complications such as bleeding, ischemia, infection or severe circulatory reactions. On the other hand, perioperative discontinuation of medication is often more dangerous. The proportion of outpatient operations has increased dramatically in recent years and will probably continue to increase. Since the implementation of DRGs (pending in Switzerland, introduced in Germany for some time), the patient enters the hospital the day before operation. This means that the referring physician as well as anesthesiologists and surgeons at an early stage must deal with issues of perioperative pharmacotherapy. This review article is about the management of the major drug classes during the perioperative period. In addition to cardiac and centrally acting drugs and drugs that act on hemostasis and the endocrine system, special cases such as immunosuppressants and herbal remedies are mentioned.

  2. Low-power sensor module for long-term activity monitoring.

    PubMed

    Leuenberger, Kaspar; Gassert, Roger

    2011-01-01

    Wearable sensor modules are a promising approach to collecting data on functional motor activities, both for repeated and long-term assessments, as well as to investigate the transfer of therapy to activities of daily living at home, but have so far either had limited sensing capabilities, or were not laid out for long-term monitoring. This paper presents ReSense, a miniature sensor unit optimized for long-term monitoring of functional activity. Inertial MEMS sensors capture accelerations along six degrees of freedom and a barometric pressure sensor serves as a precise altimeter. Data is written to an integrated memory card. The realized module measures Ø25 × 10 mm, weighs 10 g and can record continuously for 27 h at 25 Hz and over 22 h at 100 Hz. The integrated power-management system detects inactivity and extends the operating time by about a factor of two, as shown by initial 24 h recordings on five energetic healthy adults. The integrated barometric pressure sensor allowed to identify activities incorporating a change in altitude, such as going up/down stairs or riding an elevator. By taking into account data from the inertial sensors during the altitude changes, it becomes possible to distinguish between these two activities.

  3. Business Students' Choice of Short-Term or Long-Term Study Abroad Opportunities

    ERIC Educational Resources Information Center

    Fitzsimmons, Stacey R.; Flanagan, David J.; Wang, Xiaodan

    2013-01-01

    Recent years have seen a proliferation of short-term study abroad opportunities. Although they are both supplementing and replacing semester-long study abroad programs, research has focused primarily on semester (long-term) programs. We draw on the theory of planned behavior (TPB) to explore factors that predict why students choose long-term and…

  4. Long-term follow-up on recovery, return to use and sporting activity: a retrospective study of 236 operated colic horses in Finland (2006-2012).

    PubMed

    Immonen, Isa Anna Maria; Karikoski, Ninja; Mykkänen, Anna; Niemelä, Tytti; Junnila, Jouni; Tulamo, Riitta-Mari

    2017-01-05

    Surgical treatment of colic is expensive and complications may occur. Information on the prognosis and the use of the horse after surgery for colic is important for surgeons and owners. Current literature on return to athletic function after celiotomy is limited. The present study reviewed surgical cases of the Veterinary Teaching Hospital, Helsinki, Finland for 2006-2012. The aim was to follow the population of horses of different breeds for surgical findings, postsurgical complications, long-term recovery and prognosis. The findings and their influence on survival, return to previous or intended use and performance were assessed. Most of the operated horses (82.6%; 195/236) recovered from anesthesia and 74.9% (146/195) were discharged. The total follow-up time was 8 years and 10 months and the median survival time 79.2 months. Age of the horse, location of the abdominal lesion (small vs. large intestine), incidence of postoperative colic, surgical site infection, incisional hernia or convalescence time after surgery, did not significantly affect the probability of performing in the previous or intended discipline after the surgery. A majority of the discharged horses (83.7%) was able to perform in the previous or intended discipline and 78.5% regained their former or higher level of performance. Operated horses had 0.18 colic episodes per horse-year during the long-term follow-up. The incidence of colic was 20.0% within the first year after surgery. Horses operated for large intestinal colic were 3.3-fold more prone to suffer postoperative colic than horses operated for small intestinal colic. The majority of the owners (96.3%) were satisfied with the veterinary care and nearly all (98.5%) evaluated the recovery after the colic surgery to be satisfactory or above. If the horse survives to discharge, prognosis for long-term survival and return to previous level of sporting activity and performance was good after colic surgery in a population of horses of

  5. Zambia : long-term generation expansion study - executive summary.

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

    Conzelmann, G.; Koritarov, V.; Buehring, W.

    2008-02-28

    The objective of this study is to analyze possible long-term development options of the Zambian electric power system in the period up to 2015. The analysis involved the hydro operations studies of the Zambezi river basin and the systems planning studies for the least-cost generation expansion planning. Two well-known and widely accepted computer models were used in the analysis: PC-VALORAGUA model for the hydro operations and optimization studies and the WASP-III Plus model for the optimization of long-term system development. The WASP-III Plus model is a part of the Argonne National Laboratory's Energy and Power Evaluation Model (ENPEP). The analysismore » was conducted in close collaboration with the Zambia Electricity Supply Corporation (ZESCO). On the initiative from The World Bank, the sponsor of the study, ZESCO formed a team of experts that participated in the analysis and were trained in the use of computer models. Both models were transferred to ZESCO free of charge and installed on several computers in the ZESCO corporate offices in Lusaka. In September-October 1995, two members of the ZESCO National Team participated in a 4-week training course at Argonne National Laboratory near Chicago, U.S.A., focusing on the long-term system expansion planning using the WASP and VALORAGUA models. The hydropower operations studies were performed for the whole Zambezi river basin, including the full installation of the Kariba power station, and the Cahora Bassa hydro power station in Mozambique. The analysis also included possible future projects such as Itezhi-Tezhi, Kafue Gorge Lower, and Batoka Gorge power stations. As hydropower operations studies served to determine the operational characteristics of the existing and future hydro power plants, it was necessary to simulate the whole Zambezi river basin in order to take into account all interactions and mutual influences between the hydro power plants. In addition, it allowed for the optimization of reservoir

  6. GATEWAY Demonstrations: Long-Term Evaluation of SSL Field Performance in Select Interior Projects

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

    Davis, Tess E.; Davis, Robert G.; Wilkerson, Andrea M.

    The GATEWAY program evaluated the long-term performance characteristics (chromaticity change, maintained illuminance, and operations and maintenance) of LED lighting systems in four field installations previously documented in separate DOE GATEWAY reports.

  7. [Efficiency of preventive use of bemethyl during long-term voyages].

    PubMed

    Novikov, V S

    1991-03-01

    A positive effect of bemityl in the 24-hour dose of 0.25-0.5 g on the cellular and humoral factors of nonspecific defence, blood neutrophils intracellular exchange, barrier properties of the skin, working ability of operators and on morbidity has been established. An important property of the drug is long duration of preservation of the pharmacological effect, which prevents the development of disadaptation states following the cessation of its use. The data obtained gives the basis to recommend the actoprotective drug bemityl to increase nonspecific resistance during long-term voyages.

  8. Double bypass for inoperable pancreatic malignancy at laparotomy: postoperative complications and long-term outcome

    PubMed Central

    Ausania, F; Vallance, AE; Manas, DM; Prentis, JM; Snowden, CP; White, SA; Charnley, RM; French, JJ; Jaques, BC

    2012-01-01

    INTRODUCTION Between 4% and 13% of patients with operable pancreatic malignancy are found unresectable at the time of surgery. Double bypass is a good option for fit patients but it is associated with high risk of postoperative complications. The aim of this study was to identify pre-operatively which patients undergoing double bypass are at high risk of complications and to assess their long-term outcome. METHODS Of the 576 patients undergoing pancreatic resections between 2006 and 2011, 50 patients who underwent a laparotomy for a planned pancreaticoduodenectomy had a double bypass procedure for inoperable disease. Demographic data, risk factors for postoperative complications and pre-operative anaesthetic assessment data including the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) and cardiopulmonary exercise testing (CPET) were collected. RESULTS Fifty patients (33 men and 17 women) were included in the study. The median patient age was 64 years (range: 39–79 years). The complication rate was 50% and the in-hospital mortality rate was 4%. The P-POSSUM physiology subscore and low anaerobic threshold at CPET were significantly associated with postoperative complications (p=0.005 and p=0.016 respectively) but they were unable to predict them. Overall long-term survival was significantly shorter in patients with postoperative complications (9 vs 18 months). Postoperative complications were independently associated with poorer long-term survival (p=0.003, odds ratio: 3.261). CONCLUSIONS P-POSSUM and CPET are associated with postoperative complications but the possibility of using them for risk prediction requires further research. However, postoperative complications following double bypass have a significant impact on long-term survival and this type of surgery should therefore only be performed in specialised centres. PMID:23131226

  9. [LONG TERM FOLLOW-UP OF TRANSCATHETER SELF EXPANDABLE AORTIC VALVE IMPLANTATION].

    PubMed

    Chen, Shmuel; Zenios, Vicky; Gilon, Dan; Planer, David; Beeri, Ronen; Lotan, Chaim; Danenberg, Haim D

    2018-03-01

    Aortic stenosis is the most common significant valvular disease in the western world. These patients are treated operatively unless they are at high operative risk or inoperable. During the last decade an alternative approach has evolved - transcatheter aortic valve implantation (TAVI). This method was shown to be at least as effective and safe as the operative one. However, very little data exists on long term follow-up (5 years and above), especially regarding valve durability and patient survival. To present a long term follow-up on patients who underwent transcutaneous self-expandable aortic valve implantation in our department between the years 2008-2011. In September 2008 the first CoreValve implantation was performed in Israel at Hadassah Medical Center. All records of patients who were transplanted between 9.2008 and 10.2011 were reviewed. The function of the valve early after the procedure was compared to its function at the end of the follow-up period. A total of 38 patients (out of 71) survived at least 54 months, of them, 19 have an echocardiography examination at the end of the follow-up period. In all patients the implanted valve was found to function well at the end of the follow-up period, without significant stenosis or paravalvular leak. In fact, in approximately half of these patients, the degree of paravalvular leak decreased during the follow-up period. On long term (5 years) follow-up of patients who were implanted with the self-expandable aortic valve (CoreValve), no deterioration of the valve was observed. In fact, in approximately half of the patients, a decrease in the severity of the paravalvular leak was demonstrated.

  10. Long Periodic Terms in the Solar System

    NASA Technical Reports Server (NTRS)

    Bretagnon, P.

    1982-01-01

    The long period variations of the first eight planets in the solar system are studied. First, the Lagrangian solution is calculated and then the long period terms with fourth order eccentricities and inclinations are introduced into the perturbation function. A second approximation was made taking into account the short period terms' contribution, namely the perturbations of first order with respect to the masses. Special attention was paid to the determination of the integration constants. The relative importance of the different contributions is shown. It is useless, for example, to introduce the long period terms of fifth order if no account has been taken of the short period terms. Meanwhile, the terms that have been neglected would not introduce large changes in the integration constants. Even so, the calculation should be repeated with higher order short period terms and fifth order long periods.

  11. Short-term memory and long-term memory are still different.

    PubMed

    Norris, Dennis

    2017-09-01

    A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Short-Term Memory and Long-Term Memory are Still Different

    PubMed Central

    2017-01-01

    A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology—the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as “1, 3, 1” where there are 2 tokens of the digit “1” cannot be stored in the correct order simply by activating the representations of the digits “1” and “3” in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. PMID:28530428

  13. Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

    PubMed Central

    Wind, Joshua J.; Bakhtian, Kamran D.; Sweet, Jennifer A.; Mehta, Gautam U.; Thawani, Jayesh P.; Asthagiri, Ashok R.; Oldfield, Edward H.; Lonser, Russell R.

    2016-01-01

    Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in patients who underwent resection of brainstem hemangioblastomas. Methods Consecutive patients with VHL disease who underwent resection of brainstem hemangioblastomas with a follow-up of 12 months or more were included in this study. Serial functional assessments, radiographic examinations, and operative records were analyzed. Results Forty-four patients (17 male and 27 female) underwent 51 operations for resection of 71 brainstem hemangioblastomas. The most common presenting symptoms were headache, swallowing difficulties, singultus, gait difficulties, and sensory abnormalities. The mean follow-up was 5.9 ± 5.0 years (range 1.0–20.8 years). Immediately after 34 operations (66.7%), the patients remained at their preoperative functional status; they improved after 8 operations (15.7%) and worsened after 9 operations (17.6%) as measured by the McCormick scale. Eight (88.9%) of the 9 patients who were worse immediately after resection returned to their preoperative status within 6 months. Two patients experienced functional decline during long-term follow-up (beginning at 2.5 and 5 years postoperatively) caused by extensive VHL disease–associated CNS disease. Conclusions Generally, resection of symptomatic brainstem hemangioblastomas is a safe and effective management strategy in patients with VHL disease. Most patients maintain their preoperative functional status, although long-term decline in functional status may occur due to VHL disease–associated progression. PMID:20932100

  14. Bringing managed care home to the long-term care population.

    PubMed

    Nadash, Pamela; Ahrens, Joann

    2004-01-01

    Managed care has been proposed as a solution to the problems facing long-term care: its high costs, bias towards nursing homes, lack of coordination with acute and primary care, and inflexible service delivery. Kodner and Kyriacou (2003) argue that home care agencies may have considerable advantages in creating managed care systems for this population over traditional managed care organizations because of the experience home care organizations have in caring for older adults as well as people with disabilities. Although home care agencies are likely to better understand the needs of the long-term care population, they may lack the expertise and organizational resources to develop successful managed care organizations. Addressing these deficiencies will be key in order for home care organizations to successfully operate as managed care providers.

  15. Long-term performance and characterization of microbial desalination cells in treating domestic wastewater.

    PubMed

    Luo, Haiping; Xu, Pei; Ren, Zhiyong

    2012-09-01

    Microbial desalination cell represents a new technology for simultaneous wastewater treatment, water desalination, and energy production. This study characterized the long-term performance of MDC during wastewater treatment and identified the key factors that caused performance decline. The 8-month operation shows that MDC performance decreased over time, as indicated by a 47% decline in current density, a 46% drop in Columbic efficiency, and a 27% decrease in desalination efficiency. Advanced electrochemical, microscopy, and spectroscopy analyses all confirmed biofouling on the anion exchange membrane, which increased system resistance and reduced ionic transfer and energy conversion efficiency. Minor chemical scaling was found on the cation exchange membrane surface. Microbial communities became less diverse at the end of operation, and Proteobacteria spp. was dominant on both anode and AEM fouling layer surface. These results provide insights into the viability of long-term MDC operation on reactor performance and direct system development through membrane optimization. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Long-Term Memory Performance in Adult ADHD.

    PubMed

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya

    2017-02-01

    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  17. 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... payment system. The prospective payment system includes payment for inpatient operating costs of...

  18. Virtual Models of Long-Term Care

    ERIC Educational Resources Information Center

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  19. Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents.

    PubMed

    Hunnicutt, Jacob N; Chrysanthopoulou, Stavroula A; Ulbricht, Christine M; Hume, Anne L; Tjia, Jennifer; Lapane, Kate L

    2018-01-01

    Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). Cross-sectional. U.S. NHs (N = 13,522). Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

  20. Peri-operative kidney injury and long-term chronic kidney disease following orthotopic heart transplantation in children.

    PubMed

    Hoskote, Aparna; Burch, Michael

    2015-06-01

    Significant advances in cardiac intensive care including extracorporeal life support have enabled children with complex congenital heart disease and end-stage heart failure to be supported while awaiting transplantation. With an increasing number of survivors after heart transplantation in children, the complications from long-term immunosuppression, including renal insufficiency, are becoming more apparent. Severe renal dysfunction after heart transplant is defined by a serum creatinine level >2.5 mg/dL (221 μmol/L), and/or need for dialysis or renal transplant. The degree of renal dysfunction is variable and is progressive over time. About 3-10 % of heart transplant recipients will go on to develop severe renal dysfunction within the first 10 years post-transplantation. Multiple risk factors for chronic kidney disease post-transplant have been identified, which include pre-transplant worsening renal function, recipient demographics and morbidity, peri-transplant haemodynamics and long-term exposure to calcineurin inhibitors. Renal insufficiency increases the risk of post-transplant morbidity and mortality. Hence, screening for renal dysfunction pre-, peri- and post-transplantation is important. Early and timely detection of renal insufficiency may help minimize renal insults, and allow prompt implementation of renoprotective strategies. Close monitoring and pre-emptive management of renal dysfunction is an integral aspect of peri-transplant and subsequent post-transplant long-term care.

  1. Long-term temperature effects on GaAs solar cells

    NASA Technical Reports Server (NTRS)

    Heinbockel, J. H.; Hong, K. H.

    1979-01-01

    The thermal degradation of AlGaAs solar cells resulting from a long-term operation in a space environment is investigated. The solar cell degradation effects caused by zinc and aluminum diffusion as well as deterioration by arsenic evaporation are presented. Also, the results are presented of experimental testing and measurements of various GaAs solar cell properties while the solar cell was operating in the temperature range of 27 C to 350 C. In particular, the properties of light current voltage curves, dark current voltage curves, and spectral response characteristics are given. Finally, some theoretical models for the annealing of radiation damage over various times and temperatures are included.

  2. [Predictors of long-term remission after transsphenoidal surgery in Cushing's disease].

    PubMed

    Abellán Galiana, Pablo; Fajardo Montañana, Carmen; Riesgo Suárez, Pedro Antonio; Gómez Vela, José; Escrivá, Carlos Meseguer; Lillo, Vicente Rovira

    2013-10-01

    There is no consensus on the remission criteria for Cushing's disease or on the definition of disease recurrence after transsphenoidal surgery, and comparison of the different published series is therefore difficult. A long-term recurrence rate of Cushing's disease ranging from 2%-25% has been reported. Predictors of long-term remission reported include: 1) adenoma-related factors (aggressiveness, size, preoperative identification in MRI), 2) surgery-related factors, mainly neurosurgeon experience, 3) clinical factors, of which dependence on and duration of glucocorticoid treatment are most important, and 4) biochemical factors. Among the latter, low postoperative cortisol levels, less than 2 mcg/dL predict for disease remission. However, even when undetectable plasma cortisol levels are present, long-term recurrence may still occur and lifetime follow-up is required. We report the preliminary results of the first 20 patients with Cushing's disease operated on at our hospital using nadir cortisol levels less than 2 mcg/dl as remission criterion. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  3. Complex network structure influences processing in long-term and short-term memory.

    PubMed

    Vitevitch, Michael S; Chan, Kit Ying; Roodenrys, Steven

    2012-07-01

    Complex networks describe how entities in systems interact; the structure of such networks is argued to influence processing. One measure of network structure, clustering coefficient, C, measures the extent to which neighbors of a node are also neighbors of each other. Previous psycholinguistic experiments found that the C of phonological word-forms influenced retrieval from the mental lexicon (that portion of long-term memory dedicated to language) during the on-line recognition and production of spoken words. In the present study we examined how network structure influences other retrieval processes in long- and short-term memory. In a false-memory task-examining long-term memory-participants falsely recognized more words with low- than high-C. In a recognition memory task-examining veridical memories in long-term memory-participants correctly recognized more words with low- than high-C. However, participants in a serial recall task-examining redintegration in short-term memory-recalled lists comprised of high-C words more accurately than lists comprised of low-C words. These results demonstrate that network structure influences cognitive processes associated with several forms of memory including lexical, long-term, and short-term.

  4. Long-term outcomes of acute kidney injury.

    PubMed

    Coca, Steven G

    2010-05-01

    The goal of this review is to summarize the recent plethora of data that relate to long-term outcomes after acute kidney injury (AKI). Surviving patients with AKI are still at high risk for long-term adverse outcomes, even if serum creatinine returns to normal. After adjusting for potential confounders, many recent studies have demonstrated that AKI is independently associated with chronic kidney disease, end-stage renal disease, and premature death. Unfortunately, definitive evidence from randomized controlled trials demonstrating that prevention or treatment of AKI prevents long-term adverse outcomes is not yet available. AKI is clearly a prognostic marker for poor long-term outcomes, but more studies will be needed to determine whether AKI is truly causal and whether or not the risk is modifiable.

  5. Perioperative and Long-Term Smoking Behaviors in Cosmetic Surgery Patients.

    PubMed

    Van Slyke, Aaron C; Carr, Michael; Knox, Aaron D C; Genoway, Krista; Carr, Nicholas J

    2017-09-01

    Many plastic surgeons advocate smoking cessation before patients undergo cosmetic surgery with extensive soft-tissue dissection. Smoking cessation rates after cosmetic surgery are unknown. The preoperative consultation may be an opportunity to promote long-term smoking cessation. This is a retrospective, cross-sectional cohort study. All patients over an 8-year study period who smoked before their preoperative consultation; who quit 2 weeks before surgery; and who subsequently underwent rhytidectomy, abdominoplasty, or mastopexy were included. Patients were asked to complete a Web-based survey at long-term follow-up. Eighty-five smokers were included, and 47 patients completed the survey, for a response rate of 55.3 percent. Average follow-up was 63.3 months. Five respondents were social smokers and thus excluded. Of the 42 daily smokers, 17 patients (40.5 percent) were no longer smoking cigarettes on a daily basis at long-term follow-up. Of these 17 patients, 10 (23.8 percent) had not smoked since their operation. A total of 24 patients (57.1 percent) had reduced their cigarette consumption by any amount, and 70.8 percent (17 of 24) of these patients agreed that discussing adverse surgical outcomes related to smoking influenced their ability to quit/reduce. Twenty-one of 42 patients (50.0 percent) admitted that they were not compliant with the preoperative smoking cessation instructions. This is the first report to investigate long-term smoking cessation from a cosmetic surgery practice. The authors have shown a positive association between smoking cessation and cosmetic surgery. Requesting a period of cessation before cosmetic surgery may promote long-lasting smoking cessation.

  6. Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends.

    PubMed

    Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

    2013-10-01

    Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the

  7. Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends

    PubMed Central

    Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

    2013-01-01

    Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the

  8. A Long-Term View on Perovskite Optoelectronics.

    PubMed

    Docampo, Pablo; Bein, Thomas

    2016-02-16

    Recently, metal halide perovskite materials have become an exciting topic of research for scientists of a wide variety of backgrounds. Perovskites have found application in many fields, starting from photovoltaics and now also making an impact in light-emitting applications. This new class of materials has proven so interesting since it can be easily solution processed while exhibiting materials properties approaching the best inorganic optoelectronic materials such as GaAs and Si. In photovoltaics, in only 3 years, efficiencies have rapidly increased from an initial value of 3.8% to over 20% in recent reports for the commonly employed methylammonium lead iodide (MAPI) perovskite. The first light emitting diodes and light-emitting electrochemical cells have been developed already exhibiting internal quantum efficiencies exceeding 15% for the former and tunable light emission spectra. Despite their processing advantages, perovskite optoelectronic materials suffer from several drawbacks that need to be overcome before the technology becomes industrially relevant and hence achieve long-term application. Chief among these are the sensitivity of the structure toward moisture and crystal phase transitions in the device operation regime, unreliable device performance dictated by the operation history of the device, that is, hysteresis, the inherent toxicity of the structure, and the high cost of the employed charge selective contacts. In this Account, we highlight recent advances toward the long-term viability of perovskite photovoltaics. We identify material decomposition routes and suggest strategies to prevent damage to the structure. In particular, we focus on the effect of moisture upon the structure and stabilization of the material to avoid phase transitions in the solar cell operating range. Furthermore, we show strategies to achieve low-cost chemistries for the development of hole transporters for perovskite solar cells, necessary to be able to compete with other

  9. Long-Term Dynamics of Autonomous Fractional Differential Equations

    NASA Astrophysics Data System (ADS)

    Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

    This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

  10. First long-term evidence supporting endovascular repair of abdominal aortic aneurysms.

    PubMed

    Indes, Jeffrey E; Muhs, Bart E; Dardik, Alan

    2013-04-01

    The traditional method of treating abdominal aortic aneurysms with open surgical repair has been steadily replaced by endovascular repair, thought to be a more minimally invasive approach. It is not known, however, whether the endovascular approach is truly less invasive for operative physiology; in addition, this approach has a different spectrum of complications. As such, it is uncertain whether elective endovascular repair of nonruptured aortic aneurysms reduces long-term morbidity and mortality compared with traditional open approaches. In this article, the authors evaluate a recent publication investigating long-term outcomes of a prospective randomized multicenter trial evaluating patients with asymptomatic abdominal aortic aneurysms treated with either endovascular or open repair, and discuss the results in the context of current evidence.

  11. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

    ERIC Educational Resources Information Center

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  12. Correction of syndactyly using a dorsal omega flap and two lateral and volar flaps. A long-term review.

    PubMed

    D'Arcangelo, M; Gilbert, A; Pirrello, R

    1996-06-01

    The long-term results of a technique for correction of syndactyly are reported. The technique consists of a dorsal omega flap and a palmar anchor forming two palmar and lateral flaps. A long-term review was made of 50 patients with a minimum of 8 years follow-up operated over a period of 10 years. A total of 122 web spaces in simple, complex and syndromic syndactyly were operated on. Most patients achieved satisfactory reconstruction of the web spaces, resulting in a web of good shape. At long-term review, web creep was recorded in eight webs, and skin contractures in three fingers. This study shows the technique to be effective in reconstructing web spaces and in minimizing the prevalence of complications.

  13. Long-term effects of chronic intermittent ethanol exposure in adolescent and adult rats: radial-arm maze performance and operant food reinforced responding.

    PubMed

    Risher, Mary-Louise; Fleming, Rebekah L; Boutros, Nathalie; Semenova, Svetlana; Wilson, Wilkie A; Levin, Edward D; Markou, Athina; Swartzwelder, H Scott; Acheson, Shawn K

    2013-01-01

    Adolescence is not only a critical period of late-stage neurological development in humans, but is also a period in which ethanol consumption is often at its highest. Given the prevalence of ethanol use during this vulnerable developmental period we assessed the long-term effects of chronic intermittent ethanol (CIE) exposure during adolescence, compared to adulthood, on performance in the radial-arm maze (RAM) and operant food-reinforced responding in male rats. Male Sprague Dawley rats were exposed to CIE (or saline) and then allowed to recover. Animals were then trained in either the RAM task or an operant task using fixed- and progressive- ratio schedules. After baseline testing was completed all animals received an acute ethanol challenge while blood ethanol levels (BECs) were monitored in a subset of animals. CIE exposure during adolescence, but not adulthood decreased the amount of time that animals spent in the open portions of the RAM arms (reminiscent of deficits in risk-reward integration) and rendered animals more susceptible to the acute effects of an ethanol challenge on working memory tasks. The operant food reinforced task showed that these effects were not due to altered food motivation or to differential sensitivity to the nonspecific performance-disrupting effects of ethanol. However, CIE pre-treated animals had lower BEC levels than controls during the acute ethanol challenges indicating persistent pharmacokinetic tolerance to ethanol after the CIE treatment. There was little evidence of enduring effects of CIE alone on traditional measures of spatial and working memory. These effects indicate that adolescence is a time of selective vulnerability to the long-term effects of repeated ethanol exposure on neurobehavioral function and acute ethanol sensitivity. The positive and negative findings reported here help to further define the nature and extent of the impairments observed after adolescent CIE and provide direction for future research.

  14. Long-term studies of dopamine agonists.

    PubMed

    Hubble, Jean P

    2002-02-26

    Dopamine agonists have long been used as adjunctive therapy for the treatment of Parkinson's disease (PD). In more recent years these drugs have also been proved safe and effective as initial therapy in lieu of levodopa in the treatment of PD. Long-term levodopa therapy is associated with motor complications, including fluctuating response patterns and dyskinesia. By initially introducing a dopamine agonist as symptomatic drug therapy, it may be possible to postpone the use of levodopa and delay or prevent the development of motor complications. Recently, four clinical trials have explored this hypothesis by comparing the long-term response and side effects of levodopa with dopamine agonist therapy. The drugs studied have included ropinirole, pramipexole, cabergoline, and pergolide. In each of these projects, the occurrence of motor complications, such as wearing off and dyskinesia, was significantly less in the subjects assigned to initiation of therapy with a dopamine agonist. The addition of levodopa could be postponed by many months or even several years. Therefore, these long-term studies of dopamine agonists support the initiation of a dopamine agonist instead of levodopa in an effort to postpone levodopa-related motor complications. This therapeutic approach may be particularly appropriate in PD patients with a long treatment horizon on the basis of age and general good health. The extension phase of the long-term study comparing pramipexole with levodopa is ongoing, and follow-up information may help to establish the value of this treatment strategy.

  15. Predictors of short-term and long-term incontinence after robot-assisted radical prostatectomy.

    PubMed

    Shao, I-Hung; Chang, Ying-Hsu; Hou, Chun-Ming; Lin, Zheng-Feng; Wu, Chun-Te

    2018-01-01

    Purpose To determine retrospectively the prognostic factors for urinary incontinence following robot-assisted radical prostatectomy (RARP). Methods Altogether, 180 patients with localized prostate cancer underwent RARP (same surgeon). Preoperative physical status, disease characteristics, laboratory findings, and surgical technique were recorded and the patients checked 1, 6, 12, and 24 months after RARP regarding their contribution to predicting post-prostatectomy urinary incontinence (PPI). Results Overall, 114 (63.3%) patients had PPI 1 month after RARP and 19 patients (16.0%) at 24 months. Univariate analysis showed that age was a significant factor for predicting PPI at 1 month. PPI predictors at 24 months were age, body mass index, preoperative serum albumin level, previous transurethral resection of the prostate, total operative time, and bladder neck sparing. Multivariate analysis indicated that age and total operative time were significant predictors. Conclusion Older age and longer operative time were highly relevant to short- and long-term PPI occurrence after RARP.

  16. Modelling of long-term and short-term mechanisms of arterial pressure control in the cardiovascular system: an object-oriented approach.

    PubMed

    Fernandez de Canete, J; Luque, J; Barbancho, J; Munoz, V

    2014-04-01

    A mathematical model that provides an overall description of both the short- and long-term mechanisms of arterial pressure regulation is presented. Short-term control is exerted through the baroreceptor reflex while renal elimination plays a role in long-term control. Both mechanisms operate in an integrated way over the compartmental model of the cardiovascular system. The whole system was modelled in MODELICA, which uses a hierarchical object-oriented modelling strategy, under the DYMOLA simulation environment. The performance of the controlled system was analysed by simulation in light of the existing hypothesis and validation tests previously performed with physiological data, demonstrating the effectiveness of both regulation mechanisms under physiological and pathological conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Long Term TOA - M Data and Information

    Atmospheric Science Data Center

    2017-09-06

    ... A Long-Term TOA and Constrained Surface Radiation Budget Project A Long-Term TOA and Constrained Surface Readiation ... Budget Experiment (ERBE) and Clouds and the Earth's Radiant Energy System (CERES), that span nearly 30 years to date.   The ...

  18. Long term performance of membranes in an anaerobic membrane bioreactor treating municipal wastewater.

    PubMed

    Dong, Qirong; Parker, Wayne; Dagnew, Martha

    2016-02-01

    The long term impact of SRT (100-40 days) and recovery cleaning on membrane performance of an AnMBR treating authentic municipal wastewater in a large pilot plant was assessed. Successful operation of the pilot plant at a flux of 17 LMH was maintained for a period of 536 days during which the longest period of operation without recovery cleaning or membrane replacement was 178 days. Lower SRT (40 days) reduced the fouling propensity of the mixed liquor in terms of TSS concentration and the dewaterability indicators including colloidal COD (cCOD) concentration and capillary suction time (CST). Critical fluxes ranged from 21 to 23 LMH to 25-27 LMH for SRTs of 70 and 40 days respectively and this was consistent with the reduced concentrations of TSS and improved dewaterability under the latter conditions. Recovery cleaning was found to result in substantial reduction of resistance as indicated by both pilot plant operation and clean water flux tests. The long-term fouling rate was observed to be higher with cleaned membranes as compared to virgin membranes. The lower membrane fouling with virgin membranes suggested that accumulation of foulants, which were resistant to cleaning, caused the higher fouling rates for the cleaned membranes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Long-term biological investigations in space.

    PubMed

    Lotz, R G; Fuchs, H; Bertsche, U

    1975-01-01

    Missions in space within the next two decades will be of longer duration than those carried out up to the present time, and the effects of such long-term flights on biological organisms are unknown. Results of biological experiments that have been performed to date cannot be extrapolated to results in future flights because of the unknown influence of adaptation over a long period of time. Prior experiments with Axolotl, fishes, and vertebrates by our research team (in part with sounding rockets) showed that these specimens did not appear to be suitable for long-term missions on which minimization of expense, technique, and energy is required. Subsequent investigations have shown the suitability of the leech (Hirudo medicinalis), which consumes blood of mammals up to ten times its own weight (1 g) and can live more than 2 years without further food supply. Emphasis in the experiments with Hirudo medicinalis is placed on metabolic rhythm and motility. Resorption and diffusion in tissue, development, and growth under long-term effects of cosmic proton radiation and zero-gravity are other focal points. The constancy of cellular life in the mature animals is a point in favor of these specimens. We have also taken into account the synergistic effects of the space environment on the problems just mentioned. The life-support system constructed for the leech has been tested successfully in four sounding rocket flights and, on that basis, has been prepared for a long-term mission. Long-term investigations out of the terrestrial biosphere will provide us with information concerning the degree of adaptation of certain physiological and biochemical functions and as to what extent biological readjustment or repair processes can occur under the specific stress conditions of space flight.

  20. Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage.

    PubMed

    Lee, Shen-Yang; Hsu, Hsiang-Hao; Chen, Yung-Chang; Huang, Chen-Chih; Wong, Yon-Cheong; Wang, Li-Jen; Chuang, Cheng-Keng; Yang, Chih-Wei

    2009-11-01

    This study retrospectively evaluated outcomes, complications, and tumor shrinkage in renal angiomyolipomas after transcatheter arterial embolization (TAE). All renal angiomyolipoma patients who underwent TAE between August 2000 and December 2008 and had short-term (long-term (>6 months) follow-up images were evaluated. Complications and tumor relapse after TAE were reviewed. The sizes of embolized tumors were measured to calculate size reductions and reduction rates after TAE. Differences in tumor size, size reduction, and reduction rate between different time points (pre-TAE, short-term follow-up, and long-term follow-up) and groups (completely and incompletely embolized) were determined. Eleven renal angiomyolipoma patients who had undergone TAE were included. Seven (63.6%) patients had postembolization syndrome and one had abscess formation following TAE. Two patients had a tumor relapse (18.2%). The mean tumor size was 8.57+/-2.66 cm on pre-TAE images. The mean size reduction was 3.1 cm (33.3%) and 3.8 cm (43.0%) at short-term and long-term follow-up. Tumor sizes differed significantly between pre-TAE and short-term (p=0.004) or long-term images (p=0.022) but not between short-term and long-term images (p=0.059). Results stratified by the completeness of embolization indicate that only the short-term size reduction rate differed significantly (p=0.025), while the long-term reduction rate and short- and long-term follow-up tumor size and size reduction were comparable between the two groups. In conclusion, selective TAE is effective for tumor shrinkage in most renal angiomyolipomas, with acceptable complication and relapse rates. Tumor shrinkage occurring within 6 months after TAE may reflect the long-term effect of TAE.

  1. Long-term outcome and quality of life of patients requiring prolonged mechanical ventilation after cardiac surgery.

    PubMed

    Pappalardo, Federico; Franco, Annalisa; Landoni, Giovanni; Cardano, Paola; Zangrillo, Alberto; Alfieri, Ottavio

    2004-04-01

    To study the long-term survival and quality of life of patients with a complicated post-operative course after cardiac surgery requiring prolonged (>or=7 days) mechanical ventilation (MV), since they represent a heavy burden on hospital resources and their outcome has never been adequately evaluated. Out of 4827 consecutive cardiac surgical patients, 148 (3%) required prolonged post-operative MV: their hospital course was analysed and factors affecting prolonged MV and mortality were identified using multivariate analysis. Long-term survival was assessed using Cox proportional hazard method. Long-term (36+/-12 months) follow-up information was collected and quality of life was assessed by an ad hoc questionnaire. Overall mortality in the study group was 45.3 versus 2% in the control population (P<0.0001). Predictors of death in the prolonged MV group were age (odds ratio, OR 1.049) and diabetes (OR 3.459). Long-term survival was significantly worse in those patients who were extubated after 21 days: 88.9 versus 70.9% at 1 year (P=0.03) and 80.9 versus 64.5% at 5 years (P=0.05). Mild or no limitation in daily living was referred by 69% of the survivors. The hospital mortality of patients requiring prolonged MV is high. The long-term survival of patients who are weaned from MV after 21 days is significantly lower. The great majority of the survivors can enjoy a good quality of life.

  2. Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults.

    PubMed

    Minnillo, Brian J; Cruz, Jose A S; Sayao, Rogerio H; Passerotti, Carlo C; Houck, Constance S; Meier, Petra M; Borer, Joseph G; Diamond, David A; Retik, Alan B; Nguyen, Hiep T

    2011-04-01

    Laparoscopic pyeloplasty is one of the more common robotic assisted procedures performed in children. However, data regarding long-term experience and clinical outcomes for this procedure are limited. We evaluated the long-term outcomes in a large series of patients undergoing robotic assisted laparoscopic pyeloplasty at a teaching institution, and the effect of a collaborative program between the robotic surgeons, surgical nurses and anesthesiologists on overall operative time. We retrospectively reviewed 155 patients who underwent robotic assisted laparoscopic pyeloplasty between 2002 and 2009. Operative data, including surgical approach, type of procedure, total and specific operative times and placement of ureteral stents, were determined. Postoperative outcome measurements, including duration of hospital stay, duration of Foley catheter drainage, radiological findings and any subsequent complications, were assessed. Mean operative time and length of hospitalization decreased significantly by the end of the study. At a mean followup of 31.7 months the primary success rate was 96% (hydronephrosis was improved in 85% of patients and stable in 11%). The complication rate was 11%, and recurrent obstruction requiring redo robotic assisted laparoscopic pyeloplasty or open pyeloplasty developed in 3% of patients. Success rate and complication rate were unchanged during the study period. This study confirms that even within the confines of a pediatric urology training program successful collaboration between robotic surgeons, surgical nurses and anesthesiologists can lead to shorter operative times and hospital stays. Long-term surgical success and complication rates were comparable to open surgery. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Assessment of acetabular retroversion following long term review of Salter's osteotomy.

    PubMed

    Robb, Curtis A; Datta, Amit; Nayeemuddin, Mohammed; Bache, Christopher E

    2009-01-01

    Salter's innominate osteotomy may predispose to anterior over-coverage of the acetabulum. Over cover or retroversion has been demonstrated to be a cause of hip pain, impingement and subsequent osteoarthritis. We reviewed the long-term follow up of seventeen skeletally mature hips in sixteen patients who had previously undergone a Salter's osteotomy in childhood. The Salter pelvic osteotomy was performed at a mean average age of 5 years and follow up at a mean average age of 20 years. Patients were assessed by clinical examination for signs of impingement, Harris Hip Score and pelvic radiograph. Acetabular version was evaluated by the relationship between anterior and posterior walls of the acetabulum using templates applied to the pelvic radiograph as described by Hefti. The median acetabular cover averaged 17 degrees of anteversion with 2 patients (12%) demonstrating retroversion, neither of whom, had signs of impingement on examination. The mean average Harris Hip Score was 85 indicating a good outcome at long-term follow-up. We believe acetabular remodelling may occur with age after Salter's innominate osteotomy and have found good results in patients after skeletal maturation. Fears of long-term anterior over-coverage and retroversion with this operation may be unfounded.

  4. Design and operation of an anaerobic digester for waste management and fuel generation during long term lunar mission

    NASA Astrophysics Data System (ADS)

    Dhoble, Abhishek S.; Pullammanappallil, Pratap C.

    2014-10-01

    Waste treatment and management for manned long term exploratory missions to moon will be a challenge due to longer mission duration. The present study investigated appropriate digester technologies that could be used on the base. The effect of stirring, operation temperature, organic loading rate and reactor design on the methane production rate and methane yield was studied. For the same duration of digestion, the unmixed digester produced 20-50% more methane than mixed system. Two-stage design which separated the soluble components from the solids and treated them separately had more rapid kinetics than one stage system, producing the target methane potential in one-half the retention time than the one stage system. The two stage system degraded 6% more solids than the single stage system. The two stage design formed the basis of a prototype digester sized for a four-person crew during one year exploratory lunar mission.

  5. Coupling long and short term decisions in the design of urban water supply infrastructure for added reliability and flexibility

    NASA Astrophysics Data System (ADS)

    Marques, G.; Fraga, C. C. S.; Medellin-Azuara, J.

    2016-12-01

    The expansion and operation of urban water supply systems under growing demands, hydrologic uncertainty and water scarcity requires a strategic combination of supply sources for reliability, reduced costs and improved operational flexibility. The design and operation of such portfolio of water supply sources involves integration of long and short term planning to determine what and when to expand, and how much to use of each supply source accounting for interest rates, economies of scale and hydrologic variability. This research presents an integrated methodology coupling dynamic programming optimization with quadratic programming to optimize the expansion (long term) and operations (short term) of multiple water supply alternatives. Lagrange Multipliers produced by the short-term model provide a signal about the marginal opportunity cost of expansion to the long-term model, in an iterative procedure. A simulation model hosts the water supply infrastructure and hydrologic conditions. Results allow (a) identification of trade offs between cost and reliability of different expansion paths and water use decisions; (b) evaluation of water transfers between urban supply systems; and (c) evaluation of potential gains by reducing water system losses as a portfolio component. The latter is critical in several developing countries where water supply system losses are high and often neglected in favor of more system expansion.

  6. The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm.

    PubMed

    Abdulrasak, M; Resch, T; Sonesson, B; Holst, J; Kristmundsson, T; Dias, N V

    2017-01-01

    The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months' follow-up. In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15-72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to

  7. Mechanical properties and microstructure of long term thermal aged WWER 440 RPV steel

    NASA Astrophysics Data System (ADS)

    Kolluri, M.; Kryukov, A.; Magielsen, A. J.; Hähner, P.; Petrosyan, V.; Sevikyan, G.; Szaraz, Z.

    2017-04-01

    The integrity assessment of the Reactor Pressure Vessel (RPV) is essential for the safe and Long Term Operation (LTO) of a Nuclear Power Plant (NPP). Hardening and embrittlement of RPV caused by neutron irradiation and thermal ageing are main reasons for mechanical properties degradation during the operation of an NPP. The thermal ageing-induced degradation of RPV steels becomes more significant with extended operational lives of NPPs. Consequently, the evaluation of thermal ageing effects is important for the structural integrity assessments required for the lifetime extension of NPPs. As a part of NRG's research programme on Structural Materials for safe-LTO of Light Water Reactor (LWR) RPVs, WWER-440 surveillance specimens, which have been thermal aged for 27 years (∼200,000 h) at 290 °C in a surveillance channel of Armenian-NPP, are investigated. Results from the mechanical and microstructural examination of these thermal aged specimens are presented in this article. The results indicate the absence of significant long term thermal ageing effect of 15Cr2MoV-A steel. No age hardening was detected in aged tensile specimens compared with the as-received condition. There is no difference between the impact properties of as-received and thermal aged weld metals. The upper shelf energy of the aged steel remains the same as for the as-received material at a rather high level of about 120 J. The T41 value did not change and was found to be about 10 °C. The microstructure of thermal aged weld, consisting carbides, carbonitrides and manganese-silicon inclusions, did not change significantly compared to as-received state. Grain-boundary segregation of phosphorus in long term aged weld is not significant either which has been confirmed by the absence of intergranular fracture increase in the weld. Negligible hardening and embrittlement observed after such long term thermal ageing is attributed to the optimum chemical composition of 15Cr2MoV-A for high thermal stability.

  8. Long-term outcomes of external femoral derotation osteotomies in children with cerebral palsy.

    PubMed

    Õunpuu, Sylvia; Solomito, Matthew; Bell, Katharine; Pierz, Kristan

    2017-07-01

    External femoral derotation osteotomy (FDO) is an orthopaedic intervention to correct increased femoral anteversion and associated excessive internal hip rotation and internal foot progression during gait in children with cerebral palsy. The resulting functional issues may include clearance problems and hip abductor lever-arm dysfunction. The purpose of this study was to evaluate long-term gait outcomes of FDO. Twenty ambulatory patients (27 sides) with cerebral palsy who underwent pre-operative (P0) and a one year post-operative (P1) gait analysis as part of the standard of care had a second post-operative analysis (P2) approximately 11 years post-surgical intervention. Mean hip rotation in stance showed statistically significant decreases in internal rotation at P1 post-surgical intervention that were maintained long-term (mean hip rotation P0: 21±9, P1: 0±9 and P2: 6±12 degrees internal). Similar results were seen with mean foot progression (P0: 9±16 degrees internal, P1: 14±13 degrees external, P2: 13±16 degrees external). However, 2/27 sides (9%) showed a recurrence of internal hip rotation of >15° at the 11year follow-up. The reasons for this recurrence could include age, surgical location and ongoing disease process all of which need to be further examined. We conclude that FDO can show long-term kinematic and functional benefits when performed in the prepubescent child with cerebral palsy in comparison to the natural progression of of hip rotation in cerebral palsy. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Long-term effectiveness of surgical treatment of ectopic atrial tachycardia.

    PubMed

    Prager, N A; Cox, J L; Lindsay, B D; Ferguson, T B; Osborn, J L; Cain, M E

    1993-07-01

    The purpose of this study was to determine the long-term clinical outcome of patients with ectopic atrial tachycardias treated surgically. Ectopic atrial tachycardia is an uncommon arrhythmia that can be symptomatic and is associated with the development of a cardiomyopathy. Management strategies are not well defined because of the paucity of data on the long-term effectiveness of pharmacologic and nonpharmacologic therapies. The long-term clinical impact of medical and surgical therapy was determined in 15 consecutive patients with ectopic atrial tachycardia. All 15 patients were initially treated with antiarrhythmic drugs (mean 5.7 +/- 2.2 drugs/patient). An effective drug regimen was identified in only 5 (33%) of the 15 patients; the remaining 10 patients were treated surgically. In each, individualized surgical procedures were guided by computer-assisted intraoperative mapping, with atrial plaques comprising up to 156 electrodes. Focal ablation was performed in four patients and atrial isolation procedures in six. The 10 patients treated surgically were followed up a mean of 4 +/- 3.2 years. Ectopic atrial tachycardia recurred in one patient. A permanent pacemaker was implanted in two patients, one of whom also required reoperation for constrictive pericarditis. There were no operative deaths. Ectopic atrial tachycardia recurred in three (60%) of the five patients discharged on antiarrhythmic drug therapy during a mean follow-up interval of 6.4 +/- 4.3 years. There was one nonarrhythmic death. Map-guided surgery demonstrated long-term efficacy in abolishing symptoms in 9 of the 10 patients with ectopic atrial tachycardia. Results demonstrate that surgery is effective for patients with ectopic atrial tachycardias who are not easily treated with antiarrhythmic drugs.

  10. 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

    ... December 29, 2007, was co-located with an entity that is a provider-based, off-campus location of a... hospital or the satellite facility from any individual hospital not co-located with the long-term care... from any individual hospital not co-located with the long-term care hospital or with the satellite of a...

  11. Hippocampal Focal Knockout of CBP Affects Specific Histone Modifications, Long-Term Potentiation, and Long-Term Memory

    PubMed Central

    Barrett, Ruth M; Malvaez, Melissa; Kramar, Eniko; Matheos, Dina P; Arrizon, Abraham; Cabrera, Sara M; Lynch, Gary; Greene, Robert W; Wood, Marcelo A

    2011-01-01

    To identify the role of the histone acetyltransferase (HAT) CREB-binding protein (CBP) in neurons of the CA1 region of the hippocampus during memory formation, we examine the effects of a focal homozygous knockout of CBP on histone modifications, gene expression, synaptic plasticity, and long-term memory. We show that CBP is critical for the in vivo acetylation of lysines on histones H2B, H3, and H4. CBP's homolog p300 was unable to compensate for the loss of CBP. Neurons lacking CBP maintained phosphorylation of the transcription factor CREB, yet failed to activate CREB:CBP-mediated gene expression. Loss of CBP in dorsal CA1 of the hippocampus resulted in selective impairments to long-term potentiation and long-term memory for contextual fear and object recognition. Together, these results suggest a necessary role for specific chromatin modifications, selectively mediated by CBP in the consolidation of memories. PMID:21508930

  12. An European framework for the long term preservation of EO data

    NASA Astrophysics Data System (ADS)

    Forcada, E.; Albani, M.; Beruti, V.

    2009-04-01

    The need for accessing historical Earth Observation (EO) data series strongly increased in the last ten years, mainly for long term science and environmental monitoring applications. This trend is likely to increase even more in the future in particular for the growing interest on global change monitoring that requires data time-series spanning 20 years and more, and for the need to support the United Nations Framework Convention on Climate Change (UNFCCC). Content of EO data archives is extending from a few years to decades and their scientific value is continuously increasing hence is well recognized the need to preserve them without time limitation and to keep the archived EO data well accessible and exploitable as they constitute a humankind asset. The large amount of new Earth Observation missions upcoming in the next years will moreover lead to a major increase of EO data volumes. This fact, together with the increased demands from the scientific user community, marks a challenge for Earth Observation satellite operators, Space Agencies and EO data providers regarding coherent data preservation and optimum availability and accessibility of the different data products. Traditionally in Europe, there has been poor cooperation in this field with no common approach for long term preservation and access to EO space data even if cooperation and sharing are key aspects to be pursued for the benefit of the user community. Single organizations have difficulties to afford data preservation in the long term that calls for the need of optimising costs and efforts, identifying commonalities. In 2006, the European Space Agency (ESA) initiated a coordination action to share among all the European (and Canadian) stakeholders a common approach to the long term preservation of Earth Observation data. During 2007, the Agency started consultations with its Member States presenting an EO Long Term Data Preservation (LTDP) strategy targeting the preservation of all European

  13. Short-term and long-term treatment outcomes with Class III activator

    PubMed Central

    Ryu, Hyo-kyung; Chong, Hyun-Jeong; An, Ki-Yong

    2015-01-01

    Objective The purpose of this retrospective study was to investigate short-term and long-term skeletodental outcomes of Class III activator treatment. Methods A Class III activator treatment group (AG) comprised of 22 patients (9 boys, 13 girls) was compared with a Class III control group (CG) comprised of 17 patients (6 boys, 11 girls). The total treatment period was divided into three stages; the initial stage (T1), the post-activator treatment or post-mandibular growth peak stage (T2), and the long-term follow-up stage (T3). Cephalometric changes were evaluated statistically via the Mann-Whitney U-test and the Friedman test. Results The AG exhibited significant increases in the SNA angle, ANB angle, Wits appraisal, A point-N perpendicular, Convexity of A point, and proclination of the maxillary incisors, from T1 to T2. In the long-term follow-up (T1-T3), the AG exhibited significantly greater increases in the ANB angle, Wits appraisal, and Convexity of A point than the CG. Conclusions Favorable skeletal outcomes induced during the Class III activator treatment period were generally maintained until the long-term follow-up period of the post-mandibular growth peak stage. PMID:26445717

  14. Characterization of the Nimbus-7 SBUV radiometer for the long-term monitoring of stratospheric ozone

    NASA Technical Reports Server (NTRS)

    Cebula, Richard P.; Park, H.; Heath, D. F.

    1988-01-01

    Precise knowledge of in-orbit sensitivity change is critical for the successful monitoring of stratospheric ozone by satellite-based remote sensors. This paper evaluates those aspects of the in-flight operation that influence the long-term stability of the upper stratospheric ozone measurements made by the Nimbus-7 SBUV spectroradiometer and chronicles methods used to maintain the long-term albedo calibration of this UV sensor. It is shown that the instrument's calibration for the ozone measurement, the albedo calibration, has been maintained over the first 6 yr of operation to an accuracy of approximately + or - 2 percent. The instrument's wavelength calibration is shown to drift linearly with time. The knowledge of the SBUV wavelength assignment is maintained to a 0.02-nm precision.

  15. [Psychosocial issues of long-term cancer survivors].

    PubMed

    Weis, J; Faller, H

    2012-04-01

    Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

  16. Long-Term Care Financing: Lessons From France

    PubMed Central

    Doty, Pamela; Nadash, Pamela; Racco, Nathalie

    2015-01-01

    Context An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States’ long-term care financing reform efforts. Methods We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. Findings France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income adjusted and amounts are low. Nevertheless, expenditures have exceeded projections, burdening local governments. Private supplemental insurance covers 11% of French, mostly middle-income adults (versus 3% of Americans 18 and older). Whether policyholders will maintain employer-sponsored coverage after retirement is not known. The government's interest in pursuing an explicit public/private partnership has waned under President François Hollande, a centrist socialist, in contrast to the previous center-right leader, President Nicolas Sarkozy, thereby reducing the prospects of a coordinated public/private strategy. Conclusions American private insurers are showing increasing interest in long-term

  17. Long-term care financing: options for the future.

    PubMed

    Mulvey, Janemarie; Li, Annelise

    2002-01-01

    The aging of the baby boomers will have an enormous impact on the future of long-term care costs. This article projects the magnitude of that impact, discusses sources of financing, and considers the cost and feasibility of three options for financing future long-term care services. The authors investigate the alternatives of increasing personal savings, raising payroll taxes and expanding employer-sponsored private long-term care insurance coverage, respectively.

  18. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  19. Role of calcitonin gene-related peptide in cardioprotection of short-term and long-term exercise preconditioning.

    PubMed

    Sun, Xiao-Juan; Pan, Shan-Shan

    2014-07-01

    To examine the role of calcitonin gene-related peptide (CGRP) in cardioprotection of short-term and long-term exercise preconditioning (EP). Male Sprague-Dawley rats were, respectively, subjected to continuous intermittent treadmill training 3 days or 3 weeks as short-term or long-term EP protocols. The myocardial injury induced by isoproterenol (ISO) was performed 24 hours after short-term and long-term EP. The myocardial injury was evaluated in terms of the serum cardiac troponin levels and the hematoxylin-basic fuchsin-picric acid staining. Additionally, serum CGRP levels, CGRP expression in the dorsal root ganglion (DRG), and heart were analyzed as possible mechanisms to explain short-term and long-term EP-induced cardioprotection. Both short-term and long-term EP markedly attenuated the isoproterenol-induced myocardial ischemia with lower serum cardiac troponin levels. Short-term EP does not alter serum CGRP levels and CGRP expression in the DRG and heart. Long-term EP significantly increases serum CGRP levels and CGRP expression in the DRG and heart. The results indicate that short-term EP does not increase the synthesis and release of CGRP. Therefore, the cardioprotective effect of short-term EP does not involve CGRP adaptation. Furthermore, long-term EP increases CGRP synthesis in the DRG and promotes CGRP release in the blood and heart. Hence, CGRP may play an important role in the cardioprotective effect of long-term EP.

  20. DOE-NE Light Water Reactor Sustainability Program and EPRI Long-Term Operations Program. Joint Research and Development Plan

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

    Williams, Don

    2014-04-01

    Nuclear power has contributed almost 20% of the total amount of electricity generated in the United States over the past two decades. High capacity factors and low operating costs make nuclear power plants (NPPs) some of the most economical power generators available. Further, nuclear power remains the single largest contributor (nearly 70%) of non-greenhouse gas-emitting electric power generation in the United States. Even when major refurbishments are performed to extend operating life, these plants continue to represent cost-effective, low-carbon assets to the nation’s electrical generation capability. By the end of 2014, about one-third of the existing domestic fleet will havemore » passed their 40th anniversary of power operations, and about one-half of the fleet will reach the same 40-year mark within this decade. Recognizing the challenges associated with pursuing extended service life of commercial nuclear power plants, the U.S. Department of Energy’s (DOE) Office of Nuclear Energy (NE) and the Electric Power Research Institute (EPRI) have established separate but complementary research and development programs (DOE-NE’s Light Water Reactor Sustainability [LWRS] Program and EPRI’s Long-Term Operations [LTO] Program) to address these challenges. To ensure that a proper linkage is maintained between the programs, DOE-NE and EPRI executed a memorandum of understanding in late 2010 to “establish guiding principles under which research activities (between LWRS and LTO) could be coordinated to the benefit of both parties.” This document represents the third annual revision to the initial version (March 2011) of the plan as called for in the memorandum of understanding.« less

  1. Long-term operation of a novel pilot-scale six tanks alternately operating activated sludge process in treating domestic wastewater.

    PubMed

    Mohammed, R N; Abu-Alhail, S; Xi-Wu, L

    2014-08-01

    The performance of a new pilot-scale six tanks activated sludge process has been evaluated for 303 d, receiving real domestic wastewater with a flow rate of 15-24.4 L/h. Partial nitrification via nitrite and microbial community structure were investigated in this system. The result shows that the nitrite accumulation rate was achieved successfully over 94% in the last aerobic compartment through a combination of short hydraulic retention time and low dissolved oxygen (DO) level. Fluorescence in situ hybridization analysis was used to correlate ammonia-oxidizing bacteria (AOB) numbers with nutrient removal via nitrite. It was shown that in response to complete and partial nitrification modes, the numbers of AOB population were 7.7 x 10(7) cells/g mixed liquor suspended solids (MLSS) and 5.31 x 10(8) cells/g MLSS, respectively. The morphology of the sludge indicated that there is a small rod-shaped and spherical cluster which was mainly dominantly bacterial according to scanning electron microscope. Higher pollutant removal efficiencies of 86.2%, 98%, and 96.1%, for total nitrogen, NH4+ - N, and total phosphorus, respectively, were achieved by a long-term operation of the six tanks activated sludge process at a low DO concentration and low chemical oxygen demand to nitrogen ratio which were approximately equal to the complete nitrification-ldenitrification with the addition of an external carbon source at a concentration of 1.5-2.5 mg/L.

  2. Planning long-term vegetation studies at landscape scales

    USGS Publications Warehouse

    Stohlgren, Thomas J.

    1995-01-01

    Long-term ecological research is receiving more attention now than ever before. Two recent books, Long-term Studies in Ecology: Approaches and Alternatives, edited by Gene Likens (1989), and Long-term Ecological Research: An International Perspective, edited by Paul Risser (1991), prompt the question, “Why are these books so thin?” Except for data from paleoecological, retrospective studies (see below), there are exceptionally few long-term data sets in terrestrial ecology (Strayer et al. 1986; Tilman 1989; this volume). In a sample of 749 papers published in Ecology, Tilman (1989) found that only 1.7% of the studies lasted at least five field seasons. Only one chapter in each of the review books dealt specifically with expanding both the temporal and the spatial scales of ecological research (Berkowitz et al. 1989; Magnuson et al. 1991). Judging by the growing number of landscape-scale long-term studies, however, such as the Long-Term Ecological Research (LTER) Program (Callahan 1991), the U.S. Environmental Protection Agency’s Environmental Monitoring and Assessment Program (EMAP; Palmer et al. 1991), the U.S. Army’s Land Condition-Trend Analysis (LCTA) Program (Diersing et al. 1992), and various agencies’ global change research programs (CEES 1993), there is a growing interest to expand ecological research both temporally and spatially.

  3. Zeitgeists and development trends in long-term care facility design.

    PubMed

    Wang, Chia-Hui; Kuo, Nai-Wen

    2006-06-01

    Through literature analysis, in-depth interviews, and the application of the Delphi survey, this study explored long-term care resident priorities with regard to long-term care facility design in terms of both physical and psychological needs. This study further clarified changing trends in long-term care concepts; illustrated the impact that such changes are having on long-term care facility design; and summarized zeitgeists related to the architectural design of long-term care facilities. Results of our Delphi survey indicated the following top five priorities in long-term care facility design: (1) creating a home-like feeling; (2) adhering to Universal Design concepts; (3) providing well-defined private sleeping areas; (4) providing adequate social space; and (5) decentralizing residents' rooms into clusters. The three major zeitgeists related to long-term care facility design include: (1) modern long-term care facilities should abandon their traditional "hospital" image and gradually reposition facilities into homelike settings; (2) institution-based care for the elderly should be de-institutionalized under the concept of aging-in-place; and (3) living clusters, rather than traditional hospital-like wards, should be designed into long-term care facilities.

  4. Characterizing Space Environments with Long-Term Space Plasma Archive Resources

    NASA Technical Reports Server (NTRS)

    Minow, Joseph I.; Miller, J. Scott; Diekmann, Anne M.; Parker, Linda N.

    2009-01-01

    A significant scientific benefit of establishing and maintaining long-term space plasma data archives is the ready access the archives afford to resources required for characterizing spacecraft design environments. Space systems must be capable of operating in the mean environments driven by climatology as well as the extremes that occur during individual space weather events. Long- term time series are necessary to obtain quantitative information on environment variability and extremes that characterize the mean and worst case environments that may be encountered during a mission. In addition, analysis of large data sets are important to scientific studies of flux limiting processes that provide a basis for establishing upper limits to environment specifications used in radiation or charging analyses. We present applications using data from existing archives and highlight their contributions to space environment models developed at Marshall Space Flight Center including the Chandra Radiation Model, ionospheric plasma variability models, and plasma models of the L2 space environment.

  5. Impact of total pancreatectomy: short- and long-term assessment.

    PubMed

    Barbier, Louise; Jamal, Wisam; Dokmak, Safi; Aussilhou, Béatrice; Corcos, Olivier; Ruszniewski, Philippe; Belghiti, Jacques; Sauvanet, Alain

    2013-11-01

    The aim was to assess the outcome of a total pancreatectomy (TP). From 1993 to 2010, 56 patients underwent an elective TP for intraductal papillary mucinous neoplasia (n = 42), endocrine tumours (n = 6), adenocarcinoma (n = 5), metastases (n = 2) and chronic pancreatitis (n = 1). Morbidity and survival were analysed. Long-term survivors were assessed prospectively using quality-of-life (QoL) questionnaires. Five patients developed gastric venous congestion intra-operatively. Post-operative morbidity and mortality rates were 45% and 3.6%, respectively. An anastomotic ulcer occurred in seven patients, but none after proton pump inhibitor therapy. There were five inappropriate TPs according to definitive pathological examination. Overall 3- and 5-year survival rates were 62% and 55% respectively; five deaths were related to TP (two postoperative deaths, one hypoglycaemia, one ketoacidosis and one anastomotic ulcer). Prospective evaluation of 25 patients found that 14 had been readmitted for diabetes and that all had hypoglycaemia within the past month. The glycated haemoglobin (HbA1c) was 7.8% (6.3-10.3). Fifteen patients experienced weight loss. The QLQ-C30 questionnaire showed a decrease in QoL predominantly because of fatigue and diarrhoea, and the QLQ-PAN26 showed an impact on bowel habit, flatulence and eating-related items. Morbidity and mortality rates of TP are acceptable, although diabetes- and TP-related mortality still occurs. Endocrine and exocrine insufficiency impacts on the long-term quality of life. © 2013 International Hepato-Pancreato-Biliary Association.

  6. Memory for relations in the short term and the long term after medial temporal lobe damage.

    PubMed

    Squire, Larry R

    2017-05-01

    A central idea about the organization of declarative memory and the function of the hippocampus is that the hippocampus provides for the coding of relationships between items. A question arises whether this idea refers to the process of forming long-term memory or whether, as some studies have suggested, memory for relations might depend on the hippocampus even at short retention intervals and even when the task falls within the province of short-term (working) memory. The latter formulation appears to place the operation of relational memory into conflict with the idea that working memory is independent of medial temporal lobe (MTL) structures. In this report, the concepts of relational memory and working memory are discussed in the light of a simple demonstration experiment. Patients with MTL lesions successfully learned and recalled two word pairs when tested directly after learning but failed altogether when tested after a delay. The results do not contradict the idea that the hippocampus has a fundamental role in relational memory. However, there is a need for further elaboration and specification of the idea in order to explain why patients with MTL lesions can establish relational memory in the short term but not in long-term memory. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Sensitivity factor of the axial-symmetric transmission gauge: Deviation and long-term variation

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

    Takahashi, N.; Tuzi, Y.; Arakawa, I.

    2007-07-15

    The deviation of the sensitivity factors for about 50 sensors of the axial-symmetric transmission gauge (ATG) was examined. The deviation has been compared with that for about 30 sensors of the B-A gauge and for about 30 sensors of the extractor gauge. Almost the same deviations are found for the above three types of gauges. The long-term variations of the sensitivity factors for two sensors of the ATG were also measured during four years. After the initial change with operating time, the sensitivity factor stabilized after long-term operation. The room temperature effect of the sensitivity factor plays an important rolemore » on the total pressure measurement by an ionization gauge, but the change of the sensitivity factor was larger than the room temperature effect. The reason for the change of the factor is estimated in connection with the annealing and the alignment of the filament and with the deviation of the place of electron emission on the filament.« less

  8. Disability in long-term care residents explained by prevalent geriatric syndromes, not long-term care home characteristics: a cross-sectional study.

    PubMed

    Lane, Natasha E; Wodchis, Walter P; Boyd, Cynthia M; Stukel, Thérèse A

    2017-02-10

    Self-care disability is dependence on others to conduct activities of daily living, such as bathing, eating and dressing. Among long-term care residents, self-care disability lowers quality of life and increases health care costs. Understanding the correlates of self-care disability in this population is critical to guide clinical care and ongoing research in Geriatrics. This study examines which resident geriatric syndromes and chronic conditions are associated with residents' self-care disability and whether these relationships vary across strata of age, sex and cognitive status. It also describes the proportion of variance in residents' self-care disability that is explained by residents' geriatric syndromes versus long-term care home characteristics. We conducted a cross-sectional study using a health administrative cohort of 77,165 long-term care home residents residing in 614 Ontario long-term care homes. Eligible residents had their self-care disability assessed using the RAI-MDS 2.0 activities of daily living long-form score (range: 0-28) within 90 days of April 1st, 2011. Hierarchical multivariable regression models with random effects for long-term care homes were used to estimate the association between self-care disability and resident geriatric syndromes, chronic conditions and long-term care home characteristics. Differences in findings across strata of sex, age and cognitive status (cognitively intact versus cognitively impaired) were examined. Geriatric syndromes were much more strongly associated with self-care disability than chronic conditions in multivariable models. The direction and size of some of these effects were different for cognitively impaired versus cognitively intact residents. Residents' geriatric syndromes explained 50% of the variation in their self-care disability scores, while characteristics of long-term care homes explained an additional 2% of variation. Differences in long-term care residents' self-care disability are

  9. Summary of Terra and Aqua MODIS Long-Term Performance

    NASA Technical Reports Server (NTRS)

    Xiong, Xiaoxiong (Jack); Wenny, Brian N.; Angal, Amit; Barnes, William; Salomonson, Vincent

    2011-01-01

    Since launch in December 1999, the MODIS ProtoFlight Model (PFM) onboard the Terra spacecraft has successfully operated for more than 11 years. Its Flight Model (FM) onboard the Aqua spacecraft, launched in May 2002, has also successfully operated for over 9 years. MODIS observations are made in 36 spectral bands at three nadir spatial resolutions and are calibrated and characterized regularly by a set of on-board calibrators (OBC). Nearly 40 science products, supporting a variety of land, ocean, and atmospheric applications, are continuously derived from the calibrated reflectances and radiances of each MODIS instrument and widely distributed to the world-wide user community. Following an overview of MODIS instrument operation and calibration activities, this paper provides a summary of both Terra and Aqua MODIS long-term performance. Special considerations that are critical to maintaining MODIS data quality and beneficial for future missions are also discussed.

  10. Long-Term Monitoring of Global Climate Forcings and Feedbacks

    NASA Technical Reports Server (NTRS)

    Hansen, J. (Editor); Rossow, W. (Editor); Fung, I. (Editor)

    1993-01-01

    A workshop on Long-Term Monitoring of Global Climate Forcings and Feedbacks was held February 3-4, 1992, at NASA's Goddard Institute for Space Studies to discuss the measurements required to interpret long-term global temperature changes, to critique the proposed contributions of a series of small satellites (Climsat), and to identify needed complementary monitoring. The workshop concluded that long-term (several decades) of continuous monitoring of the major climate forcings and feedbacks is essential for understanding long-term climate change.

  11. Short-term exposure to JP-8 jet fuel results in long-term immunotoxicity.

    PubMed

    Harris, D T; Sakiestewa, D; Robledo, R F; Witten, M

    1997-01-01

    Chronic exposure to jet fuel has been shown to have adverse effects on human liver function, to cause emotional dysfunction, to cause abnormal electroencephalograms, to cause shortened attention spans, and to decrease sensorimotor speed. Due to the decision by the United States Air Force to implement the widespread use of JP-8 jet fuel in its operations, a thorough understanding of its potential effects upon exposed personnel is both critical and necessary. Exposure to potential environmental toxicants such as JP-8 may have significant effects on host systems beyond those readily visible (i.e., physiology, cardiology, respiratory, etc.); e.g., the immune system. Previous studies have shown that short-term, low concentration JP-8 exposure had significant effects on the immune system, which should have serious consequences for the exposed host in terms of susceptibility to infectious agents. If these alterations in immune function were long-lasting, it might also result in an increased likelihood of development and/or progression of cancer, as well as autoimmune disease. In the current study, mice were exposed for 1 h/day for 7 days to a moderate (1000 mg/m3) and a high (2500 mg/m3) concentration of aerosolized JP-8 jet fuel to stimulate occupational exposures. One to 28 days after the last exposure the mice were analyzed for effects of the exposure on their immune systems. It was observed that decrease in viable immune cell numbers and immune organ weights found at 24 h after exposure persisted for extended periods of time. Further, JP-8 exposure resulted in significantly decreased immune infection, as analyzed by mitogenesis assays, which persisted for up to 4 weeks post-exposure. Thus, short-term exposure of mice to JP-8 jet fuel caused significant toxicological effects on the immune system, which were long-lasting and persistent. It appears that the immune system may be the most sensitive indicator of toxicological damage due to JP-8 exposure. Such long-term

  12. Long Term Care Aide/Homemaker. Resource Handbook.

    ERIC Educational Resources Information Center

    Illerbrun, Marley

    This handbook provides basic information for preparing individuals to work as long-term care aides and homemakers. It is written both for college students in long-term care aide/homemaker programs and for individuals already employed in these occupations. Health care agencies giving orientation training for new employees and inservice training for…

  13. Developmental Dyslexia and Explicit Long-Term Memory

    ERIC Educational Resources Information Center

    Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano

    2010-01-01

    The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

  14. 78 FR 36449 - State Long-Term Care Ombudsman Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... 0985-AA08 State Long-Term Care Ombudsman Program AGENCY: Administration on Aging, Administration for... Act, the State Long-Term Care Ombudsman program. This proposed rule replaces AoA's 1994 Notice of... highlighted the difficulty of determining State compliance in carrying out the Long-Term Care Ombudsman...

  15. Artificial gravity: Phyiological perspectives for long-term space exploration

    NASA Astrophysics Data System (ADS)

    di Prampero, P.; Antonutto, G.

    2005-08-01

    We suggested previously the Twin Bike System (TBS) as a possible countermeasure to prevent cardiovascular deconditioning during long term space flight. The TBS consists of two bicycles, operated by the astronauts, moving at the very same speed, but in the opposite sense, along the inner wall of a cylindrical space module, thus generating a centrifugal acceleration vector, mimicking gravity. To gain some insight on the effectiveness of the TBS we hereby propose a similar approach (the Mono Bike System, MBS) to be tested during bed rest on Earth.

  16. Advancing an ethical framework for long-term care.

    PubMed

    Carter, Mary Whelan

    2002-02-01

    This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

  17. Long-term memory, sleep, and the spacing effect.

    PubMed

    Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody

    2014-01-01

    Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

  18. Long term contracts, expansion, innovation and stability: North Dakota's lignite mines thrive

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

    Buchsbaum, L.

    2009-08-15

    North Dakota's lignite coal industry is mainly located in three countries in the central part of the state. Its large surface lignite mines are tied through long-term (20-40 years) contracts to power plants. The article talks about operations at three of the most productive mines - the Freedom mine, Falkirk mine and Center Mine. 4 figs.

  19. Long-term course of opioid addiction.

    PubMed

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

    2015-01-01

    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  20. European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma.

    PubMed

    Plouin, P F; Amar, L; Dekkers, O M; Fassnacht, M; Gimenez-Roqueplo, A P; Lenders, J W M; Lussey-Lepoutre, C; Steichen, O

    2016-05-01

    Phaeochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours. Standard treatment is surgical resection. Following complete resection of the primary tumour, patients with PPGL are at risk of developing new tumoural events. The present guideline aims to propose standardised clinical care of long-term follow-up in patients operated on for a PPGL. The guideline has been developed by The European Society of Endocrinology and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles. We performed a systematic review of the literature and analysed the European Network for the Study of Adrenal Tumours (ENS@T) database. The risk of new events persisted in the long term and was higher for patients with genetic or syndromic diseases. Follow-up in the published cohorts and in the ENS@T database was neither standardised nor exhaustive, resulting in a risk of follow-up bias and in low statistical power beyond 10 years after complete surgery. To inform patients and care providers in this context of low-quality evidence, the Guideline Working Group therefore prepared recommendations on the basis of expert consensus. Key recommendations are the following: we recommend that all patients with PPGL be considered for genetic testing; we recommend assaying plasma or urinary metanephrines every year to screen for local or metastatic recurrences or new tumours; and we suggest follow-up for at least 10 years in all patients operated on for a PPGL. High-risk patients (young patients and those with a genetic disease, a large tumour and/or a paraganglioma) should be offered lifelong annual follow-up. © 2016 European Society of Endocrinology.

  1. Beyond the short term : transportation asset management for long-term sustainability, accountability and performance

    DOT National Transportation Integrated Search

    2010-01-01

    Transportation Asset Management (TAM) has long been recognized as a sound, long-term approach to managing infrastructure. It provides decision makers with a rational, long-term systematic process for making difficult and complex decisions about how t...

  2. Rural long-term care work, gender, and restructuring.

    PubMed

    Leach, Belinda; Joseph, Gillian

    2011-06-01

    Restructuring--the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost--layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies.

  3. Risk Assessment and Control through Countermeasure System Iplementation for Long-term Crew Exposure to Microgravity

    NASA Technical Reports Server (NTRS)

    Gernand, Jeremy M.

    2004-01-01

    Experience with the International Space Station (ISS) program demonstrates the degree to which engineering design and operational solutions must protect crewmembers from health risks due to long-term exposure to the microgravity environment. Risks to safety and health due to degradation in the microgravity environment include crew inability to complete emergency or nominal activities, increased risk of injury, and inability to complete safe return to the ground due to reduced strength or embrittled bones. These risks without controls slowly increase in probability for the length of the mission and become more significant for increasing mission durations. Countermeasures to microgravity include hardware systems that place a crewmember s body under elevated stress to produce an effect similar to daily exposure to gravity. The ISS countermeasure system is predominately composed of customized exercise machines. Historical treatment of microgravity countermeasure systems as medical research experiments unintentionally reduced the foreseen importance and therefore the capability of the systems to function in a long-term operational role. Long-term hazardous effects and steadily increasing operational risks due to non-functional countermeasure equipment require a more rigorous design approach and incorporation of redundancy into seemingly non- mission-critical hardware systems. Variations in the rate of health degradation and responsiveness to countermeasures among the crew population drastically increase the challenge for design requirements development and verification of the appropriate risk control strategy. The long-term nature of the hazards and severe limits on logistical re-supply mass, volume and frequency complicates assessment of hardware availability and verification of an adequate maintenance and sparing plan. Design achievement of medically defined performance requirements by microgravity countermeasure systems and incorporation of adequate failure tolerance

  4. Long-term outcomes after repair of symptomatic abdominal aortic aneurysms.

    PubMed

    Chandra, Venita; Trang, Karen; Virgin-Downey, Whitt; Dalman, Ronald L; Mell, Matthew W

    2018-04-25

    Previous studies have reported increased perioperative mortality of nonruptured symptomatic abdominal aortic aneurysms (Sx-AAA) compared with asymptomatic elective AAA (E-AAA) repairs, but no long-term-outcomes have been reported. We sought to compare long-term outcomes of Sx-AAA and E-AAA after repair at a single academic institution. Patients receiving AAA repair for Sx-AAA and E-AAA from 1995 through 2015 were included. Ruptured AAA and suprarenal or thoracoabdominal AAA were excluded. Demographics, comorbidities, and operative approach were collected. Long-term mortality was the primary outcome, determined by chart review or link to Social Security Death Index. Additionally, long-term mortality and reinterventions were compared after groups were matched with nearest neighbor propensity to reduce bias. AAA repair was performed for 1054 E-AAA (383 open repair [36%], 671 endovascular aneurysm repair [EVAR] [64%]), and 139 symptomatic aneurysms (60 open repair [43%], 79 EVAR [57%]). Age (73 years vs 74 years; P = .13) and aneurysm diameter were similar between Sx-AAA and E-AAA (6.0 cm vs 5.8 cm; P = .5). The proportion of women was higher for Sx-AAA (26% vs 16%; P = .003), as was the proportion of non-Caucasians (40% vs 29%; P = .009). After propensity matching, there were no differences between groups for patient characteristics, AAA diameter, treatment modality, or comorbidities, including hypertension, coronary artery disease, congestive heart failure, diabetes, hyperlipidemia, lung disease, diabetes, renal disease, and smoking history. Women were treated for Sx-AAA at significantly smaller aortic diameters; however, compared with men (5.1 cm vs 6.3 cm; P < .001). Perioperative mortality was 5.0% for Sx-AAA and 2.3% for E-AAA (P = .055). By life-table analysis, Sx-AAA had lower 5-year (62% vs 71%) and 10-year (39% vs 51%) survivals (P = .01) compared with E-AAA for the entire cohort. Similar trends were observed for 5-year and 10-year mortality

  5. [Long-term memory, neurogenesis and novelty signal].

    PubMed

    Sokolova, E N; Nezlina, N I

    2003-01-01

    In accordance with the advanced hypothesis the long-term memory is a collection of "gnostic units" selectively tuned to experienced events. The long-term memory is continuously supplemented by new neurons differentiated from stem cells during neurogenesis (particularly, in adults). The transformation of neuronal progenitors into event-selective gnostic units is accomplished with participation of hippocampal "novelty neurons" emphasizing information inputs to be stored in the long-term memory. The formation of the gnostic units is preceded by informational processes occurring in the ventral ("what?") and dorsal ("where?") systems. The formation of a new gnostic unit selectively tuned to a particular event is a result of combination of feature-detector excitation and novelty signal generated by hippocampal novelty neurons.

  6. Space ventures and society long-term perspectives

    NASA Technical Reports Server (NTRS)

    Brown, W. M.

    1985-01-01

    A futuristic evaluation of mankind's potential long term future in space is presented. Progress in space will not be inhibited by shortages of the Earth's physical resources, since long term economic growth will be focused on ways to constrain industrial productivity by changing social values, management styles, or government competence. Future technological progress is likely to accelerate with an emphasis on international cooperation, making possible such large joint projects as lunar colonies or space stations on Mars. The long term future in space looks exceedingly bright even in relatively pessimistic scenarios. The principal driving forces will be technological progress, commercial and public-oriented satellites, space industrialization, space travel, and eventually space colonization.

  7. Legislation on Long-Term Care Insurance. Report No. 11.

    ERIC Educational Resources Information Center

    Wisconsin State Legislative Council, Madison.

    This report presents Wisconsin state legislation on long-term care insurance. Part I summarizes key provisions of six 1987 assembly bills concerned with long-term care insurance. Part II describes activities of the Wisconsin State Legislative Council's Special Committee on Long-Term Health Care Insurance. Part III provides background information…

  8. LONG-TERM PERFORMANCE OF SOLID OXIDE STACKS WITH ELECTRODE-SUPPORTED CELLS OPERATING IN THE STEAM ELECTROLYSIS MODE

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

    J. E. O'Brien; R. C. O'Brien; X. Zhang

    2011-11-01

    Performance characterization and durability testing have been completed on two five-cell high-temperature electrolysis stacks constructed with advanced cell and stack technologies. The solid oxide cells incorporate a negative-electrode-supported multi-layer design with nickel-zirconia cermet negative electrodes, thin-film yttria-stabilized zirconia electrolytes, and multi-layer lanthanum ferrite-based positive electrodes. The per-cell active area is 100 cm2. The stack is internally manifolded with compliant mica-glass seals. Treated metallic interconnects with integral flow channels separate the cells. Stack compression is accomplished by means of a custom spring-loaded test fixture. Initial stack performance characterization was determined through a series of DC potential sweeps in both fuel cellmore » and electrolysis modes of operation. Results of these sweeps indicated very good initial performance, with area-specific resistance values less than 0.5 ?.cm2. Long-term durability testing was performed with A test duration of 1000 hours. Overall performance degradation was less than 10% over the 1000-hour period. Final stack performance characterization was again determined by a series of DC potential sweeps at the same flow conditions as the initial sweeps in both electrolysis and fuel cell modes of operation. A final sweep in the fuel cell mode indicated a power density of 0.356 W/cm2, with average per-cell voltage of 0.71 V at a current of 50 A.« less

  9. Valuing a long-term care facility.

    PubMed

    Mellen, C M

    1992-10-01

    The business valuation industry generally uses at least one of three basic approaches to value a long-term care facility: the cost approach, sales comparison approach, or income approach. The approach that is chosen and the resulting weight that is applied to it depend largely on the circumstances involved. Because a long-term care facility is a business enterprise, more weight usually is given to the income approach which factors into the estimate of value both the tangible and intangible assets of the facility.

  10. Improving the Long-Term Stability of Atmospheric Surface Deformation Predictions by Mitigating the Effects of Orography Updates in Operational Weather Forecast Models

    NASA Astrophysics Data System (ADS)

    Dill, Robert; Bergmann-Wolf, Inga; Thomas, Maik; Dobslaw, Henryk

    2016-04-01

    The global numerical weather prediction model routinely operated at the European Centre for Medium-Range Weather Forecasts (ECMWF) is typically updated about two times a year to incorporate the most recent improvements in the numerical scheme, the physical model or the data assimilation procedures into the system for steadily improving daily weather forecasting quality. Even though such changes frequently affect the long-term stability of meteorological quantities, data from the ECMWF deterministic model is often preferred over alternatively available atmospheric re-analyses due to both the availability of the data in near real-time and the substantially higher spatial resolution. However, global surface pressure time-series, which are crucial for the interpretation of geodetic observables, such as Earth rotation, surface deformation, and the Earth's gravity field, are in particular affected by changes in the surface orography of the model associated with every major change in horizontal resolution happened, e.g., in February 2006, January 2010, and May 2015 in case of the ECMWF operational model. In this contribution, we present an algorithm to harmonize surface pressure time-series from the operational ECMWF model by projecting them onto a time-invariant reference topography under consideration of the time-variable atmospheric density structure. The effectiveness of the method will be assessed globally in terms of pressure anomalies. In addition, we will discuss the impact of the method on predictions of crustal deformations based on ECMWF input, which have been recently made available by GFZ Potsdam.

  11. Long-term forest ecosystem research: a programmatic view

    Treesearch

    Wayne Swank; James Vose

    2010-01-01

    Long-term research provides the building blocks of knowledge needed to address natural resource and environmental issues. "Long-term" has frequently been considered to span decades with a time frame that usually encompasses at least one generation of scientists and frequently two or more generations. In the rich history of forest science, the origin of long-...

  12. Short- and Long-Term Consequences of Adolescent Work.

    ERIC Educational Resources Information Center

    Mihalic, Sharon Wofford; Elliott, Delbert

    1997-01-01

    Examines the short- and long-term consequences of working during adolescence. Responses from 1,725 adolescents reveal that the negative short-term effects are in the domains of school, family and friend bonding, beliefs, and substance use. The long-term beneficial effect is that the duration of early work helps employability in adulthood. (GR)

  13. The interaction of short-term and long-term memory in phonetic category formation

    NASA Astrophysics Data System (ADS)

    Harnsberger, James D.

    2002-05-01

    This study examined the role that short-term memory capacity plays in the relationship between novel stimuli (e.g., non-native speech sounds, native nonsense words) and phonetic categories in long-term memory. Thirty native speakers of American English were administered five tests: categorial AXB discrimination using nasal consonants from Malayalam; categorial identification, also using Malayalam nasals, which measured the influence of phonetic categories in long-term memory; digit span; nonword span, a short-term memory measure mediated by phonetic categories in long-term memory; and paired-associate word learning (word-word and word-nonword pairs). The results showed that almost all measures were significantly correlated with one another. The strongest predictor for the discrimination and word-nonword learning results was nonword (r=+0.62) and digit span (r=+0.51), respectively. When the identification test results were partialed out, only nonword span significantly correlated with discrimination. The results show a strong influence of short-term memory capacity on the encoding of phonetic detail within phonetic categories and suggest that long-term memory representations regulate the capacity of short-term memory to preserve information for subsequent encoding. The results of this study will also be discussed with regards to resolving the tension between episodic and abstract models of phonetic category structure.

  14. Long-term potentiation and depression after unilateral labyrinthectomy in the medial vestibular nucleus of rats.

    PubMed

    Pettorossi, Vito Enrico; Dutia, Mayank; Frondaroli, Adele; Dieni, Cristina; Grassi, Silvarosa

    2003-01-01

    We previously demonstrated in rat brainstem slices that high-frequency stimulation (HFS) of the vestibular afferents induces long-term potentiation (LTP) in the ventral part (Vp) of the medial vestibular nucleus (MVN) and long-term depression (LTD) in the dorsal part (Dp). Both LTP and LTD depend on N-methyl-D-aspartate receptor activation, which increases synaptic efficacy; however, in the Dp, LTP reverses to LTD because of the activation of gamma-aminobutyric acid-ergic neurons. Here we show that the probability of inducing long-term effects in the MVN of rat brainstem slices is altered after unilateral labyrinthectomy (UL). In fact, LTP occurs less frequently in the ventral contra-lesional side compared with sham-operated rats. In the dorsal ipsi-lesional side, LTD is reduced and LTP enhanced, while the opposite occurs in the dorsal contra-lesional side. These changes in synaptic plasticity may be useful for re-balancing the tonic discharge of the MVN of the two sides during vestibular compensation, and for enhancing the dynamic responses of the deafferented MVN neurons in the long term.

  15. Long term outcomes of bilateral congenital and developmental cataracts operated in Maharashtra, India. Miraj pediatric cataract study III.

    PubMed

    Gogate, Parikshit M; Sahasrabudhe, Mohini; Shah, Mitali; Patil, Shailbala; Kulkarni, Anil N; Trivedi, Rupal; Bhasa, Divya; Tamboli, Rahin; Mane, Rekha

    2014-02-01

    To study long term outcome of bilateral congenital and developmental cataract surgery. 258 pediatric cataract operated eyes of 129 children. Children who underwent pediatric cataract surgery in 2004-8 were traced and examined prospectively in 2010-11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP-CVF) were noted for before and after surgery. Statistical analysis was done with SPSS version 16 including multi-variate analysis. Children aged 9.1 years (std dev 4.6, range 7 weeks-15 years) at the time of surgery. 74/129 (57.4%) were boys. The average duration of follow-up was 4.4 years (stddev 1.6, range 3-8 years). 177 (68.6%) eyes had vision <3/60 before surgery, while 109 (42.2%) had best corrected visual acuity (BCVA) >6/18 and 157 (60.9%) had BCVA >6/60 3-8 years after surgery. 48 (37.2%) had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004), type of cataract surgery (P < 0.001), type of intra-ocular lens (P = 0.05), age at surgery (P = 0.004), absence of post-operative uveitis (P = 0.01) and pre-operative vision (P < 0.001), but did not depend on delay (0.612) between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP-CVF scale (P < 0.001). Pediatric cataract surgery improved the children's visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre-operative vision had betterlong-termoutcomes.

  16. Long-term survival in pseudo-Meigs' syndrome caused by ovarian metastases from colon cancer.

    PubMed

    Tajima, Yosuke; Kameyama, Hitoshi; Yamada, Saki; Yagi, Ryoma; Nakano, Masato; Nagahashi, Masayuki; Shimada, Yoshifumi; Sakata, Jun; Kobayashi, Takashi; Umezu, Hajime; Wakai, Toshifumi

    2016-11-14

    Meigs' syndrome is defined as the co-existence of benign ovarian fibroma or fibroma-like tumor, ascites, and pleural effusion. In contrast, pseudo-Meigs' syndrome is defined as the co-existence of other ovarian or pelvic tumors, ascites, and pleural effusion. In Meigs' and pseudo-Meigs' syndromes, ascites and pleural effusion resolve promptly after the complete resection of the ovarian or pelvic tumor(s). Secondary ovarian tumors from colorectal gastrointestinal metastases rarely cause pseudo-Meigs' syndrome; only 11 cases of pseudo-Meigs' syndrome secondary to colorectal cancers have been reported in the literature. Therefore, the prognosis and etiology of pseudo-Meigs' syndrome caused by ovarian metastasis from colorectal cancers remain unclear. We report here a rare case of pseudo-Meigs' syndrome caused by ovarian metastases from sigmoid colon cancer with long-term survival. A 47-year-old woman presented with abdominal distention of 1-month duration. She developed acute dyspnea 2 weeks after the initial presentation. Colonoscopy and computed tomography revealed sigmoid colon cancer with an ovarian metastasis, along with massive ascites and bilateral pleural effusion. Emergency operation, including bilateral oophorectomy and sigmoidectomy, was performed. Subsequently, ascites and bilateral pleural effusion resolved rapidly. Curative hepatic resection was performed for liver metastases 29 months after the first operation, and as of this writing, the patient is alive with no evidence of a disease 78 months after the first operation. In general, colorectal cancer with ovarian metastasis is hard to cure, and long-term survival in patients with colorectal cancer with pseudo-Meigs' syndrome is rare. Our experience suggests that curative resection for pseudo-Meigs' syndrome caused by ovarian metastasis from colorectal cancer may offer long-term survival. Our experience suggests that pseudo-Meigs' syndrome can occur in a patient with colorectal cancer after metastasis

  17. Abstracts 1987. New Horizons in Long Term Care: A Report on the Long Term Care Research and Demonstration Projects.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Public Aid, Springfield.

    This booklet provides a description of 14 projects which were awarded funds during fiscal year 1987 for collaborative research in long-term care to find new ways to treat long-term care patients in Illinois nursing homes. It includes the organization or institution receiving the award, an abstract of the research proposal, and the name of the…

  18. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

    PubMed

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

    2017-01-01

    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  19. A new image for long-term care.

    PubMed

    Wager, Richard; Creelman, William

    2004-04-01

    To counter widely held negative images of long-term care, managers in the industry should implement quality-improvement initiatives that include six key strategies: Manage the expectations of residents and their families. Address customers' concerns early. Build long-term customer satisfaction. Allocate resources to achieve exceptional outcomes in key areas. Respond to adverse events with compassion. Reinforce the facility's credibility.

  20. Long-term characteristics of nuclear emulsion

    NASA Astrophysics Data System (ADS)

    Naganawa, N.; Kuwabara, K.

    2010-02-01

    Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  1. Long-Term Stability of Residual Stress Improvement by Water Jet Peening Considering Working Processes.

    PubMed

    Hashimoto, Tadafumi; Osawa, Yusuke; Itoh, Shinsuke; Mochizuki, Masahito; Nishimoto, Kazutoshi

    2013-06-01

    To prevent primary water stress corrosion cracking (PWSCC), water jet peening (WJP) has been used on the welds of Ni-based alloys in pressurized water reactors (PWRs). Before WJP, the welds are machined and buffed in order to conduct a penetrant test (PT) to verify the weld qualities to access, and microstructure evolution takes place in the target area due to the severe plastic deformation. The compressive residual stresses induced by WJP might be unstable under elevated temperatures because of the high dislocation density in the compressive stress layer. Therefore, the stability of the compressive residual stresses caused by WJP was investigated during long-term operation by considering the microstructure evolution due to the working processes. The following conclusions were made: The compressive residual stresses were slightly relaxed in the surface layers of the thermally aged specimens. There were no differences in the magnitude of the relaxation based on temperature or time. The compressive residual stresses induced by WJP were confirmed to remain stable under elevated temperatures. The stress relaxation at the surface followed the Johnson-Mehl equation, which states that stress relaxation can occur due to the recovery of severe plastic strain, since the estimated activation energy agrees very well with the self-diffusion energy for Ni. By utilizing the additivity rule, it was indicated that stress relaxation due to recovery is completed during the startup process. It was proposed that the long-term stability of WJP under elevated temperatures must be assessed based on compressive stresses with respect to the yield stress. Thermal elastic-plastic creep analysis was performed to predict the effect of creep strain. After 100 yr of simulated continuous operation at 80% capacity, there was little change in the WJP compressive stresses under an actual operating temperature of 623 K. Therefore, the long-term stability of WJP during actual operation was

  2. Very-long-term and short-term chromatic adaptation: are their influences cumulative?

    PubMed

    Belmore, Suzanne C; Shevell, Steven K

    2011-02-09

    Very-long-term (VLT) chromatic adaptation results from exposure to an altered chromatic environment for days or weeks. Color shifts from VLT adaptation are observed hours or days after leaving the altered environment. Short-term chromatic adaptation, on the other hand, results from exposure for a few minutes or less, with color shifts measured within seconds or a few minutes after the adapting light is extinguished; recovery to the pre-adapted state is complete in less than an hour. Here, both types of adaptation were combined. All adaptation was to reddish-appearing long-wavelength light. Shifts in unique yellow were measured following adaptation. Previous studies demonstrate shifts in unique yellow due to VLT chromatic adaptation, but shifts from short-term chromatic adaptation to comparable adapting light can be far greater than from VLT adaptation. The question considered here is whether the color shifts from VLT adaptation are cumulative with large shifts from short-term adaptation or, alternatively, does simultaneous short-term adaptation eliminate color shifts caused by VLT adaptation. The results show the color shifts from VLT and short-term adaptation together are cumulative, which indicates that both short-term and very-long-term chromatic adaptation affect color perception during natural viewing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Manipulation under anaesthesia post total knee replacement: long term follow up.

    PubMed

    Yeoh, David; Nicolaou, Nick; Goddard, Richard; Willmott, Henry; Miles, Kim; East, Debra; Hinves, Barry; Shepperd, John; Butler-Manuel, Adrian

    2012-08-01

    A reduced range of motion post total knee replacement (TKR) is a recognised problem. Manipulation under anaesthesia (MUA) is commonly performed in the stiff post-operative TKR. Long-term results are variable in the literature. We retrospectively reviewed, prospectively collected data on 48 patients followed up since 1996 from one centre, over an average of 7.5 years, (range 1 to 10 years) and report on the long-term results. During the study period 2.3% of TKRs underwent MUA. The mean time to MUA post TKR was 12.3 weeks (range 3 to 48). Pre MUA, the mean flexion was 53°. The mean immediate passive flexion post MUA was 97°, an improvement of 44° (Range 10° to 90°, p<0.05). By 1year, the mean flexion was 87°, an improvement of 34°, (range -15° to 70°, p<0.05). At 10 years the mean flexion was 86°, (range 55° to 100°, p<0.05). We found no difference in the gain in range of motion (ROM) between knees manipulated before or after 12 weeks. Additionally, the gain was no different in stiff knees with a pre TKR ROM <90°, compared to a pre TKR ROM >90°. There were no complications as a result of MUA. However, one patient was eventually revised at 2 years secondary to low grade infection. Our findings show that MUA is a safe and effective method at improving the ROM in a stiff post-operative TKR. The improvement is maintained in the long term irrespective of time to MUA and range of motion pre TKR. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  4. A retrospective investigation of energy efficiency standards: Policies may have accelerated long term declines in appliance costs

    DOE PAGES

    Van Buskirk, R. D.; Kantner, C. L. S.; Gerke, B. F.; ...

    2014-11-14

    We perform a retrospective investigation of multi-decade trends in price and life-cycle cost (LCC) for home appliances in periods with and without energy efficiency (EE) standards and labeling polices. In contrast to the classical picture of the impact of efficiency standards, the introduction and updating of appliance standards is not associated with a long-term increase in purchase price; rather, quality-adjusted prices undergo a continued or accelerated long-term decline. In addition, long term trends in appliance LCCs—which include operating costs—consistently show an accelerated long term decline with EE policies. We also show that the incremental price of efficiency improvements has declinedmore » faster than the baseline product price for selected products. These observations are inconsistent with a view of EE standards that supposes a perfectly competitive market with static supply costs. These results suggest that EE policies may be associated with other forces at play, such as innovation and learning-by-doing in appliance production and design, that can affect long term trends in quality-adjusted prices and LCCs.« less

  5. Long-Term Follow-Up on the Donor Foot After Thumb Reconstruction Using Big Toe Wrap-Around Flap in Two Different Operation Methods.

    PubMed

    Ma, Zhi-Guo; Guo, Yong-Jun; Yan, Hou-Jun; Li, Qi-Ming; Ma, Bin

    2017-02-01

    The function of the donor foot has been affected after using big toe wrap-around flap for thumb reconstruction. A modified operation method has been developed to reduce the adverse effect on the donor foot. The current study compared the long-term effect of the classic and the modified operation methods on the donor foot. Gait analysis was carried out, including how the patient walked, the walking speed and walking distance, and how the patient jumped and ran. Plantar pressure was measured while the patient was standing and moving. A total of 45 patients who received the 2 different operation methods were included. The follow-up time was 4-10 years with a mean of 6.5 years. Various degrees of complications occurred for the 21 patients who received the classic operation method. For these patients, plantar pressure of the donor foot was obviously different comparing with the healthy unaffected foot while the patient was standing or walking. For the 24 patients who received the modified operation method, no obvious complications were observed and the plantar pressure of the donor foot and the healthy unaffected foot was similar while the patient was standing or walking. In conclusion, both the classic and the modified operation methods have affected the function of the donor foot after using the big toe wrap-around flap for thumb reconstruction. However, the donor foot was less affected when the modified operation method was used.

  6. Network operating system

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Long-term and short-term objectives for the development of a network operating system for the Space Station are stated. The short-term objective is to develop a prototype network operating system for a 100 megabit/second fiber optic data bus. The long-term objective is to establish guidelines for writing a detailed specification for a Space Station network operating system. Major milestones are noted. Information is given in outline form.

  7. Marketing in the long-term care continuum.

    PubMed

    Laurence, J Nathan; Kash, Bita A

    2010-04-01

    Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

  8. Decomposition of heterogeneous organic matterand its long-term stabilization in soils

    USGS Publications Warehouse

    Sierra, Carlos A.; Harmon, Mark E.; Perakis, Steven S.

    2011-01-01

    Soil organic matter is a complex mixture of material with heterogeneous biological, physical, and chemical properties. Decomposition models represent this heterogeneity either as a set of discrete pools with different residence times or as a continuum of qualities. It is unclear though, whether these two different approaches yield comparable predictions of organic matter dynamics. Here, we compare predictions from these two different approaches and propose an intermediate approach to study organic matter decomposition based on concepts from continuous models implemented numerically. We found that the disagreement between discrete and continuous approaches can be considerable depending on the degree of nonlinearity of the model and simulation time. The two approaches can diverge substantially for predicting long-term processes in soils. Based on our alternative approach, which is a modification of the continuous quality theory, we explored the temporal patterns that emerge by treating substrate heterogeneity explicitly. The analysis suggests that the pattern of carbon mineralization over time is highly dependent on the degree and form of nonlinearity in the model, mostly expressed as differences in microbial growth and efficiency for different substrates. Moreover, short-term stabilization and destabilization mechanisms operating simultaneously result in long-term accumulation of carbon characterized by low decomposition rates, independent of the characteristics of the incoming litter. We show that representation of heterogeneity in the decomposition process can lead to substantial improvements in our understanding of carbon mineralization and its long-term stability in soils.

  9. Field Test Program for Long-Term Operation of a COHPAC System for Removing Mercury from Coal-Fired Flue Gas

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

    Jean Bustard; Charles Lindsey; Paul Brignac

    With the Nation's coal-burning utilities facing the possibility of tighter controls on mercury pollutants, the U.S. Department of Energy is funding projects that could offer power plant operators better ways to reduce these emissions at much lower costs. Sorbent injection technology represents one of the simplest and most mature approaches to controlling mercury emissions from coal-fired boilers. It involves injecting a solid material such as powdered activated carbon into the flue gas. The gas-phase mercury in the flue gas contacts the sorbent and attaches to its surface. The sorbent with the mercury attached is then collected by the existing particlemore » control device along with the other solid material, primarily fly ash. During 2001, ADA Environmental Solutions (ADA-ES) conducted a full-scale demonstration of sorbent-based mercury control technology at the Alabama Power E.C. Gaston Station (Wilsonville, Alabama). This unit burns a low-sulfur bituminous coal and uses a hot-side electrostatic precipitator (ESP) in combination with a Compact Hybrid Particulate Collector (COHPAC{reg_sign}) baghouse to collect fly ash. The majority of the fly ash is collected in the ESP with the residual being collected in the COHPAC{reg_sign} baghouse. Activated carbon was injected between the ESP and COHPAC{reg_sign} units to collect the mercury. Short-term mercury removal levels in excess of 90% were achieved using the COHPAC{reg_sign} unit. The test also showed that activated carbon was effective in removing both forms of mercury-elemental and oxidized. However, a great deal of additional testing is required to further characterize the capabilities and limitations of this technology relative to use with baghouse systems such as COHPAC{reg_sign}. It is important to determine performance over an extended period of time to fully assess all operational parameters. The project described in this report focuses on fully demonstrating sorbent injection technology at a coal

  10. Alertness management in two-person long-haul flight operations

    NASA Technical Reports Server (NTRS)

    Rosekind, M. R.; Gander, P. H.

    1992-01-01

    Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.

  11. Long-Term Counterinsurgency Strategy: Maximizing Special Operations and Airpower

    DTIC Science & Technology

    2010-02-01

    operations forces possess a repertoire of capabilities and attributes which impart them with unique strategic utility. “That utility reposes most...flashlight), LTMs are employed in a similar role to cue aircrews equipped with Night Vision Devices (NVDs). Concurrently, employment of small laptop...Special Operations Forces (PSS-SOF) and Precision Fires Image Generator (PFIG) have brought similar benefit to the employment of GPS/INS targeted weapons

  12. Home health, long-term care, and other compliance activities.

    PubMed

    Anderson, T D; Sadoff, J W

    1999-04-01

    The Federal government continues to crack down on fraud and abuse in the healthcare industry with such initiatives and tools as Operation Restore Trust and intermediate tax sanctions. Home health and long-term care organizations are the latest entities under study by the Office of Inspector General, and the result of these studies likely will be more antifraud and abuse measures being taken against these entities. All healthcare organizations should pay particular attention to their tax risk exposure. Healthcare organizations that put effective compliance programs in place should be able to reduce the overall risk of challenges to their financial practices.

  13. Long term stability following genioplasty: a cephalometric study.

    PubMed

    Kumar, B Lakshman; Raju, G Kranthi Praveen; Kumar, N Dilip; Reddy, G Vivek; Naik, B Ravindra; Achary, C Ravindranath

    2015-04-01

    A receding chin associated with an orthognathic mandible is a common situation and surgical changes in chin position are often required to improve the overall harmony of the face. Genioplasty is one such procedure. Stability of hard and soft tissue changes following genioplasty on a long term basis needs to be assessed. Studies on the stability of hard and soft tissue changes following genioplasty on a short term basis have revealed it as a procedure with good stability. This study is done to assess the stability of hard and soft tissue changes following genioplasty on a long term basis. Pre-surgical, postsurgical and long term post-surgical cephalograms of 15 cases treated by vertical reduction augmentation genioplasty were obtained. Paired t-test was used to compare the changes between pre-surgical, postsurgical and long term postsurgical cephalograms. Findings of this study demonstrated that genioplasty is a stable procedure. After long term follow-up period, there was a relapse of 1.5 mm at the pogonion accounting for 24% of the surgical advancement. This is attributed to the remodeling that occurs at the surgical site, but not the instability due to the surgical procedure. With the present study, it can be concluded that vertical reduction and advancement genioplasty can be considered as an adjunctive procedure that produces predictable results and the bony and soft tissue stability were generally very good.

  14. Long term performance studies of large oil-free bakelite resistive plate chamber

    NASA Astrophysics Data System (ADS)

    Ganai, R.; Roy, A.; Shiroya, M. K.; Agarwal, K.; Ahammed, Z.; Choudhury, S.; Chattopadhyay, S.

    2016-09-01

    Several high energy physics and neutrino physics experiments worldwide require large-size RPCs to cover wide acceptances. The muon tracking systems in the Iron calorimeter (ICAL) experiment in the India based Neutrino Observatory (INO), India and the near detector in Deep Underground Neutrino Experiment (DUNE) at Fermilab are two such examples. A single gap bakelite RPC of dimension 240 cm × 120 cm, with gas gap of 0.2 cm, has been built and tested at Variable Energy Cyclotron Centre, Kolkata, using indigenous materials procured from the local market. No additional lubricant, like oil has been used on the electrode surfaces for smoothening. The chamber is in operation for > 365 days. We have tested the chamber for its long term operation. The leakage current, bulk resistivity, efficiency, noise rate and time resolution of the chamber have been found to be quite stable during the testing peroid. It has shown an efficiency > 95% with an average time resolution of ~ 0.83 ns at the point of measurement at ~ 8700 V throughout the testing period. Details of the long term performance of the chamber have been discussed.

  15. Effect of long-term exposure to Low Earth Orbit (LEO) space environment

    NASA Technical Reports Server (NTRS)

    Zimcik, D. G.

    1987-01-01

    Data obtained from components and materials from the Solar Maximum Mission satellite are presented and compared to data for similar materials obtained from the Advanced Composite Materials Exposure to Space Experiment (ACOMEX) flown on Shuttle mission STS-41G. In addition to evaluation of surface erosion and mass loss that may be of importance to very long-term missions, comparisons of solar absorptance and thermal emittance measurements for both long and short term exposures were made. Although the ratio of absorptance over emittance can be altered by proper choice of materials to ensure a proper operating environment for the spacecraft, once the thermal design is established, it is important that the material properties not change in order to maintain the operating environment for many payload and bus items such as electronics, batteries, fuel, etc. However, data presented show significant changes after short exposure in low Earth environment. Moreover, the measured changes are shown to differ according to the manner of exposure, i.e., normal or oblique, which also affects the resultant eroded surface morphology. These results identify constraints to be considered in development of flight experiments or laboratory testing.

  16. Long-term memory, neurogenesis, and signal novelty.

    PubMed

    Sokolov, E N; Nezlina, N I

    2004-10-01

    According to our suggested hypothesis, long-term memory is a collection of "gnostic units," selectively tuned to past events. The formation of long-term memory occurs with the involvement of constantly appearing new neurons which differentiate from stem cells during the process of neurogenesis, in particular in adults. Conversion of precursor neurons into "gnostic units" selective in relation to ongoing events, supplemented by the involvement of hippocampal "novelty neurons," which increase the flow of information needing to be fixed in long-term memory. "Gnostic units" form before the informational processes occurring in the ventral ("what?") and dorsal ("where?") systems. Formation of new "gnostic units" selectively tuned to a particular event results from the combination of excitation of the detector for stimulus characteristics and the novelty signal generated by "novelty neurons" in the hippocampus.

  17. Long-term care financing: lessons from France.

    PubMed

    Doty, Pamela; Nadash, Pamela; Racco, Nathalie

    2015-06-01

    POLICY POINTS: France's model of third-party coverage for long-term services and supports (LTSS) combines a steeply income-adjusted universal public program for people 60 or older with voluntary supplemental private insurance. French and US policies differ: the former pay cash; premiums are lower; and take-up rates are higher, in part because employer sponsorship, with and without subsidization, is more common-but also because coverage targets higher levels of need and pays a smaller proportion of costs. Such inexpensive, bare-bones private coverage, especially if marketed as a supplement to a limited public benefit, would be more affordable to those Americans currently most at risk of "spending down" to Medicaid. An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States' long-term care financing reform efforts. We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income

  18. What Legislators Need to Know about Long-Term Care Insurance.

    ERIC Educational Resources Information Center

    Landes, David

    This booklet discusses the potential importance to states of long-term care insurance, describes general policy characteristics, and summarizes state actions to both regulate and promote long-term care insurance. It is intended as a resource for legislators and others involved in long-term care financing and public policy formulation. Long-term…

  19. Private long-term care insurance and state tax incentives.

    PubMed

    Stevenson, David G; Frank, Richard G; Tau, Jocelyn

    2009-01-01

    To increase the role of private insurance in financing long-term care, tax incentives for long-term care insurance have been implemented at both the federal and state levels. To date, there has been surprisingly little study of these initiatives. Using a panel of national data, we find that market take-up for long-term care insurance increased over the last decade, but state tax incentives were responsible for only a small portion of this growth. Ultimately, the modest ability of state tax incentives to lower premiums implies that they should be viewed as a small piece of the long-term care financing puzzle.

  20. Joule-Thomson valves for long term service in space cryocoolers

    NASA Technical Reports Server (NTRS)

    Lester, J. M.; Benedict, B.

    1985-01-01

    Joule-Thomson valves for small cryocoolers have throttling passages on the order of 0.1 millimeter in diameter. Consequently, they can become plugged easily and stop the operation of the cooler. Plugging can be caused by solid particles, liquids or gases. Plugging is usually caused by the freezing of contaminant gases from the process stream. In small open loop coolers and in closed loop coolers where periodic maintenance is allowed, the problem is overcome by using careful assembly techniques, pure process gases, warm filters and cold adsorbers. A more thorough approach is required for closed loop cryocoolers which must operate unattended for long periods. This paper presents the results of an effort to solve this problem. The causes of plugging are examined, and various ways to eliminate plugging are discussed. Finally, the development of a J-T defroster is explained. It is concluded that a combination of preventive measures and a defroster will reduce the chance of cooler failure by plugging to such a degree that J-T coolers can be used for long term space missions.

  1. VALIDATION OF A METHOD FOR ESTIMATING LONG-TERM EXPOSURES BASED ON SHORT-TERM MEASUREMENTS

    EPA Science Inventory

    A method for estimating long-term exposures from short-term measurements is validated using data from a recent EPA study of exposure to fine particles. The method was developed a decade ago but long-term exposure data to validate it did not exist until recently. In this paper, ...

  2. The Long-Term Conditions Questionnaire: conceptual framework and item development.

    PubMed

    Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

    2016-01-01

    To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

  3. The Long-Term Conditions Questionnaire: conceptual framework and item development

    PubMed Central

    Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A’Court, Christine; Fitzpatrick, Ray

    2016-01-01

    Purpose To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Materials and methods Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Results Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. Conclusion The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey. PMID:27621678

  4. Phase and structural transformations in VVER-440 RPV base metal after long-term operation and recovery annealing

    NASA Astrophysics Data System (ADS)

    Kuleshova, E. A.; Gurovich, B. A.; Maltsev, D. A.; Frolov, A. S.; Bukina, Z. V.; Fedotova, S. V.; Saltykov, M. A.; Krikun, E. V.; Erak, D. Yu; Zhurko, D. A.; Safonov, D. V.; Zhuchkov, G. M.

    2018-04-01

    This study was carried out to evaluate the possibility of 1st generation VVER-440 reactors lifetime extension by recovery re-annealing with the respect to base metal (BM). Comprehensive studies of the structure and properties of BM templates (samples cut from the inner surface of the shells in beltline region) of operating VVER-440 reactor (after primary standard recovery annealing 475 °C/150 h and subsequent long-term re-irradiation within reactor pressure vessel (RPV)) were conducted. These templates were also subjected to laboratory re-annealing 475 °C/150 h. TEM, SEM and APT studies of BM after laboratory re-annealing revealed significant recovery of radiation-induced hardening elements (Cu-rich precipitates and dislocation loops). Simultaneously a process of strong phosphorus accumulation at grain boundaries occurs since annealing temperature corresponds to the maximum reversible temper brittleness development. The latter is not observed for VVER-440 weld metal (WM). Comparative assessment of the properties return level for the beltline BM templates after recovery re-annealing 475 °C/150 h showed that it does not reach the one typical for beltline WM after the same annealing.

  5. Beyond Quarterly Earnings: Preparing the Business Community for Long-term Climate Risks

    NASA Astrophysics Data System (ADS)

    Carlson, C.; Goldman, G. T.

    2014-12-01

    The business community stands to be highly impacted by climate change. In both short and long-term timescales, climate change presents material and financial risks to companies in diverse economic sectors. How the private sector accounts for long-term risks while making short-term decisions about operations is a complex challenge. Companies are accountable to shareholders and must report performance to them on a quarterly basis. At the same time, company investors are exposed to long-term climate-related risks and face losses if companies fail to prepare for climate impacts. The US Securities and Exchange Commission (SEC) obligates publicly traded companies to discuss risks that might materially affect their business and since 2010, the agency recommends that companies consider and discuss any significant risks to their business from climate change. Some companies have complied with this guidance and comprehensively analyze potential climate change impacts, yet others fail to consider climate change at all. Such omissions leave companies without plans for addressing future risks and expose investors and the public to potential catastrophic events from climate change impacts. Climate risk projections can inform companies about the vulnerability of their facilities, supply chains, transportation pathways, and other assets. Such projections can help put climate-related risks in terms of material costs for companies and their investors. Focusing on the vulnerability of coastal facilities, we will use climate change impact projections to demonstrate the economic impacts of climate change faced by the private sector. These risks are then compared to company disclosures to the SEC to assess the degree to which companies have considered their vulnerability to climate change. Finally, we will discuss ways that companies can better assess and manage long-term climate risks.

  6. Short-term and long-term attentional biases to frequently encountered target features.

    PubMed

    Sha, Li Z; Remington, Roger W; Jiang, Yuhong V

    2017-07-01

    It has long been known that frequently occurring targets are attended better than infrequent ones in visual search. But does this frequency-based attentional prioritization reflect momentary or durable changes in attention? Here we observed both short-term and long-term attentional biases for visual features as a function of different types of statistical associations between the targets, distractors, and features. Participants searched for a target, a line oriented horizontally or vertically among diagonal distractors, and reported its length. In one set of experiments we manipulated the target's color probability: Targets were more often in Color 1 than in Color 2. The distractors were in other colors. Participants found Color 1 targets more quickly than Color 2 targets, but this preference disappeared immediately when the target's color became random in the subsequent testing phase. In the other set of experiments, we manipulated the diagnostic values of the two colors: Color 1 was more often a target than a distractor; Color 2 was more often a distractor than a target. Participants found Color 1 targets more quickly than Color 2 targets. Importantly, and in contrast to the first set of experiments, the featural preference was sustained in the testing phase. These results suggest that short-term and long-term attentional biases are products of different statistical information. Finding a target momentarily activates its features, inducing short-term repetition priming. Long-term changes in attention, on the other hand, may rely on learning diagnostic features of the targets.

  7. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system.

    PubMed

    De Palma, Angela; Sollitto, Francesco; Loizzi, Domenico; Di Gennaro, Francesco; Scarascia, Daniele; Carlucci, Annalisa; Giudice, Giuseppe; Armenio, Andrea; Ludovico, Rossana; Loizzi, Michele

    2016-03-01

    We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16-83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. An optimal chest wall stabilization and reconstruction was achieved with the Synthes(®) titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long-term

  8. Long-term care financing through Federal tax incentives.

    PubMed

    Moran, D W; Weingart, J M

    1988-12-01

    Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost.

  9. Long-term care financing through Federal tax incentives

    PubMed Central

    Moran, Donald W.; Weingart, Janet M.

    1988-01-01

    Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost. PMID:10312964

  10. Long-term psychosocial consequences of surgical congenital malformations.

    PubMed

    Diseth, Trond H; Emblem, Ragnhild

    2017-10-01

    Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

  11. Optimization Strategies for Long-Term Ground Water Remedies (with Particular Emphasis on Pump and Treat Systems)

    EPA Pesticide Factsheets

    This fact sheet has been prepared to assist environmental case managers from Federal and State agencies, environmental program managers from private organizations, and environmental contractors with optimization of operating long-term ground water remedies

  12. The relationship between interannual and long-term cloud feedbacks

    DOE PAGES

    Zhou, Chen; Zelinka, Mark D.; Dessler, Andrew E.; ...

    2015-12-11

    The analyses of Coupled Model Intercomparison Project phase 5 simulations suggest that climate models with more positive cloud feedback in response to interannual climate fluctuations also have more positive cloud feedback in response to long-term global warming. Ensemble mean vertical profiles of cloud change in response to interannual and long-term surface warming are similar, and the ensemble mean cloud feedback is positive on both timescales. However, the average long-term cloud feedback is smaller than the interannual cloud feedback, likely due to differences in surface warming pattern on the two timescales. Low cloud cover (LCC) change in response to interannual andmore » long-term global surface warming is found to be well correlated across models and explains over half of the covariance between interannual and long-term cloud feedback. In conclusion, the intermodel correlation of LCC across timescales likely results from model-specific sensitivities of LCC to sea surface warming.« less

  13. The Upper Rio Grande Basin as a Long-Term Hydrologic Observatory - Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    Springer, E.; Duffy, C.; Phillips, F.; Hogan, J.; Winter, C. L.

    2001-12-01

    Long-term hydrologic observatories (LTHO) have been identified as a key element to advance hydrologic science. Issues to be addressed are the size and locations of LTHOs to meet research needs and address water resources management concerns. To date, considerable small watershed research has been performed, and these have provided valuable insights into processes governing hydrologic response on local scales. For hydrology to advance as a science, more complete and coherent data sets at larger scales are needed to tie together local studies and examine lower frequency long wavelength processes that may govern the water cycle at the scale of river basins and continents. The objective of this poster is to describe the potential opportunities and challenges for the upper Rio Grande as a LTHO. The presence of existing research programs and facilities can be leveraged by a LTHO to develop the required scientific measurements. Within the upper Rio Grande Basin, there are two Long-Term Ecological Research sites, Jornada and Sevilleta; Los Alamos National Laboratory, which monitors the atmosphere, surface water and groundwater; a groundwater study is being performed by the USGS in the Albuquerque Basin to examine recharge and water quality issues. Additionally, the upper Rio Grande basin served as an USGS-NAWQA study site starting in the early 1990's and is currently being studied by SAHRA (NSF-STC) to understand sources of salinity of the river system; such studies provide an existing framework on which to base long-term monitoring of water quality. The upper Rio Grande Basin has a wealth of existing long-term climate, hydrologic and geochemical records on which to base an LTHO. Within the basin there are currently 122 discharge gages operated by the USGS; and many of these gages have long-term records of discharge. Other organizations operate additional surface water gages in the lower part of the basin. Long-term records of river chemistry have been kept by the USGS, U

  14. Long-term survival after chronic subdural haematoma.

    PubMed

    Manickam, Appukutty; Marshman, Laurence A G; Johnston, Ross

    2016-12-01

    Outcome after chronic subdural haematoma (CSDH) is invariably assumed favourable: however, little data regarding long term survival (LTS) exists. One study reported excess mortality restricted to year 1, but with expected actuarial rates thereafter. We aimed to determine LTS after CSDH in a retrospective analysis relative to actuarial data from age-matched controls. Data was obtained in n=155, (M:F 97:58, 69.3±2.3years). Follow-up maxima was 14.19years (mean: 4.02±3.07years, median: 5.2years). Mortality in-hospital, at 6months, 1year, 2years and 5years was n=13 (8.39%), n=22 (14.19%), n=31 (20.35%), n=42 (27.1%) and n=54 (34.84%). LTS was significantly worse than controls (5.29±0.59years vs. 17.74±1.8years, hazard ratio [HR]: 3.52, P<0.0001). Death most frequently related to pneumonia/sepsis and ischemic heart disease (IHD). Median modified Rankin score (mRS) in those discharged home (n=94, 60.65%) was 2 [IQR: 1-3]. Discharge mRS in those who died at 6months, 1year, 2years and 5years was 5 [IQR: 3-6], 5 [IQR: 4-6], 3 [IQR: 1-3], 4 [IQR: 2-5]. Discharge mRS was significantly worse with year 1 mortality (P=0.014). LTS related to discharge mRS (HR: 37.006, P<0.001), post-operative motor-score (HR: 0.581, P=0.0026), IHD (HR: 5.186, P=0.005), warfarin-use (HR: 5.93, P=0.036) and dementia (HR: 5.39, P=0.031). No long term recurrences (LTR) were recorded. Although most were discharged home with mRS=2, LTS was markedly less than previously reported: peers lived 12.4years longer. Although greater in year 1, excess mortality was not restricted to year 1, but continued throughout prolonged follow-up. LTS related to discharge disability and dependence, and co-morbid risk factors for cerebral atrophy. No LTR suggests that, once ultimately closed, the 'subdural space' remains closed. CSDH patients represent a vulnerable group who require continued long-term medical surveillance. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  15. Group long-term care insurance: decision-making factors and implications for financing long-term care.

    PubMed

    Stum, Marlene S

    2008-01-01

    This study proposes and tests a systemic family decision-making framework to understand group long-term care insurance (LTCI) enrollment decisions. A random sample of public employees who were offered group LTCI as a workplace benefit were examined. Findings reveal very good predictive efficacy for the overall conceptual framework with a pseudo R2 value of .687, and reinforced the contributions of factors within the family system. Enrollees were more likely to have discussed the decision with others, used information sources, and had prior experience when compared to non-enrollees. Perceived health status, financial knowledge, attitudes regarding the role of private insurance, risk taking, and coverage features were additional factors related to enrollment decisions. The findings help to inform policymakers about the potential of LTCI as one strategy for financing long-term care.

  16. Informed Consent to Research in Long-Term Care Settings

    PubMed Central

    Jablonski, Rita A.; Bourbonniere, Meg; Kolanowski, Ann

    2010-01-01

    Informed consent to nursing home research is a two-tiered process that begins with obtaining the consent of a long-term care community at the institutional level and progresses to the engagement of individuals in the consent process. Drawing on a review of the literature and the authors’ research experiences and institutional review board service, this paper describes the practical implications of nurse investigators’ obligation to ensure informed consent among participants in long-term care research. Recommendations focus on applying a community consent model to long-term care research, promoting an evidence-based approach to the protection of residents with decisional impairment, and increasing investigators’ attention to ethical issues involving long-term care staff. PMID:20078005

  17. Using corporate governance to enhance 'long-term situation awareness' and assist in the avoidance of organisation-induced disasters.

    PubMed

    Siemieniuch, C E; Sinclair, M A

    2008-03-01

    This paper considers the issue of how corporate governance can and should deal with the long-term understanding of systems health-what we may call 'long-term situation awareness' (i.e. which evolves and is coherent over time) for organisational systems (and their component sub systems) in the engineering domain. Many characteristics affect long-term situation awareness-the rate of change to processes, pressures for greater efficiency from existing resources, changes in personnel, cultural changes and changes to the operational environment of the organisational systems. Many disasters (e.g. Chernobyl, Flixborough, Piper Alpha) have a causal path that indicates a loss of group situation awareness, over a long period of time. The problem of the gradual, slow drift over many years towards unsafe conduct of company operations is discussed and examples of possible consequences provided. A 'parable' from the world of manufacturing is used to exemplify the problem. The paper goes on to discuss some ways by which this problem could be addressed and longer-term system situational awareness increased; essentially by good corporate governance, knowledge management and ownership of processes. Links are made to the literature on these topics, and a route map to help organisations to gain the benefits is offered.

  18. Short-term Operation of Multi-purpose Reservoir using Model Predictive Control

    NASA Astrophysics Data System (ADS)

    Uysal, Gokcen; Schwanenberg, Dirk; Alvarado Montero, Rodolfo; Sensoy, Aynur; Arda Sorman, Ali

    2017-04-01

    Operation of water structures especially with conflicting water supply and flood mitigation objectives is under more stress attributed to growing water demand and changing hydro-climatic conditions. Model Predictive Control (MPC) based optimal control solutions has been successfully applied to different water resources applications. In this study, Feedback Control (FBC) and MPC get combined and an improved joint optimization-simulation operating scheme is proposed. Water supply and flood control objectives are fulfilled by incorporating the long term water supply objectives into a time-dependent variable guide curve policy whereas the extreme floods are attenuated by means of short-term optimization based on MPC. A final experiment is carried out to assess the lead time performance and reliability of forecasts in a hindcasting experiment with imperfect, perturbed forecasts. The framework is tested in Yuvacık Dam reservoir where the main water supply reservoir of Kocaeli City in the northwestern part of Turkey (the Marmara region) and it requires a challenging gate operation due to restricted downstream flow conditions.

  19. Evaluation of the Long-Term Durability of Joints Cut Using Early Entry Saws on Rigid Pavements

    DOT National Transportation Integrated Search

    2011-01-01

    Early-entry sawing is an attractive operation to expedite the construction of jointed concrete pavements; however, : there are some concerns that the early-entry sawing may compromise the pavements long-term performance. The Illinois : Department ...

  20. Long-lasting functional disabilities in patients who recover from coma after cardiac operations.

    PubMed

    Rodriguez, Rosendo A; Nair, Shona; Bussière, Miguel; Nathan, Howard J

    2013-03-01

    Uncertainty regarding the long-term functional outcome of patients who awaken from coma after cardiac operations is difficult for families and physicians and may delay rehabilitation. We studied the long-term functional status of these patients to determine if duration of coma predicted outcome. We followed 71 patients who underwent cardiac operations; recovered their ability to respond to verbal commands after coma associated with postoperative stroke, encephalopathy, and/or seizures; and were discharged from the hospital. The Glasgow Outcome Scale Extended (GOSE) was used to assess functional disability 2 to 4 years after discharge. Outcomes were classified as favorable (GOSE scores 7 and 8) and unfavorable (GOSE scores 1-6). Of 71 patients identified, 39 were interviewed, 15 died, 1 refused to be interviewed, and 16 were lost to follow-up. Of the 54 patients with completed GOSE evaluations, only 15 (28%) had favorable outcomes. Among patients with unfavorable outcomes, 15 (28%) died, 14 (26%) survived with moderate disabilities, and 10 (18%) had severe disabilities. Factors associated with unfavorable outcomes were increases in duration of coma (p = 0.007), time in intensive care (p = 0.006), length of hospitalization (p = 0.004), and postoperative serum creatine kinase levels (p = 0.006). Only duration of coma was an independent predictor of unfavorable outcome (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.008-1.537; p = 0.042). Patients with durations of coma greater than 4 days were more likely to have unfavorable outcomes (OR, 5.1; 95% CI, 1.3-21.3; p = 0.02). Two thirds of comatose patients who survived to discharge after cardiac operations had unfavorable long-term functional outcomes. A longer duration of unconsciousness is a predictor of unfavorable outcome. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Japanese public long-term care insured: preferences for future long-term care facilities, including relocation, waiting times, and individualized care.

    PubMed

    Sawamura, Kanae; Sano, Hiroshi; Nakanishi, Miharu

    2015-04-01

    Expenditures on long-term care insurance (LTCI) in Japan have been increasing with the aging of the population, which has led to an increase in premiums. To optimize resource allocation, we aim to clarify the priorities of the functions of long-term care facilities from the viewpoint of future beneficiaries. The present study was conducted using a cross-sectional study design. We conducted a mail-in survey targeting 2400 adults aged 50-65 in 8 cities in Japan, and 371 persons responded. Conjoint analysis was applied to measure participants' preferences for long-term care facility services. Participants read 1 of 2 vignettes of an 80-year-old person with either dementia or a fracture, and were asked to envision it as a possible future scenario for themselves. Participants then completed 8 or 9 tasks to select suitable long-term care facilities for the person described. The questionnaire also contained common questions on participants' personal profiles: age, gender, family situation, education, approximate yearly family income, experience as a family caregiver, dwelling status, present health status, and possibility of requiring long-term care services in the future. The results focused mainly on (1) possibilities of individual choice for daily schedules/meals; (2) availability of regular care staff; (3) room; (4) main daily interactions; (5) necessity of relocation associated with medical deterioration; 6) Waiting time; 7) distance from present residence; and (8) monthly fees. Necessity of relocation associated with medical deterioration was consistently given the greatest importance. Participants with experience as a family caregiver showed significantly greater preference for individualized care and communication. The option of avoiding relocation was highly valued by participants compared with private rooms and individualized care. The present situation of high demand for intensive care homes for the elderly, provoked by anxiety about future residence, will not

  2. Adverse event reporting in Czech long-term care facilities.

    PubMed

    Hěib, Zdenřk; Vychytil, Pavel; Marx, David

    2013-04-01

    To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

  3. Long-term outcomes of children undergoing video-assisted gastrostomy.

    PubMed

    Salö, Martin; Santimano, Ana; Helmroth, Sofia; Stenström, Pernilla; Arnbjornsson, Einar Ólafur

    2017-01-01

    The aims of this study were to assess the short- and long-term complication rates after video-assisted gastrostomy (VAG), the effects of age and gender on long-term complications and the effect of duration of gastrostomy tube retention on the need for gastroraphy when the gastrostomy device was removed. This was a retrospective study of children undergoing VAG at a single institution. Children who died or moved from the area were excluded. The rates of short- and long-term complications developing at 3-6 months or 2 or more years, respectively, were compared. A total of 170 children were studied, out of a cohort of 303 children. The median age at surgery was 2 years. The median duration of postoperative long-term follow-up was 5 years (2-9 years). The complications at the respective short and long-term follow-ups were as follows: granulation tissue, leakage, infection and vomiting. There were no differences in the short- versus long-term complication rates for gender and age. Children needing gastroraphy had used a gastrostomy device significantly longer compared with children with spontaneous closure. Complications after VAG decrease over time. A longer duration of gastrostomy device retention leads to increased need for gastroraphy.

  4. Long Term Stability Following Genioplasty: A Cephalometric Study

    PubMed Central

    Kumar, B Lakshman; Raju, G Kranthi Praveen; Kumar, N Dilip; Reddy, G Vivek; Naik, B Ravindra; Achary, C Ravindranath

    2015-01-01

    Background: A receding chin associated with an orthognathic mandible is a common situation and surgical changes in chin position are often required to improve the overall harmony of the face. Genioplasty is one such procedure. Stability of hard and soft tissue changes following genioplasty on a long term basis needs to be assessed. Studies on the stability of hard and soft tissue changes following genioplasty on a short term basis have revealed it as a procedure with good stability. This study is done to assess the stability of hard and soft tissue changes following genioplasty on a long term basis. Materials and Methods: Pre-surgical, postsurgical and long term post-surgical cephalograms of 15 cases treated by vertical reduction augmentation genioplasty were obtained. Paired t-test was used to compare the changes between pre-surgical, postsurgical and long term postsurgical cephalograms. Results: Findings of this study demonstrated that genioplasty is a stable procedure. After long term follow-up period, there was a relapse of 1.5 mm at the pogonion accounting for 24% of the surgical advancement. This is attributed to the remodeling that occurs at the surgical site, but not the instability due to the surgical procedure. Conclusion: With the present study, it can be concluded that vertical reduction and advancement genioplasty can be considered as an adjunctive procedure that produces predictable results and the bony and soft tissue stability were generally very good. PMID:25954070

  5. Long-term EEG in children.

    PubMed

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

    2015-03-01

    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

  6. A 35-year experience with syndromic cleft palate repair: operative outcomes and long-term speech function.

    PubMed

    Basta, Marten N; Silvestre, Jason; Stransky, Carrie; Solot, Cynthia; Cohen, Marilyn; McDonald-McGinn, Donna; Zackai, Elaine; Kirschner, Richard; Low, David W; Randall, Peter; LaRossa, Don; Jackson, Oksana A

    2014-12-01

    Associated comorbidities can put syndromic patients with cleft palate at risk for poor speech outcomes. Reported rates of velopharyngeal insufficiency (VPI) vary from 8% to 64%, and need for secondary VPI surgery from 23% to 64%, with few studies providing long-term follow-up. The purpose of this study was to describe our institutional long-term experience with syndromic patients undergoing cleft palatoplasty. A retrospective review was conducted of all patients with syndromic diagnoses undergoing primary Furlow palatoplasty from 1975 to 2011. Outcomes included postoperative oronasal fistula (ONF) and need for secondary VPI surgery. Speech scores for verbal patients 5 years or older were collected via the Pittsburgh scale for speech assessment. Aggregate scores categorized the velopharyngeal mechanism as competent, borderline, or incompetent. Outcomes were analyzed by patient and operative factors. One hundred thirty-two patients were included with average age at repair of 20.7 months. Cleft type was 9% submucosal, 16% Veau class I, 50% class II, 12% class III, and 13% class IV. Forty-five syndromes were recorded, most commonly Stickler syndrome (n = 32) and 22q11.2 deletion syndrome [22q11.2DS (n = 19)]. Forty-four patients also had associated Pierre Robin sequence (PRS). The overall ONF rate was 4.5% and was highest in Veau class IV clefts (P = 0.048). Seventy-six patients were included in speech analysis, with an average age at last assessment of 10.4 years. Overall, 60.5% of patients had a competent velopharyngeal mechanism, 23.7% borderline, and 15.8% incompetent mechanism. Fifty percent of 22q11.2DS patients had borderline speech and none had competent speech, compared to 73.3% with Stickler syndrome (P = 0.01) and 71.4% of patients with associated PRS (P = 0.02). Secondary VPI surgery was performed in 11.4% of patients overall. Patients with PRS (13.6%) and with Stickler syndrome (15.6%) had secondary VPI surgery, compared to 31.6% of patients with 22q11.2DS

  7. Assessing the market for long-term care services.

    PubMed

    Rice, J A; Taylor, S

    1984-02-01

    Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

  8. Short-Term Plasticity and Long-Term Potentiation in Magnetic Tunnel Junctions: Towards Volatile Synapses

    NASA Astrophysics Data System (ADS)

    Sengupta, Abhronil; Roy, Kaushik

    2016-02-01

    Synaptic memory is considered to be the main element responsible for learning and cognition in humans. Although traditionally nonvolatile long-term plasticity changes are implemented in nanoelectronic synapses for neuromorphic applications, recent studies in neuroscience reveal that biological synapses undergo metastable volatile strengthening followed by a long-term strengthening provided that the frequency of the input stimulus is sufficiently high. Such "memory strengthening" and "memory decay" functionalities can potentially lead to adaptive neuromorphic architectures. In this paper, we demonstrate the close resemblance of the magnetization dynamics of a magnetic tunnel junction (MTJ) to short-term plasticity and long-term potentiation observed in biological synapses. We illustrate that, in addition to the magnitude and duration of the input stimulus, the frequency of the stimulus plays a critical role in determining long-term potentiation of the MTJ. Such MTJ synaptic memory arrays can be utilized to create compact, ultrafast, and low-power intelligent neural systems.

  9. Renal recovery and long-term survival following acute kidney injury after coronary artery surgery: a nationwide study.

    PubMed

    Helgadottir, S; Sigurdsson, M I; Palsson, R; Helgason, D; Sigurdsson, G H; Gudbjartsson, T

    2016-10-01

    Acute kidney injury (AKI) is a relatively common complication following CABG and is associated with adverse outcomes. Nonetheless, we hypothesized that the majority of patients make a good long-term recovery of their renal function. We studied the incidence and risk factors of AKI together with renal recovery and long-term survival in patients who developed AKI following CABG. This nationwide study examined AKI among 1754 consecutive patients undergoing CABG in 2001-2013. AKI was defined according to the KDIGO criteria. Postoperatively 184 (11%) patients developed AKI; 121 (7%), 27 (2%), and 36 (2%) at stages 1, 2, and 3, respectively. AKI was an independent risk factor for chronic kidney disease (CKD) and AKI patients had worse post-operative outcomes. Lower pre-operative glomerular filtration rate, higher EuroSCORE and BMI, diabetes, reoperation, and units of red blood cells transfused were independent risk factors of AKI. At post-operative day 10, renal recovery rates, defined as serum creatinine ratio <1.25 of baseline, were 96 (95% CI 91-99%), 78 (95% CI 53-90%), and 94% (95% CI 77-98%) for AKI stages 1, 2, and 3, respectively. Long-term survival was predicted by AKI with 10-year survival of patients without AKI being 76% and those with AKI stages 1, 2, and 3 being 63%, 56%, and 49%, respectively (P < 0.001). Depending on the severity of the initial AKI, 78-97% of patients made good recovery of their kidney function. However, AKI was significantly linked to progression to CKD and long-term survival remained markedly affected by the severity of the initial kidney injury. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Smart Structures for Vibration Control on Long-Term Space Exploration and Habitation Missions

    NASA Technical Reports Server (NTRS)

    Gattis, Christy B.; Shepard, W. Steve, Jr.

    2004-01-01

    The current vision for space exploration focuses on human missions to the Moon, Mars, and beyond. To support these goals, it is certain that new vehicles and intermediate bases will be developed, whether that means simply re-direction of the ISS as a "mission research facility" or construction of a lunar base. Since these facilities are expected to be constructed from inherently light-weight materials, this work examines some of the potential sources of vibration and noise as well as means for controlling these vibrations. Many of the operating components within these facilities, such as pumps, fans, and motors, will produce vibrations during operation. These vibrations become structure in which they are housed. Resonances can impact acoustic noise levels and noise quality within the environment, possibly affecting crew health and productivity. For long-term missions in particular, it is expected that crew members will spend significant portions of their time restrained in the structure, such as in seats. As a result, the general health and well-being of the crew can be improved by limiting the harmful effects of human exposure to long-term audible and tactile vibration input. Besides the human factor, this work also examines some operational considerations in which vibrations play an important role. Vibrations can impact the environment for science and in-situ manufacturing research within these vehicles. Since a benign vibratory environment is beneficial for most types of science experiments, there is a need for various forms of vibration control. Because the operational characteristics of a vehicle can change during a long-term mission, it is further expected that the characteristics of many of the vibratory excitations will change with time. Consequently, the form of vibration control needed to improve overall habitability and usefulness of the vehicle or element for exploration missions will rely to some degree on the vibration control system's ability to

  11. Long-term abstinent alcoholics have normal memory.

    PubMed

    Reed, R J; Grant, I; Rourke, S B

    1992-08-01

    It is generally believed that many non-Korsakoff alcoholics have subtle defects in memory. To determine whether such defects vary as a function of length of abstinence (LOA), we performed extensive memory testing with: (1) recently detoxified (n = 31; LOA-29 days); (2) intermediate-term abstinent (n = 28; LOA = 1.9 years); (3) long-term abstinent (n = 32; LOA-7.0 years) alcoholics; and (4) nonalcoholic controls (n = 37). All subjects were matched on age and education. Alcoholics were matched on years of alcoholic drinking. Memory measures were divided into the following domains: verbal learning, verbal recall, visual learning, visual recall, and paired associate learning. A series of MANOVAs were conducted that revealed a significant relationship between visual learning and length of abstinence, and a significant interaction between age and length of abstinence on visual recall. Long-term abstinent subjects were not significantly different from controls on any test. We conclude that memory disturbance demonstrable among recently detoxified alcoholics in the early weeks of their abstinence is not evident in demographically matched long-term abstinent alcoholics with similar drinking histories.

  12. Partnership insurance: an innovation to meet long-term care financing needs in an era of federal minimalism.

    PubMed

    Meiners, Mark R; McKay, Hunter L; Mahoney, Kevin J

    2002-01-01

    In the case of long-term care financing, federal minimalism is not new news. Long-term care has long played a weak "third fiddle" to national health reform concerns about the uninsured and catastrophic expenditures on prescription drugs. The states have been left to struggle with the issue of long-term financing as part of their responsibilities in funding and administering the means-tested Medicaid program. Recently, the environment has become even more challenging. Much of what is on the national agenda for health and welfare reform has been delegated to the states. This "devolution" of responsibilities has created many competing priorities for both the attention and resources of states. This context of evolving federal minimalism calls for creative solutions that balance competing points of view. In this article, we provide some background and insights from one such effort: a collaboration between state governments and private insurers to put into operation an insurance-based approach to long-term care financing that uses Medicaid as an incentive to encourage potential purchasers.

  13. Effects of a Long-Term Participatory Action Research Project on Science Teachers' Professional Development

    ERIC Educational Resources Information Center

    Eilks, Ingo; Markic, Silvija

    2011-01-01

    This paper describes the potential of long-term co-operation between science educators and science teachers concerning the teachers' continuous professional development, based on Participatory Action Research in science education. The discussion is based on a six-year case study observing a group of about ten German chemistry teachers by chemistry…

  14. Accelerated testing of module-level power electronics for long-term reliability

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

    Flicker, Jack David; Tamizhmani, Govindasamy; Moorthy, Mathan Kumar

    This work has applied a suite of long-term-reliability accelerated tests to a variety of module-level power electronics (MLPE) devices (such as microinverters and optimizers) from five different manufacturers. This dataset is one of the first (only the paper by Parker et al. entitled “Dominant factors affecting reliability of alternating current photovoltaic modules,” in Proc. 42nd IEEE Photovoltaic Spec. Conf., 2015, is reported for reliability testing in the literature), as well as the largest, experimental sets in public literature, both in the sample size (five manufacturers including both dc/dc and dc/ac units and 20 units for each test) and the numbermore » of experiments (six different experimental test conditions) for MLPE devices. The accelerated stress tests (thermal cycling test per IEC 61215 profile, damp heat test per IEC 61215 profile, and static temperature tests at 100 and 125 °C) were performed under powered and unpowered conditions. The first independent long-term experimental data regarding damp heat and grid transient testing, as well as the longest term (>9 month) testing of MLPE units reported in the literature for thermal cycling and high-temperature operating life, are included in these experiments. Additionally, this work is the first to show in situ power measurements, as well as periodic efficiency measurements over a series of experimental tests, demonstrating whether certain tests result in long-term degradation or immediate catastrophic failures. Lastly, the result of this testing highlights the performance of MLPE units under the application of several accelerated environmental stressors.« less

  15. Accelerated testing of module-level power electronics for long-term reliability

    DOE PAGES

    Flicker, Jack David; Tamizhmani, Govindasamy; Moorthy, Mathan Kumar; ...

    2016-11-10

    This work has applied a suite of long-term-reliability accelerated tests to a variety of module-level power electronics (MLPE) devices (such as microinverters and optimizers) from five different manufacturers. This dataset is one of the first (only the paper by Parker et al. entitled “Dominant factors affecting reliability of alternating current photovoltaic modules,” in Proc. 42nd IEEE Photovoltaic Spec. Conf., 2015, is reported for reliability testing in the literature), as well as the largest, experimental sets in public literature, both in the sample size (five manufacturers including both dc/dc and dc/ac units and 20 units for each test) and the numbermore » of experiments (six different experimental test conditions) for MLPE devices. The accelerated stress tests (thermal cycling test per IEC 61215 profile, damp heat test per IEC 61215 profile, and static temperature tests at 100 and 125 °C) were performed under powered and unpowered conditions. The first independent long-term experimental data regarding damp heat and grid transient testing, as well as the longest term (>9 month) testing of MLPE units reported in the literature for thermal cycling and high-temperature operating life, are included in these experiments. Additionally, this work is the first to show in situ power measurements, as well as periodic efficiency measurements over a series of experimental tests, demonstrating whether certain tests result in long-term degradation or immediate catastrophic failures. Lastly, the result of this testing highlights the performance of MLPE units under the application of several accelerated environmental stressors.« less

  16. Predicting isoproturon long-term mineralization from short-term experiment: Can this be a suitable approach?

    PubMed

    Wang, Fang; Dörfler, Ulrike; Jiang, Xin; Schroll, Reiner

    2016-02-01

    A worldwide used pesticide - isoproturon (IPU) - was selected to test whether short-term experiments can be used to predict long-term mineralization of IPU in soil. IPU-mineralization was measured for 39 and 265 days in four different agricultural soils with a low mineralization dynamic. Additionally, in one soil IPU dissipation, formation and dissipation of metabolites, formation of non-extractable residues (NER) and (14)C-microbial biomass from (14)C-IPU were monitored for 39 and 265 days. The data from short-term and long-term experiments were used for model fitting. The long-term dynamics of IPU mineralization were considerably overestimated by the short-term experiments in two soils with neutral pH, while in two other soils with low pH and lower mineralization, the long-term mineralization of IPU could be sufficiently predicted. Additional investigations in one of the soils with neutral pH showed that dissipation of IPU and metabolites could be correctly predicted by the short-term experiment. However, the formation of NER and (14)C-microbial biomass were remarkably overestimated by the short-term experiment. Further, it could be shown that the released NER and (14)C-microbial biomass were the main contributors of (14)CO2 formation at later incubation stages. Taken together, our results indicate that in soils with neutral pH short-term experiments were inadequate to predict the long-term mineralization of IPU. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Long Term Performance Metrics of the GD SDR on the SCaN Testbed: The First Year on the ISS

    NASA Technical Reports Server (NTRS)

    Nappier, Jennifer; Wilson, Molly C.

    2014-01-01

    The General Dynamics (GD) S-Band software defined radio (SDR) in the Space Communications and Navigation (SCaN) Testbed on the International Space Station (ISS) provides experimenters an opportunity to develop and demonstrate experimental waveforms in space. The SCaN Testbed was installed on the ISS in August of 2012. After installation, the initial checkout and commissioning phases were completed and experimental operations commenced. One goal of the SCaN Testbed is to collect long term performance metrics for SDRs operating in space in order to demonstrate long term reliability. These metrics include the time the SDR powered on, the time the power amplifier (PA) is powered on, temperature trends, error detection and correction (EDAC) behavior, and waveform operational usage time. This paper describes the performance of the GD SDR over the first year of operations on the ISS.

  18. Operational summary of an electric propulsion long term test facility

    NASA Technical Reports Server (NTRS)

    Trump, G. E.; James, E. L.; Bechtel, R. T.

    1982-01-01

    An automated test facility capable of simultaneously operating three 2.5 kW, 30-cm mercury ion thrusters and their power processors is described, along with a test program conducted for the documentation of thruster characteristics as a function of time. Facility controls are analog, with full redundancy, so that in the event of malfunction the facility automaticcally activates a backup mode and notifies an operator. Test data are recorded by a central data collection system and processed as daily averages. The facility has operated continuously for a period of 37 months, over which nine mercury ion thrusters and four power processor units accumulated a total of over 14,500 hours of thruster operating time.

  19. Efficacy and durability of robotic Heller myotomy for achalasia: patient symptoms and satisfaction at long-term follow-up.

    PubMed

    Perry, Kyle A; Kanji, Aliyah; Drosdeck, Joseph M; Linn, John G; Chan, Anthony; Muscarella, Peter; Melvin, W Scott

    2014-11-01

    Laparoscopic Heller myotomy (LHM) has become the standard treatment for achalasia in the USA. Robot-assisted Heller myotomy (RHM) has emerged as an alternative approach due to improved visualization and fine motor control, but long-term follow-up studies have not been reported. We sought to report the long-term outcomes of RHM and compare them to those of LHM. A retrospective cohort study was performed for patients who underwent laparoscopic or RHM between 1995 and 2006. Long-term follow-up was performed via mail or telephone questionnaire. The primary outcome measure was durable relief of dysphagia without need for further intervention. Secondary outcomes included gastroesophageal reflux symptoms, disease-specific quality of life, and patient satisfaction with their operation. Seventy-five patients underwent laparoscopic (n = 19) or robotic (n = 56) myotomy during the study period. Long-term follow-up was obtained in 53 (71 %) patients with a median interval of 9 years. RHM was associated with a decreased mucosal injury rate (0 vs. 16 %, p = 0.01) and median hospital stay (1 vs. 2 days, p < 0.01) compared to conventional laparoscopy. All patients reported initial dysphagia relief, and 80 % required no further intervention. This did not differ between groups. Sixty-two percent required medications to control reflux symptoms at long-term follow-up, including 56 % following robotic myotomy and 80 % after laparoscopic myotomy (p = 0.27). Overall, 95 % of patients were satisfied with their operation, and 91 % would choose surgery again given the benefit of hindsight. There is a dearth of long-term follow-up data to support the effectiveness of RHM. This study demonstrates durable dysphagia relief in the vast majority of patients with a high degree of patient satisfaction and a low rate of esophageal mucosal injury. While a significant proportion of patients report reflux symptoms, these symptoms are well controlled with medical acid suppression.

  20. Focusing on Short-Term Achievement Gains Fails to Produce Long-Term Gains

    ERIC Educational Resources Information Center

    Grissmer, David W.; Ober, David R.; Beekman, John A.

    2014-01-01

    The short-term emphasis engendered by No Child Left Behind (NCLB) has focused research predominantly on unraveling the complexities and uncertainties in assessing short-term results, rather than developing methods and assessing results over the longer term. In this paper we focus on estimating long-term gains and address questions important to…

  1. Measuring short-term and long-term physiological stress effects by cortisol reactivity in saliva and hair.

    PubMed

    van Holland, Berry J; Frings-Dresen, Monique H W; Sluiter, Judith K

    2012-11-01

    The aims of this study were to investigate (1) the concurrent relationship between short-term and long-term stress reactivity measured by cortisol excretion and (2) the relationship of these physiological stress effects with self-reported stress and need for recovery after work (NFR). Participants were production workers in the meat-processing industry. Short-term cortisol excretion was calculated by summing 18 saliva samples, sampled over a 3-day period. Samples were delivered by 37 participants. Twenty-nine of them also supplied one hair sample of at least 3 cm in length for an analysis of long-term (3 months) cortisol excretion. All of them filled in a short questionnaire on self-reported stress and NFR. Self-reported stress was assessed by a three-item stress screener; NFR was assessed by an 11-item scale. Short-term and long-term cortisol excretion are significantly, but moderately, associated (r = 0.41, P = 0.03). Short-term and long-term cortisol excretion correlated weakly to self-reported stress and NFR (correlations varied from -0.04 to 0.21). Short-term and long-term physiological stress excretion levels are moderately associated. Physiological stress effects assessed from saliva and hair cannot be used interchangeably with self-reported stress because they only correlate weakly. To better predict long-term cortisol excretion in workers, the predictive value of short-term cortisol excretion must be evaluated in a prognostic longitudinal study in a working population.

  2. Long-Term Economic and Labor Forecast Trends for Washington. 1996.

    ERIC Educational Resources Information Center

    Lefberg, Irv; And Others

    This publication provides actual historical and long-term forecast data on labor force, total wage and salary employment, industry employment, and personal income for the state of Washington. The data are based upon the Washington Office of Financial Management long-term population forecast. Chapter 1 presents long-term forecasts of Washington…

  3. Long-term academic stress enhances early processing of facial expressions.

    PubMed

    Zhang, Liang; Qin, Shaozheng; Yao, Zhuxi; Zhang, Kan; Wu, Jianhui

    2016-11-01

    Exposure to long-term stress can lead to a variety of emotional and behavioral problems. Although widely investigated, the neural basis of how long-term stress impacts emotional processing in humans remains largely elusive. Using event-related brain potentials (ERPs), we investigated the effects of long-term stress on the neural dynamics of emotionally facial expression processing. Thirty-nine male college students undergoing preparation for a major examination and twenty-one matched controls performed a gender discrimination task for faces displaying angry, happy, and neutral expressions. The results of the Perceived Stress Scale showed that participants in the stress group perceived higher levels of long-term stress relative to the control group. ERP analyses revealed differential effects of long-term stress on two early stages of facial expression processing: 1) long-term stress generally augmented posterior P1 amplitudes to facial stimuli irrespective of expression valence, suggesting that stress can increase sensitization to visual inputs in general, and 2) long-term stress selectively augmented fronto-central P2 amplitudes for angry but not for neutral or positive facial expressions, suggesting that stress may lead to increased attentional prioritization to processing negative emotional stimuli. Together, our findings suggest that long-term stress has profound impacts on the early stages of facial expression processing, with an increase at the very early stage of general information inputs and a subsequent attentional bias toward processing emotionally negative stimuli. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Economic efficiency of short-term versus long-term water rights buyouts

    USDA-ARS?s Scientific Manuscript database

    Because of the decline of the Ogallala Aquifer, water districts, regional water managers, and state water officers are becoming increasingly interested in conservation policies. This study evaluates both short-term and long-term water rights buyout policies. This research develops dynamic production...

  5. Long-term actuarial survivorship analysis of an interspinous stabilization system

    PubMed Central

    Sénégas, Jacques; Pointillart, Vincent; Mangione, Paolo

    2007-01-01

    In 1986, an interspinous dynamic stabilization system (the prototype of the current Wallis implant) was designed to stiffen unstable operated degenerate lumbar segments with a hard interspinous blocker to limit extension and a tension band around the spinous processes to secure the implant and limit flexion. Restoring physiological mechanical conditions to the treated level(s) while preserving some intervertebral mobility was intended to treat low-back pain related to degenerative instability without increasing stress forces in the adjacent segments. The procedure was easily reversible. If low back pain persisted or recurred, the device was removed and stability was achieved using fusion. The intermediate-term results were promising, but the long-term safety and efficacy of this dynamic interspinous stabilization device has not been previously documented. We retrospectively reviewed the hospital files of all the patients (n = 241) who had this dynamic stabilization system implanted between 1987 and 1995, contacting as many as possible to determine the actuarial survivorship of the system. In this manner, 142 of the 241 patients (58.9%) were contacted by telephone. The endpoints used for the survivorship analysis were ‘any subsequent lumbar operation’ and ‘implant removal’. At 14 years follow-up, values of actuarial survivorship with 95% confidence interval were 75.9 ± 8.3 and 81.3 ± 6.8% for the endpoints ‘any subsequent lumbar operation’ and ‘implant removal’, respectively. There was no difference in survivorship of multiple-level implants with respect to single-level devices. Although the conclusions of the present study must be tempered by the 41% attrition rate, these findings support the long-term safety of this system, and possibly long-term protective action against adjacent-level degeneration by motion preservation. Outcomes at least equivalent to those of fusion were observed without the primary drawbacks of fusion. PMID:17426988

  6. Issues in the Development of Long Term Care Gerontology Centers: The Centers Concept. Selected Topics in Long Term Care. Volume 6.

    ERIC Educational Resources Information Center

    Mortenson, Lee E.; Berdes, Celia M.

    This document, one in a series developed to provide technical assistance to 22 Long-Term Care Gerontology Centers, describes the current administrative and structural phenomenon of these centers. Precedents useful in assessing both the current climate and actual prospects for development of long term care centers are cited. The first section…

  7. Simultaneous above and below approach to giant pituitary adenomas: surgical strategies and long-term follow-up

    PubMed Central

    D’Ambrosio, Anthony L.; Grobelny, Bartosz T.; Freda, Pamela U.; Wardlaw, Sharon; Bruce, Jeffrey N.

    2012-01-01

    Introduction Giant pituitary adenomas of excessive size, fibrous consistency or unfavorable geometric configuration may be unresectable through conventional operative approaches. We present our select case series for operative resection and long-term follow-up for these unusual tumors, employing both a staged procedure and a combined transsphenoidal-transcranial above and below approach. Method A retrospective chart review was performed on patients operated via the staged, and combined approaches by the senior author (J.N·B.). Pre-operative characteristics and postoperative outcomes were reviewed. A detailed description of the operative technique and perioperative management is provided. Results Between 1993 and 1996, two patients harboring giant pituitary adenomas underwent an intentionally staged resection, and between 1997 and 2006, nine patients harboring giant pituitary adenomas underwent surgery via a single-stage above and below approach. Nine patients (82%) presented with non-secreting adenomas and two patients (18%) presented with prolactinomas refractory to medical management. Gross total resection was achieved in six patients (55%), near total resection in 1 (9%), and subtotal removal in 4 (36%). Seven patients (64%) experienced visual improvement postoperatively and no major complications occurred. Long-term follow-up averaged 51.6 months. Panhypopituitarism was observed in four patients, partial hypopituitarism in four, persistent DI in two, and persistent SIADH in one. Conclusions The addition of a transcranial component to the transsphenoidal approach offers additional visualization of critical neurovascular structures during giant pituitary adenoma resection. Complications rates are similar to other series in which complex pituitary adenomas are resected by other means. The above and below approach is both safe and effective and the immediate and long-term advantages of a single-stage approach justify its utility in this select group of patients

  8. Sleep Quality, Short-Term and Long-Term CPAP Adherence

    PubMed Central

    Somiah, Manya; Taxin, Zachary; Keating, Joseph; Mooney, Anne M.; Norman, Robert G.; Rapoport, David M.; Ayappa, Indu

    2012-01-01

    Study Objectives: Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. Methods: 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST (< 2 h, 2-4 h, and > 4 h) and LT adherence (< 4 h, > 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. Results: There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p < 0.001). Neither ST nor LT adherence were related to demographic variables, baseline severity of untreated SDB, sleep architecture, or measures of daytime impairment. Good CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). Conclusions: These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence. Citation: Somiah M; Taxin Z; Keating

  9. Long-term memory and volatility clustering in high-frequency price changes

    NASA Astrophysics Data System (ADS)

    oh, Gabjin; Kim, Seunghwan; Eom, Cheoljun

    2008-02-01

    We studied the long-term memory in diverse stock market indices and foreign exchange rates using Detrended Fluctuation Analysis (DFA). For all high-frequency market data studied, no significant long-term memory property was detected in the return series, while a strong long-term memory property was found in the volatility time series. The possible causes of the long-term memory property were investigated using the return data filtered by the AR(1) model, reflecting the short-term memory property, the GARCH(1,1) model, reflecting the volatility clustering property, and the FIGARCH model, reflecting the long-term memory property of the volatility time series. The memory effect in the AR(1) filtered return and volatility time series remained unchanged, while the long-term memory property diminished significantly in the volatility series of the GARCH(1,1) filtered data. Notably, there is no long-term memory property, when we eliminate the long-term memory property of volatility by the FIGARCH model. For all data used, although the Hurst exponents of the volatility time series changed considerably over time, those of the time series with the volatility clustering effect removed diminish significantly. Our results imply that the long-term memory property of the volatility time series can be attributed to the volatility clustering observed in the financial time series.

  10. Long-term complications in Hodgkin's lymphoma survivors.

    PubMed

    Kilickap, Saadettin; Barista, Ibrahim; Ulger, Sukran; Celik, Ismail; Selek, Ugur; Güllü, Ibrahim; Yildiz, Ferah; Kars, Ayse; Ozisik, Yavuz; Tekuzman, Gülten

    2012-01-01

    Background. Although patients with Hodgkin's lymphoma (HL) achieve prolonged survival, long-term complications are a major cause of morbidity and mortality among long-term survivors of HL. Methods. We retrospectively evaluated long-term complications in 336 HL survivors treated between January 1990 and January 2006 at the Department of Medical Oncology of the Hacettepe University Institute of Oncology who were >16 years old at presentation. All patients were regularly followed up every 3 months for the first 2 years after complete response, biannually for 3 years, and annually after 5 years. Results. Median follow-up was 8.5 years. The mean age (±SD) of the patients at the time of diagnosis was 35.7 ± 13.1 years. The male to female ratio was 61%/39%. During follow-up, 29 second malignancies (8.6%) were diagnosed in 28 patients with HL; 22 were solid tumors and 7 were hematological malignancies. Forty-seven (14.0%) of all patients with HL were found to have thyroid abnormalities. During follow-up, 54 (16.1%) patients developed cardiovascular complications. Overall, 29 (8.6%) patients developed late pulmonary toxicities. The cumulative number of chronic viral infections was 13 (3.9%). Conclusions. Long-term survivors of HL need to be properly followed up not only for disease control but also for evaluation of possible late morbidities to minimize the consequences.

  11. Dynamical model of long-term synaptic plasticity

    PubMed Central

    Abarbanel, Henry D. I.; Huerta, R.; Rabinovich, M. I.

    2002-01-01

    Long-term synaptic plasticity leading to enhancement in synaptic efficacy (long-term potentiation, LTP) or decrease in synaptic efficacy (long-term depression, LTD) is widely regarded as underlying learning and memory in nervous systems. LTP and LTD at excitatory neuronal synapses are observed to be induced by precise timing of pre- and postsynaptic events. Modification of synaptic transmission in long-term plasticity is a complex process involving many pathways; for example, it is also known that both forms of synaptic plasticity can be induced by various time courses of Ca2+ introduction into the postsynaptic cell. We present a phenomenological description of a two-component process for synaptic plasticity. Our dynamical model reproduces the spike time-dependent plasticity of excitatory synapses as a function of relative timing between pre- and postsynaptic events, as observed in recent experiments. The model accounts for LTP and LTD when the postsynaptic cell is voltage clamped and depolarized (LTP) or hyperpolarized (LTD) and no postsynaptic action potentials are evoked. We are also able to connect our model with the Bienenstock, Cooper, and Munro rule. We give model predictions for changes in synaptic strength when periodic spike trains of varying frequency and Poisson distributed spike trains with varying average frequency are presented pre- and postsynaptically. When the frequency of spike presentation exceeds ≈30–40 Hz, only LTP is induced. PMID:12114531

  12. Long-term Operation of an External Cavity Quantum Cascade Laser-based Trace-gas Sensor for Building Air Monitoring

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

    Phillips, Mark C.; Craig, Ian M.

    2013-11-03

    We analyze the long-term performance and stability of a trace-gas sensor based on an external cavity quantum cascade laser using data collected over a one-year period in a building air monitoring application.

  13. Initiating Long-Term Soil Productivity Research in Missouri

    Treesearch

    Felix Ponder

    1997-01-01

    Management practices necessary for sustaining long-term soil productivity (LTSP) afforest lands are being defined from a network of coordinated, long-term experiments established in vartous ecosystems across the United States and British Columbia according to the same basic study plan. The study was established in the Ozark Region of southeastem Missouri in Shannon...

  14. Long-term maintenance needs planning.

    DOT National Transportation Integrated Search

    2005-09-01

    This research contributes to Kentucky's knowledge base of long-term maintenance needs in two parts. Part I presents an estimate of the average revenue needed to maintain four categories of highway in the first fifteen years after each is built or res...

  15. Older Workers: An Opportunity to Expand the Long-Term Care/Direct Care Labor Force

    ERIC Educational Resources Information Center

    Hwalek, Melanie; Straub, Victoria; Kosniewski, Karen

    2008-01-01

    Purpose: This study examined issues related to using older workers in frontline jobs in long-term care from employers' and prospective employees' perspectives. Design and Methods: Telephone surveys were conducted with employers representing 615 nursing homes and 410 home health agencies, and 1,091 low-income participants aged 40+ in Operation ABLE…

  16. Long-term use of short- and long-acting nitrates in stable angina pectoris.

    PubMed

    Kosmicki, Marek Antoni

    2009-05-01

    Long-acting nitrates are effective antianginal drugs during initial treatment. However, their therapeutic value is compromised by the rapid development of tolerance during sustained therapy, which means that their clinical efficacy is decreased during long-term use. Sublingual nitroglycerin (NTG), a short-acting nitrate, is suitable for the immediate relief of angina. In patients with stable angina treated with oral long-acting nitrates, NTG maintains its full anti-ischemic effect both after initial oral ingestion and after intermittent long-term oral administration. However, NTG attenuates this effect during continuous treatment, when tolerance to oral nitrates occurs, and this is called cross-tolerance. In stable angina long-acting nitrates are considered third-line therapy because a nitrate-free interval is required to avoid the development of tolerance. Nitrates vary in their potential to induce the development of tolerance. During long-lasting nitrate therapy, except pentaerythritol tetranitrate (PETN), one can observe the development of reactive oxygen species (ROS) inside the muscular cell of a vessel wall, and these bind with nitric oxide (NO). This leads to decreased NO activity, thus, nitrate tolerance. PETN has no tendency to form ROS, and therefore during long-term PETN therapy, there is probably no tolerance or cross-tolerance, as during treatment with other nitrates.

  17. Long-Term Mortality in Patients Operated for Perforated Peptic Ulcer: Factors Limiting Longevity are Dominated by Older Age, Comorbidity Burden and Severe Postoperative Complications.

    PubMed

    Thorsen, K; Søreide, J A; Søreide, K

    2017-02-01

    Perforated peptic ulcer (PPU) is a surgical emergency associated with high short-term mortality. However, studies on long-term outcomes are scarce. Our aim was to investigate long-term survival after surgery for PPU. A population-based, consecutive cohort of patients who underwent surgery for PPU between 2001 and 2014 was reviewed, and the long-term mortality was assessed. Survival was investigated by univariate analysis (log-rank test) and displayed using Kaplan-Meier survival curves. Multivariable analysis of risk factors for long-term mortality was assessed by Cox proportional hazards regression and reported as hazard ratio (HR) with 95 % confidence intervals (CI). A total of 234 patients were available for the calculation of ninety-day, one-year and two-year mortality, and the results showed rates of 19.2 % (45/234), 22.6 % (53/234) and 24.8 % (58/234), respectively. At the end of follow-up, a total of 109 of the 234 patients (46.6 %) had died. Excluding 37 (15.2 %) patients who died within 30 days of surgery, 197 patients had long-term follow-up (median 57 months, range 1-168) of which 36 % (71/197) died during the follow-up period. In multivariable analyses, age >60 years (HR 3.95, 95 % CI 1.81-8.65), active cancer (HR 3.49, 95 % CI 1.73-7.04), hypoalbuminemia (HR 1.65, 95 % CI 0.99-2.73), pulmonary disease (HR 2.06, 95 % CI 1.14-3.71), cardiovascular disease (HR 1.67, 95 % CI 1.01-2.79) and severe postoperative complications (HR 1.76, 95 % CI 1.07-2.89) during the initial stay for PPU were all independently associated with an increased risk of long-term mortality. Cause of long-term mortality was most frequently (18 of 71; 25 %) attributed to new onset sepsis and/or multiorgan failure. The long-term mortality after surgery for PPU is high. One in every three patients died during follow-up. Older age, comorbidity and severe postoperative complications were risk factors for long-term mortality.

  18. What are the differences between long-term, short-term, and working memory?

    PubMed

    Cowan, Nelson

    2008-01-01

    In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rather encouraging regarding the existence of both decay and capacity limits. Working memory has been conceived and defined in three different, slightly discrepant ways: as short-term memory applied to cognitive tasks, as a multi-component system that holds and manipulates information in short-term memory, and as the use of attention to manage short-term memory. Regardless of the definition, there are some measures of memory in the short term that seem routine and do not correlate well with cognitive aptitudes and other measures (those usually identified with the term "working memory") that seem more attention demanding and do correlate well with these aptitudes. The evidence is evaluated and placed within a theoretical framework depicted in Fig. 1.

  19. Stirling engine - Approach for long-term durability assessment

    NASA Technical Reports Server (NTRS)

    Tong, Michael T.; Bartolotta, Paul A.; Halford, Gary R.; Freed, Alan D.

    1992-01-01

    The approach employed by NASA Lewis for the long-term durability assessment of the Stirling engine hot-section components is summarized. The approach consists of: preliminary structural assessment; development of a viscoplastic constitutive model to accurately determine material behavior under high-temperature thermomechanical loads; an experimental program to characterize material constants for the viscoplastic constitutive model; finite-element thermal analysis and structural analysis using a viscoplastic constitutive model to obtain stress/strain/temperature at the critical location of the hot-section components for life assessment; and development of a life prediction model applicable for long-term durability assessment at high temperatures. The approach should aid in the provision of long-term structural durability and reliability of Stirling engines.

  20. Finance issue brief: long-term care insurance: year end report-2003.

    PubMed

    Tanner, Rachel C

    2003-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  1. 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…

  2. Long-term consequences of anorexia nervosa.

    PubMed

    Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Katulski, Krzysztof

    2013-07-01

    Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Reconciling long-term cultural diversity and short-term collective social behavior.

    PubMed

    Valori, Luca; Picciolo, Francesco; Allansdottir, Agnes; Garlaschelli, Diego

    2012-01-24

    An outstanding open problem is whether collective social phenomena occurring over short timescales can systematically reduce cultural heterogeneity in the long run, and whether offline and online human interactions contribute differently to the process. Theoretical models suggest that short-term collective behavior and long-term cultural diversity are mutually excluding, since they require very different levels of social influence. The latter jointly depends on two factors: the topology of the underlying social network and the overlap between individuals in multidimensional cultural space. However, while the empirical properties of social networks are intensively studied, little is known about the large-scale organization of real societies in cultural space, so that random input specifications are necessarily used in models. Here we use a large dataset to perform a high-dimensional analysis of the scientific beliefs of thousands of Europeans. We find that interopinion correlations determine a nontrivial ultrametric hierarchy of individuals in cultural space. When empirical data are used as inputs in models, ultrametricity has strong and counterintuitive effects. On short timescales, it facilitates a symmetry-breaking phase transition triggering coordinated social behavior. On long timescales, it suppresses cultural convergence by restricting it within disjoint groups. Moreover, ultrametricity implies that these results are surprisingly robust to modifications of the dynamical rules considered. Thus the empirical distribution of individuals in cultural space appears to systematically optimize the coexistence of short-term collective behavior and long-term cultural diversity, which can be realized simultaneously for the same moderate level of mutual influence in a diverse range of online and offline settings.

  4. Short-term plasticity and long-term potentiation mimicked in single inorganic synapses

    NASA Astrophysics Data System (ADS)

    Ohno, Takeo; Hasegawa, Tsuyoshi; Tsuruoka, Tohru; Terabe, Kazuya; Gimzewski, James K.; Aono, Masakazu

    2011-08-01

    Memory is believed to occur in the human brain as a result of two types of synaptic plasticity: short-term plasticity (STP) and long-term potentiation (LTP; refs , , , ). In neuromorphic engineering, emulation of known neural behaviour has proven to be difficult to implement in software because of the highly complex interconnected nature of thought processes. Here we report the discovery of a Ag2S inorganic synapse, which emulates the synaptic functions of both STP and LTP characteristics through the use of input pulse repetition time. The structure known as an atomic switch, operating at critical voltages, stores information as STP with a spontaneous decay of conductance level in response to intermittent input stimuli, whereas frequent stimulation results in a transition to LTP. The Ag2S inorganic synapse has interesting characteristics with analogies to an individual biological synapse, and achieves dynamic memorization in a single device without the need of external preprogramming. A psychological model related to the process of memorizing and forgetting is also demonstrated using the inorganic synapses. Our Ag2S element indicates a breakthrough in mimicking synaptic behaviour essential for the further creation of artificial neural systems that emulate characteristics of human memory.

  5. Long-term effects of interference on short-term memory performance in the rat.

    PubMed

    Missaire, Mégane; Fraize, Nicolas; Joseph, Mickaël Antoine; Hamieh, Al Mahdy; Parmentier, Régis; Marighetto, Aline; Salin, Paul Antoine; Malleret, Gaël

    2017-01-01

    A distinction has always been made between long-term and short-term memory (also now called working memory, WM). The obvious difference between these two kinds of memory concerns the duration of information storage: information is supposedly transiently stored in WM while it is considered durably consolidated into long-term memory. It is well acknowledged that the content of WM is erased and reset after a short time, to prevent irrelevant information from proactively interfering with newly stored information. In the present study, we used typical WM radial maze tasks to question the brief lifespan of spatial WM content in rodents. Groups of rats were submitted to one of two different WM tasks in a radial maze: a WM task involving the repetitive presentation of a same pair of arms expected to induce a high level of proactive interference (PI) (HIWM task), or a task using a different pair in each trial expected to induce a low level of PI (LIWM task). Performance was effectively lower in the HIWM group than in LIWM in the final trial of each training session, indicative of a "within-session/short-term" PI effect. However, we also observed a different "between-session/long-term" PI effect between the two groups: while performance of LIWM trained rats remained stable over days, the performance of HIWM rats dropped after 10 days of training, and this impairment was visible from the very first trial of the day, hence not attributable to within-session PI. We also showed that a 24 hour-gap across training sessions known to allow consolidation processes to unfold, was a necessary and sufficient condition for the long-term PI effect to occur. These findings suggest that in the HIWM task, WM content was not entirely reset between training sessions and that, in specific conditions, WM content can outlast its purpose by being stored more permanently, generating a long-term deleterious effect of PI. The alternative explanation is that WM content could be transferred and stored

  6. Verification of geomechanical integrity and prediction of long-term mineral trapping for the Ketzin CO2 storage pilot site

    NASA Astrophysics Data System (ADS)

    Kempka, Thomas; De Lucia, Marco; Kühn, Michael

    2014-05-01

    Static and dynamic numerical modelling generally accompany the entire CO2 storage site life cycle. Thereto, it is required to match the employed models with field observations on a regular basis in order to predict future site behaviour. We investigated the coupled processes at the Ketzin CO2 storage pilot site [1] using a model coupling concept focusing on the temporal relevance of processes involved (hydraulic, chemical and mechanical) at given time-scales (site operation, abandonment and long-term stabilization). For that purpose, long-term dynamic multi-phase flow simulations [2], [3] established the basis for all simulations discussed in the following. Hereby, pressure changes resulting in geomechanical effects are largest during site operation, whereas geochemical reactions are governed by slow kinetics resulting in a long-term stabilization. To account for mechanical integrity, which may be mainly affected during site operation, we incorporated a regional-scale coupled hydro-mechanical model. Our simulation results show maximum ground surface displacements of about 4 mm, whereas shear and tensile failure are not observed. Consequently, the CO2 storage operation at the Ketzin pilot site does not compromise reservoir, caprock and fault integrity. Chemical processes responsible for mineral trapping are expected to mainly occur during long-term stabilization at the Ketzin pilot site [4]. Hence, our previous assessment [3] was extended by integrating two long-term mineral trapping scenarios. Thereby, mineral trapping contributes to the trapping mechanisms with 11.7 % after 16,000 years of simulation in our conservative and with 30.9 % in our maximum reactivity scenarios. Dynamic flow simulations indicate that only 0.2 % of the CO2 injected (about 67,270 t CO2 in total) is in gaseous state, but structurally trapped after 16,000 years. Depending on the studied long-term scenario, CO2 dissolution is the dominating trapping mechanism with 68.9 % and 88

  7. Long-term result after operative correction of funnel chest

    PubMed Central

    Borgeskov, Sven; Raahave, Dennis

    1971-01-01

    During the last decades it has been commonly accepted that funnel chest is such a serious cosmetic handicap that it deserves correction for this reason alone. A group of patients with this deformity, operated upon by the method of Paltia (transsternal fixation with metal struts), was re-examined 5 to 10 years postoperatively. In more than 50% of the cases the immediate acceptable cosmetic result had disappeared in contrast to the satisfaction expressed by almost all the patients. Because of the high incidence of recurrence and because of various risks involved in this operation, the authors do not advocate its performance. Images PMID:5101274

  8. Enhancing Long-Term Retention of New Vocabulary Using Visual Images.

    ERIC Educational Resources Information Center

    Igelsrud, Karen

    A practicum used a new learning tool to enhance long-term retention of new vocabulary. Sixteen seventh-graders in Language Arts, who had a long-term retention mean score of approximately 40% of newly learned vocabulary, increased their long-term retention of new vocabulary by 25% (a new mean of 65% of new vocabulary). Additional objectives…

  9. Long-term nitrogen regulation of forest carbon sequestration

    NASA Astrophysics Data System (ADS)

    Yang, Y.; Luo, Y.

    2009-12-01

    It is well established that nitrogen (N) limits plant production but unclear how N regulates long-term terrestrial carbon (C) sequestration in response to rising atmospheric C dioxide (CO2)(Luo et al., 2004). Most experimental evidence on C-N interactions is primarily derived from short-term CO2 manipulative studies (e.g. Oren et al., 2001; Reich et al., 2006a), which abruptly increase C inputs into ecosystems and N demand from soil while atmospheric CO2 concentration in the real world is gradually increasing over time (Luo & Reynolds, 1999). It is essential to examine long-term N regulations of C sequestration in natural ecosystems. Here we present results of a synthesis of more than 100 studies on long-term C-N interactions during secondary succession. C significantly accumulates in plant, litter and forest floor in most studies, and in mineral soil in one-third studies during stand development. Substantial increases in C stock are tightly coupled with N accretion. The C: N ratio in plant increases with stand age in most cases, but remains relatively constant in litter, forest floor and mineral soil. Our results suggest that natural ecosystems could have the intrinsic capacity to maintain long-term C sequestration through external N accrual, high N use efficiency, and efficient internal N cycling.

  10. Finance issue brief: long-term care insurance: year end report-2002.

    PubMed

    Tanner, Rachel

    2002-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policy makers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  11. The long term agroecosystem research network - shared research strategy

    Treesearch

    Jean L. Steiner; Timothy Strickland; Peter J.A. Kleinman; Kris Havstad; Thomas B. Moorman; M.Susan Moran; Phil Hellman; Ray B. Bryant; David Huggins; Greg McCarty

    2016-01-01

    While current weather patterns and rapidly accelerated changes in technology often focus attention on short-term trends in agriculture, the fundamental demands on modern agriculture to meet society food, feed, fuel and fiber production while providing the foundation for a healthy environment requires long-term perspective. The Long- Term Agroecoystem Research Network...

  12. Long-term deconditioning of gas-filled surge arresters

    NASA Astrophysics Data System (ADS)

    Stanković, Koviljka; Brajović, Dragan; Alimpijević, Mališa; Lončar, Boris

    2016-07-01

    The aim of this paper is to identify parameters that influence the long-term deconditioning effect of gas-filled surge arrester (GFSA) and to provide practical recommendations for mitigating this effect. Namely, after some period of time, on order of hours or days, during which there is no activation due to overvoltage, the deconditioning of GFSA occurs. This effect was observed experimentally within the paper. The observed parameters that could influence the long-term deconditioning effect were the following: shape of voltage load, gas type, gas pressure, interelectrode distance, electrode material, electrode surface topography as well as GFSA design such as two- or three-electrode configuration. According to the results obtained, it has been shown that the occurrence of long-term deconditioning in an insulating system, insulated by a noble gas at a subpressure and with small interelectrode distances, is a phenomenon that always occurs when the insulating system is at rest for about an hour. It has been found that the type of noble gas does not influence the long-term deconditioning. Analysis of such insulating systems' parameters, with a prospect of being used as GFSAs, has demonstrated that this phenomenon is less pronounced at higher pressures (for the same value of the pressure (p) and interelectrode distance (d) product) and for electrodes with microscopically embossed surfaces. According to the results that were obtained by noble gases and their mixtures, as well as the results that were obtained by mixtures of SF6 gas with noble gasses, it can be claimed with confidence that the effect of the long-term deconditioning is an electrode effect. It has also been established that the deconditioning effect does not depend on the electrode material except in the case of electrodes made out of noble metals, which reduce the effect. Based on these results, it can be recommended that the working point of GFSAs be set (according to the DC breakdown voltage value) at a

  13. Artificial intelligence for the EChO long-term mission planning tool

    NASA Astrophysics Data System (ADS)

    García-Piquer, Álvaro; Ribas, Ignasi; Colomé, Josep

    2014-08-01

    The Exoplanet Characterisation Observatory (EChO) was an ESA mission candidate competing for a launch opportunity within the M3 call. Its main aim was to carry out research on the physics and chemistry of atmospheres of transiting planets. This requires the observation of two types of events: primary and secondary eclipses. The events of each exoplanet have to be observed several times in order to obtain measurements with adequate Signal-to-Noise Ratio. Furthermore, several criteria must be considered to perform an observation, among which we can highlight the exoplanet visibility, its event duration, and the avoidance of overlapping with other tasks. It is important to emphasize that, since the communications for transferring data from ground stations to the spacecraft are restricted, it is necessary to compute a long-term plan of observations in order to provide autonomy to the observatory. Thus, a suitable mission plan will increase the efficiency of telescope operation, and this will result in a raise of the scientific return and a reduction of operational costs. Obtaining a long-term mission plan becomes unaffordable for human planners due to the complexity of computing the large amount of possible combinations for finding a near-optimal solution. In this contribution we present a long-term mission planning tool based on Genetic Algorithms, which are focused on solving optimization problems such as the planning of several tasks. Specifically, the proposed tool finds a solution that highly optimizes the objectives defined, which are based on the maximization of the time spent on scientific observations and the scientific return (e.g., the coverage of the mission survey). The results obtained on the large experimental set up support that the proposed scheduler technology is robust and can function in a variety of scenarios, offering a competitive performance which does not depend on the collection of objects to be observed. Finally, it is noteworthy that the

  14. Long-term monitoring of marine gas leakage

    NASA Astrophysics Data System (ADS)

    Spickenbom, Kai; Faber, Eckhard; Poggenburg, Jürgen; Seeger, Christian; Furche, Markus

    2010-05-01

    The sequestration of CO2 in sub-seabed geological formations is one of the Carbon Capture and Storage (CCS) strategies currently under study. Although offshore operations are significantly more expensive than comparable onshore operations, the growing public resistance against onshore CCS projects makes sub-seabed storage a promising option. Even after a thorough review of the geological setting, there is always the possibility of leakage from the reservoir. As part of the EU-financed project CO2ReMoVe (Research, Monitoring, Verification), which aims to develop innovative research and technologies for monitoring and verification of carbon dioxide geological storage, we are working on the development of submarine long-term gas flow monitoring systems. The basic design of the monitoring system builds on our experience in volcano monitoring. Early prototypes were composed of a raft floating on the surface of a mud volcano, carrying sensors for CO2 flux and concentration, data storage and transmission, and power supply by battery-buffered solar panels. The system was modified for installation in open sea by using a buoy instead of a raft and a funnel on the seafloor to collect the gas, connected by a flexible tube. This setup provides a cost-effective solution for shallow waters. However, a buoy interferes with ship traffic, and it is also difficult to adapt this design to greater water depths. These requirements can best be complied by a completely submersed system. A system for unattended long-term monitoring in a marine environment has to be extremely durable. Therefore, we focussed on developing a mechanically and electrically as simple setup as possible, which has the additional advantage of low cost. The system consists of a funnel-shaped gas collector, a sensor head and pressure housings for electronics and power supply. Since this setup is inexpensive, it can be deployed in numbers to cover larger areas. By addition of multi-channel data loggers, data

  15. [Long-term outcome of surgical revascularization in patients with ischemic heart disease and left ventricular dysfunction].

    PubMed

    Wang, R; Gao, C Q; Xiao, C S; Wu, Y; Ren, C L; Gong, Z Y; Wang, Y; Liu, G P; Wang, M Y

    2016-04-19

    To analyze the long-term results and risk factors of surgical revascularization in patients with ischemic heart disease (IHD) and left ventricular dysfunction (LVD). From January 2003 to July 2013, 2 132 patients underwent coronary artery bypass grafting (CABG) in our institution. Among them, 318 patients with LVD[left ventricular ejection fraction (LVEF) ≤50%]were included in the final study. There were 26 6 male and 52 female patients with age from 36 to 83 (63±9) years old. 76 patients underwent off-pump CABG (OPCAB) and 242 patients underwent conventional CABG (CCABG). Risk factors, perioperative results and follow-up data were collected and analyzed with cox hazard ratio model. Among 318 patients, 6 cases died of the operation with a hospital mortality of 1.9%. With follow-up time from 1 to 128(45.5±32.4)months, 25 patients were lost of follow-up, causing a follow-up rate of 92.0%. Among the 287 cases with long-term follow-up results, all-cause death, cardiogenic death and re-hospitalization due to heart failure were 14.6% (42/287), 5.9%(17/287), 14.6% (42/287), respectively. Re-revascularization rate, recurrent angina and myocardial infarction rate and cerebral incidence were 3.5%(10/287), 13.6% (39/287), 1.7%(5/287), respectively. The five-year survival rate was 85.6%. With all-cause death as the endpoint, preoperative LVEF (HR=0.943, 95%CI: 0.893-0.995, P=0.031) and perioperative implantation of IABP (HR=2.509, 95%CI: 1.051-5.992, P=0.038) emerged as the risk factors that affected the long term survival. The five-year survival rate of patients with severe LVD (LVEF≤35%) was significantly lower than that of patients with mild to moderate LVD (35%long-term survival of patients with IHD and LVD undergoing surgical revascularization. The long-term survival of patients with severe LVD was significantly lower than those with mild to

  16. Setting the stage for long-term reproductive health.

    PubMed

    Payne, Craig A; Vander Ley, Brian; Poock, Scott E

    2013-11-01

    This article discusses some of the aspects of heifer development that contribute to long-term health and productivity, such as disease prevention and control. Nutrition is also an important component of long-term health, and body condition score is discussed as a way to determine whether the nutrient demands of heifers are being met. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Bridge condition assessment based on long-term strain monitoring

    NASA Astrophysics Data System (ADS)

    Sun, LiMin; Sun, Shouwang

    2011-04-01

    In consideration of the important role that bridges play as transportation infrastructures, their safety, durability and serviceability have always been deeply concerned. Structural Health Monitoring Systems (SHMS) have been installed to many long-span bridges to provide bridge engineers with the information needed in making rational decisions for maintenance. However, SHMS also confronted bridge engineers with the challenge of efficient use of monitoring data. Thus, methodologies which are robust to random disturbance and sensitive to damage become a subject on which many researches in structural condition assessment concentrate. In this study, an innovative probabilistic approach for condition assessment of bridge structures was proposed on the basis of long-term strain monitoring on steel girder of a cable-stayed bridge. First, the methodology of damage detection in the vicinity of monitoring point using strain-based indices was investigated. Then, the composition of strain response of bridge under operational loads was analyzed. Thirdly, the influence of temperature and wind on strains was eliminated and thus strain fluctuation under vehicle loads is obtained. Finally, damage evolution assessment was carried out based on the statistical characteristics of rain-flow cycles derived from the strain fluctuation under vehicle loads. The research conducted indicates that the methodology proposed is qualified for structural condition assessment so far as the following respects are concerned: (a) capability of revealing structural deterioration; (b) immunity to the influence of environmental variation; (c) adaptability to the random characteristic exhibited by long-term monitoring data. Further examination of the applicability of the proposed methodology in aging bridge may provide a more convincing validation.

  18. Sexuality and physical intimacy in long-term care.

    PubMed

    Lichtenberg, Peter A

    2014-01-01

    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long-term care settings. Because older adults in medical rehabilitation and long-term care beds present with significant frailties, and often significant neurocognitive disorders, it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long-term care, and presents two case examples. A semistructured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing the needs for protection with the needs for autonomy.

  19. Interlaboratory evaluation of Hyalella azteca and Chironomus tentans short-term and long-term sediment toxicity tests

    USGS Publications Warehouse

    Norberg-King, T. J.; Sibley, P.K.; Burton, G.A.; Ingersoll, C.G.; Kemble, N.E.; Ireland, S.; Mount, D.R.; Rowland, C.D.

    2006-01-01

    Methods for assessing the long-term toxicity of sediments to Hyalella azteca and Chironomus tentans can significantly enhance the capacity to assess sublethal effects of contaminated sediments through multiple endpoints. Sublethal tests allow us to begin to understand the relationship between short-term and long-term effects for toxic sediments. We present an interlaboratory evaluation with long-term and 10-d tests using control and contaminated sediments in which we assess whether proposed and existing performance criteria (test acceptability criteria [TAC]) could be achieved. Laboratories became familiar with newly developed, long-term protocols by testing two control sediments in phase 1. In phase 2, the 10-d and long-term tests were examined with several sediments. Laboratories met the TACs, but results varied depending on the test organism, test duration, and endpoints. For the long-term tests in phase 1, 66 to 100% of the laboratories consistently met the TACs for survival, growth, or reproduction using H. azteca, and 70 to 100% of the laboratories met the TACs for survival and growth, emergence, reproduction, and hatchability using C. tentans. In phase 2, fewer laboratories participated in long-term tests: 71 to 88% of the laboratories met the TAC for H. azteca, whereas 50 to 67% met the TAC for C. tentans. In the 10-d tests with H. azteca, and C. tentans, 82 and 88% of the laboratories met the TAC for survival, respectively, and 80% met the TAC for C. tentans growth. For the 10-d and long-term tests, laboratories predicted similar toxicity. Overall, the interlaboratory evaluation showed good precision of the methods, appropriate endpoints were incorporated into the test protocols, and tests effectively predicted the toxicity of sediments.

  20. Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: long-term follow-up of a randomized controlled trial.

    PubMed

    Hallén, Magnus; Bergenfelz, Anders; Westerdahl, Johan

    2008-03-01

    We have conducted a randomized controlled trial of totally extraperitoneal hernia repair (TEP) versus tension-free open repair (Lichtenstein repair); we have presented the results previously up to 1 year after the operation. The aim of this study was to compare patient outcome in both groups at a median follow-up of 7.3 years after operation. Of 168 patients included in a prospective, randomized controlled trial designed to compare TEP with an open tension-free technique, 154 patients (92%) answered a questionnaire and 147 patients (88%) were followed up at an outpatient clinic after a minimum of 6 years after operation. Overall, 89% of patients in the TEP group and 95% of patients in the open group reported complete long-term recovery (P = .23). Permanent impaired inguinal sensibility was more common in the open group (P = .004), whereas the proportion of patients with reported testicular pain was higher in the TEP group (P = .003). Three recurrences were found in the TEP group, and 4 recurrences were found in the open group (P = .99). Four patients in the TEP group underwent operations for complications related to the hernia repair (small bowel obstruction, umbilical hernia, testicular pain, and neuralgia). Overall, both groups showed good long-term results with low rates of recurrences. However, the TEP group was associated with a higher proportion of patients with long-term testicular pain, whereas impaired inguinal sensibility was more common in the open group.

  1. Anesthesiology Devices; Reclassification of Membrane Lung for Long-Term Pulmonary Support; Redesignation as Extracorporeal Circuit and Accessories for Long-Term Respiratory/Cardiopulmonary Failure. Final order.

    PubMed

    2016-02-12

    The Food and Drug Administration (FDA) is issuing a final order to redesignate membrane lung devices for long-term pulmonary support, a preamendments class III device, as extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure, and to reclassify the device to class II (special controls) in patients with acute respiratory failure or acute cardiopulmonary failure where other available treatment options have failed, and continued clinical deterioration is expected or the risk of death is imminent. A membrane lung device for long-term pulmonary support (>6 hours) refers to the oxygenator in an extracorporeal circuit used during long-term procedures, commonly referred to as extracorporeal membrane oxygenation (ECMO). Because a number of other devices and accessories are used with the oxygenator in the circuit, the title and identification of the regulation are revised to include extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure. Although an individual device or accessory used in an ECMO circuit may already have its own classification regulation when the device or accessory is intended for short-term use (<=6 hours), such device or accessory will be subject to the same regulatory controls applied to the oxygenator (i.e., class II, special controls) when evaluated as part of the ECMO circuit for long-term use (>6 hours). On its own initiative, based on new information, FDA is revising the classification of the membrane lung device for long-term pulmonary support.

  2. Approaches to Accountability in Long-Term Care

    PubMed Central

    Berta, Whitney; Laporte, Audrey; Wodchis, Walter P.

    2014-01-01

    This paper discusses the array of approaches to accountability in Ontario long-term care (LTC) homes. A focus group involving key informants from the LTC industry, including both for-profit and not-for-profit nursing home owners/operators, was used to identify stakeholders involved in formulating and implementing LTC accountability approaches and the relevant regulations, policies and initiatives relating to accountability in the LTC sector. These documents were then systematically reviewed. We found that the dominant mechanisms have been financial incentives and oversight, regulations and information; professionalism has played a minor role. More recently, measurement for accountability in LTC has grown to encompass an array of fiscal, clinical and public accountability measurement mechanisms. The goals of improved quality and accountability are likely more achievable using these historical regulatory approaches, but the recent rapid increase in data and measurability could also enable judicious application of market-based approaches. PMID:25305396

  3. Long-term Outcomes of Mitral Valve Repair Versus Replacement for Degenerative Disease: A Systematic Review

    PubMed Central

    McNeely, Christian A; Vassileva, Christina M

    2015-01-01

    The short-term advantage of mitral valve repair versus replacement for degenerative disease has been extensively documented. These advantages include lower operative mortality, improved survival, better preservation of left-ventricular function, shorter post-operative hospital stay, lower total costs, and fewer valve-related complications, including thromboembolism, anticoagulation-related bleeding events and late prosthetic dysfunction. More recent written data are available indicating the long-term advantage of repair versus replacement. While at some institutions, the repair rate for degenerative disease may exceed 90%, the national average in 2007 was only 69%. Making direct comparisons between mitral valve repair and replacement using the available studies does present some challenges however, as there are often differences in baseline characteristics between patient groups as well as other dissimilarities between studies. The purpose of this review is to systematically summarize the long-term survival and reoperation data of mitral valve repair versus replacement for degenerative disease. A PubMed search was done and resulted in 12 studies that met our study criteria for comparing mitral valve repair versus replacement for degenerative disease. A systematic review was then conducted abstracting survival and reoperation data. PMID:25158683

  4. Long-term Outcomes after Truncus Arteriosus Repair: A Single-center Experience for More than 40 Years.

    PubMed

    Asagai, Seiji; Inai, Kei; Shinohara, Tokuko; Tomimatsu, Hirofumi; Ishii, Tetsuko; Sugiyama, Hisashi; Park, In-Sam; Nagashima, Mitsugi; Nakanishi, Toshio

    2016-12-01

    This study aimed to analyze long-term survival and functional outcomes after truncus arteriosus repair in a single institution with more than 40 years of follow-up. Medical records were analyzed retrospectively in 52 patients who underwent the Rastelli procedure for truncus arteriosus repair between 1974 and 2002. Thirty-five patients survived the initial repair. The median age at the initial operation was 2.8 months (range, 0.1-123 months) and the body weight was 3.9 kg (range, 1.6 to 15.0 kg). The median age at follow-up was 23.6 years (range, 12.4 to 44.5 years). The median follow-up duration was 23.4 years (range, 12.3 to 40.7 years). The actuarial survival rate was 97% at 10 years and 93% at both 20 years and 40 years after the initial operation. At follow-up, most patients were in New York Heart Association (NYHA) functional classes I (73%) and II (24%). Thirty-six percent of patients had full-time jobs, 40% were students, and 21% were unemployed. Most patients (97%) had undergone conduit reoperations. Freedom from reoperation for right ventricular (RV) outflow and pulmonary artery (PA) stenosis was 59% at 5 years, 28% at 10 years, and 3% at 20 years after the initial operation. Freedom from catheter interventions for RV outflow and PA stenosis was 59% at 5 years, 47% at 10 years, and 38% at 20 years after the initial operation. Freedom from truncal valve replacement was 88% at 5 years, 85% at 10 years, and 70% at 20 years after the initial operation. In this single-center retrospective study, with long-term follow-up after repair of truncus arteriosus, long-term survival and functional outcomes were acceptable, despite the requirement for reoperation and multiple catheter interventions for RV outflow and PA stenosis in almost all patients, and the frequent requirement for late truncal valve operations. © 2016 The Authors. Congenital Heart Disease published by Wiley Periodicals, Inc.

  5. Long-Term Bridge Performance (LTBP) Program Protocols, Version 1

    DOT National Transportation Integrated Search

    2016-01-01

    The Long-Term Bridge Performance (LTBP) Program is a long-term research effort to collect scientific performance data from a representative sample of bridges in the United States. Data will be collected for in-service bridges using a variety of techn...

  6. Long-term results after the Rastelli repair for transposition of the great arteries.

    PubMed

    Hörer, Jürgen; Schreiber, Christian; Dworak, Eva; Cleuziou, Julie; Prodan, Zsolt; Vogt, Manfred; Holper, Klaus; Lange, Rüdiger

    2007-06-01

    This study sought to assess risk factors for late mortality after the Rastelli operation for patients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction. Records of 39 patients who underwent the Rastelli operation between 1977 and 2004 were reviewed. Median age at the time of operation was 5.1 years (2.2 years within the last 5 years). There were no early deaths. During a median follow-up of 8.9 years (range, 0 to 25 years), 2 patients died of sudden death, 1 of pneumonia, 1 during reoperation, and 2 received heart transplantation. Freedom from death or transplantation was 93.8% +/- 4.3% and 57.5% +/- 15.1% at 10 and 20 years, respectively. Freedom from conduit replacement was 48.8% +/- 10.3% and 32.5% +/- 10.3% at 10 and 20 years, respectively. Subvalvular and valvular left ventricular outflow tract obstruction (p = 0.012), stenosis of the peripheral pulmonary arteries (p < 0.001), enlargement of the ventricular septal defect (p = 0.030), and longer ischemic time (p = 0.015) were predictive for death or transplantation. Patients younger than 4 years at the time of the Rastelli operation showed a trend toward a better freedom from death or transplantation (p = 0.068), but needed significantly more conduit replacements (p = 0.038) compared with patients 4 years or older. The Rastelli operation is a low-risk procedure with regard to early mortality. The status of the pulmonary arteries and ventricular septal defect enlargement are predictive for long-term survival. Patients 4 years of age or older at the time of the Rastelli operation require fewer reoperations for conduit exchange. Nevertheless, early Rastelli repair is recommended because patients 4 years or older are at risk for a higher long-term mortality.

  7. What are the differences between long-term, short-term, and working memory?

    PubMed Central

    Cowan, Nelson

    2008-01-01

    In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rather encouraging regarding the existence of both decay and capacity limits. Working memory has been conceived and defined in three different, slightly discrepant ways: as short-term memory applied to cognitive tasks, as a multi-component system that holds and manipulates information in short-term memory, and as the use of attention to manage short-term memory. Regardless of the definition, there are some measures of memory in the short term that seem routine and do not correlate well with cognitive aptitudes and other measures (those usually identified with the term “working memory”) that seem more attention demanding and do correlate well with these aptitudes. The evidence is evaluated and placed within a theoretical framework depicted in Fig. 1. PMID:18394484

  8. Conversion of short-term to long-term memory in the novel object recognition paradigm.

    PubMed

    Moore, Shannon J; Deshpande, Kaivalya; Stinnett, Gwen S; Seasholtz, Audrey F; Murphy, Geoffrey G

    2013-10-01

    It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Conversion of short-term to long-term memory in the novel object recognition paradigm

    PubMed Central

    Moore, Shannon J.; Deshpande, Kaivalya; Stinnett, Gwen S.; Seasholtz, Audrey F.; Murphy, Geoffrey G.

    2013-01-01

    It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. PMID:23835143

  10. Factors affecting early and long-term outcomes after completion pneumonectomy.

    PubMed

    Chataigner, Olivier; Fadel, Elie; Yildizeli, Bedrettin; Achir, Abdallah; Mussot, Sacha; Fabre, Dominique; Mercier, Olaf; Dartevelle, Philippe G

    2008-05-01

    To identify factors that affect operative mortality and morbidity and long-term survival after completion pneumonectomy. We retrospectively reviewed the charts of consecutive patients who underwent completion pneumonectomy at our cardiothoracic surgery department from January 1996 to December 2005. We identified 69 patients, who accounted for 17.8% of all pneumonectomies during the study period; 22 had benign disease and 47 malignant disease (second primary lung cancer, n=19; local recurrence, n=17; or metastasis, n=11). There were 50 males and 19 females with a mean age of 60 years (range, 29-80 years). Postoperative mortality was 12% and postoperative morbidity 41%. Factors associated with postoperative mortality included obesity (p=0.005), coronary artery disease (p=0.03), removal of the right lung (p=0.02), advanced age (p=0.02), and renal failure (p<0.0001). Preoperative renal failure was the only significant risk factor for mortality by multivariate analysis (p=0.036). Bronchopleural fistula developed in seven patients (10%), with risk factors being removal of the right lung (p=0.04) and mechanical stump closure (p=0.03). Overall survival was 65% after 3 years and 46% after 5 years. Long-term survival was not affected by the reason for completion pneumonectomy. Although long-term survival was acceptable, postoperative mortality and morbidity rates remained high, confirming the reputation of completion pneumonectomy as a challenging procedure. Significant comorbidities and removal of the right lung were the main risk factors for postoperative mortality. Improved patient selection and better management of preoperative renal failure may improve the postoperative outcomes of this procedure, which offers a chance for prolonged survival.

  11. Forest Soil Productivity on the Southern Long-Term Soil Productivity Sites at Age 5

    Treesearch

    D. Andrew Scott; Allan E. Tiarks; Felipe G. Sanchez; Michael Elliott-Smith; Rick Stagg

    2004-01-01

    Forest management operations have the potential to reduce soil productivity through organic matter and nutrient removal and soil compaction. We measured pine volume, bulk density, and soil and foliar nitrogen and phosphorus at age 5 on the 13 southern Long-Term Soil Productivity study sites. The treatments were organic matter removal [bole only (BO), whole tree (WT),...

  12. Short-term vs. long-term heart rate variability in ischemic cardiomyopathy risk stratification.

    PubMed

    Voss, Andreas; Schroeder, Rico; Vallverdú, Montserrat; Schulz, Steffen; Cygankiewicz, Iwona; Vázquez, Rafael; Bayés de Luna, Antoni; Caminal, Pere

    2013-01-01

    In industrialized countries with aging populations, heart failure affects 0.3-2% of the general population. The investigation of 24 h-ECG recordings revealed the potential of nonlinear indices of heart rate variability (HRV) for enhanced risk stratification in patients with ischemic heart failure (IHF). However, long-term analyses are time-consuming, expensive, and delay the initial diagnosis. The objective of this study was to investigate whether 30 min short-term HRV analysis is sufficient for comparable risk stratification in IHF in comparison to 24 h-HRV analysis. From 256 IHF patients [221 at low risk (IHFLR) and 35 at high risk (IHFHR)] (a) 24 h beat-to-beat time series (b) the first 30 min segment (c) the 30 min most stationary day segment and (d) the 30 min most stationary night segment were investigated. We calculated linear (time and frequency domain) and nonlinear HRV analysis indices. Optimal parameter sets for risk stratification in IHF were determined for 24 h and for each 30 min segment by applying discriminant analysis on significant clinical and non-clinical indices. Long- and short-term HRV indices from frequency domain and particularly from nonlinear dynamics revealed high univariate significances (p < 0.01) discriminating between IHFLR and IHFHR. For multivariate risk stratification, optimal mixed parameter sets consisting of 5 indices (clinical and nonlinear) achieved 80.4% AUC (area under the curve of receiver operating characteristics) from 24 h HRV analysis, 84.3% AUC from first 30 min, 82.2 % AUC from daytime 30 min and 81.7% AUC from nighttime 30 min. The optimal parameter set obtained from the first 30 min showed nearly the same classification power when compared to the optimal 24 h-parameter set. As results from stationary daytime and nighttime, 30 min segments indicate that short-term analyses of 30 min may provide at least a comparable risk stratification power in IHF in comparison to a 24 h analysis period.

  13. Cervical cancer survivorship: Long-term quality of life and social support

    PubMed Central

    Pfaendler, Krista S.; Wenzel, Lari; Mechanic, Mindy B.; Penner, Kristine R.

    2015-01-01

    Purpose Surgery, radiotherapy and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5 year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. Methods Pertinent articles were identified through searches of PubMed for literature published from 1993-2014. We summarize quality of life data from long-term follow up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. Findings Data is varied in terms of the long term impact of treatment on quality of life but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. Implications Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment, and evaluating the effects of supportive care, may reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care. PMID:25592090

  14. Long-term outcome of primary endoscopic realignment for bulbous urethral injuries: risk factors of urethral stricture.

    PubMed

    Seo, Ill Young; Lee, Jea Whan; Park, Seung Chol; Rim, Joung Sik

    2012-12-01

    Although endoscopic realignment has been accepted as a standard treatment for urethral injuries, the long-term follow-up data on this procedure are not sufficient. We report the long-term outcome of primary endoscopic realignment in bulbous urethral injuries. Patients with bulbous urethral injuries were treated by primary endoscopic realignment between 1991 and 2005. The operative procedure included suprapubic cystostomy and transurethral catheterization using a guide wire, within 72 hours of injury. The study population included 51 patients with a minimum follow-up duration of 5 years. The most common causes of the injuries were straddle injury from falling down (74.5%), and pelvic bone fracture (7.8%). Gross hematuria was the most common complaint (92.2%). Twenty-three patients (45.1%) had complete urethral injuries. The mean time to operation after the injury was 38.8±43.2 hours. The mean operation time and mean indwelling time of a urethral Foley catheter were 55.5±37.6 minutes and 22.0±11.9 days, respectively. Twenty out of 51 patients (39.2%) were diagnosed with urethral stricture in 89.1±36.6 months after surgery. A multivariate analysis revealed that young age and operation time were independent risk factors for strictures as a complication of urethral realignment (hazard ratio [HR], 6.554, P=0.032; HR, 6.206, P=0.035). Urethral stricture commonly developed as a postoperative complication of primary endoscopic urethral realignment for bulbous urethral injury, especially in young age and long operation time.

  15. Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

    PubMed Central

    Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

    2012-01-01

    Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

  16. Structural Degradation of the Welded Joint of the Gas Main after a Long-Term Operation in Sub-Acid Soil

    NASA Astrophysics Data System (ADS)

    Maruschak, P. O.; Bishchak, R. T.; Maruschak, O. V.; Panin, S. V.

    2018-01-01

    The authors investigated the main regularities in the structural and mechanical degradation of steel and a welded joint of the “Soyuz” gas main in operation. It is established that the defect accumulation kinetics in welds are determined both by technological disruptions in their manufacture and by hydrogenation of the weld during a long operating time. A weakening of the mechanical properties of the weld after a prolonged operation is shown, which in some cases led to the appearance of cracks and fracture of the gas main.

  17. Long-term neurodevelopmental benefits of breastfeeding.

    PubMed

    Bar, Sari; Milanaik, Ruth; Adesman, Andrew

    2016-08-01

    The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of an infant#$#apos;s life, with continuation of breastfeeding for at least a year or as mutually desired by mother and child. A robust body of research literature documenting the short-term medical, developmental, and emotional benefits of breastfeeding for infants and toddlers supports this position. This article reviews the neurodevelopmental benefits of breastfeeding as it relates to preschool and school-age children, with particular emphasis on cognitive development, attention-deficit/hyperactivity disorder, and autism spectrum disorder. The majority of research studies examining breastfeeding and long-term neurodevelopmental outcomes suggest that children who breastfeed for longer than 6 months have better cognitive outcomes, lower risk of developing attention-deficit/hyperactivity disorder, and lower risk of being diagnosed with autism spectrum disorder. Pediatricians play a critical role in educating and counseling families about infant nutrition and feeding. Along with the many positive short-term medical effects that breastfeeding confers, physicians should be aware of the growing body of research suggesting that there are also significant long-term neurodevelopmental benefits of breastfeeding.

  18. Long-term sickness absence due to adjustment disorder.

    PubMed

    Catalina-Romero, C; Pastrana-Jiménez, J I; Tenas-López, M J; Martínez-Muñoz, P; Ruiz-Moraga, M; Fernández-Labandera, C; Calvo-Bonacho, E

    2012-07-01

    Although adjustment disorder is frequently reported in clinical settings, scientific evidence is scarce regarding its impact on sickness absence and the variables associated with sickness absence duration. To report sickness absence duration and to identify predictors of long-term sickness absence in patients with adjustment disorder. This observational, prospective study included subjects with non-work-related sickness absence (>15 days) after a diagnosis of adjustment disorder. A stepwise logistic regression analysis was conducted to identify the best predictors of long-term sickness absence (≥ 6 months). There were 1182 subjects in the final analysis. The median duration of sickness absence due to adjustment disorder was 91 days. Twenty-two per cent of the subjects reported long-term sickness absence. After multivariate analysis, comorbidity (OR = 2.23, 95% CI 1.43-3.49), age (25-34 years old versus <25 years old: OR = 2.78, 95% CI 1.27-6.07; 35-44 years old versus <25 years old: OR = 3.70, 95% CI 1.71-7.99; 45-54 years old versus <25 years old: OR = 3.58, 95% CI 1.60-8.02; ≥ 55 years old versus <25 years old: OR = 6.35, 95% CI 2.64-15.31) and occupational level (blue collar versus white collar: OR = 1.52, 95% CI 1.10-2.09) remained significantly associated with long-term sickness absence. Comorbidity was the strongest predictor. It is possible to predict long-term sickness absence due to adjustment disorder on the basis of demographic, work-related and clinical information available during the basic assessment of the patient.

  19. Long-term efficacy of reverse pull headgear therapy.

    PubMed

    Wells, Andrew P; Sarver, David M; Proffit, William R

    2006-11-01

    To add to the data for long-term reverse pull headgear (RPHG) outcomes and further explore possible variables that could be predictors of long-term failure. Cephalometric radiographs of 41 Class III malocclusion children treated with RPHG (face mask) were evaluated before and immediately after treatment; at 5 years posttreatment; and, for 18 patients, at 10 years posttreatment. Patients were assigned to success or failure groups according to positive or negative overjet at the longest available recall. Seventy-five percent of the patients maintained positive overjet, whereas 25% outgrew the correction. In a stepwise discriminant analysis, a large mandible and vertical positioning of the maxilla and mandible so that mandibular growth would be projected more horizontally were the major indicators of unfavorable later mandibular growth. Patients who experienced downward-backward rotation of the mandible during RPHG treatment were more likely to be categorized in the failure group. The age at which treatment began had no effect on long-term success and failure for patients younger than 10 years, but the percentage of successful treatment decreased after that age. When RPHG treatment is used for all but the most obviously prognathic children to correct anterior cross-bite in the early mixed dentition, positive overjet is maintained long-term in 70%-75% of cases, whereas 25%-30% of cases relapse into reverse overjet mainly because of increased horizontally directed and often late mandibular growth. Up to age 10, the time at which RPHG treatment began does not appear to be a major factor in long-term success in maintaining positive overjet.

  20. Long-term solar activity explored with wavelet methods

    NASA Astrophysics Data System (ADS)

    Lundstedt, H.; Liszka, L.; Lundin, R.; Muscheler, R.

    2006-03-01

    Long-term solar activity has been studied with a set of wavelet methods. The following indicators of long-term solar activity were used; the group sunspot number, the sunspot number, and the 14C production rate. Scalograms showed the very long-term scales of 2300 years (Hallstat cycle), 900-1000 years, 400-500 years, and 200 years (de Vries cycle). Scalograms of a newly-constructed 14C production rate showed interesting solar modulation during the Maunder minimum. Multi-Resolution Analysis (MRA) revealed the modulation in detail, as well as peaks of solar activity not seen in the sunspot number. In both the group sunspot number scalogram and the 14C production rate scalogram, a process appeared, starting or ending in late 1700. This process has not been discussed before. Its solar origin is unclear.

    The group sunspot number ampligram and the sunspot number ampligram showed the Maunder and the Dalton minima, and the period of high solar activity, which already started about 1900 and then decreased again after mid 1990. The decrease starts earlier for weaker components. Also, weak semiperiodic activity was found.

    Time Scale Spectra (TSS) showed both deterministic and stochastic processes behind the variability of the long-term solar activity. TSS of the 14C production rate, group sunspot number and Mt. Wilson sunspot index and plage index were compared in an attempt to interpret the features and processes behind the long-term variability.

  1. Long term acroecosystem research in the Southern Plains

    Treesearch

    Jean L. Steiner; Patrick J. Starks; Jurgen Garbrecht; Daniel Moriasi; Paul Bartholomew; Jim Neel; Kenneth E. Turner; Brian Northup

    2016-01-01

    The Southern Plains (SP) site of the Long Term Agroecosystem Research (LTAR) network is headquartered at the USDA-ARS Grazinglands Research Laboratory (GRL) in El Reno, Oklahoma. The GRL was established in 1948. A long-term watershed and climate research program was established in the Little Washita River Experimental Watershed (LWREW) in 1961 and in the Fort Cobb...

  2. Long-term effect of the insoluble thread-lifting technique.

    PubMed

    Fukaya, Mototsugu

    2017-01-01

    Although the thread-lifting technique for sagging faces has become more common and popular, medical literature evaluating its effects is scarce. Studies on its long-term prognosis are particularly uncommon. One hundred individuals who had previously undergone insoluble thread-lifting were retrospectively investigated. Photos in frontal and oblique views from the first and last visits were evaluated by six female individuals by guessing the patients' ages. The mean guessed age was defined as the apparent age, and the difference between the real and apparent ages was defined as the youth value. The difference between the youth values before and after the thread-lift was defined as the rejuvenation effect and analyzed in relation to the time since the operation, the number of threads used and the number of thread-lift operations performed. The rejuvenation effect decreased over the first year after the operation, but showed an increasing trend thereafter. The rejuvenation effect increased with the number of threads used and the number of thread-lift operations performed. The insoluble thread-lifting technique appears to be associated with both early and late effects. The rejuvenation effect appeared to decrease during the first year, but increased thereafter. A multicenter trial is necessary to confirm these findings.

  3. Long-Term Ecological Monitoring Field Sampling Plan for 2007

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

    T. Haney

    2007-07-31

    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007more » investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.« less

  4. Pathways for best practice diffusion: the structure of informal relationships in Canada's long-term care sector.

    PubMed

    Dearing, James W; Beacom, Amanda M; Chamberlain, Stephanie A; Meng, Jingbo; Berta, Whitney B; Keefe, Janice M; Squires, Janet E; Doupe, Malcolm B; Taylor, Deanne; Reid, Robert Colin; Cook, Heather; Cummings, Greta G; Baumbusch, Jennifer L; Knopp-Sihota, Jennifer; Norton, Peter G; Estabrooks, Carole A

    2017-02-03

    Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network. We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities. A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities. The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term

  5. Long-Term Monitoring Research Needs: A DOE Perspective

    NASA Astrophysics Data System (ADS)

    Moore, B.; Davis, C. B.

    2002-05-01

    The U.S. Department of Energy's Office of Environmental Management is responsible for dealing with the nation's legacy of Cold War radioactive and hazardous waste and contamination. Major efforts are underway to deal with this legacy; these are expected to last up to decades and cost up to billions of dollars at some sites. At all sites, however, active remediation must eventually cease; if hazards then remain, the site must enter into a long-term stewardship mode. In this talk we discuss aspects of long-term monitoring pertinent to DOE sites, focusing on challenges to be faced, specific goals or targets to be met, and research needs to be addressed in order to enable DOE to meet its long-term stewardship obligations. DOE LTM research needs fall into three major categories: doing what we can do now much more efficiently; doing things we cannot do now; and proving the validity of our monitoring programs. Given the enormity of the DOE obligations, it will be highly desirable to develop much more efficient monitoring paradigms. Doing so will demand developing autonomous, remote monitoring networks of in situ sensors capable of replacing (or at least supplementing to a large extent) conventional groundwater and soil gas sampling and analysis programs. The challenges involved range from basic science (e.g., inventing in situ sensors for TCE that do not demand routine maintenance) to engineering (attaining superior reliability in data reporting in remote networks) to ergonomics (developing decent ways of selecting and presenting the "right" information from the monitoring network) to regulatory affairs (presenting convincing evidence that the more efficient systems actually provide superior monitoring). We explore these challenges in some detail, focusing on the "long" in long-term monitoring as it applies to DOE sites. Monitoring system performance validation and, ultimately, regulator and stakeholder acceptance of site closure and long-term stewardship plans depend

  6. A Revised Model of Short-Term Memory and Long-Term Learning of Verbal Sequences

    ERIC Educational Resources Information Center

    Burgess, Neil; Hitch, Graham J.

    2006-01-01

    The interaction between short- and long-term memory is studied within a model in which phonemic and (temporal) contextual information have separate influences on immediate verbal serial recall via connections with short- and long-term plasticity [Burgess, N., & Hitch, G.J. (1999). Memory for serial order: a network model of the phonological loop…

  7. Musical and Verbal Memory in Alzheimer's Disease: A Study of Long-Term and Short-Term Memory

    ERIC Educational Resources Information Center

    Menard, Marie-Claude; Belleville, Sylvie

    2009-01-01

    Musical memory was tested in Alzheimer patients and in healthy older adults using long-term and short-term memory tasks. Long-term memory (LTM) was tested with a recognition procedure using unfamiliar melodies. Short-term memory (STM) was evaluated with same/different judgment tasks on short series of notes. Musical memory was compared to verbal…

  8. Long-term cropping systems study

    USDA-ARS?s Scientific Manuscript database

    This long-term study has been conducted on the Agronomy Farm at ARDC since the early 1970’s. In the beginning, the objectives were mainly related to crop production as affected by different cropping systems. The cropping systems included in the study are Continuous Corn, Soybean, and Sorghum; 2-year...

  9. Preoperative proteinuria is associated with long-term progression to chronic dialysis and mortality after coronary artery bypass grafting surgery.

    PubMed

    Wu, Vin-Cent; Huang, Tao-Min; Wu, Pei-Chen; Wang, Wei-Jie; Chao, Chia-Ter; Yang, Shao-Yu; Shiao, Chih-Chung; Hu, Fu-Chang; Lai, Chun-Fu; Lin, Yu-Feng; Han, Yin-Yi; Chen, Yih-Sharng; Hsu, Ron-Bin; Young, Guang-Huar; Wang, Shoei-Shen; Tsai, Pi-Ru; Chen, Yung-Ming; Chao, Ting-Ting; Ko, Wen-Je; Wu, Kwan-Dun

    2012-01-01

    Preoperative proteinuria is associated with post-operative acute kidney injury (AKI), but whether it is also associated with increased long-term mortality and end-stage renal disease (ESRD) is unknown. We studied 925 consecutive patients undergoing CABG. Demographic and clinical data were collected prospectively, and patients were followed for a median of 4.71 years after surgery. Proteinuria, according to dipstick tests, was defined as mild (trace to 1+) or heavy (2+ to 4+) according to the results of the dipstick test. A total of 276 (29.8%) patients had mild proteinuria before surgery and 119 (12.9%) patients had heavy proteinuria. During the follow-up, the Cox proportional hazards model demonstrated that heavy proteinuria (hazard ratio [HR], 27.17) was an independent predictor of long-term ESRD. There was a progressive increased risk for mild proteinuria ([HR], 1.88) and heavy proteinuria ([HR], 2.28) to predict all-cause mortality compared to no proteinuria. Mild ([HR], 2.57) and heavy proteinuria ([HR], 2.70) exhibited a stepwise increased ratio compared to patients without proteinuria for long-term composite catastrophic outcomes (mortality and ESRD), which were independent of the baseline GFR and postoperative acute kidney injury (AKI). Our study demonstrated that proteinuria is a powerful independent risk factor of long-term all-cause mortality and ESRD after CABG in addition to preoperative GFR and postoperative AKI. Our study demonstrated that proteinuria should be integrated into clinical risk prediction models for long-term outcomes after CABG. These results provide a high priority for future renal protective strategies and methods for post-operative CABG patients.

  10. Precise and long-term stabilization of the carrier-envelope phase of femtosecond laser pulses using an enhanced direct locking technique.

    PubMed

    Yu, Tae Jun; Hong, Kyung-Han; Choi, Hyun-Gyug; Sung, Jae Hee; Choi, Il Woo; Ko, Do-Kyeong; Lee, Jongmin; Kim, Junwon; Kim, Dong Eon; Nam, Chang Hee

    2007-06-25

    We demonstrate a long-term operation with reduced phase noise in the carrier-envelope-phase (CEP) stabilization process by employing a double feedback loop and an improved signal detection in the direct locking technique [Opt. Express 13, 2969 (2005)]. A homodyne balanced detection method is employed for efficiently suppressing the dc noise in the f-2f beat signal, which is converted into the CEP noise in the direct locking loop working at around zero carrier-envelope offset frequency (f(ceo)). In order to enhance the long-term stability, we have used the double feedback scheme that modulates both the oscillator pump power for a fast control and the intracavity-prism insertion depth for a slow and high-dynamic-range control. As a result, the in-loop phase jitter is reduced from 50 mrad of the previous result to 29 mrad, corresponding to 13 as in time scale, and the long-term stable operation is achieved for more than 12 hours.

  11. Long-term effect of lime-fly ash treated soils.

    DOT National Transportation Integrated Search

    2003-12-01

    In October of 2000 MDOT initiated State Study No. 147, entitled "Long-Term Effect of Lime-Fly Ash Treated Soils." The purpose of this study : was to evaluate the long-term performance of LFA stabilized soil as a base course material. Part of the impe...

  12. Common Calibration Source for Monitoring Long-term Ozone Trends

    NASA Technical Reports Server (NTRS)

    Kowalewski, Matthew

    2004-01-01

    Accurate long-term satellite measurements are crucial for monitoring the recovery of the ozone layer. The slow pace of the recovery and limited lifetimes of satellite monitoring instruments demands that datasets from multiple observation systems be combined to provide the long-term accuracy needed. A fundamental component of accurately monitoring long-term trends is the calibration of these various instruments. NASA s Radiometric Calibration and Development Facility at the Goddard Space Flight Center has provided resources to minimize calibration biases between multiple instruments through the use of a common calibration source and standardized procedures traceable to national standards. The Facility s 50 cm barium sulfate integrating sphere has been used as a common calibration source for both US and international satellite instruments, including the Total Ozone Mapping Spectrometer (TOMS), Solar Backscatter Ultraviolet 2 (SBUV/2) instruments, Shuttle SBUV (SSBUV), Ozone Mapping Instrument (OMI), Global Ozone Monitoring Experiment (GOME) (ESA), Scanning Imaging SpectroMeter for Atmospheric ChartographY (SCIAMACHY) (ESA), and others. We will discuss the advantages of using a common calibration source and its effects on long-term ozone data sets. In addition, sphere calibration results from various instruments will be presented to demonstrate the accuracy of the long-term characterization of the source itself.

  13. Long-term oceanographic observations in Massachusetts Bay, 1989-2006

    USGS Publications Warehouse

    Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.; Borden, Jonathan; Casso, Michael A.; Gutierrez, Benjamin T.; Hastings, Mary E.; Lightsom, Frances L.; Martini, Marinna A.; Montgomery, Ellyn T.; Rendigs, Richard R.; Strahle, William S.

    2009-01-01

    This data report presents long-term oceanographic observations made in western Massachusetts Bay at long-term site A (LT-A) (42 deg 22.6' N., 70 deg 47.0' W.; nominal water depth 32 meters) from December 1989 through February 2006 and long-term site B (LT-B) (42 deg 9.8' N., 70 deg 38.4' W.; nominal water depth 22 meters) from October 1997 through February 2004 (fig. 1). The observations were collected as part of a U.S. Geological Survey (USGS) study designed to understand the transport and long-term fate of sediments and associated contaminants in Massachusetts Bay. The observations include time-series measurements of current, temperature, salinity, light transmission, pressure, oxygen, fluorescence, and sediment-trapping rate. About 160 separate mooring or tripod deployments were made on about 90 research cruises to collect these long-term observations. This report presents a description of the 16-year field program and the instrumentation used to make the measurements, an overview of the data set, more than 2,500 pages of statistics and plots that summarize the data, and the digital data in Network Common Data Form (NetCDF) format. This research was conducted by the USGS in cooperation with the Massachusetts Water Resources Authority and the U.S. Coast Guard.

  14. Advancing nursing leadership in long-term care.

    PubMed

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.

  15. The value of short-term pain relief in predicting the long-term outcome of 'indirect' cervical epidural steroid injections.

    PubMed

    Joswig, Holger; Neff, Armin; Ruppert, Christina; Hildebrandt, Gerhard; Stienen, Martin Nikolaus

    2018-05-01

    The predictive value of short-term arm pain relief after 'indirect' cervical epidural steroid injection (ESI) for the 1-month treatment response has been previously demonstrated. It remained to be answered whether the long-term response could be estimated by the early post-interventional pain course as well. Prospective observational study, following a cohort of n = 45 patients for a period of 24 months after 'indirect' ESI for radiculopathy secondary to a single-level cervical disk herniation (CDH). Arm and neck pain on the visual analog scale (VAS), health-related quality of life with the Short Form-12 (SF-12), and functional outcome with the Neck Pain and Disability (NPAD) Scale were assessed. Any additional invasive treatment after a single injection (second injection or surgery) defined treatment outcome as 'non-response'. At 24 months, n = 30 (66.7%) patients were responders and n = 15 (33.3%) were non-responders. Non-responders exited the follow-up at 1 month (n = 10), at 3 months (n = 4), and at 6 months (n = 1). No patients were injected again or operated on between the 6- and 24-month follow-up. Patients with favorable treatment response at 24 months had significantly lower VAS arm pain (p < 0.05) than non-responders at days 6, 8-11, and at the 3-month follow-up. The previously defined cut-off of > 50% short term pain reduction was not a reliable predictor of the 24-month responder status. SF-12 and NPAD scores were better among treatment responders in the long term. Patients who require a second injection or surgery after 'indirect' cervical ESI for a symptomatic CDH do so within the first 6 months. Short-term pain relief cannot reliably predict the long-term outcome.

  16. Roadmap to Long-Term Monitoring Optimization

    EPA Pesticide Factsheets

    This roadmap focuses on optimization of established long-term monitoring programs for groundwater. Tools and techniques discussed concentrate on methods for optimizing the monitoring frequency and spatial (three-dimensional) distribution of wells ...

  17. Short-term versus long-term administration of single prophylactic antibiotic in elective gastric tumor surgery.

    PubMed

    Wang, Fang; Chen, Xin-Zu; Liu, Jie; Yang, Kun; Zhang, Bo; Chen, Zhi-Xin; Chen, Jia-Ping; Hu, Jian-Kun; Zhou, Zong-Guang; Mo, Xian-Min; Mo, Xian-Min

    2012-09-01

    To evaluate short-term versus long-term single prophylactic antibiotic for elective gastric tumor surgery. Patients in a single surgical team undergoing elective gastric tumor surgery were enrolled from November 2009 to December 2010. The included patients were aged from 18 to 70 years without conditions as severe comorbidity, preoperative infectious diseases, antibiotic administration 48 h before surgery, exploratory laparotomy only or combined colorectal resection, neoadjuvant chemotherapy, or steroid administration before surgery. The overall and infection-related postoperative complications and also economic outcomes were analyzed. The software SPSS 17.0 and TreeAge Pro 2007 were used for statistics. Patients (n=158 (45 vs. 113)) were enrolled in short-term and long-term groups. No death cases occurred. Overall postoperative complication rates were 8.9% and 8.0%, respectively (p=1.000). The rates of infection related complications were 8.9% and 4.4%, respectively (p=0.231). No surgical site infection (SSI) occurred in the short-term group, whereas SSI was 1.8% in the long-term group. Total hospitalization cost (THC) of short-term branch was 36,557RMB per patients and preferable against 39,523RMB of long-term branch. Incremental cost-effectiveness analysis showed there was a 10 times interval between the extra healthcare expenditure of benefit and harm. Short-term administration did not increase the risk of postoperative complications and was more cost-effective.

  18. Long-term personality data collection in support of spaceflight and analogue research.

    PubMed

    Musson, David M; Helmreich, Robert L

    2005-06-01

    This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

  19. Data Homogenization of the NOAA Long-Term Ozonesonde Records

    NASA Astrophysics Data System (ADS)

    Johnson, B.; Cullis, P.; Sterling, C. W.; Jordan, A. F.; Hall, E. G.; Petropavlovskikh, I. V.; Oltmans, S. J.; Mcconville, G.

    2015-12-01

    The NOAA long term balloon-borne ozonesonde sites at Boulder, Colorado; Hilo, Hawaii; and South Pole Station, Antarctica have measured weekly ozone profiles for more than 3 decades. The ozonesonde consists of an electrochemical concentration cell (ECC) sensor interfaced with a weather radiosonde which transmits high resolution ozone and meteorological data during ascent from the surface to 30-35 km altitude. During this 30 year time period there have been several model changes in the commercially available ECC ozonesondes and radiosondes as well as three adjustments in the ozone sensor solution composition at NOAA. These changes were aimed at optimizing the ozonesonde performance. Organized intercomparison campaigns conducted at the environmental simulation facility at the Research Centre Juelich, Germany and international field site testing have been the primary process for assessing new designs, instruments, or sensor solution changes and developing standard operating procedures. NOAA has also performed in-house laboratory tests and launched 28 dual ozonesondes at various sites since 1994 to provide further comparison data to determine the optimum homogenized data set. The final homogenization effort involved reviewing and editing several thousand individual ozonesonde profiles followed by applying the optimum correction algorithms for changes in type of sensor solution composition. The results of improved data sets will be shown with long term trends and uncertainties at various altitude levels.

  20. Long-term Use of Opioids for Complex Chronic Pain

    PubMed Central

    Von Korff, Michael R.

    2014-01-01

    Increased opioid prescribing for back pain and other chronic musculoskeletal pain conditions has been accompanied by dramatic increases in prescription opioid addiction and fatal overdose. Opioid-related risks appear to increase with dose. While short-term randomized trials of opioids for chronic pain have found modest analgesic benefits (a one-third reduction in pain intensity on average), the long-term safety and effectiveness of opioids for chronic musculoskeletal pain is unknown. Given the lack of large, long-term randomized trials, recent epidemiologic data suggests the need for caution when considering long-term use of opioids to manage chronic musculoskeletal pain, particularly at higher dosage levels. Principles for achieving more selective and cautious use of opioids for chronic musculoskeletal pain are proposed. PMID:24315147

  1. Frontal lobe dysfunction in long-term cannabis users.

    PubMed

    Lundqvist, T; Jönsson, S; Warkentin, S

    2001-01-01

    This study examined the neurophysiological effects of cannabis. Cerebral blood flow (CBF) was measured in 12 long-term cannabis users shortly after cessation of cannabis use (mean 1.6 days). The findings showed significantly lower mean hemispheric blood flow values and significantly lower frontal values in the cannabis subjects compared to normal controls. The results suggest that the functional level of the frontal lobes is affected by long-term cannabis use.

  2. Anticipatory eye movements and long-term memory in early infancy.

    PubMed

    Wong-Kee-You, Audrey M B; Adler, Scott A

    2016-11-01

    Advances in our understanding of long-term memory in early infancy have been made possible by studies that have used the Rovee-Collier's mobile conjugate reinforcement paradigm and its variants. One function that has been attributed to long-term memory is the formation of expectations (Rovee-Collier & Hayne, 1987); consequently, a long-term memory representation should be established during expectation formation. To examine this prediction and potentially open the door on a new paradigm for exploring infants' long-term memory, using the Visual Expectation Paradigm (Haith, Hazan, & Goodman, 1988), 3-month-old infants were trained to form an expectation for predictable color and spatial information of picture events and emit anticipatory eye movements to those events. One day later, infants' anticipatory eye movements decreased in number relative to the end of training when the predictable colors were changed but not when the spatial location of the predictable color events was changed. These findings confirm that information encoded during expectation formation are stored in long-term memory, as hypothesized by Rovee-Collier and colleagues. Further, this research suggests that eye movements are potentially viable measures of long-term memory in infancy, providing confirmatory evidence for early mnemonic processes. © 2016 Wiley Periodicals, Inc.

  3. Murine model of long term obstructive jaundice

    PubMed Central

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-01-01

    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  4. Long-term outcome of nonoperative pediatric splenic injury management.

    PubMed

    Kristoffersen, Kristian W; Mooney, David P

    2007-06-01

    Nonoperative management (NOM) of blunt splenic trauma is the standard of care in hemodynamically stable children. The long-term risk of this strategy remains unknown. The object of this study was to investigate the incidence of long-term complications after NOM of pediatric splenic injury. All children who underwent NOM for blunt splenic trauma over an 11-year period were identified. Patients were interviewed for any ailments that could be related to their splenic injury, and hospital data were analyzed. A total of 266 patients were identified, and 228 patients (86%) were interviewed. Mean follow-up time was 5 +/- 3 years. One patient had a delayed complication, a splenic pseudocyst. Pain more than 4 weeks after injury was unusual. Time until return to full activity varied broadly. The incidence of long-term complications after NOM of pediatric splenic injury was 1 (0.44%) in 228 patients. Nonoperative management of pediatric blunt splenic trauma in children is associated with a minimal risk of long-term complications.

  5. Visual working memory buffers information retrieved from visual long-term memory.

    PubMed

    Fukuda, Keisuke; Woodman, Geoffrey F

    2017-05-16

    Human memory is thought to consist of long-term storage and short-term storage mechanisms, the latter known as working memory. Although it has long been assumed that information retrieved from long-term memory is represented in working memory, we lack neural evidence for this and need neural measures that allow us to watch this retrieval into working memory unfold with high temporal resolution. Here, we show that human electrophysiology can be used to track information as it is brought back into working memory during retrieval from long-term memory. Specifically, we found that the retrieval of information from long-term memory was limited to just a few simple objects' worth of information at once, and elicited a pattern of neurophysiological activity similar to that observed when people encode new information into working memory. Our findings suggest that working memory is where information is buffered when being retrieved from long-term memory and reconcile current theories of memory retrieval with classic notions about the memory mechanisms involved.

  6. Short-term and long-term risk factors in gastric cancer

    PubMed Central

    Verlato, Giuseppe; Marrelli, Daniele; Accordini, Simone; Bencivenga, Maria; Di Leo, Alberto; Marchet, Alberto; Petrioli, Roberto; Zoppini, Giacomo; Muggeo, Michele; Roviello, Franco; de Manzoni, Giovanni

    2015-01-01

    curative gastrectomy with D2/D3 lymphadenectomy. Survival curves in the two different histotypes (intestinal and mixed/diffuse) were superimposed in the first three years of follow-up and diverged thereafter. Likewise, survival curves as a function of site (fundus vs body/antrum) started to diverge after the first year. On the contrary, survival curves differed among age classes from the very beginning, due to different post-operative mortality, which increased from 0.5% in patients aged 65-74 years to 9.9% in patients aged 75-91 years; this discrepancy later disappeared. Accordingly, the proportional hazards assumption of the Cox model was violated, as regards age, site and histology. To cope with this problem, multivariable survival analysis was performed by separately considering either the first two years of follow-up or subsequent years. Histology and site were significant predictors only after two years, while T and N, although significant both in the short-term and in the long-term, became less important in the second part of follow-up. Increasing age was associated with higher mortality in the first two years, but not thereafter. Splitting survival time when performing survival analysis allows to distinguish between short-term and long-term risk factors. Alternative statistical solutions could be to exclude post-operative mortality, to introduce in the model time-dependent covariates or to stratify on variables violating proportionality assumption. PMID:26074682

  7. Short-term and long-term risk factors in gastric cancer.

    PubMed

    Verlato, Giuseppe; Marrelli, Daniele; Accordini, Simone; Bencivenga, Maria; Di Leo, Alberto; Marchet, Alberto; Petrioli, Roberto; Zoppini, Giacomo; Muggeo, Michele; Roviello, Franco; de Manzoni, Giovanni

    2015-06-07

    curative gastrectomy with D2/D3 lymphadenectomy. Survival curves in the two different histotypes (intestinal and mixed/diffuse) were superimposed in the first three years of follow-up and diverged thereafter. Likewise, survival curves as a function of site (fundus vs body/antrum) started to diverge after the first year. On the contrary, survival curves differed among age classes from the very beginning, due to different post-operative mortality, which increased from 0.5% in patients aged 65-74 years to 9.9% in patients aged 75-91 years; this discrepancy later disappeared. Accordingly, the proportional hazards assumption of the Cox model was violated, as regards age, site and histology. To cope with this problem, multivariable survival analysis was performed by separately considering either the first two years of follow-up or subsequent years. Histology and site were significant predictors only after two years, while T and N, although significant both in the short-term and in the long-term, became less important in the second part of follow-up. Increasing age was associated with higher mortality in the first two years, but not thereafter. Splitting survival time when performing survival analysis allows to distinguish between short-term and long-term risk factors. Alternative statistical solutions could be to exclude post-operative mortality, to introduce in the model time-dependent covariates or to stratify on variables violating proportionality assumption.

  8. Long-term success of combined kidney-lung transplantation in a patient with cystic fibrosis.

    PubMed

    Borro, José M; Rama, Pablo; Rey, Teresa; Fernández-Rivera, Constantino

    2013-06-01

    Advanced kidney disease is usually considered an absolute contraindication for lung transplantation due to the difficult management of these patients in the post-operative period. Combined lung-kidney transplantation, however, could offer an opportunity for selected patients with renal and pulmonary dysfunction. This study summarizes the long-term success of a double transplantation in a 38-year-old male patient with cystic fibrosis who presented respiratory and kidney failure. After a complicated post-operative period, the patient currently lives completely independently 46 months after the operation and he enjoys excellent pulmonary and renal function. Copyright © 2012 SEPAR. Published by Elsevier España, S.L. All rights reserved.

  9. Long term self esteem assessment after height increase by lengthening and then nailing.

    PubMed

    Emara, K; Al Kersh, M A; Emara, A K

    2017-03-01

    The purpose of the study is to assess the long term psychosocial functioning after height increase, using the external fixation then nailing method. Rosenberg Self-esteem scale and a questionnaire to assess social functioning were completed by 28 patients both preoperatively and at a mean follow-up of 7 years. The mean total score of RSE self-esteem for the 28 patients before lengthening was 21.5 (SD 1.03) (20-24). The mean total score of RSE for the patients 1 year after lengthening was 22 (SD 1.17) (20-24) with highly significant difference (p = 0.002).The mean total RSE self-esteem score after 7 years was 21.7 (SD 1.12) (21-25) with no significant difference (p = 0.11) Improvement was an evident in the short term self esteem after 1 year of follow up of the patients with height increase. On the other hand, there was an evident deterioration in the long term psychosocial evaluation during follow up after 7 years of height increase, returning to near pre-operative levels of self esteem.

  10. Distinct cerebellar engrams in short-term and long-term motor learning.

    PubMed

    Wang, Wen; Nakadate, Kazuhiko; Masugi-Tokita, Miwako; Shutoh, Fumihiro; Aziz, Wajeeha; Tarusawa, Etsuko; Lorincz, Andrea; Molnár, Elek; Kesaf, Sebnem; Li, Yun-Qing; Fukazawa, Yugo; Nagao, Soichi; Shigemoto, Ryuichi

    2014-01-07

    Cerebellar motor learning is suggested to be caused by long-term plasticity of excitatory parallel fiber-Purkinje cell (PF-PC) synapses associated with changes in the number of synaptic AMPA-type glutamate receptors (AMPARs). However, whether the AMPARs decrease or increase in individual PF-PC synapses occurs in physiological motor learning and accounts for memory that lasts over days remains elusive. We combined quantitative SDS-digested freeze-fracture replica labeling for AMPAR and physical dissector electron microscopy with a simple model of cerebellar motor learning, adaptation of horizontal optokinetic response (HOKR) in mouse. After 1-h training of HOKR, short-term adaptation (STA) was accompanied with transient decrease in AMPARs by 28% in target PF-PC synapses. STA was well correlated with AMPAR decrease in individual animals and both STA and AMPAR decrease recovered to basal levels within 24 h. Surprisingly, long-term adaptation (LTA) after five consecutive daily trainings of 1-h HOKR did not alter the number of AMPARs in PF-PC synapses but caused gradual and persistent synapse elimination by 45%, with corresponding PC spine loss by the fifth training day. Furthermore, recovery of LTA after 2 wk was well correlated with increase of PF-PC synapses to the control level. Our findings indicate that the AMPARs decrease in PF-PC synapses and the elimination of these synapses are in vivo engrams in short- and long-term motor learning, respectively, showing a unique type of synaptic plasticity that may contribute to memory consolidation.

  11. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary support...

  12. 21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary support...

  13. Long-Term Use of Benzodiazepines and Nonbenzodiazepine Hypnotics, 1999-2014.

    PubMed

    Kaufmann, Christopher N; Spira, Adam P; Depp, Colin A; Mojtabai, Ramin

    2018-02-01

    Clinical guidelines suggest that benzodiazepines (BZDs) and non-BZD hypnotics (NBHs) be used on a short-term basis. The authors examined trends in long-term BZD and NBH use from 1999 to 2014. Data included 82,091 respondents in the 1999-2014 waves of the National Health and Nutrition Examination Survey (NHANES). NHANES recorded medications used in the past 30 days on the basis of prescription bottles, and participants reported use duration. BZD and NBH use were categorized as short, medium, and long term, and time trends in use were assessed. BZD and NBH use increased from 1999 to 2014, driven by increases in medium- and long-term use, even after adjustment for age and race-ethnicity. In most years, only a fifth of current BZD or NBH users reported short-term use. Long-term BZD and NBH use has grown independent of U.S. demographic shifts. Monitoring of use is needed to prevent adverse outcomes.

  14. Long-term prognosis of depression in primary care.

    PubMed Central

    Simon, G. E.

    2000-01-01

    This article uses longitudinal data from a primary care sample to examine long-term prognosis of depression. A sample of 225 patients initiating antidepressant treatment in primary care completed assessments of clinical outcome (Hamilton Depression Rating Scale and the mood module of the Structured Clinical Interview for DSM-IIIR) 1, 3, 6, 9, 12, 18 and 24 months after initiating treatment. The proportion of patients continuing to meet criteria for major depression fell rapidly to approximately 10% and remained at approximately that level throughout follow-up. The proportion meeting criteria for remission (Hamilton Depression score of 7 or less) rose gradually to approximately 45%. Long-term prognosis (i.e. probability of remission at 6 months and beyond) was strongly related to remission status at 3 months (odds ratio 3.65; 95% confidence interval, 2.81-4.76) and only modestly related to various clinical characteristics assessed at baseline (e.g. prior history of recurrent depression, medical comorbidity, comorbid anxiety symptoms). The findings indicate that potentially modifiable risk factors influence the long-term prognosis of depression. This suggests that more systematic and effective depression treatment programmes might have an important effect on long-term course and reduce the overall burden of chronic and recurrent depression. PMID:10885162

  15. Trends in Streamflow Characteristics at Long-Term Gaging Stations, Hawaii

    USGS Publications Warehouse

    Oki, Delwyn S.

    2004-01-01

    The surface-water resources of Hawaii have significant cultural, aesthetic, ecologic, and economic importance. Proper management of the surface-water resources of the State requires an understanding of the long- and short-term variability in streamflow characteristics that may occur. The U.S. Geological Survey maintains a network of stream-gaging stations in Hawaii, including a number of stations with long-term streamflow records that can be used to evaluate long-term trends and short-term variability in flow characteristics. The overall objective of this study is to obtain a better understanding of long-term trends and variations in streamflow on the islands of Hawaii, Maui, Molokai, Oahu, and Kauai, where long-term stream-gaging stations exist. This study includes (1) an analysis of long-term trends in flows (both total flow and estimated base flow) at 16 stream-gaging stations, (2) a description of patterns in trends within the State, and (3) discussion of possible regional factors (including rainfall) that are related to the observed trends and variations. Results of this study indicate the following: 1. From 1913 to 2002 base flows generally decreased in streams for which data are available, and this trend is consistent with the long-term downward trend in annual rainfall over much of the State during that period. 2. Monthly mean base flows generally were above the long-term average from 1913 to the early 1940s and below average after the early 1940s to 2002, and this pattern is consistent with the detected downward trends in base flows from 1913 to 2002. 3. Long-term downward trends in base flows of streams may indicate a reduction in ground-water discharge to streams caused by a long-term decrease in ground-water storage and recharge. 4. From 1973 to 2002, trends in streamflow were spatially variable (up in some streams and down in others) and, with a few exceptions, generally were not statistically significant. 5. Short-term variability in streamflow is

  16. Anxiety Disorders in Long-Term Survivors of Adult Cancers

    PubMed Central

    Greer, Joseph A.; Solis, Jessica M.; Temel, Jennifer S.; Lennes, Inga T.; Prigerson, Holly G.; Maciejewski, Paul K.; Pirl, William F.

    2011-01-01

    Background Little is known about the prevalence of anxiety disorders among long-term survivors of adult cancers. Using data from the National Comorbidity Survey-Replication (NCS-R), we compared rates of anxiety disorders between long-term cancer survivors and individuals without a history of cancer. Methods A nationally representative sample of 9,282 adults participated in a household survey to assess the prevalence of DSM-IV psychiatric disorders, a subset of whom also answered questions about medical comorbidities, including cancer. Long-term survivors were defined as those who received an adult cancer diagnosis at least five years before the survey. Multiple logistic regression analyses were used to examine associations between cancer history and anxiety disorders in the past year. Results The NCS-R sample consisted of 225 long-term cancer survivors and 5,337 people without a history of cancer. Controlling for socio-demographic variables, long-term cancer survivors were more likely to have an anxiety disorder (OR: 1.49, 95% CI: 1.04-2.13), including specific phobia (OR: 1.59, 95% CI: 1.06-2.44) and medical phobia (OR: 3.45, 95% CI: 1.15-10.0), during the past 12 months compared to those without cancer histories. Rates for social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder and agoraphobia were not significantly different between groups. Conclusion Long-term survivors of adult cancers were more likely to have an anxiety disorder diagnosis, namely specific phobia, in the past 12 months compared with the general public. Further longitudinal study is needed to clarify the timing and course of anxiety relative to the cancer diagnosis. PMID:21907059

  17. Inflammatory markers in relation to long-term air pollution.

    PubMed

    Mostafavi, Nahid; Vlaanderen, Jelle; Chadeau-Hyam, Marc; Beelen, Rob; Modig, Lars; Palli, Domenico; Bergdahl, Ingvar A; Vineis, Paolo; Hoek, Gerard; Kyrtopoulos, Soterios Α; Vermeulen, Roel

    2015-08-01

    Long-term exposure to ambient air pollution can lead to chronic health effects such as cancer, cardiovascular and respiratory disease. Systemic inflammation has been hypothesized as a putative biological mechanism contributing to these adverse health effects. We evaluated the effect of long-term exposure to air pollution on blood markers of systemic inflammation. We measured a panel of 28 inflammatory markers in peripheral blood samples from 587 individuals that were biobanked as part of a prospective study. Participants were from Varese and Turin (Italy) and Umea (Sweden). Long-term air pollution estimates of nitrogen oxides (NOx) were available from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Linear mixed models adjusted for potential confounders were applied to assess the association between NOx and the markers of inflammation. Long-term exposure to NOx was associated with decreased levels of interleukin (IL)-2, IL-8, IL-10 and tumor necrosis factor-α in Italy, but not in Sweden. NOx exposure levels were considerably lower in Sweden than in Italy (Sweden: median (5th, 95th percentiles) 6.65 μg/m(3) (4.8, 19.7); Italy: median (5th, 95th percentiles) 94.2 μg/m(3) (7.8, 124.5)). Combining data from Italy and Sweden we only observed a significant association between long-term exposure to NOx and decreased levels of circulating IL-8. We observed some indication for perturbations in the inflammatory markers due to long-term exposure to NOx. Effects were stronger in Italy than in Sweden, potentially reflecting the difference in air pollution levels between the two cohorts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Cognitive correlates of long-term cannabis use in Costa Rican men.

    PubMed

    Fletcher, J M; Page, J B; Francis, D J; Copeland, K; Naus, M J; Davis, C M; Morris, R; Krauskopf, D; Satz, P

    1996-11-01

    Cognitive correlates of long-term cannabis use have been elusive. We tested the hypothesis that long-term cannabis use is associated with deficits in short term memory, working memory, and attention in a literate, westernized culture (Costa Rica) in which the effects of cannabis use can be isolated. Two cohorts of long-term cannabis users and nonusers were studied. Within each cohort, users and nonusers were comparable in age and socioeconomic status. Polydrug users and users who tested positive for the use of cannabis at the time of cognitive assessment after a 72-hour abstention period were excluded. The older cohort (whose age was approximately 45 years) had consumed cannabis for an average of 34 years, and comprised 17 users and 30 nonusers, who had been recruited in San José, Costa Rica, and had been observed since 1973. The younger cohort (whose age was approximately 28 years) had consumed cannabis for an average of 8 years, and comprised 37 users and 49 nonusers. Short-term memory, working memory, and attentional skills were measured in each subject. Older long-term users performed worse than older nonusers on 2 short-term memory tests involving learning lists of words. In addition, older long-term users performed worse than older nonusers on selective and divided attention tasks associated with working memory. No notable differences were apparent between younger users and nonusers. Long-term cannabis use was associated with disruption of short-term memory, working memory, and attentional skills in older long-term cannabis users.

  19. Verbal Short-Term Memory Reflects the Organization of Long-Term Memory: Further Evidence from Short-Term Memory for Emotional Words

    ERIC Educational Resources Information Center

    Majerus, Steve; D'Argembeau, Arnaud

    2011-01-01

    Many studies suggest that long-term lexical-semantic knowledge is an important determinant of verbal short-term memory (STM) performance. This study explored the impact of emotional valence on word immediate serial recall as a further lexico-semantic long-term memory (LTM) effect on STM. This effect is particularly interesting for the study of…

  20. Forecasting stock return volatility: A comparison between the roles of short-term and long-term leverage effects

    NASA Astrophysics Data System (ADS)

    Pan, Zhiyuan; Liu, Li

    2018-02-01

    In this paper, we extend the GARCH-MIDAS model proposed by Engle et al. (2013) to account for the leverage effect in short-term and long-term volatility components. Our in-sample evidence suggests that both short-term and long-term negative returns can cause higher future volatility than positive returns. Out-of-sample results show that the predictive ability of GARCH-MIDAS is significantly improved after taking the leverage effect into account. The leverage effect for short-term volatility component plays more important role than the leverage effect for long-term volatility component in affecting out-of-sample forecasting performance.

  1. Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success.

    PubMed

    Erdöl, Hidayet; Akyol, Nurettin; Imamoglu, Halil Ibrahim; Sözen, Engin

    2005-06-01

    To evaluate the long-term follow-up results of external dacryocystorhinostomy (Ex-DCR) and to assess the role of some factors in its success. Between January 1990 and November 2002, 437 nasolacrimal systems of 387 patients were operated on and included in the study. The success rates were determined on the basis of the last examinations of the patients, and the correlations between success rates and factors such as age, gender, the duration of obstruction, history of acute dacryocystitis, the side of obstruction, and the postoperative follow-up period were calculated. The mean follow-up period was 5.9 +/- 2.5 years. Fifty cases (12.9%) were operated bilaterally. The initial success rate was 91.5% and the last success rate was 98.4% after reoperations. We found meaningful correlations between success and duration of obstruction, age of the patient, and the duration of postoperative follow-up (r = 0.18, 0.17 and -0.14, p = 0.036, 0.001 and 0.002, respectively). In comparison to newly developed surgical techniques for the treatment of nasolacrimal duct obstruction, Ex-DCR still appears to offer higher success rates, even after long-term follow-up. In addition to being a cost-effective procedure, it requires no sophisticated instruments. In our opinion, the high success rates may be explained by the nature of the operation, which creates a fistula between the sac and the nasal mucosa.

  2. Implicit short- and long-term memory direct our gaze in visual search.

    PubMed

    Kruijne, Wouter; Meeter, Martijn

    2016-04-01

    Visual attention is strongly affected by the past: both by recent experience and by long-term regularities in the environment that are encoded in and retrieved from memory. In visual search, intertrial repetition of targets causes speeded response times (short-term priming). Similarly, targets that are presented more often than others may facilitate search, even long after it is no longer present (long-term priming). In this study, we investigate whether such short-term priming and long-term priming depend on dissociable mechanisms. By recording eye movements while participants searched for one of two conjunction targets, we explored at what stages of visual search different forms of priming manifest. We found both long- and short- term priming effects. Long-term priming persisted long after the bias was present, and was again found even in participants who were unaware of a color bias. Short- and long-term priming affected the same stage of the task; both biased eye movements towards targets with the primed color, already starting with the first eye movement. Neither form of priming affected the response phase of a trial, but response repetition did. The results strongly suggest that both long- and short-term memory can implicitly modulate feedforward visual processing.

  3. Long-Term Results of Mitral Valve Repair

    PubMed Central

    da Costa, Francisco Diniz Affonso; Colatusso, Daniele de Fátima Fornazari; Martin, Gustavo Luis do Santos; Parra, Kallyne Carolina Silva; Botta, Mariana Cozer; Balbi Filho, Eduardo Mendel; Veloso, Myrian; Miotto, Gabriela; Ferreira, Andreia Dumsch de Aragon; Colatusso, Claudinei

    2018-01-01

    Introduction Current guidelines state that patients with severe mitral regurgitation should be treated in reference centers with a high reparability rate, low mortality rate, and durable results. Objective To analyze our global experience with the treatment of organic mitral regurgitation from various etiologies operated in a single center. Methods We evaluated all surgically treated patients with organic mitral regurgitation from 2004-2017. Patients were evaluated clinically and by echocardiography every year. We determined early and late survival rates, valve related events and freedom from recurrent mitral regurgitation and tricuspid regurgitation. Valve failure was defined as any mitral regurgitation ≥ moderate degree or the need for reoperation for any reason. Results Out of 133 patients with organic mitral regurgitation, 125 (93.9%) were submitted to valve repair. Mean age was 57±15 years and 52 patients were males. The most common etiologies were degenerative disease (73 patients) and rheumatic disease (34 patients). Early mortality was 2.4% and late survival was 84.3% at 10 years, which are similar to the age- and gender-matched general population. Only two patients developed severe mitral regurgitation, and both were reoperated (95.6% at 10 years). Freedom from mitral valve failure was 84.5% at 10 years, with no difference between degenerative and rheumatic valves. Overall, late ≥ moderate tricuspid regurgitation was present in 34% of the patients, being more common in the rheumatic ones. The use of tricuspid annuloplasty abolished this complication. Conclusion We have demonstrated that mitral regurgitation due to organic mitral valve disease from various etiologies can be surgically treated with a high repair rate, low early mortality and long-term survival that are comparable to the matched general population. Concomitant treatment of atrial fibrillation and tricuspid valve may be important adjuncts to optimize long-term results. PMID:29617498

  4. 47 CFR 1.9030 - Long-term de facto transfer leasing arrangements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Long-term de facto transfer leasing... PROCEDURE Spectrum Leasing General Policies and Procedures § 1.9030 Long-term de facto transfer leasing...) and a spectrum lessee may enter into a long-term de facto transfer leasing arrangement in which the...

  5. Long-term viability of carbon sequestration in deep-sea sediments

    NASA Astrophysics Data System (ADS)

    Teng, Y.; Zhang, D.

    2017-12-01

    Sequestration of carbon dioxide in deep-sea sediments has been proposed for the long-term storage of anthropogenic CO2, due to the negative buoyancy effect and hydrate formation under conditions of high pressure and low temperature. However, the multi-physics process of injection and post-injection fate of CO2 and the feasibility of sub-seabed disposal of CO2 under different geological and operational conditions have not been well studied. On the basis of a detailed study of the coupled processes, we investigate whether storing CO2 into deep-sea sediments is viable, efficient, and secure over the long term. Also studied are the evolution of the multiphase and multicomponent flow and the impact of hydrate formation on storage efficiency during the upward migration of the injected CO2. It is shown that low buoyancy and high viscosity slow down the ascending plume and the forming of the hydrate cap effectively reduces the permeability and finally becomes an impermeable seal, thus limiting the movement of CO2 towards the seafloor. Different flow patterns at varied time scales are identified through analyzing the mass distribution of CO2 in different phases over time. Observed is the formation of a fluid inclusion, which mainly consists of liquid CO2 and is encapsulated by an impermeable hydrate film in the diffusion-dominated stage. The trapped liquid CO2 and CO2 hydrate finally dissolve into the pore water through diffusion of the CO2 component. Sensitivity analyses are performed on storage efficiency under variable geological and operational conditions. It is found that under a deep-sea setting, CO2 sequestration in intact marine sediments is generally safe and permanent.

  6. EARLY AND LATE COMPLICATIONS AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMY OR ANASTOMOSIS

    PubMed Central

    Liu, Liyan; Herrinton, Lisa J.; Hornbrook, Mark C.; Wendel, Christopher S.; Grant, Marcia; Krouse, Robert S.

    2012-01-01

    Purpose Among long-term (≥5 years) colorectal cancer survivors with permanent ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life. Background The incidence and effects of complications on long-term health-related quality of life among colorectal cancer survivors are not adequately understood. Methods Participants (284 ostomy/395 anastomosis) were long-term colorectal cancer survivors enrolled in an integrated health plan. Health-related quality of life was assessed via mailed survey questionnaire in 2002–2005. Information on colorectal cancer, surgery, co-morbidities, and complications was obtained from computerized data and analyzed using survival analysis and logistic regression. Results Ostomy and anastomosis survivors were followed an average 12.1 and 11.2 years, respectively. Within 30 days of surgery, 19% of ostomy and 10% of anastomosis survivors experienced complications (p<0.01). From 31 days on, the percentages were 69% and 67% (after adjustment, p<0.001). Bleeding and post-operative infection were common early complications. Common long-term complications included hernia, urinary retention, hemorrhage, skin conditions, and intestinal obstruction. Ostomy was associated with long-term fistula (odds ratio 5.4; 95% CI 1.4–21.2), and among ostomy survivors, fistula was associated with reduced health-related quality of life (p<0.05). Conclusions Complication rates remain high despite recent advances in surgical treatment methods. Survivors with ostomy have more complications early in their survivorship period, but complications among anastomosis survivors catch up after 20 years, when the two groups have convergent complication rates. Among colorectal cancer survivors with ostomy, fistula has especially important implications for health-related quality of life. PMID:20087096

  7. Effect of long-term successive storm flows on water reclamation plant resilience.

    PubMed

    Zhu, Jun-Jie; Anderson, Paul R

    2017-03-15

    A water reclamation plant (WRP) needs to be resilient to successfully operate through different kinds of perturbations. Perturbations such as storm events, especially long-term successive storm flows, can adversely affect operations. A better understanding of these effects can provide benefits for plant operation, in terms of effluent quality and energy efficiency. However, the concept of resilience for a WRP has not been widely studied, and we are not aware of any studies specifically related to storm flows. In this work we applied measures of resistance and recovery time to quantify resilience, and used a WRP simulation model to investigate how different storm flow characteristics (flowrate and duration) and the amount of aeration influence resilience. Not surprisingly, increasing storm flowrate leads to decreasing resilience. Although the aeration rate plays an important role in determining resilience, there is an aeration threshold (6 m 3 /s for our WRP model); higher aeration rates do not increase resilience. Results suggest that aeration costs could be reduced by as much as 50% while still maintaining the resilience needed to meet effluent quality permit requirements through the perturbations examined in this study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Long-Term Orientation and Educational Performance. Working Paper 174

    ERIC Educational Resources Information Center

    Figlio, David; Giuliano, Paola; Özek, Umut; Sapienza, Paola

    2017-01-01

    We use remarkable population-level administrative education and birth records from Florida to study the role of Long-Term Orientation on the educational attainment of immigrant students living in the US. Controlling for the quality of schools and individual characteristics, students from countries with long-term oriented attitudes perform better…

  9. Long-term effects of interference on short-term memory performance in the rat

    PubMed Central

    Missaire, Mégane; Fraize, Nicolas; Joseph, Mickaël Antoine; Hamieh, Al Mahdy; Parmentier, Régis; Marighetto, Aline; Salin, Paul Antoine; Malleret, Gaël

    2017-01-01

    A distinction has always been made between long-term and short-term memory (also now called working memory, WM). The obvious difference between these two kinds of memory concerns the duration of information storage: information is supposedly transiently stored in WM while it is considered durably consolidated into long-term memory. It is well acknowledged that the content of WM is erased and reset after a short time, to prevent irrelevant information from proactively interfering with newly stored information. In the present study, we used typical WM radial maze tasks to question the brief lifespan of spatial WM content in rodents. Groups of rats were submitted to one of two different WM tasks in a radial maze: a WM task involving the repetitive presentation of a same pair of arms expected to induce a high level of proactive interference (PI) (HIWM task), or a task using a different pair in each trial expected to induce a low level of PI (LIWM task). Performance was effectively lower in the HIWM group than in LIWM in the final trial of each training session, indicative of a “within-session/short-term” PI effect. However, we also observed a different “between-session/long-term” PI effect between the two groups: while performance of LIWM trained rats remained stable over days, the performance of HIWM rats dropped after 10 days of training, and this impairment was visible from the very first trial of the day, hence not attributable to within-session PI. We also showed that a 24 hour-gap across training sessions known to allow consolidation processes to unfold, was a necessary and sufficient condition for the long-term PI effect to occur. These findings suggest that in the HIWM task, WM content was not entirely reset between training sessions and that, in specific conditions, WM content can outlast its purpose by being stored more permanently, generating a long-term deleterious effect of PI. The alternative explanation is that WM content could be transferred and

  10. Cognitive functioning of long-term heavy cannabis users seeking treatment.

    PubMed

    Solowij, Nadia; Stephens, Robert S; Roffman, Roger A; Babor, Thomas; Kadden, Ronald; Miller, Michael; Christiansen, Kenneth; McRee, Bonnie; Vendetti, Janice

    2002-03-06

    Cognitive impairments are associated with long-term cannabis use, but the parameters of use that contribute to impairments and the nature and endurance of cognitive dysfunction remain uncertain. To examine the effects of duration of cannabis use on specific areas of cognitive functioning among users seeking treatment for cannabis dependence. Multisite retrospective cross-sectional neuropsychological study conducted in the United States (Seattle, Wash; Farmington, Conn; and Miami, Fla) between 1997 and 2000 among 102 near-daily cannabis users (51 long-term users: mean, 23.9 years of use; 51 shorter-term users: mean, 10.2 years of use) compared with 33 nonuser controls. Measures from 9 standard neuropsychological tests that assessed attention, memory, and executive functioning, and were administered prior to entry to a treatment program and following a median 17-hour abstinence. Long-term cannabis users performed significantly less well than shorter-term users and controls on tests of memory and attention. On the Rey Auditory Verbal Learning Test, long-term users recalled significantly fewer words than either shorter-term users (P =.001) or controls (P =.005); there was no difference between shorter-term users and controls. Long-term users showed impaired learning (P =.007), retention (P =.003), and retrieval (P =.002) compared with controls. Both user groups performed poorly on a time estimation task (P<.001 vs controls). Performance measures often correlated significantly with the duration of cannabis use, being worse with increasing years of use, but were unrelated to withdrawal symptoms and persisted after controlling for recent cannabis use and other drug use. These results confirm that long-term heavy cannabis users show impairments in memory and attention that endure beyond the period of intoxication and worsen with increasing years of regular cannabis use.

  11. An exotic long-term pattern in stock price dynamics.

    PubMed

    Wei, Jianrong; Huang, Jiping

    2012-01-01

    To accurately predict the movement of stock prices is always of both academic importance and practical value. So far, a lot of research has been reported to help understand the behavior of stock prices. However, some of the existing theories tend to render us the belief that the time series of stock prices are unpredictable on a long-term timescale. The question arises whether the long-term predictability exists in stock price dynamics. In this work, we analyze the price reversals in the US stock market and the Chinese stock market on the basis of a renormalization method. The price reversals are divided into two types: retracements (the downward trends after upward trends) and rebounds (the upward trends after downward trends), of which the intensities are described by dimensionless quantities, R(t) and R(b), respectively. We reveal that for both mature and emerging markets, the distribution of either retracements R(t) or rebounds R(b) shows two characteristic values, 0.335 and 0.665, both of which are robust over the long term. The methodology presented here provides a way to quantify the stock price reversals. Our findings strongly support the existence of the long-term predictability in stock price dynamics, and may offer a hint on how to predict the long-term movement of stock prices.

  12. The Histone Deacetylase HDAC4 Regulates Long-Term Memory in Drosophila

    PubMed Central

    Fitzsimons, Helen L.; Schwartz, Silvia; Given, Fiona M.; Scott, Maxwell J.

    2013-01-01

    A growing body of research indicates that pharmacological inhibition of histone deacetylases (HDACs) correlates with enhancement of long-term memory and current research is concentrated on determining the roles that individual HDACs play in cognitive function. Here, we investigate the role of HDAC4 in long-term memory formation in Drosophila. We show that overexpression of HDAC4 in the adult mushroom body, an important structure for memory formation, resulted in a specific impairment in long-term courtship memory, but had no affect on short-term memory. Overexpression of an HDAC4 catalytic mutant also abolished LTM, suggesting a mode of action independent of catalytic activity. We found that overexpression of HDAC4 resulted in a redistribution of the transcription factor MEF2 from a relatively uniform distribution through the nucleus into punctate nuclear bodies, where it colocalized with HDAC4. As MEF2 has also been implicated in regulation of long-term memory, these data suggest that the repressive effects of HDAC4 on long-term memory may be through interaction with MEF2. In the same genetic background, we also found that RNAi-mediated knockdown of HDAC4 impairs long-term memory, therefore we demonstrate that HDAC4 is not only a repressor of long-term memory, but also modulates normal memory formation. PMID:24349558

  13. Long-term results with the Atlas IIIp elastic cementless acetabular component in total hip replacement.

    PubMed

    Lee, Paul Yuh Feng; Rachala, Madhu; Teoh, Kar Ho; Woodnutt, David John

    2016-09-01

    Modular cementless elastic acetabular systems have advantages over cemented and hard shell cementless acetabular systems. There are few reports on the medium-term and long-term follow up of this particular type of implant. This study describes our experience with the Atlas IIIp modular acetabular system, which is a thin shell cementless elastic acetabular implant for total hip replacement commercialized under this name in many countries. We prospectively followed 244 patients treated with Atlas IIIp acetabular system between 2001 and 2004. Minimum ten year follow up was available for 148 hips (139 patients) from the original cohort of 263 hips (244 patients). One hundred five patients had died from unrelated causes and were excluded from the results. Post-operative and follow up radiographs of patients were assessed; and Harris hip scores were used as clinical outcome. Revision for any reason was defined as the end point for survivorship analysis. The mean pre-operative Harris hip score was 48 (S.D. 16) and the average post-operative score was 82 (S.D. 12). The mean follow up in our series was 11.5 years, ranging from ten to 13.5 years. Thirteen hips required further surgery in our cohort; of which ten cases required cup revision. The 13-years cumulative implant survival was 91.2 % and the risk of implant revision was 8.8 % at 13 years in 148 hips (139 patients). Kaplan-Meier analysis showed the implant survival rate of 95.2 % at ten years for revision for any reason and 99.4 % for aseptic loosening. Our clinical experience with this acetabular cup suggests good long-term survival rates that are similar to other cups on the market. The clinical experience in this study shows long-term survival rates that are consistent, acceptable and good results achieved with a low revision rate. Therapeutic III; therapeutic study.

  14. 26 CFR 1.467-3 - Disqualified leasebacks and long-term agreements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 6 2011-04-01 2011-04-01 false Disqualified leasebacks and long-term agreements... Disqualified leasebacks and long-term agreements. (a) General rule. Under § 1.467-1(d)(2)(i), constant rental... long-term agreement within the meaning of paragraph (b) of this section. Constant rental accrual may...

  15. 26 CFR 1.467-3 - Disqualified leasebacks and long-term agreements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 6 2012-04-01 2012-04-01 false Disqualified leasebacks and long-term agreements... Disqualified leasebacks and long-term agreements. (a) General rule. Under § 1.467-1(d)(2)(i), constant rental... long-term agreement within the meaning of paragraph (b) of this section. Constant rental accrual may...

  16. 26 CFR 1.467-3 - Disqualified leasebacks and long-term agreements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 6 2013-04-01 2013-04-01 false Disqualified leasebacks and long-term agreements... Disqualified leasebacks and long-term agreements. (a) General rule. Under § 1.467-1(d)(2)(i), constant rental... long-term agreement within the meaning of paragraph (b) of this section. Constant rental accrual may...

  17. 26 CFR 1.467-3 - Disqualified leasebacks and long-term agreements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 6 2010-04-01 2010-04-01 false Disqualified leasebacks and long-term agreements... Disqualified leasebacks and long-term agreements. (a) General rule. Under § 1.467-1(d)(2)(i), constant rental... long-term agreement within the meaning of paragraph (b) of this section. Constant rental accrual may...

  18. 26 CFR 1.467-3 - Disqualified leasebacks and long-term agreements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 6 2014-04-01 2014-04-01 false Disqualified leasebacks and long-term agreements... Disqualified leasebacks and long-term agreements. (a) General rule. Under § 1.467-1(d)(2)(i), constant rental... long-term agreement within the meaning of paragraph (b) of this section. Constant rental accrual may...

  19. Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis.

    PubMed

    Jawad, Zaynab A R; Tsim, Nicole; Pai, Madhava; Bansi, Dev; Westaby, David; Vlavianos, Panagiotis; Jiao, Long R

    2016-02-01

    To evaluate the short and long term outcomes of duodenum preserving pancreatic head resection (DPPHR) procedures in the treatment of painful chronic pancreatitis. A systematic literature search was performed to identify all comparative studies evaluating long and short term postoperative outcomes (pain relief, morbidity and mortality, pancreatic exocrine and endocrine function). Five published studies fulfilled the inclusion criteria including 1 randomized controlled trial comparing the Beger and Frey procedure. In total, 323 patients underwent surgical procedures for chronic pancreatitis, including Beger (n = 138) and Frey (n = 99), minimal Frey (n = 32), modified Frey (n = 25) and Berne's modification (n = 29). Two studies comparing the Beger and Frey procedure were entered into a meta-analysis and showed no difference in post-operative pain (RD = -0.06; CI -0.21 to 0.09), mortality (RD = 0.01; CI -0.03 to 0.05), morbidity (RD = 0.12; CI -0.00 to 0.24), exocrine insufficiency (RD = 0.04; CI -0.10 to 0.18) and endocrine insufficiency (RD = -0.14 CI -0.28 to 0.01). All procedures are equally effective for the management of pain for chronic pancreatitis. The choice of procedure should be determined by other factors including the presence of secondary complications of pancreatitis and intra-operative findings. Registration number CRD42015019275. Centre for Reviews and Dissemination, University of York, 2009. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  20. The stability of the international oil trade network from short-term and long-term perspectives

    NASA Astrophysics Data System (ADS)

    Sun, Qingru; Gao, Xiangyun; Zhong, Weiqiong; Liu, Nairong

    2017-09-01

    To examine the stability of the international oil trade network and explore the influence of countries and trade relationships on the trade stability, we construct weighted and unweighted international oil trade networks based on complex network theory using oil trading data between countries from 1996 to 2014. We analyze the stability of international oil trade network (IOTN) from short-term and long-term aspects. From the short-term perspective, we find that the trade volumes play an important role on the stability. Moreover, the weighted IOTN is stable; however, the unweighted networks can better reflect the actual evolution of IOTN. From the long-term perspective, we identify trade relationships that are maintained during the whole sample period to reveal the situation of the whole international oil trade. We provide a way to quantitatively measure the stability of complex network from short-term and long-term perspectives, which can be applied to measure and analyze trade stability of other goods or services.

  1. Long Term Illness and Wages

    ERIC Educational Resources Information Center

    Sandy, Robert; Elliott, Robert R.

    2005-01-01

    Long-term illness (LTI) is a more prevalent workplace risk than fatal accidents but there is virtually no evidence for compensating differentials for a broad measure of LTI. In 1990 almost 3.4 percent of the U.K. adult population suffered from a LTI caused solely by their working conditions. This paper provides the first estimates of compensating…

  2. Tetracycline sclerotherapy of hydroceles and epididymal cysts. Long-term results.

    PubMed

    Honnens de Lichtenberg, M; Miskowiak, J; Krogh, J

    1990-01-01

    Fourty patients with 32 hydroceles and 11 epididymal cysts were treated by aspiration and instillation of tetracycline. After a follow up period of 24-39 months the cure rate was 77%. Most of the early recurrences were the results of chemical inflammation and vanished spontaneously. This group should therefore not be operated on until three months after their initial treatment. As aspiration of the fluid had allowed palpation of the testis and cytological examination, only a small proportion of patients with recurrences wanted further treatment. We therefore recommend tetracycline sclerotherapy because it is quick, easy, safe, and effective in the long as well as the short term.

  3. Mechanisms of Translation Control Underlying Long-lasting Synaptic Plasticity and the Consolidation of Long-term Memory

    PubMed Central

    Santini, Emanuela; Huynh, Thu N.; Klann, Eric

    2018-01-01

    The complexity of memory formation and its persistence is a phenomenon that has been studied intensely for centuries. Memory exists in many forms and is stored in various brain regions. Generally speaking, memories are reorganized into broadly distributed cortical networks over time through systems level consolidation. At the cellular level, storage of information is believed to initially occur via altered synaptic strength by processes such as long-term potentiation (LTP). New protein synthesis is required for long-lasting synaptic plasticity as well as for the formation of long-term memory. The mammalian target of rapamycin complex 1 (mTORC1) is a critical regulator of cap-dependent protein synthesis and is required for numerous forms of long-lasting synaptic plasticity and long-term memory. As such, the study of mTORC1 and protein factors that control translation initiation and elongation have enhanced our understanding of how the process of protein synthesis is regulated during memory formation. Herein we will discuss the molecular mechanisms that regulate protein synthesis as well as pharmacological and genetic manipulations that demonstrate the requirement for proper translational control in long-lasting synaptic plasticity and long-term memory formation. PMID:24484700

  4. Overview of developing desired conditions: Short-term actions, long-term objectives

    Treesearch

    J. D. Chew; K. O' Hara; J. G. Jones

    2001-01-01

    A number of modeling tools are required to go from short-term treatments to long-term objectives expressed as desired future conditions. Three models are used in an example that starts with determining desired stand level structure and ends with the implementation of treatments over time at a landscape scale. The Multi-Aged Stocking Assessment Model (MASAM) is used for...

  5. Long-term weather predictability: Ural case study

    NASA Astrophysics Data System (ADS)

    Kubyshen, Alexander; Shopin, Sergey

    2016-04-01

    The accuracy of the state-of-the-art long-term meteorological forecast (at the seasonal level) is still low. Here it is presented approach (RAMES method) realizing different forecasting methodology. It provides prediction horizon of up to 19-22 years under equal probabilities of determination of parameters in every analyzed period [1]. Basic statements of the method are the following. 1. Long-term forecast on the basis of numerical modeling of the global meteorological process is principally impossible. Extension of long-term prediction horizon could be obtained only by the revealing and using a periodicity of meteorological situations at one point of observation. 2. Conventional calendar is unsuitable for generalization of meteorological data and revealing of cyclicity of meteorological processes. RAMES method uses natural time intervals: one day, synodic month and one year. It was developed a set of special calendars using these natural periods and the Metonic cycle. 3. Long-term time series of meteorological data is not a uniform universal set, it is a sequence of 28 universal sets appropriately superseding each other in time. The specifics of the method are: 1. Usage of the original research toolkit consisting of - a set of calendars based on the Metonic cycle; - a set of charts (coordinate systems) for the construction of sequence diagrams (of daily variability of a meteorological parameter during the analyzed year; of daily variability of a meteorological parameter using long-term dynamical time series of periods-analogues; of monthly and yearly variability of accumulated value of meteorological parameter). 2. Identification and usage of new virtual meteorological objects having several degrees of generalization appropriately located in the used coordinate systems. 3. All calculations are integrated into the single technological scheme providing comparison and mutual verification of calculation results. During the prolonged testing in the Ural region, it was

  6. [Long-term 10-year outcome after chemonucleolysis for lumbar disc herniation].

    PubMed

    Aribit, F; Charissoux, J L; Arnaud, J P

    2002-05-01

    We studied the efficacy of papaine for treatment of herniated discs at a mean 10-year follow-up and compared results with other series and other treatments. From an initial group of 160 patients, 96 patients, 53 men and 43 women, mean age 39 years, were selected for evaluation. These patients had 46 L4L5 herniations and 50 L5S1 herniations. All 96 patients were operated in the same department and received the same dose of papaine under the same anesthesia conditions. All patients were followed regularly to 3 months postoperatively then were reviewed 3 to 17 years after surgery. Inquiries were made about return to work, pain, and activity. Physical examination and x-rays were obtained for all patients. There were no neurological complications in our series. Seventeen patients required a second procedure for sciatic pain. Most of the patients continued their normal occupational and social activities after papaine treatment, but many of them had chronic lumbar pain. Our results were comparable with series reporting a similar long follow-up. Surgery is more efficient than papaine but long-term results are equivalent. Chemopapaine treatment provided good long-term results in our patients, similar to surgery. Chemonucleolysis may be employed as first line treatment for young patients with non-excluded disc herniation with sciatic pain.

  7. Long-term results of in situ saphenous vein bypass. Analysis of 2058 cases.

    PubMed Central

    Shah, D M; Darling, R C; Chang, B B; Fitzgerald, K M; Paty, P S; Leather, R P

    1995-01-01

    OBJECTIVE: The authors evaluated the long-term patency and outcome of patients undergoing infrainguinal reconstruction using the in situ saphenous vein. SUMMARY BACKGROUND DATA: The in situ saphenous vein bypass has demonstrated excellent patency and limb salvage rates in numerous studies. The authors previously reported their early results with these bypass procedures, and this article represents their long-term experience with 2058 in situ saphenous vein bypasses during a 20-year period. This comprises the largest series with long-term follow-up of in situ saphenous vein bypasses in the literature. METHODS: From 1975 to 1995, 3148 autogenous vein bypasses were performed at the authors' institution, of which 2058 used the saphenous vein in situ. The indication for operation was limb-threatening ischemia in 1875 of 2058 patients (91%). In 88% of patients with an intact ipsilateral saphenous vein, an in situ bypass was completed successfully. One thousand twenty-three bypasses (69%) were terminated at the infrapopliteal level. Of these bypasses, 1562 of 2058 (76%) were completed using the closed in situ technique. RESULTS: The 30-day patency rate was 96%, and the cumulative secondary patency was 91%, 81%, and 70% at 1, 5, and 10 years, respectively. Limb salvage rates using the in situ bypass were 97%, 95%, and 90% at 1, 5, and 10 years, respectively. CONCLUSION: The infrainguinal inflow source, length of bypass, specific outflow vessel, or vein diameter did not have a significant effect on immediate or long-term bypass performance. These data suggest that the in situ saphenous vein is an excellent conduit for femoropopliteal and femoral to infrageniculate bypasses for limb salvage. PMID:7574925

  8. Murine model of long-term obstructive jaundice.

    PubMed

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-11-01

    With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Overall, 70% (7 of 10) of tCL mice died by day 7, whereas majority 67% (10 of 15) of pCL mice survived with loss of jaundice. A total of 19% (3 of 16) of LMHL mice died; however, jaundice continued beyond day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 d after ligation but jaundice rapidly decreased by day 7. The LHML group developed portal hypertension and severe fibrosis by day 14 in addition to prolonged jaundice. The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice, but long-term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Teen motherhood and long-term health consequences.

    PubMed

    Patel, Payal H; Sen, Bisakha

    2012-07-01

    The objective of this article is to examine the association of teen motherhood and long-term physical and mental health outcomes. The physical and mental health components (PCS and MCS) of the SF-12 Healthy Survey in the NLSY79 health module were used to assess long-term health outcomes of women who experienced teenage motherhood. Various familial, demographic, and environmental characteristics were indentified and controlled for that may have predicted teen motherhood and long-term health outcomes. The two comparison groups for teen mothers were women who experienced teen-pregnancy only and women who were engaged in unprotected sexual activity as a teenage but did not experience pregnancy. Multivariate ordinary least squares regression was used for analysis. The average PCS and MCS for teen mothers was 49.91 and 50.89, respectively. Teen mothers exhibited poorer physical health later in life compared to all women as well as the comparison groups. When controlling for age, teen mothers had significantly lower PCS and MCS scores compared to all other women. Furthermore, when controlling for familial, demographic, and environmental characteristics, teen mothers exhibited significantly lower PCS and MCS scores. When comparing teen mothers to the two comparison groups, PCS was not statistically different although MCS was significantly lower in the teen-pregnancy group. Teen motherhood does lead to poorer physical health outcomes later in life. On the other hand, poorer mental health outcomes in later life may be attributed to the unmeasured factors leading to a teen pregnancy and not teen motherhood itself. Additional research needs to be conducted on the long-term consequences of teen motherhood.

  10. Visual working memory buffers information retrieved from visual long-term memory

    PubMed Central

    Fukuda, Keisuke; Woodman, Geoffrey F.

    2017-01-01

    Human memory is thought to consist of long-term storage and short-term storage mechanisms, the latter known as working memory. Although it has long been assumed that information retrieved from long-term memory is represented in working memory, we lack neural evidence for this and need neural measures that allow us to watch this retrieval into working memory unfold with high temporal resolution. Here, we show that human electrophysiology can be used to track information as it is brought back into working memory during retrieval from long-term memory. Specifically, we found that the retrieval of information from long-term memory was limited to just a few simple objects’ worth of information at once, and elicited a pattern of neurophysiological activity similar to that observed when people encode new information into working memory. Our findings suggest that working memory is where information is buffered when being retrieved from long-term memory and reconcile current theories of memory retrieval with classic notions about the memory mechanisms involved. PMID:28461479

  11. The roles of long-term phonotactic and lexical prosodic knowledge in phonological short-term memory.

    PubMed

    Tanida, Yuki; Ueno, Taiji; Lambon Ralph, Matthew A; Saito, Satoru

    2015-04-01

    Many previous studies have explored and confirmed the influence of long-term phonological representations on phonological short-term memory. In most investigations, phonological effects have been explored with respect to phonotactic constraints or frequency. If interaction between long-term memory and phonological short-term memory is a generalized principle, then other phonological characteristics-that is, suprasegmental aspects of phonology-should also exert similar effects on phonological short-term memory. We explored this hypothesis through three immediate serial-recall experiments that manipulated Japanese nonwords with respect to lexical prosody (pitch-accent type, reflecting suprasegmental characteristics) as well as phonotactic frequency (reflecting segmental characteristics). The results showed that phonotactic frequency affected the retention not only of the phonemic sequences, but also of pitch-accent patterns, when participants were instructed to recall both the phoneme sequence and accent pattern of nonwords. In addition, accent pattern typicality influenced the retention of the accent pattern: Typical accent patterns were recalled more accurately than atypical ones. These results indicate that both long-term phonotactic and lexical prosodic knowledge contribute to phonological short-term memory performance.

  12. Long-Term Effects of Atrial Ganglionated Plexi Ablation on Function and Structure of Sinoatrial and Atrioventricular Node in Canine.

    PubMed

    Zhang, Ming; Wang, Ximin; Xie, Xinxing; Wang, Zhongsu; Liu, Xiaoyan; Guan, Juan; Wang, Weizong; Li, Zhan; Wang, Jiangrong; Gao, Mei; Hou, Yinglong

    2015-10-01

    Long-term effects of ganglionated plexi (GP) ablation on sinoatrial node (SAN) and atrioventricular node (AVN) remain unclear. This study is to investigate the long-term effects of ablation of cardiac anterior right GP (ARGP) and inferior right GP (IRGP) on function and structure of SAN and AVN in canine. Thirty-two dogs were randomly divided into an operated group (n = 24) and sham-operated group (n = 8). ARGP and IRGP were ablated in operated group which was randomly divided into three subgroups according to the period of evaluation after operation (1 month, 6 months, 12 months). The functional and histological characteristics of SAN and AVN, as well as the expression of connexin (Cx) 43 and Cx 45 in SAN and AVN, were evaluated before and after ablation. Resting heart rate was increased and AVN effective refractory period was prolonged and sinus node recovery time (SNRT) and corrected SNRT were shortened immediately after ablation. These changes were reverted to preablation level after 1 month. At 1 month, ventricular rate during atrial fibrillation was slowed, atria-His intervals were prolonged, and Cx43 and Cx45 expression in SAN and AVN were downregulated. At 6 months, all changes were reverted to preablation level. The histological characteristics of SAN and AVN did not change. Ablation of ARGP and IRGP has short-term effects on function and structure of SAN and AVN rather than long-term effects, which suggests that ablation of ARGP and IRGP is safe. Atrioventricular conduction dysfunction after ablation may be related to downregulated Cx43 and Cx45 expression in AVN. © 2015 Wiley Periodicals, Inc.

  13. Long-term management of patients with multiple sclerosis.

    PubMed

    Weightman, Cherie

    2006-07-01

    This article explores the challenges of long-term case management for patients who have multiple sclerosis (MS). Currently there is scant research into district nursing input into long-term management of patients who have MS. Until now the role of the community nurses has been confined to palliation or terminal care, focusing on the more physical manifestations of MS. The contemporary role of district nurse is going to evolve to include proactive approaches. Governmental initiatives demand proactive services, and place emphasis on self-care for patients with MS. Themes that emerge from this article relate to the pre-existing skills--such as managing patients with complex needs and the advanced assessment skills--that will be required to achieve this. What is clear is that community nurses already possess many of the prerequisite skills needed for long-term management, and they should not be daunted by this prospect.

  14. Long-term survivors of primary central nervous system lymphoma.

    PubMed

    Yamanaka, Ryuya; Morii, Ken; Sano, Masakazu; Homma, Jumpei; Yajima, Naoki; Tsukamoto, Yoshihiro; Ogura, Ryouske; Natsumeda, Manabu; Aoki, Hiroshi; Akiyama, Katsuhiko; Saitoh, Takafumi; Hondoh, Hiroaki; Kawaguchi, Atsushi; Takahashi, Hitoshi; Fujii, Yukihiko

    2017-02-23

    In this study, we provide long-term outcome data of patients with primary central nervous system lymphoma. The long-term outcomes of PCNSL patients diagnosed between 1982 and 2006 were reviewed. Neurological late neurotoxicity symptoms, neuroradiological brain atrophy and leukoencephalopathy were evaluated. Surviving patients completed the Quality of Life Questionnaire-30 and Brain Cancer Module-20. The differences in overall survival were assessed using the Kaplan-Meier method and log-rank test. The differences between groups in terms of each investigated parameter were analyzed using the Wilcoxon signed-rank test. Among 112 PCNSL patients, there were 33 (29.4%) long-term (> 5 years) survivors. The median survival of all long-term survivors was 105.7 months; of these, 8 (7.1%) were alive at the latest follow-up, with a mean survival time of 170.2 months (range, 121.8–286.4). Clinical assessment revealed severe neurotoxicity in 14 patients (42.4%), moderate neurotoxicity in 5 (15.1%), and normal status in 14 (42.4%). Correlations were seen between the neuroradiological imaging score changes and neurocognitive condition (P=0.0001), neurocognitive condition and the whole brain irradiation dose (P=0.0004), and atrophy and the whole brain irradiation dose (P=0.0035). A more severe clinical condition was found to be associated with increasing age and whole brain irradiation dose in long-term survivors with PCNSL. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  15. Recognition of predictors for mid-long term runoff prediction based on lasso

    NASA Astrophysics Data System (ADS)

    Xie, S.; Huang, Y.

    2017-12-01

    Reliable and accuracy mid-long term runoff prediction is of great importance in integrated management of reservoir. And many methods are proposed to model runoff time series. Almost all forecast lead times (LT) of these models are 1 month, and the predictors are previous runoff with different time lags. However, runoff prediction with increased LT, which is more beneficial, is not popular in current researches. It is because the connection between previous runoff and current runoff will be weakened with the increase of LT. So 74 atmospheric circulation factors (ACFs) together with pre-runoff are used as alternative predictors for mid-long term runoff prediction of Longyangxia reservoir in this study. Because pre-runoff and 74 ACFs with different time lags are so many and most of these factors are useless, lasso, which means `least absolutely shrinkage and selection operator', is used to recognize predictors. And the result demonstrates that 74 ACFs are beneficial for runoff prediction in both validation and test sets when LT is greater than 6. And there are 6 factors other than pre-runoff, most of which are with big time lag, are selected as predictors frequently. In order to verify the effect of 74 ACFs, 74 stochastic time series generated from normalized 74 ACFs are used as input of model. The result shows that these 74 stochastic time series are useless, which confirm the effect of 74 ACFs on mid-long term runoff prediction.

  16. A Mössbauer spectral study of degradation in La 0.58Sr 0.4Fe 0.5Co 0.5O 3–x after long-term operation in solid oxide electrolysis cells

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

    Mahmoud, Abdelfattah; Daroukh, Mahmoud Al; Lipinska-Chwalek, Marta

    Here, degradation processes of oxygen electrodes in solid oxide electrolysis cells (SOECs) were studied by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Mössbauer spectroscopy. La 0.58Sr 0.4Fe 0.5Co 0.5O 3–x (LSCF) anodes (oxygen electrode) were analyzed after different long-term operations durations of 1774, 6100 and 9000 h. The results were compared with a cell in the initial state. Besides the LSCF anode, the SOECs were composed of a Ce 0.8Gd 0.2O 1.9 barrier layer between the anode and electrolyte, yttria-stabilized zirconia (YSZ) as electrolyte and Ni-YSZ as cathode (hydrogen electrode). Mössbauer spectra of the iron-containingmore » anode were acquired in order to determine the alteration of the iron oxidation state and its local environment during operation. Mössbauer spectroscopy yields indirect information about the degradation mechanism, especially in combination with SEM, TEM, and XRD. XRD and TEM revealed the appearance of Co 3O 4 during the SOEC operation and SEM analyses confirmed the formation of SrZrO 3 at the electrode/electrolyte interface. The spectral analysis confirmed the reduction of iron from Fe(IV) to Fe(III) in LSCF after long-term operation. The fraction of Fe(IV) in the electrode decreased with time and 18, 15, 13 and 11% were obtained for 0, 1774, 6100, and 9000 h of operation, respectively.« less

  17. A Mössbauer spectral study of degradation in La 0.58Sr 0.4Fe 0.5Co 0.5O 3–x after long-term operation in solid oxide electrolysis cells

    DOE PAGES

    Mahmoud, Abdelfattah; Daroukh, Mahmoud Al; Lipinska-Chwalek, Marta; ...

    2017-10-21

    Here, degradation processes of oxygen electrodes in solid oxide electrolysis cells (SOECs) were studied by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Mössbauer spectroscopy. La 0.58Sr 0.4Fe 0.5Co 0.5O 3–x (LSCF) anodes (oxygen electrode) were analyzed after different long-term operations durations of 1774, 6100 and 9000 h. The results were compared with a cell in the initial state. Besides the LSCF anode, the SOECs were composed of a Ce 0.8Gd 0.2O 1.9 barrier layer between the anode and electrolyte, yttria-stabilized zirconia (YSZ) as electrolyte and Ni-YSZ as cathode (hydrogen electrode). Mössbauer spectra of the iron-containingmore » anode were acquired in order to determine the alteration of the iron oxidation state and its local environment during operation. Mössbauer spectroscopy yields indirect information about the degradation mechanism, especially in combination with SEM, TEM, and XRD. XRD and TEM revealed the appearance of Co 3O 4 during the SOEC operation and SEM analyses confirmed the formation of SrZrO 3 at the electrode/electrolyte interface. The spectral analysis confirmed the reduction of iron from Fe(IV) to Fe(III) in LSCF after long-term operation. The fraction of Fe(IV) in the electrode decreased with time and 18, 15, 13 and 11% were obtained for 0, 1774, 6100, and 9000 h of operation, respectively.« less

  18. Long-term Morbidity of Testicular Cancer Treatment.

    PubMed

    Fung, Chunkit; Fossa, Sophie D; Williams, Annalynn; Travis, Lois B

    2015-08-01

    Second malignant neoplasms, cardiovascular disease, neurotoxicity and ototoxicity, pulmonary complications, hypogonadism, and nephrotoxicity are potentially life-threatening long-term complications of testicular cancer and its therapy. This article describes the pathogenesis, risks, and management of these late effects experienced by long-term testicular cancer survivors, who are defined as individuals who are disease free 5 years or more after primary treatment. Testicular cancer survivors should follow applicable national guidelines for cancer screening and management of cardiovascular disease risk factors. In addition, health care providers should capitalize on the time of cancer diagnosis as a teachable moment to introduce and promote lifestyle changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Long-term penile morphometric alterations in patients treated with robot-assisted versus open radical prostatectomy.

    PubMed

    Capogrosso, P; Ventimiglia, E; Cazzaniga, W; Stabile, A; Pederzoli, F; Boeri, L; Gandaglia, G; Dehò, F; Briganti, A; Montorsi, F; Salonia, A

    2018-01-01

    Neglected side effects after radical prostatectomy have been previously reported. In this context, the prevalence of penile morphometric alterations has never been assessed in robot-assisted radical prostatectomy series. We aimed to assess prevalence of and predictors of penile morphometric alterations (i.e. penile shortening or penile morphometric deformation) at long-term follow-up in patients submitted to either robot-assisted (robot-assisted radical prostatectomy) or open radical prostatectomy. Sexually active patients after either robot-assisted radical prostatectomy or open radical prostatectomy prospectively completed a 28-item questionnaire, with sensitive issues regarding sexual function, namely orgasmic functioning, climacturia and changes in morphometric characteristics of the penis. Only patients with a post-operative follow-up ≥ 24 months were included. Patients submitted to either adjuvant or salvage therapies or those who refused to comprehensively complete the questionnaire were excluded from the analyses. A propensity-score matching analysis was implemented to control for baseline differences between groups. Logistic regression models tested potential predictors of penile morphometric alterations at long-term post-operative follow-up. Overall, 67 (50%) and 67 (50%) patients were included after open radical prostatectomy or robot-assisted radical prostatectomy, respectively. Self-rated post-operative penile shortening and penile morphometric deformation were reported by 75 (56%) and 29 (22.8%) patients, respectively. Rates of penile shortening and penile morphometric deformation were not different after open radical prostatectomy and robot-assisted radical prostatectomy [all p > 0.5]. At univariable analysis, self-reported penile morphometric alterations (either penile shortening or penile morphometric deformation) were significantly associated with baseline international index of erectile function-erectile function scores, body mass index, post-operative

  20. Long-Term Retention of Basic Science Knowledge: A Review Study

    ERIC Educational Resources Information Center

    Custers, Eugene J. F. M.

    2010-01-01

    In this paper, a review of long-term retention of basic science knowledge is presented. First, it is argued that retention of this knowledge has been a long-standing problem in medical education. Next, three types of studies are described that are employed in the literature to investigate long-term retention of knowledge in general. Subsequently,…

  1. Winning market positioning strategies for long term care facilities.

    PubMed

    Higgins, L F; Weinstein, K; Arndt, K

    1997-01-01

    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

  2. Ethics and Intimate Sexual Activity in Long-Term Care.

    PubMed

    Metzger, Eran

    2017-07-01

    A case is presented in which the staff of a long-term care facility discovers that the husband of a resident with dementia is engaged in sexual activity with her. The case illustrates a dilemma for long-term care facilities that create a home-like environment with a goal of maximizing residents' autonomy while ensuring their safety. An approach to assessing capacity to consent to intimate sexual activity is described, followed by guidelines that nursing homes can implement to support residents who wish to engage in sexual activity. Recommendations are also offered for supporting long-term care staff and family members of residents who are interested in intimate sexual activity. © 2017 American Medical Association. All Rights Reserved.

  3. Short-term and long-term effects of violent media on aggression in children and adults.

    PubMed

    Bushman, Brad J; Huesmann, L Rowell

    2006-04-01

    To test whether the results of the accumulated studies on media violence and aggressive behavior are consistent with the theories that have evolved to explain the effects. We tested for the existence of both short-term and long-term effects for aggressive behavior. We also tested the theory-driven hypothesis that short-term effects should be greater for adults and long-term effects should be greater for children. Meta-analysis. Children younger than 18 years and adults. Violent media, including TV, movies, video games, music, and comic books. Measures of aggressive behavior, aggressive thoughts, angry feelings, physiological arousal (eg, heart rate, blood pressure), and helping behavior. Effect size estimates were combined using meta-analytic procedures. As expected, the short-term effects of violent media were greater for adults than for children whereas the long-term effects were greater for children than for adults. The results also showed that there were overall modest but significant effect sizes for exposure to media violence on aggressive behaviors, aggressive thoughts, angry feelings, arousal levels, and helping behavior. The results are consistent with the theory that short-term effects are mostly due to the priming of existing well-encoded scripts, schemas, or beliefs, which adults have had more time to encode. In contrast, long-term effects require the learning (encoding) of scripts, schemas, or beliefs. Children can encode new scripts, schemas, and beliefs via observational learning with less interference and effort than adults.

  4. Insulin signaling is acutely required for long-term memory in Drosophila.

    PubMed

    Chambers, Daniel B; Androschuk, Alaura; Rosenfelt, Cory; Langer, Steven; Harding, Mark; Bolduc, Francois V

    2015-01-01

    Memory formation has been shown recently to be dependent on energy status in Drosophila. A well-established energy sensor is the insulin signaling (InS) pathway. Previous studies in various animal models including human have revealed the role of insulin levels in short-term memory but its role in long-term memory remains less clear. We therefore investigated genetically the spatial and temporal role of InS using the olfactory learning and long-term memory model in Drosophila. We found that InS is involved in both learning and memory. InS in the mushroom body is required for learning and long-term memory whereas long-term memory specifically is impaired after InS signaling disruption in the ellipsoid body, where it regulates the level of p70s6k, a downstream target of InS and a marker of protein synthesis. Finally, we show also that InS is acutely required for long-term memory formation in adult flies.

  5. Private Long-Term Care Insurance: Value to Claimants and Implications for Long-Term Care Financing

    ERIC Educational Resources Information Center

    Doty, Pamela; Cohen, Marc A.; Miller, Jessica; Shi, Xiaomei

    2010-01-01

    Purpose: The purpose of this study was to obtain a profile of individuals with private long-term care (LTC) insurance as they begin using paid LTC services and track their patterns of service use, satisfaction with services and insurance, claims denial rates, and transitions over a 28-month period. Design and Methods: Ten LTC insurance companies…

  6. Neural correlates of long-term intense romantic love.

    PubMed

    Acevedo, Bianca P; Aron, Arthur; Fisher, Helen E; Brown, Lucy L

    2012-02-01

    The present study examined the neural correlates of long-term intense romantic love using functional magnetic resonance imaging (fMRI). Ten women and 7 men married an average of 21.4 years underwent fMRI while viewing facial images of their partner. Control images included a highly familiar acquaintance; a close, long-term friend; and a low-familiar person. Effects specific to the intensely loved, long-term partner were found in: (i) areas of the dopamine-rich reward and basal ganglia system, such as the ventral tegmental area (VTA) and dorsal striatum, consistent with results from early-stage romantic love studies; and (ii) several regions implicated in maternal attachment, such as the globus pallidus (GP), substantia nigra, Raphe nucleus, thalamus, insular cortex, anterior cingulate and posterior cingulate. Correlations of neural activity in regions of interest with widely used questionnaires showed: (i) VTA and caudate responses correlated with romantic love scores and inclusion of other in the self; (ii) GP responses correlated with friendship-based love scores; (iii) hypothalamus and posterior hippocampus responses correlated with sexual frequency; and (iv) caudate, septum/fornix, posterior cingulate and posterior hippocampus responses correlated with obsession. Overall, results suggest that for some individuals the reward-value associated with a long-term partner may be sustained, similar to new love, but also involves brain systems implicated in attachment and pair-bonding.

  7. Neural correlates of long-term intense romantic love

    PubMed Central

    Aron, Arthur; Fisher, Helen E.; Brown, Lucy L.

    2012-01-01

    The present study examined the neural correlates of long-term intense romantic love using functional magnetic resonance imaging (fMRI). Ten women and 7 men married an average of 21.4 years underwent fMRI while viewing facial images of their partner. Control images included a highly familiar acquaintance; a close, long-term friend; and a low-familiar person. Effects specific to the intensely loved, long-term partner were found in: (i) areas of the dopamine-rich reward and basal ganglia system, such as the ventral tegmental area (VTA) and dorsal striatum, consistent with results from early-stage romantic love studies; and (ii) several regions implicated in maternal attachment, such as the globus pallidus (GP), substantia nigra, Raphe nucleus, thalamus, insular cortex, anterior cingulate and posterior cingulate. Correlations of neural activity in regions of interest with widely used questionnaires showed: (i) VTA and caudate responses correlated with romantic love scores and inclusion of other in the self; (ii) GP responses correlated with friendship-based love scores; (iii) hypothalamus and posterior hippocampus responses correlated with sexual frequency; and (iv) caudate, septum/fornix, posterior cingulate and posterior hippocampus responses correlated with obsession. Overall, results suggest that for some individuals the reward-value associated with a long-term partner may be sustained, similar to new love, but also involves brain systems implicated in attachment and pair-bonding. PMID:21208991

  8. Assessing the associative deficit of older adults in long-term and short-term/working memory.

    PubMed

    Chen, Tina; Naveh-Benjamin, Moshe

    2012-09-01

    Older adults exhibit a deficit in associative long-term memory relative to younger adults. However, the literature is inconclusive regarding whether this deficit is attenuated in short-term/working memory. To elucidate the issue, three experiments assessed younger and older adults' item and interitem associative memory and the effects of several variables that might potentially contribute to the inconsistent pattern of results in previous studies. In Experiment 1, participants were tested on item and associative recognition memory with both long-term and short-term retention intervals in a single, continuous recognition paradigm. There was an associative deficit for older adults in the short-term and long-term intervals. Using only short-term intervals, Experiment 2 utilized mixed and blocked test designs to examine the effect of test event salience. Blocking the test did not attenuate the age-related associative deficit seen in the mixed test blocks. Finally, an age-related associative deficit was found in Experiment 3, under both sequential and simultaneous presentation conditions. Even while accounting for some methodological issues, the associative deficit of older adults is evident in short-term/working memory.

  9. Variable Renewable Energy in Long-Term Planning Models: A Multi-Model Perspective

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

    Cole, Wesley J.; Frew, Bethany A.; Mai, Trieu T.

    Long-term capacity expansion models of the U.S. electricity sector have long been used to inform electric sector stakeholders and decision makers. With the recent surge in variable renewable energy (VRE) generators - primarily wind and solar photovoltaics - the need to appropriately represent VRE generators in these long-term models has increased. VRE generators are especially difficult to represent for a variety of reasons, including their variability, uncertainty, and spatial diversity. To assess current best practices, share methods and data, and identify future research needs for VRE representation in capacity expansion models, four capacity expansion modeling teams from the Electric Powermore » Research Institute, the U.S. Energy Information Administration, the U.S. Environmental Protection Agency, and the National Renewable Energy Laboratory conducted two workshops of VRE modeling for national-scale capacity expansion models. The workshops covered a wide range of VRE topics, including transmission and VRE resource data, VRE capacity value, dispatch and operational modeling, distributed generation, and temporal and spatial resolution. The objectives of the workshops were both to better understand these topics and to improve the representation of VRE across the suite of models. Given these goals, each team incorporated model updates and performed additional analyses between the first and second workshops. This report summarizes the analyses and model 'experiments' that were conducted as part of these workshops as well as the various methods for treating VRE among the four modeling teams. The report also reviews the findings and learnings from the two workshops. We emphasize the areas where there is still need for additional research and development on analysis tools to incorporate VRE into long-term planning and decision-making.« less

  10. 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…

  11. Long-Term Recency in Anterograde Amnesia

    PubMed Central

    Talmi, Deborah; Caplan, Jeremy B.; Richards, Brian; Moscovitch, Morris

    2015-01-01

    Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant’s recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation. PMID:26046770

  12. The Long-Term Public Health Benefits of Breastfeeding.

    PubMed

    Binns, Colin; Lee, MiKyung; Low, Wah Yun

    2016-01-01

    Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer. © 2015 APJPH.

  13. Factors important in the purchase of partnership long-term care insurance.

    PubMed

    McCall, N; Mangle, S; Bauer, E; Knickman, J

    1998-06-01

    To understand the factors important in the purchase of long-term care insurance through the Robert Wood Johnson Foundation Partnership for Long-Term Care. Information on the Partnership programs, telephone surveys, data on Partnership purchasers, and random sample frames. Logistic regression analysis is used to examine characteristics associated with the purchase of a Partnership insurance policy. Independent variables are health status, demographic and financial characteristics, knowledge, and attitudes. A telephone survey of Partnership purchasers and a random sample of the population in each Partnership state were conducted. Survey questions included health status, opinions about long-term care and long-term care insurance, financial planning, demographic characteristics, and income and assets. Important in the purchase of a Partnership policy were variables associated with education and knowledge about long-term care. Other important factors include attitudes and health status. Partnership purchase is associated with higher income and asset levels up to a point, with the effect plateauing and decreasing at the highest income and asset levels. Improved education and knowledge are important in increasing long-term care insurance purchase. Attitudes about having a caregiver, and about the government's role in paying for long-term care as well as the potential purchaser's willingness to consider nursing home care affect policy purchase. Also associated with Partnership policy purchase are better health and middle income and asset levels.

  14. Long-term follow-up of the surgical management of neuropathic arthropathy of the spine.

    PubMed

    Haus, Brian M; Hsu, Andrew R; Yim, Eugene S; Meter, Jeffrey J; Rinsky, Lawrence A

    2010-06-01

    No studies have discussed the long-term surgical management and outcomes of Charcot arthropathy of the spine. This case series presents nine patients treated over 30 years. The study hypothesis was that surgery would reduce instability, pain, recurrence, and the need for revision surgery in the long-term, given previous study findings of successful fusion of Charcot spine in the short-term. To evaluate the long-term outcomes of surgery for Charcot spine. Retrospective case series. Cases took place at Stanford University Medical Center and Santa Clara Valley Medical Center. All patients had either complete paraplegia or dense paraparesis with both major motor and sensory deficits. Seven patients developed Charcot spine after spinal instrumentation for trauma, one after scoliosis repair for meningomyelocele, and one after spinal instrumentation for neuromuscular scoliosis caused by birth injury resulting in C6-C7 quadraplegia. Average time between initial instrumentation and development of Charcot spine was 7.6 years. Two patients underwent posterior fusion alone, six had anterior-posterior fusion, and one was managed with thoracolumbar orthosis. Average follow-up was 14.3 years. Revisions were necessary in 75% (6 of 8) of patients for complications including nonunion, new Charcot joints, recurrent hardware failure, and osteomyelitis. Achieving fusion often required multiple operations, and there were no deaths or neurologic complications. Long-term follow-up showed a high rate of revision surgery. Solid fusions often resulted in late breakdown or new junctional Charcot arthropathies. Patients initially fused to the lumbar spine instead of the sacrum or pelvis had a higher rate of developing another Charcot joint. Fusion was often difficult with persistent nonunions and functional deficits because of decreased mobility. We recommend that Charcot spine well tolerated without skin, seating problems, or dysreflexia should be cautiously observed with conservative

  15. Child maltreatment: pathway to chronic and long-term conditions?

    PubMed

    Taylor, Julie; Bradbury-Jones, Caroline; Lazenbatt, Anne; Soliman, Francesca

    2016-09-01

    The manifesto Start Well, Live Better by the UK Faculty of Public Health (Start Well, Live Better-A Manifesto for the Public's Health. London: UK Faculty of Public Health, 2014) sets out 12 compelling priorities for the protection of people's health. The focus of this document is preventative, calling for a comprehensive strategy to target a wide-ranging set of challenges to public health; however, it fails to mention child maltreatment and its negative impact on long-term health outcomes. In this article, we explore the long-term negative consequences of child maltreatment and how these can be conceptually aligned with four different characteristics of long-term health conditions. We suggest that situating child maltreatment within a long-term conditions framework could have significant advantages and implications for practice, policy and research, by strengthening a commitment across disciplines to apply evidence-based principles linked with policy and evaluation and recognizing the chronic effects of maltreatment to concentrate public, professional and government awareness of the extent and impact of the issue. We argue that a public health approach is the most effective way of focusing preventative efforts on the long-term sequelae of child maltreatment and to foster cooperation in promoting children's rights to grow and develop in a safe and caring environment free from violence and abuse. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Short and long-term energy intake patterns and their implications for human body weight regulation.

    PubMed

    Chow, Carson C; Hall, Kevin D

    2014-07-01

    Adults consume millions of kilocalories over the course of a few years, but the typical weight gain amounts to only a few thousand kilocalories of stored energy. Furthermore, food intake is highly variable from day to day and yet body weight is remarkably stable. These facts have been used as evidence to support the hypothesis that human body weight is regulated by active control of food intake operating on both short and long time scales. Here, we demonstrate that active control of human food intake on short time scales is not required for body weight stability and that the current evidence for long term control of food intake is equivocal. To provide more data on this issue, we emphasize the urgent need for developing new methods for accurately measuring energy intake changes over long time scales. We propose that repeated body weight measurements can be used along with mathematical modeling to calculate long-term changes in energy intake and thereby quantify adherence to a diet intervention and provide dynamic feedback to individuals that seek to control their body weight. Published by Elsevier Inc.

  17. Short and long-term energy intake patterns and their implications for human body weight regulation

    PubMed Central

    Chow, Carson C.; Hall, Kevin D.

    2014-01-01

    Adults consume millions of kilocalories over the course of a few years, but the typical weight gain amounts to only a few thousand kilocalories of stored energy. Furthermore, food intake is highly variable from day to day and yet body weight is remarkably stable. These facts have been used as evidence to support the hypothesis that human body weight is regulated by active control of food intake operating on both short and long time scales. Here, we demonstrate that active control of human food intake on short time scales is not required for body weight stability and that the current evidence for long term control of food intake is equivocal. To provide more data on this issue, we emphasize the urgent need for developing new methods for accurately measuring energy intake changes over long time scales. We propose that repeated body weight measurements can be used along with mathematical modeling to calculate long-term changes in energy intake and thereby quantify adherence to a diet intervention and provide dynamic feedback to individuals that seek to control their body weight. PMID:24582679

  18. The Status of Long-Term Disability Plans in Higher Education.

    ERIC Educational Resources Information Center

    Cook, Thomas J.

    1981-01-01

    Long-term disability income coverage is seen as the most rapidly growing staff benefit in recent years. A Teachers Insurance and Annuity Association's survey of existing long-term disability plans, which provide adequate income replacement, is discussed. (MLW)

  19. Vitamin D status among long-term survivors of testicular cancer.

    PubMed

    Schepisi, Giuseppe; De Padova, Silvia; Scarpi, Emanuela; Lolli, Cristian; Gurioli, Giorgia; Menna, Cecilia; Burgio, Salvatore L; Rossi, Lorena; Gallà, Valentina; Casadio, Valentina; Salvi, Samanta; Conteduca, Vincenza; De Giorgi, Ugo

    2017-05-30

    A correlation between disturbances in hormone levels and the onset of metabolic disorders has been reported in long-term survivors of testicular cancer (TC).We evaluated serum vitamin D levels and other biological parameters in a consecutive series of 61 long-term (≥3 years) unilateral TC survivors with a median a follow-up of 4 years and in a cohort of healthy males. Deficient vitamin D levels were observed in 10 (17%) of the 58 long-term unilateral TC survivors but were not reported in healthy males (p=.019, Fisher test). Median vitamin D levels were 18.6 ug/L in 58 assessable TC survivors and 23.6 ug/L in 40 healthy males (p=.031). In univariate logistic regression analysis, TC diagnosis was associated with inadequate levels of vitamin D (p=.047). Vitamin D levels were lower when follow-up was > 10 years, albeit this difference was not statistically significant (p=.074). Long-term (especially > 10 years) TC survivors may have difficulty maintaining optimal vitamin D levels. Larger studies are needed to better characterize vitamin D status and possible correlations with premature hormonal aging reported in long-term TC survivors.

  20. Persistent increased PKMζ in long-term and remote spatial memory.

    PubMed

    Hsieh, Changchi; Tsokas, Panayiotis; Serrano, Peter; Hernández, A Iván; Tian, Dezhi; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

    2017-02-01

    PKMζ is an autonomously active PKC isoform that is thought to maintain both LTP and long-term memory. Whereas persistent increases in PKMζ protein sustain the kinase's action in LTP, the molecular mechanism for the persistent action of PKMζ during long-term memory has not been characterized. PKMζ inhibitors disrupt spatial memory when introduced into the dorsal hippocampus from 1day to 1month after training. Therefore, if the mechanisms of PKMζ's persistent action in LTP maintenance and long-term memory were similar, persistent increases in PKMζ would last for the duration of the memory, far longer than most other learning-induced gene products. Here we find that spatial conditioning by aversive active place avoidance or appetitive radial arm maze induces PKMζ increases in dorsal hippocampus that persist from 1day to 1month, coinciding with the strength and duration of memory retention. Suppressing the increase by intrahippocampal injections of PKMζ-antisense oligodeoxynucleotides prevents the formation of long-term memory. Thus, similar to LTP maintenance, the persistent increase in the amount of autonomously active PKMζ sustains the kinase's action during long-term and remote spatial memory maintenance. Copyright © 2016. Published by Elsevier Inc.

  1. Germany's long-term-care insurance: putting a social insurance model into practice.

    PubMed

    Geraedts, M; Heller, G V; Harrington, C A

    2000-01-01

    A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

  2. The long-term performance degradation of a radioisotope thermoelectric generator using silicon germanium

    NASA Technical Reports Server (NTRS)

    Stapfer, G.; Truscello, V. C.

    1976-01-01

    The successful utilization of a radioisotope thermoelectric generator (RTG) as the power source for spaceflight missions requires that the performance of such an RTG be predictable throughout the mission. Several mechanisms occur within the generator which tend to degrade the performance as a function of operating time. The impact which these mechanisms have on the available output power of an RTG depends primarily on such factors as time, temperature and self-limiting effects. The relative magnitudes, rates and temperature dependency of these various degradation mechanisms have been investigated separately by coupon experiments as well as 4-couple and 18-couple module experiments. This paper discusses the different individual mechanisms and summarizes their combined influence on the performance of an RTG. Also presented as part of the RTG long-term performance characteristics is the sensitivity of the available RTG output power to variations of the individual degradation mechanisms thus identifying the areas of greatest concern for a successful long-term mission.

  3. Long-term results of treatment of urethral strictures by transpubic urethroplasty.

    PubMed

    Zvara, V; Hornák, M

    1986-01-01

    Intrapelvic ruptures of membraneous urethra connected with pelvis fractures lead, as a rule, to strictures. Relative inaccessibility of these strictures above diaphragma urogenitale and behind symphysis makes their surgical treatment difficult. Transpubic approach with removal of wedge of pubic bones enables a direct approach to stricture and its modification under sight control. Technique of transpubic approach is described and long-term results obtained in 10 patients being 29-54 months after operation are evaluated. In one patient urinary continence in a sense of stress incontinence was disturbed, in one patient impotence occurred and one patient had disturbed gait.

  4. Plastic mulching in agriculture. Trading short-term agronomic benefits for long-term soil degradation?

    PubMed

    Steinmetz, Zacharias; Wollmann, Claudia; Schaefer, Miriam; Buchmann, Christian; David, Jan; Tröger, Josephine; Muñoz, Katherine; Frör, Oliver; Schaumann, Gabriele Ellen

    2016-04-15

    Plastic mulching has become a globally applied agricultural practice for its instant economic benefits such as higher yields, earlier harvests, improved fruit quality and increased water-use efficiency. However, knowledge of the sustainability of plastic mulching remains vague in terms of both an environmental and agronomic perspective. This review critically discusses the current understanding of the environmental impact of plastic mulch use by linking knowledge of agricultural benefits and research on the life cycle of plastic mulches with direct and indirect implications for long-term soil quality and ecosystem services. Adverse effects may arise from plastic additives, enhanced pesticide runoff and plastic residues likely to fragment into microplastics but remaining chemically intact and accumulating in soil where they can successively sorb agrochemicals. The quantification of microplastics in soil remains challenging due to the lack of appropriate analytical techniques. The cost and effort of recovering and recycling used mulching films may offset the aforementioned benefits in the long term. However, comparative and long-term agronomic assessments have not yet been conducted. Furthermore, plastic mulches have the potential to alter soil quality by shifting the edaphic biocoenosis (e.g. towards mycotoxigenic fungi), accelerate C/N metabolism eventually depleting soil organic matter stocks, increase soil water repellency and favour the release of greenhouse gases. A substantial process understanding of the interactions between the soil microclimate, water supply and biological activity under plastic mulches is still lacking but required to estimate potential risks for long-term soil quality. Currently, farmers mostly base their decision to apply plastic mulches rather on expected short-term benefits than on the consideration of long-term consequences. Future interdisciplinary research should therefore gain a deeper understanding of the incentives for farmers

  5. Independence of long-term contextual memory and short-term perceptual hypotheses: Evidence from contextual cueing of interrupted search.

    PubMed

    Schlagbauer, Bernhard; Mink, Maurice; Müller, Hermann J; Geyer, Thomas

    2017-02-01

    Observers are able to resume an interrupted search trial faster relative to responding to a new, unseen display. This finding of rapid resumption is attributed to short-term perceptual hypotheses generated on the current look and confirmed upon subsequent looks at the same display. It has been suggested that the contents of perceptual hypotheses are similar to those of other forms of memory acquired long-term through repeated exposure to the same search displays over the course of several trials, that is, the memory supporting "contextual cueing." In three experiments, we investigated the relationship between short-term perceptual hypotheses and long-term contextual memory. The results indicated that long-term, contextual memory of repeated displays neither affected the generation nor the confirmation of short-term perceptual hypotheses for these displays. Furthermore, the analysis of eye movements suggests that long-term memory provides an initial benefit in guiding attention to the target, whereas in subsequent looks guidance is entirely based on short-term perceptual hypotheses. Overall, the results reveal a picture of both long- and short-term memory contributing to reliable performance gains in interrupted search, while exerting their effects in an independent manner.

  6. Long Term Deck Deterioration : final report.

    DOT National Transportation Integrated Search

    1990-09-01

    In May of 1981 the Oregon State Highway Division was asked by the Federal Highway Administration to participate in a long term deck deterioration study. The study, an extension of an earlier study was finalized in 1979, was to run through 1990. Revie...

  7. 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.

  8. Long-term outcomes of unilateral transtibial amputations.

    PubMed

    Ebrahimzadeh, Mohamad H; Hariri, Sanaz

    2009-06-01

    the long-term outcomes of wartime transtibial amputations have not been well documented. The purpose of this case series is to present the long-term functional, social, and psychological outcomes of modern-day military unilateral transtibial amputees. the Iranian Veterans Administration of the Khorasan province invited their Iranian military amputees from the Iran-Iraq War (1980-1988) to its medical center for evaluation. The patients filled out a detailed questionnaire and were interviewed and examined by each team member. two hundred (77%) of the 260 invited amputees were willing and able to come back for follow-up. Ninety-six of these patients (48%) were unilateral transtibial amputation. The average follow-up was 17.4 years (range 15-22 years). Land mines were the leading cause of war injury necessitating a transtibial amputation (68%). The most common symptoms about their amputated limbs were phantom sensations (54%), phantom pain (17%), and stump pain (42%). Lower back pain, contralateral (nonamputated limb) knee pain, and ipsilateral (amputated limb) knee pain were reported by 44%, 38%, and 13% of subjects, respectively. Sixty-five percent of patients were employed or had been employed for multiple years after their war injury. All patients were married, and 97% had children. Fifty-four percent of amputees reported psychological problems; 26% were currently utilizing psychological support services. at long-term follow-up, most military transtibial amputees experienced phantom sensation or some type of stump pain. More than half had persistent psychiatric problems, but only about half of these patients were receiving psychological treatment. Although this case series reports the status of these amputees, the next step would be to prospectively follow modern wartime amputees using standardized, validated outcome measures. With the goal of optimizing long-term amputee outcomes, researchers should correlate outcomes with demographics, injury characteristics, and

  9. High-Contrast Imaging of Intermediate-Mass Giants with Long-Term Radial Velocity Trends

    NASA Technical Reports Server (NTRS)

    Ryu, Tsuguru; Sato, Bun'ei; Kuzuhara, Masayuki; Narita, Norio; Takahashi, Yasuhiro; Uyama, Taichi; Kudo, Tomoyuki; Kusakabe, Nobuhiko; Hashimoto, Jun; Omiya, Masashi; hide

    2016-01-01

    A radial velocity (RV) survey for intermediate-mass giants has been operated for over a decade at Okayama Astrophysical Observatory (OAO). The OAO survey has revealed that some giants show long-term linear RV accelerations (RV trends), indicating the presence of outer companions. Direct imaging observations can help clarify what objects generate these RV trends. We present the results of high-contrast imaging observations of six intermediate-mass giants with long-term RV trends using the Subaru Telescope and HiCIAO camera. We detected co-moving companions to gamma Hya B (0.61+0.12 -0.14 Stellar Mass), HD 5608 B (0.10 +/- 0.01 Stellar Mass), and HD 109272 B (0.28 +/- 0.06 Stellar Mass). For the remaining targets( Dra, 18 Del, and HD 14067) we exclude companions more massive than 30-60 M(sub Jup) at projected separations of 1''-7''. We examine whether these directly imaged companions or unidentified long-period companions can account for the RV trends observed around the six giants. We find that the Kozai mechanism can explain the high eccentricity of the inner planets Dra b, HD 5608 b, and HD 14067 b.

  10. High-contrast Imaging of Intermediate-mass Giants with Long-term Radial Velocity Trends

    NASA Astrophysics Data System (ADS)

    Ryu, Tsuguru; Sato, Bun'ei; Kuzuhara, Masayuki; Narita, Norio; Takahashi, Yasuhiro H.; Uyama, Taichi; Kudo, Tomoyuki; Kusakabe, Nobuhiko; Hashimoto, Jun; Omiya, Masashi; Harakawa, Hiroki; Abe, Lyu; Ando, Hiroyasu; Brandner, Wolfgang; Brandt, Timothy D.; Carson, Joseph C.; Currie, Thayne; Egner, Sebastian; Feldt, Markus; Goto, Miwa; Grady, Carol A.; Guyon, Olivier; Hayano, Yutaka; Hayashi, Masahiko; Hayashi, Saeko S.; Hełminiak, Krzysztof G.; Henning, Thomas; Hodapp, Klaus W.; Ida, Shigeru; Ishii, Miki; Itoh, Yoichi; Iye, Masanori; Izumiura, Hideyuki; Janson, Markus; Kambe, Eiji; Kandori, Ryo; Knapp, Gillian R.; Kokubo, Eiichiro; Kwon, Jungmi; Matsuo, Taro; Mayama, Satoshi; McElwain, Michael W.; Mede, Kyle; Miyama, Shoken; Morino, Jun-Ichi; Moro-Martin, Amaya; Nishimura, Tetsuo; Pyo, Tae-Soo; Serabyn, Eugene; Suenaga, Takuya; Suto, Hiroshi; Suzuki, Ryuji; Takami, Michihiro; Takato, Naruhisa; Takeda, Yoichi; Terada, Hiroshi; Thalmann, Christian; Turner, Edwin L.; Watanabe, Makoto; Wisniewski, John; Yamada, Toru; Yoshida, Michitoshi; Takami, Hideki; Usuda, Tomonori; Tamura, Motohide

    2016-07-01

    A radial velocity (RV) survey for intermediate-mass giants has been in operation for over a decade at Okayama Astrophysical Observatory (OAO). The OAO survey has revealed that some giants show long-term linear RV accelerations (RV trends), indicating the presence of outer companions. Direct-imaging observations can help clarify what objects generate these RV trends. We present the results of high-contrast imaging observations of six intermediate-mass giants with long-term RV trends using the Subaru Telescope and HiCIAO camera. We detected co-moving companions to γ Hya B ({0.61}-0.14+0.12{M}⊙ ), HD 5608 B (0.10+/- 0.01{M}⊙ ), and HD 109272 B (0.28+/- 0.06{M}⊙ ). For the remaining targets (ι Dra, 18 Del, and HD 14067), we exclude companions more massive than 30-60 M Jup at projected separations of 1″-7″. We examine whether these directly imaged companions or unidentified long-period companions can account for the RV trends observed around the six giants. We find that the Kozai mechanism can explain the high eccentricity of the inner planets ι Dra b, HD 5608 b, and HD 14067 b.

  11. Short-term and long-term effects of GDP on traffic deaths in 18 OECD countries, 1960-2011.

    PubMed

    Dadgar, Iman; Norström, Thor

    2017-02-01

    Research suggests that increases in gross domestic product (GDP) lead to increases in traffic deaths plausibly due to the increased road traffic induced by an expanding economy. However, there also seems to exist a long-term effect of economic growth that is manifested in improved traffic safety and reduced rates of traffic deaths. Previous studies focus on either the short-term, procyclical effect, or the long-term, protective effect. The aim of the present study is to estimate the short-term and long-term effects jointly in order to assess the net impact of GDP on traffic mortality. We extracted traffic death rates for the period 1960-2011 from the WHO Mortality Database for 18 OECD countries. Data on GDP/capita were obtained from the Maddison Project. We performed error correction modelling to estimate the short-term and long-term effects of GDP on the traffic death rates. The estimates from the error correction modelling for the entire study period suggested that a one-unit increase (US$1000) in GDP/capita yields an instantaneous short-term increase in the traffic death rate by 0.58 (p<0.001), and a long-term decrease equal to -1.59 (p<0.001). However, period-specific analyses revealed a structural break implying that the procyclical effect outweighs the protective effect in the period prior to 1976, whereas the reverse is true for the period 1976-2011. An increase in GDP leads to an immediate increase in traffic deaths. However, after the mid-1970s this short-term effect is more than outweighed by a markedly stronger protective long-term effect, whereas the reverse is true for the period before the mid-1970s. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Long-term change of activity of very low-frequency earthquakes in southwest Japan

    NASA Astrophysics Data System (ADS)

    Baba, S.; Takeo, A.; Obara, K.; Kato, A.; Maeda, T.; Matsuzawa, T.

    2017-12-01

    On plate interface near seismogenic zone of megathrust earthquakes, various types of slow earthquakes were detected including non-volcanic tremors, slow slip events (SSEs) and very low-frequency earthquakes (VLFEs). VLFEs are classified into deep VLFEs, which occur in the downdip side of the seismogenic zone, and shallow VLFEs, occur in the updip side, i.e. several kilometers in depth in southwest Japan. As a member of slow earthquake family, VLFE activity is expected to be a proxy of inter-plate slipping because VLFEs have the same mechanisms as inter-plate slipping and are detected during Episodic tremor and slip (ETS). However, long-term change of the VLFE seismicity has not been well constrained compared to deep low-frequency tremor. We thus studied long-term changes in the activity of VLFEs in southwest Japan where ETS and long-term SSEs have been most intensive. We used continuous seismograms of F-net broadband seismometers operated by NIED from April 2004 to March 2017. After applying the band-pass filter with a frequency range of 0.02—0.05 Hz, we adopted the matched-filter technique in detecting VLFEs. We prepared templates by calculating synthetic waveforms for each hypocenter grid assuming typical focal mechanisms of VLFEs. The correlation coefficients between templates and continuous F-net seismograms were calculated at each grid every 1s in all components. The grid interval is 0.1 degree for both longitude and latitude. Each VLFE was detected as an event if the average of correlation coefficients exceeds the threshold. We defined the detection threshold as eight times as large as the median absolute deviation of the distribution. At grids in the Bungo channel, where long-term SSEs occurred frequently, the cumulative number of detected VLFEs increases rapidly in 2010 and 2014, which were modulated by stress loading from the long-term SSEs. At inland grids near the Bungo channel, the cumulative number increases steeply every half a year. This stepwise

  13. Long-term ecological research in a human-dominated world

    Treesearch

    G. Philip Robertson; Scott L. Collins; David R. Foster; Nicholas Brokaw; Hugh W. Ducklow; Ted L. Gragson; Corinna Gries; Stephen K. Hamilton; A. David McGuire; John C. Moore; Emily H. Stanley; Robert B. Waide; Mark W. Williams

    2012-01-01

    The US Long Term Ecological Research (LTER) Network enters its fourth decade with a distinguished record of achievement in ecological science. The value of long-term observations and experiments has never been more important for testing ecological theory and for addressing today’s most difficult environmental challenges. The network’s potential for tackling emergent...

  14. Long-Term Results of Aortic Root Surgery in Marfan Syndrome Patients: A Single-Center Experience.

    PubMed

    Nicolo, Francesco; Romeo, Francesco; Lio, Antonio; Bovio, Emanuele; Scafuri, Antonio; Bassano, Carlo; Polisca, Patrizio; Pellegrino, Antonio; Nardi, Paolo; Chiariello, Luigi; Ruvolo, Giovanni

    2017-07-01

    The study aim was to compare long-term results of Marfan syndrome (MFS) patients affected by aortic root disease undergoing aortic root replacement with the Bentall or David operation. Since 1994, a total of 59 patients has been followed at the authors' Marfan Center, having undergone either a Bentall operation (Bentall group, n = 30) or a David operation (David group, n = 29). No operative mortality was recorded. After 20 years (mean follow up 97 ± 82 months; range 1 to 369 months) no prosthesis-related major bleeding or thromboembolic events had been observed; the 20-year survival was 94 ± 6% in the Bentall group, and 100% in the David group (p = 0.32). Freedom from reintervention for aortic valve dysfunction was 100% in the Bentall group, and 75 ± 13% in the David group (p = 0.04). This inter-group difference became relevant after the first eight-year period of follow-up, and was mainly associated with a particular familiar genetic phenotype involving three out of four reoperated patients. Freedom from all-cause death, myocardial infarction, stroke, prosthetic valve-related complications, and reintervention on any aortic segment was 69 ± 12% in the Bentall group, and 67 ± 14% in the David group (p = 0.33). The Bentall and David operations are both associated with satisfactory long-term results in MFS patients. The low rate of valve prosthesis-related complications suggested that the Bentall operation would continue to be a standard surgical treatment. The reimplantation technique, adopted for less-dilated aortas, provides satisfactory freedom from reoperation. Careful attention should be paid to the reimplantation technique in patients affected by a serious familiar genetic phenotype.

  15. Long-term effect of set potential on biocathodes in microbial fuel cells: electrochemical and phylogenetic characterization.

    PubMed

    Xia, Xue; Sun, Yanmei; Liang, Peng; Huang, Xia

    2012-09-01

    The long-term effect of set potential on oxygen reducing biocathodes was investigated in terms of electrochemical and biological characteristics. Three biocathodes were poised at 200, 60 and -100 mV vs. saturated calomel electrode (SCE) for 110 days, including the first 17 days for startup. Electrochemical analyses showed that 60 mV was the optimum potential during long-term operation. The performance of all the biocathodes kept increasing after startup, suggesting a period longer than startup time needed to make potential regulation more effective. The inherent characteristics without oxygen transfer limitation were studied. Different from short-term regulation, the amounts of biomass were similar while the specific electrochemical activity was significantly influenced by potential. Moreover, potential showed a strong selection for cathode bacteria. Clones 98% similar with an uncultured Bacteroidetes bacterium clone CG84 accounted for 75% to 80% of the sequences on the biocathodes that showed higher electrochemical activity (60 and -100 mV). Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Dispositional optimism as predictor of outcome in short- and long-term psychotherapy.

    PubMed

    Heinonen, Erkki; Heiskanen, Tiia; Lindfors, Olavi; Härkäpää, Kristiina; Knekt, Paul

    2017-09-01

    Dispositional optimism predicts various beneficial outcomes in somatic health and treatment, but has been little studied in psychotherapy. This study investigated whether an optimistic disposition differentially predicts patients' ability to benefit from short-term versus long-term psychotherapy. A total of 326 adult outpatients with mood and/or anxiety disorder were randomized into short-term (solution-focused or short-term psychodynamic) or long-term psychodynamic therapy and followed up for 3 years. Dispositional optimism was assessed by patients at baseline with the self-rated Life Orientation Test (LOT) questionnaire. Outcome was assessed at baseline and seven times during the follow-up, in terms of depressive (BDI, HDRS), anxiety (SCL-90-ANX, HARS), and general psychiatric symptoms (SCL-90-GSI), all seven follow-up points including patients' self-reports and three including interview-based measures. Lower dispositional optimism predicted faster symptom reduction in short-term than in long-term psychotherapy. Higher optimism predicted equally rapid and eventually greater benefits in long-term, as compared to short-term, psychotherapy. Weaker optimism appeared to predict sustenance of problems early in long-term therapy. Stronger optimism seems to best facilitate engaging in and benefiting from a long-term therapy process. Closer research might clarify the psychological processes responsible for these effects and help fine-tune both briefer and longer interventions to optimize treatment effectiveness for particular patients and their psychological qualities. Weaker dispositional optimism does not appear to inhibit brief therapy from effecting symptomatic recovery. Patients with weaker optimism do not seem to gain added benefits from long-term therapy, but instead may be susceptible to prolonged psychiatric symptoms in the early stages of long-term therapy. © 2016 The British Psychological Society.

  17. Acute kidney injury after non-cardiovascular surgery: risk factors and impact on development of chronic kidney disease and long-term mortality.

    PubMed

    Pourafkari, Leili; Arora, Pradeep; Porhomayon, Jahan; Dosluoglu, Hasan H; Arora, Preksha; Nader, Nader D

    2018-05-03

    To identify factors associated with acute kidney injury (AKI) and its progression to chronic kidney disease (CKD) in a non-cardiac/non-vascular surgery setting. This study examined the Veterans Affairs Surgical Quality database for surgical entries between 2000-2014. Demographics, comorbidities, laboratory findings and hospital outcomes were assessed. The primary end-point was the occurrence of AKI, defined as an increase of ≥0.3 mg/dL, 48 h post-operatively. Major adverse cardiac event (MACE) was defined as the composite first occurrence of myocardial infarction, cardiac arrest, and death in 30 days (secondary end-point) and was compared between two groups. Rates of progression to CKD in 1 year and long-term survival were examined. Occurrence of AKI 48 h post-operatively. AKI was documented in 8.5% of patients. Age, diabetes, and chronic obstructive pulmonary disease, chronic kidney disease, platelet count, serum albumin level, and duration of surgery were identified as independent predictors of AKI. In total, 6.4% patients developed MACE, which was more frequent in patients with AKI (p < .001). Age and pre-operative hematocrit <30% were independent predictors of progression to CKD. Pre-operative hematocrit with a cut-off value of 30% was the only modifiable factor to predict the long-term survival. Development of AKI is associated with increased odds of various post-operative complications and long-term renal insufficiency and mortality.

  18. Fontan Operation: Indications, Short and Long Term Outcomes.

    PubMed

    Rao, P Syamasundar

    2015-12-01

    Fontan operation, since its original description, has undergone a number of modifications so that it is now a staged, total cavo-pulmonary connection with fenestration. Stage I is palliation, depending upon the pathophysiology of the defect complex in early life, Stage II is bidirectional Glenn at about the age of 6 mo and Stage III is transfer of inferior vena caval blood to the pulmonary circuit along with fenestration between 2 to 4 y. Any patient that has only one functioning ventricle is a candidate for Fontan surgery. The morbidity and mortality have remarkably improved since the institution of staged, total cavo-pulmonary connection with fenestration. Complications during follow up continue to occur, though diminished with the newer modifications, and should be promptly addressed.

  19. Working memory, long-term memory, and medial temporal lobe function

    PubMed Central

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance in patients with MTL lesions on tasks with short retention intervals, or no retention interval, and neuroimaging findings with similar tasks have been interpreted to mean that the MTL is sometimes needed for working memory and possibly even for visual perception itself. We present a reappraisal of this interpretation. Our main conclusion is that, if the material to be learned exceeds working memory capacity, if the material is difficult to rehearse, or if attention is diverted, performance depends on long-term memory even when the retention interval is brief. This fundamental notion is better captured by the terms subspan memory and supraspan memory than by the terms short-term memory and long-term memory. We propose methods for determining when performance on short-delay tasks must depend on long-term (supraspan) memory and suggest that MTL lesions impair performance only when immediate memory and working memory are insufficient to support performance. In neuroimaging studies, MTL activity during encoding is influenced by the memory load and correlates positively with long-term retention of the material that was presented. The most parsimonious and consistent interpretation of all the data is that subspan memoranda are supported by immediate memory and working memory and are independent of the MTL. PMID:22180053

  20. LONG-TERM STEWARDSHIP AT DOE HANFORD SITE - 12575

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

    MOREN RJ; GRINDSTAFF KD

    2012-01-11

    The U.S. Department of Energy's (DOE) Hanford Site is located in southeast Washington and consists of 1,518 square kilometers (586 square miles) of land. Established in 1943 as part of the Manhattan Project, Hanford workers produced plutonium for our nation's nuclear defense program until the mid 1980's. Since then, the site has been in cleanup mode that is being accomplished in phases. As we achieve remedial objectives and complete active cleanup, DOE will manage Hanford land under the Long-Term Stewardship (LTS) Program until completion of cleanup and the site becomes ready for transfer to the post cleanup landlord - currentlymore » planned for DOE's Office of Legacy Management (LM). We define Hanford's LTS Program in the ''Hanford Long-Term Stewardship Program Plan,'' (DOE/RL-201 0-35)[1], which describes the scope including the relationship between the cleanup projects and the LTS Program. DOE designed the LTS Program to manage and provide surveillance and maintenance (S&M) of institutional controls and associated monitoring of closed waste sites to ensure the protection of human health and the environment. DOE's Richland Operations Office (DOE-RL) and Hanford cleanup and operations contractors collaboratively developed this program over several years. The program's scope also includes 15 key activities that are identified in the DOE Program Plan (DOE/RL-2010-35). The LTS Program will transition 14 land segments through 2016. The combined land mass is approximately 570 square kilometers (220 square miles), with over 1,300 active and inactive waste sites and 3,363 wells. Land segments vary from buffer zone property with no known contamination to cocooned reactor buildings, demolished support facilities, and remediated cribs and trenches. DOE-RL will transition land management responsibilities from cleanup contractors to the Mission Support Contract (MSC), who will then administer the LTS Program for DOE-RL. This process requires an environment of cooperation

  1. Haloperidol for long-term aggression in psychosis.

    PubMed

    Khushu, Abha; Powney, Melanie J

    2016-11-27

    Psychotic disorders can lead some people to become agitated. Characterised by restlessness, excitability and irritability, this can result in verbal and physically aggressive behaviour - and both can be prolonged. Aggression within the psychiatric setting imposes a significant challenge to clinicians and risk to service users; it is a frequent cause for admission to inpatient facilities. If people continue to be aggressive it can lengthen hospitalisation. Haloperidol is used to treat people with long-term aggression. To examine whether haloperidol alone, administered orally, intramuscularly or intravenously, is an effective treatment for long-term/persistent aggression in psychosis. We searched the Cochrane Schizophrenia Group Trials Register (July 2011 and April 2015). We included randomised controlled trials (RCT) or double blind trials (implying randomisation) with useable data comparing haloperidol with another drug or placebo for people with psychosis and long-term/persistent aggression. One review author (AK) extracted data. For dichotomous data, one review author (AK) calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a fixed-effect model. One review author (AK) assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE. We have no good-quality evidence of the absolute effectiveness of haloperidol for people with long-term aggression. One study randomising 110 chronically aggressive people to three different antipsychotic drugs met the inclusion criteria. When haloperidol was compared with olanzapine or clozapine, skewed data (n=83) at high risk of bias suggested some advantage in terms of scale scores of unclear clinical meaning for olanzapine/clozapine for 'total aggression'. Data were available for only one other outcome, leaving the study early. When compared with other antipsychotic drugs, people allocated to haloperidol were no more likely to leave the study

  2. Lightning climatology over Jakarta, Indonesia, based on long-term surface operational, satellite, and campaign observations

    NASA Astrophysics Data System (ADS)

    Mori, Shuichi; Wu, Peiming; Yamanaka, Manabu D.; Hattori, Miki; Hamada, Jun-Ichi; Arbain, Ardhi A.; Lestari, Sopia; Sulistyowati, Reni; Syamsudin, Fadli

    2016-04-01

    Lightning frequency over Indonesian Maritime Continent (MC) is quite high (Petersen and Rutledge 2001, Christian et al. 2003, Takayabu 2006, etc). In particular, Bogor (south of Jakarta, west Jawa) had 322 days of lightning in one year (Guinness Book in 1988). Lightning causes serious damage on nature and society over the MC; forest fore, power outage, inrush/surge currents on many kinds of electronics. Lightning climatology and meso-scale characteristics of thunderstorm over the MC, in particular over Jakarta, where social damage is quite serious, were examined. We made Statistical analysis of lightning and thunderstorm based on TRMM Lightning Image Sensor (LIS) and Global Satellite Mapping of Precipitation (GSMaP) together with long-term operational surface observation data (SYNOP) in terms of diurnal, intraseasonal, monsoonal, and interannual variations. In addition, we carried out a campaign observation in February 2015 in Bogor to obtain meso-scale structure and dynamics of thunderstorm over Jakarta to focus on graupel and other ice phase particles inside by using an X-band dual-polarimetric (DP) radar. Recently, Virts et al. (2013a, b) showed comprehensive lightning climatology based on the World Wide Lightning Location Network (WWLLN). However, they also reported problems with its detection efficiency (< 10%) and small sampling frequency (< 0.1% of the time fly over tropics) by satellites. Therefore, we firstly examine in situ lightning data based on SYNOP observed by the Indonesian Agency for Meteorology, Climatology, and Geophysics (BMKG) because lightning is quite local and sporadic phenomena. We've started to analyze lightning characteristics over Jakarta region based on SYNOP as the ground truth data and GSMaP. Variability of lightning frequency around Jakarta was affected much by local conditions, e.g., topography (elevation) and proximity to the coastline. We confirmed the lightning frequency and its diurnal variation around Jakarta were much

  3. Immersion-scanning-tunneling-microscope for long-term variable-temperature experiments at liquid-solid interfaces

    NASA Astrophysics Data System (ADS)

    Ochs, Oliver; Heckl, Wolfgang M.; Lackinger, Markus

    2018-05-01

    Fundamental insights into the kinetics and thermodynamics of supramolecular self-assembly on surfaces are uniquely gained by variable-temperature high-resolution Scanning-Tunneling-Microscopy (STM). Conventionally, these experiments are performed with standard ambient microscopes extended with heatable sample stages for local heating. However, unavoidable solvent evaporation sets a technical limit on the duration of these experiments, hence prohibiting long-term experiments. These, however, would be highly desirable to provide enough time for temperature stabilization and settling of drift but also to study processes with inherently slow kinetics. To overcome this dilemma, we propose a STM that can operate fully immersed in solution. The instrument is mounted onto the lid of a hermetically sealed heatable container that is filled with the respective solution. By closing the container, both the sample and microscope are immersed in solution. Thereby solvent evaporation is eliminated and an environment for long-term experiments with utmost stable and controllable temperatures between room-temperature and 100 °C is provided. Important experimental requirements for the immersion-STM and resulting design criteria are discussed, the strategy for protection against corrosive media is described, the temperature stability and drift behavior are thoroughly characterized, and first long-term high resolution experiments at liquid-solid interfaces are presented.

  4. Overview of long-term field experiments in Germany - metadata visualization

    NASA Astrophysics Data System (ADS)

    Muqit Zoarder, Md Abdul; Heinrich, Uwe; Svoboda, Nikolai; Grosse, Meike; Hierold, Wilfried

    2017-04-01

    BonaRes ("soil as a sustainable resource for the bioeconomy") is conducting to collect data and metadata of agricultural long-term field experiments (LTFE) of Germany. It is funded by the German Federal Ministry of Education and Research (BMBF) under the umbrella of the National Research Strategy BioEconomy 2030. BonaRes consists of ten interdisciplinary research project consortia and the 'BonaRes - Centre for Soil Research'. BonaRes Data Centre is responsible for collecting all LTFE data and regarding metadata into an enterprise database upon higher level of security and visualization of the data and metadata through data portal. In the frame of the BonaRes project, we are compiling an overview of long-term field experiments in Germany that is based on a literature review, the results of the online survey and direct contacts with LTFE operators. Information about research topic, contact person, website, experiment setup and analyzed parameters are collected. Based on the collected LTFE data, an enterprise geodatabase is developed and a GIS-based web-information system about LTFE in Germany is also settled. Various aspects of the LTFE, like experiment type, land-use type, agricultural category and duration of experiment, are presented in thematic maps. This information system is dynamically linked to the database, which means changes in the data directly affect the presentation. An easy data searching option using LTFE name, -location or -operators and the dynamic layer selection ensure a user-friendly web application. Dispersion and visualization of the overlapping LTFE points on the overview map are also challenging and we make it automatized at very zoom level which is also a consistent part of this application. The application provides both, spatial location and meta-information of LTFEs, which is backed-up by an enterprise geodatabase, GIS server for hosting map services and Java script API for web application development.

  5. Epilepsy increases vulnerability of long-term face recognition to proactive interference.

    PubMed

    Bengner, T; Malina, T; Lindenau, M; Voges, B; Goebell, E; Stodieck, S

    2006-02-01

    Proactive interference (PI) decreases short- and long-term memory in healthy subjects. Neurological patients exhibit a heightened PI effect on short-term memory. It is, however, not known if PI affects long-term memory in neurological patients. We analyzed whether epilepsy heightens the negative effect of PI on long-term face memory. PI was induced by a list of 20 faces learned 24 hours prior to a target list of 20 faces. We tested immediate and 24-hour recognition for both lists. Twelve healthy controls and 42 patients with generalized epilepsy or temporal lobe epilepsy (TLE) were studied. PI led to a decrease in 24-hour recognition in patients with generalized epilepsy and TLE but not in controls. Thus, PI may cause long-term memory disturbances in epilepsy patients. PI was also associated with decreased short-term memory, but only in right TLE. This confirms the dominant role of the right temporal lobe in short-term face memory.

  6. Short-term and long-term outcomes of laparoscopic hepatectomy, microwave ablation, and open hepatectomy for small hepatocellular carcinoma: a 5-year experience in a single center.

    PubMed

    Li, Wenda; Zhou, Xue; Huang, Zejian; Zhang, Kelin; Luo, Xuan; Zhong, Jinyi; Chen, Yajin

    2017-06-01

    Laparoscopic hepatectomy (LH), microwave ablation (MWA), and open hepatectomy (OH) are three widely used methods to treat small hepatocellular carcinoma (HCC). However, few studies have compared the short- and long-term outcomes of these three treatments. The aim of this study was to investigate their effectiveness. The data were reviewed from 280 patients with HCCs measuring ≤3 cm (Barcelona Clinic Liver Cancer stage 0 or A) who received LH (n = 133), OH (n = 87), or MWA (n = 60) in our research center from 2005 to 2010. Short-term outcomes included intraoperative blood loss, operation time, and length of hospital stay. The disease-free survival and overall survival rates were analyzed as long-term outcomes. The patients in the MWA and LH groups showed better short-term outcomes compared with those in the OH group. There were no significant differences in overall survival rates among the three treatments. The LH group showed significantly lower recurrence rates than the MWA group (P = 0.0146). Laparoscopic hepatectomy may be a better option for patients with small HCC located on the liver surface and left lateral lobe. The short-term outcome of MWA is promising, although the high risk of local recurrence after the operation should be considered when planning treatment. © 2016 The Japan Society of Hepatology.

  7. Beryllium sensitization and disease among long-term and short-term workers in a beryllium ceramics plant.

    PubMed

    Henneberger, P K; Cumro, D; Deubner, D D; Kent, M S; McCawley, M; Kreiss, K

    2001-04-01

    Workers at a beryllium ceramics plant were tested for beryllium sensitization and disease in 1998 to determine whether the plant-wide prevalence of sensitization and disease had declined since the last screening in 1992; an elevated prevalence was associated with specific processes or with high exposures; exposure-response relationships differed for long-term workers hired before the last plant-wide screening and short-term workers hired since then. Current workers were asked to complete a questionnaire and to provide blood for the beryllium lymphocyte proliferation test (BeLPT). Those with an abnormal BeLPT were classified as sensitized, and were offered clinical evaluation for beryllium disease. Task- and time-specific measurements of airborne beryllium were combined with individual work histories to compute mean, cumulative, and peak beryllium exposures for each worker. The 151 participants represented 90% of 167 eligible workers. Fifteen (9.9% of 151) had an abnormal BeLPT and were split between long-term workers (8/77 = 10.4%) and short-term workers (7/74 = 9.5%). Beryllium disease was detected in 9.1% (7/77) of long-term workers but in only 1.4% (1/74) of short-term workers (P = 0.06), for an overall prevalence of 5.3% (8/151). These prevalences were similar to those observed in the earlier survey. The prevalence of sensitization was elevated in 1992 among machinists, and was still elevated in 1998 among long-term workers (7/40 = 18%) but not among short-term workers (2/36 = 6%) with machining experience. The prevalence of sensitization was also elevated in both groups of workers for the processes of lapping, forming, firing, and packaging. The data suggested a positive relationship between peak beryllium exposure and sensitization for long-term workers and between mean, cumulative, and peak exposure and sensitization for short-term workers, although these findings were not statistically significant. Long-term workers with either a high peak exposure or work

  8. [Postconditioning can reduce long-term lung injury after lower limb ischemia-reperfusion].

    PubMed

    Garbaisz, Dávid; Turóczi, Zsolt; Fülöp, András; Rosero, Olivér; Arányi, Péter; Ónody, Péter; Lotz, Gábor; Rakonczay, Zoltán; Balla, Zsolt; Harsányi, László; Szijártó, Attila

    2013-06-01

    Operation on the infrarenal aorta could cause ischemic-reperfusion (IR) injury in local tissues and remote organs (e.g. the lung). Our aim was to reduce long-term lung damage, after lower limb IR with postconditioning. Male Wistar rats underwent 180 minutes of bilateral lower limb ischemia. Animals were divided into three groups: Sham-operated, IR, Postconditioned (PostC) and further to two subgroups according to reperfusion time: 24 h and 72 h. Serum free radical and IL-6 levels, histological changes, Wet/Dry (W/D) ratio, tissue myeloperoxidase (MPO) activity and Hsp72 levels were investigated. Postconditioning can reduce histological changes in the lung. Free radical levels are significantly lower in PostC groups than in IR groups (42.9 ± 8.0 vs. 6.4 ± 3.4; 27.3 ± 4.4 vs. 8.3 ± 4.0 RLU%; p < 0.05). IL-6 level (238.4 ± 31.1 vs. 209.1 ± 18.8; 190.0 ± 8.8 vs. 187.0 ± 14.9 pg/ml) and Hsp72 expression did not show any significant difference. Compared to the IR group, lung MPO activity did not change in the PostC groups. W/D ratio in PostC groups is significantly lower at all measured time-points (68% vs. 65%; 72% vs. 68%; p < 0.05). Postconditioning may reduce long-term damages of the lung after lower limb ischemic-reperfusion injury.

  9. Infants long-term memory for complex music

    NASA Astrophysics Data System (ADS)

    Ilari, Beatriz; Polka, Linda; Costa-Giomi, Eugenia

    2002-05-01

    In this study we examined infants' long-term memory for two complex pieces of music. A group of thirty 7.5 month-old infants was exposed daily to one short piano piece (i.e., either the Prelude or the Forlane by Maurice Ravel) for ten consecutive days. Following the 10-day exposure period there was a two-week retention period in which no exposure to the piece occurred. After the retention period, infants were tested on the Headturn Preference Procedure. At test, 8 different excerpts of the familiar piece were mixed with 8 different foil excerpts of the unfamiliar one. Infants showed a significant preference for the familiar piece of music. A control group of fifteen nonexposed infants was also tested and showed no preferences for either piece of music. These results suggest that infants in the exposure group retained the familiar music in their long-term memory. This was demonstrated by their ability to discriminate between the different excerpts of both the familiar and the unfamiliar pieces of music, and by their preference for the familiar piece. Confirming previous findings (Jusczyk and Hohne, 1993; Saffran et al., 2000), in this study we suggest that infants can retain complex pieces of music in their long-term memory for two weeks.

  10. Smoking and long-term labour market outcomes.

    PubMed

    Böckerman, Petri; Hyytinen, Ari; Kaprio, Jaakko

    2015-07-01

    To examine the long-term effects of smoking on labour market outcomes using twin data matched to register-based individual information on earnings. Twin data for Finnish men born 1945-1957 was used to remove the shared environmental and genetic factors. The results were subjected to extensive robustness testing. Lifetime cigarette consumption was measured by (cumulative) cigarette pack-years in early adulthood. The average of an individual's earnings (and, alternatively, taxable income) was measured over a subsequent 15-year period in later adulthood. Smokers have lower long-term income and earnings. For example, controlling for the shared environmental and genetic factors using the data on genetically identical twins, smoking is negatively associated with lifetime income (p=0.015). The negative association was also robust to the use of various covariates, such as education, health indicators and extraversion. Smoking is negatively related to long-term labour market outcomes. The provision of information about the indirect monetary costs of smoking may thus complement the policy efforts that aim at educating consumers about the health costs of smoking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Long-term analysis of clogging and oil bio-degradation in a System of Catchment, Pre-treatment and Treatment (SCPT).

    PubMed

    Fernández-Barrera, Andrés H; Castro-Fresno, Daniel; Rodriguez-Hernandez, Jorge; Vega-Zamanillo, Angel

    2011-01-30

    Runoff contamination has motivated the development of different systems for its treatment in order to decrease the pollutant load that is discharged into natural water bodies. In the long term, these systems may undergo operational problems. This paper presents the results obtained in a laboratory study with a 1:1 scale prototype of a System of Catchment, Pre-treatment and Treatment (SCPT) of runoff waters. The analysis aims to establish the operational behaviour of the SCPT in the long term with respect to oil degradation and hydraulic conductivity in the geotextile filter. It is concluded that bio-degradation processes take place inside the SCPT and that hydraulic conductivity of the geotextile filtration system decreases slowly with successive simulated runoff events. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. Long-term outcomes of septal reduction for obstructive hypertrophic cardiomyopathy.

    PubMed

    Sedehi, Daniel; Finocchiaro, Gherardo; Tibayan, Yen; Chi, Jeffrey; Pavlovic, Aleksandra; Kim, Young M; Tibayan, Frederick A; Reitz, Bruce A; Robbins, Robert C; Woo, Joseph; Ha, Richard; Lee, David P; Ashley, Euan A

    2015-07-01

    Surgical myectomy and alcohol septal ablation (ASA) aim to decrease left ventricular outflow tract (LVOT) gradient in hypertrophic cardiomyopathy (HCM). Outcome of myectomy beyond 10 years has rarely been described. We describe 20 years of follow-up of surgical myectomy and 5 years of follow-up for ASA performed for obstructive HCM. We studied 171 patients who underwent myectomy for symptomatic LVOT obstruction between 1972 and 2006. In addition, we studied 52 patients who underwent ASA for the same indication and who declined surgery. Follow-up of New York Heart Association (NYHA) functional class, echocardiographic data, and vital status were obtained from patient records. Mortality rates were compared with expected mortality rates of age- and sex-matched populations. Surgical myectomy improved NYHA class (2.74±0.65 to 1.54±0.74, p<0.001), reduced resting gradient (67.4±43.4mmHg to 11.2±16.4mmHg, p<0.001), and inducible LVOT gradient (98.1±34.7mmHg to 33.6±34.9mmHg, p<0.001). Similarly, ASA improved functional class (2.99±0.35 to 1.5±0.74, p<0.001), resting gradient (67.1±26.9mmHg to 23.9±29.4mmHg, p<0.001) and provoked gradient (104.4±34.9mmHg to 35.5±38.6mmHg, p<0.001). Survival after myectomy at 5, 10, 15, and 20 years of follow-up was 92.9%, 81.1%, 68.9%, and 47.5%, respectively. Of note, long-term survival after myectomy was lower than for the general population [standardized mortality ratio (SMR)=1.40, p<0.005], but still compared favorably with historical data from non-operated HCM patients. Survival after ASA at 2 and 5 years was 97.8% and 94.7%, respectively. Short-term (5 year) survival after ASA (SMR=0.61, p=0.48) was comparable to that of the general population. Long-term follow-up of septal reduction strategies in obstructive HCM reveals that surgical myectomy and ASA are effective for symptom relief and LVOT gradient reduction and are associated with favorable survival. While overall prognosis for the community HCM population is similar

  13. Long-term watershed research and monitoring to understand ecosystem change in parks and equivalent reserves

    USGS Publications Warehouse

    Herrmann, R.

    1997-01-01

    Integrated watershed ecosystem studies in National Parks or equivalent reserves suggest that effects of external processes on 'protected' resources are subtle, chronic, and long-term. Ten years of data from National Park watersheds suggests that temperature and precipitation changes are linked to nitrogen levels in lakes and streams. We envision measurable biotic effects in these remote watersheds, if expected climate trends continue. The condition of natural resources within areas set aside for preservation are difficult to ascertain, but gaining this knowledge is the key to understanding ecosystem change and of processes operating among biotic and abiotic ecosystem components. There is increasing evidence that understanding the magnitude of variation within and between such processes can provide an early indication of environmental change and trends attributable to human-induced stress. The following four papers are case studies of how this concept has been implemented. These long-term studies have expanded our knowledge of ecosystem response to natural and human-induced stress. The existence of these sites with a commitment to gathering 'long-term' ecosystem-level data permits research activities aimed at testing more important hypotheses on ecosystem processes and structure.

  14. Progress of long pulse operation with high performance plasma in KSTAR

    NASA Astrophysics Data System (ADS)

    Bae, Young; Kstar Team

    2015-11-01

    Recent KSTAR experiments showed the sustained H-mode operation up to the pulse duration of 46 s at the plasma current of 600 kA. The long-pulse H-mode operation has been supported by long-pulse capable neutral beam injection (NBI) system with high NB current drive efficiency attributed by highly tangential injections of three beam sources. In next phase, aiming to demonstrate the long pulse stationary high performance plasma operation, we are attempting the long pulse inductive operation at the higher performance (MA plasma current, high normalized beta, and low q95) for the final goal of demonstration of ITER-like baseline scenario in KSTAR with progressive improvement of the plasma shape control and higher neutral beam injection power. This paper presents the progress of long pulse operation and the analysis of energy confinement time and non-inductive current drive in KSTAR.

  15. Nextgen Technologies for Mid-Term and Far-Term Air Traffic Control Operations

    NASA Technical Reports Server (NTRS)

    Prevot, Thomas

    2009-01-01

    This paper describes technologies for mid-term and far-term air traffic control operations in the Next Generation Air Transportation System (NextGen). The technologies were developed and evaluated with human-in-the-loop simulations in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. The simulations were funded by several research focus areas within NASA's Airspace Systems program and some were co-funded by the FAA's Air Traffic Organization for Planning, Research and Technology.

  16. Long-Term Habituation of the C-Start Escape Response in Zebrafish Larvae

    PubMed Central

    Roberts, Adam C.; Pearce, Kaycey C.; Choe, Ronny C.; Alzagatiti, Joseph B.; Yeung, Anthony K.; Bill, Brent R.; Glanzman, David L.

    2016-01-01

    The cellular and molecular basis of long-term memory in vertebrates remains poorly understood. Knowledge regarding long-term memory has been impeded by the enormous complexity of the vertebrate brain, particularly the mammalian brain, as well as by the relative complexity of the behavioral alterations examined in most studies of long-term memory in vertebrates. Here, we demonstrate a long-term form of nonassociative learning—specifically, long-term habituation (LTH)—of a simple reflexive escape response, the C-start, in zebrafish larvae. The C-start is triggered by the activation of one of a pair of giant neurons in the zebrafish’s hindbrain, the Mauthner cells. We show that LTH of the C-start requires the activity of NMDA receptors and involves macromolecular synthesis. We further show that the long-term habituated reflex can by rapidly dishabituated by a brief tactile stimulus. Our results set the stage for rigorous, mechanistic investigations of the long-term memory for habituation of a reflexive behavioral response, one that is mediated by a relatively simple, neurobiologically tractable, neural circuit. Moreover, the demonstration of NMDAR and transcriptionally dependent LTH in a translucent vertebrate organism should facilitate the use of optical recording, and optogenetic manipulation, of neuronal activity to elucidate the cellular basis of a long-term vertebrate memory. PMID:27555232

  17. Short-term and long-term plasticity interaction in human primary motor cortex.

    PubMed

    Iezzi, Ennio; Suppa, Antonio; Conte, Antonella; Li Voti, Pietro; Bologna, Matteo; Berardelli, Alfredo

    2011-05-01

    Repetitive transcranial magnetic stimulation (rTMS) over primary motor cortex (M1) elicits changes in motor evoked potential (MEP) size thought to reflect short- and long-term forms of synaptic plasticity, resembling short-term potentiation (STP) and long-term potentiation/depression (LTP/LTD) observed in animal experiments. We designed this study in healthy humans to investigate whether STP as elicited by 5-Hz rTMS interferes with LTP/LTD-like plasticity induced by intermittent and continuous theta-burst stimulation (iTBS and cTBS). The effects induced by 5-Hz rTMS and iTBS/cTBS were indexed as changes in MEP size. We separately evaluated changes induced by 5-Hz rTMS, iTBS and cTBS applied alone and those induced by iTBS and cTBS delivered after priming 5-Hz rTMS. Interactions between 5-Hz rTMS and iTBS/cTBS were investigated under several experimental conditions by delivering 5-Hz rTMS at suprathreshold and subthreshold intensity, allowing 1 and 5 min intervals to elapse between 5-Hz rTMS and TBS, and delivering one and ten 5-Hz rTMS trains. We also investigated whether 5-Hz rTMS induces changes in intracortical excitability tested with paired-pulse transcranial magnetic stimulation. When given alone, 5-Hz rTMS induced short-lasting and iTBS/cTBS induced long-lasting changes in MEP amplitudes. When M1 was primed with 10 suprathreshold 5-Hz rTMS trains at 1 min before iTBS or cTBS, the iTBS/cTBS-induced after-effects disappeared. The 5-Hz rTMS left intracortical excitability unchanged. We suggest that STP elicited by suprathreshold 5-Hz rTMS abolishes iTBS/cTBS-induced LTP/LTD-like plasticity through non-homeostatic metaplasticity mechanisms. Our study provides new information on interactions between short-term and long-term rTMS-induced plasticity in human M1. © 2011 The Authors. European Journal of Neuroscience © 2011 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

  18. Descriptive Characteristics of Long-Term Private Practice Psychotherapy Clients.

    ERIC Educational Resources Information Center

    Koss, Mary P.

    Data from public and private sectors reveal that few persons stay in psychotherapy long enough to be classified as "long-term" clients. Those who do remain in psychotherapy for a long time are rarely studied because attention has generally been focused on terminators. Demographic, treatment, and psychometric characteristics of 64 long-term…

  19. [The education and training of manpower in elderly & long-term care].

    PubMed

    Chen, Huey-Tzy

    2008-08-01

    With the rapid expansion of the aged population, elderly & long-term care has become a significant issue in Taiwan, as in many developed countries, such as Japan. Service resources in long-term care have benefitted profoundly from investment and development in the past 15 years in Taiwan, but the education and training of manpower in long-term care has only recently begun to be addressed. The purpose of this article is to describe the education and training of nursing manpower in long-term care in Taiwan and in other countries. Three recommendations are also made: (1) To integrate Gerontology Nursing & Practicum into the nursing curriculum to cultivate nursing students with competency in providing direct care and competency in accountability. (2) To prepare RN-BSN students with secondary competency in management/information & communication/activities design. (3) To incorporate faculty from across disciplines in the running of gerontology & long-term care programs in order to develop students' competency in transdisciplinary team work.

  20. Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

    PubMed Central

    Kim, Tae Yeob; Lee, Jae Gon; Kim, Ji Yeoun; Kim, Sun Min; Kim, Jinoo; Jeong, Woo Kyoung

    2016-01-01

    Purpose The present study aimed to investigate the role of hepatic venous pressure gradient (HVPG) for prediction of long-term mortality in patients with decompensated cirrhosis. Materials and Methods Clinical data from 97 non-critically-ill cirrhotic patients with HVPG measurements were retrospectively and consecutively collected between 2009 and 2012. Patients were classified according to clinical stages and presence of ascites. The prognostic accuracy of HVPG for death, survival curves, and hazard ratios were analyzed. Results During a median follow-up of 24 (interquartile range, 13-36) months, 22 patients (22.7%) died. The area under the receiver operating characteristics curves of HVPG for predicting 1-year, 2-year, and overall mortality were 0.801, 0.737, and 0.687, respectively (all p<0.01). The best cut-off value of HVPG for predicting long-term overall mortality in all patients was 17 mm Hg. The mortality rates at 1 and 2 years were 8.9% and 19.2%, respectively: 1.9% and 11.9% with HVPG ≤17 mm Hg and 16.2% and 29.4% with HVPG >17 mm Hg, respectively (p=0.015). In the ascites group, the mortality rates at 1 and 2 years were 3.9% and 17.6% with HVPG ≤17 mm Hg and 17.5% and 35.2% with HVPG >17 mm Hg, respectively (p=0.044). Regarding the risk factors for mortality, both HVPG and model for end-stage liver disease were positively related with long-term mortality in all patients. Particularly, for the patients with ascites, both prothrombin time and HVPG were independent risk factors for predicting poor outcomes. Conclusion HVPG is useful for predicting the long-term mortality in patients with decompensated cirrhosis, especially in the presence of ascites. PMID:26632394